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Residents of the island nation of Tuvalu will be among the first of the 1.7 million Pacific Islanders to be displaced by the effects of climate change (including rising sea levels, changing distributions of agriculture, and unpredictable weather patterns). Already 3,500 Tuvaluans live in New Zealand (approximately 25 percent of the world's Tuvaluan population), some of whom moved due to climate change. Immigrating to New Zealand presents several challenges for Tuvaluans, including limited job opportunities, health care disparities, and dietary changes. Nevertheless, Tuvaluans in New Zealand continue their culture as they redefine their identity in a new country. Given the growing effects of climate change, physicians around the world will soon care for a new generation of immigrants and will play an important role in advocating for health equity and self-determination among climate-sensitive populations. This article uses personal stories and photographs of Tuvaluans and photographs of Tuvalu and New Zealand to present Tuvaluans' struggles and ethical issues pertaining to health that arise in relocating Tuvaluans.

Rising Waters and a Smaller Island: What Should Physicians Do for Tuvaluans?