Climate and Health

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. E. Didem EVCİ KİRAZ
Aydın Adnan Menderes Üniversitesi Tıp Fakültesi, Çevre Sağlığı BD, Aydın, Türkiye
Article Language: TR
İklim değişikliği taraflarının 2018 yılında bir araya geldiği 24. toplantılarında (COP24), iklim değişikliğinin sağlık etkilerinin boyutunu sorgulayan özel bir rapor yayınlayan Dünya Sağlık Örgütü (DSÖ), bir bakıma yılların biriken çaresizliğine yönelik bir çığlık attı: 'Başarısız olduk'. COVID-19 pandemisinin de getirdiği sağlık yüküyle kırılganlığı artmış dünyada, iklim eylemlerinde başarısızlık, geleceği peşinden sürükleyen ana risk olarak kabul edilmektedir. Büyük risk altındayken sıfır pişmanlık nasıl sağlanabilir?

Sağlığı sosyal sektör olarak gören ve sağlığı sadece sağlık hizmeti sunan kurum ve kuruluşlarla sınırlayan iklim ve sağlık yaklaşımlarının yanlış olduğu COP25'te DSÖ tarafından yayınlanan araştırma sonuçları ile de ortaya konmuştur. Sağlık, iklim değişikliği çalışmalarında ana sektördür. İklim değişikliğinin etkilerini azaltmaya yönelik çabaların (azaltım) ve iklimle mücadele gücünü sağlayan uyum faaliyetlerinin hepsi'sağlıklı yaşam ortamları, iyi sağlık ve refah'a ulaşmak için gerçekleştirilmektedir. Bu gerçeği kavrayabilen ve halk sağlığı bakış açısına sahip liderler, geleceğin liderleri olacaktır. İklim değişikliğinde halk sağlığı bakış açısı nasıl olmalıdır?

COP26'ya hazırlık çalışmalarında, DSÖ 'Sıfır Pişmanlık' yaklaşımı ile sağlığı iklim değişikliğinin etkilerinden korumaya yönelik sağlık argümanlarını ortaya koydu. Bu argümanlardan birisi 'Sağlık pazarlık konusu değildir' cümlesiyle açıklandı. İklim değişikliği ile mücadelede, sağlığı iklim değişikliğinin etkilerinden korumaya yönelik politikalarda, girişimlerde, plan ve programlarda, hiçbir sağlık pazarlığı yapmadan, sağlık etki değerlendirmesi yaparak, gerçek ve geçerli hedefe nasıl ulaşılır?

Azaltım ve uyum ikiz eylemdir. İklim değişikliği raporlarını hazırlayan heyet (IPCC), en son raporlarında, değişimlere hızlı yanıt verenlerin ve değişimlere uyum sağlayanların hayatta kalacağını vurgulamaktadır. Uyum, iklim değişikliğinin sağlık etkilerine yönelik çabaların temelini oluşturur. Uyum, istenen hızla gerçekleşmemiştir. Sağlık; bedenen, ruhen ve sosyal yönden tam bir iyilik hâliyse, iklim değişikliğine sağlıklı ve sürdürülebilir uyum nasıl sağlanmalıdır?

İklim değişikliği yaşamın bir parçası olarak kabul edilmeli ve şu an sahip olunan tüm alışkanlıklar, yaşam tarzları, mevcut uygulamalar vb. bırakılmalıdır. Hızlı değişim sağlanmadığı sürece, iklim krizi ve iklim afetleri şeklinde tanımlamalarla zaman kaybedilebilir.

Kriz ve afet; değişimlerin veriler ve kanıtlarla izlenmediği, erken uyarı sistemlerinin kurulmadığı, olaylara ilişkin farkındalık ve eğitim düzeyinin düşük olduğu, hızlı yanıt mekanizmalarının olmadığı ve geleceğe yönelik senaryolarla yönetme sistemi kurulmadığı zaman gerçekleşir. Sağlığın iklim belirleyicilerine odaklı bilgi sistemleri, halk sağlığı erken uyarı sistemleri, iklim ve sağlık okuryazarlığı çalışmaları, coğrafi bilgi sistemleri altyapısıyla güçlenen, meteorolojik verilerle entegre sürveyans sistemleri ne zaman günlük uygulamaların bir parçası olacaktır?

Sağlığın sadece sağlık disiplinlerinin konusu olmadığını 'Şehir Sağlığı' kitabımızda birlikte ele almıştık. Aynı şekilde, 'İklim ve Sağlık' kitabında da bunu vurgulamalıyız. Dünyanın, ülkelerin, bölgelerin, şehirlerin, mahallelerin, hanelerin, bireylerin sağlığını iklim değişikliğinin olumsuz etkilerine karşı güçlendiren ve geliştiren her türlü stratejik hedefe farklı disiplinler ve sektörlerin birlikte çalışmasıyla ulaşılabilir. Tek sağlık bakış açısı geliştirilmelidir. Yerel yönetimlerin rolü çok önemlidir. Sağlık, yerel yönetimlerce hazırlanacak iklim değişikliğine yönelik planların ana başlığı olmalıdır. Yerel iklim ve sağlık eylem planlarını hazırlamak için geç mi kaldık?

Bütün soruların cevaplarını 'İklim ve Sağlık' kitabında bulacaksınız. Kitabı okuduktan sonra, siz de yepyeni sorular sormaya başlayacaksınız. Her soru, bilimsel araştırmalar ile yanıtlanabilir. Araştırma boşluklarının olduğu alanları tespit edip, yeni cevaplarla bu kitabı geliştirmek siz okuyucularımızın sorumluluğudur. Epidemiyolojiyi kullanarak, dijital veri platformlarının desteğiyle, iklim değişikliği sinyalleri, tehlikeleri, etkileri, etkilenebilirlik (hassasiyet ve uyum kapasitesi) ve risk düzeylerini gerçeğe yakın hesaplamak mümkündür. Sağlığın iklim verileri ile birlikte harmanlanması özel bir uzmanlık gerektirir. Temel epidemiyolojik veriler olan nüfus, doğum ve ölüm verileri ile meteorolojik verilerin karşılaştırılması ile başlayan sürecin, hane-mahalle-şehir bazında iklim değişikliğinin sağlık etkilerinde ilk etkilenecek noktanın tespiti hâline dönüştürülmesine ihtiyaç vardır. 'İklim ve Sağlık' kitabı, geleceğin iklim ve sağlık çalışmalarında başvuru kitabı niteliğindedir ve yukarıda yer alan tüm soruların ve yapılması gerekenlerin cevaplarını bilenler tarafından hazırlanmıştır.

Hepimizden hepinize güzel okumalar dileriz.

Prof. Dr. E. Didem EVCİ KİRAZ
Editör
The World Health Organization (WHO), which published a special report questioning the extent of the health effects of climate change at its 24th meeting (COP24), where climate change parties came together in 2018, in a way cried out to the accumulated desperation of years: 'We have failed'. In the world, whose vulnerability has increased with the health burden brought by the COVID-19 pandemic, failure in climate action is accepted as the main risk that drives the future. How can zero regrets be achieved when at great risk?

The results of the research published by WHO at COP25 have also shown that the climate and health approaches that see health as a social sector and limit health to institutions and organizations that provide health services are wrong. Health is the main sector in climate change studies. Efforts to reduce the effects of climate change (mitigation) and adaptation activities that provide the power to combat climate are all carried out to achieve 'healthy living environments, good health and well-being'. Leaders who can grasp this reality and have a public health perspective will be the leaders of the future. What should be the public health perspective on climate change?

In its preparatory work for COP26, WHO put forward the health arguments to protect health from the effects of climate change with the "Zero Regrets" approach. One of these arguments was explained with the sentence 'Health is not negotiable'. How to reach the real and valid target in the fight against climate change, in policies, initiatives, plans and programs aimed at protecting health from the effects of climate change, without making any health negotiations, by making health impact assessments?

Mitigation and adaptation are twin actions. In its latest reports, the panel that prepares the climate change reports (IPCC) emphasizes that those who respond quickly and adapt to change will survive. Adaptation underpins efforts to address the health impacts of climate change. Adaptation did not occur at the desired speed. Health; if it is a state of complete physical, mental and social well-being, how can a healthy and sustainable adaptation to climate change be achieved?

Climate change should be accepted as a part of life and all habits, lifestyles, current practices etc. should be left. Unless rapid change is achieved, time can be lost with definitions as climate crisis and climate disasters. Crisis and disaster; they happen when changes are not monitored with data and evidence, early warning systems are not established, the level of awareness and education about events is low, there are no quick response mechanisms and a management system with future scenarios is not established. When will surveillance systems integrated with meteorological data, powered by health information systems focused on climate determinants, public health early warning systems, climate and health literacy studies, geographic information systems infrastructure, become a part of daily practices?

We have discussed together in our book 'City Health' that health is not only the subject of health disciplines. Likewise, we should emphasize this in the book 'Climate and Health'. All kinds of strategic goals that strengthen and improve the health of the world, countries, regions, cities, neighborhoods, households and individuals against the negative effects of climate change can be achieved by the cooperation of different disciplines and sectors. One health perspective should be developed. The role of local governments is very important. Health should be the main topic of the plans for climate change to be prepared by local governments. Is it too late to prepare local climate and health action plans?

You will find the answers to all your questions in the book 'Climate and Health'. After reading the book, you will start asking brand new questions. Every question can be answered with scientific research. It is the responsibility of you, our readers, to identify areas of research gaps and develop this book with new answers. Using epidemiology, with the support of digital data platforms, it is possible to calculate real-like climate change signals, hazards, impacts, vulnerability (sensitivity and adaptive capacity) and risk levels. Blending health with climate data requires special expertise. The process, which starts with the comparison of population, birth and death data, which is the basic epidemiological data, and meteorological data, needs to be transformed into the determination of the first point to be affected in the health effects of climate change on a household-neighborhood-city basis. The 'Climate and Health' book is a reference book for future climate and health studies and has been prepared by those who know the answers to all the above questions and what needs to be done.

We wish you all a good reading.

Prof. Dr. E. Didem EVCİ KİRAZ
Editor

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