Global Health : a broader perspective of environmental

health

Michael Kidd

•  21st century global and local health challenges

•  How to become a resilient doctor and a medical leader

•  Your legacy – how to use your medical career to make a difference

“First, do no harm …”

Not only do no harm to our patients

It is also about protecting the wellbeing of our families, our colleagues, our

environment and ourselves

Challenges you will face

•  Tackling the challenges of inequity: - inequity of access to health care - inequity of outcomes of health care

•  How do we work to ensure that high quality health care is available to all people in every nation of the world, including those who are disadvantaged and marginalised?

Millennium Development Goals

What’s missing?

The power of healthcare to transform the world

•  7 billion people •  1 billion with no access to health care

services

•  Bryan Steveson, equal justice advocate (TED)

•  “You judge the character of a society, not by how they treat their rich and the powerful and the privileged, but by how they treat the poor, the condemned, the incarcerated.”

Dr Margaret Chan Director-General

World Health Organization

•  “Climate change is one of the greatest challenges of our time. Climate change will affect, in profoundly adverse ways, some of the most fundamental determinants of health: food, air, water. In the face of this challenge, we need champions throughout the world who will work to put protecting human health at the centre of the climate change agenda.” –  World Health Day 2008

WHO: Major Health Consequences of Climate Change

1. Disruption of food supplies 2. Increased frequency of extreme weather

events 3. Increased threats to water security and

quality 4. Effects of higher temperatures 5. Changing patterns of distribution of

mosquito-borne disease

All will contribute to disruption and destruction of vulnerable towns and cities and population displacement

“Climate change is the greatest moral challenge of our time”

May 30, 2007

Ratified Kyoto Protocol December 3, 2007

•  ''The argument [on climate change] is absolute crap. However, the politics of this are tough for us. Eighty per cent of people believe climate change is a real and present danger.'' The Hon Tony Abbott MP, September 30, 2009

Messages from WHO

United Nations Climate Change Conference Copenhagen December 2009

•  “Along with environmental and economic damage, the ultimate impact of climate change represents a toll on our most precious resource – human lives and health.”

•  “The health sector will bear most of the burden of protecting and treating people that are negatively impacted by climate change.”

What’s good for reversing climate change is also good for your health •  “Cut carbon, improve health” Lancet 2009

•  Low carbon societies – the next global health advance

•  Policies that reduce greenhouse gas emissions result in health gains by reducing obesity, heart disease, diabetes, cancer, road deaths, disease from air pollution

•  Unprecedented opportunity to reduce global health inequities

Our role as health practitioners •  We are well placed to instigate changes within

our workplaces •  We have a role in educating and raising

awareness of public health issues •  DEA educational resources

Specific actions – one doctor’s list

•  Robyn McDermott, GP and public health physician, MJA 2010

•  Reduce adverse environmental impact of the health care industry

•  Develop a nationwide comprehensive food and nutrition policy based on the entire food production cycle

•  Urban redesign to encourage active transport •  More support for sexual and reproductive health

services in developing countries

How to be a resilient doctor

•  If we are going to make a difference, even in the face of the odds, and achieve important things with our lives we need to be resilient

•  Resilience is the ability to remain strong and to grow stronger when facing adversity

6 ways to be a resilient doctor

1.  Value strong relationships

•  Take time every day to nurture healthy relationships with your patients and your colleagues.

•  “Be caring and curious about your patients’ stories.” – Dr Faith Fitzgerald

6 ways to be a resilient doctor

1.  Value strong relationships 2.  Make home a sanctuary

Time out

•  Make an appointment with yourself

•  Time out •  to think •  and reflect •  and rest •  and re-energise

6 ways to be a resilient doctor

1. Value strong relationships 2. Make your home a sanctuary 3. Recognise conflict as an opportunity

•  “Honest differences are often a healthy sign of progress.” – Gandhi

6 ways to be a resilient doctor

1.  Value strong relationships 2. Make your home a sanctuary 3. Recognise conflict as an opportunity 4. Stand up for what is right

“To sin by silence when they should protest, makes cowards out of good men.” – Abraham Lincoln (1809-1865)

6 ways to be a resilient doctor

1.  Value strong relationships 2.  Make your home a sanctuary 3. Recognise conflict as an opportunity 4. Stand up for what is right 5. Have your own doctor

•  “A physician who treats himself (or herself) has a fool for a patient.” – Sir William Osler (1849-1919)

6 ways to be a resilient doctor

1.  Value strong relationships 2. Make your home a sanctuary 3. Recognise conflict as an opportunity 4. Stand up for what is right 5. Have your own doctor 6. Create your legacy

•  “I don’t know what your destiny will be but one thing I do know.

•  “The only ones among you who will be really happy are those who have sought and found how to serve.”

Dr Albert Schweitzer Nobel Peace Prize 1952

•  “I don’t know what your destiny will be but one thing I do know.

•  “The only ones among you who will be really happy are those who have sought and found how to serve.”

Who are your role models in medicine?

The 4 remarkable legacies of 4 remarkable Australian doctors

•  “We’re giving a beautiful woman a new life and this is why I stay in Ethiopia. It is because I love them.”

Catherine Hamlin

•  “I have a conviction that it’s only when you are put at full stretch that you can realize your full potential.”

Edward Dunlop

•  “You don’t need to be a surgeon to restore someone’s sight. It’s a simple operation.”

Fred Hollows

Who is the fourth doctor?

Which of your peers inspire you to achieve greatness?

•  As medical practitioners we are all leaders in our communities

•  Many of us take on leadership roles with our professional societies, with other organisations which do good works, and supporting the work of our governments

•  Working together we can make a difference

“Change will not come if we wait for some other person or some other time. We

are the ones we've been waiting for. We are the change that we seek.”

“With great power comes great responsibility”

“With great power comes great responsibility”

Spiderman

It is amazing where your medical career can take you

Things I didn’t know 36 years ago

Our responsibilities as medical practitioners …

•  To be an advocate for social justice and human rights

•  To contribute towards ensuring equity of access to health care – “a fair go”

•  To speak out for what is right •  To stand up for freedom and justice and

peace •  To care for the health of our planet as well

as the health of our patients

5 ways to make a difference in the impact of your career

1. Identify the qualities you admire in your role models, mentors and colleagues and adopt them as your own.

5 ways to make a difference in the impact of your career

2. Uphold your integrity in everything you do.

5 ways to make a difference in the impact of your career

3. Develop goals for all aspects of your life -  your spiritual life -  your physical and mental health -  your career -  your relationships with other people, especially

those who love you and provide you with support.

5 ways to make a difference in the impact of your career

4. Provide support to your colleagues – the people who work alongside you every day

and who share your commitment to delivering the highest possible quality care to the people who trust you for their health care and advice.

5 ways to make a difference in the impact of your career

5. Find the meaning and the purpose in your everyday work

- and discover and then rediscover every day of your life the joy and the privilege of being a doctor.

Dr Sun Yat-Sen

“If you believe in yourself, you can

move mountains and fill in the ocean: no matter how difficult

the task, you will see the day when you

succeed.”

Be the change you want to see in the world

•  Why are you studying medicine? •  What is your passion in life? •  What do you want to have achieved in the

next 5 years? •  And the next 10 years? •  How will you make a difference? •  Who are your role models? •  How will you inspire the next generation?

And what will be your legacy?

•  A lot of us enter medicine wanting to change the world for the better

•  Working together we can actually do it

•  That way you will know you have succeeded

And always remember, no matter where and how you choose to

practise medicine… •  Our important work as doctors will continue

•  Never forget that we are privileged to work as doctors and to work with our local communities

•  Never forget that through our work each of us makes a positive difference in the lives of our patients every single day