Effects of increase in temperature and open water on transmigration and access to health care by the Nenets reindeer herders in northern Russia

Background. The indigenous Nenets reindeer herders in northern Russia annually migrate several hundred kilometers between summer and winter pastures. In the warming climate, ice-rich permafrost and glaciers are being significantly reduced and will eventually disappear from parts of the Arctic. The emergent changes in hydrological cycles have already led to substantial increases in open water that stays unfrozen for longer periods of time. This environmental change has been reported to compromise the nomadic Nenets' traditional way of life because the presence of new water in the tundra reduces the Nenets' ability to travel by foot, sled, or motor vehicle from the summer transitory tundra campsites in order to access healthcare centers in villages. New water can also impede their access to family and community at other herder camps and in the villages. Although regional and global models predicting hydrologic changes due to climate changes exist, the spatial resolution of these models is too coarse for studying how increases in open water affect health and livelihoods. To anticipate the full health impact of hydrologic changes, the current gap between globally forecasted scenarios and locally forecasted hydrologic scenarios needs to be bridged. Objectives. We studied the effects of the autumn temperature anomalies and increases in open water on health care access and transmigration of reindeer herders on the Kanin Peninsula. Design. Correlational and time series analyses were completed. Methods. The study population consisted of 370 full-time, nomadic reindeer herders. We utilized clinical visit records, studied surface temperature anomalies during autumn migrations, and used remotely sensed imagery to detect water bodies. Spearman correlation was used to measure the relationship between temperature anomalies and the annual arrival of the herders at the Nes clinic for preventive and primary care. Piecewise regression was used to model change in mean autumnal temperature anomalies over time. We also created a water body product to detect inter-annual changes in water area. Results. Correlation between arrivals to the Nes clinic and temperature anomalies during the fall transmigration (1979-2011) was r = 0.64, p = 0.0004; 95% CI (0.31; 0.82). Regression analysis estimated that mean temperature anomalies during the fall migration in September-December were stochastically stationary pre-1991 and have been rising significantly (p<0.001) since then. The rate of change was estimated at +0.1351 degrees C/year, SE = 0.0328, 95% CI (+0.0694, +0.2007). The amount of detected water fluctuated significantly interannually (620-800 km(2)). Conclusions. Later arrival of freezing temperatures in the autumn followed by the earlier spring thaws and more open water delay transmigration and reduce herders' access to health care. The recently observed delays in arrival to the clinic are likely related to the warming trend and to concomitant hydrologic changes.