The health network at the time of climate change

Le réseau de la santé à l’heure des changements climatiques

Photo: Jacques Nadeau Le Devoir
Number of people lose their lives or end up in hospital each year following a cold wave.

Heat waves, winters that make the yo-yo and floods : extreme weather events, linked to climate change, may increase hospitalizations and deaths in the coming years in Quebec. But in front of a health system, already out of breath, experts are sounding the alarm and calling for change, and quickly.

“The climate change-related risks will increase, accrue to a system that already has difficulty functioning. […] It is more than urgent to change the way we see our health-care system “, prevents the phone Céline Campagna, scientific director of the programme climate Change and health, national Institute of public health of Quebec (INSPQ).

With three of his colleagues of the Institute, Diane Bélanger, Pierre Gosselin, and Ray Bustinza, she also co-wrote the book climate Change and health. To prevent, to heal and adapt, which will make its debut in bookstores in quebec next Wednesday.

The book provides a comprehensive portrait of the direct and indirect impacts of climate change on the health of the population. Number of people lose their lives or end up in hospital each year, in the wake of a storm, floods, a heat wave or a cold wave. But these extreme weather events are also the cause of cardiovascular problems, kidney or respiratory ; they have also led to cases of post-traumatic stress disorder, anxiety, or psychological distress. Not to mention their role in the contamination of food or water that spread so a variety of viruses and bacteria.

Results : the emergency overflow and the agendas of health professionals — family doctor, social worker, passing by the psychologist — fill at high speed. “There are already long waiting lists, and the aging population brings a lot of diseases additional. If one adds the impact of climate change, it is impossible that the present system is able to adapt if we do not change our ways of doing things “, warns Céline Campagna, recalling the serious lack of staff in the health network.

Beware of the heatwave

She gives the example of the accommodation centres, long-term care (CHSLD) in Quebec. If the organization and the quality of care are often criticised, the situation is much more problematic in the heat. “Most of our NURSING homes are in old hospitals non-air-conditioned, located in heat islands. With that, it barely has enough nurses and orderlies to do the round of the patients. How to ensure in the heat that these vulnerable people — who sometimes suffer from dementia and are no longer able to tell if they are cold, hot, or thirsty — are not dehydrated or in hyperthermia ? “questions the researcher.

I dare to hope that it’s going to change, but it will take probably dead for to realize, at the political level, it is necessary to change things

— Céline Campagna

A situation all the more worrying that the aging population will increase the demand for places in NURSING homes and that heatwaves will be more frequent.

Recall that nearly 90 people died in a heat wave last July in the province, according to a preliminary assessment. In 2010, they are no less than 106 death related to extreme heat that had been identified, including a fortnight in hospital.

It is the impact of climate change that Quebec should have to worry about according to Ms. Campagna, which states that, by 2050, the episodes of extreme heat by was expected to double in the province. “We are all vulnerable to the heat, and even more people who are already fragile, such as the elderly or those with cardiovascular problems or lung, among others. “

More training

For the authors of the book, the health system has no choice but to adapt quickly to this reality, since global warming is such that a return back now seems impossible. “Even if we eliminate tomorrow morning the global emissions of greenhouse gases, [those] that are already present in the atmosphere will continue to change the climate for the next century. The health system and its professionals must prepare themselves accordingly. “

General practitioners are the first to feel that they lack the training to cope with climate challenges in their practice. At least that is the opinion of 65 % of doctors who responded to a poll conducted by the INSPQ and Université Laval in 2015 to this topic. “And it is likely that this training need is also felt in other first line responders, such as nurses, social workers and psychologists “, note the authors.

Their book is the main tool of an online course offered by the INSPQ from Monday. It aims to educate health professionals on the link between climate change and the health of individuals, so that they raise awareness and provide information to the best of their patients.

Ms. Campagna is hoped, however, that the book will have a wider impact and will be able to call on the political class. Governments could do more in terms of prevention, organization, adding staff, and even development of the territory. “I dare to hope that it’s going to change, but it will take probably dead for to realize, at the political level, it is necessary to change things “, let t-it, however, fall with regret.

Climate change and health. To prevent, to heal and adapt

Céline Campagna, Diane Bélanger, Pierre Gosselin, and Ray Bustinza, Presses de l’université Laval, Québec, 2019, 236 pages