Position Statement of the Sri Lanka College of Paediatricians on Climate Change
All children have the right to clean air, safe water, sanitation, affordable and nutritious food, and shelter. Yet, millions of children, especially in developing countries like Sri Lanka, do not have access to such critical basic amenities. It is worse with the current economic crisis and sustainably worsened by environmental change.
Children pay a disproportionate price for climate change, with some estimates suggesting up to 88% of the burden of disease being related to it. Policy makers and the government will require concerted and extensive multisectoral efforts at a considerable scale, as defined by the Paris Climate Change Treaty.
National, regional and global Paediatric Associations must include educational activities on climate change and health within their conferences and programmes for educating delegates. Paediatricians and Paediatric Associations must become strong advocates to exert pressure on governments, corporations and private sector institutions to adopt mitigation strategies for climate change.
Paediatricians can play a pivotal role in translating research into practice and leading a global movement that can address many determinants of planetary health and health inequities within a generation.
The following are some of the cardinal manoeuvres that are proposed in this endeavour.
- Measures to improve the environmental impact of meetings organized by the SLCP within the office
- Use electronic versions of publications/letters to circulate among members
- Use electronic signatures for attendance sheets
- Use re-usable cutlery
- Avoid wasting food, reduce portion sizes, introduce more plant based food which is locally grown wherever possible.
- Use appropriate ventilation to minimize use of fans/air conditioners.
- Use water dispensers rather than individual plastic water bottles.
- Measures to improve the environmental impact of meetings organized by the SLCP as College Events, courses and conferences
- Use electronic versions of reading material
- Use electronic assessment systems
- Avoid plastic food wrappers/cutlery
- Use re-usable plates/glasses
- Avoid food waste by letting the participants to serve what and how much of the food they plan to consume
- Keep the doors/windows closed when using air conditioning
- Use energy saving bulbs
- Minimize transportation
- Encourage to have meetings/lectures via Zoom
- Share laptops/electronic devices for the zoom meetings
- Facilitate conferences via zoom and project the lectures and events in local hospitals for small groups to gather, watch and listen
- Support development of a policy to be used by other Academic Organisations to help minimize the carbon foot print
- This will include the use of electronic versions of abstract books and a virtual conference
- Minimize food waste
- Avoid plastics
- Virtual visit of sponsors rather than having separate booths for every sponsor
- Minimize the number of events which requires air conditioning/lighting/back drops (E.g. Cultural Shows for each conference)
- Providing an E-certificate for participants
- Work in partnership with the other professional bodies in order to share knowledge and strategies to mitigate climate effects
- Improve awareness among Paediatricians on effects of climate change and their role in mitigating climate change and climate resilience.
Relevance of climate change in Paediatric Practice
- Climate change affects the health and well-being of every child and even go on to affect every organ system.
- It Increases natural disasters such as drought or floods.
- Increase the infectious disease risks
- Food security will be increasingly threatened
- Climate change worsen all top five causes of under-5-year-old child mortality.
- Acute respiratory illness
- neonatal deaths
What is Climate action?
Reducing greenhouse gas emissions and preparing for climate change
Supporting optimal child health, growth, and development.
How Paediatricians could help climate action
- Can take the opportunity to engaging patients and families during routine visits, to talk about climate change and its effects
- Paediatricians can screen for climate risks, just as we screen for social determinants of health
- Paediatricians can identify children at risk of harmful exposures (extreme heat/air pollution etc), enhance health promotion, and prepare children and their families to protect their health and wellbeing in climate crises.
- Promoting healthy habits at each clinic visit can address climate change
- Plant-based diets can reduce greenhouse gas emissions and reduce lifetime risk of chronic diseases
- Reducing food waste – reduce greenhouse gas emissions
- Exclusively breastfeeding
- Promoting physical activity, savings on costs of transportation, and decreasing pollution-associated respiratory illnesses.
- Walking and biking to school to keep them physically fit, helps improve the air, and helps address climate change.
- Time spent outside and in nature improves cognitive functioning and encourages healthy peer relationships.
- Heat, pollution, pollen, and wildfire smoke, worsen air quality and contribute towards respiratory illnesses and asthma – Avoid outdoors when air quality is poor.
- Avoid exercising near high traffic areas.
- Early switching from MDI to DP capsules when appropriate
- Exercise earlier in the day when air quality is typically better.
- Advise parents never to leave children unattended in a vehicle.
- Children and youth involved in athletic activities are at risk for heat related illnesses. Paediatricians should counsel on prevention of heat illness;
- Appropriate clothing, sunscreen, and other sun protection
- Encourage hydration during strenuous outdoor activity
- Acclimatize at the beginning of the season
- Avoid the hottest time of the day
- Recognize the signs and symptoms of heat illness
- Encourage hydration during exercise (150-240ml) every 20 min, and wear light coloured and lightweight clothing
- Paediatricians can teach older children and parents about the signs of heat exhaustion, heat stroke and when to seek immediate care: warm, dry skin, temperature above 40 ◦C, or altered mental status
- Planning for disasters is critical for children with complex needs who depend on close management of health conditions.
- Ensure contingency plans for cold-chain dependent medications and electricity-dependent devices
- Telemedicine visits, when clinically appropriate for patients who have transportation difficulties or for those who live far from clinics
- Guidance on appropriate medication storage and use during the hot season, especially for medications that alter heat or water homeostasis (e.g., anticholinergics, antihistamines, tricyclic antidepressants, antidopaminergics, selective serotonin uptake inhibitors (SSRIs), antipsychotics, sympathomimetics, and diuretics) or increase risk of side effects with dehydration (e.g., non-steroidal anti-inflammatory drugs).
- Discuss sun protection, outdoor safety, drowning prevention, and disaster safety, as appropriate, depending on the region
- Identify changing patterns of infections which increase health risks.
Eg; Diarrhoeal illness and dengue during the rainy season
- Reduce unfavourable personal emissions
- Encourage their health care unit to prevent energy/water waste
- Take measures to encourage health authorities to implement renewable energy sources.
- Support/assist public health colleagues with prevention programmes (vaccines, vector control, nutritional supplementation, and food and water safety), disease surveillance and public education.
- Join with ‘Climate and Health’ advocacy groups
- Encourage other health professionals and professional bodies to publicly support strong climate action.