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pharmacy
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surgery
swine flu
telehealth
tests
TGA
trauma
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Acknowledgement
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social and emotional wellbeing
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consumer health matters
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What can we learn from one community’s efforts to address #HeatwaveHealth?

As much of Australia swelters in record-breaking heat, a #CroakeyGO at Sunshine in Melbourne’s western suburbs has showcased how one local community is responding to the serious health risks of heatwaves.

The walking journalism event enabled participants to share ideas, amongst the group and more widely, with both of the event’s hashtags trending nationally on Twitter – #HeatwaveHealth and #CroakeyGO.

See this vibrant photo gallery from the walk, a comprehensive, 60-page Twitter summary, and this playlist of 17 videos. We encourage readers to continue using the hashtag #HeatwaveHealth to share relevant news and resources.

The event was sponsored by community health service provider, IPC Health, with funding from the Lord Mayor’s Charitable Foundation.


Amy Coopes writes:

In the absence of federal action on the climate crisis as Australia swelters through an unprecedented summer of bushfires and heat, local communities are stepping up to the challenge with powerful advocacy and place-based solutions.

This was the striking message of last week’s #CroakeyGO in western Melbourne’s Sunshine, an act of walking journalism that profiled both the scale and urgency of the climate change effects now engulfing Australia, and the importance of connection, collaboration and local action in confronting the crisis.

As Sydney choked on hazardous smoke pollution and Liberal MPs, including federal Environment Minister Sussan Ley, broke ranks to draw a link between climate change and the megafires smouldering across the East Coast, a #CroakeyGO showcased some of the work already underway at a local level to prepare communities around #HeatwaveHealth.

It also highlighted a clear social gradient to the climate crisis, with events such as heatwaves disproportionately affecting the most disadvantaged and vulnerable, underscoring the need for equity to be front and centre of mitigation and adaptation efforts.

The #HeatwaveHealth #CroakeyGO profiled IPC Health’s Keep Cool in Summer campaign and the Lord Mayor’s Charitable Foundation’s Hot Spots project. It took place on the lands of the Kurung-Jang-Balluk and Marin-Balluk clans of the Woi Wurrung and Wurundjeri people of the Kulin Nation.

Calls for action

The event coincided with the passage of Brimbank City Council’s draft Climate Emergency plan, which is open for public comment until February 26, and features some powerful calls to action for the Victorian Government to:

  • Immediately declare a climate emergency
  • Commit to a 100% renewable energy target by 2030
  • Implement a price on carbon, preferably the Australian Carbon Dividend Plan, as soon as possible but no later than 2022.

The plan, which also commits the council to a series of actions including zero net emissions, is the result of a community petition in Brimbank, which is one of metropolitan Melbourne’s hottest, driest municipalities and the city’s second-most socioeconomically disadvantaged (third-most across all of Victoria).

It is one of Melbourne’s most populous regions, and one of the most culturally and linguistically diverse in Australia, with half of all residents born overseas and 160 languages spoken in the municipality. (You can explore the community in more detail here).

Sunshine recently made headlines after two doctors were attacked leaving work at the local hospital, and the region has been caught in the crossfire of Federal Government rhetoric about ‘African gangs’ terrorising Melbourne.

Sunshine has a rich industrial history: the 1907 Harvester Case that established Australia’s minimum wage was centred on the Sunshine Harvester factory, and the suburb was also home to a major munitions production line in World War Two. The iconic harvesters hang in a number of public spaces in Sunshine.

It is now a bustling melting-pot of cultures, churches (seven in 10 residents report having a religion) and commerce, with laneways and public spaces plastered with public art: murals, mosaics, collage.

A mammoth bronze sculpture, ‘Man Lifting Cow’, has pride of place on Sunshine’s main street, gifted by artist John Kelly who grew up locally and has gone on to international renown with his epic bovine tributes to William Dobell.

Lived experience

#HeatwaveHealth’s first stop was the Sunshine rail and bus interchange, where Biripi woman and academic, Dr Tess Ryan, shared her lived experience of chronic illness and how it intersects with extreme weather events.

Though it was uncharacteristically cold for a summer’s morning, little more than 15 degrees under overcast skies, the mercury had crept close to 40 degrees just two days before the #CroakeyGO in Melbourne’s west.

In such heat, Ryan said her type 1 diabetes became more difficult to manage, affecting the body’s regulatory hormones, absorption and stability of her insulin, and her thermostat. It also posed a risk to her kidneys which, pre-renal disease, required adequate hydration.

Ryan told #CroakeyGo walkers:

“On hot days like the day we had on Monday, I just stay inside.

I’m lucky enough that I can stay inside in a house that has really effective ventilation, I can afford to have the air conditioning on… but that wasn’t always the case.

As a student I was on a part-disability payment, living in public housing. Going out on a day like Monday was a difficult thing for me to do.”

Dr Tess Ryan

Presentations surge

Fida Masri, senior team leader at Melton for Ambulance Victoria, said heat stress was one of the leading causes of death from natural disasters in Australia. Unlike more acute natural disasters, heatwaves were not taken seriously by communities, with an “insidious” course that took time to manifest.

“On the first day, people are relatively well prepared; they put the air conditioning on and they stay indoors… it’s generally the second and third day of a heatwave that we find a spike in our demand for our services,” said Masri.

Ambulance Victoria typically saw a surge in presentations from the very young and very old during such periods, she said, as well as from people with chronic disease or poorly managed conditions, including mental illness, she said. Disadvantage also played a significant role, Masri said.

“That’s one of the issues that we are finding, our elderly residents or disadvantaged cohorts of our community can’t afford to run an air conditioner for two or three days, so by the third day the air conditioner is off and the inside of the house can actually be hotter than the outside of the house,” she said.

According to the police, this was compounded by a fear or perception of crime in the area, which led some elderly people to keep their windows and doors locked, trapping heat in the house, said Megan Chuchiarelli, head of health promotion and community strengthening at IPC Health.

The deadliness of heat events has been a focus in Victoria since 2009, when the Black Saturday bushfires killed 173 people, but the preceding heatwave caused 374 excess deaths. During that period Ambulance Victoria saw a 25 percent surge in total cases, including a 46 percent increase over the three hottest days and a 34-fold increase in specifically heat-related conditions, 61 percent of which were in people aged 75 years or older.

Masri stressed some simple messages for heatwave events: stay hydrated, dress appropriately, time or cancel your activities to avoid the hottest times, keep your home cool by closing blinds and windows and (if affordable) run the air conditioning, and check in on neighbours and relatives, particularly the elderly and those who are vulnerable.

One of the walkers, social work coordinator Margareta Windisch, is doing her PhD on urban heatwaves and social vulnerability, with a focus on older women who live alone. She said her work had revealed that “the biggest barriers are actually the social disadvantage”.

“It’s not necessarily the hazard itself, like heatwaves, it’s where you locate it socially,” Windisch said during the walk.

“If you’ve got money, if you’ve got social connections, there is a really high chance that you are going to be okay during a heatwave because you can keep yourself cool, you have people checking in on you. But if you are poorer, if you live alone, you don’t have a strong network, and if you live in a house that’s not equipped to keep you cool then that creates, really, your vulnerability.”

Local solutions

Social isolation and the affordability of energy use came into sharp focus at the Uniting Church drop-in centre, where walkers heard about a number of community initiatives aimed at some of the area’s more vulnerable residents.

Matt Cairns, program manager of energy and financial literacy at Kildonan Uniting Care, shared the success of a pilot collaboration with energy provider Jemena known as Power Changers offering education on power use and bills and free home energy assessments, with the capacity to retrofit homes and replace poorly-performing appliances through a retailer swap or no-interest loan.

“For us the big issue is that we have a lot of vulnerable people who really don’t like to use their electricity, summer’s a really big issue,” said Cairns.

Emily Duck, from Jemena, said energy use typically tripled on a hot day and, when such conditions were prolonged there could be a significant bill shock for consumers.

Under the Power Changers program, Cairns said Kildonan ran education sessions on how to maximise use of household appliances, understand their power bills and choose the best tariffs to reduce costs and anxiety about use.

They also taught people how to maximise cooling of their home without the use of air conditioners, and offered advice on cool public spaces including the Uniting drop-in centre, where people could come for refuge from the heat. Cairns said pets were a major issue for people in the area who could not afford to cool their home, but were also unable to go to a public space because animals weren’t allowed.

Transport concerns

Transport to such locations was also identified as a major gap during the #CroakeyGO discussions. Attendees also raised concern about public cool spaces like libraries and community centres only opening during business hours, leaving people to seek refuge in shopping centres, movie theatres and pokies venues.

“There is a concern potentially about the adverse health impacts of going to pokie venues when we know that Brimbank does have the highest number of pokies losses of any local government area in Victoria,” said Glenn Menner, coordinator of policy advocacy and research at Brimbank City Council.

Christine Bell, the council’s volunteer coordinator and development officer, shared experiences from the Brimbank Community Register, where residents aged 50 or over, or people with a disability, could register for weekly, fortnightly or monthly phone calls from a volunteer to check in on them.

During heatwaves this involved updates on the weather, advice on fluid intake and keeping cool, with the ability to send around an emergency assessment officer if required, and escalate to next of kin and police if they were unable to be reached.

There were currently 500 people on the register but Bell said “it should be 5,000”. They ranged in age from 18 to 102 years.

Jemena was asked to comment on the contributions of tree pruning around power infrastructure to the urban heat island effect. Isabella Powell, from the electricity distribution strategy team, acknowledged this was an issue.

“We are looking into ways that we can be innovative in the way that we manage vegetation; using things like artificial intelligence to keep a closer eye on how quickly these trees are growing means that we may not have to trim them back as much,” said Powell.

Greening the west

#CroakeyGO participants, including dogs, were then welcomed into the local library, located in a modern, open-plan building that also houses the Brimbank Community and Civic Centre.

Adrian Gray, manager of urban design at Brimbank City Council, is also co-chair of Greening the West, an alliance of green space advocates from local and state government that was spurred into action after the 2009 heatwave, where most of the deaths occurred in Melbourne’s north and west.

“Out west we have very few trees, our canopy cover out west in Brimbank is 6.2% and we know now from multiple studies that liveability is sustained when you’ve got a least 30% canopy cover,” Gray told #CroakeyGO walkers.

Over the past decade, a concerted $32million campaign to upgrade some 105 parks in the catchment had seen Brimbank’s green space network go from one of Melbourne’s worst to one of its best, at least in the west, Gray said.

Parks were not only important public amenities, Gray said they had important microclimate affects for the surrounding neighbourhoods, improving temperature variation and promoting cooling.

He shared heat mapping of a park called International Gardens in St Albans – “one of our most heat-vulnerable suburbs” – showing the positive effects of reforestation.

Just around the corner from the walk route, he said an old school site had been repurposed into a state-of-the-art green space the Sun Vale Community Park, which is fully self-irrigating via an innovative design of rain gardens that capture and store stormwater runoff in a 100,000-litre tank underground. It features native plants, a water play area, herb garden and Indigenous art.

It will stay green, there is water, and it is a template for how we want all our parks to be green for the future,” Gray said in a later visit to the park. Listen to his interview there with Croakey’s Dr Ruth Armstrong.

Sunvale Community Park

Making an oasis

Ben Bowman, the council’s sustainability coordinator, said these parks formed the “cool core” of an initiative they were calling Brimbank Oasis, where they would plant street trees and establish rain gardens in the surrounding streets and encourage landowners to also plant on their properties.

“If we do replicate that a number of times that’s sort of how we address climate change, is in this place-based way, bit by bit, in chunks,” Bowman said.

The council was planning a major civic green as part of its main street master plan, which would see traffic lanes and carparking given over to shaded parkland, Gray said. It was also pushing for the $500million upgrade of Sunshine Station as a super-hub in the Melbourne Airport Rail Link project to follow urban design best practices around green space.

Once completed, Sunshine Station will be as large as Southern Cross in the Melbourne CBD, and the council has ambitions to make Sunshine “the capital of the west”, following its identification by the state government as one of seven national employment and innovation clusters.

“We want this station to be the greenest coolest station in Australia,” Gray said, speaking as #CroakeyGO got underway at the transport interchange. “We hope that it’s a much greener cooler place once the airport project kicks off.”

As Bowman and Gray were speaking in the foyer of the Sunshine Library, an important urban cool space in heatwaves, a bystander shouted out comments, warning that world was “going to hell in a handbasket” and the apocalypse was at hand. “There’s not going to be a future, people are going to die,” he shouted.

Bowman said humanity had a decade left to address the climate emergency “and that includes both reducing emissions but also obviously building our capacity to cope with heat and other impacts, particularly lack of water”.

“We all, and that’s everyone here, need to do everything they can, all at the same time, so that we can address this issue,” he said.

Collective actions

The council’s Climate Emergency Plan covered a suite of collective actions, from the household level (retrofits and insulation, including some of the measures recommended by VCOSS for people on low income) up, said Bowman:

“We need to get serious about 100 percent renewables, we need to get serious about a price on carbon, and weed to get serious about the climate emergency right through to the state level and above to the federal level,” he said in an interview following the walk.

“Everyone has a part to play, it’s really up to everyone to think about how they can lead actions at a household level right through to their workplace, their clubs and associations, friendship networks families everything.”

Brimbank declared a Climate Emergency in June, joining more than 75 other Australian jurisdictions in the face of what leading emergency doctor Dr Simon Judkins (immediate past president of the Australasian College for Emergency Medicine) described during the walk as “deafening” silence from the Federal Government.

Bowman said local government had become an avenue for citizens frustrated by inaction to demand leadership on the climate crisis that was not beholden to vested interests.

“There’s only one Australian government, and it’s easy for a whole lot of lobbyists to influence that one government,” he said.

“Whereas with local government, I think there’s over 500 across Australia and they’re much closer to their community, and it’s a lot harder for people with a vested interest to influence 500 governments.”

Supporting local leadership

For Harriet McCallum, senior program manager for healthy and resilient communities at the Lord Mayor’s Charitable Foundation – patron of the Croakey GO event – local communities represented both a significant gap and also an opportunity in the climate change space.

“People who are already experiencing disadvantage or health inequities will disproportionately feel the impact of climate change-related events,” McCallum told Croakey in an interview after the event. “The community sector are the ones that are working with these people and they’re not resourced, they’re not having their capacity built.”

“By funding those grassroots, community-based organisations to not only become real actors on the issue of health and climate change but to be leaders at a local level as well… it’s putting the resources where they need to be but where the leadership is also needed.”

Meanwhile, as the walk unfolded, so was it becoming clear that the United Nations climate talks in Madrid, the COP 25, were heading for a disappointing outcome, with Australia among those nations blamed.

Another brick in the wall

In a week where Swedish teenager Greta Thunberg was named Time magazine’s Person of the Year for 2019 for sparking the school strikes movement on climate action, the Youth Junction Visy Cares hub, a drop-in centre for young people and one-stop shop for service provision, was a fitting final stop our walk.

A modern, open, airy space hung with vibrant and often political art, the hub was abuzz with activity, teenagers crowded around the computers and young clients from Inclusion Melbourne delighted by the visiting #CroakeyGO dogs, Harpo and Zella.

A huge mural in the centre of the space reads:

Not just another brick in the wall.

Youth are the solution, not the problem. Nothing about us without us for us.

Good decisions come from experience; experience comes from bad decisions.

I have bent and broken, but I hope into a better shape.”

Dr Michael Clarke, CEO of the hub, did not mince words, noting that bushfires were scorching NSW and Queensland, while Sydney residents were experiencing air pollution 11 times hazardous levels.

“Climate change is real, friends. While politicians may wish to deny it, I think the reality shows that we cannot,” he said.

For the young people of Sunshine, Clarke said the hub was a refuge during heatwave events where they could come in and charge their phones, use the computers and attend programs.

During the summer holidays, it would open after hours on Thursday and Friday nights to give locals “something that’s positive’ something that’s creative” to do on hot evenings.

With employment services, disability services, multicultural services and mental health groups such as headspace and Orygen all located under one roof, Clarke said it also minimised the need, on a hot day, for young people to go from site to site to get all their needs met.

Such partnerships and collaborations were seen as the way forward on heatwaves and climate change more generally, with people welcoming the #CroakeyGO as an opportunity to take discussions out of an office and into the streets, to walk and talk with and among affected communities and across silos.

“I think what I take away from this is, it’s not the community that’s not on board, but we need to push federal and state governments a lot more to take heatwaves seriously as part of the climate crisis,” said Windisch.

Added Menner: “Hopefully we can turn this into a bit of a social movement, not just around action on climate change but really about thinking global and acting local around thinking about what impact this has on our health.”

• Also see a Twitter summary of IPC Health’s guest tweeting for @WePublicHealth during the week of 9 December.


Analytics

A #CroakeyGO aims to build networks and connections, both in real life and online. The video interviews broadcast via Periscope had been watched by 3,740 viewers as of 19 December.

Between December 1-19, analytics from Symplur show 335 participants sent 2,072 tweets, creating 20.3 million Twitter impressions. The Twitter transcript can be read here.

Warm thanks to all who participated, including the #HeatwaveHealth #CroakeyGO team: Dr Ruth Armstrong, Amy Coopes, Dr Tess Ryan, Dr Melissa Sweet, Rebecca Thorpe, Mitchell Ward, Harpo, Zella and to Marie McInerney for long-distance support. And a special shout out to photographer Andrew Arch.

We are grateful to the IPC Health team for excellent organising of the itinerary, and also acknowledge and thank all speakers who contributed during the walk.

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