Stories

Tag: HRH

  • Climate change is a threat to the health of the communities we serve: health workers speak out at COP28

    Climate change is a threat to the health of the communities we serve: health workers speak out at COP28

    The Geneva Learning Foundation’s Charlotte Mbuh spoke today at the COP28 Health Pavilion in Dubai, United Arab Emirates (UAE). Watch the speech at COP28…

    Good afternoon. I am Charlotte Mbuh. I have worked for the health of children and families in Cameroon for over 15 years.

    I am one of more than 5,500 health workers from 68 countries who have connected to share our observations of how climate is affecting the health of those we serve. 

    “Going back home to the community where I grew up as a child, I was shocked to see that most of the rivers we used to swim and fish in have all dried up, and those that are still there have become very shallow so that you can easily walk through a river you required a boat to cross in years past.”

    These are the words of Samuel Chukwuemeka Obasi, a health worker from Nigeria.

    Dr Kumbha Gopi, a health worker from India said: “The use of motor vehicles has led to an increase in air pollution and we see respiratory problems and skin diseases”.

    Climate change is hurting the health of those we serve. And it is getting worse.

    Few here would deny that health workers are an essential voice to listen to in order to understand climate impacts on health.

    Yet, a man named Jacob on social media snapped: “Since when are health workers the authority on air pollution?”

    Here are the words of Bie Lilian Mbando, a health worker from my country: “Where I live in Buea, the flood from Mount Cameroon took away all belongings of people in my neighborhood and killed a secondary school student who was playing football with his friends.”

    Climate change is killing communities.

    Cecilia Nabwirwa, a nurse in Nairobi, Kenya: “I remember my grand-son getting sick after eating vegetables grown along areas flooded by sewage. Since then I resolved to growing my own vegetables to ensure healthy eating.”

    And yet, another man on social media, Robert, found this “ridiculous. As if my friend who sells fish at his fish stall comes as an expert on water quality.”

    I wondered: why such brutal responses?

    Well, unlike scientists or global agencies, we cannot be dismissed as “experts from on-high”.

    What we know, we know because we are here every day.

    We are part of the community.

    And we know that climate change is a threat to the health of the communities we serve.

    We are already having to manage the impacts of climate change on health.

    We are doing the best that we can.

    But we need your support.

    The global community is investing in building a new scientific field around climate and health.

    Massive investments are also being made in policy.

    Are we making a commensurate investment in people and communities?

    That should mean investing in health workers.

    What will happen if this investment is neglected?

    What if big global donors say: “it’s important, but it’s not part of our strategy?”

    Well, in 5, 10, or 15 years, we will certainly have much improved science and, hopefully, policy.

    Yet, some communities might reject better science and policy.

    Will the global community then wonder: “Why don’t they know what’s good for them?” 

    I am an immunization worker. For over 15 years, I have worked for my country’s ministry of health.

    Like my colleagues from all over the world, I know more than a little about what it takes to establish and maintain trust.

    Trust in vaccination, trust in public health.

    Trust that by standing together in the face of critical threats to our societies, we all stand to do better.

    Local communities in the poorest countries are already bearing the brunt of climate change effects on health.

    Local solutions are needed.

    Health workers are trusted advisors to the communities we serve.

    With every challenge, there is an opportunity.

    On 28 July 2023, 4,700 health workers began learning from each other through the Geneva Learning Foundation’s platform, community, and network.

    Thousands more are connecting with each other, because they choose to.

    And because they want to take action.

    It is our duty to support them.

    In March 2024, we will hold the tenth Teach to Reach conference.

    The last edition reached over 17,000 health workers from more than 80 countries.

    This time, our focus will be on climate and health.

    We invite global partners to join, to listen and to learn.

    We invite you to consider how you, your organization, your government might support action by health workers on the frontline.

    Because we will rise.

    As health workers, with or without your support, we will continue to stand up with courage, compassion and commitment, working to lift up our communities.

    Our perseverance calls us all to press forward towards climate justice and health equity.

    I wish to challenge us, as a global community, to rise together, so that  the voices of those on the frontline of climate change will be at the next Conference of Parties.

    By standing together, we all stand to do better.

    Thank you.

  • Before, during, and after COP28: Climate crisis and health, through the eyes of health workers from Africa, Asia, and Latin America 

    Before, during, and after COP28: Climate crisis and health, through the eyes of health workers from Africa, Asia, and Latin America 

    Samuel Chukwuemeka Obasi, a health professional from Nigeria:

    “Going back home to the community where I grew up as a child, I was shocked to see that most of the rivers we used to swim and fish in have all dried up, and those that are still there have become very shallow so that you can easily walk through a river you required a boat to cross in years past.”

    In July 2023, more than 1200 health workers from 68 countries shared their experiences of changes in climate and health, at a unique event designed to shed light on the realities of climate impacts on the health of the communities they serve.

    Before, during and after COP28, we are sharing health workers’ observations and insights.

    Follow The Geneva Learning Foundation to learn how climate change is affecting health in multiple ways:

    • How extreme weather events can lead to tragic loss of life.
    • How changing weather patterns are leading to crop failures and malnutrition, and forcing people to abandon their homes.
    • How infectious diseases are surging as mosquitoes proliferate and water sources are contaminated.
    • How climate stresses are particularly problematic for those with existing health conditions, like cardiovascular disease and diabetes.
    • How climate impacts are having a devastating effect on mental health as people’s ways of life are destroyed.
    • How climate change is changing the very fabric of society, driving displacement and social hardship that undermines health and wellbeing.
    • How a volatile climate is disrupting the delivery of essential health services and people’s ability to access them.
    • We will finish the series with  inspiring stories of how health workers are already responding to such challenges, working with communities to counter the effects of a changing climate.

    On 1 December 2023, TGLF will be publishing a compendium and analysis of these 1200 contributions – On the frontline of climate change and health: A health worker eyewitness report. Get the report…

    This landmark report – a global first – kickstarts our campaign to ensure that health workers in the Global South are recognized as:

    • The people already having to manage the impacts of climate change on health.
    • An essential voice to listen to in order to understand climate impacts on health.
    • A potentially critical group to work with to protect the health of communities in the face of a changing climate.

    Before, during, and after COP28, we are advocating for the recognition and support of health workers as trusted advisers to communities bearing the brunt of climate change effects on health.

    Watch the Special Event: From community to planet: Health professionals on the frontlines of climate change

  • How do we reframe health performance management within complex adaptive systems?

    How do we reframe health performance management within complex adaptive systems?

    We need a conceptual framework that situates health performance management within complex adaptive systems.

    This is a summary of an important paper by Tom Newton-Lewis et al. It describes such a conceptual framework that identifies the factors that determine the appropriate balance between directive and enabling approaches to health performance management in complex systems.

    Existing health performance management approaches in many low- and middle-income country health systems are largely directive, aiming to control behaviour using targets, performance monitoring, incentives, and answerability to hierarchies.

    Health systems are complex and adaptive: performance outcomes arise from interactions between many interconnected system actors and their ability to adapt to pressures for change.

    In my view, this paper mends an important broken link in theories of change that try to consider learning beyond training.

    The complex, dynamic, multilevel nature of health systems makes outcomes difficult to control, so directive approaches to performance management need to be balanced with enabling approaches that foster collective responsibility and empower teams to self-organise and use data for shared sensemaking and decision-making.

    Directive approaches may be more effective where workers are primarily extrinsically motivated, in less complex systems where there is higher certainty over how outcomes should be achieved, where there are sufficient resources and decision space, and where informal relationships do not subvert formal management levers.

    Enabling approaches may be more effective in contexts of higher complexity and uncertainty and where there are higher levels of trust, teamwork, and intrinsic motivation, as well as appropriate leadership.

    Directive and enabling approaches are not ‘either-or’: designers of health performance management systems must strive for an appropriate balance between them.

    The greater the dissonance between designing a health performance management system and the real context in which it is implemented, the more likely it is to trigger perverse, unintended consequences.

    Interventions must be carefully calibrated to the context of the health system, the culture of its organisations, and the motivations of its individuals.

    By considering each factor and their interdependencies, actors can minimise perverse unintended consequences while attaining a contextually appropriate balance between directive or enabling approaches in complex adaptive systems.

    The complexity of the framework and the interdependencies it describes reinforce that there is no ‘one-size-fits-all’ blueprint for health performance management.

    For higher-order learning and whole-system improvement to occur, practical and tacit knowledge needs to flow among complex adaptive systems’ actors and organisations, thus leveraging the power of networks and social connections (eg, learning exchanges and communities of practice).

    Reference

    Newton-Lewis, T., Munar, W., Chanturidze, T., 2021. Performance management in complex adaptive systems: a conceptual framework for health systems. BMJ Glob Health 6, e005582. https://doi.org/10.1136/bmjgh-2021-005582l