The “C” word that must be uttered


Climate change is fundamentally a health issue. Doctors' groups need to face up to this truth and divest from hazardous fossil fuels, which are one of the primary drivers of rising temperatures, writes DEA's Richard Yin in this piece for doctorportal.

As we have seen in dozens of countries in the Northern Hemisphere, it has been an extreme summer of heat. Scorching temperatures have triggered devastation in North America, the Arctic, Africa and Europe.  In Japan 125 people have died while 57,000 people were hospitalised with heat-related conditions over the last three months.

There have been dangerous fires in Sweden, Greece, California, leaving many people dead or displaced, while in the United Kingdom, which has had milder impacts, images of parched lawns, moorland fires, sun-drenched beaches packed with people and tennis players sweltering are scenes rarely seen before.

Our summer is still to come but already we are seeing unseasonal weather evident with warmer and drier conditions expected through to October in much of southern and eastern mainland Australia. Much of NSW has declared an early start to the bushfire season (from October to August) and farmers are dealing with a devastating Big Dry that is the worst we’ve seen in 400 years.

No one single event can be attributed to global warming, however the patterns that are emerging across the globe fit with the scientific modelling and projections of anthropogenic climate change. A recent rapid-response study has calculated that climate change has made the current heatwave in Northern Europe twice as likely.

Against this dire backdrop of rising temperatures, associated trauma and adverse health events, the UK’s Royal College of General Practitioners’ (RCGP) recent announcement that it will end its investments in climate disrupting fossil fuel industries is very welcome.

Commenting on their divestment announcement, Professor Helen Stokes-Lampard, Chair of the Royal College of General Practitioners warned that climate change was putting the NHS under severe strain:

 “We already face a seasonal crisis every winter that threatens to destabilise our national health service, but with our summers forecasted to become hotter and hotter, we risk the emergence of a second seasonal crisis, and the NHS will simply be unable to cope.”

The RCGP’s decision to divest comes soon after the announcement by the American Medical Association, and before it the Canadian Medical Association, to also cut ties with gas, oil and coal companies.

The American Medical Association’s decision however goes much further. It also went on to:
support efforts of physicians and other health professional associations to proceed with divestment, including to create policy analyses, support continuing medical education, and to inform our patients, the public, legislators, and government policy makers.

The decision was supported by statements that acknowledged that fossil fuel combustion was detrimental to human health, contributed significantly to global climate change and recognised the need for doctors to engage with policymakers at all levels to mitigate against climate change to protect the health of the public.

These peak medical bodies recognise that climate change is a major health issue which is already costing lives and impacting emergency services, and that increasing frequency of extreme weather events will add further pressure on health services and the economy.

To date the only major medical organisation in Australia to divest from fossil fuels has been the Royal Australian College of Physicians. Hence medical group Doctors for the Environment Australia has written to the AMA, RACGP, RACS, ANZCA, ACEM, RANZCOG, RANZCP, ACRMM asking them to divest from climate disrupting fossil fuels and signal strongly their commitment to advocacy for action on climate change.

The UK government clearly understands climate change and its adverse health implications much more than we do in Australia. Last month it released its updated adaptation plan to prepare for the effects of climate change including preparing the health service for more extreme weather, including both flooding and extreme heat. The British health sector itself has done its part towards mitigation by reducing emissions by 11% since 2007 despite health and care activities increasing 18%.

In contrast, Australia’s emissions are growing, spending on climate issues are projected to drop by $1.4 billion for 2018-19, we continue to debate energy policy without acknowledging the health costs of coal combustion (approximately $2.6 billion annually) and we have no national climate change adaptation plan.

We have the unenviable accolade according to the recent Sustainable Development Goal Index of being the worst-performing country in the world on climate action.

Like Harry Potter’s arch-nemesis, Voldemort whose name every witch or wizard dare not utter, it seems the government struggles with the word climate change and in this year’s budget the “c” word was barely mentioned.

Yet Australia is one of the countries most vulnerable to climate change and its impacts.

Our national average mean temperature is now nearly 1 degree above the average. As the temperature rises it increases the likelihood of heatwaves, bushfires and supercharged storms placing Australian lives at risk. Heatwaves are silent killers causing more deaths since the 1890’s than all natural disasters combined. The elderly and very young are most vulnerable along with those with chronic health conditions. Outdoor workers and emergency responders are also more vulnerable.

Increasing frequency of extreme weather events will not only add further pressure on health services but will also impact on our health budget. The Victorian heatwave of 2009 and the Queensland floods of 2010-11 resulted in intangible costs, largely related to health impacts, of $3.9 and $7.4 billion dollars respectively.

Against the backdrop of climate inaction in this country, doctors who are the forefront of healthcare need to be speaking out about the impacts of climate change on our patients.

The urgency to act behoves all our major health organizations and colleges, who represent medical professionals committed to the principle to first do no harm, to send a clear signal, as other health bodies around the world have done, that we cannot continue to burn fossil fuels or support further investment in industries that are the primary drivers to global warming. They must fulfil their responsibility as health advocates and demand action on climate change mitigation and adaptation to protect the health of Australians.

The climate is warming, we humans are the cause, and as doctors whose primary role is to protect health we need to speak out and act. Silence is complicity; inaction a sin of omission.


Dr Richard Yin is a Perth-based GP and a member of Doctors for the Environment Australia

First published in doctorportal on 8 August 2018


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