Dr. Diane de Camps Meschino is an Associate Professor in the Department of Psychiatry at the University of Toronto, specializing in health leadership and system transformation. She founded the Reproductive Life Stages Program at Women’s College Hospital and is a founding member of Sanokondu, a global community of practice dedicated to advancing health care leadership education. Dr. Meschino also serves as a Complex Care Psychiatrist at Sick Kids Hospital in Toronto. Passionate about global health, she champions leadership education to improve health care delivery and drive the evolution of health systems.
Read on to learn about Dr. Meschino’s upbringing and her perspective on the intersection of health leadership and climate resilience. She shares her vision for creating sustainable health care practices and adapting health systems to address climate change.
Read the full blog below.
Introduction: My Path to Planetary Health Leadership
I had the great fortune of growing up in a humble family cottage in the wilderness of Ontario. As kids (I was 5) we helped build the dwelling over decades. For a long time, it was effectively a tent with only tarpaper exterior walls- small comfort as the wolves howled me to sleep (or not) every night. Deeply connected to the land, sky and water, there was wonder, mystery and hard work. In my adolescence, I was transformed as a steward and painter of planet earth when I first dipped my canoe paddle, wandering further into the wilderness, travelling to untouched, unseen beauty. We had a kind of Huck Finn freedom then. Leave no trace was the traveler’s code; it was our bond.
Planetary health and climate change pose a significant health care crisis, but they also offer opportunities for transformative leadership in health systems. As we navigate the delicate balance of our planet, we must focus on the intricate relationship between planetary health, climate change, and health care, acknowledging both the direct and indirect effects these challenges present.
Leadership: An Updated Purpose- Have you assessed your vulnerabilities and needs?
Effective leadership is critical in addressing the intertwined crisis of climate change and health care. Leaders must move beyond traditional directives, embracing accountability to the communities they serve. This requires a comprehensive understanding of local vulnerabilities, such as health care facilities, human resources, geographical location, socioeconomic factors, and existing health disparities; this will help in tailoring strategies to specific patient and community needs. Establishing dedicated funding and leadership roles focused on climate health is essential for fostering a responsive health system. Wise health leadership will also respond to despair and anxieties in the population to cultivate hope, collective participation and community-this is health care!
Radical Collaboration: Breaking Down Silos
Climate change is a complex, multi-sectoral issue that necessitates “radical collaboration” across various fields. Leaders must transcend silos and traditional barriers, forming partnerships with public health, social services, upstream suppliers, urban planning, justice and environmental organisations etc. By fostering an environment where diverse expertise converges, innovative solutions can emerge to address climate-related health threats. Engaging stakeholders with differing agendas before decisions are made can break the stalemate of the status quo, leading to effective public health strategies that include preparedness for extreme weather events. Diplomacy and techniques such as scenario planning and liberating structures facilitate relationship building and purpose focused action while getting unstuck from barriers to change.
The Power of Imagination and Action
Leadership demands imaginative thinking and creative visioning. It is imperative for leaders to act now, prioritizing the protection of vulnerable populations who lack resources to shield themselves from climate impacts. This requires leveraging positional power to reshape health systems for the changing world, fostering collaboration even with dissenting voices.
Distributed Leadership: Empowering Change
Leadership should not be confined to a select few; effective action can emerge from anyone within the system. Promoting distributed leadership empowers individuals to engage in climate health actions, ensuring that a wider range of voices contribute to systemic transformation. Health care systems must be re-evaluated and adapted to address the ongoing climate crisis, with every decision weighed for its potential impact on both health and climate.
Systems Transformation: Rethinking Foundations
To effectively combat climate impacts, existing health care systems must undergo rapid transformation. This involves reassessing foundational pillars that may no longer serve their intended purpose, particularly in light of pandemic recovery and underfunded health systems. Leaders must prioritize preventive measures, investing in community health initiatives as a cost-effective strategy against climate-related health issues.
The Scale of Change: Urgency and Adaptation
Every action taken to mitigate climate change matters, especially considering the scientific consensus that we appear to have surpassed the 1.5°C threshold for planetary sustainability. The health care sector must prepare for the inevitable health impacts arising from climate change, particularly extreme heat, floods and smoke. Proactive adaptation strategies can save lives, making it crucial for health care leaders to learn from past crises, like what has happened in British Columbia, and engage in forward-thinking planning.
Addressing Barriers to Change
Several factors contribute to the slow adaptation within health care systems, including a historical lack of urgency surrounding climate issues. Leaders must approach climate change as a Complex Adaptive System, recognizing that subsystems and systems can collapse without warning due to interdependent stresses. Preventive actions are essential to avert tipping points that could lead to catastrophic health consequences and unmanageable costs.
Strengthening Supply Chains
Identify vulnerabilities in existing supply chains to mitigate potential disruptions. Building local supply chains and safe storage is vital for resilience, as reliance on imported food and medications poses significant risks. Estimated food storage is six days, especially problematic if borders close or foreign supply chains fail.
Facilities, Infrastructure and Crisis Preparedness
Investing in resilient health care infrastructure is essential to withstand climate-induced disruptions. Health care facilities must be equipped to withstand extreme weather, utilizing passive cooling methods and ensuring robust HVAC systems This includes retrofitting facilities for extreme weather and ensuring backup power systems. Developing emergency response protocols will further strengthen health care systems against climate challenges. Positioning patients in inpatient facilities must consider the possibility of floods, heat, fire and evacuation needs.
Infrastructure for emergency preparedness must create tiers of intervention that prevent EMS, primary care and emergency rooms from overload. This may involve creative ways to monitor and treat patients who can be treated in community settings. Engaging digital apps, civilian volunteers, alternate transportation and alternate treatment-monitoring sites appropriate to the level of need are ideas for local development.
Education of health care professionals on recognizing and managing extreme heat impacts and managing other emerging hazards is crucial for effective patient care during climate crises. Redundant supply is essential to managing surge needs during climate events. Engaging volunteers, check in processes, outreach aids and social services may serve to identify and educate vulnerable patients in prevention and adaption methods.
Community Engagement and Mental Health
Engaging communities in climate adaptation is paramount. Public education about the health impacts of climate change can empower individuals and communities to take preventative measures. Additionally, addressing the psychological effects of climate-related events through mental health support and awareness programs is critical for fostering community resilience. The predicted volume of need will overwhelm mental health services such that novel approaches to support and connect those in need, especially youth are needed. Engaging stakeholders to co-create desirable services will be most impactful and sustainable.
Advocacy and Policy Influence
Health care leaders play a crucial role in advocating for health-centric climate policies. Engaging with policymakers and eco lawyers to prioritize public health in climate discussions can lead to more effective interventions and secure funding for resilience projects.
Continuous Learning and Communication
Ongoing research and knowledge exchange are vital for adapting to climate change impacts. Leaders should support initiatives that explore the health-climate relationship and promote evidence-based practices. Effective communication about health protection and prevention is essential for fostering engagement and mobilizing community action, instilling hope that collective efforts can lead to meaningful change.
Conclusion
As we confront the realities of climate change, health care leaders must act decisively to prepare for the challenges ahead. Through imaginative evidence-based leadership frameworks including LEADS in a Caring Environment, “Radical Collaboration to Transform Social Systems (Adam Kahane)”, and a commitment to community engagement, we can create resilient health systems capable of protecting both planetary and human health. The time for action is now; the health of our planet and its inhabitants depends on it.
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In an era where climate change poses unprecedented challenges, Dr. Meschino’s work stands as a beacon for transforming health care systems into resilient, sustainable entities. By championing health leadership and innovative practices, she inspires a collective commitment to safeguarding both public health and our planet for future generations.
Thank you, Dr. Meschino, for your invaluable contributions to sustainable health care and for inspiring us all to strive for a more resilient future.
Learn more about leadership in health care, at Sanokondu, or contact them at sanokondu.com@gmail.com
Want to get more involved in the green health care community? Check out these resources and projects!
Environmental stewardship implementation guides for boards, executive leaders and clinical staff: https://greenhealthcare.ca/guidebooks/
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