By PHUOC LE, MD and SAM APTEKAR
In the last fifteen years, we have witnessed dozens of natural disasters affecting our most vulnerable patients, from post-hurricane victims in Haiti to drought and famine refugees in Malawi. The vast majority of these patients suffered from acute on chronic disasters, culminating in life-threatening medical illnesses. Yet, during the course of providing clinical care and comfort, we rarely, if ever, pointed to climate change as the root cause of their conditions. The evidence for climate change is not new, but the movement for climate justice is now emerging on a large scale, and clinicians should play an active role.
Let’s be clear: there is no such thing as an “equal opportunity”
disaster. Yes, climate change poses an existential threat to us all, but not on
equal terms. When nature strikes, it has always been the poor and historically
underserved who are most vulnerable to its wrath. Hurricane Katrina provides an
example of how natural disasters target their victims along racial and
socioeconomic lines even in the wealthiest nations. Writes TalkPoverty.org, “A black homeowner in New Orleans was more than three times as
likely to have been flooded as a white homeowner. That wasn’t due to bad luck;
because of racially discriminatory housing practices, the high-ground was taken
by the time banks started loaning money to African Americans who wanted to buy
a home.” Throughout the world, historically marginalized communities have been
pushed to overcrowded, poorly-built, and unsanitary neighborhoods where natural
disasters invoke much greater harm.
The poor also tend to work more physically demanding jobs that
become particularly dangerous with rising temperatures. Scientific American
reported more than 20,000 workers dying in Central America and southern Mexico from
chronic kidney disease caused by extreme temperatures and unreasonable
employment conditions. According to the World Health Organization, climate
change is expected to cause 250,000 additional deaths per year from diarrhea, malnutrition,
malaria, and stress.
Moreover, resource-denied countries have the greatest economic
reliance on agriculture, which is by far the most vulnerable industry to
anthropogenic weather changes. Throughout the Horn of Africa, droughts have
been recorded at historically intense levels (the 2016-17 rains in Somalia are
the driest on record) and have destroyed the economic sustenance of
millions of farmers. According to Oxfam,
“The region was hit by an 18-month drought caused by El Niño and higher
temperatures linked to climate change.” They estimate that 10.7 million people
currently face severe hunger throughout Ethiopia, Kenya, Somalia, and
Somaliland as their crops and cattle die. With resource-denied countries such
as these relying so strongly on agriculture to keep their economies afloat, the
World Bank reported that climate change has the ability to send more than 100 million people into
poverty by 2030. More than 23.3 million people are already in need of humanitarian aid in the Horn
of Africa.
Climate change has
already made certain regions of the world uninhabitable and threatens the
sociopolitical stability of numerous others. According to the Internal
Displacement Monitoring Center, there were 18.8 million climate-related displacements in 2017 alone. The Syrian
Civil War, which left millions in search of a new home and catalyzed political
instability throughout the region, holds climate change as one of its many contributing factors.
Unfortunately, these patterns
show no signs of slowing down. Globally, the number of weather-related
disasters has tripled since the 1960s.
In September, Hurricane Dorian battered the Bahamas and left a humanitarian crisis in
its wake; thousands are homeless, without food, water, and electricity as the
islands remain flooded. This was just two years after Hurricane Maria destroyed
thousands of homes in Puerto Rico and only one year after Hurricane Matthew
killed 49 people
and caused $10.8 billion in damage in North Carolina. The United States Geological
Survey reports, “With increasing global surface temperatures the possibility
of more droughts and increased intensity of storms will occur.”
The classification of hurricanes, tornadoes, and droughts as
“natural” disasters suggests their origin are separate from human behavior,
that they exist purely in the realm of nature where man has no influence. But
if we look at the destruction they have caused historically, we see that their
effects are almost completely determined by human action, specifically our
social, economic, and political policies that continue to leave some more
vulnerable than others. While the Silicon Valley dreams of future technological
solutions to climate change, there are social policies that we, as healthcare
professionals, can address right now.
Climate change is a public health emergency, and as guardians of
the public’s health, it is our role as healthcare professionals to continuously
stress the magnitude of the situation. We must assert with medical expertise
that as “natural” disasters intensify and transform entire ecosystems, the poor
and historically underserved have been, and will continue to be, the hardest
hit. By providing honest, evidence-driven accounts of climate change and its
health consequences, healthcare professionals can elevate the voices of
millions who are left out of most contemporary climate movements and bring
their stories to the fore as we continue to fight climate change together.
Internist, Pediatrician, and Associate
Professor at UCSF, Dr. Le is also the co-founder of two health equity
organizations, the HEAL Initiative and Arc Health.
Sam Aptekar is a recent graduate of UC Berkeley and a current
content marketing and blogging affiliate for Arc Health Justice.
This post originally appeared on Arc Health here.
