COP28 starts in Dubai this week, but the climate crisis has already come to Philadelphia

This past July was the hottest month ever recorded. While Philadelphia sweltered under typical summer temperatures, record-breaking heat was documented near the southern border. Phoenix had the hottest period recorded in a U.S. city. Austin, Texas, saw 11 consecutive days over 105 degrees Fahrenheit.

These extremes felt distant from the Philadelphia hospital where we work, but the impact of this unfolding climate crisis would come right to our doorstep.

A young patient arrived in July, only a toddler. She was admitted for dehydration, a common issue in our pediatric hospital each summer. One of us, the son of Salvadoran immigrants, gathered their information in Spanish. In conversation, it became clear that this small patient embodied some of the largest challenges facing our health-care system.

Her family’s arrival in Philadelphia was the end of an overland journey that had started in South America. Brutal heat had been their traveling companion, and like many migrants with limited resources, they were dangerously exposed to its impacts.

We provided the child with lifesaving intravenous rehydration, but these challenges extend well beyond one patient. What could we do to protect others from the forces that had brought this patient to our hospital, thousands of miles from home?

Climate change has been identified by the World Health Organization and numerous health publications as today’s single biggest threat to human health. Its hazards are many, from searing heat waves to widespread malnutrition — especially dangerous for children — due to drought and floods. These disasters are drivers of displacement and forced migration. And displacement leads to additional health concerns, both physical and mental, for people who have lost their support networks.

From Nov. 30 to Dec. 12, an estimated 70,000 people will travel to Dubai, United Arab Emirates, to attend COP28, the annual United Nations climate meeting. In an acknowledgment of the unavoidable links between climate change and human health, this year’s meeting will center a full day’s discussions on these issues for the first time.

It is essential that global leaders honor this recognition by committing to a rapid transition away from the fossil fuels that are polluting our air and water while destabilizing our atmosphere and oceans.

Taking bold action to fight the root causes of climate change is central to protecting health, especially within vulnerable populations. For individuals and families who are already on the cusp of forced migration, however, immediate action is needed.

Nations that have greater financial resources — and greater responsibility for climate disruption through a history of burning fossil fuels — must lead efforts to stabilize existing immigration systems and protect migrant health.

In an example from 2007 heralded as “environmental migration,” Spain established a bilateral agreement with Colombia to facilitate the temporary migration of those displaced by natural disasters. While this effort was discontinued after Spain’s economic crisis in the early 2010s, it represented a novel approach to the victims of extreme weather events and should be expanded as part of multinational plans for climate adaptation.

Equally important will be the strengthening of COP27’s breakthrough agreement for a “loss and damage fund,” which directed financial support from wealthier countries toward building climate-resilient infrastructure and institutions in less affluent nations.

There is a drafted agreement of support for such an endowment at this year’s gathering, and it is imperative that the final version boosts commitments and closes the gaps in the first. Investment will be an essential part of any effort to ensure futures free from traumatic displacement for those living on the front lines of the climate crisis.

While many health consequences of human-driven climate change are already being felt by those — like our young patient and her family — with greater exposure to extreme heat, dwindling water supplies, and other threats, this is not a reason to concede to fatalism.

In the past, human dedication and innovation have led to innumerable breakthroughs that were previously unimaginable, and the scope and dangers of today’s climate crisis demand a commensurate response. Otherwise, countless families will be forced to experience the risk and heartbreak of leaving a home in search of a safe, secure future.

As we look forward to COP28, we ask everyone who shares our hope for a livable planet to join us in asking the world’s leaders to understand the current stakes — and the possibilities.

Douglas Villalta is a pediatric resident physician in Philadelphia with an interest in language-based health disparities. Paul Devine Bottone is an adolescent health specialist in Philadelphia with an interest in the health impacts of climate change.