The Eyes of Future Generations
Climate change is already impacting health and patient care across Canada. Faculty members and learners are advocating for more sustainable practices, curriculum changes and interdisciplinary solutions to address the issue
By Emily Leighton, MA'13
"The eyes of all future generations are upon you. And if you choose to fail us, I say – we will never forgive you. We will not let you get away with this. Right here, right now is where we draw the line. The world is waking up. And change is coming, whether you like it or not.” With these powerful words at the UN Climate Action Summit in 2019, 16-year-old Greta Thunberg captured the anxiety and rage of a generation forced to live with today’s inaction.
Climate change is leading to devastating health impacts, food insecurity, extreme weather events, ecosystem collapse and changing patterns of infectious disease – the latter alarmingly demonstrated by the current global pandemic.
“If we continue down our current path, a child born today will live through a world that is more than four degrees warmer, with a changing environment threatening the food they eat, the air they breathe and the communities they grow up in,” write the authors of the Lancet Countdown’s 2019 report. “Without accelerated intervention, this new era will come to define the health of people at every stage of their lives.”
“The report showed there is significant room for improvement in how planetary health is being incorporated into the curriculum.” — George Kitching
Dr. Anna Gunz, Assistant Professor, is already seeing these effects in her practice as a paediatric critical care physician in London, Ontario – from young patients with severe asphyxic asthma to families unable to return home for months due to extreme annual flooding.
“This is happening right here in Ontario,” she said. “This isn’t something we can avoid.”
With a background in geography and climate science, Dr. Gunz is studying the paediatric intensive care unit’s emergency preparedness in the event of an extreme weather event or climate emergency. Are there enough provisions of food, water and medical supplies? How should medications be stockpiled? What happens if the supply chain is knocked out?
It may sound like a doomsday scenario, but Dr. Gunz says these types of issues are getting harder to ignore. “We’re seeing historic floods and ice storms in Ontario. And imagine something like that compounded by COVID-19,” she said. “If something happens, how do we adapt? How can we make ourselves and our communities more resilient?”
Dr. Gunz is also focused on building sustainable health care practices. The Lancet Countdown identified Canada’s health care sector as the third highest emissions producer among its global counterparts. “We need to look at what we’re purchasing, the movement of supplies and how we’re disposing of them,” she said.
Fourth-year medical student George Kitching is part of national advocacy efforts to incorporate climate change into medical education. “Climate change will frame my career,” he said. “All the patients I treat will be impacted in some way.”
Kitching is a member of the Health and Environment Adaptive Response Taskforce (HEART), part of the Canadian Federation of Medical Students (CFMS). In 2019, the group completed an evaluation of planetary health education at Canada’s 17 medical schools and in 2020, published the final report, including nine recommendations.
“The report showed there is significant room for improvement in how planetary health is being incorporated into the curriculum,” explained Kitching.
Recommendations included working with faculty members and students to develop longitudinal learning objectives and incorporating planetary health into existing learning to demonstrate the multifaceted impact of climate change and practical applications. As an example, Kitching points to the inclusion of air pollution as part of respirology courses or covering new ideas around eco-grief as part of psychiatry courses.
“We need to learn about the direct health impacts of climate change, but also build an understanding that the way we relate to the environment is inherently unhealthy,” said Kitching. “By talking about planetary health, we’re acknowledging that human health exists in relation to the environment in which we live.”
For Dr. Francisco Olea-Popelka, the School’s Beryl Ivey Chair in One Health, understanding this interconnection is fundamental. “When we think of health, we cannot only think about human health,” he said. “Climate conversations that only consider one species on the planet are obsolete. Everything is interconnected – the health of humans, other animals and the environment we all share.”
The One Health approach represents tremendous opportunity, as well as a responsibility to be more inclusive. As one of the first institutions in North America to support a One Health program, Schulich Medicine & Dentistry is leading the way, but more needs to be done to move the work forward.
“We’re generating knowledge and educating, but we’re not implementing the vision,” said Dr. Olea-Popelka. “We need to integrate teaching and research across different departments and faculties, and we need to connect the University to the outside world. How can we, as scholars, influence policymakers and relevant stakeholders in industry, the media and the communities we serve?”
As one of the first institutions in North America to support a One Health program, Schulich Medicine & Dentistry is leading the way, but more needs to be done to move the work forward.
Another core value for climate activism is social and racial justice. Globally, the people and communities emitting the least are experiencing the most severe consequences.
In Canada, mainstream climate advocacy and research often fail to account for the unique impacts experienced by Indigenous communities – an essential step in the reconciliation process.
Members of HEART are working with Indigenous medical students in the CFMS on protocols for engaging Indigenous communities in advocacy, bringing a climate justice focus to the work the group and others are doing. “We need to ensure what we do is not continuing or sustaining the systems of oppression that exist within Canada,” said Kitching. “When advocating for climate change, it is also about supporting anti-racism.”
In the midst of a global pandemic and important conversations about systemic racism, the intersection of climate change, justice and equity is evident. Kitching says seeing the communityled response to these issues provides some hope.
“As a young person and as a medical student, I think about the ability to make major, rapid change,” he said. “The COVID-19 pandemic has shown us that our health is key, so much so that we will shut down the economy. That makes me hopeful that we can bring about societal change.”