Introduction by Croakey: The United States election results will be critical for global climate health, making the upcoming 2024 Greening the Healthcare Sector Forum an extremely timely event.
Hosted by the Climate and Health Alliance (CAHA), the forum will be held 100 per cent online on six days over two weeks from 12-21 November, to make it accessible while keeping its carbon footprint down.
Marie McInerney will report from Greening the Healthcare Sector Forum for the Croakey Conference News Service, and previews some of the discussions below.
Marie McInerney writes:
For proud Yorta Yorta, Wemba Wemba, Dharug woman Nikki Burns, one of the most powerful ways for non-Indigenous clinical health practitioners to “get” Aboriginal and Torres Strait Islander health, wellbeing and knowledge is through cultural immersion on Country.
Burns, who is UnitingCare Queensland’s Reconciliation Action Plan (RAP) Partner for Hospitals, has found that a walk or tour on Country with Traditional Owners or Elders is “the most impactful way of getting across our message of First Nations ways of knowing, doing and being”.
An example is when practitioners visit the Cherbourg Ration Shed Museum in south-east Queensland, which commemorates the pain and trauma of Stolen Generations survivors who endured abuse and neglect at the notorious Cherbourg Dormitories up until the 1970s.
Going there with colleagues from across UnitingCare services, “is very powerful”, Burns says. “And it dispels the myth of ‘it all happened so long ago, get over it’.
“Some of these dormitory children are still alive today. That certainly helps people to ‘get it’,” she said.
Burns will be one of the presenters at this month’s Greening the Healthcare Sector Forum, hosted by the Climate and Health Alliance (CAHA).
The event, taking place on six days over two weeks from 12-21 November, will be run online, to make it as accessible as possible while keeping its own carbon footprint down.
This is something more health and medical conferences should consider, “to ease the impact on the planet”, CAHA CEO Michelle Isles told Croakey.
“Human connection is important but we do not need to meet in person every year.”
Across nine sessions, the forum will feature health sector leaders across Australia and the Pacific who are decarbonising their operations, strengthening climate resilience, and actively working to improve health equity.
Burns will speak in the Caring for Country session on 19 November. Talking about how her work can illuminate efforts to green the healthcare sector, her message is clear:
My work of caring for Country is caring for the holistic health and wellbeing of Aboriginal and Torres Strait Islander peoples.
We ARE Country.
Our practices of connection to place, spirit, culture, kin and Country means that we are strong in who we are. There is no disconnect of us and Country. It’s our spirit and soul.”
See Burns’ full comments ahead of the forum here.
Political stakes
The Greening the Healthcare Sector forum is a timely event.
Last week’s 2024 Lancet Countdown on health and climate change reported that people around the world are facing record-breaking threats to their wellbeing, health, and survival from the rapidly changing climate.
The report was published as Spain grappled with its worst floods in recent memory, resulting in more than 200 people deaths in and around the eastern province of Valencia and sparking urgent calls for food, water and medical supplies.
Yet despite ever more alarming and frequent disasters, the Lancet warned that the focus on health and climate may be declining across key sectors, including in the media and from governments, with significantly fewer mentioning health and climate change in their annual UN General Debate statements.
That could also worsen this week, depending the result of the US presidential election. Former Democrat candidate Senator Bernie Sanders last week warned: “If Trump wins, to be honest with you, the struggle against climate change is over.”
At home, climate policy is once again in a volatile political landscape. Conservative governments have been newly elected in both Queensland – where a pivot is expected from state Labor’s ambitious renewable targets towards “smaller hydro projects and coal continuity” – and in the Northern Territory, where the new CLP Government has been warmly welcomed by the fossil fuels industry.
Meanwhile, with polls suggesting a change of government may come nationally next year, the federal Opposition’s nuclear power-led approach is being described by the Climate Council as “a reckless distraction that will delay real cuts to climate pollution and expose Australians to even more dangerous climate change”.
The Lancet singled out the “powerful and trusted leadership of the health community” as potentially holding the key to reversing disastrous climate trends and to “making people’s wellbeing, health, and survival a central priority of political and financial agendas”.
But it said that many public health professionals – who have a crucial role in developing and implementing health-promoting adaptation and mitigation interventions – are “ill-prepared” because the integration of climate change education and training is largely not mandated in public health curricula.
The Lancet also warns that health systems, particularly those in the wealthier countries like Australia, are increasingly contributing to the problem.
“Greenhouse gas emissions from health care have increased by 36 per cent since 2016, making health systems increasingly unprepared to operate in a net zero emissions future and pushing health care further from its guiding principle of doing no harm”.
The report also highlights the need for Indigenous health systems and medicines to be properly represented in health systems and responses, saying Indigenous knowledge is essential to “avoiding, reducing, and managing climate-related health threats”.
Collective action
Michelle Isles says CAHA has designed the forum to be “really engaging” through keynotes, presentations, discussions, and interactive workshops, plus posters and other information around the theme: ‘Accelerating collective action for sustainable and climate-resilient healthcare’.
With more than 500 health stakeholders expected to attend over the two weeks, it will provide updates on early adopters in greening healthcare spaces, feature international and regional perspectives, and thread First People’s perspectives throughout.
Topics and dates for the nine sessions will be:
- Opening (12 November)
- Changing hearts and minds at every level (12 November)
- Health systems in a warming world: from insights to action (13 November)
- Indigenous regenerative sustainability for climate and health (13 November)
- High-value, low carbon care in action. What is it? How you can get started (14 November)
- Caring for Country (19 November)
- Making the news (with Croakey) (20 November)
- Stories of healthcare resilience in climate impacted communities (20 November)
- Where are they now? Stories of progress from previous presenters at the Greening the Healthcare Sector forum (21 November).
The opening session will feature a panel discussion on national and international perspectives on climate, health and justice.
This will be led by Indigenous nursing and midwifery leader Dr Doseena Fergie OAM, a founding member and Elder of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), Professor Fiona Stanley, a former Australian of the Year, Diana Picon Manyari from the global Health Care Without Harm alliance, and Dr Kate Charlesworth who works in NSW Health as a medical specialist in environmentally sustainable healthcare – the first such role in Australia.
“We’re pretty excited about who’s come on board,” said Isles, speaking to Croakey from Vietnam where she was attending the International Scientific Conference on Climate Change and Health and the 6th Asia-Pacific Green Healthcare System Conference.
Policy matters
The CAHA forum’s opening session will also hear from Ged Kearney, Assistant Minister for Health, Aged Care and Indigenous Health, who is being urged to ensure the National Health and Climate Strategy is fully resourced.
The Strategy has four major objectives:
- to build a climate-resilient health system and enhance its capacity to protect health and wellbeing from the impacts of climate change
- to build a sustainable, high-quality, net zero health system
- to collaborate internationally to build sustainable, climate-resilient health systems and communities
- support healthy, climate-resilient and sustainable communities through whole-of-government action which recognises the relationship between health and climate outcomes.
The Federal Government last week committed $251 million to establish a national Centre for Disease Control (CDC), in response to the report on Australia’s handling of the COVID-19 pandemic, although it won’t be set up until 2026.
CAHA, together with the Public Health Association of Australia, the Royal Australasian College of Physicians, and the Australasian Society for Infectious Diseases, called last month for the Federal Government to “urgently commit funds for a permanent CDC”.
The CDC announcement was “a pleasant surprise”, Isles said. “The certainty about its future is most important. Resourcing will need to build overtime.”
But she said what’s still needed is a clear signal about the National Health Sustainability and Climate Unit and strategy.
“While we all want to see outcomes it is unfair to rely on NGOs, peak bodies and medical colleges to do the heavy lifting on implementation,” she said.
The focus from the health sector also needs to be bigger, she said.
Due to the advocacy of groups like CAHA and other sector leaders who will feature in the program, Isles said Australia has shifted from seeing healthcare sustainability issues as essentially an “engineering” problem to acknowledging the need for holistic climate health action, involving clinicians across the board.
However, despite clear interest and excellent climate heath programs in many areas, she has been to a number of recent Australian health conferences where climate change is “not front and centre”.
Yet, when she raises the issue, “then actually the stories come out, the evidence, the experience”.
Broken Hill has been a dramatic case in point in recent weeks, highlighting the threat to energy reliability and resilience, and therefore to health and healthcare, for Australia as it becomes increasingly vulnerable to storms, fires and other natural disasters.
Proper resources will be “critical to supporting health sector and health systems, who are on the frontline” of climate change, as would beginning to properly account for the health costs of “so-called natural disasters” caused by climate change, Isles said.
“Everyone knows about ambulances ramping,” she said. “We need to be talking about climate change impacts and why there are more emergency responses more often.”
Sustainability mindset
In a changing political landscape, Isles is confident that any government, particularly those “that may have a history in cost cutting in health”, will be interested in addressing the financial, health and environmental cost of providing low value care.
The forum will highlight “huge opportunities” to reduce the 30 percent of care assessed as low value in Australia, presenting compelling case studies and evidence “to show why we should be dual tracking value of care and resource efficiency, which ultimately delivers better health outcomes, but also for the bottom line”, Isles said.
In one session, Maja van Bruggen, Director of Sustainability Action at Northern Territory Health, will describe how to integrate sustainability “into the DNA of health services”.
She told Croakey her main message will be the need to embed a “sustainability mindset” across whole organisations and sectors in order to get the scale and speed of transformation required to reduce emissions and waste.
Some of van Bruggen’s practical tips include:
- building climate literacy at all levels so everyone understands why urgent and collaborative action is required
- progressively aligning and integrating sustainability factors into all aspects of a healthcare organisation, particularly at key decision points (including planning, design, funding, prioritisation, etc)
- targeting all levels in parallel (from individual grassroots efforts, site specific operational changes and strategic/system wide reform)
- supporting the scaling up and ‘norming’ of successful practices, ie working to elevate effective grassroots efforts to operational, organisational wide ‘business as usual’.
“Fortunately environmental sustainability efforts have co-benefits for staff, patients and the budget,” she said.
The forum will also hear updates on efforts to green the healthcare sector in Darwin and Brisbane, through the work of specialist NT emergency physician Dr Mark de Souza and Renae McBrien, the Sustainability Consultant for Children’s Health Queensland. See this earlier article at Croakey about their work.
Lessons from the Pacific
The forum will also coincide with #COP29, the 29th Conference of the Parties to the UN Framework Convention on Climate Change, which will take place in Baku, Azerbaijan, from 11 to 22 November 2024.
Australia’s Climate Change Minister Chris Bowen will be co-leading COP29 negotiations to create a new finance goal to help developing countries fight and limit climate catastrophe — of big interest to Australia’s Pacific and south east Asian neighbours.
Australia will also be hoping to be named there as host, in partnership with Pacific nations, of the COP31 global climate talks in 2026, although Tuvalu recently said recent coal mine expansions undermined Australia’s case to partner with the Pacific.
Pacific island nations delivered a strong message to Australia, Canada and the United Kingdom at the recent Commonwealth Heads of Government Meeting (CHOGM) in Samoa, demanding they commit to phasing out fossil fuel exports.
Tuvalu’s prime minister Feleti Teo told media at CHOGM that the current policies of major polluters including Australia represented a “death sentence” for his country.
A graphic case study of Galoa Island, in southern Fiji, will highlight to the CAHA forum how the climate crisis in the Pacific “has expanded beyond the threats of weather and climate-related events to impact the health and wellbeing of the people directly”.
Dr Esala Vakamacawai, a Fijian physician who is Pacific Health Manager at Pegasus Health Care in Christchurch, and a PhD candidate at the University of Canterbury, told Croakey that Galoa was once dependent solely on the sea and land for its livelihood and sustenance.
Now climate change is affecting its ecosystem and healthy food supply, and increasing the level of obesity and non-communicable diseases (NCD) like diabetes.
Vakamacawai and his co-author Charlie Rasu have reported how rising sea levels and prolonged droughts are adversely affecting villagers’ fresh drinking water supply, forcing them to seek alternative supplies that have proved a major financial burden.
Education at the local school has been significantly disrupted, particularly by king tides. As well, the school ground is pockmarked with deep holes caused by seawater that have become a habitat for land crabs and other crustaceans, “posing a serious health and safety hazard”. The soil in nearby gardens, which previously provided healthy food and vegetables for students and teachers, is now unsuitable for planting.
Vakamacawai warns that the lived experience of Galoa Island is “testament to what can happen if we do not take climate change seriously and find ways to address it”.
And he says, it’s not just an academic exercise for neighbours like Australia, who have for so long failed the Pacific on climate action.
“Whatever is happening on our island will not take too long to start impacting Australia and New Zealand,” he said. “If we can learn from this, then maybe we can prepare for what’s going to come.”
Feature image: UnitingCare Queensland staff at one of the organisation’s Walks on Country with the Jellurgal Aboriginal Cultural Centre on the traditional lands of Kombumerri Aboriginal people, Burleigh Heads, Gold Coast.
Note: A quote in this article that was not intended for publication has been deleted.
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