Health in the Time of Disaster

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Hurricane Dorian ravaged the Bahamas, and is set to make landfall in the United States. A hurricane, in itself not extraordinary during this time of year, that has undoubtedly increased in ferocity due to the changing climate. Humanitarian crises and disasters like these will only increase in frequency as well as intensity as time goes on. As we reckon with what the consequences of a planet heating beyond repair would mean, the question of what it will mean for our human rights, and in particular the human right to health, remains under-explored.

Perhaps the most obvious consequence of the increase and violence of natural disasters, is the fact that it will be more and more difficult to physically reach the people affected, affecting their accessibility to healthcare. Indeed, an increase in humanitarian crises will mean that more people will have difficulty accessing clean water, food, and medicines,  and will be more at risk of developing infectious diseases. Unsurprisingly, the most vulnerable and poorest populations, both within countries and between countries with the Global South more affected than the Global North in this respect, will be hardest hit when disaster strikes. The vulnerable and poorest being hardest hit means that they will be likeliest to need medical assistance, and simultaneously means that it will be harder to reach these communities. This is a bind that most, if not all, healthcare systems are likely not sufficiently prepared to tackle, but it is already a reality for many people around the world.

As briefly mentioned in the above paragraph, another consequence of a global rise in temperature is the increase in infectious diseases and parasites. The global rise in temperatures will likely make previously uninhabitable parts of the world for parasites more attractive to them, and they will increasingly appear where they would normally not be found.  In addition, water scarcity as a result of drought can lead to poor sanitation which will increase the incidence of diseases such as cholera. Again, unsurprisingly the people bearing the brunt of these issues are poorer communities in the Global South. 

Beyond communicable diseases, mental health issues are an under appreciated consequence of the global climate emergency. ‘Ecological grief‘, a sense of grief borne out of the changing ecological landscape, and a loss of a way of living, seems to be particularly felt by people who live in synchrony with nature. Indeed, indigenous communities, like the Greenlandic Inuit, have increased mental health issues related to a loss of their way of life, their ability to live with nature and off of nature. Voices of many indigenous communities who have been losing their land, their livelihoods, and their ability to live in synchrony with their ancestral lands are rarely heard, but the climate catastrophe has dire consequences on their mental health. Ecological grief, ties together the climate crisis, mental health, and indigenous rights. In general, a sense of climate despair seems to be affecting people’s mental health across the world, making many people question the point of existence as a sense of hopelessness about the situation takes over. Whether our mental health services, especially in a world where there are not an awful lot of mental health professionals, are capable of rising up to this challenge remains uncertain.

Health, whether physical or mental, communicable or non-communicable, is a fundamental human right that is under pressure in a changing world.

The United Nations rapporteur on human rights and extreme poverty, has said that human rights might be threatened due to climate change. The world’s wealthiest might be able to escape the worst of climate change’s effects whilst the world’s poorest will have their right to housing, food, life, safety and, as I outlined here, health, threatened. When it comes to human rights, and particularly the gains we have made in health and the precariousness of these gains, it is imperative that we keep them at the heart of our climate policy and the societal debates we are having on what best to do to tackle the climate crisis. Health, whether physical or mental, communicable or non-communicable, is a fundamental human right that is under pressure in a changing world. The potential repercussions of that are dire if our policymakers and health systems do not adapt to these realities quickly. Conversations surrounding ambitious policy proposals like the Green New Deal ought to centre human rights in general, however the right to health should not be underestimated or kept on the back burner. At the end of the day, vulnerable, poor, and indigenous communities will bear the brunt of our complacency, and we cannot afford to let that happen.

Indigenous rights and the climate emergency

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“The lungs of our planet are on fire” was a common refrain heard in the past days as a response to the unprecedented wildfires in the Brazilian Amazon. An international outcry from politicians, celebrities, and regular people on the internet alike, was urgent and panicked: we need to do something now or we’ll lose the forests, we’ll release high levels of carbon stored in the rainforest’s trees into the atmosphere, and we’ll lose the Amazon’s immense biodiversity. However, the focus on the inhabitants of their ancestral lands, however fleeting, came much later, even though they have been raising concerns about the Brazilian government’s rhetoric and its encouraging of illegal exploitation of indigenous land for a long time.

A couple of days before the Amazon wildfires reached global headlines, Brazilian indigenous women marched against Bolsonaro’s government. This was just one instance of the Amazon rainforest’s indigenous tribes – and in particular its women – fighting to preserve their ancestral land even when we aren’t paying attention.

Environmentalism has regained its fashionability as our winters feel like summers and our summers become infernal, and young voices are getting more earnest about what climate catastrophe would mean for them and the next generations to inhabit the planet. However, it seems like the movement has its internal issues it ought to, but doesn’t nearly as much as it should, contend with. One of the main issues with the movement was showcased when the emphasis was placed on the Amazon being the ‘lungs of our planet’ without mention of the many people who have lived there for generations and the systematic destruction of their homes, livelihood and land at the hands of governments and Western consumer behaviour. When the plight of indigenous tribes across the world are mentioned, it’s often from a Western perspective with an insidious sense of paternalism rather than highlighting the voices of the people on the front lines. The United Nations itself has said that indigenous peoples play an important role in tackling climate change. But it goes beyond just including, or even centring, indigenous voices in the climate debates. When indigenous people, in particular women, are still disenfranchised, abused, incarcerated, have trouble accessing a basic human right like healthcare and still fight for a say in how their sacred land is used, it is imperative that we do not just see indigenous peoples as resources to be used to fight the climate emergency, but as communities that are vulnerable to climate change’s effects and many social injustices. It is clear that if we are going to be serious about environmentalism, that we will have to centre indigenous voices and fight for the (human) rights of indigenous peoples.

In the Congo, Baka people have been pleading with WWF and the European Commission to stop funding a national park that threatens their way of life. Sadly, this is hardly a unique situation when it comes to indigenous people’s rights and livelihoods in the conservation industry. Human rights abuses seem to be commonplace in conservation, with a recent scandal haunting the world’s most recognisable conservation NGO the WWF. Local poor and indigenous people are being murdered, raped, attacked and shunned, all in the name of conservation. The narrative we have constructed says, sometimes implicitly and sometimes not, that we care about indigenous land and its biodiversity, but not about indigenous peoples. Simultaneously, we seem to place the blame of climate destruction squarely on the shoulders of the poor and indigenous rather than face our own patterns and unsustainable economic systems in the metaphorical mirror.

The narrative we have constructed says, sometimes implicitly and sometimes not, that we care about indigenous land and its biodiversity, but not about indigenous peoples

To have environmentalism, conservation, and climate change activism mean something, we will have to centre human rights and indigenous voices. Climate activism without social and economic justice and respecting human rights is nothing but a self-congratulatory movement that does more harm than good. Caring about, and centring, indigenous voices means taking a step back and listening when necessary as well as amplifying and lobbying on tribes’ behalf when asked.

Whether it is indigenous tribes in the Brazilian Amazon, or Baka people in the Congo, the rights of people living on, and in sync with, their ancestral land should be respected and should be front and centre in the climate debates. For our activism, lobbying, policies and worries to mean anything we need to listen and act when required. What use are lungs without the peoples that make up the body?

(consider donating to Amazon Watch, Survival International and the indigenous women’s march in Brazil.  Also consider writing your MP/MEP and sharing indigenous voices on social media)

You can’t eat money.

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Greta Thunberg, the 16-year-old climate activist that I have talked about on this blog before, seems to bring out the worst in a (mostly) male cohort across Europe. In The Netherlands, Britain and Italy, mocking the teenager and her autism seems to be a national sport. Grown men being threatened by a child who has been speaking truth to power is baffling to many of us, but let those voices not deter us from her message that is still incredibly pertinent.

When we talk about climate change, we often think about middle-class environmentalists and we focus intently on individual sins: your carbon footprint is too high, you should be vegan, you you should not take long showers, you should not use plastic bags or bottles and ideally you really ought to drive an electrical car and not have more than two children (or even better: have no children at all!). Individual acts to counter climate change are always welcome, but I am afraid the focus on personal sinfulness does little to challenge the systemic sins of large corporations, the current economic system, and the collective “climate delaying” by our governments. In addition, the narrative surrounding climate change seems to easily point the finger at the Global South, who are historically far from the worst polluters, rather than confront the West’s longstanding intransigence. This has to change.

Just to be clear, individual choices to live a sustainable lifestyle are absolutely necessary. We are all responsible for the planet because this is, to quote Pope Francis, Our Common Home after all. However, the scale of the change needed to avert climate catastrophe far exceeds what can be done by simple individual changes in lifestyle. As 70% of the green house emissions since 1988 is produced by just 100 companies it seems clear that our individual changes alone are not going to cut it. What is needed is radical, systemic, change that comes from the top. Like Vox reporter David Roberts said (and I’m paraphrasing): we will have to stop signing resolutions and producing reports at one point, and actually start implementing policy changes.

Leaving it up to the market to solve seems to be, to some, a rational response to the climate catastrophe that awaits us. But in a globalised world full of consumers where companies are the main polluters, and where the fossil fuel lobby still holds sway over decisions made by our government, it seems to me that the problem might be with the unsustainable capitalistic system we have now. If we want to steer clear from the absolute worst case scenario, we will have to do something drastic and possibly eschew capitalism altogether. Saying that, understandably, evokes memories of the 20th century’s brutal dictatorships, but there is very little preventing us from creating a system that is both democratic and does not worship the market and place it above human dignity or the survival of our planet and species. What is needed is the will and the vision of (young) ambitious policymakers and politicians who are not in the pocket of the industries that are commodifying our human experiences and ‘our common home’. We need to think beyond the current frameworks, and that includes looking beyond an unsustainable economic system that we have grown so accustomed to.

Alanis Obomsawin, the Abenaki filmmaker, once said that:

When the last tree is cut, the last fish is caught, and the last river is polluted; when to breathe the air is sickening, you will realize, too late, that wealth is not in bank accounts and that you can’t eat money.

To effect actual change that is needed on a large scale we need to move beyond the highly atomised perspective of personal sins and individual carbon footprints. The sheer scale of the task ahead of us, the task we, as stewards of the earth, are burdened with, requires a radical approach. It requires the fundamental, and collective, overhaul of our current economic and political system. It needs to go beyond good will, treaties and pledges and towards radical policy changes. This will mean that we will all have to chip in, and more than anything that the largest fossil fuel and transport corporations will need to be taxed heavily. The fact of the matter is that we can’t eat money. Our common home is more than a commodity to be passed between hands, or a resource to be continually exploited at the expense of the worlds poorest, sickest and youngest. When children are dying because of air pollution induced asthma and when people around the world are dying because of extreme weather, it is clear we have to do something. It means listening to the scientists, to the young and ambitious politicians, and to the young activists like Greta (who deserves more than mockery for her passion for the planet and her autism). Right now it is not yet too late. But how much longer can we say that?

Climate change, anti-vaxxers, and ‘alternative facts’

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The last days of February were somewhat of a shock to the system of humans and nature alike, as temperatures rose to 21 degrees celsius in Kew, and many parts of Northwestern Europe saw April-like weather conditions. Whilst most people were enjoying the sun by lunching in parks, eating ice cream, and chatting on terraces, something about these scenes were equally unsettling. Clearly these temperatures are far from normal, and enjoying it felt an awful lot like the famous meme where Jay-Z bobs his head to music with an anxious expression on his face.

The Intergovernmental Panel on Climate Change (IPCC) recently released a report detailing what will happen if the Earth warms by 1.5 degrees celsius or by 2 degrees, and issued stark warnings. The World Health Organisation (WHO) warned of the health risks associated with climate change and an increased air pollution, and unsurprisingly the poorest people in low income countries who are far from the biggest polluters, will bear the brunt of the detrimental effects of climate change. In August 2018, 16 year old Greta Thunberg became somewhat of a celebrity when she started the school strikes for climate action that have become a phenomenon across Europe as of late. Expected petulance from the adults in the room aside, climate change has been firmly on the table. Whether through Greta and her age cohort’s school strikes, the IPCC’s reports, or Alexandria Ocasio-Cortez’s “Green New Deal“, climate change is something finally talked about in earnest. The interesting phenomenons that come with this increased attention for climate change, are both climate change deniers and climate delayers.

Climate delayers (thanks for coining the term, AOC) are the climate change deniers more respectable cousins. These are people who are aware of the devastation of climate change, but are reluctant to support or enact drastic reform of laws and regulations to make a meaningful difference to reverse, or more realistically lessen, the devastation that awaits us and our progeny. These are often politicians who will say that they are already doing more than they should, and expediently postpone any major changes for long enough so the next administration can not deal with the issue. Climate change deniers are the people (like the US president) who have an absolute commitment to denying all the scientific evidence for global warming and climate change, and are hostile to any measures taken to mitigate the effects of climate change. This outright denial of the evidence is an interesting phenomenon. As we all know, countering climate change denial with facts or insults do not help change people’s minds — in fact, they might even get more entrenched and double down on their views even more (this is called cognitive dissonance). It is easy to believe that many of the climate change denying politicians have some kind of vested interest in maintaining the status quo, but the reasons why the general public might not believe in climate change are less obvious and more disparate. These reasons range from misinformation (‘alternative facts’ if you’re Kellyanne Conway), to a lack of knowledge on what global warming entails or what the consensus really is.

This brings me on to anti-vaxxers. Anti-vaxxers are often young, middle-class parents who have chosen not to vaccinate their children because vaccines cause autism. Let me make it absolutely crystal clear: vaccines DO NOT cause autism. There is no evidence for this, and Andrew Wakefield is a disgraced physician who lost his license because of his shoddy and unethical study. Those are the facts based on countless scientific studies, but relaying those facts will probably cause cognitive dissonance if it is someone’s strongly held belief that vaccines are a Big Pharma conspiracy that will endanger their child.

Recently, there have been countless measles outbreaks across the world, with, for example the European Centre for Disease Prevention and Control identifying a suboptimal vaccination coverage to create herd immunity as the culprit. Many of the people who fell victim from this outbreak were young children who were too young to be vaccinated (and who, just like the immunocompromised, herd immunity is meant to protect). Just like with climate change, there seem to be people who are aware of the function and effectivity of vaccines, but think parents’ right to choose trumps public health. An argument can be made that if we are proponents of liberalism, individual liberty is of prime importance. Even so, John Stuart Mill, the father of liberalism, proposed that “The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others”. Indeed, I would argue that governments being more diligent about getting at least 95% of the population vaccinated — perhaps even making them mandatory for those who aren’t immunocompromised — fits perfectly within Mill’s harm principle. Particularly when there are so many people who suffer without any choice in the matter, because of somebody else’s parent’s decision not to vaccinate their children. The most vulnerable in society bear the brunt of this, again, not unlike with climate change. Indeed, the WHO has named a lack of vaccination as one of the biggest threats to global health. Whilst low- and middle income countries, despite challenges, do their best to get vaccinations to the most vulnerable populations, there are instances where Westerners reintroduce preventable diseases to countries that had finally put a handle on them, and even export the fearsome stories of what might happen to vaccinated children. A recent example of exported disease it that of the French family who reintroduced measles to a measles-free Costa Rica. Situations like this give an eerily colonialist feel to the case. But I digress…

Whether it is climate scepticism, or anti-vaxxers, how we change people’s minds is a difficult question to answer. It is clear that questioning parents’ love for their children, or insulting climate sceptics is not working. Perhaps, in the case of climate change deniers, Greta and her peers’ strategy of striking until the grownups finally listen is a good idea. Maybe we should all be lobbying politicians, striking, signing petitions, at least so the policymakers end up doing something — the rest of the population might follow. When it comes to those firmly believing in the anti-vaccination movement it is important that we try to tackle these harmful untruths with evidence and understanding. Moreover, public health officials ought to do a better job at educating the population, the government ought to be more diligent in tackling misinformation, and journalists should stop inviting ‘both sides’ to create a sense of false balance. Scepticism is not a bad trait. Indeed, even a dose of scepticism towards established science is not necessarily a bad thing. But it is up to critical citizens to find factual and truthful answers to their questions based on research and scientific evidence, and why it is that scientists have reach consensus over something. I promise you, scientists do not reach consensus easily. So, I leave you with some sage advice: please, don’t believe everything you read on Facebook.