Kai, You have raised questions that I'm sure many of us have asked ourselves; I always question myself about conference travel. As Elisabeth mentions, it is always nice to reconnect with our colleagues in the profession face to face; yet so much of our professional travel purposes can be accomplished with e-meetings. I have been training GSAP Microflush toilet makers in several countries over the past year and a half. Most of that has been done via extended skype conversations with shared screens;it as followed by exchanges of photos at stages of the first few toilets the newly trained makers fabricate. Is it as effective as travel and face to face training and field work? No. Yet it does work and it avoids the energy and $ expense of air travel as well as time. We are economizing further by developing training videos and using these followed by shorter skype sessions. When we put our minds to the options for frequent air travel, we can find satisfactory ways to lessen our footprint on the globe.

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Note by moderators: This post was made by a former user with the login name smecca who is no longer a member of this discussion forum.

Since the topic is relates to carbon emissions, should we also question where project funding comes from? BMGF funding has investments in fossil fuels: www.theguardian.com/environment/ng-inter...mate-change-campaign
Where does one draw the line?


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Note by moderator (EvM):

The following is copied from the link to the Guardian Website given above:

Sign the petition

To Bill and Melinda Gates, founders of the Bill and Melinda Gates Foundation; Jeremy Farrar and Sir William Castell, director and chair of the Wellcome Trust:

Your organisations have made a huge contribution to human progress and equality by supporting scientific research and development projects. Yet your investments in fossil fuels are putting this progress at great risk, by undermining your long term ambitions.

Climate change poses a real threat to all of us, and it is morally and financially misguided to invest in companies dedicated to finding and burning more oil, gas and coal. Many philanthropic organisations are divesting their endowments from fossil fuels. We ask you to do the same: to commit now to divesting from the top 200 fossil fuel companies within five years and to immediately freeze any new investments in those companies.

Hector - You've pinpointed what, for me at least, is most at issue. The problem is that we're NOT talking about any of it (as evidenced by the scant replies here). In large part, we're not drawing any of the lines that you refer to. We're not addressing the contradictions. Instead, we're going along largely just doing the same things. And positive change is never an outcome of a system that doesn't address its core contradictions and problems. Case in point, its not international development types that are behind the actions aimed at the BMGF (Bill and Melinda Gates Foundation). Its the Guardian newspaper (!).

To many of us feel like "What can I do?" when in reality its by each of us aligning our practices with our beliefs (and putting our money where our mouth is) that the possibility for change lies. Here's an alarming statistic: what we're doing isn't working and in fact its making things (far) worse. So, therefore, its time that we try something different.

The amazing thing is that we (particularly those us with disposable incomes and privilege; in other words, "consumers") are all change-makers - we just need to perceive and wield the power that our habits hold. For example, airplanes fly (and pollute) only because we keep buying their tickets. Water pollution persists only because we keep flushing toilets; because we keep buying toxic products; because we keep driving cars; because we keep buying foods sold to us by the agro-industrial complex, and so on. Industry is clearly the problem yet most of us are intrinsically culpable because we keep believing their advertising and buying into their hype.

So, indeed, where do we draw the line?

Well, I guess this is a good opportunity and venue for those funded by the BMGF to put their mouth where there money is and take a stance on the matter.

At a recently held Nexus Conference in Dresden, Germany the issue of climate change was paramount. Population growth and urbanisation with their attendant impact on climate were some of the key themes for discussion at various sessions that had several papers delivered.
During a discussion on the sideline of the conference, a participant's comment was just similar to this question raised by Kai - that we continue to lament over climate variability forgetting that we (climate advocators)hop from one conference to the other aboard aeroplanes oblivious of our carbon footprints. Not long after, in a chat with another person, he indicated that the Dresden conference was his 3rd successive conference relative to climate change.
Is this an irony of the climate war being pursued? Kai's question is timely because I also began thinking about this after the conference. A food for thought!

Hello everyone. I am picking up on this thread from 4 years ago (!) by forwarding to you a message I sent to the HIFA discussions forum a few days ago. I think SuSanA, HIFA and other virtual communities of practice could make a significant difference to reduce the carbon footprint of international health and development communications. We need fewer, smarter physical conferences, complemented by 24/7 communities of practice...

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From: "Neil Pakenham-Walsh" <This email address is being protected from spambots. You need JavaScript enabled to view it.>
To: "HIFA - Healthcare Information For All" <This email address is being protected from spambots. You need JavaScript enabled to view it.>
Subject: [hifa] The Lancet: Air travel for global health: flying in the face of sustainable development?

A recent paper in The Lancet draws attention to the 'inconsistency between undertaking work to promote sustainable development and travelling in a way that undermines sustainability'

Air travel for global health: flying in the face of sustainable development?
Ishtar Govia et al.
doi.org/10.1016/S0140-6736(19)32680-7

International health conferences are hugely damaging in terms of CO2 emissions. So how can we improve collaboration, communication and cooperation while reducing impact on environment and climate?

The answer surely must be to have *fewer* physical conferences and to invest more in virtual communication.

With minimal investment, virtual communities of practice such as HIFA have a great potential to promote communication and collaboration. They are much less expensive, much less environmentally damaging and much more inclusive than physical conferences. Physical conferences will always be needed, but they can be effectively complemented by virtual communication, as we have seen with the recent HIFA discussion in the run-up to the Dhaka Symposium on Community Health Workers.

With minimal additional investment as compared with the cost of physical meetings, HIFA could readily transform into a multilingual global health space for communication and collaboration. If you agree with me in the unrealised potential of virtual discussion forums, please contact me: This email address is being protected from spambots. You need JavaScript enabled to view it. Perhaps we can identify one or more investors to support HIFA as a flagship case study on how to improve global health communication while protecting planetary health.

Best wishes, Neil

Thanks, Neil. It's good to give this thread from 2015 another boost and to remind us all to think about this issue and to think twice before booking an airline ticket to a conference far away in another corner of the world when video streaming (or indeed online discussion forums like this) could be a viable alternative. I am copying below some messages that were submitted on the HIFA discussion forum in response to Neal's post there:

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24 December, 2019
Dear Neil,

I could not agree with you more. I have seldom learned much at conferences. They do serve a social need and that should not be neglected. I can’t say the same for project visits. Though where they require flights, they should be minimized, I have found that face to face exchange is so valuable that it would be a risk to dispense with it completely. When visiting our project in Afghanistan, members of the project team have told me, sometimes on the last day of a visit, important things which they had for some reason held back from mentioning even on Skype. And when there are very difficult issues to discuss, there is no substitute for meeting face-to-face in getting the ‘chemistry’ right.

Though we know the harm to the planet from flying and any travel that burns fossil fuels, it seems that most of us tend to see what we ourselves do as being so important that we should be an exception. For each of us the main person we have to convince of the necessity of our flying is ourself. That can be rather easy – so long as we don’t think of the harm to the planet which our children and grandchildren will have to contend with and how they will, in the future, judge our decisions on air travel. So rather than riding on a sense of our own self-importance, that our contributions are so important that we must fly, can doctors and nurses actually use such respect as we may have in the public eye by setting an example in reducing our flying?

I am glad that you have brought this up at the end of the year, a time for reflection of what we have done or not done, and when we sometimes resolve to do better in the year ahead. I suggest that it could be a time for counting up the flights we have taken and reckoning whether each was worth the cost to future life on earth. I have flown one return journey from London to Afghanistan and one internal return flight there, and my internal jury on whether it was justified is still out.

Best wishes.

Stewart

HIFA profile: Stewart Britten is advisor to the British NGO, HealthProm, on its project to reduce maternal and child deaths in Northern Afghanistan. He has worked for the reduction of institutionalisation of babies and small children in Russia by introduction of parent support programmes.

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24 December, 2019

Basically, you should just stay home and go vegan. And while you’re at home, cooled by ozone depletion and warmed by climate change, you shouldn’t use aerosols or plastic bags, and you should upgrade your fridge. You should dump the microwave, bin your electric toothbrush, and switch off the LED lights. You should figure out what to do with that ever-changing array of old computers and phones (clue: don’t send them to Ghana or Kenya as eWaste), and don’t save your digital ravings in the cloud (so-called “cloud” computer farms are very terrestrial and are projected to use about 14% of global energy at current rates). Say no to planes and keep the seasick pills handy (but only for sailboats, not cruise vessels, so you’ll have to plan your conference attendance a year in advance). Say no to cars and hello to bikes, but ideally bikes without tires (Americans discard 285 million tires a year, a major source of microplastic pollution, malaria breeding grounds, etc.). Walking or running is fine, but ideally in canvas trainers. No cigarettes, vapes or barbecues, let alone that marshmallow-toasting campfire or the romantic fire on the beach

Just making a partial little list like this shows how far we have come down the wrong roads - and what a long way back it’s going to be.

Chris Zielinski

Blogs: ziggytheblue.wordpress.com and ziggytheblue.tumblr.com

HIFA profile: Chris Zielinski: As a Visiting Fellow in the Centre for Global Health, Chris leads the Partnerships in Health Information (Phi) programme at the University of Winchester.

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25 December, 2019
Dear Neil,

I welcome your proposal for investment in HIFA virtual global discussion forums, but will leave aside the multilingual side as I have no competence there.

My experience of webinars has been unsatisfactory and I feel sure they could be improved on. If one is simply tuned in to a physical meeting, as well as sometimes having difficulty in hearing the discussion, the experience is surely one of feeling, as well as being, remote, with one’s virtual presence forgotten. The present webinar format seems likely, without intending to do so, to devalue those who are not in the centre, which tends to be in a capital city, and those at the global periphery – and by “periphery” I mean very far from that physical meeting. Surely there is now the technology to flag up when distant speakers want to contribute and to show them on a screen when they do so?

Best wishes,

Stewart

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25 December, 2019
Dear Chris and all

Thank you Chris for sharing you critique of the current status. It’s true that environmental degradation is surrounding us in all what we do and all what we eat and it sees that there is no escape. The impact of all this on health of people is enormous and cannot be ignored. There are people and states that don’t think of any thing except their own economic interest on the expense of the world population. They kill people by awful products and the damage on the environment and they invent medicines, machines and technology only to try to cure. More manage and more money. The absence of ethics and presence of power (military and economic) got us to this situation.

Best regards.

Najeeb Al-Shorbaji, PhD, FIAHSI

Former Director, Knowledge, Ethics and Research Department, WHO/HQ, President, eHealth Development Association of Jordan, Independent Consultant in Knowledge Management and eHealth

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25 December, 2019
Hi Neil and colleagues

Thanks for raising this important issue. Is anyone aware of institutions that have policies for minimising air travel so as to reduce the institution’s carbon footprint? If so, it would be great to have links to these so that we can take up this issue in our own institutions.

I am certainly one of those who is using air travel too much. For the recent Symposium on using qualitative evidence to inform decision making for the SDGs, held in Brasilia in October, we combined the face-to-face Symposium of about 160 people with an online virtual Symposium, for which over 600 people registered. In addition, colleagues organised about 6 satellite sessions at their own institutions across 3 continents during or after the Brasilia Symposium. These were both really useful ways of involving a larger group of people while also reducing air travel, and we should perhaps be doing much of this and much less air travel. You can find more information on the Symposium, including webcasts and podcasts here: qesymposium.org/media/

Best wishes

Simon

HIFA profile: Simon Lewin is a health systems researcher at the Norwegian Institute of Public Health and the Medical Research Council of South Africa ( www.mrc.ac.za ).

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25 December, 2019
Najeeb thank you, you hit the nail on the head. The irony or surprise to some of us old enough to remember the good old days, is that the very countries that preached interdependence and who birthed globalization are the very ones now touting isolationism because they command all the forces of power, coercion, sheer brute force.

But you know what tragically Ebola reminded the world that countries must remain interconnected and ready to face human disasters like climate change together not separately. Ebola in 2014 started in poor and ‘not so important’ countries and crept into the all mighty and strong countries and killed people in the poor and in the richer countries before there was a truly global reaction and response. Climate change threatens us all where ever one is but some richer countries responsible for more of the pollution have not woken up to the fact, until it may be too late. That is the challenge, the world must act together otherwise we are all in peril

Joseph Ana

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria.

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I am forwarding another message from HIFA on this topic (originally sent 26 Dec 2019):

From: "Erica Frank, Canada" <This email address is being protected from spambots. You need JavaScript enabled to view it.>
To: "HIFA - Healthcare Information For All" <This email address is being protected from spambots. You need JavaScript enabled to view it.>
Subject: [hifa] Walking the talk - how can HIFA members reduce global
aviation emissions?

Dear colleagues,

It has been gratifying to both of us (Neil and Erica) to see this HIFA conversation, and the growth of the academic/health flying less movement, and we think there is an opportunity to markedly accelerate our effect. Next September 14-16, the American [ policysearch.ama-assn.org/policyfinder/d...%2FHOD.xml-0-309.xml ], British [ www.ukhealthalliance.org/members/ ], Canadian [ policybase.cma.ca/en/viewer?file=%2fdocu...0change&phrase=false ], World [ www.wma.net/policies-post/wma-resolution-on-climate-emergency/ ] and other Medical Associations will be meeting in London (for this doc health conf www.bma.org.uk/events/2020/september/int...hysician-health-2020 ), and we would like to co-create with
HIFA members and some of those/other health leaders an Academic/Health Flying Less Summit just before or after -- in London for those nearby, and modelling the activity with helpful others in the diaspora on their laptops. While all these medical organizations have made enthusiastic policy commitments to reducing climate change, there remains an enormous carbon footprint around travel for the meetings all these organizations regularly sponsor, and the countless others their members regularly attend. Such travel typically is by far the largest carbon footprint of any of us who fly (have a look at this for-me-life-changing-bar graph [ drive.google.com/file/d/0BxNu1Nv4t3B7U2t...UNOQlo3YkxTdTdV/view ]), and I think we could model and get our professional organizations to commit to meaningfully changing this outlier-carbon-intensive practice...

All of these organizations have serious climate change policy (that's what the links above go to) -- in fact the UK Health Alliance's climate change policy recommendations (like others') mandate our action:

'As health professionals we have a duty to protect and promote public health in the face of these threats, and a unique and vital role to play. Our expertise, diverse roles and the trust invested in us mean we are, and should be, leaders in protecting the public from the health consequences of climate change. We know that actions that protect our planet, and mitigate climate change, are also good for our health. Phasing out polluting vehicles...'

I (Erica) have been actively working to reduce academicians'/physicians' carbon footprint since 2008, when I got the American Medical Association to pass this progressive climate policy, and was President of Physicians for Social Responsibility, switching PSR to having 2 vs 3 yearly in-person Board meetings. And Neil (through www.HIFA.org ) and I (through www.NextGenU.org ) both are committed to promoting investment in virtual communications, which are more inclusive, more equitable, less expensive, much less environmentally damaging, and potentially more effective than physical conferences -- and we'd love you to join us!

We see this gathering as a high impact, low carbon opportunity to readily advance our cause of reducing academic and physician travel, and of having that as not only an inherent good but as a critical role/population for modelling this behavior for others. We hope that you'll be interested in joining us, and look forward to hearing from you.

Yours, in walking the talk/grounding those Santa-shlepping reindeer,
Erica and Neil

Erica Frank, MD, MPH, FACPM
Professor + Canada Research Chair, University of British Columbia

Founder, www.NextGenU.org
Principal Investigator, Healthy Doc = Healthy Patient

HIFA profile: Erica Frank is the Founder and President of NextGenU.org, the world's first portal to free, accredited higher education, now being used in 193 (of 195) countries, and offering the world's first free degree (a Master's degree in Public Health), as well as a MedSchoolInABox that includes Graduate Medical Education.

Further information from Neil about this:

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27 December, 2019
Dear all,
I have been asked:
"How does one join your movement?"

There is no formal agenda or new organisation to join, and thoughts/ideas from all are welcome. Please do continue to follow and contribute to the discussion on HIFA, as you and others are doing. At this stage I think it would be helpful to identify any activities or organisations that are already actively looking at these issues, and to see how we might contribute/collaborate. As Erica and I mentioned in our post, the UK Health Alliance on Climate Change is one such organisation www.ukhealthalliance.org/ and is chaired by HIFA member Richard Smith. There is also the Global Climate and Health Alliance climateandhealthalliance.org/

I am conscious our discussion on HIFA would be a very small (but significant) part of a much bigger 'movement' around raising awareness of, and reducing humanity's impact on, climate change. There are (at least) two aspects that are directly relevant to HIFA:

The first, as mentioned in Erica and my message, is to recognise the damage done by air travel to international physical conferences and explore the potential for virtual communication tools such as HIFA to help reduce CO2 emissions while strengthening global communication and collaboration.

The second is to explore the information and learning needs of the public, health workers and policymakers around objective understanding of the issue and, in particular, the impact on health of current and future generations.

Thoughts on these and any other aspects are welcome.

Best wishes, Neil

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I copy replies from Kate and Enku on HIFA:

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29 December, 2019
Hello,

I'm delighted to read the interesting ideas on this this thread. I used to work in the field of medical educational publishing and often wondered at the expense of the conferences and all the waste they created.

I wondered whether you'd heard of this group - sustainablehealthcare.org.uk/ ?

They have a number initiatives, including one to green NHS properties and another to promote re-use of various equipment and tools regularly distributed by the NHS.

Personally, as someone who works in online learning, I'm comfortable attending whole conferences online and I've seen a move towards this in most sectors. Indeed, I've had the luxury of viewing a whole conference on medical education by the Association of International Medical Education online as part of my job. It certainly cuts costs and makes it more affordable if and when one can afford the technology and data for streaming services.

Thanks too for the reminder of this portal of free qualifications.

I look forward to reading more about the interesting initiatives others are implementing.

Kind regards,

Kate Whittaker

HIFA profile: Kate Whittaker is a freelance researcher with an interest in the debates around access to medical information and training materials. She previously worked with CABI developing an online course on working in microbiology laboratories. She also assisted with the development of the African Health project of Open Educational Resources (OER) Africa.

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30 December, 2019
Dear colleagues,

Wish you a happy new year!

The discussion we are having is truly global and we can do something about it. We have precedence.

In 1987, the global community banned the production and use of chlorofluorocarbons (CFCs) and protected the stratospheric ozone layer. This was known as the Montréal Protocol. At the conclusion of the meeting it was assumed that when fully implemented, millions of skin cancer cases, millions of deaths from skin cancer and millions of cases of cataracts would be avoided.

Before 1900, there were no cars. Until 1975, those old cars used to pollute. The introduction of catalytic converters to all cars reduced toxic gases produced by fuel combustion from newer models and now we all have better cars.

Now, we need cleaner jet fuel. We have the technology but we need political will to expedite and complete the process. We the people individually and collectively could take steps to cheer our legislatures globally to allow the production and use of clean jet fuel.

Did you know every 747 flight burns 10.5 tons of jet fuel, Kerosene, every hour? One ton equals approximately 30,000 gallons and a gallon for kerosene costs more than USD 5.00. A 747 will take 5 hours and 40 minutes to fly from New York to Los Angeles, 6 hours and 30 minutes to London and 19 hours to Sydney, Australia. According to FAA, globally there are more than 44,000 flights daily. KLM recently advised its clients to fly less. This may be against its shareholders’ interests but it was to highlight the urgency and to find ways to mitigate the overuse of fossil fuel.

By the way, there were 29 major meetings and several side meeting to conclude the Montreal Protocol. Therefore, it is never good to shame flying because we have to get around but, in addition to advocating for cleaner kerosene, it is always good to ask ourselves: what can we do to offset our carbon footprint? Could we get the information without using so much fossil fuel? The Lancet article published few days ago on 19 December 2019, noted that:

'Between 1990 and 2014 the global burn of jet kerosene from civil aviation increased by 86%.... Without effective action, over the coming decades anthropogenic greenhouse gas emissions will lead to substantial increases in morbidity and mortality including from illnesses related to heat, poor air quality, reduced food security and quality, and increases in some vector borne diseases - Human health and wellbeing are indivisible from planetarry health.'

But we are all consumers and we can also agree that excessive Green House Gasses impact our health and HIFA members could individually and/or collectively advocate to:

Increase car mileages to at least 55 mpg.

Convert all new municipal buses to electricity.

Promote cleaner fuel for aircrafts.

Recapture precious metals from discarded electronic waste products, which are now sent to landfills.

Reduce the use of fossil fuel and their byproducts such as plastics and synthetic fabrics.

Reduce the number of face-to-face meetings without compromising outcomes using virtual technology. If medical treatment can be done with the help of telemedicine, a lot could also be done virtually.

Would it help if we start a thematic in-depth discussion on this subject? I will be happy to join. [*see note below]

Best wishes,

Enku

HIFA profile: Enku Kebede-Francis (PHD, MS, MEd) is an advisor in global health governance.

[*Note from HIFA moderator (Neil PW): Thank you Enku. Can anyone recommend a community of practice that discusses issues of how to reduce carbon emissions and the links between climate change and health? We can then collaborate with such communities for increased impact.]

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And a reply by Joseph with a comment from Neil:

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31 December, 2019

Enku's posting is full of valuable information, historic and contemporary, I have read it at least twice already. The insight I get from it is that it illustrates how different it is across the globe, and many of these studies in the high income countries still leave out the situation in LMICs. Of course there are flights in low income countries and cars as well, but it appears that the damage to the environment comes more from activities like cutting of forests for fire wood which is the most common form of energy for cooking, heating, pollution, etc. In sone countries, whole government policies are centered on destroying forest reserves, austensibly for 'development'. Suggestions of suitable alternative interventions for development are ignored and in some cases seen as coming from enemies of progress.

As we discuss environmental protection on HIFA let's cover all the contexts, for LMICs there is the need to raise the level of awareness in rural and surburban LMIC communities, where travel is mostly by non fossil-burning means, of the damaging impact of destroying the remaining forests, fauna and animals. [*see note below]

'˜Let no one be left behind' as the world tackles climate change and aims to limit the damage to humanity.

Joseph Ana

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria.

[*Note from HIFA moderator (Neil PW): Some aspects of this discussion are relevant to HIFA, but the wider discussion goes beyond HIFA's remit. Can anyone recommend discussion forums on climate change whom HIFA could contact with a view to collaborate rather than duplicate? A quick Google search suggests there are many, including this: www.climate-debate.com/forum/ ]

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Another post on this topic by Stewart:

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2 January, 2020
Dear Enku and colleagues,

While welcoming most of your advocacy points, I cannot agree that it is, as you say, never good to shame flying because we have to get around. If or when we harm the planet by air travel to the detriment of our children and grandchildren, in my view we should feel shame. In the case of those who don’t feel guilt, shame at how others see us is powerful and valuable. I have worked in countries where, at the time, many doctors smoked, including in healthcare premises. Now I guess that almost all would be stopped by shame. That does not mean that flying, and indeed other uses of fossil fuels, are never justified, but in a day and age when most of us take short cuts for our own convenience, though we may see it as the importance of what we do, reckoning whether a flight justifies the cost to future life on earth is a very important exercise for each of us. I expect to make one almost unavoidable return flight in the coming year and to feel guilt at doing so. And increasing car miles per gallon to at least 55 is good, but in the longer term – and indeed now for those who can afford it – it is not good enough. We will need to use electric cars as soon as possible.

Best wishes,

Stewart Britten

HIFA profile: Stewart Britten is advisor to the British NGO, HealthProm, on its project to reduce maternal and child deaths in Northern Afghanistan.

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