Call to action in health

Captions: The ever-popular Martin Khor; No South African event is complete without traditional dancers; Kumi Naidoo moved the audience; Dr Hugh Mongomery and Minister Dr Aaron Motsoaledi

“I doubt there is a more important group at COP17 than you,” said Professor Hugh Montgomery (a founding member of the UK Climate and Health Council and director of the University College London’s Institute for Human Health and performance). “I doubt whether I will ever give a more important talk than this one.”

He was talking to a group of delegates, observers and visitors to the 17^th Conference of the Parties running in Durban, South Africa, where governments and corporate interests are negotiating and advocating around climate change. The group comprised roleplayers in health-care worldwide, from nurses to student doctors to NGOs.

Why does he consider them so important? Healthcare professionals were referred to as a ‘sleeping giant’ during this day-long Climate and Health Summit: trusted by society as healthcare providers, they number millions around the globe and could be hugely influential, both in shifting public perceptions and swaying political interests.

The summit was held on 4 December, and organised by Health Care Without Harm, the Climate and Health Council, the World Federation of Public Health Associations, the Nelson R Mandela School of Medicine at University of KwaZulu-Natal and with help from the South African NGO groundwork, addressed.

Professor Montgomery followed South Africa’s Minister of Health Dr Aaron Motsoaledi as keynote speakers, and they as well as other speakers repeatedly spelled out a simple message, yet one that has never yet been so clearly articulated at climate change events: health is the core issue of climate change. Forget sea-level rise and tornadoes and melting ice, the images so over-used in this context: when it comes right down to it, the most important, tragic and costly impact will be on the health of humans (and of course, with them, all other animals and species).

By the end of the day, the group had racked up a first: a declaration from and call to action for all health professionals worldwide to use their considerable clout and societal leverage to fight climate change.

Here’s a few possible consequences for humans which are already being felt around the world, and nowhere more so than in the countries that are home to the world’s poorest:

* Deaths and increased illness from living and working in significantly higher temperatures

* Respiratory disease as a result of the fatal collision of pollutants and rising temperatures, which trigger chemical changes in the air we breathe

* Malnutrition and starvation as crops fail (or are destroyed by extreme weather events, from floods to landslide to cyclones to wildfires – remember Russia’s breadbasket in flames last year?)

* Under-nutrition as food prices rise around the world, and people are forced to make poorer food choices

* Rising incidence of allergens as allergenic plants produce pollen sooner and extend their pollen season as warm weather lasts longer

* Rises in water-borne diseases and those carried by insect vectors which are able to expand their range due to warmer conditions, as well as quicker breeding by diseases like malaria due to more favourable conditions

* More injuries and deaths due to conflicts provoked by migration in search of food or water

… and much more.

These are the risks we face – but there are also benefits, said Professor Montgomery. There is what he called the “convenient truth”: that tackling climate change seriously will entail making real changes to our lifestyles – and it so happens that those changes bring with them enormous public health benefits: reducing our use of cars would mean increasing exercise throughout society as people walk and cycle more; reducing our intake of meat, one of the most ‘expensive’ foods in terms of greenhouse gas production would bring down animal fat intake and improve cardiovascular health; reducing the particulate pollution in the air would mean vastly improved respiratory health across societies.

“Waiting for someone else to do what must be done does not show moral leadership,” Montgomery said. “The talk about delays of eight years is frankly nonsense. If we plan to write a prescription in eight years time, we might well find ourselves writing a death certificate instead.”

Executive director of the South Centre, Martin Khor, closed the plenary session with tough talk that also, in his inimitable style, had everyone laughing. He said we all need to change our way of life and our desires dramatically: “We used to have a shoe to wear; now we have a shoe to go running, a shoe to go jogging – but not running… we all have a little Imelda Marcos in us.” We are squandering resources on what we don’t need today – and in the process, we are ensuring there will be no resources for tomorrow, he said. “We have to change our perception of what life is.” It’s not the wasteful stuff we use that makes up life: “Life is the wealth we have inside of us.”

A highly informative afternoon of parallel sessions was closed by a pair of rousing speeches, one from the premier of the province of KwaZulu-Natal where COP17 is being held, Dr Zweli Mkhize (who said, “What is the problem at these climate change negotiations? It’s the politics of profit…”) Dr Mkhize called for health professionals to find a way to bring research and evidence-based information of changing patterns in health to support advocacy at this and future meetings of its kind.

Kumi Naidoo, our ‘homeboy’ from KwaZulu-Natal who now heads up Greenpeace, drew on his experiences as an activist in South Africa’s struggles to call for a commitment from health professionals and all of civil society to fight climate change. He told the group of a friend of his, Lenny Naidoo (no relation), who was also an anti-apartheid activist, and who asked him once, back in those days, what was the greatest thing he could do for the struggle. Kumi replied, “To give my life for it.”

“You mean to die for it?”

“Yes.”

“Wrong answer. The greatest thing you could do is to give the rest of your life for it,” said Lenny. (Ironically, some years later, while in exile, Kumi heard that his friend had been brutally killed by security forces.)

Naidoo asked that we all do exactly that: show our conviction and commitment by giving the rest of our lives to it.

The group made a fine start with a heartfelt and ringing reading of the declaration it had drawn up, followed by a Call to Action:

Given the gravity and urgency of the situation—and the opportunity to promote public health by addressing climate change--we call on our colleagues in public health organizations, health professional associations, hospitals, health systems and ministries of health around the world to endorse this Call to Action and take concerted action.

Having convened at the first Global Climate and Health Summit in Durban, South Africa, we hereby commit to:

1. Provide Leadership: As representatives of our organizations, we will drive the agenda for climate and health, promoting this Call to Action throughout the world.

2. Engage and Inform: We will engage and inform our constituencies of millions of doctors, nurses, public health workers, hospitals, health systems and health policy makers about the health risks from climate change, and the health benefits of climate action. As health professionals, we will also serve as messengers to our patients, our communities and our governments about the major health impacts of climate change and the steps they can take to reverse their impact.

3. Mitigate: We will lead by example and reduce the carbon footprint of our own institutions, practice and activities. We will strive to make our hospitals greener and healthier by reducing waste, investing in energy efficiency and clean energy sources, while promoting sustainable transport and resource consumption. By doing so, we commit to demonstrating how our societies can move toward carbon neutrality.

4. Adapt: We will strive to make our health systems more resilient and capable of withstanding and responding to the human toll of natural disasters and the shifting burden of disease.

5. Advocate Locally and Nationally: We will work within our countries to advocate for emissions reductions and/or low-carbon development strategies that promote both a healthy climate and public health. We will call for solutions that reduce the local health impacts of fossil fuels; solutions that foster clean energy and social justice; solutions that save lives and money while protecting public health from climate change.

6. Advocate Globally: We will advocate for a fair and binding global agreement, as articulated in the Durban Declaration on Climate and Health, that:

* Places the protection of human health as a primary objective of any agreement.

* Establishes an ambitious fair shares framework to reduce global emissions (based on the principles of Equity and Common but Differentiated Responsibilities and Respective Capabilities) in order to avoid a global public health disaster.

* Fosters both energy efficiency and clean, renewable energy that protects public health by reducing both local and global pollution.

* Provides the immediate necessary resources to operationalize the Green Fund, and in the longer term, appropriate mitigation and adaptation funding required to address the health impacts of climate change, assuring all countries’ Rights to Sustainable Development and their ability to pursue a low carbon development pathway.

The matter is urgent. The health of the world’s population is at risk. The time for action is now.

• For more information visit www.climateandhealthcare.org
• Download the Durban Declaration on Climate and Health
• Download the Durban Global Climate and Health Call to Action

What the best-dressed activists are wearing

Yesterday I attended a full-day summit, a great day on the impact of climate on health, addressed by some high-powered people, and culminating in an important declaration. I'll write that up later when I get the text of the Call to Action. Meanwhile, I've been collecting t-shirt slogans off activists at COP17!

Third post for 3 December march

I had to include a pic of the Godiva trio, of course - and of the activists at the beach, which was the terminus of the march.

Second post on 3 Dec march

There were some brave Canadians present, giving some civil society balance to their government's position!
Don't you love the school kids rushing to join the march?
Click on my other 3 December posts (at right) for more.

Long walk to climate justice

"At last, something real," I heard one activist say. 'Something real' was the Global Day of Action, which drew, what, 8,000 protestors? (The police told me 5,000, an activist leader said 8,000 - you pays yer money and you takes yer choice.)
It took more than two and half hours to march from an area known as the Warwick Triangle to the International Convention Centre - with a pause en route outside the USA Consulate. At the ICC, the crowd met Christiana Figueres, Executive Secretary of the UNFCCC, and the COP17 president, Minister Maite Nkoana-Mashabane (who graciously acknowledged that civil society was an 'important component' of the COP - and advised the activists to support the local economy by visiting the beachfront and the shopping malls). Veteran activist Tom Goldtooth (Indigenous Environmental Network) joined African leaders like trade unionist Zwelinzima Vavi in making speeches.
Some colourful characters had flown in long-haul, including a trio of women whom I'm sure every camera snapped - they marched bare-breasted (but painted) against nuclear power. Every kind of local activist was present, from the subsistence fisherfolk of Durban to rural women to an LBGT contingent and many unionists.
I found the two key songs of the march rather amusing in counterpoint: a favourite of march leader Virginia Magwaza-Setshediwas a song which runs: "My mother was a kitchen girl/my father was a garden boy/That's why I'm a socialist, I'm a socialist, I'm a socialist..." A male march leader whom I never managed to identify, on the other hand, opted for Umshini wami (Bring me my machine gun), SA President Jacob Zuma's theme song.
I'm going to post three times today, to get enough pics in!

You have struck the women, you have struck a rock...

Today, the Rural Women's Movement turned up en masse at Speaker's Corner opposite the UN precinct in Durban, South Africa, where COP17 is being held. They are concerned about the very real impact of climate change which is already affecting their smallholder and subsistence farms.
Dancing, singing and speeches in one spot were not enough for them, so they set off on an impromptu march. Then the men and women of the One Million Climate Jobs campaign arrived in their gorgeous red T-shirts, and off we went! (Contrary to appearances, the police were quite calm, just concerned to contain the march within certain streets and not let it spread.)
Thirsty work protesting, so the Occupy people offered returning marchers water. (It's great exercise, too: one zaftig young woman yelled to me, "After tomorrow's march, I will wear a size 36!")

Down to zero

Captions: Marlen Charcon from Costa Rica with New England waste pickers; A truck-full of recyclables; Great slogans; l-r Manisha Desai, outreach manager at SWACH, India, with Mrs Sushila Sabale and Mrs Suman More;

Visit any dump site or landfill in the developing world and you will see people picking through the waste, alongside flocks of birds doing the same. Most of us who live comfortable suburban lives will shudder and turn away, either horrified at the desperation or repulsed by the idea of sorting through others’ grubby, messy leavings.

But we should not. We should applaud the waste pickers as strong and independent people who are making a living off our excessive trash – and as heroes in the struggle against climate change.

Waste pickers extend the life of landfill sites by reducing the amount of waste that needs to decompose; they reduce greenhouse gas emissions (GHG) from the landfill itself; they reduce GHG by making available materials that would otherwise have to be obtained from virgin sources (every ton of paper recycled means 17 trees left standing, for instance); using recycled materials is often less demanding on power than virgin materials, thus reducing GHG again; and on top of all that, the waste pickers are making a living, supporting their own families and even supporting other jobs (in the recycling industry) which would not exist but for their work.

Finally, consider this: “Recycling is one of the cheapest and fastest ways to reduce greenhouse gas emissions. Avoiding one ton of CO2 emissions through recycling costs 30% less than doing so through energy efficiency, and 90% less than wind poer.” (www.globalrec.org, the website of the Global Alliance of Waste Pickers)

Talking to a meeting of waste pickers at COP17, Neil Tangri of the Global Anti-Incinerator Alliance asked “How many times has it happened to you that a stranger comes up to you and says Thank you for what you are doing, thank you for fighting climate change?” The answer, from an audience composed of South African Waste Pickers Alliance members and several representatives of international organisations, was loud shouts of “No! Never!”

On Day 3 of COP17, leaders of waste picker-groups in most major cities of South Africa talked about the obstacles they face and the solutions they need, and listened as Indian and Costa Rican waste pickers offered encouragement and practical advice.

Given the huge contribution waste pickers are able to make to mitigating climate change, it’s astonishing how often the same problems are repeated, over and over again: harassment by police and municipal authorities, lack of recognition for their role and active disrespect, being blocked from landfill sites and more.

Perhaps local and regional governments should take a long hard look at the science available on options for managing waste. On the one hand, you have the classic landfill site, in which layers of shale and clay and high-density poly-ethylene are used to seal the ground beneath pits which will hold strata of waste. This will ultimately be sealed over, and, according to international standards of best practice, will be rehabilitated with vegetation, while the methane gas which forms in the decomposing mound will be siphoned off to create electricity or be used for cooking. Alternatively, waste can be incinerated, but this, of course, has environmental impacts and should, ideally, be a last resort (and incinerators used to generate electricity emit more CO2 than coal-fired power plants).

Waste pickers, on the other hand, are a very efficient method of reducing waste to – well, it sounds like wishful thinking to say to zero, but that’s the promise we were made by Mrs Suman More from Pune, the eighth largest metropolis in India (it’s in the same state as Mumbai). “We are confident that we can recycle ALL the waste which is generated – except waste which cannot be recycled at all,” she says firmly. She brings years of hands-on waste-picking and organising among waste pickers to bear when she speaks.

Human beings are by far the best ‘machine’ for doing this work, she said on a field trip to two local landfills. Our group was standing on a berm overlooking the New England Landfill outside Pietermaritzburg (the Msunduzi municipality), a small city close to Durban where COP17 is being held. We were watching a group of waste pickers pack a truck with a towering load of material they’d picked off the dump and were now taking to sell to companies which recycle paper, plastics and other materials.

Where the role of the waste picker is recognised by authorities, dry waste is reduced to a minimum in this way, while wet waste (organic and messy stuff like food) is separated before even reaching the landfill and used to make compost. (Since it decomposes rapidly and produces methane in the process, this can be used to generate electricity or cooking gas.)

Humans are highly efficient at picking out every last little bit of opportunity in the mounds of waste brought to landfill sites. Before we visited Pietermaritzburg, we’d explored the state-of-the-art Marianhill Landfill site just outside Durban. While the rest of us admired the beautiful and pioneering conservancy around the site, and the attractive green hill created by a rehabilitated landfill, Indian, Costa Rican and South African waste pickers were shocked to see all that recyclable waste being simply covered over!

The New England Landfill is a very different set-up. Of course it’s not a pretty sight, but dozens of people were still at work waste-picking in the late afternoon when we arrived, and they gathered around curiously. When they discovered that the international delegates did the same work, and had experiences to share, they were eager to hear more.

The Indian women, Sushila Sabale and More, talked about how they had fought for recognition 15 years. Now waste pickers have identity cards which entitle them to collect rubbish door to door, directly from householders (this makes separation less arduous), and they have their own shop selling recyclables, which has improved the prices they get for their materials.

“You must be organised,” Marlen Charcon from Costa Rica told the group. Having seen how it can help improve circumstances for waste pickers, she is passionate about uniting in organised groups, which can negotiate better prices with buyers and better conditions with waste site managers.

The manager at the New England site, Cyril Naidoo, listened with interest. He is a rare exception, a manager who, after 16 years on the job, appreciates the role the waste pickers play and sees them as human beings with a right to earn a living.

“It’s not good to work here – but we can support our families,” said Patricia Kheswa, a middle-aged woman waste picker at the New England site. There was general agreement that it’s not pleasant work, but it opens up opportunities. “Our children don’t work as waste pickers,” said More. Her children have all been able to study – one of them, she tells us, is a journalist. Her days of hard manual labour, which are reflected in her hands and face, have left a proud legacy.

Life should not – and does not – have to be so hard for waste pickers, in both the global north and south (wherever there is waste, there are waste pickers). If we all clearly understood the cost our throwaway society was extracting from the environment, we would be more respectful of their role, actual and potential, in mitigating that. And once we’ve recognised that, it’s surely does not take much to offer safer on-site conditions through simple equipment like heavy-duty gloves and boots, as well as some comfort in the form of, perhaps, ablution blocks and sheds for shelter? At the very least, we could refrain from harassing them and chasing them away from landfill sites. At best, as Naidoo hopes to do, landfill management could negotiate a safe and legal role for organised groups of waste pickers.

And at the level of COP17, waste pickers around the world would like official support for waste recycling (rather than the fashionable ‘waste-to-energy’ projects espoused by so many cities round the world). Carbon credits for incinerators and landfills just discourage recycling, they say. Waste pickers would like direct access to funding available through ‘Green Climate Funds’ to enhance their efficiency at recycling – and make the most of their ability to reduce GHG. Here’s hoping some of the bigwigs in COP17 are listening!