As humans, we like to think in categories, but the truth is we’ve never lived in a world where the health of humans, ecosystems and the planet could be effectively addressed in silos. The severe and wide-ranging effects of climate change, the biggest health threat of the 21st century according to the World Health Organization, force us to confront and address this reality. We are depleting natural resources, generating massive amounts of waste and toxic pollutants, causing large-scale biodiversity loss, and fundamentally changing our landscapes, the composition of our atmosphere, and the health of our oceans. Despite the hard-won public health gains of the past century, we are rapidly faced with the negative health impacts of degraded air quality, threatened food production, new infectious disease exposures, decreasing access to fresh water, and more frequent natural disasters. Humanity is, consequently, more and more susceptible to malnutrition, mental health illness, injury, and disease. In other words, the health of human civilization is at risk as humans dismantle the natural, ecological systems upon which our very civilization depends.
In its timely call-to-action, published in the Lancet medical journal, the Planetary Health Alliance is calling on doctors of the world to act on planetary health, and be planetary healers. Co-signed by 30 medical associations and healthcare organizations around the world, including Health In Harmony, the call reflects a broad and unprecedented commitment of the healthcare community to planetary health. It aims to increase awareness of the severe public health impacts of environmental change.
How exactly do doctors, nurses, and other healthcare providers – inside their daily practices in Portland, Zagreb and Jakarta – become powerful agents of change? Along with attending to human health, how do they focus on the planet's health? This may seem like a tall order for busy doctors and nurses. However, for more than 10 years, the practitioners in our non-profit organization, Health In Harmony, have practiced a Planetary Health approach in our medical facilities in Borneo, where we provide healthcare to the more than 120,000 people living around Gunung Palung National Park (GPNP).
A decade ago Borneo was experiencing one of the fastest rates of deforestation the world had ever known, and GPNP was losing tree cover at an alarming rate. This was mostly due to illegal, small-scale logging by people in marginalized communities on the edge of the park, who had no other way to pay for their basic needs or healthcare. In 2007, we spent over 400 hours listening to people in 40 villages bordering the park to understand the critical connection between the health of people and the health of surrounding forest. Per the consensus decisions of these communities, we provide access to affordable, quality health services and training in sustainable agriculture, as lack of health access and income opportunity were key drivers of deforestation in the park.
Our medical practice in Borneo is similar to what people expect in a conventional hospital, yet different. Instead of only healthcare providers being present, doctors and nurses find themselves teamed with farmers, foresters, and educators. Community members can pay with barter for their healthcare costs in our clinic (such as tree seedlings for reforestation), and the costs are tiered based on their village’s commitment to reduce logging. Furthermore, our doctors, nurses and midwives understand their patients’ asthma, TB, dengue, malaria and nutrition status are reflections of the integrity of local rainforest ecosystem, and they discuss this everyday with their patients.
This approach is working. We have seen an 88% decline in the number of households participating in illegal logging in GPNP, and significant decline in infant mortality. The loss of primary forest has ceased, 50,000 acres of forest have regenerated, and habitat for 2,500 endangered Bornean Orangutans has been protected. Our doctors’ stethoscopes are helping heal this amazing rainforest, an important lung of the earth. Linking human health and ecosystem health is reversing the rainforest destruction that contributes to the acceleration of global warming. To put this in perspective, the amount of carbon in the park that would have otherwise been lost to logging is equivalent to 14 years of carbon emissions created in San Francisco.
The newly-launched Clinicians for Planetary Health initiative is mobilizing clinicians and clinicians’ groups around the world, recognizing their importance in protecting our health, their authority as globally-trusted sources of information spanning political and cultural divides, “To educate patients that a suite of behavior and lifestyle modifications can simultaneously improve their own health while helping to secure the health of the world’s least-resourced and future generations by protecting our planet’s natural systems.”
This Earth Day, patients and doctors alike should be thinking about climate health in conjunction with their personal health. Examples of lifestyle modifications with health and environmental co-benefits, include plant-based and locally-sourced diets and active transport (i.e., by bike or walking). Community-level actions could include advocating for farmers’ markets, bike lanes, and transitions to renewable energy. They can advocate for healthy, low-carbon energy systems, and for the protection of urban green spaces, and can encourage patients to benefit from the healing effect of being in Nature. By becoming planetary healers, healthcare providers globally stand on the front-lines of optimizing the health of not only this generation of patients – but of all those yet to come.
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