Tony Waterston on climate change and maternal and child health

Tony Waterston Connecting four countries by video on a Friday afternoon could be an exercise in technological disaster

But with obstetricians, midwives, and paediatricians present at the delivery, a safe and healthy passage was guaranteed, and indeed all went smoothly at the first global conference on climate change and maternal and child health held at the Royal College of Obstetricians and Gynaecologists (RCOG),  in London.

With four countries connecting via a bridge at the World Health Organization (WHO), the potential complications were considerable but there were only minor glitches during the three hour meeting. Organised by the RCOG with the RCPCH and Royal College of Midwives, the meeting was intended both to illustrate the feasability of a carbon neutral international meeting, and to highlight how climate change is affecting mothers and children now.

Speakers were Dr Mala Rao from the All India Institute in Hyderabad, Prof Louis Reynolds from the Red Cross Children’s Hospital in Cape Town, and Dr Monir Islam at WHO in Geneva, together with Dr David Pencheon of the NHS Sustainable Development Unit in England. There were audiences in South Africa and India, and each had their own question time for speakers, with a 45 minute discussion period at the end when questions came from all centres. The only problems were a short period of loss of contact with the south Africans and an irritating echo from Geneva, but each audience seemed thoroughly engaged.

The data and ideas presented were of huge value and illustrated the need for an urgent and collaborative approach to tackle climate change now.

From India, we heard how climate change is contributing to maternal deaths owing to women’s vulnerability in terms of drought, climate conflict, food security, and household air pollution. Women and children are 14 times more likely to die in disasters than men, and more than 70% of deaths in the Asian tsunami were women. Rao strongly made the point that it is because of women’s already existing impoverishment and gender inequity that they are feeling the effects of climate change so badly.

Reynolds painted a stark picture of child health in South Africa which will be one of the most severely affected countries by global warming. Already the position is worsening for children as a result of high levels of inequity, poverty, and HIV infection. Although Africa has contributed less than any other continent to CO2 emissions, it is the one that will be affected the most. Reynolds also graphically illustrated his own effort to reduce his carbon footprint – to a level that (were he living in the UK) would require two planets to sustain, if replicated across mankind.

Pencheon spoke of the need for the NHS to reduce its own huge carbon emissions, currently producing 1/4 of all public sector emissions. He urged us to present solutions to policy makers, rather than problems, and to summate the carbon benefits of each one.

Question time ranged far and wide and was always informative and stimulating. Topics covered were population control (and the need to look first at our own carbon footprint), the valuable part that tribal peoples in India play in conserving their environment, the considerable action under way in India on climate change, and how to influence the coming election in the UK (answer: write to all parliamentary candidates, preferably as a group of doctors). There was valuable discussion on what is a developing country – surely not one that is going to become as profligate with resources as the USA and Europe? According to Reynolds, Cuba is the only poor country that merits the term “developing.”

Summing up, the chair called for us to spread information; to take action ourselves on carbon reduction, and urge our organisations to do the same; to use our networks, and above all, to advocate for action on this coming health crisis.

Tony Waterston is a paediatrician in Newcastle-upon-Tyne, working mainly in the community with long term conditions, disability, child abuse and social and mental health concerns. His interests are in child public health, children’s rights and global child health and he leads the RCPCH teaching programme in the occupied Palestinian territories. He co-wrote this blog with his colleague, Jean Bowyer.