Diaspora communities are a growing source of external assistance and resources to meet unmet needs and to strengthen existing health systems in their home countries. Although a growing number of articles have been published in this realm, very few have looked at diaspora communities’ role and the place translocal communities give to health (care) in the various remittance dynamics, whilst including power relationships and environmental change. This article examines the motivations and practices through which Senegalese diasporas engage with the health system in their origin country and what barriers they face in their interventions. The results of the migration-environment-health nexus are critically discussed with a political ecology approach. We found that households and villages with a critical number of members abroad, and with strong political and/or international networks, are better off and less exposed to health risks in the face of adverse extreme climate impacts.