Green doctors, or doctors who care for the environment are not new to India. Bharat Ratna Dr BC Roy, (whose birth and death anniversary on July 1 is celebrated as Doctor’s Day in India) was an eminent physician and humanitarian who also served as chief minister of West Bengal. His concern for the environment is however, lesser known. In his early career he had recommended a study on water pollution in Hooghly and suggested measures to prevent the problem in the future.

Despite being an essential determinant of disease, the study of the environment is a neglected topic in the medical curriculum in India. The urgent need is to upgrade knowledge and skills of doctors. Specific examples include customizing the environmental history section of the American Academy of Paediatrics and the US Agency for Toxic Substances and Disease Registry (ATSDR) guidelines for the workplace environment to the Indian context. These include assessment of exposure to carcinogens such as asbestos and arsenic. India's research capacity in environmental health also needs to be rapidly boosted. All these measures assume significance as the environmental crisis become more daunting in the years to come.

Keep it clean

The air pollution problem has been highlighted by relentless media coverage. 13 of 20 most polluted cities in the world are now in India according to a recent WHO report, with Delhi surpassing Beijing. The Government realizes the gravity of the issue and has already set in place, a real-time monitoring system and national air quality index in select cities of India.

In the short run, physicians can encourage patients to monitor outdoor pollution levels to decide on their activity level. Respirator use as well as vehicular and indoor air purifiers should be considered, particularly for vulnerable categories such as children and the elderly for whom these conditions are even more challenging.

Climate change will add to the conundrum of environmental health. The impacts already being felt such as diarrhoea, vector-borne diseases, heat strokes and asthma would increase in frequency and severity.

Doctors will be at the receiving end of this new and slowly worsening ‘climate epidemic’ at a time where drug resistance and logistics are posing tremendous challenges. Amongst other measures, early warning systems need to be developed right down to the ‘last mile physician’.

At the international level there has been a push for Green Health Facilities for lowering the carbon footprint from this sector. The Green Health Facility concept is not limited to the building alone, but also to other dimensions such as water, biomedical waste and transport.

There are now several examples of Greening of the Health sector in India, both public and the private, such as AIIMS and Fortis. As this process extends to other hospitals in the country, it is also essential to persuade doctors owning smaller facilities such as nursing homes.

A cynical doctor may argue that it is not possible to make a meaningful contribution to a Green India. For those who are immersed in the toil of the profession, it is easy to forget that doctors can be the best change agents for society.

For patients and those around, a doctor is a role model. If his nursing home bears the green stars or if she uses the Metro, on a subliminal level it could certainly be expected to have a ripple effect.

Doctors in India have made considerable strides in biomedical waste management in a relatively short time span of less than 20 years. As the world moves towards a possible tipping point, our healers must now don the ‘green mantle’ in order to help heal the planet.

The writer is a recipient of the Fulbright-Nehru Environmental Leadership Program Fellowship. The views expressed are personal.

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