Why doctors must fight against climate change (and what they can do to do so)

“As a member of the Medical Profession
I solemnly pledge to dedicate my life to the service of humanity;
the health and well-being of my patient will be my first consideration. “

– Declaration of Genève –

Every medical doctor’s career begins with the Oath.
That Oath represents a commitment to Society.
Every medical doctor swears to pursue the protection of physical and mental health.

Every doctor swears to promote the elimination of all forms of inequality in health. This means many things, well known to most. But this Oak also stands for a matter less considered by many medical doctors, but significant: climate change is their problem, and fighting it their duty.

Why is that? What does climate change have to do with the medical profession?

It is simple: climate change is also a medical problem. Climate change is also a matter of health.

The consequences of climate change on health are now witnessed and no longer only hypothesized or predicted. There are now several scientific studies available in the literature supporting this.

The increase in temperatures is associated with a higher frequency of extreme events, specifically floods and droughts, both at the base of a compromise of the agricultural sector, particularly sensitive to climate change. This impacts on the availability of food for the population and, consequently, on their health status.

The number of injuries and deaths caused by extreme weather events is (and will be) always higher. The Nargis cyclone in Myanmar with over one hundred thousand deaths is just one example.

Water is essential for hygiene and extreme phenomena, such as drought, may reduce their availability. On the other hand, extreme events in the opposite direction, such a flood, may impact health due to a rise in diarrheal disorders. This group of diseases is today responsible for one million eight hundred thousand deaths each year and represents the second cause of mortality due to infectious causes during childhood.

Heatwaves increase morbidity and mortality in the elderly suffering from cardiovascular and respiratory diseases. In Europe, it was estimated that in 2003, 70,000 deaths were associated with excessive heat.

Changes in temperature and precipitation patterns could lead to changes in the distribution and frequency of infectious diseases. The spread of vector insects would lead to an increase in infectious diseases such as malaria and dengue fever. Similar phenomena were already observed, such as the spread of Plasmodium falciparum (responsible for malaria) in East Africa, schistosomiasis in China and tick-borne encephalitis in Europe.

Rising temperatures will increase the mobility of pollen, other airborne allergens, and pollutants in the air we breathe every day.

Moreover, recently, some researchers have also brought evidence on a potential direct relationship between climate change and an increase in mental disorders.

A side effect of climate change will also be mass migrations and conflicts. Hunger, floods and the collapse of infrastructures will contribute to a further increase in the migration phenomenon, with the consequent spread of infections, mental disorders such as post-traumatic stress disorder, depression and post-partum depression, and overload of the health system of the countries of ‘arrival. Precarious social and health conditions accompany the migration phenomenon. Furthermore, the growth of the migration phenomenon will also lead to an increase in protectionism on the part of affluent countries concerning their resources, with political and health consequences already evident today.

Within this framework, there is so much that doctors can do every day to combat climate change.

In 2008, the British National Health System created a Unit for Sustainable Development intending to reduce the impact of the NHS itself.

Also from the United Kingdom, there are six indications for medical doctors, a re-adaptation of the Council’s recommendations on Climate and Health.

  1. Encourage patients to walk and use bicycles whenever possible, both to improve their cardiovascular health and to improve the quality of the air they breathe.
  2. Suggest dietary changes, advising to reduce the amount of meat taken drastically. A great contribution to global warming is due to breeding and meat production. If the entire population of the United Kingdom did not eat meat for a day a week, it would be like removing 5 million cars from the road. This would also have a double impact, given that the consumption of meat is associated with an increase in cardiovascular and cancer risk.
  3. Raising awareness and offering a model of a sustainable lifestyle is another weapon doctors can use. This can be done for what concerns mobility and energy, but also in terms of living arrangements, trying to adapt your home to reduce energy consumption.
  4. To prescribe participation in voluntary activities can have beneficial effects both on the well-being of the most socially isolated individuals, and on those struggling with mental disorders and self-esteem. Taking part in voluntary associations committed on the environmental front would be another way of bringing benefits to the patient and at the same time to the entire Society.
  5. Make yourself a spokesman in the Commissions and in the meetings in which you take part, in an attempt to reduce the environmental impact of the Health System where possible.
  6. Set an example by trying to drink tap water, consume local and less processed foods, use bicycles and public transport for travel.

Perhaps among the images in the head when studying to become doctors, there was not that of the activist on the front line against climate change.

It does not matter.
It does not matter if
they like it or not,
every doctor,
when he swore,
he has sworn to do so.

Fabio Porru

REFERENCES

  • Declaration of Geneve (https://www.wma.net/policies-post/wma-declaration-of-geneva/)
  • Death toll exceeded 70,000 in Europe during the summer of 2003 (Robine et al.)
  • Effect of 1997-98 El Niño on highland malaria in Tanzania (Lindsay SW et al.)
  • Potential impact of climate change on schistosomiasis transmission in China (Zhou XN et al. )
  • Climate change: present and future risks to health, and necessary responses (McMichael, Lindgren)
  • Empirical evidence of mental health risks posed by climate change (Nick Obradovich et al.)
  • Climate change: what can doctors do? (Micklewright)

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