Volume 24, Number 7: July 2023
Palliative care for a person, like care for the planet, have unexpectedly similar aspects, including this: both are complex problems that require complex solutions.
Photo supplied by Pixabay. Used with permission.
Climate & Health at the World Health Assembly:
Implications for the global palliative care movement
By Natalie Greaves, IAHPC Board Member,
and Michael Campbell
Recently, thought and policy leaders in health gathered at the United Nations in Geneva for the 76th World Health Assembly. The WHA, as the decision-making body of the World Health Organization, is an annual forum for member states and nonstate actors to discuss, adopt, and enact policies and budget priorities that impact the health of the world’s citizens.
A particular highlight of this year's WHA was the strategic roundtable on climate and health attended by WHO Director General Dr. Tedros Adhanom Ghebreyesus, youth advocate Dr. Omnia El Omrani, and the intergenerational father-and-daughter climate advocates Dr. John and Dr. Vanessa Kerry, who was appointed June 22 as the first WHO Director-General Special Envoy for Climate Change and Health.
Underlying aspects of this climate and health discussion resonated with many key positions that we hold dear within the global palliative care movement.
Complex problems need multidisciplinary action
First, the unofficial tenet that complex problems are best understood and resolved through multidisciplinary problem-solving.1 In palliative care we have long valued the multidisciplinary team model as a tool for systematically identifying and addressing the challenges faced by our clients.1 It was interesting to see this framework being used at the population versus individual clinical level, informing and even underpinning global policy-level dialogue on the complex social, economic, and political issues occurring because of the climate crisis.
All people matter, equally
Second, the operationalization of Dame Cicely’s principle—“You matter because you are you.”—is central to the climate discussion.2 All lives matter because of the equal value innately possessed by all human beings. So, as we in palliative care have been trying to practice for years (but not without challenges), all people are deserving of care, without regard to diagnoses, ethnicities, geographic locations, or other factors.2,3 Though needs may differ, the root positioning of palliative care is, and has always been, equality, autonomy, dignity, and respect. It was refreshing to see this core value of palliative care being reflected within the climate discussion. Certainly, this multidisciplinary, equal-voice approach will be crucial to mitigating the impact of the climate crisis on palliative care provision globally, both now and in the future.
From the perspective of people living and working in small island developing states, known as SIDS, the integration of current thinking about the climate crisis in discussions of health policy is welcome and viscerally relevant, but the reality is that the climate crisis is already having an impact on the physical, social, and psychological quality of life of patients and families,4 even more so for those with palliative care needs.
Our complex needs experience is valuable
Palliative care clients and providers struggle daily with climate-related food and water insecurity, strife, and conflict (such as disruptions of access to essential palliative care medicines), and the dual burden associated with coping with life-limiting illness such as cancer while facing increased risk of contracting and coping with emerging and re-emerging vector-borne diseases such as cholera or malaria.5
Therefore, we urge us all as members of the global palliative care community to see that palliative care and the climate crisis are inextricably linked. Further, within palliative care we have more than 50 years of experience in addressing complex health needs and can lend our expertise to solutions that might be needed in the climate field. Finally, solution-oriented thinking is crucial for identifying and implementing practical interventions to mitigate the impact of climate crisis on our clients.
Natalie Greaves, MBBS, PhD, is a lecturer in public health and coordinator of the MPhil/ PhD Programme in Public Health and Epidemiology at The University of the West Indies, Cave Hill Campus, Barbados. Natalie merges her clinical passion for community based palliative care with academic applied public health, providing expertise in using qualitative methods to explore complex issues such as serious health related suffering and climate and health.
Dr. Michael Campbell is senior lecturer in behavioral science/psychology and deputy dean (research & graduate studies) in the Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Barbados. He publishes in the areas of global health psychology and bioethics, and is a fellow of the American Psychological Association, associate fellow of the British Psychological Society, and past president of the Barbados Society of Psychology.
References
1. Borgstrom E, Cohn S, Driessen A, et al. Multidisciplinary Team Meetings in Palliative Care: An ethnographic study. BMJ Supportive Palliat Care. Published Online First: 30 September 2021. DOI: 10.1136/bmjspcare-2021-003267
2. Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation. Dame Cicely Saunders: A palliative care pioneer. King’s College London.
3. Tobin J, Rogers A, Winterburn I, Tullie S, Kalyanasundaram A, Kuhn I, Barclay S. Hospice Care Access Inequalities: A systematic review and narrative synthesis. BMJ Supportive Palliat Care 2022; 12: 142-151.
4. Campbell M, Greaves N. Climate. Caribbean mental health professionals support climate resilience through community engagement, disaster response, and research. Int Review Psychiatry 2022; 34(5): 516-519. DOI: 10.1080/09540261.2022.2093101.
5. Di Sorbo P. Palliative Care and Climate Change. ehospice. April 4, 2023.