In from The Hague: Madeleen Helmer takes a break during a recent U.N. visit. Beth Perkins

Back in the 1990s, few people gave any thought to the effects of climate change on the developing world. Madeleen Helmer was one of the first. In 1994, working with the European Center on Pacific Issues, she collaborated on a documentary film about the future impact of sea- level rise on small Pacific nations such as Tuvalu, Fiji, and the Solomon Islands. Today she is the head of the Red Cross/Red Crescent Climate Center. Founded in 2002, the center now has four part-time staff in its headquarters in The Hague, supplemented by technical advisers in Boston, Fiji, and Bangkok.

Helmer talked about her work with the Paris-based German journalist Bernhard Poetter, author of the forthcoming book Tatort Klimawandel (Crime Scene Climate Change), which he describes as a report on “the culprits, victims, and profiteers of global warming.” Poetter found Helmer deeply involved in preparations for the international conference in Copenhagen in December 2009 that will try to reach a new agreement to replace the Kyoto Protocol. “There is not much time,” Helmer told him. “All the important decisions are going to be made in the next few months.”

People think of the Red Cross as a symbol for first aid. Is there something like a first-aid kit for climate change?

I don’t think the Red Cross is only a disaster response and first-aid agency. There has been a shift since the 1980s, when we started to think that while it’s OK to help after a disaster, it’s even better to ensure that the impact of future disasters is reduced. So we’re investing more and more in risk awareness and risk reduction programs at the community level. We’re investing more in improved early warning systems and in detecting long-term trends such as migration or the HIV-AIDS epidemic. Climate change fits into that framework.

Is there a shift in the kind of disasters you’re dealing with these days?

Natural geophysical disasters like earthquakes, volcanic eruptions, or tsunamis are lethal, but their incidence remains fairly constant. But we’ve seen a doubling of weather-related disasters in the past 20 years, particularly involving floods and particularly in Asia. All the trend lines are going upward, and better reporting can’t be the only explanation.

Those floods obviously have a tremendous impact on public health.

Yes, the water and sanitation situation gets worse with flash floods, pollution of drinking water, contamination of stagnant water. The long-term predictions for Asia are very worrying. As glaciers melt in the Himalayas, there may be too much water today but not enough water in the future. There’s also the problem of sea-level rise. That’s going to evolve over decades, and it may not seem that dramatic in the immediate future, unless it’s combined with heavy storms. But low-lying areas are already being affected by salination as a result of sea-level rise, which affects crops and food security and has a direct impact on human health.

A lot of people say malaria is going to be the most serious health risk arising from climate change.

It depends on where you live. In general, malaria is moving to higher latitudes and higher altitudes. But the risk in Europe is not very high. On the other hand, chikungunya [a mosquito-borne virus that causes symptoms similar to dengue and normally occurs in Africa and Asia] has been observed in Italy, which was a real surprise. Many diseases are spreading. Dengue fever, which is also mosquito-borne, is on the rise, with epidemic reports coming in from places as far apart as Rio de Janeiro and Bangkok. There’s also an upsurge in meningitis and Rift Valley fever [a virus transmitted from animals to humans and named for the area of Kenya where it was first identified]. So our dilemma is, should we build the capacity to deal with all of them, or do we just single out one disease, like dengue, and make it the center of a campaign to raise awareness? We have to make health officials in the affected countries understand the increasing risks that climate change brings. If we tell Kenya to focus only on malaria and there’s an outbreak of Rift Valley fever, then we’re not being very smart.

If not malaria, what is your biggest single concern?

It isn’t any particular disease. It’s that the health community is too late in assessing the risks. Here in Europe, for example, the risk of heat waves like the ones we had in 2003, 2006, and 2007 is quite dramatic. But our reaction time is too slow.

Why is that?

Because we tend not to react to a disaster until it’s happened. The risk of heat waves is well understood, but we don’t plan for them in a systematic way. We react only when a heat wave is already upon us, and not in January, when people are planning their holidays and need to figure out whether someone will be around to take care of the elderly.

How do you get the information you need to make these long-range risk assessments?

From two groups of experts. First there are the climate scientists and meteorologists; they’re the big knowledge centers. But there is also another group of experts: the poorest of the poor in the poorest countries. These people are going to be the most seriously affected, even though they did the least to create the problem. They’re describing phenomena they’ve never seen before. They don’t talk about climate change. They say it’s funny weather, it’s not like it used to be, the sun is coming closer, it’s an act of God. One of the few assets that poor, uneducated people have is their traditional knowledge of the weather. They know when to sow, when to harvest. But that knowledge is no longer reliable.

But if that knowledge is no longer reliable, how do you make plans and forecasts?

The paradox is that as the certainty of climate change has increased, so has the uncertainty about its impact. That makes things very difficult. Planners don’t like uncertainty. So there’s a tendency to wait until we have greater certainty, whereas what we need are plans that embrace greater uncertainty and more risks. And risk assessments about climate change have to take into account other trends, such as population growth, deforestation, and the energy crisis. Life is getting more complicated.

You mentioned food security. How does that relate to climate change?

The impact of rising food prices has been horrible, and at least two of the reasons are climate related: the failed harvest in Australia, due to an exceptionally long drought, and the production of biofuels, which is designed in part to reduce carbon emissions. I think we were all taken by surprise by the recent reports from the World Bank and others identifying the production of biofuels as the main cause of rising food prices.

Isn’t it harder to fund risk assessment than traditional relief work?

Yes, it is. Less than 5 percent of humanitarian funding is used for disaster preparedness; the rest, for disaster relief and rehabilitation. That’s a dead-end street unless we get smarter. As for funds for adaptation to climate change, the idea is that this money will come not from traditional development funds but from things like a levy on greenhouse gas emissions.

What about raising money for the poorest of the poor? That can’t be easy either.

We’re in competition with the polar bears. That’s a fact. It’s sad that a polar bear should be more of a catalyst for action than tens of thousands of people being flooded or threatened by a heat wave. It’s also a problem that there is a lot more investment in adaptation in the north than in the south. Here in the Netherlands, for instance, a lot more money is being spent to protect this country than to help poor countries.

But it’s normal to think about yourself first.

Yes, it is normal for me to take more care of my family than of yours. But this is the twenty-first century. My actions have an impact on a family in Mali that I don’t even know. With every shower I take, with every computer I turn on, I have an impact.