The floods in south India that killed at least 350 people and made millions homeless are a result of climate change. Who had imagined that there would be floods in the dry and arid southern Indian district of Kurnool, that too in October? Climate change seems to have been the cause of a series of disasters in Asia in recent weeks – floods in India and typhoons in the Philippines, Vietnam, Cambodia Thailand and most recently in Japan. Interestingly, last month, world leaders met for a one-day global summit on climate change at the UN Sessions ahead of the G-20 meeting in America. This was a precursor to the major climate summit in Copenhagen scheduled in December to update the 1997 Kyoto Protocol. As it stands, China has overtaken the United States as top emitter of greenhouse gases that cause rising sea levels, droughts, wildfires, spread diseases and cause powerful cyclones. And yet, the world is still split over how to divide the burden of cuts in greenhouse gases between rich and poor nations.
The debate about whether global environmental change is real is now over. The recent happenings bring in the realization that it is happening more rapidly than predicted. What we probably do not realize or provide serious consideration to, is that, these changes can constitute a strong challenge to our health, both directly, and indirectly by promoting other risks as well. Do healthcare providers have a role to inform themselves about these issues and to become agents of change in their communities?
A study published in the Environmental Health Perspectives Volume 114, Number 12, December 2006, lists the impact of global climate change on health. These include the direct effect of heat (in 2003 in Europe, over 37,000 deaths were directly attributable to an historically unprecedented heat wave); influences on severe weather, flooding, and drought; worsened cardiovascular and pulmonary ailments due to heat; the influence of heat on air pollution; threats to food production and different [atypical] types of diseases that spread through insect bite [such as malaria] and waterborne disease transmission. An article in Pharmaceutical Technology, Sep2008, Vol. 32 Issue 9, p114-113 talks of an unmet need for a malaria vaccine for the modern world. Something that Bill Gates famously called “the forgotten disease”.
This is the most worrisome part. What healthcare providers should worry about is that climate changes can result in more indirect, complex, and atypical causes of disease that are today considered “conquered” in the modern world. This is similar to something that one sees during war or social conflict. Both are undoubtedly to blame for deaths, but not just because they “cause” death, but because these phenomena fundamentally alter the social conditions of life in ways that create new and lethal risks to mental and physical health and human life. Furthermore, as climate change causes the ecosystem to degrade over time, this can cause greater difficulties with food production as seen in the global food crisis, which in turn increases violence and conflict – a cascading cycle of environmental change, scarcity, conflict, social disruption, and death.
The healthcare industry, through clinicians/doctors, pharmaceutical companies, hospitals, the distribution chain, counselors and awareness agents, amongst others, can play a vital role to educate patients and their communities on the connections between unsustainable behavior and global environmental changes that threaten their health and security. The industry must actively educate healthcare providers about these issues and help clinicians practice behavior change with their patients. In addition industry lobbies, hospitals and medical associations can come together adding their voices to this issue with the government. But then, do healthcare industry bodies consider this an important issue to support or one that is within their purview of influence?
Companies do consider the impact on the environment in most aspects of their activities, such as R&D, production, distribution, marketing, procurement and administration, and make the best efforts to conserve and improve the environment. But, there are some simple steps that the industry can activate easily by taking a leaf out of what others in varied sectors do, such as the development of environmental-labeling of products, utilizing options for choosing environmentally sustainable packing material, products and services etc. Even if they do it, not much of it is talked about causing very little to be known and learnt by clinicians who can subsequently influence the people they treat. An interesting idea on how companies can provide tangible evidence of being environmentally conscious is provided here.
While politicians and business leaders delay, or eternally debate and search for solutions that require minimum sacrifice and impact on economic growth, clinicians and other healthcare service providers must think rigorously about what can be done now.