vision
„Medicine is a practice. And it's not hard for people trained as clinicians to understand that there is another practice to learn: community organizing.“
Peja Stojic, Lecturer at Harvard School of Public Health
Spotlight
As climate impacts intensify, medical professionals are increasingly on the front lines. From the dangers of extreme heat to the spread of infectious diseases, climate change is a health crisis. Doctors, nurses, and other health care workers are taking this into account in their daily work and increasingly find themselves caught up in the broader fight for climate change mitigation and justice. I am. Because of this, they are also a great test group for understanding what it takes to move someone from resignation to empowerment. It turns out there is actually a blueprint that anyone can follow. And one recent initiative with medical experts is showing the way.
In 2022, the Center for Health Equity Education and Advocacy was established at Cambridge Health Alliance, a teaching hospital of Harvard University. fellowship Provide health professionals with community organizing tools for climate action. Fellows worked with his three-person or four-person teams to learn organizing principles and work on climate change advocacy projects in their communities.
last week, Research published in Academic Medicine I am looking at the results of the first year of the fellowship (currently in the third year). This study uses pre- and post-fellowship surveys to help participants deepen their understanding of the historical context of climate change and the health inequalities it creates, as well as gain confidence in their ability to do something about it. I found out that
„What was exciting to me was that people's sense of purpose and community really increased,“ said Gaurav Basu, a primary care physician and director of education and policy at Harvard's Center on Climate, Health, and the Global Environment. . fellowship. (We previously covered his efforts) Incorporating climate-related materials into Harvard medical school curriculum) At the beginning of the fellowship, only 47% of health organization fellows agreed that their organization had the tools to fight climate change and felt prepared to fight climate change in their communities. There were even fewer people. After the training they received, that number rose to over 90 percent, according to a survey the fellows took.
“Health professionals feel they understand the health implications of climate change, air pollution and ecosystem degradation, but feel very discouraged by it. . It feels so big and overwhelming,” Bass said. “For me, education is a way to empower individuals and help them understand that they can be in a position to actually make a difference.”
Peja Stojčić, another co-director of the Climate Health Organizing Fellowship and a lecturer at Harvard University's TH Chan School of Public Health, trained to become a doctor in her native Serbia. He also grew up in the 1990s during the Yugoslav wars and dictatorship, and said he was „trained as an activist out of necessity.“ Slobodan Milosevic. „As young people, we felt the need to resist it and lead the country to democracy,“ he said.
Later, as a physician, he also helped organize a coordinated response to the HIV/AIDS epidemic in Eastern Europe. However, he began to feel that there were certain limits to medical practice, treating one patient at a time. “Then I had the pleasure of learning about community organizing in the civil rights movement and farm worker union tradition here in the United States,” he said. “The experience of learning how to teach something, which I have been practicing for quite some time, has helped me connect the dots. Similarly, this is not something only you can do. It also has the potential to be transmitted to others.”
Stojicic's approach to teaching others transitioning to advocacy, learned from a renowned organizer and educator Marshall Gantzfocuses on first building a community and then activating that community toward a specific goal.
The health organizing fellowship curriculum followed an arc of five key skills: storytelling, relationship building, team building, strategizing, and taking action. This formal instruction lasted for six months. Fellows met monthly to participate in virtual training sessions with experienced community organizing coaches and also attended three weekend courses. Over the next six months, the fellows continued to meet monthly with their coach and develop a community project.
![Two side-by-side images show a woman speaking to reporters in a park, and another crouching in the grass holding a planter full of seedlings.](https://grist.org/wp-content/uploads/2024/01/Nordson-Green-Earth-LF-1.jpg?quality=75&strip=all&w=1200)
![Two side-by-side images show a woman speaking to reporters in a park, and another crouching in the grass holding a planter full of seedlings.](https://grist.org/wp-content/uploads/2024/01/Nordson-Green-Earth-LF-1.jpg?quality=75&strip=all&w=1200)
One of the fellows, Dr. Sheetal Rao, co-founded a nonprofit called Nordson Green Earth to increase tree equity in the Chicago area. Courtesy of Dr. Sheetal Rao
Part of these trainings involves a kind of mindset shift for clinicians who are used to having the answers and literally prescribing solutions, Stosic said. „Community organizing teaches us something else: Start with people, build relationships with people, and together ask, 'What projects do we want to work on collectively?' you need to do.”
Gabriel Cisneros, a Pittsburgh pediatrician and first-year fellow, said he never considered himself an activist or community organizer before the training. „Much of my education has focused on patient care, protecting children from disease, and prescribing medications,“ he says. Although he has long been interested in the environment and even studied it as an undergraduate, he didn't realize it had any impact on his day-to-day work as a doctor until he received a „wake-up call.“ I hadn't thought about it. While he and other health care workers were battling the pandemic, wildfires broke out in California. It was near the house where Mr. Cisneros grew up and where his young daughter was visiting his grandmother.
A complex crisis has hit close to home. “That led me back to my original background in the field and made me think about what my role as a pediatrician is to protect the health of my patients from this climate crisis, a health crisis. ” Cisneros said. “And I found out that there were other doctors with similar experiences and thoughts.”
Cisneros participated in a fellowship with two colleagues, and through their training, Clinicians for climate action Born as a community of concerned colleagues at the University of Pittsburgh Medical Center (UPMC). As a capstone project for the fellowship, the group successfully advocated for employers to: Sign the health sector climate change pledgecommitted to reducing greenhouse gas emissions by 50 percent by 2030.
It began with a petition that Cisneros and others circulated among staff. “Instead of spamming the entire system, it was a matter of making personal requests to colleagues I work with and who might be interested. From there, we multiplied our membership. This was done in conjunction with Earth Day 2022, and I think we received almost 300 names within a week, including doctors, nurses, medical students, and various medical professionals. And the basics. We immediately got a positive response that the CEO supported this.”
Since signing the pledge, UPMC has Phasing out the use of an anesthetic called desflurane, which is also a powerful greenhouse gas. Other initiatives include the rollout of EV charging stations to facilitate more environmentally friendly transportation to and from hospital grounds.
“We are looking for ways to balance patient needs without contributing to emissions,” Cisneros said. „It's a huge undertaking. We're still learning how we as a system are contributing to warming.“
In a somewhat similar vein, another capstone project during the first year of the fellowship involved lobbying the American Medical Association. Declaring a climate change public health crisis — It took place in June 2022.
Other groups focus on local efforts to improve community health and equity. Examples include working with nonprofits to strengthen tree equity in and around Chicago, and supporting mapping and mitigation. Milwaukee Flood Vulnerability.
For Cisneros, climate action is personal. He is fighting for a viable future not only for his young patients, but also for his own daughter, now 10 years old. And he feels his obligation to take advantage of the position and authority he is given as a physician. “When I speak, people listen,” he said. “Other people who I think are a little bit bad have to do the following. interfere with play to convey their message. And here I am given the opportunity to speak and be heard. That's why I have participated in this activity and will continue to do so. ”
Stojic believes people who choose to become health care providers have already chosen a life of essentially advocating on behalf of their patients. It is not a huge leap to extend this argument outside the hospital to the societal level.
„Clinicians, in many ways, see the world of pain as they work and develop deep, trusting relationships with their patients,“ Dr. Stojicic said. Changing climate. „And when we start to see that, we all ask ourselves: What can we do about it?“
As the Fellowship participants' research showed, giving people concrete answers to that question – what can I do and how should I do it – changes people's attitudes towards climate change. , and the work they were able to do in the community both yielding productive results.
But this fellowship also shows us something else. Being a climate change advocate (or a social issue advocate) doesn't mean abandoning everything else. For medical professionals, when you add advocacy work on top of their incredibly demanding jobs, it seems like things could get even worse. Burnout rates are already high — But by focusing on building community first, fellows were able to rely on their teams and take time away from work during periods when other priorities required their attention. Stojic stressed that this does not indicate a lack of commitment, but rather a commitment to giving as much of themselves as possible and a sense of trust in the community they have worked so hard to build.
— Claire Ellis Thompson
further exposure
parting shot
Another interesting climate and health story. Peruvian epidemiologist Gabriel Carrasco is working to create an early warning system for disease outbreaks that are becoming more common due to climate-related factors. The Washington Post featured Carrasco's research in an interactive feature The researchers are looking at how AI-powered systems can track patterns that lead to increased exposure to diseases such as dengue fever, with the hope that they may one day be able to predict outbreaks early. In this photo, a team of researchers investigates a pool of standing water, a breeding ground for mosquitoes, flagged by drone imagery.