Thursday, December 21, 2017

Planetary health, civil disobedience and the age of hubris

This is adapted from an article published in Croakey, called A call to civil disobedience as we face a planetary healthemergency .

On December 14, 2017 the University of Sydney launched a new Planetary Health Platform, with high-level support from within the university and from leading figures in global health, notably Drs Helen Clark, until recently head of the UNDP, and Richard Horton, the long-standing editor of the Lancet.

By cosmic coincidence, earlier on the same day, what may turn out to be Australia’s (and even the planet’s) largest-yet, civilly disobedient planetary health protest by health professionals was reaching a crescendo, over 2,000 kilometres to the north, four hours drive inland from Bowen, Queensland.

Fifteen pioneering planetary heath protectors took part: three public health physicians, two other medical doctors (a geriatrician and a GP), two veterinarians, three nurses, four allied medical practitioners and a medical student. Two of the public health physicians were tethered to gates by bicycle locks around their necks and were arrested, along with three nurses, who refused to obey police commands to leave.

This group was protesting a vast proposed coal mine, aimed to take the carbon formed by ancient sunlight from the vast Galilee Basin, home of the Wangan and Jagalingou peoples. The mine, if built, will be operated by Adani, a giant Indian conglomerate that has extensive investments in renewable energy (including in Queensland), and which has been linked with alleged money laundering and other forms of corruption. A huge, though unknown volume of ancient underground water will also to be given to the mine by the people of Australia, some of it to be contaminated.

Four hundred kilometres from the mine, ships are planned to leave from Abbott Point, facing the Great Barrier Reef, itself dying due to global heating, to carry coal away for burning, to provide energy, but to further pollute sky and ocean. To reach port, coal must be transported along a costly, barely started railway line. The protest occurred at the entrance to a camp making a tiny start on the railway, the funding of which has been turned down by a slew of banks (even from China), but not yet by the hapless Australian taxpayer. If the railway is built it will be an investment in futility (a "stranded asset") and a massive opportunity cost.

Civil disobedience and public health

Health workers in Australia and other democracies have an honourable history of engagement in civil disobedience, most famously in the “BUGA-UP” campaign, which saw the creative defacing of numerous pro-tobacco billboards, the existence of which can now barely be imagined in Australia. Some graffiti artists were arrested.

In the early 1980s about 1,500 people were arrested in Australia’s largest campaign of civil disobedience to date, against Tasmania’s proposed Franklin Dam. While some of those arrested were health workers, and the campaign was led by a former GP (Bob Brown), the passion which led so many to risk their career, at that time, was mainly environmental.

In 2004, Dr Peter Pullinger (a dentist), Dr Frank Nicklason (a geriatrician) and a Victorian group called Doctors For Native Forests were three of the parties sued (for damages exceeding $6 million) by the Tasmanian woodchipper Gunns, in a case that came to be known as the "Gunns 20", one of many attempts by corporations to stifle dissent, a classic strategic law suit against public participation, as described by Sharon Beder in her book "Global Spin: The Corporate Assault on Environmentalism".

The anti-nuclear organisation ICAN, awarded the 2017 Nobel Peace Prize, has many of its roots in health, including in Australia, and there is a long and noble tradition of civil disobedience in the name of peace, including by some health professionals who clearly see the health risk of conflict.
However, only a handful of health workers that I know of, perhaps as few as 11, have previously been arrested in Australia as part of civil disobedience campaigns trying to awaken the public, including fellow health professionals, to the profound health dangers from global heating and weather wilding. Several other health professionals, especially nurses, have also been arrested as part of less focussed protests against Australian coal mines.

Until 2017, the largest such group of health workers (at least in Australia) prepared to do this was Medics Against Coal, about a dozen health workers, four of whom were arrested at the Maules Creek coal mine in NSW, in early 2014.

Although that protest entailed considerable effort, this latest protest near Bowen involved far more due its remoteness. The 15 health workers involved travelled over 50,000 kms return.

December 14, 2017: A planetary health landmark

Such intense effort and sacrifice, neither to make money nor to gain power, but to defend a principle, is an important landmark for planetary health, not only in Australia but worldwide. Many readers sympathetic to this blog will have signed petitions, and some will have contacted their local politicians, to try to promote “public goods” for health, such as clean air, clean food, clean water and other aspects related to social justice. Some will have marched, and some may also have risked arrest to protest Australia's flouting of the refugee convention, which it ]signed over six decades ago. But, for very good reasons, not many will have been arrested in the name of public health.

Civilly disobedient Australians will not face the ordeals of the English suffragettes or Chartists. And, on many occasions, Australian police have failed to make arrests concerning climate protection, in order to minimise public attention to the opposition to the issue which former Australian Prime Minister Kevin Rudd correctly identified as the greatest moral issue of our age.

Compare this to suffragettes, some of whom were force-fed through naso-gastric tubes inserted against their will. Leading Chartists at the Newport rising (1839 in Wales) were the last in Britain to be sentenced to the medieval torture of being hanged drawn and quartered, before having their sentence commuted to transportation to colonies such as NSW and Van Diemen’s Land. (Some Chartists were violent in that protest, but many were peaceful. Those who were violent appear to have been provoked, and the facts are contested. I am yet to find out if anyone other than Chartists were killed, given how victors write history, you would think if the rebels, armed mainly with pikes, had killed any of the soldiers then it would have been widely reported.)

Though civilly disobedient health workers have rarely, if ever, been imprisoned in this country (for more than a few hours), this does not mean that Australian authorities are benign.

When I was arrested at the Maules Creek coal mine in late 2014 (as a health worker, but as part of a group organised by the Australian Religious Response to Climate Change), I was charged with damaging mine property, which carries a maximum seven year jail term. On the charge sheet I was advised that I would have to repay the mine at least $40,000, as compensation for the damage I had allegedly caused, by blocking a road for 50 minutes. Thankfully, this threat was revoked.

Part of my charge sheet, given to me during my 2014 arrest

One consequence was that, two months later, I was unable to attend the Lancet Rockefeller Commission Planetary Health Commission meeting in New York City (as the only Australian reviewer) because the US refused to grant a timely visa. When I renewed my medical registration in 2015, a police check was required, and at the time of writing I am seeking another, this time to attempt to visit Canada for a meeting about Limits to Growth and health, relevant to planetary health.

Humility, hubris and the Australian government

In his lecture to the planetary health launch, Horton suggested the world is leaving an “age of hubris” for an “age of humility”. But hubris still characterises most of the Australian political elite, not only with regard to climate change but many other aspects of planetary health.

In 2015 Josh Frydenberg, then Minister for Resources, claimed that Australian coal exports to India were a moral imperative, to help reduce poverty.

But Horton, a cricket fan, had used, in his talk, a slide which showed the vast global burden of particulate air pollution, including in India, some of it from coal. Also this month, a Sri Lankan fast bowler became obviously ill from Delhi’s filthy winter air. Had the match been played in summer, heat exhaustion may have resulted, also in part due to the combustion of coal.

Frydenberg, whose own family was persecuted in Europe, showed in his claim a lamentably primitive understanding of the determinants of poverty and social exclusion in India. India exhibits, in its cities, a profligate waste of human and material resources (including energy), principally by its wealthy class of neo-rajahs (such as Gautam Adani) and its exploding middle class, some of whom are starting to rival Australians as planet wreckers, and whose behaviour, like that of Frydenberg, often reveals contempt for the poor.

Hundreds of millions of Indians are still afflicted by energy poverty. But the solution is not more coal-fired electricity. Frydenberg must be aware of the march of increasingly affordable solar energy in India and elsewhere, starting to enlighten villages and districts, including at a microscale.

Solar panels (and other inventions such as wind-up radios) can brighten and bring information to huts in which some of the most oppressed Indians still endure short lives blighted by coal dust (such as near the mines of Jharkhand) and the emissions of burning cow dung. While a handful of solar panels are, as yet, insufficiently powerful to solve the enormous challenge of providing smoke-free cooking and heating to rural India, Frydenberg’s view that the country’s cumbersome, often-corrupt bureaucracy will provide the infrastructure needed to deliver centralized electrical power to many such places is naïve, in a country in which caste discrimination and acid attacks are still commonplace.

The moral and economic failings of the Adani mine have been frequently highlighted in Australia, not only on the ABC’s Four Corners, but on social media that so many of our elected politicians still ridicule. One misrepresentation of the truth by Adani is particularly brazen and sad, disdainful to workers who crave economic and social security. This is its almost sevenfold exaggeration of the scale of permanent employment, admitted to by one of its own expert witnesses, when under oath. Given the long trajectory of large mines to replace humans with machines and artificial intelligence this overstatement is likely to prove even higher.

Coal combustion, combined with dazzling inventions, lifted hundreds of millions of people from poverty during the Industrial Revolution. Without coal, modern civilisation could not have been created. But today, fossil fuels are the chief poison of the Anthropocene, something China has recognized in its call for an eco-civilisation. In Australia, in the fleeting transition from soot-blackened workers to robots, coal mining briefly provided lucrative and comparatively safe and non-strenuous occupation to a few. This enabled a standard of living and health undreamed of by their mining forebears, who risked silicosis (black lung), and whose cousins in Jharkand and elsewhere still do.

Frydenberg and his advisors must also be aware of the boom in employment, both urban and rural, emerging from the generation of solar and some other forms of comparatively clean power, both in Australia and overseas, including in India. He may even have heard of visionary projects to ship clean power, captured in Australia, to Asia, such as from algal fuels or via lines transmitting clean energy. Were he and his government truly interested in reducing suffering in India, there is much he could do.
When Margaret Thatcher was in power, her government tried to strip tax deductible status from Oxfam, due to the charity’s opposition to apartheid in South Africa. Protests against apartheid protesters in Brisbane, in 1971, led to the declaration of a state of emergency. Opponents of behaviours now widely considered unacceptable were once savagely attacked by government. The removal of the social licenses for slavery, restricted voting and apartheid required courage in the face of indifference. In the future, fossil fuel burning and the other behaviours which erode planetary health will also lose their social license

A Planetary Emergency

We face a planetary emergency. If civilisation survives, it will be because of the courage of the few against the indifference and rapacity of companies like Adani and their political allies, some of whom, like Eddy Obeid, the disgraced NSW politician, are deservedly incarcerated.

Some health workers, who by their calling and training seek to help others, feel a duty of care to contribute to this struggle. The leading US climate scientist James Hansen (himself arrested four times, but not explicitly to protect health) has recently proposed that civil disobedience is not enough, and has instead called for greater legal action.

But neither course is sufficient, and both are necessary. The prominence of the Adani campaign in the recent Queensland election and the retreat of Premier Palaszczuk’s support for it demonstrates that the campaign is having a beneficial effect.

As climate change worsens, the world may see protests to slow its pace that rival or exceed that against the Vietnam War, the height of nuclear brinkmanship and the US-led invasion of Iraq. This movement is likely to evolve as people increasingly understand the enormous risk that climate change and many other forms of ecological destruction entails. 

Opportunity and responsibility

Health workers have a great opportunity and indeed a responsibility to become involved. As Richard Horton said at the launch of the Planetary Health Platform, the notion that the impact of health workers can be measured by grant income and articles in The Lancet does not apply in the age of humility.

And, as Helen Clark observed, in response to a question during the launch at the University of Sydney, protest is permissible in a democracy.

Climate change and other aspects of “planetary overload” constitute a slow motion planetary emergency. The plight of polar bears and Adélie penguins is bad enough, but very few people as yet understand the existential risk we face; our existence as a species is literally threatened. This risk to health is at least an order of magnitude higher than the conditions currently funded by the NHMRC.

It is very easy, using old world thinking (from the age of hubris) to dismiss visionaries such as René Dubos and Tony McMichael as “crying wolf” but we should recall the wolf did arrive.

We can and should use our voice to demand greater understanding of these issues among our peers and leaders at every possible opportunity.

 • Professor Colin Butler is Principal Research Fellow, College of Arts, Humanities & Social Sciences, Flinders University; Campus Visitor, National Centre for Epidemiology and Population Health, Australian National University; and Adjunct Professor, Health Research Institute, University of Canberra. He is also co-founder of the NGO BODHI Australia, which has supported development projects, particularly in India, since 1989.