One clear bright day last winter, a tidal surge swept over an ocean embankment here in the remote, low-lying island country of Kiribati, smashing through the doors and windows of Betio Hospital and spewing sand and debris across its maternity ward.
Beero Hosea, 37, a handyman, cut the power and helped carry frightened mothers through the rubble and water to a nearby school.
"If the next one is combined with a storm and stronger winds, that's the end of us," he said. "It's going to cover this whole island."
For years, scientists have been predicting that much of Kiribati may become uninhabitable within decades because of an onslaught of environmental problems linked to climate change. And for just as long, many here have paid little heed. But while scientists are reluctant to attribute any specific weather or tidal event to rising sea levels, the tidal surge last winter, known as a king tide, was a chilling wake-up call.
"It shocked us," said Tean Rube, a pastor with the Kiribati Uniting Church. "We realised, OK, maybe climate change is real."
Pacific island nations are among the world's most physically and economically vulnerable to climate change and extreme weather events like floods, earthquakes and tropical cyclones, the World Bank said in a 2013 report. While world powers have summit meetings to negotiate treaties on how to reduce and mitigate carbon emissions, residents of tiny Kiribati, a former British colony with 110,000 people, are debating how to respond before it is too late.
Much of Kiribati, a collection of 33 coral atolls and reef islands scattered across a swathe of the Pacific Ocean about twice the size of Alaska, lies no higher than 1.8m above sea level. The latest climate models predict that the world's oceans could rise up to the same level by 2100. The prospects of rising seas and intensifying storms "threaten the very existence and livelihoods of large segments of the population," the government told the United Nations in a report last year. Half of the 6,500-person village of Bikenibeu, for instance, could be inundated by 2050 by sea-level rises and storm surges, according to a World Bank study.
The study lays out Kiribati's future in apocalyptic detail. Causeways would be washed away, crippling the economy; degraded coral reefs, damaged by warming water, would allow stronger waves to slam the coast, increasing erosion, and would disrupt the food supply, which depends heavily on fish supported by the reefs. Higher temperatures and rainfall changes would increase the prevalence of diseases like dengue fever and ciguatera poisoning.
Even before that, scientists and development experts say, rising sea levels are likely to worsen erosion, create groundwater shortages and increase the intrusion of salt water into freshwater supplies.
In response, Kiribati (pronounced Kee-ree-bas in the local language) has essentially been drawing up plans for its demise. The government has promoted "migration with dignity," urging residents to consider moving abroad with employable skills. It bought nearly 6,000 acres in Fiji, an island nation more than 1,600km away, as a potential refuge. Fiji's higher elevation and more stable shoreline make it less vulnerable.
Anote Tong, a former president who pushed through the Fiji purchase, said it was also intended as a cry for attention from the world. "The issue of climate change is real, serious, and we'd like to do something about it if they're going to take their time about it," he said in a recent interview. But packing up an entire country is not easy, and may not be possible. And many Kiribati residents remain sceptical of the need to prepare for an eventuality that may be decades away.
Sceptics include the rural and less educated residents of the outer islands who doubt they could obtain the skills needed to survive overseas, and Christians who put more faith in God's protection than in climate models. "According to their biblical belief, we're not going to sink because God is the only person who decides the fate of any country," said Rikamati Naare, news editor at Radio Kiribati, the state-run broadcaster.
The Fiji purchase was not the first effort to address Kiribati's perilous future. The World Bank-led Kiribati Adaptation Program, begun in 2003, developed water-management plans, built coastal sea walls, planted mangroves and installed rainwater-harvesting systems. The bank says the project, which cost US$17.7 million (622 million baht), has conserved fresh water in Tarawa and protected about 1.6km of Kiribati's 1,142km of coastline.
But a 2011 government-commissioned report cast doubt on whether the World Bank project helped Kiribati prepare for climate change. And while the mangroves and water management plans have helped, a 2014 study said the first round of sea walls, made of sandbags, had proved counterproductive and caused more erosion.
"Adaptation is just this long, ugly, hard slog," said the study's lead author, Simon Donner, a professor of geography at the University of British Columbia in Vancouver. "The idea that an outside organisation can just come in with money, expertise and ideas and implement something easily is naive. What you need is consistent, long-term funding -- the type of stuff that's hard to pull off with development aid."
Denis Jean-Jacques Jordy, a senior environmental specialist at the World Bank, acknowledged that "we had some issues" with the first sea walls but said subsequent ones made of rock were better designed.
There is no shortage of ideas to avert Kiribati's environmental fate. China's construction of artificial islands in the South China Sea shows the promise of sophisticated island-engineering technology, experts say. Mr Tong commissioned a study on raising Kiribati's coastline.
But such measures are financially unrealistic for a resource-poor, aid-dependent country like Kiribati. "It's not about the place going underwater," Prof Donner said, noting that some of Kiribati's islands had actually grown in recent years because of land reclamation or natural coastal dynamics. "It's about it becoming prohibitively expensive to live in. That's the real challenge for Kiribati."
The parallel freshwater crisis is also fixable, at a cost. Clean drinking water is scarce on several islands, and saltwater from high ocean tides has infiltrated some wells. Many residents of South Tarawa, home to half the country's people, now get their drinking water exclusively from rainwater tanks. Experts worry that as sea levels rise, Kiribati's fragile groundwater supply will face even greater risks, while the next drought could quickly exhaust the municipal supply and household rainwater tanks. Kiribati could invest in desalinisation equipment or ship in drinking water, but this is a country with only one paved road.
"It's all do-able," said Doug Ramsay, the Pacific Rim manager at the National Institute of Water and Atmospheric Research in New Zealand. "It's just going to be a very expensive exercise."
Still, migration may become increasingly important. Mr Tong said he hoped to prepare his people to move with job-training programs that would meet standards recognised in Australia and New Zealand. "The science of climate change is not 100% precise," he said. "But we know without any argument that, in time, our people will have to relocate unless there are very, very significant resources committed to maintain the integrity of the land."
Coastal threats are increasingly clear to residents of Buariki, an oceanside village of thatched-roof huts and towering coconut palms on the island of North Tarawa. Erosion along the beach has toppled dozens of coconut trees. The World Bank estimates that 18% to 80% of the village, which sits on a peninsula not more than a few hundred metres wide, may be underwater by 2050.
Some villagers said they were resigned to leaving. "Our government already has land in Fiji for the Kiribati people, so if there are more high tides here, they'll bring people to live there," said Kourabi Ngauea, 29. "But it depends on the government, and if they can support us."
Others see no need to leave. "This is where I belong," Aroita Tokamaen, 76, said. "I would rather stay."