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Connected to Africa: Dr Lueme focuses on a healthy planet
Author: Corporate Communications and Marketing
Published: 30/05/2023

The institutional theme at Stellenbosch University (SU) for May this year is “Connected to Africa" and on 25 May we celebrated Africa Day with the rest of the world. Africa Day is the annual commemoration of the foundation of the Organisation of African Unity on 25 May 1963. SU has nurtured relationships with many institutions in other African countries over the past decades and our academics are collaborating with top scientists on the continent. In this series, we showcase a few of the SU academics who epitomise academic excellence through a meaningful footprint in the African context.  

Dr Christian Lueme, a researcher at SU's School for Climate Studies, is an expert in planetary health. His research area covers climate change, air pollution and health, planetary health medical education and building climate-resilient primary healthcare. His approach focuses on the quantification and prediction of the magnitude of health risks and uncertainties of healthcare resilience to climate change and air pollution. 

What inspired you to pursue a career in planetary health research, and how has your research evolved over time? 

Through the One Health approach and ecological health readings, I became aware of the interconnectedness and interaction of climate change, air pollution and other global ecological drivers such as the loss of biodiversity and the impact on human and animal health and vegetation health.

I quickly realised there was little research on the impact on healthcare services. We can't speak about health and well-being without also looking at aspects of healthcare such as infrastructure, patient care, clinical governance, leadership, etc.. 

I was also fascinated by the Anthropocene era and exceptional human activities in this era as the main drivers of the ecosystem imbalance. I came across the online talks of Dr Samuel Meyers and Prof Frumkin Howard (from Harvard University) on planetary health as the framework of a solution-orientated inter- and transdisciplinary approach to protecting nature to protect ourselves. I was fascinated by the need to teach planetary health mostly to health professionals. 

How do you define the concept of planetary health, and why is it an important area of study? 

According to the Lancet Commission on Planetary Health, planetary health is the science of “the health of human civilization and the state of the natural systems on which it depends". Planetary health is an inter- and transdisciplinary framework of health that identifies, analyses, and addresses the impacts of human disruptions of the earth's natural systems on the health and well-being (and migration) of all life on earth.

Planetary health is a solutions-oriented field as well as a social movement that puts health and well-being at the heart of global environmental challenges. It does not only identify and analyse the problem but seeks innovative solutions from different and collaborative approaches.  

Could you tell us more about your research on the interaction between climate change patterns and air pollution on human health in South African cities, and what findings have emerged from this? 

My PhD was on the interaction impact of climate change and air pollution, two incredible ecological drivers of change in cardiovascular and respiratory diseases (CVDs and RDs) and unintentional injuries. Climate change – the most apparent temperature increase – and air pollution (also transboundary air pollution) have led to increased hospital admissions and emergency visits of CV patients with diseases such as stroke and heart failure and RD patients with asthma and bronchitis.

Apparent temperature increase or decrease above or below the threshold tolerated by the human body often leads to unintentional injuries, for example road accidents. The apparent temperature is the physiological feeling of the ambient temperature. Some cities are affected by transboundary air pollution from other regions and continents. 

How can we integrate planetary health into primary healthcare and patient care, and what impact do you think this would have on healthcare outcomes in Africa? 

We need to embed planetary health into the medical curriculum of undergraduate students and future primary healthcare givers to explain the way to resilience, adaptation, and mitigation. There is a need for clinicians to reflect on how climate change and environmental pollution impacts manifest on diseases and what communication they need to have with their patients and communities.

Developing countries and poor people will suffer the most from the global environmental crises and particularly from the effects of climate change. More than five million people are living with food insecurity, insufficient potable water and in emergency conditions in southern, northern, and eastern Africa. Children, pregnant women, certain people with comorbidities, the elderly, and the poorest people are often the most vulnerable.

Higher levels of air pollution, coupled with rising temperatures, have already resulted in increased hospital admissions and emergency room visits for asthma, allergies, electrolyte disorders, depression, anxiety, hypertension, stress, as well as increases in premature deaths. 

What are the major health risks associated with climate change in Africa, and what steps can be taken to mitigate these risks? 

The major health risks are linked to a lack of climate-resilient healthcare systems, the re-emergence of climate-sensitive and neglected diseases, and a location shift of some diseases.

Several researchers have warned about the effect of the global degradation of the ecosystem on health and the well-being of all life on the planet. It's time to think about adaptation, mitigation, and resilience strategies.

There is a need for a good collaborative approach to the problem, from public health to healthcare services. There is a need for multidisciplinary, transdisciplinary and multisectoral collaboration. There is a need for community of practices and regional transdisciplinary research collaboration on climate change and health effect. The health sector must join hands with other sectors such as agriculture, energy, environment, water, and sanitation as well as education to inform the public.

Climate change and air pollution will be with us for the next two to three decades. We need to increase education on planetary health, climate change and health, the One Health approach, environmental health, and ecological health. We also need to raise awareness in communities and support advocacy aimed at policymakers to include resilience, adaptation, and mitigation in their priority lists.  

We need to innovate tools of climate resilient healthcare systems and we need to measure and implement these tools. 

How do you collaborate with other researchers and organisations in your work, and what role do these collaborations play in advancing the field of planetary health? 

I am collaborating with international and national researchers from the Climate Change, Migration and Health Network (led by Ghent University); SU's School for Climate Study; family physician associations such as Primary Care and Family Medicine Network for sub-Saharan Africa (Primafamed); the World Organisation of National College Academies; and the Academic Associations of General Practitioners/Family Physicians' (Wonca) Global Environment Group. 

We just started another collaboration through the SU International Office with the Research Alliance on Climate and Health (REACH). I also collaborate with the Climate Change Forum within the Western Cape Department of Health. Another collaboration is with the South African Association of Health Educationalists. All these collaborations help to improve my expertise in planetary health medical education and building climate-resilient primary healthcare.   

What do you enjoy most about working at SU?  

The opportunity to develop and improve my expertise in planetary health medical education and climate-resilient primary healthcare. From working on my master's degree in public health, I realised that climate change and health research need to move from a public health perspective to how these environmental crises manifest in patient care. I came across an article by SU's Prof Bob Mash on “Climate change, the threat of collapse and the opportunity for transformation". I hoped to collaborate with him in this area and SU has provided that opportunity.