Kiribati 2025 © Pratistha Koirala/MSF

Kiribati

Addressing the health impacts of climate change and lack of access to nutrition

Water security in a changing climate: Learnings from Kiribati

September 22, 2026 — For people in Tabontebike, a village in the remote Pacific island nation of Kiribati, access to water shapes everyday life. With no public water system, the community relies on shallow groundwater wells or rainwater collection for their daily needs — but climate change is weakening these already-fragile sources. This has raised the risk of waterborne diseases, skin infections, and other climate-linked health concerns, with children, the elderly, and pregnant women especially vulnerable.

Doctors Without Borders/Médecins Sans Frontières (MSF) is working closely with local health workers and the Ministry of Health and Medical Services to strengthen climate-resilient health systems and address key health challenges in the community. Our water, sanitation, and hygiene team in Tabontebike is reinforcing water infrastructure in places like schools and clinics, protecting groundwater, improving rainwater harvesting and storage, and upgrading sanitation facilities.

Our work in Kiribati

In Kiribati, Doctors Without Borders/Médecins Sans Frontières (MSF) continues to strengthen care for pregnant women and people living with chronic conditions, working in close collaboration with the Ministry of Health and Medical Services.

MSF bases operations on the outer island of Abaiang from an open air hut.

What’s happening in Kiribati

Kiribati is a remote island nation in the central Pacific Ocean, where drought, saltwater intrusion, and rising sea levels have reduced the availability of fresh water and nutritious foods. This has contributed to a range of health issues, including undernutrition among women and children, obesity, and non-communicable diseases like gestational diabetes and pregnancy-related hypertension. This has put more pressure on an overstretched public health system.

MSF pharmacist Jasmine Vicentillo working with Kiribati Central Pharmacy

How we’re helping in Kiribati

In 2025, MSF conducted health screenings across villages on Abaiang Island and Eita, South Tarawa. We also trained community volunteers to identify early signs of malnutrition and monitor children aged 6-59 months for undernutrition and diarrheal diseases. MSF refers those found at risk to health centers.

In addition, we trained community volunteers to use tools, such as the CRADLE Vital Signs Alert system, to detect early signs of hypertension and carry out blood sugar tests for diabetes. In clinics, we worked to improve early detection of gestational diabetes by offering oral glucose tolerance tests to ensure safer pregnancies. Together with clinic nurses and community volunteers, we strengthened local capacity to identify at-risk women, reducing costly emergency referrals to the capital.

Our water and sanitation team tested wells in Abaiang for salinity and coliform bacteria. The results showed that nearly all were contaminated with coliforms, and 19 percent were above safe salinity threshold levels for people with hypertension. We integrated these findings, along with GPS data, into a multilayered interactive geographic information system map developed with the Ministry of Health and Medical Services. MSF’s water and sanitation team uses this tool to guide well rehabilitation and improve rainwater harvesting methods.

MSF continues to provide midwifery support and training at Tungaru Central Hospital, however, we concluded our support for pharmacy services at the facility in October 2025, including supply, waste, and regulatory processes.