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How Saving Ecosystems Saves Lives
Like many places in the tropics, Borneo is burning—and the consequences are widespread.
Every year more than 2 million acres [almost 810,000 hectares] of Indonesian rainforest are destroyed. Between 2000 and 2010, nearly a quarter of Borneo’s diverse peat forests and their rich soils were drained, burned and cleared.
Before this trip, I’d known of the plight of orangutans, thousands of which have died as their forest habitat disappears. I also knew about the outsized role that clearing of these forests plays in driving climate change. I was less prepared for the impact that damage to these ecosystems has on human health.
For me, the burning forests were a nuisance to my visit. For the locals, they were a matter of life and death.
Though it’s hard to track the number of deaths from these fires and their long-term impacts, airborne particulates from previous fires here were associated with a 5- to 25-fold increase in cases of pneumonia alone, a disease consistently one of the biggest causes of death of both the elderly and young children in the region.
Burning forests are not the only health threats to the island’s people. Borneo’s rivers are plied by barges scouring river sediments for gold. The process they use releases tons of mercury into the rivers where families catch fish and practice aquaculture. Mercury contamination damages riparian ecosystems and results in smaller, more toxic catches for thousands who depend on rivers for their food security and livelihoods. Parts of the Kahayan River harbor more than twice the legally allowable level of mercury.
I left Borneo with a heavy feeling in my gut. In other places there’s warfare, or HIV or other headline-grabbing atrocities that capture our attention. Yet the sad truth is that a shocking amount of human suffering comes from far less sensational things, such as the silent scourge of environmental degradation and ecosystem loss, which destroy opportunities for healthy and productive lives.
In Borneo, it is the slow burn of peat forests and steady contamination of mercury that quietly, but gravely, threaten the communities living there.
The idea that the natural environment is important to human health isn’t new. It was foremost in Hippocrates’ mind (yes, that Hippocrates) more than 2,000 years ago. But compared to our reactions to other important factors for human health—consider the many public health practices we’ve implemented over the centuries as we’ve learned how disease spread—societies have done very little in the way of sensibly managing ecosystems to protect our health.
One reason we may have neglected our natural lifelines for so long is that we didn’t know just how closely human health is connected to our environment. But that’s rapidly changing thanks to recent scientific advances.
I recently worked with a team of scientists and public health researchers on a study of the links between ecosystems and human health. The evidence we know of, published in Proceedings of the National Academy of Sciences, connects ecological health to a surprising range of human health dimensions:
- Nutrition. Nutritional deficiencies account for many of the leading causes of death and disability globally, especially for children. With insects, birds and bats pollinating about 1 in 3 food crops worldwide, nature’s role in pollination alone is essential for a big portion of nutrients and calories in the human diet. Meanwhile, fisheries and wild animal populations are key sources of nutrients for billions of people. Without wild game, children in Madagascar would experience a minimum 30 percent higher risk of anemia—increasing their risk for sickness and death in many ways. The global decline of wildlife poses a nutritional crisis for many, with the worst impacts felt by those unable to replace wild food sources with domesticated species or fortified foods.
- Disasters. Healthy mangroves and other coastal barriers defend communities against coastal storms. Researchers estimated one cyclone in Orissa, India would have killed three times as many residents had mangroves not buffered their villages. Global loss of mangroves, reefs, wetlands and dunes places in harm’s way millions who live near the world’s coasts.
- Infectious disease. From hunting to the destruction of habitats, people’s actions alter communities of wild species in many ways, often with unforeseen and significant consequences. Healthy wildlife populations can influence the continued function of ecosystems and check the spread of disease. For example, in both Panama and the Brazilian Amazon, reduction in the diversity of mammal species has been linked to increased risk of human exposure to Chagas disease.
- Climate change. Already the impacts of global forest loss—the combined result of a million matches, bulldozers and machetes—account for more carbon dioxide emissions than all passenger cars combined. As these and other human-caused sources of greenhouse gas emissions continue, the resulting climate shifts contribute to a range of human health impacts, including heat stress, air pollution, spread of infectious disease, respiratory allergens, natural hazards, food insecurity and water scarcity.
- Indirect impacts. Many consequences of ecosystem loss take less direct pathways. In Belize, it took detailed study to discover that fertilizers applied to croplands caused changes in wetland vegetation far downstream. Unfortunately for coastal residents, these changes favor a variety of mosquito much more effective at transmitting malaria. Farming practices in one place have unwittingly resulted in greater exposure to malaria many miles away.
Evidence is mounting that the ecosystems we’re destroying are important for a range of vital human health needs. But countries, communities and families don’t have equal ability to deal with these impacts.
In a wealthy country, low fish catch might result in an altered menu or a shopping inconvenience. In another country it could be a matter of life and death. Indeed it is often the world’s poor—those with few alternative food sources, with less public infrastructure, with limited health care and insurance—who feel the most immediate brunt of environmental losses.
But is money a panacea? In 2013, Singapore, a nation with one of the world’s most productive economies and most admired healthcare systems, found itself choked by smoke from burning forests in neighboring Indonesia. The nation’s otherwise moderate air quality reached “hazardous” levels for the first time ever, and residents flocked to hospitals with cardiopulmonary illnesses.
In the U.S., the potentially debilitating Lyme disease afflicts thousands annually, while West Nile virus killed nearly 300 Americans in 2012. For both diseases, researchers have found higher risk of infection in places where diversity of native animal species has been reduced. Mounting evidence supports the theory that a higher number of species can “dilute” the harmful impact of those few species most effective at transmitting disease.
I write these words from a hospital in Austin, TX. My father experienced a life-threatening infection earlier in the week, by a form of bacteria resistant to nearly all forms of treatment. Thankfully his condition is now improving. As I watch him getting back to cracking jokes and talking about his grandchildren, I notice the antibiotic in Dad’s IV: vancomycin. I remember that it is one of the world’s precious few “antibiotics of last resort.” And I think of its humble origins: a handful of rich soil from the remote forests of Borneo.
Earth’s biodiversity is, in fact, a remarkable storehouse of compounds and innovations that has provided more than half of all commercial medicines, and may harbor undiscovered cures for cancer, malaria or the next emerging infectious disease.
As we destroy Earth’s forests, reefs, wetlands and other ecosystems, we light a fire to our storm barriers, our air filters, our water towers and our medicine cabinets, all at the same time. But we can turn this around: Stewarding nature would unleash a powerful, vital force in sustaining human life.
The notion that death and suffering can be prevented has been a driving force in medicine and has completely transformed human existence. We’re rapidly learning about the health consequences of ecosystem loss, and the countless life-saving benefits that natural ecosystems give us. How much longer should we wait to use that knowledge to save and improve human lives?
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By Joni Sweet
Should you skip your annual checkup? The answer would have been a resounding "no" if you asked most doctors before the pandemic.
But with the risk of COVID-19, the answer isn't so clear anymore.
Are States Allowing Preventive Care Visits?<p>First things first: If you're experiencing a medical emergency, don't delay treatment.</p><p>While there's the potential that you could be <a href="https://www.cdc.gov/hai/data/portal/index.html" target="_blank">exposed to infections at the emergency room</a>, the health risks of avoiding urgent medical care could be far more severe.</p><p>Hospitals have also implemented precautionary measures, like distributing masks to patients, that help cut down the risk of viral exposure.</p><p>Now that that's out of the way, is it possible to start catching up on routine healthcare appointments, like physicals and dental cleanings?</p><p>"Different places are in different stages of opening up," said <a href="https://www.methodisthealth.org/doctors/arvind-ankireddypalli/" target="_blank">Dr. Arvind Ankireddypalli</a>, primary care physician and geriatrician at Methodist Le Bonheur Healthcare. "Preventative services might not even be available in some communities, [and in others] medical appointments may be on a case-by-case basis."</p>
Is it Safe to Go to the Doctor?<p>If your state is open (or will end its lockdown soon), you may be able to start booking preventive care appointments, like Pap smears, cancer screenings, checkups, and dental cleanings.</p><p>But is it worth the risk of possible exposure to the new coronavirus?</p><p>Opinions vary among healthcare providers and the conditions of their patients, as well as the infection rate in their communities and availability of personal protective equipment.</p><p><a href="https://www.lenhorovitz.com/" target="_blank">Dr. Len Horovitz</a>, internist, pulmonary specialist, and director of Carnegie Medical, recommends that patients avoid delaying their annual physical or other types of preventive care.</p><p>"You will encounter problems that are best seen earlier rather than later," he said. "It is possible to provide a safe environment for a patient in the doctor's office. There's no reason for people to put off an annual exam; these are important appointments that help keep problems from getting out of control."</p><p>In an effort to curb the spread of infection, Horovitz has been following a strict set of procedures at his office, including allowing just one patient in at a time, requiring patients to wear masks and gloves, and disinfecting the examination room between every patient.</p><p>Other physicians, like Ankireddypalli, conduct a risk-benefit analysis for every patient before agreeing to see them in person.</p><p>"It is probably not appropriate to keep delaying visits for high-risk patients, like older adults or people with chronic conditions," he explained.</p>
Role of Telehealth Visits<p>Telemedicine visits, where doctors connect with patients via phone or video chat, can be an option if in-person appointments are risky or prohibited.</p><p>The <a href="https://www.medicaid.gov/medicaid/benefits/downloads/medicaid-chip-telehealth-toolkit.pdf" target="_blank">Centers for Medicare & Medicaid Services</a> and some private insurance companies have expanded coverage for telehealth services during the pandemic. As a result, some practices have seen the <a href="https://www.healthcareitnews.com/news/during-pandemic-telehealth-visits-soar-10-week-300-group-practice" target="_blank">use of telemedicine services soar</a> over the last few months.</p><p>"Telemedicine is a way that patients can be seen, evaluated, counseled, and informed about their healthcare without being exposed to the dangers of going into lobbies and offices," said <a href="https://www.mayoclinic.org/biographies/ommen-steve-r-m-d/bio-20053861" target="_blank">Dr. Steve Ommen</a>, cardiologist and associate dean of the Mayo Clinic Center for Connected Care, which offers telemedicine services.</p><p>"It is particularly relevant for patients who already have a relationship with a provider, the appointment is for an ongoing care episode, and the patient doesn't need to be touched," he said.</p><p>A virtual doctor's visit can't be a substitute for all routine care, though. Cancer screenings, blood draws, evaluations of lumps, Pap smears, and other services still need to be done in person.</p><p>But even if you do have to go to the doctor's office, telehealth services can help cut down on the amount of time you spend there, thus potentially reducing your exposure to the new coronavirus and other germs.</p>
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By Jeannette Cwienk
When it comes to recycling and recyclability, very little, it seems is straightforward — even something as seemingly simple as orange juice can present a conundrum. In Germany, many smaller shops sell drinks in cartons or plastic bottles, both of which will end up in the yellow recycling bin. But how do their recycling credentials stack up?
More and More Multilayer Packaging<p>How easy is it to recognize multilayer packaging? With drink cartons, it's usually obvious that they're made from a combination of different materials, but with other products, such as candy wrappers, it's a different story.</p><p>Such packaging can be made from a complex mix of up to 10 different films of plastic, which as Joachim Christiani, managing director of German recycling institute cyclos-HTP, explains, is <a href="https://www.dw.com/en/germany-produces-record-amount-of-packaging-waste/a-51293541" target="_blank">invisible to consumers</a>.</p><p>"In recent years there's been a trend toward so-called multilayer packaging, which is extremely light and thin. It saves material as well as CO2 emissions during transport, but can't be recycled," Christiani says.</p><p>Because it is not possible to melt the different plastics together, or — at least for now — to separate the individual films from one another at recycling plants.</p>
Lack of Recycled Plastic<p>A 2017 cyclos-HTP study into the recyclability of conventional packaging waste concluded that a third of it was not recyclable, and only 40% of the remaining two-thirds was made into plastic recyclate. The rest was used as fuel <em>—</em> in other words it was incinerated.</p><p>"There was no economic or political pressure to recycle more than this amount," Christiani says. "The prescribed recycling quotas were met, and there were not nearly enough recycling plants."</p>
Room for Greenwashing<p>According to a 2018 survey by Germany's vzbv consumer protection association, most consumers would like to see more plastic recycling, especially when it comes to packaging.</p><p>Although some products come in packaging that is advertised as being "made from recycled material," Elke Salzmann, a resource protection officer with vzbv, says that can be misleading.</p><p>"It says nothing about how much recycled material the packaging actually contains," according to Salzmann. "And it also doesn't mean that the recycled plastic comes from collected plastic waste. It could just as well come from plastic leftovers created during the production of primary plastic."</p><p>The term "ocean plastic," which some textile and shoe manufacturers use to advertise the recycled plastic in their product lines, can also be misleading, Salzmann says.</p><p><span></span>"Plastic waste from the ocean is in much too bad a state to be recycled. Instead, they use plastic waste from beaches or riverbanks."</p>
Laws Against Plastic<p>Images of garbage choking our waters and <a href="https://www.dw.com/en/eurythenes-plasticus-a-deep-sea-crustacean-full-of-plastic/a-52663559" target="_blank">killing marine wildlife</a> have played a key role in giving plastic a negative reputation among the public, and politicians have started to act.</p><p>Many countries worldwide have introduced bans on single-use items, and in Germany, a 2019 packaging law stipulates a plastics recycling quota of 90% from 2022, up from 36%. That said, the quota only refers to how much material has to be fed into the recycling system, not how much ultimately needs to be recycled.</p>
Rethinking the Whole System<p>Although plastic is a very useful material, at the end of its life it causes many problems, EASAC environmental program director Michael Norton tells DW, adding that we have to rethink the whole system and completely change the way we use plastic.</p><p>Joachim Christiani says the packaging industry is starting to catch on. Around 70% of recycled mass can currently be generated from packaging, but that figure is expected to rise in the future.</p><p>"95% is quite feasible," says the engineer, adding that sorting facilities are currently undergoing improvements, while packaging design is also changing.</p>
Clear Plastics Are Easiest to Recycle<p>As things stand, PET bottles are easiest to recycle because they're not mixed with other materials. New bottles can therefore easily be made from the old ones and the recycling rate is high. But the color of the bottle can pose a problem.</p><p>Because plastic is sorted by type rather than color, if different colors of plastic are mixed, the resulting recyclate cannot be used for light-colored packaging, which many manufacturers want. The upshot is the introduction of new plastic instead.</p><p>Consumer and environmental associations have long called for recyclability, greater sorting purity and better sorting facilities, but their most important demand remains waste avoidance through reusable systems.</p><p>"Why melt down disposable bottles to make new disposable bottles when you can refill them up to 20 times?" Buschmann asks.</p>
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When the coronavirus pandemic hit, the future of the Cannard Family Farm—whose organic vegetables supplied a single Berkeley restaurant—was looking stark.
Building Food Communities<p>Family farms in California and across the country have been hit hard by the impact of the coronavirus on their markets. But in the health-conscious Bay Area, where celery was already one of the first groceries to disappear from the produce rack, demand for fresh local produce has shot up. The challenge is in redirecting food from farms to new customers.</p><p>Sonoma County has historically been an agricultural region. When the organic food movement sprang up in the 1970s, this area was one of its early proponents. The first farmers markets and CSAs appeared in the 1980s and flourished, but the burgeoning network was later eclipsed by an inflated wine industry, much of it owned by distant corporations.</p><p>According to a 2018 crop report, 60,000 acres have gone to grapes, with only 500 acres in food crops. Land prices have skyrocketed, the cost of labor has gone up, and increased regulations have all made it harder to run a viable business here. Many farmers had turned to "boutique" specialty crops for restaurants.</p><p>"Farmers are always in an uphill battle, especially ecological farmers," says Wiig of the Community Alliance with Family Farmers. "I often hear them say, 'I'm working my butt off and hoping for the best.'" That's even more true now, as the pandemic strangles economies the world over.</p>
Scaling Up Support<p>F.E.E.D. Sonoma, a food hub that aggregates produce from dozens of local farms, was another quick responder. When the pandemic hit, it went from serving Bay Area restaurants to building a cooperative of farmers, filling food boxes for distribution at F.E.E.D.'s Petaluma warehouse and other drop spots in the county.</p><p>"Our local food system is extremely diverse," says co-founder Tim Page, who has the energy of a visionary combined with the skills of a businessman. "We have a ton of small farms but we don't have the infrastructure to support them. That is what F.E.E.D. is trying to establish." Since converting the restaurant supply business to a CSA, it has gone from 90 boxes to 450. Ultimately, the goal is 1,800 or more.</p><p>"I grew up in L.A.," Page says. "Every single farm is gone. The same thing will happen here if the general public does not understand the importance of it.</p><p>"That understanding was on display at the Sonoma Farmers Market, which now operates with strict restrictions and safety precautions because of the virus. "We think F.E.E.D. is going to save us," said Candy Wirtz, co-director of Paul's Produce, a well-established farm in Sonoma, as she weighed out my purchases. The CSA model could be transformative for Paul's and other farms across the country.</p><p>Subscribing to a CSA is a lifestyle change for consumers, to be sure. It means eating what's in season and learning to cook unfamiliar vegetables. But it's a change that many people are making now because of the stay-at-home orders. "People just have to learn to cook again instead of eating out," says Judith Redmond, part-owner of Full Belly Farm near Sacramento.</p><p>In light of this newfound commitment to CSAs, Perrotti, of Coyote Family Farm, says: "My hope is that this solidifies instead of going back to the way things were. I hope the importance of local farming stays at the forefront."</p>
Farms With Futures<p>To help small farmers stay in business during the crisis, Community Alliance is also advocating for stimulus dollars. "Most often subsidies go to a small number of the largest farms, or to buy food that goes to food banks from far away, while local farmers can't sell their food," Wiig says. "We want food banks to buy from local farms."</p><p>This seems like a win-win. Millions of tons of food is being plowed under as 60 million people are now going hungry, 17 million of them since the pandemic began, according to Feeding America, the national network of food banks.</p><p>But it's complicated. David Goodman of the Redwood Empire Food Bank puts it plainly: Local food is too expensive. "We distribute nine and a half million pounds of produce annually," he says. "It costs about 9 cents a pound, 3 cents to transport. With 82,000 people to feed, it would be a luxury to think of tending to local needs by buying locally."</p><p>That reticence is partly because the food bank system is tangled in bureaucracy. The USDA decides what to purchase and from where. Because of the distances between sites, the federal agency has tended to favor foods with long shelf lives, such as canned and processed foods, and long-lasting produce like apples and potatoes. "If local food is what we need, there has to be a plan," Goodman says.</p><p>Such a plan might be where short-term disaster relief meets long-term resilience. Michael Dimock is president of Roots of Change, a nonprofit organization that advocates for transforming California's food system. To get serious about preparing the food system for future disasters, Dimock says, the government needs to be involved. Roots of Change is now advocating for a tax on sugary beverages to help foot the bill.</p><p>Dimock says the state needs a paradigm shift for farms to remain viable in the face of multiplying disasters to come—not only pandemics, but fires, floods, and other symptoms of climate change. "How bold will people get in the months ahead to demand real change? My hope is they will get more radical."</p><p>Food is fundamental. While farmers have yet to face the full economic impact of this pandemic, their collaborative efforts, along with local grassroots networks, could mark the beginning of a new economy laboring to be born.</p>
By Andrea Germanos
Nearly 200 Canadian organizations on Monday rolled out their demands for a "just recovery," saying that continuing business-as-usual after the pandemic would prevent the kind of far-reaching transformation needed to put "the health and well-being of ALL peoples and ecosystems first."