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Calling on clinicians to take up the climate challenge

Climate change was a notable omission from Tuesday night’s Federal Budget, yet it is central to our future wellbeing and health.

If the government isn’t willing to put it on the agenda, it is up to doctors to advocate, educate and take action – from mundane daily tasks such as recycling through to lobbying the nation’s politicians – according to Alice McGushin from Doctors for the Environment Australia.

McGushin ran a workshop for doctors at the recent WONCA World Rural Health Conference in Cairns on climate change and health, where participants brainstormed the many and varied ways they could walk the talk on conservation and global warming.

She’s provided this excellent summary of the workshop, which culminated in the Cairns Action Statement on Climate Change and Environmental Health (soon to be made available on the WONCA website so stay tuned).


Alice McGushin writes:

The health impacts of climate change have particular significance for rural and remote communities.

This can be because these communities’ livelihoods often depend on their natural environment and reliable weather patterns; their risks of rising sea levels and extreme weather events; and their diminished access to health services in rural settings.

In Australia, the mental health impacts of drought and extreme weather events in Australia’s farming communities have been well documented.

The organisers of the 14th World Rural Health Conference in Cairns (the World Organization of Family Doctors, WONCA) from the 29th of April to the 2nd of May recognised the unique impacts of climate change on rural communities, and environmental issues were a prominent feature of the program.

Professor Alistair Woodward outlined the health impacts of climate change and the health benefits that can be gained by well thought-out policies designed to tackle climate change.

Dr Tim Senior identified how we could utilise the specific skills we learn as GPs and rural doctors to become climate advocates and communicators. Professor Barb Doty presented on an Environmental and Population Health Fellowship she has been developing for GPs in Alaska.

As the representative from the WONCA Working Party on the Environment, I was invited to present a Workshop entitled “Climate Change and Rural Health: Impacts, Opportunities and Action”.

A prescription for action

I began this workshop by briefly reviewing the science of climate change; where we are now in terms of atmospheric CO2 and temperature change; what is required to limit global warming in line with the Paris Agreement and what is left in our carbon budget.

We then discussed the health impacts of climate change and the health opportunities presented by policies to take action on climate change.

As a resident, only in my second year from graduation, I felt intimidated to run a workshop for rural doctors, some of whom have been working for longer than I have been alive. These doctors shared their experiences of the impacts climate change had made on their own communities.

My main objective for this workshop was for participants to leave the room with formulated ideas and commitments to take stronger action on climate change.

Participants worked in groups to come up with ideas on what they could do, as individuals, small networks, the medical profession and as the wider community at the local, national and global scale.

Participants plotted their ideas on a diagram with “least effort” to “most effort” on the x axis and “local” to “global” on the y axis. This helped participants identify simple things they could change in their own behaviour and then expand beyond that to a much wider scale, with actions that are beyond the capability of medical professionals alone.

The geographic and generational diversity within the workshop was invaluable, and participants came up with a wide range of ideas on what they could achieve.

From local to global

Simple, low effort individual actions participants identified included home recycling, taking active transport, eating less meat, growing vegetables, sustainable shopping, writing to politicians, visiting politicians, installing personal solar panels and joining Doctors for the Environment Australia.

Participants also identified that medical educators and the medical profession could take leadership by including climate change in medical curricula, online training and medical conferences on environmental health.

At the health clinic/hospital/system level, actions included improving telehealth services, improving the carbon footprint of clinics, hospitals and health systems and educating clinicians on thoughtful decision making regarding patient care.

Actions that could be made at the community level at a local, national and global scale included community gardens, improving cycling and public transport infrastructure, including climate change in school curricula, putting a price on pollution, reducing national meat consumption and using sustainable timber.

Participants’ ideas extended beyond the capability of the medical profession to include having accountable governments, changing our economic system, ending corruption, and having a persuasive (perhaps forceful) influence on President Trump.

(Note: the WONCA Working Party on the Environment and WONCA Rural do not endorse kidnapping certain world leaders).

Each group presented their ideas to the rest of the workshop and I collated all the groups’ ideas onto one diagram below.

WRHC workshop diagram

The Cairns statement: a call to arms

Using the ideas and discussions taken from the workshop as a foundation, Professor Barb Doty and I worked on creating the “Cairns Action Statement on Climate Change and Environmental Health”, which was presented at the closing ceremony of the World Rural Health Conference.

In this statement, we challenged General Practice and Family Medicine members of the world to consider the environmental impact of their own activities and practice, to remain educated and educate their peers, and to take leadership in action on climate change.

We challenged those in medical education to include climate change and health in medical curricula and we challenged hospitals and health systems, pharmaceutical and other medical goods industries to take action to reduce their carbon footprints.

Finally, we challenged the government decision makers of the world to work together to achieve the commitments outlined in the Paris Agreement and to adopt policies to invest in renewable energy, active transport, sustainable agriculture, as well as considering a moratorium on new damaging power plants, including coal and nuclear.

This statement was accepted by the conference organisers and has gone to the WONCA Executive for final approval before it will be made publicly available on the WONCA website.

We hope that those who participated in my workshop and attended the other climate change and health plenaries and workshops are inspired to take further action and leadership.

We hope that those who we identify in our Action Statement take on our challenges to address the health impacts of climate change from the level of individual practice, to the global scale.

Dr Alice McGushin is a resident medical officer, currently working in paediatrics in Kalgoorlie, Western Australia, and a member of the National Management Committee for Doctors for the Environment Australia (DEA) as well as the Asia-Pacific Chair for the World Organization of Family Doctors (WONCA) Working Party on the Environment.

Alice completed an internship with the World Health Organization Climate Change team in Geneva and she will be starting a Master of Public Health in the Environment and Health stream at the London School of Hygiene and Tropical Medicine in September 2017. 

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