It’s not just politicians and environmental scientists sounding the alarm on climate change anymore. A growing number of professionals are calling for action, including civil engineers, landscape architects, chefs and school teachers.

In commentary published in The New England Journal of Medicine in January, a pair of Boston doctors claim physicians have “a special responsibility” to safeguard humankind from the crescendo in climate change-related health problems.

The World Health Organization backs this idea, calling climate change “the greatest challenge of the 21st century.”

“It is a true public health emergency,” declares a call for policy action issued this year by the American Medical Association and 73 other medical groups.

Religious leaders are also driving action for climate justice. While many evangelical Christians reject the premise of climate change as a crisis spawned by humans, other Christian congregations are mobilizing to reduce their greenhouse gas emissions.

The Episcopal church, notably, has called out climate change denial as immoral. Regardless of the official U.S. stance on the Paris climate agreement, the church maintains that it’s still committed to the international solutions deal.

Civil Beat talked to a Honolulu doctor and a Kailua Episcopal reverend who are taking new approaches to their work in the face of a warming climate.

Connecting Climate And Disease

When Kaena Point’s greenish brown triangle finally punctured the monotonous blue line where sky meets sea, Dr. Darragh O’Carroll jolted himself out of a strange peace.

“I spent 19 days at sea just kind of bonding with the earth’s largest ocean and experiencing sunsets every evening and really kind of experiencing what this world has to offer us,” recounts O’Carroll, who was serving as medical director aboard Hikianalia, the Hawaiian sailing canoe, on its return to Hawaii after a California voyage in late 2018.

“Then,” he said, “when I reached the islands and saw Kaena Point come up out of the distance, that was really the catalyst that made me think about how we are affecting the world on such a grand scale.”

O’Carroll vowed to tap into his credibility as a trusted medical professional and add his voice to the discussion on climate change, merging the distinction between Earth’s rapidly altering weather patterns and troubling new trends in public health.

He is among a growing number of physicians thinking differently about heath care and how to deliver it in a world where the cause and spread of pandemic disease is shifting with the seasons. 

O’Carroll, 34, is an emergency room doctor at Kuakini Medical Center. Born in Ireland and raised in Hawaii Kai, he developed a love of sports like rugby and paddling, an interest in cars and mechanical engineering and a deep appreciation for the ocean lapping at his neighborhood’s sandy edges.

In college, O’Carroll shadowed a general practitioner at Pali Momi Medical Center for a summer when he was still in search of his calling. That’s when he first set his sights on a career in medicine.

The apprenticeship also helped him arrive at an understanding of what drives his overarching purpose: A desire to be of service.

“I think I went into medicine to be helpful and useful, and I chose emergency medicine because I was just trying to think about, ‘Where can I be the Swiss army knife?’” O’Carroll said.

“With emergency medicine, it’s kind of about grabbing everything that’s emergent and unique about every field and having to know about all of that — bones, heart attacks, strokes, severe infections. In that way, I think the emergency medicine physician is kind of akin to the old school physician.”

The intersection between climate change and public health is something O’Carroll discovered years later while reading a research paper about the Kenyan highlands. He learned that warmer weather and spiking humidity were driving mosquitoes to higher altitudes, infecting a population of Kenyans with malaria that previously didn’t have to worry about insect-borne diseases.

O’Carroll figured there must be other climate change consequences for public health. So he sought them out, scouring science journals and news stories for connections between weather and medicine.

Here’s a sampling of what he found: The risk of vector-borne illness, such as dengue fever and Lyme disease, is heightened in places like southeast Asia, Micronesia and New England, where mosquito and tick bites are on the rise. Heat illness is making vulnerable new populations that aren’t accustomed to prolonged and severe heat waves. The severity of natural disasters caused by hurricanes, wildfires, flooding and tsunamis is amplifying.

“Disease patterns vary throughout the seasons and so now that our seasons are changing all of our disease patterns are altering, as well,” O’Carroll explained.

“Probably one of the more tragic issues that I’ve encountered is that seawater salt is getting into the drinking water of people in Bangladesh and causing high blood pressure and tragic miscarriages in a patriarchal society where miscarriages are automatically seen as the woman’s fault.”

A Physician’s Guide To Climate Change

In the ER, O’Carroll incorporates what he knows about climate change into his patient assessments. For example, his radar is tuned up for signs of severe fever, headache or body aches in patients who have recently traveled to countries experiencing dengue fever outbreaks.

It’s not something Hawaii residents should worry about now, O’Carroll said. Hawaii has not had a dengue outbreak since 2015-2016, when there were 264 confirmed cases, primarily on the Big Island.

But with dengue risk high in many parts of Asia and the Pacific, he’s keeping a close eye out for symptoms in travelers at risk of importing the illness to the islands.

By illuminating the ways climate change is already influencing people’s health, O’Carroll believes he’s found a way to personalize a predicament that, although dire, can often seem distant.

“People, me included, have a hard time putting things in perspective until they start losing their own health,” O’Carroll said. “When you start losing your own health, it’s the things that you never appreciated before that start to matter most.”

“So if we can convince people that climate change is affecting you now and today, then hopefully you’ll take the steps to convince the politicians representing you and your local leaders to take action on it.”

Boots On The Ground

Apart from his vigilance in the ER, O’Carroll is joining the fight for climate justice by volunteering for disaster relief efforts around the globe.

In September he spent two weeks providing on-the-ground aid and assistance to people devastated by Dorian, the worst tropical cyclone to strike the Bahamas in the country’s history.

Last month he became the medical director for All Hands And Hearts, a nonprofit disaster relief organization that’s helping rebuild storm-ravaged communities in places like Florida, Texas, Mexico, Puerto Rico, Mozambique and Peru.

Now he’s in the process of filming a documentary titled “Infected Earth” about the public health impacts of climate change.

So far he has self-funded the filming of a segment that tells the story of a New Hampshire family in which the father, mother and daughter have all been infected with tick-borne diseases.

O’Carroll is raising funds to complete the film and, he hopes, find it a home on a major movie streaming platform.

“My whole goal is to get across to people that this is something that is here today,” O’Carroll said. “It’s not just a problem of melting ice caps and polar bears. While those are tragic, it is affecting us now, our families and our communities.”

Fostering A ‘Place Of Hope’

On a recent Sunday, The Rev. Annalise Pasalo gave a sermon about stewardship, for which the Episcopal church dedicates an entire season.

It’s the time of year associated with financial gifts congregants make annually to the church. But on this day Pasalo encouraged members of Emmanuel Episcopal Church in Kailua to also reflect on how they can gift their time and talents in greater service of God.

One way of doing this, Pasalo offered, is to rally for climate justice.

To those observing the tangible manifestations of climate change with growing worry, Pasalo offers a theological framework for how to approach the looming crisis.

While many people are so numbed by the problem that they feel paralyzed to act, Pasalo said she strives to foster a faith-based community through which congregants can explore how they can take action with spiritual urgency.

“What’s happening to the planet is a really heavy emotional situation and there’s not a lot of hope in it,” Pasalo said. “I think that’s a place where the church can step in to be a place of hope anyway because we believe that people can change and do what is right to make a difference.”

A Moral Emergency

Pasalo is not rogue in her application of climate justice to scripture. The Episcopal church promotes government policies and personal actions that mitigate greenhouse gas emissions, encourages sustainable energy and protects against the misuse of natural resources.

“We are not bible literalists,” Pasalo said. “We believe in science.”

As a clergy leader, Pasalo strives to be a model for how a Christian should approach the climate crisis.

But she’s tempered in her approach, offering guidance to congregants who signal an interest in answering this spiritual call to action. Guilt and fear are not part of her method.

Pasalo’s own initial reluctance to confront climate change, and her gradual adoption of everyday eco-friendly changes, is now a tool she uses to encourage others to begin by taking on small daily lifestyle revisions.

“Honestly it scared me and it scared me so much that I didn’t want to think about it at all for awhile,” Pasalo said. “I finally got to the point where I was just like, ‘I can be scared of this or I can face it and do something.’ I decided to have faith that I can make a difference.”

She re-doubled her dedication to backyard composting and abstinence from fast fashion five months ago when she birthed her son.

“I think often about what the world will be like for him,” she said. “What we’re doing now is not good enough.”

‘It’s Not Politics’

Pasalo preaches about climate change as it relates to what the church calls creation care, a calling to look after the natural world. She also engages church members in conversation about why she carries around a metal straw, her favorite reusable diaper brand and how her household fared in choosing to nix the air conditioning for a more energy efficient whole house fan.

As a church leader, Pasalo budgets for ceramic coffee mugs rather than styrofoam cups. Attendees of a recent fundraiser, held under the church’s solar panel-topped roof, dined on palm leaf plates with bamboo forks.

The church where Pasalo preaches also embraces an Interfaith Energy and Climate Manifesto that promotes an awareness of the spiritual nature of the world’s climate challenges.

And when church board members select charities to fund at the year’s end, Pasalo said she will advocate for local organizations fighting to a healthier environment.

“I think people are tempted to say, ‘Well, the church shouldn’t get involved in politics,’” Pasalo said. “And from where we’re coming from, it’s not politics. It’s not a political statement.”

“It’s our tradition. It’s our scripture. It’s the idea that this creator gave us this amazing planet and it’s up to us to care for it.”

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