As the dust settles on the COP26 conference in Glasgow, health professionals are finally feeling acknowledged by the global climate community, according to a report in The Washington Post exploring the health sector’s unprecedented presence at this latest COP (even though Australia’s health ministers and departments missed the memo).
Associate Professor Zerina Tomkins, who attended COP26 virtually as a member of an interdisciplinary delegation from Monash University, writes below that empowering nurses and midwives is critical for climate action.
She also highlights the importance of addressing the impacts of the climate crisis on the health workforce, and calls for “radical, bold and brave approaches equipping individuals to make choices and create innovations that collectively add to better outcomes for the planet”.
Zerina Tomkins writes:
During COP26, nearly 46 million health workers from around the world called on world leaders to act to protect people’s health from extreme climate-related events and to commit to keeping global temperature rises below 1.5°C (see more on this from The Global Climate and Health Alliance).
I am one of them.
Yet, despite this unified, inspiring call, hope quickly fades when your country gets a “Colossal Fossil” award at the United Nations Climate Summit, openly sports sponsorship by a fossil fuel company, attends COP26 with nothing to offer and does not sign an agreement to reduce methane or put health ahead of fossil fuels companies.
At the same time, Tuvalu Finance Minister Seve Paeniu’s emotional plea with the world for a better future for his people inspires me to continue striving for better.
At COP26, people spoke of existing experiences of climate injustice, loss of livelihoods, safety and starvation. Climate scientists expressed their concerns that catastrophic changes will occur in their lifetime, which brings further despair and sense of urgency.
Hope is further crushed by evidence that the wealthy countries are not doing their fair share to contribute to climate funds desperately needed by the low and low-medium income countries to implement transition to a just, cleaner future and to cover loss and damages arising from climate-driven changes.
Where is common sense?
The hardest of all is to look through the window of my in-laws’ farm house, nested between Cadgee and Eurobodalla on the lands of Bugelli-Manji and Yuin Nation Peoples, and see the devastating impact of the 2019-2020 megafires, knowing that soon there may be another one of those.
The trees here are struggling to recover.
After two years of pandemics and after the 2019-2020 Australian megafires, as a registered nurse, a recent past course coordinator of a nursing degree, a clinical researcher and a human being, I am also tired.
Although I am tired from the pressures of COVID-19 pandemic, I am more tired of people who play with our destinies and those of future generations with little regard for the outcome of their non-evidence-based decisions.
I struggle with knowing that a government would purposely choose interventions that harm the health and wellbeing of its people, ignoring that the climate crisis intertwines the faiths of all living creatures on this planet. I feel guilty when I think that the youth of today and tomorrow, our brightest hope, will be left with so much burden, as if what the youth is facing today is not already enough.
I try to stop myself from thinking that with the climate crisis comes untold suffering for thousands of other species in our ecosystem. If plants and animals had a voice, I wonder what they would say.
Human rights, right to health, First Nations Peoples’ rights, intergenerational justice and equity – these should all be common sense and uniformly supported.
Yet, COP26 has shown that this is not the case. Instead, the negotiations are complex and often undermined by delegations whose agenda is not global health and wellbeing of the ecosystems but vested interests. Despite this, there is no time to feel defeat.
The Global Climate and Health Alliance teams worked tirelessly to advocate to get health in the final text of the COP26 agreement. Thousands of youths took to the streets across the world to demand economic, social, cultural and diversity elements become essential for achieving equity, social justice and dignity for all living creatures.
Speakers at the World Health Organization (WHO) Global Conference on Health and Climate Change held during COP26 asked that we commit to actions to address vulnerabilities, the progress made, and the lessons learnt and how to scale up what really works. Attendees, led by young advocates, demanded to hear more from the First Nations Peoples and to learn more on nature-based solutions.
As a member of the 14-delegate strong Monash University’s COP26 interdisciplinary delegation, I attended COP 26 via their technical platform from Australia. Our delegation included representatives from health, law, education, engineering, environmental science and was comprised of staff and students.
Monash University’s strategic 10-year plan commits the University to address the global challenges of climate change through education, research and in collaboration with community, government and industry (Impact 2030 – Strategic Plan | Monash University).
The COP26 technical platform, hosted by the United Nations Framework Convention on Climate Change (UNFCC) aimed to support virtual participation to plenary meetings, extensive side event program, observation of some negotiations, to explore exhibits but also to foster exchange of ideas.
In reality, as a virtual delegate I could watch all the events on the platform but not speak or post questions, leading to a sense of being invisible and silenced.
There was a notable absence of pavilions for virtual posters and virtual booths to meet old collaborators or form new collaborations. Students did not get an opportunity to show their work or to network. The platform lacked a direct link to pavilions themselves.
Thus, as someone interested in the Health Pavilion, I had to wait for the recording to be posted on the webpage of the World Health Organization. This was a wasted opportunity for greater engagement to foster development of a diverse community of practices and form new solutions for the planet. Nevertheless, I have learned a great deal.
Focus on nurses and midwives
During the WHO Global Conference on Health and Climate Change and presentations at the Health Pavilion, nurses and midwives were singled out on several occasions as the workforce that needs to be empowered more to advocate for health and wellbeing of community in building health resilience to climate change.
As well as accounting for almost 50 percent of the world’s healthcare workforce, another strength is the nature of our relationships with the communities we care for.
Those close, trusting relationships provide us with unique opportunities to help communities learn and understand the impact of climate change on their health, address issues of climate justice and help provide interventions that a person can achieve within their means, ensuring that no person is left behind.
To help with the work of climate mitigation and adaptation, nurses and midwives need interdisciplinary and transdisciplinary education related to climate change across the nursing continuum, starting with nursing students and all the way to nurse practitioners, directors of nursing and chief nursing officers.
Such educational interventions will empower nurses and midwives with critical skills and competencies needed to deliver education to the broader community to help them adapt to climate crisis, to help communities develop health resilience, and to develop surveillance systems to monitor what is happening to our communities in terms of health and wellbeing.
We also need to develop innovative ways of further reducing the environmental footprint that our healthcare systems are creating. Nurses and midwives are not the only profession needing these supports. All healthcare workers will require this type of upskilling.
In addition to implementing changes to our practice to purposefully address the climate crisis in terms of health and wellbeing and educating current and future workforces, we must engage more in climate change research and advocacy.
With respect to research, we need to bravely move away from our usual healthcare interdisciplinary collaborations, moving away from medicine’s dominance and out of our comfort zone towards collaborations with very different disciplines such as urban planners, building industry, engineers, climate change scientists, finance experts and agriculture experts.
Our work in advocacy and policy development needs to be bold and demand better health and wellbeing for our communities as we seek to adapt to the climate crisis.
The Australian College of Nursing (ACN) recently launched its national ‘Nursing Leadership in Emissions Reduction Guiding Principles’, which helps guide these activities.
Furthermore, the ACN has developed a program for registered nurses to participate in the ACN Foundation Policy Fellows Program for those wishing to develop skills in policy development.
As I reflect on the COP26 overall, my hope is that we will move away from familiar, safe approaches of telling people what to do and move to more radical, bold and brave approaches equipping individuals to make choices and create innovations that collectively add to better outcomes for the planet.
I hope that we will actively seek to address the absence of actions that are being undertaken to address vulnerabilities, focus more on the existing progress made in communities most impacted by the climate crisis, the lessons learnt and how we can scale up what really works for communities.
Presenters at COP26 clearly signalled that the climate crisis is a health crisis that without timely interventions may become a global humanitarian crisis. It is worth remembering that Australia already has a shortage of nurses and midwives, and other healthcare workers. This is exacerbated by the exodus of healthcare workers due to the impacts of COVID-19 pandemic.
No amount of importing healthcare professionals from other parts of the world will fix this. If anything, it will cause greater problems for the healthcare systems from where those healthcare workers have been lost. In other words, these types of interventions further undermine those countries and their efforts to adapt to the climate change crisis.
If governments chose to ignore the climate crisis and disregard advice on how to prepare and manage the climate crisis at individual, community and organisational levels, when the extreme natural events start to wreak havoc on the planet, there will not be enough healthcare workers to respond.
We need not wait for the next COP to change direction. Through educating, empowering and purposefully preparing our healthcare workforce and people we serve to face the changes that are coming we stand a chance to do the right thing by this planet.
After all, there is no Planet B.
• Associate Prof Zerina Tomkins is Affiliate Senior Research Fellow, Department of General Medicine, Royal Children’s Hospital Melbourne, and at Monash University
This article is part of the #HealthyCOP26 series, published in partnership with the Climate and Health Alliance