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Arnagretta Hunter
Health in a changing climate

41 min 28 sec

Dr Arnagretta Hunter BA (Hons) MBBS MPH FRACP is a physician and cardiologist concerned with the effects of climate change on human health. Currently Canberra-based, she has previously practiced in Sydney and regional NSW. Hunter is the Human Futures Fellow at the College of Health and Medicine at Australian National University (ANU), where she is also a senior lecturer in the Medical School. She is also chair of the Commission for the Human Future and a member of the ANU Institute for Climate, Energy and Disaster Solutions. Hunter co-hosts the Policy Forum Pod podcast at ANU and writes on health policy, public policy and the impact of the environment on health. 

Marian Wilkinson is a multi-award-winning journalist whose career has spanned radio, television and print, covering politics, national security and climate change. She has been a foreign correspondent in Washington for the Sydney Morning Herald and The Age and executive producer of the ABC’s Four Corners. As environment editor for the SMH in 2009 her joint Four Corners production, The Tipping Point, reporting on the rapid melt of Arctic Sea ice won a Walkley Award. Wilkinson has authored four books including, The Carbon Club: How a network of influential climate sceptics, politicians and business leaders fought to control Australia’s climate policy (2020).

Raised on a farm in regional Australia, cardiologist Dr Arnagretta Hunter understands the impacts of drought and heat on health. After the devastating fires of 2019 that exposed many to air pollution, Hunter began studying the impacts of bushfire smoke on community health and is determined to adapt care to cope with climate change. 

We really need to find space, safe spaces, where we can use both our science and our imagination to work with our communities to reduce the impacts of these extreme weather events.

– Arnagretta Hunter

…conversations in my consulting room flipped…from my standard conversation of ‘How can we help you to get a bit more active? What are the barriers to exercise? …to telling so many of my patients, ‘Please don’t go outside. It’s unsafe for you to spend any period of time in this heat.

– Arnagretta Hunter

… it was deeply personal, tremendously important to every single member of [the Bushfire Impact Working Group]…to be actively involved in caring for our community through what was one of the most significant environmental challenges that had been faced.

– Arnagretta Hunter

I often ask people … ‘Why do we need to take this seriously?’ The reason we need to take it seriously is human health and survival. It’s centre, it’s completely centre.

– Arnagretta Hunter

My favourite phrase is ‘strategic imagination’; for us to be able to sit down to understand the science of climate change, to understand the impacts that those extreme weather events might have on our communities.

– Arnagretta Hunter

If we make choices through a prism of care, caring for our planet, caring for our community, caring for our family and friends, caring for ourselves, how different the choices we might make will be.

– Arnagretta Hunter

We really need to find space, safe spaces, where we can use both our science and our imagination to work with our communities to reduce the impacts of these extreme weather events.

– Arnagretta Hunter

Marian Wilkinson

Hello and welcome to 100 Climate Conversations at the Powerhouse museum. Today is number 21 of our 100 conversations happening here every Friday. The series presents 100 visionary Australians that are taking positive action to respond to the most critical issue of our time, climate change. We’re broadcasting in the Boiler Hall of the Powerhouse museum. Before it was home to the museum, it was the Ultimo Power Station. Built in 1899, it supplied coal fired electricity to Sydney’s tram system right up until the 1960s. So, it’s fitting that in this museum we shift our focus forward to the solutions to the climate crisis. I’d like to acknowledge that we’re meeting on the Traditional Lands of the Gadigal People of the Eora Nation and pay my respects to their Elders past, present and future.

My name is Marian Wilkinson and as a journalist I’ve written and broadcast many stories about climate change. My latest book, The Carbon Club, describes Australia’s fraught political battles over climate policy, that too often saw the advice of our scientists and our experts ignored or undermined. That’s why today I’m so excited to bring you a conversation with Arnagretta Hunter, a doctor and medical expert who is working to change our healthcare and disaster response systems to cope with the reality of climate change. She’s also a member of the Australian National University’s Institute for Climate, Energy and Disaster Solutions, and she chairs the Commission for the Human Future. Welcome, Arnagretta Hunter.

Arnagretta Hunter

Fabulous to be here.

MW

Well, you were a child of a doctor, but your mother didn’t want you to be a doctor. So, what decided you to go against your mother’s wishes?

AH

I guess my route to medicine, it was an interesting one. I grew up on a farm on the outskirts of Melbourne and I had a very fortunate, very privileged childhood. My education was great and something that I enjoyed. I think I had difficulty focusing in on one particular thing and at the end of school, I really probably still didn’t know what I wanted to do, and I went off and did an arts degree. I majored in international relations, I did a bit of maths and physics at the same time, and at the end of my Honours Degree, thinking about the balance of power and global conflict in light of the end of the Cold War, which is so interesting, because years later, it’s actually fascinating stuff to go back to. But at that point, in the mid-1990s, I thought, ‘Well, what shall I do next?’ And I really wanted to help people, I think I felt a fairly strong desire to make the world a better place and so that’s how I ended up in medical school.

MW

Well, your interest in climate change, I think, came through Doctors for the Environment. How did you get to them? What was it about them that attracted you?

AH

Again, it might be that I have had difficulty looking at one particular thing. So, training as a cardiologist takes a fair amount of intensity and that certainly occupied a large amount of my time over the training. And I love it, it’s fantastic, it’s still an extraordinary privilege to be working as a physician and as a cardiologist. What becomes really interesting as you’re starting to work as a doctor though, is really beginning to appreciate the complexity of the lives that we lead, the sorts of experience that patients bring into us, the stories that people tell us and the way in which we might be able to help with making lives as rich and as meaningful as possible, despite the presence of illness and disease. And I remember sitting in my office about ten years or so ago thinking a lot about the conversations and the themes that emerged in most of my consultations and most of my consultations with patients will touch on issues around nutrition and food, often about how we might be how to manage our weight effectively. And I also talk a lot about exercise and how to keep ourselves relatively active. And I talk about those two things because they’re actually really important for our health and wellbeing, the food that we eat and the activity that we get access to.

And then I thought a bit about the differences in those different places that I’ve lived, the centre of Sydney, in the centre of Melbourne, growing up on a farm, working and living in regional New South Wales and then Canberra. And there’s a tremendous diversity of built environment across those spaces. In Wagga, in summer it’s really hard to go outside and exercise on those 35 or 45 degree days. Access to the built environment is tremendously challenging and so we see this impacted in terms of the exercise that people can do. Similarly in the ACT, we’re pretty good at our built infrastructure in the ACT, but there are parts where people can access exercise easily and parts where it’s a little bit less clear cut. So, I was really interested in the health impacts of the built environment, the cities that we live in, the suburbs that we construct. And I sort of fell from that into climate change because these sorts of extreme weather events that we’re so much more literate in now than we were even five years ago, were obviously going to play a significant role in our health and wellbeing.

MW

And as a cardiologist, which you are by training, what do you look for when you think about the impact of climate change on the human body?

…conversations in my consulting room flipped…from my standard conversation of ‘How can we help you to get a bit more active? What are the barriers to exercise? …to telling so many of my patients, ‘Please don’t go outside. It’s unsafe for you to spend any period of time in this heat.

– Arnagretta Hunter

AH

I think the story that I probably tell too often now is January 2019. This is the summer before what we call Black Summer. And I remember coming back to work in sort of mid-January and we had in the ACT at that point the beginning of a heat wave. And it was a very hot period, 35 to 45 degrees. We had a number of days over 40 degrees and I remember, I ride my bike to work usually at 8 o’clock in the morning thinking actually it’s a little bit too hot for me, who’s younger and healthy to be outside. And so that was the moment where I realised my conversations in my consulting room flipped. They flipped from my standard conversation of, ‘How can we help you to get a bit more active? What are the barriers to exercise? What sorts of things might be good for you? Where can you go to the park? Can you enjoy going for a walk with friends?’ The conversation completely flipped to telling so many of my patients, ‘Please don’t go outside. It’s unsafe for you to spend any period of time in this heat.’

This heat we know 5, 10, 15 minutes, we can see issues around dehydration, and we start to see the health impacts of 35, 40 degrees, all of us, we feel it. And so, if you don’t have access to shade or adequate hydration, you really shouldn’t be doing very much outside. You certainly shouldn’t be exercising in the way that many of us enjoy on a regular basis. And that wasn’t just a couple of days, so a couple of days of heatwave is something that we’re all used to. I grew up in Melbourne and so heatwaves and days where you lie on the couch, that’s not uncommon in the Australian landscape.

What was really uncommon in this particular heatwave event at the beginning of 2019 was that duration and intensity. So, it wasn’t a few days, it was a couple of weeks. And we know again from other health research that says if you’ve got three weeks or four weeks or a month or so where you’re not able to get out and physical activity really changes and people might understand this now, if they’ve been unwell with coronavirus in recent years, that that recovery after a period of immobility can really take its toll. And so, I thought, ‘Wow, if this is a taste of what we have ahead, we’re going to see significant impacts to our health and wellbeing from the changing environment, this increase in extreme weather events.’

MW

And if people do go out and have to work in these 35 degree days over any sustained period, as a cardiologist again, what does that do to the human body?

AH

Look, there’s remarkable literature from both here in Australia and globally, that looks at outdoor workers in heatwaves and we see mortality. Young men usually who are dying because of the heat wave events. We see an increase in cardiovascular disease. We also see a significant rise in kidney disease associated with that work in the hot environment. And so, it shortens life expectancy, and it certainly shortens what we term in the medical literature, disability free life expectancy. So that period of your life where you enjoy good health is much shorter when you’re working in an occupation where you’re exposed to heat on a regular basis. And this is a challenge for us all as we watch the climate change.

MW

And we’re really watching that now, especially in Europe, where we’re seeing these big heatwaves coming through Spain, Portugal and also in California, the way we had those heatwaves in 2019 in Australia. But I want to now move on to the Black Summer bushfires in Canberra because that had, I think a really big effect on your life as well as your work. You once described it, I think, as living through a dystopian experience at the time. What did you mean by that?

AH

Look, there are emotive words that you can put over that summer, dystopian, apocalyptic. It really was a remarkable period and certainly a time that is branded on my psyche and on so many of us who live in that southeastern corner of New South Wales. The ACT region was particularly vulnerable to the bushfire smoke and so we had hazardous air pollution for many months or for a good period at the end of 2019 and then into 2020. And it was challenging. It was a matter of looking out the window and deciding if it was okay to go outside.

Many people were trying to balance the air pollution outside with the passive ventilation that many of us use to cool our houses and so it was a choice between heat inside and smoke outside and trying to make those sorts of health tradeoffs where we had a fair paucity of information. So, from a health perspective, the bushfire smoke exposure, questions that came up, the clinical questions around what are the impacts? Our understanding of this literature, of these sorts of events, is not as good as it could be. And hopefully, as we understand and reflect on the events of that summer, we’ll understand it with more appreciation.

MW

Now you were at the height of the crisis, I think, you were on call at Canberra hospital. What was that like? What patients were you seeing and what were the sort of symptoms you were seeing?

AH

I work as a cardiologist and I was working at that point doing general medicine, looking after people across a fairly broad range of medical conditions. I think this is part of what I see emerging in medical practice is a paradigm shift so that we can understand the impact of the environment around us. Every patient in hospital over that period had at least the tiniest, if not a medium size or a large impact from what was going on outside from the environmental impacts on their health. Small impacts like the psychology of looking outside, and that could be quite devastating, we had patients in hospital who really just weren’t coping because it was really quite extraordinarily bad outside, the dystopian, the apocalyptic landscape, walking out into a garden where everything is dead, watching animals suffer, our pets all suffered in the heat.

I had birds in my front garden where we were having to put out water regularly. And you could watch the wildlife and the trees and the landscape in Canberra through that period, really, really under pressure. And that has a deep emotional impact for us all. The physical health impacts, we know that that sort of air pollution increases the likelihood of infections really anywhere. So, things like skin infections and chest infections, urinary tract infections, diabetes control is often a significant issue when there’s changes to exercise, when the body is working under stress through heat and through bushfire smoke. And so basically every patient that I looked after in hospital during that period, you could see the adverse mark from this apocalyptic summer on their health and wellbeing.

… it was deeply personal, tremendously important to every single member of [the Bushfire Impact Working Group]…to be actively involved in caring for our community through what was one of the most significant environmental challenges that had been faced.

– Arnagretta Hunter

MW

Well, what was amazing to me was that in this crisis atmosphere, somehow you and a group of colleagues at the university at ANU decided you had to do something more than just treat your patients and you set up something called the Bushfire Impact Working Group. What was the idea behind that? Because it came up with some pretty important innovations to help people at that time.

AH

At the beginning of January 2020, led by our new Dean Russell Gruen, we came together, a group of academics and researchers across ANU from the Climate Change Institute, from the Public Awareness of Science and Science Communication group, and of course, from the College of Health and Medicine, from Public Health Communications and from clinical services. The first meeting took place off campus because ANU campus was closed because of the bushfire smoke, and we weren’t allowed on. And so, the first meeting took place in my office, which is just nearby in Braddon and around that table there about 15 or so of us and about a quarter of those people had been in the evacuation centres on the south coast just the week before, most of them with their children.

So again, these are real important research questions, they are tremendously important for us to be engaged in, but it was deeply personal, tremendously important to every single member of that group and the group expanded very quickly. We were really keen to be actively involved in caring for our community through what was one of the most significant environmental challenges that had been faced.

MW

And I think one of the most important things you began to look at was this measurement of the pollution in the bushfire smoke and getting the message to people about what they could and couldn’t cope with. Can you explain how you did that? And also, what is the impact of this pollution when it gets to the levels that you were seeing in Canberra?

AH

So we’re back to talking about PM 2.5, which people might remember from that summer. PM 2.5 is a measurement. So, when we measure particulate matter, which is PM in our air, we sometimes refer to the particles that are called PM 10, which is a larger size particle and PM 2.5 is a smaller sized particle. PM 10 is generally filtered out as we breathe in. PM 10, it’s filtered by the lungs, we cough it back up. People might remember doing that at various points during the fire. PM 2.5 is particularly of concern because it’s absorbed into the bloodstream and then it has more systemic effects on our body. It can impact on organ function, it can impact on our blood vessels, and we know there’s a relationship there with acute cardiovascular events, things like heart attack or stroke or arrhythmia. Sudden cardiac death is higher when we’re exposed to PM 2.5. And so, PM 2.5, there’s a tremendous literature from the global research, mostly on urban air pollution it has to be said.

This event, this bushfire event we had in Australia in 2019, 20 really is unparalleled in the Australian history. We’ve not had an event like that with medium term bushfire smoke exposure, so we needed to bring our understanding of the science from PM 2.5 research, again mostly in that urban environment, and then try and translate that into what we had in front of us. And I think we’re all hoping it was going to be a shorter duration than it was but imagining what would happen if we had weeks or months of exposure to PM 2.5. So, in November, December 2019, groups like the Climate and Health Alliance, groups like Doctors for the Environment, the AMA began to become a little bit involved with how to communicate appropriate health advice.

I don’t think we had as much federal leadership at that point as would have been helpful. And so, for the group at ANU, at the beginning of January 2020, we saw this tremendous need for clear communication to explain PM 2.5, what it is, what the health impacts might be, and how we can protect ourselves. So, with the wearing of masks or with the keeping of our indoor space as good as possible. Of course, there are other layers of complexity there, we don’t routinely measure our air pollution in a way that provides us real information and people might remember that at the beginning of the bushfire smoke challenge across New South Wales in November, December 2019, that we had the air quality measurements which reflects the 24 hours that preceded that particular number. And so that real live PM 2.5, this is what’s happening right now, we had to see that evolve and it was mostly crowd sourced, it was, those sorts of measurement devices were developed by individuals. Quite an extraordinary response to an unprecedented crisis.

MW

Yes, it was an amazing display of people power, academic power and individuals getting involved in a way where they were filling the gap that government left. I remember at the time seeing – or shortly after – seeing a satellite map of Australia showing the smoke pollution. I know you’ve looked at the numbers on this, but could you give us an idea of how many Australians were affected at the time? Because I think the numbers are quite extraordinary and again, give us an insight into what happens in these climate change extreme events.

AH

I’d just like to start perhaps by thinking about how we look routinely at our health data. And we tend to look at our health data through the prism of disease of biology. So, we’re quite comfortable in the number of coronavirus cases that are happening today and yet many people will appreciate there’s nuance around that of coronavirus pandemic related health impacts, of difficulty with accessing health services or the disruption to life can then have a significant impact. And so, our health data is largely set up to look at particular discrete diseases, cardiovascular disease, respiratory disease, endocrine disease, etc. The social determinants potentially play a significant role there and the environmental factors that then feed back into these biological conditions are things that our health data doesn’t look at routinely.

Although enthusiasm to understand this is most definitely growing, it was growing before the Black Summer event and it’s becoming much, much, much more important from a bureaucratic and from a public health perspective. So, with that in mind, we do have data on the health impacts of the Black Summer. There was a publication from the Medical Journal of Australia that looked at the likely mortality, and we’ve estimated that around 400 people died because of the exposure to PM 2.5 and we make that estimate because we know how many people normally die over the summer and there was an increase in mortality.

We know that several thousands of people ended up in hospital, particularly across the east coast of Australia, with cardiovascular conditions, with respiratory conditions and with a range of other health conditions that led to a net increase in hospitalisation. But we also know that around 12 million of us in Australia breathe the air. And so, in terms of the long-term health impacts of the bushfire smoke exposure, I think we can now make an argument to say about 50 per cent, maybe more, of Australians have had an event, a climate change driven environmental event, which will have either a tiny impact or a more measurable impact in our long-term health and wellbeing. And then we can add in recent time the health impacts of the floods and then the sort of longer term psychological, particularly mental health impacts from the floods and the fires.

MW

And I want to go here to some really important work I think you and your colleagues did immediately post the bushfires and that was to get the Royal Commission that was held into the disaster response to the bushfires and a lot of the other inquiries, including in parliamentary inquiries to get health put in in a prominent way into those inquiries. Did it surprise you that in the beginning health wasn’t really a priority in those inquiries when they were first conceived?

I often ask people … ‘Why do we need to take this seriously?’ The reason we need to take it seriously is human health and survival. It’s centre, it’s completely centre.

– Arnagretta Hunter

AH

Certainly as a group, the Bushfire Impact Working Group at ANU, which it’s a multidisciplinary team, it’s coming across the university and I think this is actually tremendously important in terms of how we might contend, particularly for adaptation, that we’re not going to have adaptation responses that are adequate if we simply look at emergency service delivery. And that was part of the case that we were making both to the Royal Commission into National Natural Disaster Arrangements and into the Senate inquiry that looked at the Black Summer response. And so, putting health centre in those discussions was certainly a big driver for us. It’s a big driver for me in the climate change work that I do. And I often ask people why we’re acting on climate change. What, why? Why do we need to take this seriously? And the reason we need to take it seriously is human health and survival. It’s centre, it’s completely centre. And so, we made that case, I think, in both the Royal Commission and in that Senate inquiry.

MW

One of the very obvious things that I think you have discussed in this, which often doesn’t occur to people, is what happens to the local community in an extreme event that goes on for weeks and sometimes months, like the bushfires or the floods. What happens to the primary health care in the area, in terms of the doctors’ surgeries, the nurses, the local health support group? I wonder if you could walk us through why that is so important to think about those primary health carers in a disaster situation.

AH

Because in disaster situations we come up with health challenges. So, people still need access to lifesaving medicines, medicines like asthma treatments, medicines like blood pressure treatments, medicines like insulin that are needed to keep people alive. It’s really important that communities can provide that fundamental level of care.

Some of the stories that have come from the Black Summer experience are really worth considering. Of hospitals where the electricity supply was disrupted and again, not disrupted for a short period of time but for days and if you don’t have power, the reliable power supply in your hospital, then you can’t really provide adequate clinical care. So, if you’ve got somebody who needs an emergency caesarean section to deliver a baby, a woman who’s in labor at that moment in time, you might not be able to provide the usual standard of care without power, without access to water.

So, in many of the towns along the south coast of New South Wales, water supply was disrupted. They were trucking in or they were using bottled water for a period of time. Their power was coming from generators, fuel supply was compromised and many people who were tourists on that part of the coast will have stories about the challenge of trying to get enough petrol to then get back to where they’ve come from. And so, all of the provision of health care that those sorts of lifesaving procedures for somebody who’s had an accident, who needs attention, who needs stitches, who needs their broken bones set, those sorts of things are completely essential. And so, this is part of the work that needs to be done. Part of what was highlighted in that Royal Commission into National Natural Disasters, is that building in resilience into our primary care and our hospital system so that we can prepare for unprecedented disasters, it’s a tremendously important thing for our health and wellbeing.

MW

There were quite a number of recommendations in the end that did come out of the Royal Commission on Health Care, including things like national standards on bushfire smoke pollution. What do you think from your point of view were the most important recommendations and are we actually doing anything about them yet?

AH

The reason I like this document and this particular Royal Commission review so much is because it takes a whole of system approach. It gives us a multitude of layers from federal to state to local to community groups to work as individuals that can help us, even just intellectually, even just strategically, even emotionally, to prepare for the sorts of events that are going to take place with increasing frequency over the decades ahead. And so it’s a really important read, it’s got fabulously quotable quotes, including the fact that something being unprecedented is not an excuse for being unprepared and that really, as a community, if we’re hoping to minimise the community wide impacts of extreme weather events, that to use, and again my favorite phrase is ‘strategic imagination’, for us to be able to sit down to understand the science of climate change, to understand the impacts that those extreme weather events might have on our communities.

And that work is local, that work is geographic, that work is done with communities, that if we do though that work, and if we can see that sort of conversation facilitated across all levels of government and across all parts of our community, that we will be in a better position. Not a perfect position, because I do think some of the challenges that we face will pose extraordinary questions about habitability, about whether the towns that we have in different parts of Australia, whether the resources that we have will be adequate to protect people, places, the natural environment in face of the sorts of events that might take place.

MW

Well, I know in the work you’re doing now, including with the university and with the Commission for the Human Future, that you talk a lot about things like scenario planning. And I wonder for you in the next year or so, what scenario do you think you would like most to plan for in the disaster area?

My favourite phrase is ‘strategic imagination’; for us to be able to sit down to understand the science of climate change, to understand the impacts that those extreme weather events might have on our communities.

– Arnagretta Hunter

AH

Look, I actually think at the moment we need to have an open, honest conversation around national risk. Part of the work that the Commission for the Human Future does is on climate change. But in fact, the commission comes around the idea of catastrophic and existential risks. Again, it’s really difficult subject matter and it’s easy to turn off but if we can’t talk about the sorts of threats that are in front of us, then we won’t be prepared. And that makes particular sense for us I think at this point in time, like it would not have made sense a couple of years ago.

The sorts of catastrophic existential risks that we face are environmental: climate change, loss of biodiversity, water and food contamination, supply chain disruptions. They’re technological, things like misinformation and the use of information in a way which is really harmful to the functioning of society. The rise of artificial intelligence which potentially is highly beneficial but may also have some downsides. The biological challenges, things like a global pandemic, which we understand now more than we did a few years ago. But again, the science will tell us that the likelihood of more pandemics, more events like we’ve been through in the last couple of years, unfortunately it’s not zero, it’s measurable that these events will occur in the future. And so, the other element of course into this, is the geostrategic conflict around us. And if I use the words nuclear war, even 12 months ago, people would have looked at me strangely.

But we do need to be prepared for the prospect of all sorts of bad things happening. So, understanding this grid of national risk, being able to talk about it, gives us a position to much better prepare for the sorts of challenges that are ahead. And again, I’m going to use that science and imagination mix of being able to understand what we know from history and imagining a future where the complexity is measurable and the challenges that will be very real and making some decisions about how we get to a better place together.

MW

Well, a few years ago, even in this country, it would have been hard to imagine convening a national meeting, say, of health ministers on the climate change issue. But things are changing really quickly. Do you think a serious discussion of the health impacts of climate change with government at all levels would now be possible? And do you think you and your colleagues will be pushing for that?

AH

Well, certainly the work that the Climate and Health Alliance have done in the last couple of years looking at the need for a national climate change and health strategy has been remarkable. And our recently elected Labor government has committed to developing a climate and health strategy. People might be interested to know that, for example, that the 10-year health plan that was released in 2019 didn’t touch on the environment, certainly didn’t mention climate change. It comes back a little bit to what I was saying earlier about how we measure health data and again, that landscape is changing quickly.

The Institute of Health and Welfare are looking actively at the relationship between environmental variables and things like rates of disease and rates of hospitalisation. Looking at the points where we can really make a difference to population, health and wellbeing by addressing our concerns about the environment. And so that data delivery and the research, research has been hugely under-funded in the Australian landscape, particularly for the last decade. Just recently, a large network of health researchers has been awarded $10 million from the MRFF group but that was the first time any money has been given to climate change in health research for more than a decade.

MW

In the most recent floods where you have people going through the second or third time of an extreme event, something I know that you’ve been looking at for the future, is this sense of community resilience. How important is that conscious decision to support community resilience?

AH

So adaptation, which I guess is, our conversation is all on adaptation. It’s either our failure to prepare for events or how we can prepare better to reduce both the environmental impacts of the extreme weather events, the preserving and caring for the planet that we live on, as well as preparing to protect our communities. Adaptation is local. Adaptation occurs in geographic locations with particular environmental vulnerabilities. And so, it’s bringing people together to be an active part of both the understanding the challenges that might be ahead and then designing and preparing their own particular approaches. And look, there are a whole series of potential adaptation plans that can be used in all sorts of different parts of the Australian landscape, but it’s fostering that conversation. So, we’re all part of the solution, which I think will reduce the health impacts from the extreme weather events that we’re going to face in the future.

MW

As you go on, you’re trying to take on as one person, in a sense, a lot of these really big, complex issues. But I’m wondering about the impact on you. And I know you said at one point that an early tragedy in your own life, which was the stillbirth of a child, did turn you into a more positive person. And I wonder now, looking at the work that you do, how important that positivity is.

AH

Yeah. So, in 2008 I was pregnant with my first child. It was going to be a really interesting time and I was so immensely excited about the birth of our son. And I was one-week past due date when I had a hemorrhage and my baby died. Stillbirth is extraordinarily difficult to talk about. It is challenging for the person who’s experienced the grief and for their partner and family and it’s really difficult to hear about. I remember going back to work after the birth of my son and people would rush up in the corridor and say, ‘How’s the baby?’ There’s no answer, there’s no way of dealing with that and it was a tremendously disruptive period. I thought about it like skiing, you’re going up a – I don’t ski – that huge take off and then just slam straight into a wall. And it left me changed in ways that I still reflect very much on today, gave me a much, much deeper understanding of suffering and grief.

I’ve had a very privileged life. I’ve been given such an extraordinary range of opportunities and that really did show me that some of the adversity that people face in life is challenging, it’s really hard. So, creating space and creating time for people to process grief and to deal with the psychological impacts of those sorts of events is tremendously important to me. And I think in the last couple of years, I’ve particularly been able to shift my focus from a sense of looking at my own career and getting my own stuff done, to actually being how to look at the world around me and think about how I can positively contribute with the time that I have left. Because my understanding of my own mortality was changed quite deeply through that experience. None of us are here forever, and so the time that we have here, I feel so lucky to be able to make the best use of it that I can. And I thank my beautiful boy for that.

MW

I wonder when you’re doing this work and you see on the other hand, people who are continuing to want to go along in the old business as usual way and keep on pouring greenhouse emissions into the atmosphere. Do you get frustrated and how do you overcome that frustration?

If we make choices through a prism of care, caring for our planet, caring for our community, caring for our family and friends, caring for ourselves, how different the choices we might make will be.

– Arnagretta Hunter

AH

Yeah, look, I’ve been working with a friend at ANU, we run a podcast out of the Crawford School and we talk a lot about different public policy challenges. And we came up with a hashtag a couple of years back called ValueCaring. And so rather than engaging with the frustration that so many of us feel about particular choices and particular decisions, I really invite people to take on board the concepts of caring and think about how if we make choices through a prism of care, caring for our planet, caring for our community, caring for our family and friends, caring for ourselves, how different the choices we might make will be.

The sorts of choices about whether to preserve a natural environment, the sorts of choices about whether to use vehicles that will pollute the air, that then impact on both the biological life, the trees and the plants and the animals, as well as the human health and well-being in those locations. And so I think we can see a different way emerging through this series of conversations have already come up with the most amazing groups of ideas on how we can flip the paradigm, how we can change our approach from consumption and destruction of lives and of the planet toward a more holistic understanding that our health and well-being, our survival, but our meaningful life, our joy and our pleasure and our fun and our lives can be made better if we take a different approach and if we can value that caring relationship.

MW

Well, you are rising to a lot of challenges at the moment, but obviously climate change and dealing with these extreme events are at the core of some of your most interesting work. I wonder, you often talk about scenario planning for future disasters, and I’d like to ask you, if you had the ministers in front of you now, what scenarios would you like them to workshop?

AH

So, in Australia we need to think about the sorts of extreme weather events that we’re vulnerable to. And the last couple of years have given us a real taster for that. I think we need to prepare for heat, and we need to have some very detailed conversations about the regional heat variation and [there are] climate scientists who understand this much better than I do. But when we talk about a 1.5 or 1.7 degree global target, the way that 1.7 degrees is translated into the Australian environment really is worthy of some pretty serious attention and public discussion because 1.7 is not the blanket across the Australian landscape, in fact 1.7 will be hotter because we’re a landmass and it will be significantly hotter in central and in northern parts of Australia.

So, preparing for heat and understanding what heat might look like in the Australian landscape, preparing our communities, conversations around habitability, particularly during the hotter periods of the year. Understanding what sort of impacts that has on the health of the population and also on health service delivery, things like electricity and water supply disruptions, all things that we saw in a very serious way in 2019. Heat as an Australian health impact really does need some serious discussion and attention. So do the other natural disasters, so things like flooding. And again, you can see that there might be a real benefit to bringing together coastal communities to talk in an honest way about what the forecasts mean in terms of rainfall and in terms of disaster planning for floods.

Understanding what bushfire risk looks like and how we can mitigate that and reduce the risks of the sorts of Black Summer events, was there more we can do from a forestry perspective? Are there different ways of approaching land management on the Save the Trees side? But really those conversations need to be taken down. And why? Because the air that we breathe, the food that we eat, the water that we need to survive, these things are core to our human health and well-being, and they’re all impacted by the extreme weather events that unfold around us. Where we live, the houses and the structures and how we live there, the way in which we care for each other, these are also impacted by extreme weather events and how we can design ourselves around that will speak volumes as to our future and the way in which climate change impacts our health.

MW

Well, I must say, your energy, your enthusiasm and your ability to work through this huge issue of health and climate change is incredibly inspiring. So please join me in a round of applause for Dr Arnagretta Hunter.

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