Reviewed 11/26/2011

Changing Planet, Changing Health, by Epstein & Ferber

Access to this book courtesy of the
San Jose, CA Public Library
How the Climate Crisis Threatens Our Health and What We Can Do about It
Paul R. Epstein, MD
Dan Ferber
Jeffrey Sachs (Fwd.)
Berkeley: University of California Press, April 2011




ISBN-13 978-0-520-26909-5
ISBN-10 0-520-26909-8 355pp. HC $27.95?

The principal author of this book is Paul Epstein (1943-2011). Trained as a physician, he practiced in rural Mozambique from 1978-1980. That experience involved fighting a devastating epidemic of cholera, among other diseases. At various times he also visited Haiti, studied health and nutrition in a village in southern Mexico, accompanied public health students to investigate the health of civilians caught in Daniel Ortega's battle with the Contras in Nicaragua, and assisted Kurdish refugees displaced by the first Gulf War.1 During the 1980s he earned a Master's degree in public health, and he was active in Physicians for Human Rights and Physicians Against Nuclear War. He saw the threat of climate change earlier than most.

"Dan Ferber and I have written this book to call attention to the problems climate change poses for human health and welfare and to help chart a path toward a cleaner and healthier future. It is no longer a luxury to make our economy low-carbon and sustainable. It's a matter of preventing harm to the species who dwell on the Earth, including our own. Just as an ailing patient can recover, so can an ailing planet. But we must act now."

– Paul R. Epstein, Boston, MA, October 2010 (page 5)

The book is part biography, part exposition on the growing understanding of how our changing climate is likely to affect the health of humans all over the globe. It interleaves episodes of scientific discovery, such as Rita Colwell finding Vibrio cholerae, the bacterium that causes cholera, in Chesapeake Bay,2 with episodes from Dr. Epstein's life. In some ways it resembles Dr. Stephen Schneider's memoir Science as a Contact Sport — not least because both appeared in print less than twelve months before their authors died.

But the resemblance goes deeper than the mere coincidence of untimely death. The contents of this book show Dr. Epstein to be a systems thinker, able to grasp the relationships among disparate phenomena such as the maturation time of the malaria mosquito and the temperature of its environment and to discern the implications of those relationships for human society going forward. He also understood the importance of professional and personal relationships to solving systemic problems like disease epidemics or climate change; and this involved an understanding of the media of mass communications. These abilities are gifts, and all too rare. Dr. Schneider, who died in July 2010 on the way home from a conference, had them too. Both men will be sorely missed.

The genius of this book is that it shows us both the personal and global impacts of climate change. There is Kenyan schoolteacher Anne Mwangi nursing her daughter through a bout of malaria; there are 750,000 deaths each year from malaria in Africa, per World Health Organization estimate. There is Chris Ballas, an active New Jersey 43-year-old, paralyzed by Lyme disease; there are ten times more cases of Lyme disease in Maine between 2001 and 2009. Dr. Juan Almendares fought flooding and hostile guards to save prisoners at the central prison in Tegucigalpa during Hurricane Mitch in 2008; nationwide, Honduras lost 189 bridges, 100 highways, and 200,000 kilometers of electrical power lines to the storm.

There is a great deal more to say about the devastation climate change is already bringing to some nations today, and the greater devastation it is likely to bring to nations around the world by this century's end.3 Dr. Epstein says it very well in this book, writing about public health, about forests and food crops, about water supplies, about weather, about the oceans. But he also says that there is hope of averting much of the devastation. The key to the solution may be the insurance industry, which has been instrumental in establishing fire codes and standards for safer vehicles and buildings.

I don't think there's any need to belabor the point here. If you read this book, you will be frightened — and you should be. But you will also be reassured, both by learning that fixing the climate change problem is not the world-wrecker certain factions make it out to be, and by knowing that good people like Dr. Epstein have been and will be on the case. (Quite a few of them are introduced in these pages.) So read the book: it bears an important message, and communicates it well.

"We had no shortage of material. By the early 1990s, many scientists were concerned about the numerous diseases that were being reported with increasing frequency in marine organisms from all parts of the world. For example, during a large El Niño in 1983, the Caribbean Sea warmed more than usual, and an infectious disease decimated the dominant species of sea urchin, which clean algae from coral reefs, thereby maintaining their health. The repercussions were huge: Jamaica's renowned ring of reefs was snuffed out from mats of algae, and they have still not recovered. The 1983 El Niño, another El Niño in 1987, and gradually warming seas all contributed to other losssesin the Caribbean: four thousand hectares of turtle grass perished in Florida Bay, several species of coral disappeared in multiple locales, and dolphins and other marine mammals experienced mass die-offs. In the North Atlantic, mass die-offs of marine mammals had become increasingly common, with our pollution appearing to play a major role."

– Page 126

Forty-two illustrations (photographs and charts) supplement the text. There are of course chapter endnotes and an excellent index.

1 That would be Desert Storm (1990-91).
2 Her discovery explained how cholera epidemics could spring up in widely separated coastal cities almost simultaneously, with no land-based carriers visiting at those times. It also frightened her funding agency, NOAA's National Marine Fisheries Service, which cut off her grant. However, she found a new grant from another part of NOAA and continued learning about cholera.
3 For a more comprehensive summary of this devastation, see my Impacts page, linked below.
n The heat can also bake soils so rainwater runs off, contaminating local drinking water and spreading diseases. This happened after the India heat wave.
n+1 New York Times obituary for Dr. Epstein
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