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Healthcare is a big contributor to global warming, and climate change has significant health risks. RCSI alumni and staff tell us about the threat to human health, and steps that must be taken to avert further impact
his year, on World Health Day, the World Health Organization (WHO) shone a spotlight on the health of the planet and how it’s connected to human health. The WHO’s message was clear: our global population depends on biodiversity and the ecosystem for resources such as clean air and water, food and shelter. All of these come from the planet, and if we keep destroying and polluting the way we do, our health will be at risk. Health risks associated with climate change include allergies, asthma and respiratory problems linked to air pollution; heat exposure, heatstroke and the increased incidence of mosquito and tick-borne diseases resulting from higher temperatures; and threats to cardiovascular and mental health. The pandemic has reminded us of the interconnection between animal, human and planetary health. If aggressive deforestation and the wanton use of fertilisers and pesticides continue, we will be creating an environment in which the barrier of protection between animal and human health will disappear, and we will be much more vulnerable to the emergence of new viruses and zoonotic diseases. One of the shocking figures cited by the WHO is that each year there are 13 million premature deaths linked to environmental risk factors including climate change. Seven million of those – that’s 13 people every minute – die from diseases such as lung cancer, heart disease and stroke linked to toxic air, with pollution coming from the combustion of fossil fuels and burning of biomass. Rising temperatures and floods caused by climate change put two billion people around the world at risk of dengue fever, and two billion people lack safe drinking water, causing 829,000 people to die from diarrhoea every year. The WHO says the transition to clean, renewable and affordable sources of energy has to happen quickly. Cities, currently designed around cars, must become liveable in terms of active transport in order to tackle noncommunicable diseases such as obesity, and there needs to be an increased focus on sustainable food systems, so we stop polluting our rivers and oceans via the way we produce food. The WHO’s view is that this is all possible if the right political choices are made and we come together to support those who stand for the healthy choices and balance out the lobbying from those who seek to perpetuate the unhealthy choices for the planet that have got us into this situation. The warnings from the WHO are stark, and there is an urgent need to reboot our societies to create better wellbeing. But in the face of fake news, attacks on science, and economies that need to be reimagined post pandemic, it can be hard for doctors as individuals to know how they can play their part. One RCSI alumna who has tackled the issue of air pollution head on in her constituency of Klottey-Korle in Accra is Dr Zanetor Agyeman-Rawlings (Class
30
of 2003) who practised as a GP in Ireland for ten years before returning home to Ghana where she has been a member of the national parliament since 2017. In 2019 she spearheaded a project at the Osu night market in Accra. The longestablished market serves fish and meat alongside popular dishes such as kenkey, rice, kelewele, fried yam, fufu, as well Dr Zanetor Agyeman-Rawlings (Class of 2003), Member of Parliament, Ghana. as porridge, and is visited by travellers, drivers and government officials. But cooking with inefficient cookstoves and smoking ovens was causing air pollution, and Dr Rawlings was aware of health issues being experienced by the women working in the market. “They complained about the exposure to smoke and soot from the cooking,” she explains. “I knew one woman who had died as a result of long exposure and others who had developed chronic lung disease. The idea was to improve their quality of life as well as to make tangible the concept of their carbon footprint and incentivise them to reduce their carbon emissions. The added advantage was the fact that they would be spending less money on fuel which meant their profit margins would be bigger. Eighty per cent of the market women were on board, while the rest didn’t quite get it. We went ahead, and those who were interested got their stoves retro-fitted. By the time the project was over, the rest of the women were clamouring to be part of it! “In order to quantify the benefits, we measured the particulate emissions before and after, so it was possible to see a very tangible reduction in carbon emissions. It’s been a very successful project, which has made a huge impact on the lives of the women in the market by empowering them in economic terms, as well as having a positive impact on their health and on reducing their environmental impact. Climate change is usually so abstract but this project has made it tangible, they spend less money on fuel and so make a bigger profit.” Dr Rawlings is continuing her work on projects in her constituency and elsewhere in Ghana, where she hopes to tackle the issues of burning rubbish in municipal areas (against bye-laws, but it still happens), water pollution due to illegal mining, the use of landfill causing the leaching of chemicals into the
