The climate health crisis: A call to the medical community

 

When I started practicing as an internal medicine physician years ago, I had many thoughts about what my future in patient care might hold. I can confidently say that flying to Egypt for the international climate conference COP27 was not one of them! And yet, mid-career, I found myself in Sharm El-Sheikh, encountering images and stories of global health concerns I had never learned about in medical school. I was joined by other clinicians, as part of a physician climate and health fellowship, there to underscore the health harms of fossil-fuel-driven climate change. A goal of the COP is to coordinate global climate action, but images of polar bears stranded on melting ice caps hadn’t done enough to move the international community to act. We knew our patients’ real-life stories would be more compelling: a child’s asthma triggered by wildfire smoke, a senior sweltering in a high rise without A/C, a teen struggling with climate anxiety. The best people to tell these stories were, of course, our patients with lived experience, but we clinicians could empower these same patients by amplifying their narratives, and offering clinical insight in order to influence upstream change.

At COP27, I attended several presentations and discussions highlighting the intersection of health and climate change. Listening to the UNFCCC and Health Care Without Harm Health Futures Lab, I was riveted by Dr. Arvind Kumar’s presentation. This Chest surgeon from India displayed a slide showing three sets of lungs in a row. The healthy lungs furthest to the left served as a “control.” The other two sets belonged to Delhi residents and looked diseased–the underlying pink tissue speckled with black. The middle set belonged to a non-smoking man in his mid-40’s while the lungs on the far right, though marginally less damaged, were the most unsettling. They belonged to a 14-year-old boy, a child close in age to my own sons, whose lungs looked like a smoker’s despite never having smoked. Dr. Kumar went on to say that the air quality in Delhi, one of the world’s most polluted cities, was so poor that living there led to lung damage equivalent to smoking 20 cigarettes a day. He then relayed that fossil fuel pollution damages many tissues in the body (including the heart and brain) and it begins in utero. My reaction was visceral. I had witnessed the immense potential of clinician storytelling to engage, motivate and lead change.

Sitting in on a New York Times Climate Forward panel titled “Extreme Heat, Extreme Solutions”, provided yet another eye-opening experience. There, I learned the Middle East is warming at twice the rate as the rest of the planet (the world’s hottest temperature of 127.7° F was recently recorded in Kuwait). I know my patients are at risk from extreme heat, which is the number one weather-related killer in the US, so I could only imagine the compounded impact of thermal stress on people living in the Middle East, given this accelerated warming.  My fear was confirmed by a panelist who shared that a rapid rise in temperature posed such a threat to health that some regions would soon be rendered unliveable. Soaring temps limited outdoor activities, including exercise, confining the privileged to air-conditioned homes while the rest suffered through days and nights of oppressive heat. During the warmest months, even the simple, everyday routine of commuting to work could be deadly. The panelists mentioned adaptation measures such as adding tree canopy, A/C and early warning systems, yet revealed how challenging it was to secure funding and change policies. Here was a clear opportunity for the health care voice to educate stakeholders. Clinicians treating patients with heat-related illnesses could offer these experiences to bolster arguments and motivate decision-makers, pointing them towards evidence-based choices and life-saving measures.

Healthcare voices at COP27, including my own, shared insight on many topics encompassing the convergence of health and climate. These included antimicrobial resistance, community resilience to weather extremes and emergency preparedness for environmental disasters. Such challenges demand increasing attention from the international community and in each instance, clinicians offered a unique perspective that enhanced collaborative efforts. Furthermore, physicians are among the small group of experts that studies show to be the most trusted messengers to communicate climate change. The WHO has called climate change the greatest threat to the health of humanity. Because this threat too often impacts the patients we serve, “first and worst,” it is crucial for clinicians to participate in current and future climate discussions such as COP27. It’s true that my past self would never have imagined having a role at a climate conference as a physician. However today, I clearly see why a growing number of physicians are speaking out against fossil fuel pollution. Moving forward, I urge my colleagues to come together in advocacy for patients and our planet. When we combine our expertise with effective patient care storytelling, we have immense power to change political will and affect upstream change.

About the author: Sheetal Khedkar Rao, MD is a US-based practicing board-certified internist and a current Climate and Health Science Policy Fellow with the University of Colorado, Anschutz. She is co-founder and Chief Health Officer of the Illinois environmental non-profit Nordson Green Earth Foundation.

Competing interests: Unpaid officership of US non-governmental organisation, (Sheetal is the Chief Health Officer of Nordson Green Earth Foundation an Illinois-based environmental non-profit).

Handling Editor: Neha Faruqui

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