Coal Harms Health: Climate Change and Health, Past, Present and Future

Hello everyone. It’s a great pleasure to be speaking (October 16, 2021) at the 20^th anniversary conference of Doctors for the Environment Australia (DEA); I’d like to thank the organisers and to acknowledge the traditional owners, the Kuarna people. I’d also like to congratulate DEA for no longer being a teenager and for having over 2,500 members. I can recall when there were fewer than ten.

The organisers asked me to prepare no slides but with one exception – I am thus calling my talk “Coal harms health”. This photo was taken near Maules Creek coal mine, in 2014. It’s an export mine; from there coal is taken by train, through the air-polluted Hunter Valley, to the coal dust contaminated city of Newcastle, where I studied medicine. This protest was organised by the Australian Religious Response to Climate Change; my support team were devout – even if they look scruffy.

While waiting to be arrested I was holding this book – the first edition of “Climate Change and Global Health”, which had just been published, and which I edited. 

 

At that time I had also just contributed to the health chapter of the 2014 IPCC report, thus I was the first IPCC health contributor to be arrested for what could be called “climate disobedience”.  I take the issue of climate and health seriously, and I also take seriously the issue of climate justice – the main reason I chose arrest was to protest at the immorality of rich Australia profiting from the export of a substance clearly harmful to health, especially future health. I also lament the decline of ethics in science.

If this was not virtual I would ask for a show of hands: who attended the first iDEA conference, in Melbourne in 2009? I did – in person of course. My talk there focussed on the “tertiary” – or catastrophic - health consequences of climate change, including conflict, war and famine. The first editorial on climate change and health – in The Lancet in 1989 – hinted at these issues. However the topic is still vastly under-recognised, despite the implications of Will (and other’s) work. For me, the risk of runaway climate change (or Hothouse Earth) is terrifying, and trying to prevent that has now motivated me for 3 decades. We are making progress but there is enormous work ahead.

Since the early 90s I have used a three-way categorisation of how climate change will impact human health and well-being. In addition to tertiary effects are what is generally called direct and indirect, or “primary” and “secondary”. I based the first and forthcoming editions of my edited book on these categories.

By “primary” health effects Andy Haines and co-authors meant comparatively obvious things, such as heat stroke. Of course, nothing is simple, but I ask you to consider the field at a time when the existence of anthropogenic climate change was challenged by most, and when, for conservative doctors, links between it (as opposed to climate) and health were considered speculative. Thus tertiary health effects were a largely no go area at that time.

Temperatures in the high 40s in Australian cities were unimagineable when I was at medical school, they now seem almost unremarkable. Extreme heat has adverse effects that are pretty well-known; such as heat strain and heat stroke. Their risk is worsened by high humidity; indeed in some parts of the world, in the near future (without emergency climate action), the combination of heat and humidity will be fatal, even without exercise. Thus some areas of the planet will literally be uninhabitable, at least for some times of the year. Heat strain is an incredibly important issue for occupational health, especially for outdoor workers in already hot places and for emergency workers wearing protective clothing in hot conditions. Heat strain may also have a “long tail” of adverse effects, including on some chronic diseases – especially people with pre-existing cardiovascular disease. What happens to people who are vulnerable but who recover? It seem unlikely that they all return to their previous level of function. I believe this question remains under-explored.

An important co-author of that early work on primary, secondary and tertiary effects was the late Tony McMichael. Tony, with David Shearman, were the true founders of DEA. Both were far ahead of their time; with viewpoints best called “ecological.” Tony’s most influential book, published in 1993, was called “Planetary Overload”. Four years later, David’s book “Green or Gone” was published.

Four years after, DEA was born, and now it is 2021.

Some of you will have heard of the UN Conference on the Human Environment, in Stockholm: 1972. More will have heard of the Rio Earth Summit, 20 years later. The main organiser for these meetings was Maurice Strong; he was also founding director of the UN Environment Programme.

His autobiography, “Where on Earth are We Going?” was published in 2001. It starts with a report to the shareholders, from 2031; a world of profound disorder, massive forest fires, including Siberian, and famines, droughts, floods, conflict, refugees, plague and “Virus X”. Global population is below five billion; it is, today, about eight. These risks arise not only from climate change, but as Kerryn Higgs, a co-editor for the 2^nd edition of Climate Change and Global Health, says, endless growth on a finite planet is a collision course.

 

 

Hopefully Strong’s forecast is too pessimistic. However, global life expectancy has fallen due to the pandemic; hunger has risen, and foodprices are at a 10 year high.

There is risk from exaggeration, but also from under-statement. Pessimism paralyses; understatement generates complacency. I believe it is our duty to sound a warning. Prevention is better than cure. Past civilisations have collapsed; ours could too.

But I will end with hope. Activism lifted Greta Thunberg from depression, and is an important antidote to despair; as is fellowship. Getting arrested – even here – is serious; consequences can be unforeseen. I was unable to attend the inaugural planetary health conference in New York because a timely visa was denied.

Protest is necessary, but not sufficient.

Last month, over 230 medical journals jointly published an editorial (includiung in the Medical Journal of Australia) calling for “emergency action to limit global temperature increase, restore biodiversity, and protect health.”

That is progress. So is the growth of DEA and the involvement of so many medical colleagues and colleges in this struggle, globally. The link between the health of our planet and the health of people is now widely accepted. Tough times are ahead, but together we can make a great difference.

Thank you.  

Is the Pandemic a Warning we are Pushing Nature too Hard?

This is the text of my prepared talk given at the Inaugural Regional Session of UNEP Science Policy Business Forum held in Korea and virtually on October  5, 2021. 

Our session starts at 7 hours 2 minutes (I am responding to the first question); I answer the second question (The Ambitious Actions that Pave the Way) at 8 hours 6 minutes.

I will add some other links later

Thank you for that question and my thanks also to the organisers of this session and to the government of the Republic of South Korea. Good morning and good afternoon to my online colleagues.

You have asked me to comment on whether we are pushing nature too hard and is the pandemic a warning. 

My first comment is that nature is not vindictive, and has no mind of its own. So the question should not be taken literally. However, from our human perspective I think we should definitely treat this pandemic as a profound warning. 

 

I’m not sure how many in the audience are familiar with the United Nations Conference on the Human Environment, held in Stockholm, Sweden in 1972. Probably more of you will have heard of the conference in Rio de Janeiro, Brazil, two decades later, often called the Earth Summit. The first meeting, in 1972, was very important in the foundation of the United Nations Environment Programme, the UNEP, which was founded in the same year.

 

The main organiser for both of these meetings was a Canadian businessman and diplomat called Maurice Strong; he also became the founding director of the UNEP. 

 

Strong’s autobiography “Where on Earth Are We Going?”, published in 2001, starts with a “report to the shareholders”, from 2031. It describes a world of profound disorder, of massive forest fires, including in Siberia, and of famine, drought, floods, refugees and plague. Global population has fallen to fewer than five billion; it is, today, about 8 billion. 

 

2031 is now only nine years away, and it looks as though Strong’s forecast is too pessimistic – but perhaps he would justify that by saying that he was trying to motivate his readers. 

 

There is, however, a risk from exaggeration. I have been unable to discover if Confucianism or other Asian philosophies discuss “crying wolf”, in other words, of warning of something so often, and so prematurely, that the listener becomes jaded, and ignores it – even though the warning is valid and the wolf appears. The story of crying wolf is credited to a Greek slave who lived about 2,500 years ago, but it is likely that Aesop, the slave, collected these fables, rather than wrote them. I think it is ancient story, and I hope its message may be universally understood. 

 

Clearly, human civilisations could not have evolved and flourished without their leaders collectively preparing for risk, whether from winter, food shortage or invasion. The Great Wall of China shows an understanding of risk by many successive Chinese governments. 

 

The manifesto by Bertrand Russell and Albert Einstein, signed in 1955 at the height of the Cold War, also warned that the continued existence of our species is in doubt, due to the threat of nuclear weapons. That risk has not gone away, but it has abated, although it took 30 more years, and a great deal of effort, before that happened. But, just as the risk of nuclear war seemed to be lessening, a book was published called “New World New Mind”. Its authors argued that although humans have evolved to understand some risks, such as from a predatory animal, or winter, our species has not evolved to easily understand the risks that arise from excessive global climate change or from global biodiversity loss.

I think Maurice Strong understood those risks. 

 

Bad as it is, the direct deathtoll from COVID-19 is small compared to annual human population increase. However, the pandemic has had many indirect effects, including a significant increase in global hunger. 

 

Strong, and others of his generation had personally experienced great hardship, wrought by the Great Depression and World War II. I think, for people of that time, the risk of another catastrophe seemed more plausible than to many people now alive, in which many experience abundance and affluence on an once unimaginary scale. That is great progress, but it creates a risk of complacency.

 

When the ocean suddenly retreated around the Andaman Islands in 2004 its Indigenous people did not go out to explore the seabed, as some did elsewhere, but instead they interpreted this sign, as an urgent warning: in that case of the tsunami. As far as is known, they all survived, because they immediately fled to higher ground. 

 

In the Indian city of Surat, in 1994, the rumour of plague caused a great panic, with as many as 100,000 people immediately fleeing. We may be better, collectively, at responding to earthquakes and plague than to climate change and biodiversity loss, the challenge is to see that these issues are connected.

We are pushing nature too hard, we are creating unprecedented risk, and if, as now seems plausible, vaccines and new drugs make COVID-19 manageable, then we should use that breathing space to re-invigorate the global community to prepare and to prevent the many risks from adverse environmental change which too many complacent populations are currently creating. 

 

VII. The Ambitious Actions that Pave the Way (see 8 hours 6 minutes at this link)

 

Maurice Strong, who I mentioned earlier, was also influenced by the book The Limits to Growth also published in 1972. He argued that the task for humanity was “rational global management of the finite resources of the Earth” on behalf of all people.

 

We need to establish international co-operation, different from the slogan of globalization, which relies too much on market forces. The UN system needs to more clearly acknowledge that resources are limited; instead of thinking that economic growth is endless. The UN should champion redistribution, especially of hope and opportunity, as I believe Dag Hammarskjöld, the UN secretary general whose plane mysteriously crashed in 1961 did. We need to recognise and respond to climate change as a genuine emergency. We need more integration of the understandings of the Population Division of UN with its other parts, including to respond to and prevent refugees, and hunger. We also need, collectively, to develop a less exploitative attitude to nature, greater emotional attachment to nature, greater respect for animals (which have consciousness and emotion), more appreciation of the health risks of diets high in meat and better treatment and prevention of parasitic diseases.

 

The generation who were children in 1945 are old today, and even their children are retiring. I think that the inevitable loss of people whose lives were personally transformed by the experience of those crises has created vulnerability, where the idealism, determination, and hope that gave birth to the UN risks being replaced with dogma. I think one example of dogma is excessive belief, even faith, that market forces alone will solve our problems. Another is too much faith in technology, technology is necessary but not sufficient. We have lost idealism; “Health for All by the Year 2000” now seems naïve, but it did not when it was promoted, in the 1970s, a time which Halfdan Mahler then WHO Director General called the “warm decade for social justice”. Although we have the SDGs, they are, in my view, a poor substitute; they are too obviously out of reach and rely too much on market forces. We need idealism, but we need to recognise the reality of limits and to build social mechanisms to attain our targets.

 

**

 

key points

 

Is the Pandemic a Warning we are Pushing Nature too Hard?

 

1.              Nature is not vindictive – however, we should treat the pandemic as a profound warning.

2.              The main individual driving the formation of UNEP and its founding director (Maurice Strong) was, by 2001, deeply concerned that civilisation would collapse, perhaps as soon as 2031.

3.              There is a risk of “crying wolf” – but remember, the wolf did appear.

4.              The UN system was founded and inspired by visionaries who had personally experienced and witnessed great hardship. Their direct influence has passed. “Abundance for many” – since – may inadvertently have created vulnerability.

 

The Ambitious Actions that Pave the Way

 

1.              There are limits to Earth’s abundance; we should not fool ourselves otherwise.

2.              We need genuine co-operation, not slogans of globalisation; market forces are not enough to save civilisation.

3.              We need to develop and practice greater respect for nature; make nature more of a partner than a resource.