How could climate change affect my health?

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Ted Tech has you covered. Get ahead of the curve with digestible downloads on some of the biggest ideas and technology, from AI and virtual reality to clean tech. Find Ted Tech wherever you get your podcasts. Hello and welcome to the Climate Question from the BBC World Service. I'm Greer Jackson.

“And this week, how is climate change affecting our health and what can we do about it?”

I'm joined by two doctors to discuss. From Malaysia, Dr. Jamila Mammood. Jamila is an obstetrician and gynecologist was special advisor to Malaysia's Prime Minister on public health and has worked in humanitarian aid for over two decades. Today she's executive director at the Sunway Center for Planetary Health in Malaysia. Welcome. Thank you very much, a pleasure to be here. Next to her is Dr. Omnir L. Omrani, trained in Egypt, Omnir worked in Cairo's biggest public

hospital and his vice chair of the Global Climate and Health Alliance. That's a consortium of global climate and health organisations. Thank you so much for joining us. Thank you, such a pleasure to be here. Jamila, why did you become a doctor? That's a difficult question. I think so many things.

First of all, I was challenged to say, maybe I won't make it as a doctor. So I took the challenge

“and did medicine. I also saw my father die from cancer when I was only 11 years old. So I think”

you know, being in another hospital, seeing him, must have had an effect on me as well. But most of all, I think I just like people. I like the caring industry. I come from a family that's very caring and very generous. So I think medicine is the best fit for me. Omnir, best fit for you, for the caring or was there another reason that you entered the profession? I mean, the main reason is like, like Dr. Jamila, I really wanted to have a career around helping people in every way that

I can. And when I was studying science and biology, I felt, well, I'd like to do that for the rest of my life. Like, how can I have the opportunity to be working with people to be helping them in any way that I can? And in Egypt, it was a transfer me to do that. And I was the only doctor in my

family. And my father really wanted me to do that. And he recently passed away. But anyway, I always

feel that I'm doing what he always is part for me to do. And at the same time, whether working on health of the people or the health of the planet, it is a career that is constantly offering service to people. So when did climate change enter the picture for you, Jamila? Actually, quite late. I must admit, when I was a medical student, climate change did not feature in our curriculum. It was in my humanitarian career. I worked more than 20 years in this and coming

from Asia, I saw a lot of the impacts of climate change with severe weather events, flooding, cyclones, particularly in countries like Philippines and Bangladesh. And, you know, seeing up front the impact of climate change on health, particularly the fact that climate change and the impacts of health are not gender neutral. So as an obstetrician and gynecologist, I mean, it really sort of woke me up. Probably the most compelling moment for me was watching a woman in Mozambique having to climb up a

tree to give birth during the very severe floods in the year 2000. I thought, you know, as an obstetrician and gynecologist, gosh, you know, this is not how women are supposed to have their babies and how climate change is also a threat multiplier, how it's also related to social equity and it is so

“important for us as physicians to really seriously undertake the responsibility of knowing about the”

impacts of climate change on health but also being strong advocates. I've seen that video that women giving birth and a tree and having given birth to a child myself. I cannot even father how she did that. Absolutely. I mean, I've delivered many, many babies and it's not easy to deliver one, you know, in a probably labor ward rather than on a tree. So I can't imagine, I mean, you train that women should probably be a real superduper obstetrician because, you know,

she can do it in such terrible situations. But guess what? In 2019, I was back in Mozambique after severe flooding at the time I was working with the International Federation Red Cross and Red Cross and I was just, you know, telling a midwife in the community I was about the story and she just smiled and pointed to a child that I was playing with actually and said, well, his mum just gave birth on a tree and I said, my goodness, 19 years down the line as a humanitarian,

drivers of why health is so severely impacted by climate change yet we're not doing enough.

“Well, come to that very pivotal question later on in the program because I'm new. I wanted to ask”

you where climate change started entering in your workplace. I mean, you worked in Cairo in the biggest public health hospital there. What were you seeing on the woods? So I started working

on climate change when I was a medical student. I was really lucky to be part of this incredible

medical student organization of over one many medical students from over 100 and 40 countries and we had a small program that focused on climate change, understanding the research on how climate change affects health and also going to climate conferences and really joining young climate activists in their movement and I was very engaged in that but the realisation started when I did an internship in emergency medicine in the US. It was the first time for me to go and

during my second week and there was Hurricane Irma and I was in their emergency hospital and I saw patients who are coming with direct injuries but also those who needed care and the hospital the generator was not working so they were unable to get the urgent care that they needed or even the medication that they needed living with chronic diseases and just became a slow-awaitalisation but then went back to Egypt. I started my residency. I was doing general surgery and then reconstructive

surgery and not a single day was passed without a child and then their brothers and sisters coming with an asthma exacerbation or a lung infection. I became a normal thing to do that you would prescribe for them a treatment for their just condition but then you would postpone this urgent surgical care that they needed because they cannot undergo any anesthesia and then I started to realize well if they come and then their family members come and their younger siblings come we're treating

them but then we're standing them to the very environment with high levels of air pollution that is causing their health to deteriorate both their lung health but also their neurological and their mental health and as Dr. Gemila said as doctors we need to bring the narrative to it's no longer an environmental issue it's children's health that is being devastated continuously even at a chronic level through the air that they breathe the food that they can't access

the water that they don't have and just to really spell out for listeners who don't perhaps know what the link is between air pollution and climate change when we burn fossil fuels in this particular instance in our cars be that petrol or diesel it releases not only planet warming gases but these tiny particles particular matter and go into the lungs and the body and have

“very serious health effects I think it's one of the biggest killers is it one in five people die”

from air pollution is right well about seven million people have premature deaths per year and nine

out of them children breathing polluted air globally serious yeah and so on there there you were dealing with the impacts of climate change and hospitals in you know in Egypt and the US but were you actually trained to deal with it when you were learning to be a doctor? The only remotely relevant module I had was around occupational health where heat was mentioned as a threat to people who work in construction and I decided because I was part of this

medical student organization we did a global survey across 112 countries over two thousand institutions and we asked it's climate change thought in your medical curriculum if yes how is it thought are you also thought about air pollution in particular which is much more clear link

for doctors so basically more than 85 percent of the institutions in the countries that we had

had no mention of climate change in their training or the curriculum of doctors so this means 85 percent of doctors worldwide are not trained about climate change and even if they are we also mapped out how it was a very inconsistent of a module a lecture it's not mandatory there are no particular assessment on it so there's a huge gap and we're asking we're expecting doctors to be at the frontline of responding but they are not provided with the knowledge or the tools

or the ways to treat the patients that they are going to get.

“Jimiela what do you think? I think thanks to Omia and her friend study that was 2020 a lot has”

changed since then you know in the UK for example the curriculum for medical schools on climate change has advanced and I think it's really progressed a lot I can certainly say in our own experience in Malaysia we are at my university at least introducing planetary health which is broader than climate change and health that includes pollution and so forth as a mandatory component of education among all undergraduates since this year and from next year it's now a higher education

in the curriculum? What is it that doctors need to know? I think it's not just doctors well doctors

“in particularly need to know the particular risks to health let me give you an example someone comes”

in with a myocardial infection with a heart attack right or stroke and you don't take a history whether they've been exposed to the sun for a long time whether they're working outdoors and so forth with the risks of cardiovascular event it's much higher when you're exposed to extreme heat. So you might miss the fact that that was the primary driver right um this is a fact treatment it doesn't affect treatment but it helps you to better understand the environment they come from

because at the end of the day it's not just about prescribing medicine it's also about ensuring

that the social conditions the other determinants of health because 85% of the determinants of health

outside the medical care complex prevention prevention and you know anticipation of you know possible medical complications that will happen I mean the UK right now is also you know going through a little bit of a heat wave so what are the things you might expect to happen who will be most vulnerable they will be the elderly you'll be women it will be people who are working outdoors

“and so forth so I think you know having that understanding better prepares you to anticipate better”

prepares you to take a much more comprehensive history and understanding the conditions but also understanding the impacts for example with vector bond diseases so mosquito's mosquitoes and ticks and so forth right there's a rise in dengue virus infections that could be deadly they're seeing it now in temperate countries and where again medical students and doctors may not have been exposed to you know a lot of learning on tropical diseases so it means that we need to better

understand that global health issues now are truly global that you know tropical diseases are no longer confined to the tropics right on yeah what I wanted to add is also another anecdote here in the UK so recently doctors noticed that patients who are living with mental health conditions are coming during extreme heat waves with mental health emergencies that their body cannot adapt to the heat and this is actually because their psychiatric medication has a side effect of

impairing the body's ability to self-regulate and adapt to increasing temperature and this is actually like because of the heat physicians would anticipate reducing the dose of the medication or changing it because temperature are increasing but because this dose adjustment was not done

“patients go into the emergency room with heat stroke that's why it's fundamentally needs to be”

taught in the curriculum it's not a short side for them but they never learned about it if you're

struggling to keep up with all the latest innovations in tech and what they'll mean for your life tech tech has you covered get ahead of the curve with digestible downloads on some of the biggest ideas and technology from AI and virtual reality to clean tech find tech wherever you get your podcasts a reminder you're listening to the climate question from the BBC world service I'm Greg Jackson and we're asking how is climate change affecting our health and what can we do

about it? We have two doctors here to share their in-site doctor Jameela Mammood and Dr Omnia El Omrani we've just been discussing how lots of doctors aren't trained in climate health there's some changes there but what are the major challenges that we haven't mentioned that they're facing on here? So you need more doctors but you also need house potatoes and health care facilities that are able to adapt to the impacts of climate change this means that you have early warning systems

you have hospitals that can anticipate the next climate disaster the next flood the next infectious disease and for hospitals to be able to do with that you need the funding and the right government policies that would prioritize that and also similarly one of the things we're working on is how can the health sector itself reduce its own carbon emissions and its own carbon contribution how big is the global health sector's contributions to the crisis at a global

level it's 3.5% from global carbon emissions lying yes and it's also about the principle right as doctors our moral duty is to do no harm and that also translates to our workplace that we don't want to contribute to the issue of climate and to the carbon emissions that is driving it and at the same time there is the case to make if you reduce carbon emissions you can also save a lot of costs that will improve the quality of the health care service that you are delivering to our patients

and our communities how big is the cost saving you know to me it depends on what you know adaptation

in the Ministry of Health is really going through a decarbonization exercise a race to zero

or so to speak and they've already seen the profound benefit millions saved but more than that as Omnia rightly mentioned it's about how do you build systems that will be able to better withstand mitigate but also adapt to climate change and I think particularly I want to raise the importance of nurses in community health workers and allied health workers right nurses are probably the most trusted people in the world nurses and doctors and I think you know this is where they

play a very very important role in being able to also educate the patients and look at alternative

“measures that can be taken I think in UK social prescribing has become very very important the”

pointers of nature bringing nature into your prescription ensuring that you know nature doesn't just help you to cope with the mental health stress but also bringing nature to urban cities you know cools down cities significantly thereby reducing risks of heat strokes and heat shocks and so forth I cannot believe how sort of interwoven health is with that so much I mean your mind just must be full of information I don't know how you bring it all together but eloquently but this is why a

planetary health is so important this is what Omnia and I are real champions off because it's a new approach right and what it explicitly tells us is that the health of human civilization is very dependent on the natural systems which means is the environments the planet you cannot have healthy people with our healthy planet we need finance we need social justice we need economic development that is pro planet that's pro people and you know I'm pretty proud that in my country now we've developed

a national planetary health action plan that will go through parliament soon to really push our systems approach so that we will achieve the sustainable development goals eventually what would a sort of hospital that's resilient to say floods or hurricanes or drought what it actually look like Omnia can you help us visualize it if we're talking about the mitigation and like reducing the carbon emission coming out of the hospital thinking about what kind of energy is

powering and in Egypt for example we've been having a huge expansion of installing solar panels on hospitals starting with showed machine which is a coastal city up to Cairo and it's being put not just as an opportunity for us to reduce our own emissions but it's also cheaper and it's reliable for us to do that especially in Egypt and then at the same time early warning systems

“are so important it's so fundamental and when you look at like the components of health care”

system we call it like building blocks so we're starting from the health workforce you're looking into the supply chain itself you're looking at the equipment how can you improve even the maintenance of equipment the amount of carbon and money that you save from properly maintaining the life cycle

of medical equipment it's incredible another thing is the use of anesthetic gases there are

anesthetic gases that are carbon intensive and if you choose one that is more carbon friendly you are going to get the same patient outcome but you're actually reducing carbon emissions and similarly goes for the use of energy similarly goes for waste disposal and so these solutions and are they're proven by so many studies globally of what works doctors are also looking at the amount of water that you can save by watching your hands before surgery there are studies up to that extent wow

but fundamentally I think we need to shift from treatment to prevention I think we've got to you know go back to making sure people remain healthy and therefore not required to go to hospitals and of course the other aspect of it is also looking at making sure that health care is also decentralized to community-based approaches and bringing the community into finding solutions that work for them I think that you know anything that's right and action I've seen this in actually

no so many ways one of the best examples you know I'm a big fan of this is a program in Kalimantan not far from Malaysia in Indonesia where as three you know one of the organizations that came out of health in harmony you know there's a lot of deforestation in Kalimantan and what they did was spoke to the community to say why are you cutting down these streets and they said well

“because we kind of thought health care and you know that's how we get our income so what they did”

was you know basically put down your machetes we'll provide you health care in return we'll train

you on alternative livelihoods on organic farming and so forth you can pay by bringing a seat links you can bring manure and so forth you know and what happens is the windwind situation communities got healthier their health co-benefits their environmental co-benefits trees grow back

Thailand which is a catchman area for water and deforestation was going on and a private bank right

“agricultural bank came in and said okay let's look at how we might prevent deforestation and”

got them to plant medicinal herbs for example right so they got alternative source of livelihood they got better access to health care with more income and they protected the water shed so communities will know what they need they can adapt they can tell us and teach us that there can be very low cost approaches to finding health solutions that have both economic and planetary benefits and likewise environmental solutions that will have health co-benefits is it just the community here

that we need to take action I mean what sort of responsibility do for instance these big climate conferences have or governments where do they fit into that picture and supporting communities

“but they will presumably have a much bigger world than that I think we need both right”

global meetings are very difficult to navigate particularly in the current geopolitical climate but I think the more local we get not just in terms of communities but also cities may as local leadership regional leadership we've seen may as stepping up making sure that urban heat islands are addressed cities are cool down better facilities are there to prevent

you know emissions so I think everyone needs to pay a price as I always say you know the research

the evidence is clear the thing that I always say is that we have to work at the speed of science and not the pace of politics it's easier said than done absolutely absolutely but you know we need political will ultimately the elephant in the room is how do we get leadership today to wake up to realize the planet will survive we won't we're on a trajectory which is going to be extremely dangerous for humanity we have time to reverse it if we make the right decisions

why do you think there is this lack of political will that gemelists are scraping on

“yeah I think fundamentally it's the narrative around climate because there is the narrative around”

climate doomism which leads to loss of agency and especially in many with the young people that I work with they feel a lot of burnout and they feel well what we're doing is it going to make a difference

I think the second thing is also the complexity of climate science and this is why we need to be

able to translate the complex numbers and targets and temperature increases into human stories and and bringing in why we need to act on climate doctor omniel on runny and doctor jameela let me thank you so much for joining us on the climate question this week thank you so much it's been great thank you so much for having us the production team this week where producers day on Richardson and Jordan Dumbar the editor was Simon Watts and the sound engineers were Philip Bull and Tom Brignore

send us your climate questions for a future show no quandary too big or too small the email is the climate question at bbc.com I've been Greg Jackson and we'll see you next time bye bye if you're struggling to keep up with all the latest innovations in tech and what they'll mean for your life tech has you covered get ahead of the curve with digestible downloads on some of the biggest ideas in technology from AI and virtual reality to clean tech fine tech wherever you get your podcasts