If the planet were a patient…

Tarun Weeramanthri – PHAA President 

We have heard about the science and data of climate change, its global significance and its environmental impacts. Health researchers have carefully described its precise physical and mental health impacts; they are building us a library of knowledge of the links between climate change and ill-health. Whether it is the effect of extreme heat on children and the elderly, or the impact of air pollution and bushfires on respiratory disease, or the anxiety that comes with years of drought.

So, what do we do with this library, that leads to solutions and change? Of course, yes, make it accessible to everyone and free. But more importantly, recognise its significance as not just a compilation of data but as a companion to a collection of stories. To trigger action, we don’t only need creators of knowledge, but also curators and tellers of stories, and in my experience, this is often the missing bit, and where health comes in. Numbers are impressive but impersonal, in someone’s famous phrase ‘Statistics are people with the tears wiped off.’ Combining statistics with stories is way more powerful as a trigger for attention and action than either alone!

And this combination is also the essential element of health and medicine. An encounter with a patient starts with the taking of a history (an individual story), moves onto a physical examination (a combination of sight and touch, of our senses), and ends by gathering of data from special tests.

If the planet were a patient, we would recognise her as sick when she walked into the emergency department. The diagnosis would be obvious, namely serious overheating, and the cause easily identifiable from the history, namely man-made burning of fossil fuels. We would recognise the impacts, both environmental and health, written into the planetary body, and experienced through our senses. The testing data would be overwhelming in its consistency, and the medical records would be a series of thick files, labelled ‘IPCC reports’, one to six.

If the planet were a patient, we would see immediately that she was deteriorating and an urgent response was needed. We would recognise that doing nothing was not an option, and ethically unsupportable, as it would lead to continuing harm. That merely treating the symptoms and not the cause would lead to further deterioration, and that further treatment delay would be fatal. And that on the other hand, treating the patient, the planet, with existing known remedies, will lead to extraordinary co-benefits, reducing for example common chronic diseases and air pollution, and benefitting everyone.

So, health professionals being pragmatic people, the decision to act on climate is not hard to make. We in the health sector accept that we are responsible (public and private both) for approximately 7% of all emissions in Australia. Many professional colleges have called out the climate emergency for what it is, have hit the ‘code red’ button. Perhaps us older professionals have been moved to action by the whisperings of young people, our students, around the bedside, asking ‘ Why have our teachers and leaders not acted on the science and evidence of climate change, as they have taught us to do for other serious health threats?’

There are now calls from the top of the health sector to ‘lead by example’, so in the lead up to COP 26, and in the years after, what might this leadership and action look like?

Firstly, the sector is taking responsibility for its own emissions and substantial waste, including single-use items and plastics.  All state and territory governments have committed to net zero by 2050, so we have to reduce emissions and waste at least as fast as other sectors. Our size gives us some advantages – we are big buyers of goods and services, so we have purchasing power that can reshape supply chains and procurement practices. We employ many thousands of workers, so small changes in how we get to work, or how we recycle materials, adds up quickly. And some of the greatest opportunities lie in changing the way we deliver care, from hospital to more community based, and with a greater emphasis on prevention.

As we pledge to do more as a sector, we also urge the Australian Government to be more ambitious for our country. A national climate and health strategy as put forward by the Climate and Health Alliance is overdue and essential, and could form part of Australia’s nationally determined contributions, which currently omit health altogether.

We must reduce the striking gaps – between national commitments, Paris Agreement targets and actual emission reductions; between actions individuals take to reduce waste at home and what they can do in a healthcare setting; and between the care the health system provides to the individual in front of us and the responsibility we have for the next generation. The most fundamental gap to fill is the relative lack of health care access for groups in society, who have the greatest vulnerability, have contributed the least to emissions and are impacted the hardest. Climate action without fairness or justice is not ethical from a health or public health perspective.

We in the health sector are aware of our own power and influence in society. We know we are trusted by the public but should not take that for granted or lightly. As part of the status quo, we must be part of the problem too, and we will need to heal and change ourselves as well as others. Our privilege can be turned into influence for good. Taking finance as an example, individual health professionals are looking at their personal choice of superannuation fund, while health professional bodies will be asked by their members who they bank with and why. As advocates, we can also speak to our patients, the media and the public about climate and health, lobby politicians, speak up and activate our networks, and use our positional influence to get the issue on the agenda at all kinds of meetings.

Lastly, we can and do commit to not just advocating but allying or partnering with others. During our yearlong Climate Health WA Inquiry  all agreed that climate action is everyone’s responsibility and committed to supporting government action and leadership. In the inquiry, we collected and curated a collection of stories from WA, not just of the diverse environmental and health challenges in different regions, but of the positive responses from local communities, and new partnerships between civil society organisations and health care providers. We recommended that WA Health establish a Sustainable Development Unit to catalyse and coordinate this growing activity into measurable change. Our model, the SDU in the UK helped the NHS cut emissions by 18% in a decade (2007-2017), while activity rose by 27%, saving approximately 90 million pounds annually.

Health professionals as a group firstly care, and then do their best to cure. If the planet were a patient, we would tell and respond to her story, and answer yes to three questions: is the patient sick? Do we know what to do? And can we do more and quickly?

This presentation by Tarun Weeramanthri was delivered today at the Better Future Forum breakout session – Prioritising health in the national climate response.

Photo credit: Daria Shevtsova from Pexels