An update from the Environmental Sustainability in Surgical Practice Working Group
Message from the Chair
2020 has been a challenging year due to the horrendous bushfires in Australia and a once in a lifetime global pandemic. What we have witnessed are the impacts these events have had on the environment. The Royal Australasian College of Surgeons Environmental Sustainability in Surgical Practice Working Group has been working tirelessly to advocate on behalf of the surgical profession. With the assistance of the RACS’s Fellowship Division and their Policy and Advocacy Team, as well as the valuable input of the Working Group members, we have managed to accomplish quite a lot in the last six months since the commencement of the Group. This is however only the beginning as there is still much more to do in 2021 and beyond. While much of the initial work has had an Australian focus, our New Zealand partners are an essential part of this Working Group. I present to you a short summary of our year in advocacy.
Prof David Fletcher AM, MBBS, MD, FRACS, GAICD
1. Australian Royal Commission into Natural Disaster Arrangements in Australia
The Working Group has helped to write two important and extensive submissions to the Australian Royal Commission into Natural Disaster Arrangements outlining surgeons’ involvement in treating the health impacts of bushfires and other natural disasters. We provided several recommendations for consideration. For example, while banked allograft (cadaver) skin or biodegradable temporizing matrix (BTM) are important clinical components for treating burns patients, there is no national stockpile of donor skin, and there remains a lack of rehabilitation beds. From our New Zealand surgeons, the Whakaari/White Island volcano fires last year help shed greater insight into this problem. Another area of need has been the geographic misdistribution of medical specialists which has had an impact on the immediate attendance of burns victims earlier this year.
Other areas of concerns stemming from the major bushfires of 2019 to 2020 were the failure of telecommunication networks, increased domestic violence in the wake of a natural disaster, the retrieval of casualties from disaster zones and the impact of climate change as a catalyst for such disaster events. As a result of our efforts, we were invited to speak at the Royal Commission hearing. Following that, the Royal Commission cited our concerns relating to increased domestic violence and the need for a domestic stockpile or reserve capacity of essential community resources. Prior to our engagement, the Royal Commission hadn’t taken surgical practice as a focal point. After our advocacy, there has been a new found emphasis upon the important involvement of surgeons. The final report from the Royal Commission was released on 30 October (see here).
2. Australian Parliamentary Inquiry into Covid-19’s Impact on Australia’s Foreign Affairs, Defence and Trade Policies
Here was yet another example of the Working Group placing surgical practice and RACS on the radar via our advocacy. Prior to our engagement the Australian Government had not placed much thought into the relevance of our experience as it relates to trade and regional security. The Joint Standing Committee on Foreign Affairs, Defence and Trade held an inquiry as to the strategic implications of the pandemic known as COVID-19 with regards to various security threats within our region. The Working Group helped to organise collaboration with other important RACS affiliates like Global Health, Sustainability in Healthcare Working Group, Rural Surgery Section, and the Trauma Committee to name just a few from our internal governance structure.
The end product was an extensive and substantive submission. In it we emphasised the need for a more secure supply line for personal protective equipment (PPE) and ventilators, health humanitarianism of our Pacific Island neighbours where RACS is already committed with surgical training, and greater medical waste management based upon the increase of PPE pollution due to the pandemic. The Inquiry released its Report in December 2020 (See here). In it our submission on behalf of RACS was cited on four occasions relating to all of our concerns.
3. Webinar 2021 on The Five Rs - Reduce, Reuse, Recycle, Rethink, Research
The RACS paper entitled ‘Environmental impact of surgical practice (2018)’ (see here) will be updated in 2021. The principles underpinned by the five Rs will seek greater traction in the form of a RACS Webinar to be held in 2021, with further work to be made towards a forum for our fellows to participate in.
4. 2021 Inter-College and Binational Collaboration
Recently the not-for-profit group Doctors for Environment Australia (DEA) had written a 2020 inter-college letter to the Australian Prime Minister which called for a post-COVID-19 #HealthyRecovery. RACS is committed with this call for action as demonstrated in the Working Group’s involvement in the above submissions which are akin to the concerns expressed in the DEA inspired letter. The New Zealand Board made a similar submission to the NZ Prime Minister. The principles expressed in those submissions will bring together collectively our state and territory offices as well as New Zealand in 2021.