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Archive for the ‘Climate change’ Category

By Alan Maryon-Davis

The call went out to all churches in KwaZulu-Natal to pray for rain. The drought had ravaged Zululand for months following a disappointingly dry rainy season. For the seventh year in a row the parched land had received less than 75% of its previous average rainfall. The underground aquifers were empty. Natural springs and boreholes, the sole source for most of the rural communities had dried up. The once mighty uMfolozi river was a trickle. Severe water restrictions were in place. Farmers’ livelihoods were at stake. The situation was critical.

I had been invited to visit South Africa by the College of Public Health Medicine (ironically to talk to a number of groups about climate change and receive an honorary fellowship) and I could see the effects of the drought with my own eyes. The sugarcane fields were in a sorry state, other produce was shrivelled and even the drought-resistant eucalyptus trees, a cash crop, were showing signs of stress. The bush veldt of Zululand is well used to dry summers – but this was early spring – the seventh dry early spring – a worrying pattern. Commentators talked of climate change in action – allied to trends already seen further up the east coast of Africa.

And yet, despite the emerging threat to its own economy and the health and wellbeing of its people, the ‘Rainbow State,’ like many other countries that straddle the developed and developing worlds, is far from wholeheartedly embracing the green agenda. It is caught between, on the one hand, the need to play its part as a major economy in reducing carbon emissions to help combat global warming, and on the other, the impetus to increase its GDP and offer a comfortable lifestyle to its burgeoning, upwardly mobile, urbanised middle classes.

South Africa’s per capita carbon footprint is about the same as the European average. Its energy comes overwhelmingly from its extensive coal resources and, despite recently approving a more balanced energy-generating policy, there’s little sign of any imminent shift towards renewables or nuclear. The potential for solar energy, especially in more remote rural areas, is high – but start-up costs are considered too prohibitive to roll-out on a large scale. Other priorities, such as education, healthcare and housing, come first.

In many ways, South Africa’s dilemma over carbon emissions is typical of its fellow BRICS economies – Brazil, Russia, India and China – and highlights the challenges that will be faced by negotiators at the next round of climate change talks in Mexico in December. How can the world move towards some sort of contraction and convergence formula that is fair and practicable and politically acceptable to countries at all stages of development? And at the same time ensure that those most vulnerable to the impacts of climate change are helped to become more resilient.

Meanwhile, back in Zululand – something good has happened. The skies have darkened, the clouds have opened and rain has filled the water tanks, runnels and ditches. Could this be the power of prayer – or merely the serendipities of a troubled atmosphere?

Either way, the sugarcane farmers and smallholders are smiling again.

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By Matthew Kilgour

What are the difficulties encountered when planning for and responding to natural disasters and adverse weather conditions in the UK?  This was the topic of discussion at the FPH Annual Conference session on Wednesday 7 July,  featuring contributions from Lucy Reynolds from the London School of Hygiene and Tropical Medicine, Wayne Elliott, Head of the Health Programme at the Met Office, Shona Arora, NHS Director of Public Health for Gloucestershire, and Andy Wapling, NHS Head of Emergency Response for London.

The three key environmental factors affecting UK emergency planning and response were outlined as excessive cold, heat and flooding.  All the speakers were keen to point out that the implications of these factors stretch beyond immediate and physical dangers, and stressed the need to understand the social and mental health implications of events like floods or heatwaves. Andrew Wapling, discussed the need to conflate the public health and emergency response agendas saying, “the quicker an effective response is mounted, the lesser the impact on individuals.“  He cited early response to disasters as a key determinant in minimising longer-term implications.   He also stressed the need to identify critical infrastructure and the events that could potentially ground services and impede response.

Shona Arora discussed her involvement with the response to 2007’s flooding in Tewkesbury, Gloucestershire. The flooding heavily disrupted day-to-day patterns of life, and vulnerable individuals and groups like the poor, the elderly or those with learning difficulties did not, in many cases, have access to the information or resources to protect themselves.  Lucy Renolds stressed this same issue in her closing remarks by saying, “it is always the poorest communities who are affected the worst”.  Large percentages of individuals affected by the flooding did not have sufficient insurance, and many were left without access to serviceable kitchens.  Ms Arora admitted that the evidence base for pre-empting eventualities like these was thin, and placed emphasis on the need to address this factor.

Lucy Reynolds highlighted the key role that mass media can play in information sharing and raising public awareness in response to disasters.  She stressed the need for reliable communications networks when dealing with disaster relief, as public phone network can become overloaded and unreliable.  The need for effective and reliable communication between departments was emphasised repeatedly throughout the session. Wayne Elliott from the Met Office said that “unless you communicate at the right time, and in the right manner, nothing will get done.”

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Morning parallel session, at the Faculty of Public Health annual conference, on Wednesday 7 July.

Chaired by Professor Alan Maryon-Davis (former President, UK Faculty of Public Health), and panel members Lucy Reynolds (London School of Hygiene and Tropical Medicine), Wayne Elliott (Head of the Health Programme, Met Office) and Shona Arora (Director of Public Health, NHS Gloucestershire) and Andy Wapling (Head of Emergency Preparedness, NHS London).

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Sir Liam Donaldson, the Chief Medical Officer has published his Annual Report 2009 this week. In the report the CMO highlights the key areas of public health requiring action and looks at progress made since previous annual reports.  One issue that he reflects on is the damage caused by “passive” drinking and the recommendation he made for a minimum price for alcohol in his last Annual Report.

FPH President Professor Alan Maryon-Davis  commented:

We’re strongly behind Sir Liam on this issue. The government should never have bottled out with minimum pricing. It makes total sense to ban ultra-cheap booze. We call on this government and future ones to reconsider all the evidence that is available.

In fact, the CMO’s Report refers to FPH’s public health manifesto calling for minimum pricing earlier this year:

The Alcohol Health Alliance UK brings together the Royal College of Physicians, the Royal College of Surgeons, the Academy of Medical Royal Colleges, the Faculty of Public Health and 20 other such organisations. To see such a group of medical bodies speaking together with one voice is very powerful. They speak in particular of the passive harms of drinking. They, too, call for a minimum price per unit.

Other professionals have echoed this call. The Faculty of Public Health represents 3,000 public health specialists from the United Kingdom and elsewhere. The Royal Society for Public Health has 6,000 members from health-related professions. In January 2010, these two institutions joined forces to publish a public health manifesto. It listed 12 actions that government could, and should, take to tackle a range of public health concerns. The first action on the list was a minimum price per unit of alcohol. (p.16)

The major challenges the Annual Report discusses this year include climate change and health, the benefits of physical activity on health and risk of cold weather on health.

FPH has produced a booklet about climate change and health called Sustaining A Healthy Future – A Special Focus on the NHS .

There is plenty of evidence about alcohol minimum pricing being the best public health intervention to problem drinking, for instance an independent review by the School of Health and Related Research at Sheffield University.

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… to the Climate and Health Council pledge to protect health through active engagement to limit the causes of human-caused climate change.  http://www.climateandhealth.org/pledge/index.asp

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Doctors, nurses and students highlighted the health benefits of tackling climate change in the lead up to the mass climate change march The Wave on 5 December. Wearing blue scrubs, pushing a hospital bed carrying a ‘sick’ globe and distributing ‘prescriptions’ for a healthy planet the group aimed to raise awareness of the threat of climate change to human health here and around the world.

On the march the Health Wave group also met the Climate Change Secretary Ed Miliband to deliver him the message “what’s good for the climate is good for your health”.

See pictures of the Health Wave event

Read the blog by David Pencheon, Director of NHS Sustainable Unit, on BMJ.com
Read the blog by Tony Waterston, Medact, on BMJ.com

The event was organised by the Medact, the Campaign for Greener Healthcare, the Climate & Health Council, Medsin, the NHS Sustainable Development Unit and the Royal College of Nursing.

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Friday, 4 December 2009.

I’m somewhere over the steppes of Central Asia – on my way back from an international conference in Hong Kong on the theme of emerging issues in public health. Time to sit back and reflect.

It was a good conference – attracting delegates from all over East Asia and beyond. Inevitably, much of the focus was on the ever-increasing burden of chronic disease in this rapidly developing and urbanising region – not just China and India, but Vietnam, Cambodia, Thailand, Malaysia and even Burma.

The same pattern is repeated again and again.  People flock to the cities to find work, the buildings zoom up, the traffic multiplies, the diet westernises and the waistbands expand. Obesity linked to diabetes linked to heart disease and stroke. Not helped by the efforts of the tobacco industry. As a result, the health systems, mostly private sector, creak and buckle. There’s widespread recognition that public health improvement and primary care are vital – but also widespread concern that they are chronically underfunded, patchily organised and poorly linked together.

One key to this is education – linking public health and clinical training -, a recurring theme of the conference and the main thrust of my keynote presentation.

But the real value in my travelling to Hong Kong was undoubtedly in the face-to-face meetings with people who have the power and influence to build up public health and primary care and link them together. There is no substitute for the personal touch in this part of the world – perhaps in any part of the world. Tele-meetings, invaluable though they are for many purposes, simply don’t cut it for forming close working relationships and building camaraderie and trust. Business people know this – to clinch a deal you need to get to know each other.

But, as I fly back across Mongolia and Siberia towards Moscow, St Petersburg and the Baltic, Copenhagen edges into my moving map and gnaws at my conscience. I know that this kind of meeting will have to become a rarity – at least for me. I do not want to be a climate criminal. I do not want to let the planet down. Of course I only fly long-haul to meetings where I feel my being there might make a real difference. But even so, I am determined to be much more selective in future. And I’m sure many others will be making the same resolution.

Yes, it poses awful dilemmas – can I really accept this next invitation to another faraway place? But it’s a nettle the academic world, and the business world, will increasingly have to grasp.

Otherwise Heathrow will need a third runway – and we’ll all need another Earth.

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