WHEN a friend and colleague at Great Ormond Street Hospital first came up with the idea of 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. The most I had ever cycled was 30km in a day.

Soon, however, it was October, and we were setting off from London at 8am with an 800km bike ride ahead of us. We were carrying two powerful documents on health and climate – the Healthy Climate Prescription letter signed by organisations representing 45 million health professionals globally, and the World Health Organisation Special Report on The Health Argument for Climate Action. They were encased in a satchel covered in pleas for action from paediatric patients, and we were going to try to present this satchel to decision-makers. At the time of going to press, campaigners were inside the summit still trying to put this into the hands of COP26 president Alok Sharma.

If we care about children we must address the climate crisis - Featured Image

Diarmid-Campbell-Lendrum, WHO’s Climate change and Health lead, Katie Huffling and Cara Coo, Association of Nurses for a Healthy Environment, Humza Yousaf, Scotland’s Cabinet Secretary for Health and Social Care, Richard Smith, President of the UK Health Alliance on Climate Change, Mohamed Eissa, Liaison Officer for Public Health Issues, Liaison Officer for Public Health Issues at the International Federation of Medical Students Associations (IFMSA), Poornima Prabhakaran, Deputy Director of the Public Health Foundation of India.

The riders were deliberately children’s healthcare providers. Almost everyone says they care about children, politicians not least. But how can we, as children’s healthcare providers claim this, if we willfully ignore the climate health emergency?

In paediatric healthcare, if we get it right, our patients will live for another 60 to 80 years. Our patients are going to suffer from the climate emergency far more than adult or geriatric patients, while bearing the least responsibility for the situation. My generation has caused the problem, and it is our responsibility to fix it.

In the UK, the most immediate and clear impact on children’s health is air pollution. Our cities regularly exceed WHO’s minimum standards on air quality. The best estimates of mortality caused by particulate matter from fossil fuels is 7.2% of all lower respiratory tract illness deaths in the 0-5 years age range. This would indicate that 605 0-5-yearolds die in Europe annually from fossil fuel derived air pollution. We also know that air pollution contributed to the death of 1250 babies in their first month of life in high-income countries in 2019, a figure which rises to half a million worldwide, although two-thirds of these are attributable 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. That all changed when, late in 2020, a coroner certified that the death of nine-year-old Ella Kissi-Debrah was caused by a combination of severe asthma and air pollution, and directed health care providers to prevent future deaths. She had been suffering severe asthma attacks for some time and lived near the hugely polluted London South Circular Road.

There are potential Ellas all over the world. 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. This is why Ride for Their Lives travelled with 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 London, even if the pods appear there. The installation then progresses to New Delhi, and in this pod you can barely see let alone breathe. During the ride we stopped for several public events with the pods to get our message out there.

If we care about children we must address the climate crisis - Featured Image

Pollution Pods by artist Michael Pinsky in Granary Square, King’s Cross

In Australia, the population is also facing extreme heat, bushfires, floods and droughts, and as an Australian citizen myself, I fear for our children’s future.

Many families living in areas with significant air pollution may not be aware of the tragic consequences. We wanted to do something to expose this harsh reality. We also wanted to get air pollution on the agenda at the climate summit. It has largely the same causes as the climate crisis and largely the same solutions.

Why did I do it?

As a paediatric intensivist, I think a lot about how you deal with 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.

One of the things that stops us taking action on the climate crisis is the fallacy that we can only act confidently in our own sphere of expertise. But we have no time to become climate science experts. As clinicians we routinely rely on research from others. We appraise it and take actions based upon it, not try to reproduce it ourselves. Rather than promoting ourselves as climate scientists we need to do what we do best, interpret the science and explain it to our colleagues and patients. We should use the influence and trust we enjoy, based on our professional dedication to the preservation of 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. To do that we need influential people and health professionals can be influential. That’s why we cycled to Glasgow – to use our influence.

We also need to collaborate across borders.  Walls, lockdowns and oceans do not stop the spread of CO2. Ride for Their Lives, while diverse in most aspects of the physical riders, needed to include the international child healthcare provider community. To do this we created the virtual ride where healthcare riders and the public could contribute their own kilometres from anywhere in the world. We aimed for one million kilometres in October and we made it (although we needed a few days in November to sneak over the line). More importantly we got the support of 506 child healthcare providers from across the planet with the greatest support in Australia and Chile.

Oddly, the ride itself was hugely motivating and enjoyable and made us all feel much more hopeful. 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 emotion will ripple out beyond the cyclists across the whole healthcare community. Action is the best treatment for despair and delay.

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. As paediatricians we may feel that we are dedicated to helping sick children. But we are lying to ourselves if we ignore the destruction of their inheritance, the earth.

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.

As clinicians, every single one of us needs to see tackling the climate emergency as part of our job. If we really do care about children, as we claim, how can we do otherwise? What is more, it will make you healthier and more hopeful, as I found out on the Ride for Their Lives.

Dr Mark Hayden is an Australian-trained paediatric intensive care specialist at Great Ormond Street Hospital in London. 




The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.


Doctors have a responsibility to advocate for urgent climate change action
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8 thoughts on “If we care about children we must address the climate crisis

  1. George Crisp says:

    Dear ‘ skeptical medico’ (try and be honest and use your real name)

    You seen to worry about people dying from the smoke from burning wood and peat, but curiously less so the 8.7 million deaths attributed to burning fossils ? In fact you are promoting more ill-health that would arise from air pollution exposure through more coal and gas

    If you are a medic you should be supporting the health co benefits from renewable energy that resolves the health problems consequent of air pollution. Unlike climate mitigation, these benefits arise immediately and are cumulative.

    Yes solar and wind can provide energy for heating and cooling. Heat pumps are by far the most effecient and cheapest way to do this.

    We should be helping developed nations to bypass dirty polluting fossil fuels to enable this.

    PS Gas cooking causes an estimate 12% of asthma cases in Australia.

  2. Skeptical medico says:

    Dear George,

    The climate models don’t seem to work – they catastrophise. Earth’s actual temperature isn’t following any of their dire predictions.

    Why are doctors trying to deny coal or gas powered (safe) heating and reliable electricity to hundreds of millions of poor and disadvantaged people in the third world and developing countries?
    Over 3.8 million deaths a year are estimated to be caused by wood and peat smoke – used by the poor to cook and to survive the cold (according to the WHO). Will solar or wind help them to cook and stay warm? Professor Bjorn Lomberg has written powerfully on this topic.

    The selfishness of the western climate elite and many privileged western medicos to deny coal and gas to these impoverished peoples saddens me…

  3. George Crisp says:

    to the assorted climate deniers responding to this excellent article.

    1. IPCC reports are prepared by a large group of publishing scientists – it is extensively reviewed, the recent AR6 WG1 report received around 70 000 comments all of which are addressed. it is the most up to date review of ALL the science on this area. You should read it: https://www.ipcc.ch/report/ar6/wg1/

    The Royal Society – the world’s oldest scientific body – has a very good summary that explains climate change and why we know human contributions are responsible ( as does NASA). it also explains the difference between weather and climate Robert 😉

    2. Roy Spencer used to work at UAH. Clearly Max you misunderstand this too – it is not a direct measure of temperature – it is a proxy – using satellite measured oxygen radiance – I’d advise that you go an look at this dataset too – guess what? it also shows warming of about 1C – https://www.nsstc.uah.edu/climate/

    3. the atmospheric concentration of CO2 is now > 400 ppm (0.04% ) when it has been below 280 for at least 800 000 years (ice core measurements). We’ve known about the effect of increasing atmospheric CO2 of Earth;s temperature – for more than a hundred years before the first computer of computer model was conceived.

    We can now actually measure the effect of that C02 on radiative forcing – https://climate.nasa.gov/news/3072/direct-observations-confirm-that-humans-are-throwing-earths-energy-budget-off-balance/

    All established uncontested science.

  4. Max says:

    Dear George,

    Climate change may well be occurring (it has a tendency so to do).

    That it is anthropogenic is in no sense ‘unequivocal’.

    It is not possible to be ‘factually wrong’ when the datum under consideration is merely a model.

    The IPCC was a body formed on the premise that anthropogenic global warming is occurring: it has no remit to consider the opposite, and so its output is obviously self-affirming.

    Like all UN bodies (and world congresses in medicine btw), its need for diplomacy and diversity means that it may sacrifice intellectual rigour for inclusiveness. It is therefore not a peak body investigating the climate, but has a much narrower scope and calibre.

    The greater cost of extreme weather events documented by insurers relates to the level of greater development and investment in at risk locations. Even the IPCC no longer claims that extreme weather events are becoming more frequent.

    Doctors are renowned for bearing a God-complex, but one would be surprised if this extended to a belief that they could change the climate.

    By all means reduce emissions, but hair shirt flagellation that relegates (at least) hundreds of millions of people to a life of poverty from energy starvation is a misanthropic First World indulgence.

  5. George Crisp says:

    Dear Dr Tucker,

    Anthropogenic (human caused) climate change is ‘unequivocal’. There are numerous observations, datasets and studies that confirm and quantify this. To dispute this is factually wrong.

    The frequency, intensity, duration and range if extreme weather events also changing, with greater exposure of human populations – resulting in health and economic impacts. Again not disputed by meteorologists, scientists and insurance agencies.

    This explainer from BBC in August details the links https://www.bbc.co.uk/news/science-environment-58073295

    Similarly health impacts resulting from a change in climate have also been determined as ‘unequivocal’ by recent IPCC reviews and peak health bodies

    You can have your own opinions, but not your own facts.

    Climate change is occuring and increasingly damaging our health. For people practicing medicine to be in denial about this is very concerning

  6. Rational Scientist says:

    I sincerely hope that medical doctors read and understand the basic science. Carbon Dioxide is an invisible, odourless gas that doesn’t cause respiratory problems. All living creatures breathe out CO2 with every breath. CO2 is currently 0.04% of Earth’s atmosphere. During Earth’s Cambrian period CO@ was 0.4%…

    China is emitting over 14 Billion tons of CO2 annually (>40% global emmissions)
    Australia emits around 1% of global CO2, and Australia also acts as a CO2 sink – thanks to our green agricultural land and national parks. Plants and trees exist by eating CO2…

    Earth’s satellite measured global temperature has not increased for the past 7 years. Look at HADCRUT or the UAH satellite data.

    There is no “climate crisis”.
    Don’t believe the Green/Evangelist hype.

    Please read more science…

    As doctors we all need to read the science. The Guardian and The Age sadly present biased Green/Left propaganda.

    Please read Professor Richard Lindzen, Professor Judith Curry, or Professor William Briggs to get a balanced scientific view.

    And please look at Dr Roy Spencers UAH satellite temperature data – the world standard for temperature measurement…

  7. Adrian R. Clifford says:

    Robert Tucker, truer words have never been spoken. If doctors think that anthropomorphic CO2 production is going to make the slightest difference to global warming and climate change then they are deluding themselves. The sun is responsible for all changes on the planet and also the uncontrolled population numbers ever increasing and requiring more and more energy. There is an alternative to fossil fuels, but they are expensive and come with hazards. If we are serious about supplying adequate renewable energy, then the future is Thorium / Salt reactors. We need to encourage governments world wide to build them now and control population growth. The planet was never designed to support more than 5 billion people, let alone the 10 million by the end of this century.

  8. Robert G Tucker says:

    Well…..the discussion continues about Climate and weather! Climate is what you would like,and weather is what you get !! needless to say…no one walking this earth can do anything about Climate; and weather is still what you get !!

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