The largest ever survey on climate change conducted among over 3000 healthcare professionals in India, has revealed that the health sector should play a crucial role in action and advocacy on climate change in India. Over 85% respondents believed that the healthcare sector has a responsibility to address climate change and reduce their own carbon footprint. 3062 healthcare professionals including doctors, nurses, paramedical staff, hospital administrators, Accredited Social Health Activist (ASHA) workers, Non-Governmental Organizations (NGO) health staff and healthcare students were surveyed in this study conducted between August and December 2020.
The respondents belonged to six states in the country representing various zones: Uttar Pradesh, Bihar, Meghalaya, Chhattisgarh, Maharashtra, and Karnataka.
The survey has clearly established that overall awareness of climate change among all sections of health workers is as high as 93%. Out of the 7 groups of health workers interviewed, doctors were the most aware category at 97.5%, followed by healthcare students at 94.8% and hospital administration staff at 94.3%. ASHA workers with 92.5% awareness ranked fourth leaving behind nurses at 89.6% who are the least aware of climate change, its causes, impacts and links to human health among all the healthcare workers. It is evident that since the ASHA workers are key for delivering government healthcare to the last mile, they are more in tune with the schemes and initiatives and hence are more aware.
The findings of the study clearly indicate that health sector leaders want the sector to be at the front and center of action and advocacy on climate change. Indian health sector can make a substantial contribution to mitigate the effects of climate change by adopting green technologies to reduce various greenhouse gas emissions and decreasing energy consumption by adopting renewable energy – Dr. Arvind Kumar, Founder Trustee, Lung Care Foundation.
More than 81% of the respondents agreed that deforestation, burning fossil fuels, waste generation, emissions from industries and population growth are the main reasons for greenhouse gas emissions, which are resulting in rampant climate change. This awareness level among healthcare workers indicates a much higher understanding of the causes of climate change than observed in most perception studies in India. Almost 74% of the respondents also believed that the public health community is now faced with an increased burden of climate-sensitive diseases, that directly and indirectly impacts both the healthcare professionals and infrastructure. This first of a kind study to understand the knowledge, attitude, perception and practice of the healthcare sector towards climate change was conducted by Healthy Energy Initiative – India in collaboration with data agency, Morsel India.
The survey, conducted during the second half of 2020 when the country and the world was dealing with the effects of the COVID-19 pandemic, revealed that majority of the respondents did not believe that there were adequate preparations to deal with the pandemic and that the healthcare infrastructure is not even prepared to deal with a mass epidemic in the future. One of the major findings of the survey on priorities in the post COVID-19 recovery plan was that 83.4% of the respondents indicated that activities that prioritize health of the citizens must be high on the post COVID-19 recovery plan, whereas 82.8% of the respondents said activities focusing on conserving and protecting the environment in a strict manner is important.
The findings clearly lay out that health professionals and students – more than ever – want to be involved in fighting climate change and protecting our communities. The findings also bring out the gaps that exist in our own knowledge as a community, that we are determined to work on – Poorvaprabha Patil, President, Medical Students Association of India.
Air pollution is often perceived as a Delhi related problem, but interestingly the survey clearly shows that the health impacts of toxic air are understood by healthcare workers across the country. 88.7% of respondents believe that air pollution related illnesses will have a direct impact on the health sector, ranking it as the highest threat among heat & cold related illnesses, vector & water borne diseases, communicable diseases, mental illnesses and malnutrition. 68.9% of the healthcare workers believe that climate change has a direct impact on the health sector, while 74% believe that there has been an increase in climate-sensitive disease burden on the populations.
While the survey found high awareness among healthcare professionals on the issue of climate change, it also revealed that not many of them are currently actively raising the issue of climate change and its impacts among the public. The respondents were of the opinion that much work was needed to make the healthcare systems climate resilient and that the healthcare professionals should be equipped with adequate information for them to raise awareness among the public. 72.8% of those who participated in the survey agreed that it was the need of the hour and climate change and its health impacts must be included in the medical curriculum in India.
Climate change is a health issue, and it is quite clear from the study that there is a great opportunity for engaging the health sector professionals to embrace climate change mitigation, adaptation and risk reduction practices and embark on a path towards climate resilience. Government should operationalize the early warning systems to get advance information about expected climate induced extreme weather events and diseases, facilitate stronger interdepartmental collaboration, provide sufficient supply of manpower and medicines and speed up setting of climate resilient health infrastructure to combat the impacts of climate change” – Dr. Poornima Prabhakaran, Deputy Director of the Centre for Environmental Health at the Public Health Foundation of India
The study provides recommendations to effectively build capacity among the healthcare professionals and advocates the need to provide nuanced information of the multiple ways (direct, indirect and through economic and social disruption) in which health could be adversely impacted due to climate change. It further recommends that climate change and health impacts should be a subject in the medical curriculum for education of healthcare professionals from all streams and specializations; Healthcare professionals should be provided with information and training on the international negotiations on climate treaties, especially the Paris Agreement; and detailed information regarding state and national action plans on climate change and human health, in an easy to understand format must be provided to the healthcare workers.
The health impacts of air pollution have become mainstreamed to the extent that not a day goes by when we don’t see a news article on this. With COP26 coming up, the health message needs to be clearly communicated that the causes of air pollution and causes of climate change overlap at least 75%, which allows us to drive the point in negotiations, that more than 7 million premature deaths can be associated to air pollution, and therefore if we talk about climate change, we will contribute to save lives. This is the type of message that needs to be provided to our policymakers with a very clear modelling scenario, that if you implement the Paris Agreement treaty at a certain rate, these are the number of lives you will save and delay will lead to these many deaths, the responsibility for which rests on your shoulders. We have to provide concrete data on the type of diseases, and reduction in prevalence and reduction in mortality due to policy measures. Good health is a very positive economic resource and we need to convince our policymakers that mitigation measures can be taken strategically, intelligently, and by being more respectful of human health – Dr. Maria Neira, Director, Department of Public Health, WHO, who also attended the webinar where this study was released.