Dakor (Kheda District), Gujarat, India
December 1, 2019
Softly and subtly, the rustling of the leaves quickens and a cool breeze sweeps across the town. A child rocks gently on a swing and a father stands in the bazaar bartering for the best value for vegetables for dinner. His wife is hospitalized with hemorrhagic dengue; shivering with fevers that rise and fall as do her blood counts. The surroundings quickly transform from the afternoon’s thick, sweltering heat, to a crescendo rumbling in the distance. Slowly, the skies darken and loom overhead. Moments later, floodgates open from above and crackling, pouring rain pounds into the ground. Townspeople rush to seek shelter as water rapidly fills the streets and quickly overwhelms what now feels like makeshift infrastructure of the town. Puddles coalesce into streams, the water sloshes about, and settles. The mess takes days to subside.
Rain like this is not foreign to the dwellers of this region. They have borne witness to monsoon seasons for years. And yet, as families watch the rains come down, there is underlying confusion. Diwali, the annual festival of light, has passed; the monsoon season should have ended weeks prior. Yet here, at the start of December, the town is once again coated with rain and mud. Each rainstorm is stronger than the last, staggered by long waves of drought. Morning coolness, afternoon heat, evening rain — three seasons have intertwined into one large, unpredictable state. The consequence? An unsettling combination of large areas of pooled water and infrastructure damage leads to flourishing of waterborne and vector borne diseases. Hundreds of cases of dengue, malaria, typhoid fever erupt across the town.
Not surprisingly, the most affected are the impoverished, set up for failure with longstanding poor access to clean water and medical care. But the impacts trickle to even the most elite. Farmers struggle to provide steady crops to the town, shaping the diets of all. Home aides for the elderly do not report to work for weeks as they succumb to febrile illnesses. Their absence is sorely missed, as it leaves elderly men and women mustering strength to complete basic health and household tasks that they would not otherwise do alone. Two streets over, a grandfather slips and falls in an attempt to draw a bath and sustains a fatal epidural hemorrhage. A grandmother with congestive heart failure pauses to catch her breath, sighing heavily as she sweeps the floor — a broom in one hand, a cane in another. Climate change is here.
Understanding and combating climate change is my passion. I first learned of greenhouse gases, fossil fuel emissions, and global warming as an optimistic undergraduate. There, our courses taught us the evidence alongside a background of “controversy.” This was the calm before the storm. This was before our carbon dioxide emissions were so high that the impacts would be irreversible. Shadows of doubt murmured across public opinion: “Was climate change real? Was it caused by humans?” I pushed forward, applying to medical school with a vision to heal and uplift the health and well-being of children. I anxiously followed the complex narrative for years: the seismic shift from climate change to climate crisis. Years passed, emissions rose, and we now sit with 1.1 degrees Celsius of warming already under our belts. 99.9% of the science is in agreement.
As I near the end of my residency, my two worlds crash into one another. Health and climate. The links are omnipresent and irrefutable. Natural disasters and extreme weather are mainstream news, bringing along with them disease, depression, and despair. Ashes from wildfires settle; air pollution and lung disease rise. Medication shortages, hospital demands, malnutrition. The public health emergency of our time enters the global stage as I emerge as a newly minted pediatrician. What comes next?
Author’s note: This is the first installation in a new column on in-House entitled “The Climate Lens: Physician Perspectives of the Climate Crisis,” with more installations to follow.