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A Croakey #longread: remembering those we’ve lost – and a call to action for planetary health

This week marks the first anniversary of the traumatic loss of Professor Gavin Mooney and his partner Dr Delys Weston.

The lengthy article below captures some of the themes from a recent conference that honoured their work and their activism for a fairer, more sustainable world.

It includes a remarkable cri de coeur from Siobhan Harpur, Director of Population Health Operations for the Tasmanian Department of Health and Human Services.

She urges us to seize our “individual and collective responsibility to make a difference”. Reading her speech is a good place to start.

***

“We need new ways…”

At a recent forum in Hobart, leading public health experts painted a grim picture of the state of planetary health, warning of eco-collapse and growing inequalities.

Associate Professor Peter Sainsbury, of the University of Sydney, told the forum that humanity is in “a mess of our own making”, which threatens the future of our species.

“I’m very pessimistic there will be anything more than very rudimentary human life on this planet in 200 years time,” he said.

Sainsbury said that this mess of “unprecedented proportions” had arisen because humanity had ignored that we’re part of part of complex, adaptive ecosystems and that we live in a world of finite resources, and because we had failed to learn from what science tells us.

“This emphasis on ‘me’, here and now, this disregard for people elsewhere and future generations – this is a failure of morality,” he said. “This is clearly manifest by the inability of western democratic governments to see a way through.

“We need new ways of collective decision-making that are responsive, inclusive, and that include minorities, not just the majorities, and that create maximum harmony.”

Associate Professor Marilyn Wise, from the University of NSW, stressed the importance of ensuring that those groups who traditionally missed out were represented in decision-making within institutions, organisations and governments.

“We need to share power, create spaces, conversations, examine our own institutions and look at how they are perpetuating old ways of thinking,” she said. “We always need to ask who’s in the room when decisions are being made.”

The forum, “Our health – who decides”, was convened by Tasmania’s Social Determinants of Health Advocacy Network to honour the memories of the late Professor Gavin Mooney (a prolific Croakey contributor), his partner Dr Del Weston, and also Ms Linda Jamieson, an advocate for the rights of older Tasmanians.

There were few dry eyes as we heard courageous presentations from Weston’s children – lawyer Katherine Weston and community development student Alex Soares.

Their talks, which cannot be reported, were a powerful reminder of the toll that mental illness and unresponsive services take upon families and communities.

The forum also heard a strong presentation on the economic and political drivers of health inequities from Professor Sharon Friel, Professor of Health Equity at the ANU (the image behind her in the photograph below is from the album Unity Creates Strength.)

Like Mooney, Friel grew up in Glasgow, and shared his outrage at the “completely avoidable injustices” that continue to occur in that city (as shown in variations in life expectancy between rich and poor areas) and elsewhere in the world.

She described the “structural pathologies” that contribute to health inequities by shaping peoples’ everyday living conditions, including access to a healthy food supply.

The major drivers of an unhealthy food supply are unfettered liberalisation of international food trade, increased foreign direct investment, and globalised advertising and marketing, she said.

Friel added that Coca Cola is more easily available than water in some countries in Africa, and that for low and middle income countries, having a Free Trade Agreement with the US was associated with increased soft drink consumption.

Friel also described how the Trans Pacific Partnership trade and investment agreement that is currently under negotiation may limit governments’ ability to regulate industries that manufacture and market products that are potentially harmful to health – such as the tobacco, alcohol and processed food industries.

Friel (pictured to the left with CEO of the Heart Foundation in Tasmania, Graeme Lynch): said:

“Governments need to be able to raise the prices of unhealthy goods, to restrict marketing and advertising, sale and distribution, and to regulate labelling of these products.

“We want to, for example, retain the ability to put warnings on alcohol products, or to introduce new rules around nutrition labelling for food.

“But many parts of the TPP could allow the private sector to meddle in government policy, and restrict the flexibility – or policy space – for governments to be able to set and implement these important public health policies.”

Friel said Mooney wrote about how to create just, fair and compassionate institutions in the face of neoliberalism and injustices in the distribution of money, resources, and power.

“He writes about reclaiming power,” said Friel. “We need to celebrate the fact that it can be done.”

Indeed, the two-day event was marked by duelling themes of light and dark – and of people power mustering against unjust institutions and political systems.

One of the conference organisers, Miriam Herzfeld, noted that while the gathering had arisen out of sadness at the traumatic loss of friends, it was also about looking to a future filled with activism and a commitment to tackling the big and difficult issues.

This dualism was powerfully captured in a very personal speech from one of the forum’s organisers, Siobhan Harpur, Director of Population Health Operations for the Tasmanian Department of Health and Human Services, reproduced below.

***

In this sometimes dark world….what is the inspiration that we can find for a brighter future?

By Siobhan Harpur

I will share with you some my own personal reflections – some of them are dark observations that sit beside the hope that I have for a brighter future.

What right do we have to ownership of the earth and its resources? The earth’s resources, economic, social, the land itself – the split between ourselves and people who are much poorer than ourselves, the split between ourselves and those of future generations who may not have what we have because we have used so much of the collective entitlement up.

This observation is true for our care of the earth itself, and it is also a reflection of our relationship to money and to power; to democracy and the fundamentals of civil society.

We have been captured by individualism.  We have been captivated by the comforts, the conveniences and opportunities that the system has offered. We have had too much to lose, and we have refused to see.

The extraordinary success of the system for so many of us individually has blinded us to its failure to care for the whole. I have been told that I am too unrealistic in my expectations, too much of a purist. It is impractical, they say, to expect too much of large organisations and contemporary society.

I challenge this limiting view and say that we can tread gently, treat people kindly and live simply.  And I know that I am not alone.

We are the stewards and the custodians  – the temporary beneficiaries of this land we stand on and the life we have been given – our responsibility is to work with it, to do our very best to pass it on in an improved condition to our future generations.  To put it simply we should take responsibility for “paying it forward”.

If our values are not fundamental to the way we see society more broadly, then how can we expect to see them in our organisations?

I invite you to come with me.  I stand here today because I am challenging myself to personally to share my truth. I look to that of good in everyone, and an interconnectedness that surpasses people and extends to all living things.  I am challenged by this personally, professionally and spiritually.

These are not new thoughts. When I was at primary school my friend Billy and I used to talk about running away to visit the zoo.  I knew there were separate rules for those of us who lived at the top of the hill, and my friend Billy lived at the bottom, so I took the initiative and stole two bicycles in order for us to get there faster.

The result – without sharing all of the adventure that ended with us being brought back by the police – was that the headmaster spoke to me about responsibility and modifying my behaviour, and Billy got the cane in front of the rest of the school the following morning.

In the last 50 years we have lived through a period of extraordinary growth built on debt, and which has given free market globalisation its veneer of success. I was fascinated by the loss of the gold standard when I was at school and its implications.

And now, money, and even gold itself, has become its own commodity, trading in currency fuelled by speculation and no longer linked to goods and services, which are themselves fuelled by a rampant consumerism that more and new is always better than making do with what we have.

Poverty kills people and here and now thousands of people are dying prematurely or unnecessarily. There are 97,000 people living in poverty in Tasmania, which is one fifth of our population.

I am shocked that the difference in life span in Australia today is predicted at birth to be as much as 15 years shorter for an Indigenous or Aboriginal person, and 10 years between the wealthiest and the least wealthy in society generally. So many people in generational difficulty.

It is by leaning into this pain and suffering that I can foster my own compassion.

What is it that I am responsible for, and what am I complicit in not challenging?

When I ask the question who makes the decisions about my health, I am reminded that international corporations are influential, and outside of my control, or even the control of the State or National Governments.

Picture, for example, the action by Coca Cola Amatil in the Tiwi Islands. (Coca Cola itself was started by the company British American Tobacco – but that’s an older story).  The Islanders were supported in their campaign to ban the sales of Coca Cola in their general stores, and then shocked when Coca Cola Amatil negotiated directly with individual citizens to install vending machines on peoples’ decks.

That population with its high incidence of type 2 diabetes, was making a stand to invest in preventable action, and it was thwarted with the action of a powerful multi national. Big pharma, big food, big banks – they are here and now and we can acknowledge the facts – whatever my level of education and income, where I live will impact on my health because I may not have the access to making healthy choices in what I eat, how I live, or whether my children can play safely.

In Tasmania we know that there are many food “deserts” – identifiable places where there is little or no access to fresh fruit or vegetables for sale within a reasonable distance from your home. But most places have access to a takeaway with a deep fryer, and the answers are not simply giving people fresh food.

Just like by friend Billy who didn’t choose to live at the bottom of the hill.

The world is more complex and we appreciate that there are many more competing forces, and everything happens instantly, especially globally.

But we can’t keep hoping for a gold class standard public system without paying more than the equivalent value of a 20 year old Holden for it.  But we can look together at what we have, and consider how we can use this precious investment wisely and effectively so that it can be much better. Especially how it can be more equitable.

If I squeeze my values into a very narrow area of spirituality that doesn’t deal with public life, I am denying the very opportunity of life itself.  Living life honestly, with integrity, questioning and reflecting on our actions, speaking truth to power.

Like many of you at this Conference, my faith and confidence were shattered on the 19th of December 2012 when Gavin Mooney and Del Watson so tragically died at Mountain River.

I would describe myself as a reluctant leader, increasingly coming to terms with this perhaps being my leading, and confirmed very deeply in the brief friendship that we made as a family with Gavin and Del during the 18 months they were here.

Gavin encouraged me to feel proud to be in public service, reminding me often that it is a most important job.

I have been thinking about how I can be more effective and influence what is possible as I find myself meeting head on all of the challenges of living in this complex world.  I know that by challenging ourselves in the decisions and choices that we make every day, and throughout each day is not only more meaningful and rewarding, it also offers the real and tangible opportunity for a brighter future for all Tasmanians.

What is that you will bring of yourself, what is your commitment?

There is three times as much mental distress experienced by people who have less power in their own lives.  And it isn’t just about income, it is about equity.

The person with an intellectual disability or impairment whose behaviour brings them into the criminal justice system. Someone with a mental illness who ends up homeless and struggles to settle in accommodation of any sort long term. Or another person with the experience of trauma or abuse who has turned to alcohol or drugs as a coping mechanism.

Any or all of these people may need help to find work and support for themselves and their families. We have both an individual and a collective responsibility to make a difference.  I have a passion for creative innovation and bringing out the very best in people and in my job as a Director in Population Health inside Government I am committed to improving the health, social and economic outcomes for people and communities.

One of the theoretical arguments for change is that there needs to be a burning platform before people will want something different enough to jump from what they are used to, to an unknown future. Isn’t that the very basis of trust and belief?

All systems can change and are transient.  Everything has its time. And the time for action is now. The social and economic consequences of doing nothing to challenge and to question are huge – increased suicide, people in prison, obesity, homelessness, risky use and violence as a result of drugs and alcohol, crime, low literacy. We are paying this price now, and we should not be silent about it.

The biggest difference that we can make is to provide meaningful work for all. Fulfilment and self worth have an economic and social consequence that has a health outcome. Putting values into action is not a unique conversation in community sector organisations or the public service.  There are increasingly enlightening board rooms as executive and non executive directors realise that the focus on risk reduction and financial return is not enough to truly succeed in business and create wealth overall.

We can do so much here in Tasmania, and we have the advantage of our size and agility, and all of our relationships. We can re build trust in business by enabling small and new enterprises to grow, especially worker owned, cooperatives, partnerships, social enterprises, business that is creating wealth and is founded on values of integrity, fairness and exchange.

Change starts with me. I am both incredibly important, at the same time as being of absolutely no consequence at all.

What I realise, and what I endeavour to make sense of every day in my work, and in my encounters with people, is that every encounter matters. Where people feel humiliated, afraid, ashamed, and unwanted – these experiences are passed on through other encounters.

Where people experience respect and acknowledgement, this too holds the possibility for change. And big changes happen because of the actions of individuals.

There is an urgent argument for all of us individually and within our families, our neighbourhoods, our workplaces, work teams, organisations, businesses, schools and communities – to invest our time and effort for a brighter future.  We can claim health as a resource for