THE IDEAS OF GREAT ORMOND STREET HOSPICE was first suggested by a colleague and friend of the hospital. Ride for their Lives — a cycle ride from London to Glasgow in the run up to the UN Climate Change Conference (COP26) – I laughed. There are some serious cyclists on the hospital’s staff, but some of us hadn’t ridden a bicycle since childhood. My most recent ride was 30km in one day.
It was October and we were leaving London at 8am. We had 800km of riding ahead. We were carrying two powerful documents on health and climate – the Healthy Climate PrescriptionLetter signed by 45 million health professionals worldwide, and the World Health Organisation Special Report on The Health Argument for Climate Action. They were enclosed in a satchel with pleas from paediatric patients for action. We were going to present this satchel at the decision-makers. Campaigners were still trying desperately to get this into the hands Alok Sharma, COP26 President, at the time that we went to press.
The riders were deliberately children’s healthcare providers. Nearly everyone claims they care about children, not just politicians. But how can we, as children’s healthcare providers claim this, if we willfully ignore the climate health emergency?
If we do the right thing in paediatric care, our patients can live another 60 to 80 year. While our patients will suffer more from the climate emergency than adults or geriatrics, they are also going to bear the least responsibility. My generation has created the problem and it is our responsibility fix it.
In the UK, the most immediate and clear impact on children’s health is air pollution. The cities we live in regularly exceed WHO’s minimum standards on air quality. 7.2% of all lower respiratory tract illnesses deaths in the 0-5 year age group are thought to be caused by particulate matter from fossilfuels. This would indicate that 605 children between 0 and 5 years old die each year in Europe from air pollution caused by fossil fuels. We also know that pollution has contributed to the deaths of 1250 babiesIn 2019, high-income countries will see a rise in the number of people who live in the first month of their lives. half a million worldwideHowever, two-thirds of these can be attributed to indoor air pollution.
For a long time in the UK we had a surreal situation where we knew significant numbers of children were dying from air pollution, but it didn’t appear on any death certificates. This all changed when, in 2020, a coroner certify that the death of nine-year-old Ella Kissi-Debrah was caused by a combination of severe asthma and air pollutionShe also directed health care providers to prevent future deaths. She had suffered severe asthma attacks for some years and lived near the highly polluted London South Circular Road.
All over the globe, there are potential Ellas. Air pollution is one of the most universal of the deadly health impacts of the climate crisis – London’s pollution is mild compared to some world cities. Ride for Their Lives was founded to help people like you. Pollution Pods, an art installation which recreates some of the world’s most polluted air. The first pod recreates the incredibly pure air of a Norwegian wilderness, the second London’s air – health and safety regulations decree this cannot contain the real air of LondonEven if the pods are there, it is not necessary to do so. The installation continues to New Delhi. In this pod, you can barely see or breathe. To spread our message, we stopped at several public events that the pods hosted during the ride.
Australia is also experiencing extreme heat, bushfires floods and droughts. I am an Australian citizen. I fear for our children’s future.
Many families who live in areas of high air pollution might not be aware of its devastating effects. We wanted to make this a reality. We also wanted to include air pollution in the agenda for the climate summit. It has many of same causes as the climate crises and offers a lot of the same solutions.
Why did I do it?
As a paediatrician intensivist, my thoughts are often on how to handle a crisis. Denying that a child’s medical condition is deteriorating, and delaying taking action, will not save their life. Yet this is exactly what we are doing about the planet’s rapidly deteriorating condition.
The fallacy that we can only act in our own areas of expertise is one of the reasons that we are unable to take action on climate change. We don’t have the time or resources to become climate scientists. As clinicians, we rely heavily on research from others. It is what we use to evaluate it and make decisions based on it. We don’t try to replicate it ourselves. Instead of promoting ourself as climate scientists, we need to do what is best for us: interpret the science and share it with our colleagues and patients. We should make the most of the trust and influence we have, based upon our professional dedication to the preservation human health.
Tackling the climate crisis will be challenging, it’s a question of getting everyone to play their part and take the necessary steps. Influential people are necessary to achieve this goal. Health professionals can be influential. That’s why we cycled to Glasgow – to use our influence.
We must also collaborate across borders. The spread of CO is not stopped by walls, lockdowns, and oceans.2. Ride for their Lives was not only diverse in the physical aspects of the riders, but also needed to include international child healthcare providers. We created the virtual ride so that healthcare riders and the general public could contribute their own kilometres from anywhere on the planet. We set a goal of one million kilometres in October, and we achieved it (although it took us a few days to get there in November). More importantly, we had the support and assistance of 506 child healthcare providers across the globe with the greatest support in Australia or Chile.
Oddly enough, the ride itself was extremely motivating and enjoyable. It made us all feel more optimistic. That wasn’t necessarily the reason why we did it – I personally was motivated by guilt and shame – but it was still a good outcome. I hope that this emotion will spread beyond the cyclists and reach the entire healthcare community. Action is the best medicine for despair and delays.
We need to use the trust and influence we enjoy as doctors to make the link very clear for patients, employers and local and national governments – what we are doing, by our addiction to fossil fuels, will wipe out our children’s future.
The impact on our children’s future is the underlying, unifying message. Although we may feel that our profession is dedicated to the care of sick children, we can’t help but feel guilty. We are lying to our children if we neglect the destruction of their earthly inheritance.
Health professionals are capable of actions that span all levels of society – from rallying communities, to being a thorn in the side of climate-crisis-denying governments, to having sensitive conversations with individual patients and their families.
Each of us as clinicians must view tackling the climate crisis as part of our job. How can we pretend not to care about children if that is what we really believe? You will be happier, healthier, and more hopeful, as I discovered during the Ride for Their Lives.
Dr Mark Hayden is an Australian-trained paediatric intensive health specialist at Great Ormond Street Hospital, London.
The opinions and statements made in this article are the authors’ views. They do not reflect the official policy of AMA. MJAOr InSight+Except where otherwise stated.