Studying physiotherapy sparked my passion for what we call the ‘health care system’, and more specifically primary healthcare. I decided to follow up on this passion and pursue an advanced Master degree in Global Health, where I had the opportunity to dive deeper in this topic. I started to realize the potential of primary healthcare, and the key role of its care providers, in adapting to climate change.
What is primary healthcare? According to the World Health Organization and UNICEF, it is defined as “a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment”. This definition allows us to understand the vision of primary healthcare put forward by the World Health Organization and UNICEF, but the implementation differs depending on each individual country. Despite these differences though, rehabilitation is an explicit part of the definition and in every country physiotherapy is an established part of primary healthcare. Moreover, we are – together with nurses – the primary healthcare provider with the most contact with patients.
Climate change and biodiversity loss are undeniably amongst the greatest challenges for humankind in the 21st century, and impact health in many ways. According to the World Health Organization, climate change can impact health directly through for example heat and pollution, and it can impact health indirectly through natural and human systems like food yields and disease vectors, natural disasters or related migration and conflicts. The urgency of the situation has been indicated by the Intergovernmental Panel on Climate Change, stating that climate change is increasing the “frequency and/or intensity and/or duration of extreme weather events” (IPCC, 2021).
Tibo Uyttersprot (PT, MSc)
Global Health professional, Intern CliMigHealth
Tibo Uyttersprot (MSc) is a recent graduate from the advanced master’s in Global Health at Ghent Univeristy in Flanders (Belgium), specialising in research methods and tools. Previously, he graduated in 2020 with a master’s in Rehabilitation Sciences and Physiotherapy at Ghent University. His current research interests are at the nexus of climate change, migration and primary healthcare.
I am writing this blogpost because I believe we need physiotherapists, as part of primary healthcare, to adapt to the health impacts of climate change. The first reason is that we have the privilege to spend many hours with our patients. This often leads to long-term patient-provider relationships with a strong foundation of trust. These long-term relationships provide an opportunity to detect and mediate the – often chronic – health impacts of climate change such as diabetes, chronic obstructive pulmonary disease and mental health problems. The World Health Organization also pointed out that vulnerable people (for example immigrants, impaired people and certain occupational groups) are more at risk for the adverse impacts of climate change, so helping these populations should be a priority. If we use our interaction with patients efficiently, we could contribute to a long and healthy life for our patients, despite the pressure of climate change.
A second reason is that we are well-trained to influence the challenge that climate change represents. Climate change is – according to the World Health Organization and the Intergovernmental Panel on Climate Change – altering the social and environmental determinants of health and is therefore a critical factor in a complex chain of issues influencing health. As physiotherapists, we are well-trained to unravel these complex chains, exemplified by our strong analytical training on the interconnectedness between various joints, body parts, and systems. Thinking about climate change might be out of our comfort zone for now, but the way of thinking necessary for understanding and addressing it is similar.
A third reason relates to empowering patients. I have always been trained to empower patients, to allow them to take agency for their own health. As mentioned in the first argument, we have a role to play in our patients’ health, but I personally believe we should move beyond the health-related impacts of climate change. They can be an entry point to start the conversation with patients, which could be well-received by them, but I think we should also inform them about sustainable choices for a healthy life and so contribute to informing the broader community.
I have been working for the past year at CliMigHealth, an international thematic network of Ghent University on the intersection of climate change, migration, and health. It helped me to develop a vision for the future of primary healthcare in the face of climate change. When I heard about the Environmental Physiotherapy Association, I was very happy to find an organization that shares a vision for physiotherapy aligning closely with mine. Their efforts in planetary health education, research and practice, as well as awareness raising among physiotherapists are essential for the future, and will help us to reap the full potential of our profession.
I would love to hear from you to continue discussing this topic or to exchange ideas for the future of (physiotherapy in) primary healthcare.