The Black Summer fires of 2019–20 had a dramatic impact on my rural community of Albury–Wodonga, on the border of New South Wales and Victoria. Climate change is the number one health emergency and we certainly live this reality in the country.
A doctor for over 30 years, I am a local general practitioner (GP) for around 4,000 patients and am privileged to care for up to four generations. I’m also a farmer who has had my farm destroyed by bushfires and a mother who has cared for my children through long weeks of bushfire smoke. It’s fair to say I have ‘skin in the game’.
In 2021, I presented to the Australian Senate inquiry on ‘Lessons to be learned in relation to the Australian bushfire season 2019–20’. I discussed the impact of inhaled bushfire smoke on all my patients, particularly when pregnant, and ways to help people respond to real-time air quality.
It is well known that bushfire smoke negatively impacts pregnancy. It is linked to increased rates of miscarriage, preterm birth, foetal growth restriction, hypertensive disorders of pregnancy and gestational diabetes, along with an increase in mental health problems and domestic violence.
I have cared for many patients who have real-life experience of these conditions after being exposed to bushfire smoke with small particulate matter.
There was one case, in particular, that had a lasting impact on me. A patient who had significant smoke exposure for weeks on end while pregnant, delivered her baby in mid-2020. Her placenta looked like she had been a pack-a-day smoker, despite never having smoked. The placenta was in such bad condition – ‘grey, grainy and coming apart’ – that it needed to be removed surgically. Her baby was born small and with respiratory difficulties.
I spoke out about this case to many media outlets at the time, having interviews with the ABC (Radio and TV), 2GB, 3AW, CBC Canada, Newstalk Ireland, BBC Radio and BBC TV (over 100 million viewers), in print media The Sun and on Al Jazeera. I experienced what it is like to go ‘viral’.
I have also been part of an amazing Australian documentary, Burning, on the impact of the 2019–20 fires on Australia – now on Amazon Prime (rolled out to 240 countries) – raising the alarm about the impact of climate change on my patients and, in particular, babies born to mothers exposed to bushfire smoke.
I also spoke to the Australian Senate regarding the urgent need for practical solutions to manage exposure to bushfire smoke. We all need clear advice and instructions on what to do according to measurements such as the local Air Quality Index. However, different states have different standards of air quality
The 2020 Royal Commission into National Natural Disaster Arrangements (also referred to as the Bushfire Royal Commission) found ‘there is an urgent need for national consistency in the categorisation of air quality’.
Our patients need access to, and to become more educated about and directed to, free air pollution monitor apps (such as AirRater, Plume or EPA AirWatch) that provide location-specific reports of PM2.5 particles, drawn from multiple local monitoring stations. These are available on smartphones.
There urgently needs to be a nationally coordinated approach to raising public awareness of the acute and long-term health effects of exposure to bushfire smoke, in particular on pregnant women and their babies. There also needs to be real-time monitoring of air quality to allow people to make meaningful changes to their lives and protect themselves from the dangers of bushfire smoke.
I encourage all GPs to speak out when and where they can on the impact that climate change has on our patients. The world is listening.