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Women paying the health
cost of the climate crisis
Ritu Bharadwaj, Team Leader and Principal Researcher, Climate Change Group
(Ritu.Bharadwaj@iied.org)
7 March 2024
Ritu Bharadwaj / @IIED
1. Introduce Comprehensive – Climate Impact Quantification (C-
CIQ) methodology
2. Share findings of the paper quantifying loss and damage faced
by women battling drought, debt and migration
3. Panel discussion on practical ways of tackling loss and
damage (what program and support needed, how it can be
delivered and how can be financed)
2
What we will cover today
www.iied.org @IIED
Comprehensive – Climate
Impact Quantification (C-CIQ)
methodology
Ritu Bharadwaj / @IIED
What is Comprehensive – Climate Impact Quantification (C-CIQ)
approach
Shared
Learning
Dialogues
Assessing
Predisposing,
Precipitating
& Protective
factors
Index
based
valuation
02 03 04
01
Solutions
pathway
www.iied.org @IIED
Women paying the cost of the
climate crisis with their wombs:
Quantifying loss and damage
faced by women battling
drought, debt and migration
Ritu Bharadwaj / @IIED 6
Study Area
Ritu Bharadwaj / @IIED
Understanding underlying
vulnerabilities and factors that
push communities to undertake
distress migration
Ritu Bharadwaj / @IIED 8
3 P Approach
Ritu Bharadwaj / @IIED
Ritu Bharadwaj / @IIED
Ritu Bharadwaj / @IIED
Ritu Bharadwaj / @IIED 12
Ritu Bharadwaj / @IIED 13
Protective
factors
Ritu Bharadwaj / @IIED 14
Ritu Bharadwaj / @IIED 15
Ritu Bharadwaj / @IIED
Reasons for migrating (% cumulative scores)
Ritu Bharadwaj / @IIED 17
Ritu Bharadwaj / @IIED
Measuring loss and damage
Ritu Bharadwaj / @IIED
Intangible
Tangible
Intrinsic Functional
Loss of income
Crop loss
Livestock yield loss
Employment loss
Loss of organs
Hysterectomy
Permanent Disability
Mental
health
problems
Labour rights violation
Loss of life
Death of family members
Health effects
of
hysterectomy
Drudgery caused by water
scarcity
Increased debt
Health cost because of
water scarcity related
drudgery
Human rights violation
Gynaecological problems
Short term Long term Short term Long term
Source
Destination
Source
Destination
Ritu Bharadwaj / @IIED 20
Ritu Bharadwaj / @IIED
Crop loss because of the latest drought
(% of households)
Group II (non-migrant)
Group I (Migrant)
Lost crop yield
20,735.29
9,150.20
Average crop loss
value (INR)
Ritu Bharadwaj / @IIED
Number of days of employment lost because
of the latest drought (% of households)
11.46
15.02
5.53
3.56
0.79
12.25
1.19
-
7.91
4.71
10.00
3.53
3.53
1.18
7.06
0.59
0.59
2.35
- 2.00 4.00 6.00 8.00 10.00 12.00 14.00 16.00
<30
30-60
60-90
91-120
121-150
151-180
181-210
210-240
>240
Group 2 Group 1
Ritu Bharadwaj / @IIED
Average number of employment days lost
because of the latest drought
Group II (non-migrant)
Group I (Migrant)
Variable
Sl. No.
37.95
72.69
Average number of
employment days lost
1.
9,637.65
15,613.64
Average value of
income lost because of
loss of employment
(INR)
2.
Ritu Bharadwaj / @IIED
Impact of walking long distance to fetch
water in drought periods
Group II (non-migrant)
Group I (Migrant)
Illness due to water related
drudgery
880.59
1643.88
Average amount
spent to treat the
illness (INR)
Ritu Bharadwaj / @IIED
Average current loan outstanding from
different sources (INR)
14,766.80
16,235.29
29,407.11
15,341.18
671.94
-
2,648.22
4,411.76
13,426.88
5,764.71
3,308.30
3,414.12
60,474.33
-
- 20,000.00 40,000.00 60,000.00 80,000.00 100,000.00 120,000.00 140,000.00
Group I
Group II
Banks Local moneylenders Pawn brokers
Village traders Friends and relatives SHGs/MFIs
Sugarcane work middleman
Total:
45,167.06
Total:
124,703.58
Ritu Bharadwaj / @IIED
Indebtedness during drought periods when
compared to the non-drought periods is
3.95
20.16
10.67
38.74
26.48
11.18
22.94
11.18
34.71
20.00
-
5.00
10.00
15.00
20.00
25.00
30.00
35.00
40.00
45.00
Very less Less Same High Very high
%
of
households
Group I Group II
Ritu Bharadwaj / @IIED
Functional loss and damage
Tangible
loss
and
damage
Short term Long term
Temporal dimension of loss and damage
At
Source
At
destination
Spatial
dimension
of
loss
and
damage
Loss of income
(Crop loss, livestock yield
loss, employment loss
Health cost because of
water scarcity related
drudgery
Drudgery caused by water
scarcity
Increased indebtedness
34.92 26.83
Group I
Group II
66.11 43.74
45.20
19.54
50.33
21.23
43.15
33.68
Ritu Bharadwaj / @IIED 28
Ritu Bharadwaj / @IIED
Labour rights violation-univariate indices
- 20 40 60 80 100 120
Forced to work when you are sick
Forced to work during menstrual period
Wage deduction for leave of absence
Paid additional wage for working on day-offs
Forced to take harmful or dangerous tasks
Provided with safety equipment for risky tasks
Group II at source Group I at destination site Group I at source
Ritu Bharadwaj / @IIED
Human rights violation-univariate indices
- 10 20 30 40 50 60 70 80 90 100
Exposure to sun heat, rain, and cold weather
Exposure to attack by insects, snakes, and other animals
Trespass by strangers in the living area
Lack of privacy for bathing
Lack of privacy and sanitation for defecating, urinating,…
Access to water facility for drinking and domestic purposes
Electricity facility
Frequency of physical abuse by the employer or the…
Frequency of verbal abuse by the employer or the…
Frequency of sexual abuse by the employer/ contractor…
Group II at source Group I at destination site Group I at source
Ritu Bharadwaj / @IIED
Gynaecological problems-univariate indices
- 10 20 30 40 50 60 70 80 90
Heavy menstrual bleeding, pelvic pain, and pressure on
the bladder or rectum
Severe menstrual pain and chronic pelvic pain
Uterus drops from its normal position into the vaginal
canal, often causing discomfort, urinary incontinence, and
pelvic pressure
Severe, chronic, or recurrent infections in the pelvis
Prolonged, heavy, or irregular menstrual bleeding that
does not respond to other treatments
Group II Group I
Ritu Bharadwaj / @IIED
Cost of treating illness caused by work environment
Cost (INR)
Group II non-migrant)
Cost (INR)
Group I (migrant)
Type of costs
Sl.
No.
11.76
4,596.84
Cost of the
hospitalisation
1.
2.94
468.38
Cost of lab testing and
medical consultations
2.
5.88
288.54
Cost of medication
(tablets, post-surgery
therapy etc.
3.
20.59
5,333.75
Total cost
4.
Ritu Bharadwaj / @IIED
Functional loss and damage
Intangible
loss
and
damage
Short term Long term
Temporal dimension of loss and damage
At
Source
At
destination
Spatial
dimension
of
loss
and
damage
Forced labour index
Human rights index
Gynaecological problems
index
82.41
84.37
44.42
22.30
74.01
36.38
34.92
46.82
Group I Group II
@source
@source
@destination
@destination
@source
@source
80.24 15.61
Ritu Bharadwaj / @IIED 34
Ritu Bharadwaj / @IIED
Age at which hysterectomy was performed
Group II (non-
migrant)
Group I (Migrant)
Age in years
Sl.
No.
3.45
4.26
<=25
1.
6.90
31.21
26-30
2.
13.79
29.79
31-35
3.
20.69
24.82
36-40
4.
20.69
6.38
41-45
5.
13.79
3.55
46-50
6.
13.79
-
51-55
7.
6.90
-
>55
8.
42.93
34.64
Average age
Ritu Bharadwaj / @IIED
Cost of hysterectomy
Cost (INR)
Group II non-migrant)
Cost (INR)
Group I (migrant)
Type of costs
Sl.
No.
13,058.82
45,391.30
Cost of the
hysterectomy surgery
1.
3,264.71
9,964.43
Cost of lab testing and
medical consultations
2.
1,982.35
8,018.97
Cost of medication
(tablets, post-surgery
therapy etc.
3.
18,305.88
63,374.70
Total cost
4.
Ritu Bharadwaj / @IIED
Impact of Hysterectomy-univariate Indices
47.04 47.33
41.70
38.83 40.02
37.75
45.06
40.12
35.87
37.65
15.44
13.68
15.44
12.35 12.35 13.24
15.44
14.12
15.59
12.50
-
5.00
10.00
15.00
20.00
25.00
30.00
35.00
40.00
45.00
50.00
Menopausal
symptoms like hot
flashes, night
sweats, mood
swings
Weakening of
bones
Prone to bone
fractures
Pain during
intercourse
Loss of libido
(sexual desire or
drive)
Decline in sexual
satisfaction
Pelvic discomfort Involuntary loss of
urine
Obesity Hear diseases
Group I Group II
Ritu Bharadwaj / @IIED
Cost of treating accident injury (INR)
Cost (INR)
Group II non-migrant)
Cost (INR)
Group I (migrant)
Type of costs
Sl.
No.
1,176.47
962.85
Cost of the
hospitalisation
1.
235.29
629.25
Cost of lab testing and
medical consultations
2.
176.47
476.28
Cost of medication
(tablets, post-surgery
therapy etc.
3.
1,588.24
2,068.38
Total cost
4.
Ritu Bharadwaj / @IIED
Productive income lost because of
permanent disability for lifetime
Amount (INR)
Sample Category
Sl. No.
32,015.81
Group I (migrant)
1.
28,23.53
Group II (non-migrant)
2.
The loss of productive income has been calculated by taking the following assumptions
-productive age of a person – 58 years
-income by a physically active/normal person per year – INR 60,000
Ritu Bharadwaj / @IIED
Intrinsic loss and damage
Tangible
loss
and
damage
Short term Long term
Temporal dimension of loss and damage
At
Source
At
destination
Spatial
dimension
of
loss
and
damage
Loss of organs
(Womb, other body
parts)
55.73 17.06
Group I
Group II
Health cost because of
loss of organs
57.14 20.37
56.44
18.71
Ritu Bharadwaj / @IIED 41
Ritu Bharadwaj / @IIED
Amount spent to treat health effects of
hysterectomy
Cost (INR)
Group II non-migrant)
Cost (INR)
Group I (migrant)
Type of costs
Sl.
No.
1,948.24
6,901.19
Per year cost
1.
25,037.65
90,028.46
Total cost from the year
of hysterectomy till date
2.
Ritu Bharadwaj / @IIED
Loss of income because of health effects
of hysterectomy
Cost (INR)
Group II non-migrant)
Cost (INR)
Group I (migrant)
Loss
Sl.
No.
1.64
7.07
Average number of days
of employment lost per
month
1.
3,924.71
16,970.75
Loss of income per year
(INR)
2.
70,785.88
214,842.69
Total loss of productive
income from the year of
hysterectomy till date
3.
Ritu Bharadwaj / @IIED
Mental health problems-univariate indices
88.54
78.66
84.39
68.08
73.42
62.55
56.13
67.39 66.30
59.88
65.00
56.47
70.15
51.91
57.50
46.18
39.71
53.09 53.68
43.53
-
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
100.00
Persistent
sadness
Loss of interest
in life
Fatigue and
decreased
energy
Sense of
isolation
Feeding
hopeless
Increased
crying spells
Suicidal
thoughts
Loss of libido Difficulty in
concentration
Feeling guilt
and worthless
Group I Group II
Ritu Bharadwaj / @IIED
Loss of income because of mental health problems
Cost (INR)
Group II non-migrant)
Cost (INR)
Group I (migrant)
Loss
6,470.59
10,424.90
Productive income lost
because of mental health
problems per year
1,912.94
5,554.15
Cost of treating the mental
health problem per year
Assumption: 250 days of work in a year
Ritu Bharadwaj / @IIED
Intrinsic loss and damage
Intangible
loss
and
damage
Short term Long term
Temporal dimension of loss and damage
At
Source
At
destination
Spatial
dimension
of
loss
and
damage
Health effects
of hysterectomy
Mental health
problems
41.14 14.01
70.53 53.72
55.84
33.84
Group I
Group II
Ritu Bharadwaj / @IIED 47
Thank you

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Women paying the health cost of the climate crisis

  • 1. www.iied.org @IIED Women paying the health cost of the climate crisis Ritu Bharadwaj, Team Leader and Principal Researcher, Climate Change Group (Ritu.Bharadwaj@iied.org) 7 March 2024
  • 2. Ritu Bharadwaj / @IIED 1. Introduce Comprehensive – Climate Impact Quantification (C- CIQ) methodology 2. Share findings of the paper quantifying loss and damage faced by women battling drought, debt and migration 3. Panel discussion on practical ways of tackling loss and damage (what program and support needed, how it can be delivered and how can be financed) 2 What we will cover today
  • 3. www.iied.org @IIED Comprehensive – Climate Impact Quantification (C-CIQ) methodology
  • 4. Ritu Bharadwaj / @IIED What is Comprehensive – Climate Impact Quantification (C-CIQ) approach Shared Learning Dialogues Assessing Predisposing, Precipitating & Protective factors Index based valuation 02 03 04 01 Solutions pathway
  • 5. www.iied.org @IIED Women paying the cost of the climate crisis with their wombs: Quantifying loss and damage faced by women battling drought, debt and migration
  • 6. Ritu Bharadwaj / @IIED 6 Study Area
  • 7. Ritu Bharadwaj / @IIED Understanding underlying vulnerabilities and factors that push communities to undertake distress migration
  • 8. Ritu Bharadwaj / @IIED 8 3 P Approach
  • 12. Ritu Bharadwaj / @IIED 12
  • 13. Ritu Bharadwaj / @IIED 13 Protective factors
  • 14. Ritu Bharadwaj / @IIED 14
  • 15. Ritu Bharadwaj / @IIED 15
  • 16. Ritu Bharadwaj / @IIED Reasons for migrating (% cumulative scores)
  • 17. Ritu Bharadwaj / @IIED 17
  • 18. Ritu Bharadwaj / @IIED Measuring loss and damage
  • 19. Ritu Bharadwaj / @IIED Intangible Tangible Intrinsic Functional Loss of income Crop loss Livestock yield loss Employment loss Loss of organs Hysterectomy Permanent Disability Mental health problems Labour rights violation Loss of life Death of family members Health effects of hysterectomy Drudgery caused by water scarcity Increased debt Health cost because of water scarcity related drudgery Human rights violation Gynaecological problems Short term Long term Short term Long term Source Destination Source Destination
  • 20. Ritu Bharadwaj / @IIED 20
  • 21. Ritu Bharadwaj / @IIED Crop loss because of the latest drought (% of households) Group II (non-migrant) Group I (Migrant) Lost crop yield 20,735.29 9,150.20 Average crop loss value (INR)
  • 22. Ritu Bharadwaj / @IIED Number of days of employment lost because of the latest drought (% of households) 11.46 15.02 5.53 3.56 0.79 12.25 1.19 - 7.91 4.71 10.00 3.53 3.53 1.18 7.06 0.59 0.59 2.35 - 2.00 4.00 6.00 8.00 10.00 12.00 14.00 16.00 <30 30-60 60-90 91-120 121-150 151-180 181-210 210-240 >240 Group 2 Group 1
  • 23. Ritu Bharadwaj / @IIED Average number of employment days lost because of the latest drought Group II (non-migrant) Group I (Migrant) Variable Sl. No. 37.95 72.69 Average number of employment days lost 1. 9,637.65 15,613.64 Average value of income lost because of loss of employment (INR) 2.
  • 24. Ritu Bharadwaj / @IIED Impact of walking long distance to fetch water in drought periods Group II (non-migrant) Group I (Migrant) Illness due to water related drudgery 880.59 1643.88 Average amount spent to treat the illness (INR)
  • 25. Ritu Bharadwaj / @IIED Average current loan outstanding from different sources (INR) 14,766.80 16,235.29 29,407.11 15,341.18 671.94 - 2,648.22 4,411.76 13,426.88 5,764.71 3,308.30 3,414.12 60,474.33 - - 20,000.00 40,000.00 60,000.00 80,000.00 100,000.00 120,000.00 140,000.00 Group I Group II Banks Local moneylenders Pawn brokers Village traders Friends and relatives SHGs/MFIs Sugarcane work middleman Total: 45,167.06 Total: 124,703.58
  • 26. Ritu Bharadwaj / @IIED Indebtedness during drought periods when compared to the non-drought periods is 3.95 20.16 10.67 38.74 26.48 11.18 22.94 11.18 34.71 20.00 - 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00 45.00 Very less Less Same High Very high % of households Group I Group II
  • 27. Ritu Bharadwaj / @IIED Functional loss and damage Tangible loss and damage Short term Long term Temporal dimension of loss and damage At Source At destination Spatial dimension of loss and damage Loss of income (Crop loss, livestock yield loss, employment loss Health cost because of water scarcity related drudgery Drudgery caused by water scarcity Increased indebtedness 34.92 26.83 Group I Group II 66.11 43.74 45.20 19.54 50.33 21.23 43.15 33.68
  • 28. Ritu Bharadwaj / @IIED 28
  • 29. Ritu Bharadwaj / @IIED Labour rights violation-univariate indices - 20 40 60 80 100 120 Forced to work when you are sick Forced to work during menstrual period Wage deduction for leave of absence Paid additional wage for working on day-offs Forced to take harmful or dangerous tasks Provided with safety equipment for risky tasks Group II at source Group I at destination site Group I at source
  • 30. Ritu Bharadwaj / @IIED Human rights violation-univariate indices - 10 20 30 40 50 60 70 80 90 100 Exposure to sun heat, rain, and cold weather Exposure to attack by insects, snakes, and other animals Trespass by strangers in the living area Lack of privacy for bathing Lack of privacy and sanitation for defecating, urinating,… Access to water facility for drinking and domestic purposes Electricity facility Frequency of physical abuse by the employer or the… Frequency of verbal abuse by the employer or the… Frequency of sexual abuse by the employer/ contractor… Group II at source Group I at destination site Group I at source
  • 31. Ritu Bharadwaj / @IIED Gynaecological problems-univariate indices - 10 20 30 40 50 60 70 80 90 Heavy menstrual bleeding, pelvic pain, and pressure on the bladder or rectum Severe menstrual pain and chronic pelvic pain Uterus drops from its normal position into the vaginal canal, often causing discomfort, urinary incontinence, and pelvic pressure Severe, chronic, or recurrent infections in the pelvis Prolonged, heavy, or irregular menstrual bleeding that does not respond to other treatments Group II Group I
  • 32. Ritu Bharadwaj / @IIED Cost of treating illness caused by work environment Cost (INR) Group II non-migrant) Cost (INR) Group I (migrant) Type of costs Sl. No. 11.76 4,596.84 Cost of the hospitalisation 1. 2.94 468.38 Cost of lab testing and medical consultations 2. 5.88 288.54 Cost of medication (tablets, post-surgery therapy etc. 3. 20.59 5,333.75 Total cost 4.
  • 33. Ritu Bharadwaj / @IIED Functional loss and damage Intangible loss and damage Short term Long term Temporal dimension of loss and damage At Source At destination Spatial dimension of loss and damage Forced labour index Human rights index Gynaecological problems index 82.41 84.37 44.42 22.30 74.01 36.38 34.92 46.82 Group I Group II @source @source @destination @destination @source @source 80.24 15.61
  • 34. Ritu Bharadwaj / @IIED 34
  • 35. Ritu Bharadwaj / @IIED Age at which hysterectomy was performed Group II (non- migrant) Group I (Migrant) Age in years Sl. No. 3.45 4.26 <=25 1. 6.90 31.21 26-30 2. 13.79 29.79 31-35 3. 20.69 24.82 36-40 4. 20.69 6.38 41-45 5. 13.79 3.55 46-50 6. 13.79 - 51-55 7. 6.90 - >55 8. 42.93 34.64 Average age
  • 36. Ritu Bharadwaj / @IIED Cost of hysterectomy Cost (INR) Group II non-migrant) Cost (INR) Group I (migrant) Type of costs Sl. No. 13,058.82 45,391.30 Cost of the hysterectomy surgery 1. 3,264.71 9,964.43 Cost of lab testing and medical consultations 2. 1,982.35 8,018.97 Cost of medication (tablets, post-surgery therapy etc. 3. 18,305.88 63,374.70 Total cost 4.
  • 37. Ritu Bharadwaj / @IIED Impact of Hysterectomy-univariate Indices 47.04 47.33 41.70 38.83 40.02 37.75 45.06 40.12 35.87 37.65 15.44 13.68 15.44 12.35 12.35 13.24 15.44 14.12 15.59 12.50 - 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00 45.00 50.00 Menopausal symptoms like hot flashes, night sweats, mood swings Weakening of bones Prone to bone fractures Pain during intercourse Loss of libido (sexual desire or drive) Decline in sexual satisfaction Pelvic discomfort Involuntary loss of urine Obesity Hear diseases Group I Group II
  • 38. Ritu Bharadwaj / @IIED Cost of treating accident injury (INR) Cost (INR) Group II non-migrant) Cost (INR) Group I (migrant) Type of costs Sl. No. 1,176.47 962.85 Cost of the hospitalisation 1. 235.29 629.25 Cost of lab testing and medical consultations 2. 176.47 476.28 Cost of medication (tablets, post-surgery therapy etc. 3. 1,588.24 2,068.38 Total cost 4.
  • 39. Ritu Bharadwaj / @IIED Productive income lost because of permanent disability for lifetime Amount (INR) Sample Category Sl. No. 32,015.81 Group I (migrant) 1. 28,23.53 Group II (non-migrant) 2. The loss of productive income has been calculated by taking the following assumptions -productive age of a person – 58 years -income by a physically active/normal person per year – INR 60,000
  • 40. Ritu Bharadwaj / @IIED Intrinsic loss and damage Tangible loss and damage Short term Long term Temporal dimension of loss and damage At Source At destination Spatial dimension of loss and damage Loss of organs (Womb, other body parts) 55.73 17.06 Group I Group II Health cost because of loss of organs 57.14 20.37 56.44 18.71
  • 41. Ritu Bharadwaj / @IIED 41
  • 42. Ritu Bharadwaj / @IIED Amount spent to treat health effects of hysterectomy Cost (INR) Group II non-migrant) Cost (INR) Group I (migrant) Type of costs Sl. No. 1,948.24 6,901.19 Per year cost 1. 25,037.65 90,028.46 Total cost from the year of hysterectomy till date 2.
  • 43. Ritu Bharadwaj / @IIED Loss of income because of health effects of hysterectomy Cost (INR) Group II non-migrant) Cost (INR) Group I (migrant) Loss Sl. No. 1.64 7.07 Average number of days of employment lost per month 1. 3,924.71 16,970.75 Loss of income per year (INR) 2. 70,785.88 214,842.69 Total loss of productive income from the year of hysterectomy till date 3.
  • 44. Ritu Bharadwaj / @IIED Mental health problems-univariate indices 88.54 78.66 84.39 68.08 73.42 62.55 56.13 67.39 66.30 59.88 65.00 56.47 70.15 51.91 57.50 46.18 39.71 53.09 53.68 43.53 - 10.00 20.00 30.00 40.00 50.00 60.00 70.00 80.00 90.00 100.00 Persistent sadness Loss of interest in life Fatigue and decreased energy Sense of isolation Feeding hopeless Increased crying spells Suicidal thoughts Loss of libido Difficulty in concentration Feeling guilt and worthless Group I Group II
  • 45. Ritu Bharadwaj / @IIED Loss of income because of mental health problems Cost (INR) Group II non-migrant) Cost (INR) Group I (migrant) Loss 6,470.59 10,424.90 Productive income lost because of mental health problems per year 1,912.94 5,554.15 Cost of treating the mental health problem per year Assumption: 250 days of work in a year
  • 46. Ritu Bharadwaj / @IIED Intrinsic loss and damage Intangible loss and damage Short term Long term Temporal dimension of loss and damage At Source At destination Spatial dimension of loss and damage Health effects of hysterectomy Mental health problems 41.14 14.01 70.53 53.72 55.84 33.84 Group I Group II
  • 47. Ritu Bharadwaj / @IIED 47