By Michelle Read
Writer
Humanity is feeling the devastating health effects of a planet on its knees from climate change.
With the health care industry estimated to cause between one and five percent of total global environmental impacts, the Faculty of Medicine is stepping up as a leader in planetary stewardship to protect the health of populations—setting a precedent for medical schools in Canada.
“Our ailing planet is leading to sicker people,” says Dr. Mark Walker, interim vice-dean of internationalization and global health (IGHO) at the Faculty. “The Earth is essentially a patient that we need to treat if we are to protect the health of our populations.”
The health effects of a crisis
A glance at any newscast reveals the myriad health problems brought on by a stressed planet. Global warming is flooding coasts, causing mass human migration and resulting fragility. Heat waves precipitate droughts, affecting agriculture and thus food security.
Pollution triggers asthma, myocardial infarctions, pre-term births, lower sperm counts and other deleterious effects, says Dr. Walker, and the distribution of insects is altered by climate change, influencing the transmission of vector-borne diseases.
“Even the recent power outages from snowstorms in Texas saw deaths due to lack of infrastructure,” says Dr. Walker, an epidemiologist, obstetrician-gynecologist, professor at the Faculty, and senior scientist with the Ottawa Hospital Research Institute. “These burdens on humans are causing great damage to physical and psychological health.”
Although meant to cure the sick, in a roundabout way health care is also contributing to sickness. For example, Dr. Walker acknowledges hospitals as big users and wasters of paper, plastic and power, and thus contributors to carbon emissions.
The synergy of medicine and public health
In 2020, the Faculty unveiled its five-year strategic plan, Leading Innovation for a Healthier World, reiterating its commitment to embracing economic, social and environmental sustainability. Emerging as a priority, planetary health brings together considerations of global health and social accountability, with the respective Faculty offices implicated in the mandate.
Dr. Manisha Kulkarni is interim director of IGHO’s Global Health Program, as well as an associate professor and researcher at the Faculty’s School of Epidemiology and Public Health (SEPH). SEPH has incorporated education and research on climate change and planetary health into its global health curriculum since 2016.
“Planetary health goes beyond climate change to encompass other disruptions to the ecosystems on which our societies depend,” says Dr. Kulkarni. “It considers a wide range of global changes that lead to ill health, including the spillover of zoonotic diseases like COVID-19.
“It’s really an issue of health equity, since the health impacts of climate and environmental changes are being disproportionately felt by populations that least contributed to the problem,” she continues. “Addressing the health impacts associated with climate and environmental changes necessitates the synergy of medicine and public health.”
Planetary health also weaves in considerations of social accountability, such as local advocacy that can be done on our own doorsteps. The Faculty will examine options for “going green” in its clinical and basic science departments and laboratories, such as reducing paper, plastic, laundered garments, batteries and other materials, as well as finding alternative anesthetic gases to reduce volatile compounds. A PPE recycling program launched in March.
Rallying the troops for climate change
Infrastructure efficiencies are also critical to incorporate, such as heat pumps, geothermal systems and smart systems for controlling lights, temperatures and HVAC. “I estimate we could find 20% in infrastructure efficiencies by studying our facilities,” says Dr. Walker.
But a University’s partner hospitals and research institutes are massive facilities; moving this Titanic will require a coordinated effort.
“At the Faculty, there are a lot of sparks but no fire; appointing a point person will create that fire,” says Dr. Walker. “No medical school in Canada has a planetary health lead—everybody is talking about it, but no one is leading it.”
The Faculty’s vision for planetary health includes the creation of a leadership position to usher in initiatives and best practices across the Faculty. Priorities include decreasing the footprint of the Faculty and its partners, performing scholarship on the effects of climate change on human health, and building knowledge gained into the educational curriculum.
“We have an opportunity to go beyond the climate and health education that we currently offer to our students to broaden awareness across the Faculty, and to really take actionable measures,” says Dr. Kulkarni.
Leading the initiative requires consolidating the desires of many stakeholders, says Dr. Claire Kendall, associate dean of social accountability at the Faculty as well as an associate professor of family medicine practicing out of Bruyère Continuing Care.
“There is great enthusiasm to address planetary health, and our students are rightfully holding us accountable,” says Dr. Kendall. “Securing a planetary health lead is our first step in harnessing our activities in education, research and partnerships to honour our commitment to this mandate.”
Change management requires involvement of a leader at institutional discussion tables, bringing the topic of reducing one’s carbon footprint into every discussion. “Factoring efficiencies into new facilities will have costs now, but will pay off later,” says Dr. Walker.
Influence beyond the Faculty
Organizing infrastructure will mean opportunities to collaborate with uOttawa central, the city of Ottawa and the Canadian government, as well as opportunities to attract donations and lead programs for the government. Dr. Walker also points to physicians and professors as respected members of the community able to influence government, the public and society at large, and to join relevant councils and seek opportunities to educate.
“We’re also hoping to have a domino effect, influencing other medical schools to follow suit,” he says.
The Earth’s looming climate crisis will have a much bigger impact than even the current COVID-19 pandemic, warns Dr. Walker—the effects are here, and we must move quickly.
It’s time to get this patient to the ICU, stat.
Update September 2021:
The Faculty of Medicine recently appointed Dr. Husein Moloo as Director of Planetary Health; such a new position and portfolio is a first nationwide. This new appointment is part of the Faculty’s contribution to the University’s Transformation 2030 pledge to promote use of greener practices and activities on campus, and beyond. Dr. Moloo's appointment comes at a time when the climate crisis has been declared a public health emergency of unprecedented proportions by the World Health Organization.
