Human health and planetary health are intertwined

Human health and planetary health are intertwined

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. Along with attending to human health, we must also focus on the planet's health. Planetary Health as defined in 2015 by "Lancet," is  “the health of human civilization and the natural systems upon which it depends.”

In its timely Declaration calling on family doctors of the world to act on planetary health, the World Organization of Family Doctors (WONCA) urged doctors globally to “communicate to patients that their health ultimately depends on the environment, both in their immediate vicinity and globally.”

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According to WONCA, “With planetary health in mind,” doctors should “be aware of and monitor local environmental factors, such as heatwaves and other natural disasters, land clearing and air quality, which may affect your patients’ health or response to treatment. [And] advise patients about important co-benefits — everyday choices and key changes that they can make in their own lives to simultaneously benefit their own health and that of the environment, including food choices and a transition to a more sustainable plant-based diet.”

 

Attending to this degree of complexity can seem like a tall order for busy doctors and nurses. For more than 10 years, however, the practitioners in our organization have practiced a planetary health approach in our medical facilities in Borneo, where we provide health care 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 health care. 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 the 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 work is similar to what people expect in a conventional hospital, yet different.  Instead of only health-care providers being present, doctors and nurses find themselves teamed with farmers, foresters and educators. Community members can pay with barter for their health-care 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 rain forest ecosystem and they discuss this everyday with their patients.

This approach is working. We have seen an 88 percent 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 rain forest, 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.   

What would it look like if, as we did with the logging-dependent communities in Borneo, health-care providers spent hundreds of hours listening to the concerns of coal-mining communities and communities in fracking-heavy regions?

What if we listened and then designed health systems that put family health as a primary outcome, while simultaneously enabling family earners to find the alternative livelihoods they require to feed their children today — and protect the planet for their children’s future?

As societies’ most trusted sources of information, health-care providers globally can advocate for bike lanes to increase activity levels and decrease air pollution, or help patients learn the skills necessary to transition to a more plant-rich diet.

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, health-care providers can optimize the health of not only this generation of patients, but of all those yet to come.

Dr. Kinari Webb is the founder of Health In Harmony. Dr. Courtney Howard is an emergency physician and the North American Co-Chair of WONCA’s Working Party on the Environment and a Health in Harmony board member.