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OK, thank you. OK, so um the next book is from me. So I'm um my name is Becca. I'm the Clinical Sustainability Lead for the Trust. Um I've met quite a few of you within my role as a resident doctor at hospital. Um But I'm now working, focusing on how we can make our clinical care um more sustainable and reduce the impact here as a lot of action is done on a broader scale. So, on a kind of um uh like a professional scale within a whole institution can make a much bigger difference. Um And the things I'm gonna talk about in this talk, um We're going to this diagram from the wh O sets out the focus areas for climate change, for health. So we're going to talk a little bit about the health impacts of climate change just so that we as healthcare professionals are all aware and we can talk to our patients and, and recognize those impacts. Um We're also going to talk about how we can deliver sustainable health care and what their health co benefits are from acting on climate change. Um So just a short amount of more slightly sad stuff and then we'll go on to the actions of the positive things. Um So climate change is, has been linked to lots of adverse health um impacts and a lot of them are quite obvious, but there are some less clear ones. So we'll just go through them. So obviously, with rising temperatures, we're going to see more heat and more extremes of heat which will cause heat related diseases like heart attacks. Um sorry, just going back, um heart attacks, strokes, chronic kidney disease and death from heat exhaustion. Um and it is projected to get worse. Obviously, as temperatures rise, we're going to likely see more droughts and fires with rainfall patterns growing less predictable. So obviously, there's risk of dehydration and injuries from these um and exacerbation of respiratory illnesses. But also we'd like you to see crop shortages resulting in rises in prices. Um and also um increase in infectious diseases is when we have droughts, we have poor access to sanitation. So it's harder to maintain proper hygiene practices. And already um 30% of Southern Europe is in chronic water stress. We've all, I think at some point experienced a hosepipe ban or a short drought here, but it's projected to get more um prolonged and scaring the fire chief council. Um say that the UK is not prepared for this. So it's both from fires but also from response to emergencies from extreme weather events. Obviously, on the flip side, we'd like to see more flooding. Um And obviously, this can cause damage to infrastructure in homes, which also has health impacts on mental health, but also um being displaced from your home or being in a moldy damp house. And it can also risk contaminating our water as well as sewage overflows into um the water system as well. Um and warmer winters and more flooding is going to be the norm. Um And it was just, I think the winter previously, we had a lot of flooding around near us. So we had, I live very close to Debenham and this is what happened in the autumn there, there was just a sudden downpour and flash floods and there hadn't been a flood there for about 50 years or so, but they had to evacuate all the primary school Children in tractors because it just happened so quickly. So it really is on our doorstep. Um And widely 12% of people and 11% of hospitals in Europe are in flood um risk areas. So we're all a bit precarious from that. Um Obviously storms, um as temperatures rise, they're going to get more and more powerful, which is really scary. Um And there's even risk of more kind of on the less severe scale compared to kind of the deaths and injuries from the storms. And there's already some evidence suggests that thunderstorms can exacerbate asthma and cause asthma attacks. And so we'll probably likely see a sing or two, the changes in temperature changing vector ecology. So we're seeing mosquitoes already spreading across Europe. So there's been locally acquired case of West Nile virus in Italy, Greece, Germany Croatia France. Um and also Dengue is on the rise in France and Spain. We're already seeing non native ticks establishing themselves in the UK as well. Um And I don't know about you, you had a lot of mosquitoes in December, which is really unsettling. Um There's also going to be a risk of um new pandemics as you alluded to. So obviously, with changes in um ecology because of change in temperatures, but also coupled with drives of climate change, like deforestation, pushing animals into closer proximity with humans, that's going to increase the risk of viruses and other infectious diseases jumping across species. Um Food insecurity is also a big risk. So in the UK, we import 46% of our food. So climate events elsewhere in the world can affect us here. Um And obviously there's a risk to our um domestic production of crops um from climate change with de already highlighting that this is a really big threat. It's the biggest factor, our food production and we're already seeing this um and it's resulting in price rises. So even just last Friday, I went to try and buy bananas for everyone in the coffee break. But because of tropical storms in the Pacific, there are no bananas in quite a lot of places across the UK. So this is stock market, Tesco completely sold out. So, although this is quite minor, this is going to become more and more common. And as I said, um, climate change is responsible for actually a really significant proportion of the prices in food prices that we've already seen. And as he alluded to you, there's likely to be migration and conflict from people fleeing to move to safer land or because where they are just isn't habitable. And there's also likely to be conflict over scarce resources and that a very, very basic need over water and food and shelter. Um And he mentioned how many people are going to have to migrate and there's also going to be disruption to healthcare. And this is really important for us to be aware of as health professionals. So there's likely to be damage to facilities. So we've already seen this in the UK with hospitals being flooded, Harri had to evacuate. Um One of their wards cos there was when we had the wildfires a couple of summers ago, there was one that broke out right next to the hospital, so they had to evacuate. Um It's like that patients will be unable to access healthcare, so they'll either be unable to drive to access us or ambulances won't be able to get to them, which is really scary, obviously, damage to equipment, power and it outages guys and Thomas has had a massive um it outage a couple of summers ago during a heatwave, the service was overheated and shut down, which obviously, I'm sure you can all imagine the chaos that that causes and obviously the risk of not having enough clean water in the hospital will be a huge property. Um, supply chain disruption. I think everyone's um who works clinically at some point has experienced a shortage in one medication or a piece of or another. Um But with climate change, that's also going to impact both the shipping, but also the production of what we need and our access to get hold of those. So there's already been examples of shortages of IV bags because where they were produced, there was a big hurricane there. Um in the US, they haven't been able to get enough blood because people weren't able to go and um donate blood and then also get it to hospitals in time. I there's also a risk to us at work. Obviously, when it gets hot, it gets really hot for us to work. We get overheated, dehydrated, we can't think properly. Um But also from pollution and infectious diseases and just working around at all. Um We like to see an increase in cases. So that's going to increase our work burden and just put an extra strain on us. And obviously, we don't need any more of that. Um And finally, we're going to likely see an increased demand both from um kind of extreme weather events and really um responding to those but also chronic diseases are likely to get worse. There's things like chronic kidney disease, if we have the heat, heat waves and dehydration, that's going to exacerbate it the same with cardiovascular disease. And then also there's likely to be unexpected infectious disease outbreaks which you're probably going to have to respond to, to. Um and there's already examples of people having to be admitted to hospital because where they live is uninhabitable thanks to weather events. So it's quite clear to see that we've already breached that 1.5 and we can see how these events um are going to impact health. Um And obviously, there's a lot of mental health impacts um both from experiencing extreme weather events yourself, but also from the fear of it happening. And I'm sure quite a few of you are probably feeling that right now. Um But this is one that just really made me sit up and realize just how worrying it is. Um So this survey, a lot of Children, I think they're in their teenage years across the globe asking them about um how worried they are about climate change. And the blue bar shows that 26 to 74% of young people are so anxious about climate change that it impacts their daily functioning. Um And it's higher in the countries that are on the frontline of climate change. So particularly in the global South. Um And in the UK, 50% of Children and young people are very or extremely worried about climate change and this is not how our Children should be growing up, they should not be worried about their future, they should be enjoying their childhoods. Um And this is just summarizing from our ICB. So they have identified our current risk rating is significant um for, to health, both from extreme weather events and the impacts on health is that but also on healthcare. Um And the NHS does recognize the risk from climate change. They've highlighted in this report that climate change and resulting disease could undermine years of health gains. Um And but actually now has the potential to save 100s of thousands of lives. And numerous Royal colleges have declared climate emergencies. Lots of them have produced guidance on what we can do at work to um be more sustainable and to try and mitigate climate change. Um And actually earlier this year, the GMC added in their new um medical practice that we should be using our resources um responsibly, we should be choosing sustainable options and we do have a duty of care to our patients to talk and highlight when there is a risk of their health. And it's clear in the situation that there is