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Surviving extreme heat

12 Jul 2022

2022 CRANAplus Conference invited speaker Dr Simon Quilty discusses how increased temperatures are impacting remote communities and what Aboriginal culture can teach non-Indigenous Australians about adapting to warming.

In the hottest part of Aus­tralia, we have the poor­est peo­ple,” says Dr Simon Quilty.

A spe­cial­ist physi­cian who has been work­ing in the NT since 2004, Dr Quilty’s research papers on the health impacts of cli­mate change num­ber in the dou­ble figures.

In the remote com­mu­ni­ties I’ve worked in, peo­ple have very lim­it­ed infra­struc­ture and resources to fend off the heat… There’s severe base­line pover­ty, very poor-qual­i­ty hous­ing, severe ener­gy insecurity.”

In the El Niño year of 2019, a RAAF base near Kather­ine record­ed 54 days of 40°C or above, break­ing the pre­vi­ous record of 20 days.

Mod­el­ling shows that before the end of the decade, there’ll be over 100 days above 40 degrees in towns like Kather­ine,” Dr Quilty says. They can become uninhabitable.”

2019’s extreme heat killed vast tracts of savan­nah for­est around Kather­ine – and Dr Quilty warns that the same thing will hap­pen to humans if they don’t have the capac­i­ty to shield from the heat.”

How increased heat impacts health

The way that you die from heat depends on what your comor­bidi­ties are and what your expo­sure is,” Dr Quilty continues.

Fac­tors that increase risk include age; car­diac dis­ease (ischemic heart dis­ease, car­diac fail­ure, RHD); renal dis­ease; cog­ni­tive impair­ment, demen­tia, and phys­i­cal disability.”

Despite these risk fac­tors, only 1000 Aus­tralian death cer­tifi­cates list­ed heat as a cause of death between 2006 and 2017. Revis­it­ing the data in 2020, Dr Quilty found that heat should have been list­ed on over 37,000 certificates.

We have very lim­it­ed capac­i­ty at the moment to mea­sure the impact of heat on health out­comes and that needs to be rapid­ly rec­ti­fied so we can react and respond in a coor­di­nat­ed way,” he says.

We also need to con­sid­er the indi­rect influ­ences of heat on med­i­cines and our health­care system.

[First­ly, say] you have epilep­sy, and you take sodi­um val­proate, and you acci­den­tal­ly leave your tablets in the car just once [in hot tem­per­a­tures] – they will not work,” Dr Quilty says.

[Sec­ond­ly], 35 per cent of North­ern Ter­ri­to­ry doc­tors are in the process of leav­ing or are plan­ning to leave because of their con­cerns about the impact of cli­mate change.

That’s just doc­tors but pre­sum­ably it is repli­cat­ed across the health­care, edu­ca­tion, and oth­er pro­fes­sions as well.

It’s a high­ly per­son­al deci­sion… The hot­ter it gets, the less time you have avail­able to go down to the park with your kids in the afternoon.”

Pho­to cred­it: Benedet­ta-Bar­ban­ti — stock​.adobe​.com

Lessons from Indige­nous culture 

Remote Indige­nous com­mu­ni­ties might seem like a canary in the coal mine” that indi­cates how urban cen­tres will ulti­mate­ly be affect­ed, Dr Quilty says.

How­ev­er, the NT mor­tal­i­ty data­base he is cur­rent­ly inves­ti­gat­ing sug­gests that while Indige­nous Aus­tralians are adept at liv­ing in hot envi­ron­ments, non-Indige­nous Aus­tralians are becom­ing more susceptible.

Abo­rig­i­nal peo­ple have phys­i­o­log­i­cal­ly and cul­tur­al­ly adapt­ed from 1000s of years of expe­ri­ence, and the way they live their lives is around hot weath­er,” Dr Quilty says.

Here we’ve got, right in front of us, incred­i­ble experts over many, many gen­er­a­tions, and they’re very hap­py to tell us what to do, and it’s remark­ably sim­ple. It is: lis­ten to the envi­ron­ment and don’t be an idiot.”

Simons laughs at this point.

I’ve gone for a jog late in the after­noon in Kather­ine and had Abo­rig­i­nal peo­ple look at me like I’m mad, and they were right,” he says.

Prepar­ing for cli­mate change, the most impor­tant thing is cul­tur­al change,” he continues.

Indige­nous Elders have explained to me that non-Indige­nous peo­ple are a bit warun­ga, or mad, because we seem to take no notice of the heat. We’re much more dri­ven by the desire to fin­ish off a job and get paid than we are to recog­nise and accept the inhos­pi­tal­i­ty of the heat of the day.”

By work­ing, liv­ing and trav­el­ling in air-con­di­tioned envi­ron­ments, we’re also fail­ing to phys­i­o­log­i­cal­ly adapt for when we need to go outdoors.

Pho­to cred­it: Alexan­der — stock​.adobe​.com

Your pow­er as a health professional

Dr Quilty speaks with can­did frus­tra­tion about the lack of atten­tion local aca­d­e­m­ic insti­tu­tions have paid to cli­mate change; the gov­ern­ment deci­sion to allow frack­ing to pro­ceed in the Bee­taloo Basin; and the lack of solar pan­els on Ter­ri­to­ry hospitals.

An advo­cate for urgent and imme­di­ate action, Dr Quilty is using research to doc­u­ment the sit­u­a­tion on the ground and inform cli­mate-aware health pol­i­cy. He reminds health pro­fes­sion­als of their own pow­er as changemakers.

Scream up the ranks to insist for eco­log­i­cal­ly respon­si­ble health care that has an aware­ness of its car­bon foot­print,” Dr Quilty says.

Health­care in Aus­tralia is respon­si­ble for 7 per cent of our car­bon foot­print, and we as pro­fes­sion­als need to do some­thing about it.”

Dr Simon Quilty will be dis­cussing cli­mate change and health at the CRANAplus Con­fer­ence this Octo­ber. Head to crana​con​fer​ence​.com to find out more and register.