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Surviving extreme heat
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.”
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.
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 cranaconference.com to find out more and register.