On 12 April 2019 Alex Armitage wrote a powerful piece for BMJ Opinion on “Extinction Rebellion”, the environmental activist group which has been hitting our headlines for the past few weeks. As a paediatrician and the father of a young child, Alex joined the group, stating simply “we have just 11 years to avert ecological and social disaster”. With the same concerns, medical students across the country—indeed, across the world—have been joining in too.

I made the decision to be part of the ten-day protests in London (which came to a close last week). My time was split between helping block roads in Parliament Square, and “arrestee support.” This involved meeting arrestees on their release from the cells, and giving them a hug and a chat, some food, and escorting them back to their friends. Young and old, these were people with different backgrounds and stories—but all with a common sense of urgency. The arrestees filled the waiting room one by one: a sixty-something grandmother who emerged whooping at the news that Waterloo Bridge still belonged to “the rebels”; a 27-year-old man who had travelled from Cardiff after hearing about it on the news; and a mum of two, who had joined the protest for her daughters’ futures, who straightaway had to organise their pick-up from school. Their warmth, energy and courage were inspiring.

Healthcare professionals must be engaged with the issue of climate change. As authors of The Lancet Commission warned us a decade ago, climate change is the “biggest global health threat of the 21st century”. The public health consequences—currently being disproportionately felt by those in the Global South—are already very real. Looking to the future, even the most conservative projections are bleak. If current trends continue, we should expect a global temperature rise of well over 1.5°C by 2030. As the UN IPCC has warned, a world of >1.5°C warming would be characterised by widespread food insecurity and malnutrition, extreme weather events, infectious diseases, conflict, mass displacement, and economic and societal collapse.

Extinction Rebellion’s demands have been criticised as politically unrealistic, and their tactics of civil disobedience have been labelled as extreme. But the bottom line is that an emergency calls for desperate measures. Even if all countries adhere to their national commitments of the 2015 Paris Agreement, we still accept a temperature rise of higher than 1.5°C. If we are to keep warming to 1.5°C, then radical change is needed in the way our societies operate. Only through transformative change of political and economic systems can we avert the public health catastrophe of a >1.5°C world.

I too was motivated to be there because of a shared sense of urgency. I’m worried about the scale of human suffering caused by climate change—both now and in the future. And during the protest I came across other medical students with the same concerns. Jess Zollman Thomas, a Sheffield medical student volunteering as a first aider, said “I look to the future of the health of people and the planet and I am terrified. The world of healthcare is going to be massively shaped by climate change. We need not only to be prepared for these challenges, but also to be dealing with the issues at the root of the problem…We are at such a crucial point in time, and for me Extinction Rebellion expresses this.” Ailsa Bell, medical student from Newcastle, added “I believe medicine should be ultimately about empathy. If we cannot extend our moral imagination to other nations and generations in the face of an oncoming crisis, then we have failed as a profession”.

There is no doubt that for the medical students of today, wherever we work, our future practice will be drastically shaped by this unfolding crisis. As doctors of the future, we have a platform for advocacy and action. In the spirit of the duties of a doctor—including “to protect and promote the health of patients and the public”—we must speak out on behalf of the generations of patients whose health and wellbeing is facing unprecedented threat. This involves calling for alternatives to “business-as-usual” economics and politics which are underwriting climate breakdown. In the words of 16-year-old Swedish activist Greta Thunberg: “we need to start acting like our house is on fire. Because it is.” Not just as future doctors but as citizens of the planet, this is an issue of immediate moral relevance to every one of us. We all have a role to play in demanding a safe future. Before time runs out.

Kate Bernard is a medical student at Sheffield, currently doing an intercalated Msc in ‘Humanitarian Studies’ at the Liverpool School of Tropical Medicine.

Competing interests: None declared.