Palliative Care and Climate Change

Categories: Featured and Opinion.

Greetings readers.  This essay delineates key linkages and mitigation strategies related to the climate change crisis now impacting humanity, and the palliative care delivery system continues to evolve in our world – with an emphasis on low and middle-income countries.


  • Extreme weather events occur globally every year, and are predicted to continue to do so for years to come, worsening in both frequency and intensity. Together with earthquakes, coastal flooding, extended periods of drought, and other rapid-developing environmental traumas, these events impact the lives of palliative care patients, as well as the agencies and institutions that serve them – disproportionally so in low and middle-income countries, and for the most vulnerable persons in those countries.  Seriously ill persons, particularly children, are among the most vulnerable in natural disasters and severe weather events – for survival, for debilitating after-effects, and for long-term challenges.


  • These climate change-related events concurrently impact energy and water infrastructure in low and middle income countries. Such infrastructure may already be weakened due to years of neglect, insufficient funds for basic maintenance and upgrading, corruption, worker shortages, or global events such as war, political violence, or cyber sabotage.  Climate change, therefore, is inherently linked to electrical grid issues, power outages, and load shedding schemes.
  • These two general scenarios have significant impact on quality of life issues for seriously ill patients and their household members, including access to fresh water for sustenance and for medication compliance, food insecurity, household damage or displacement,
    and access to health care services, treatments, and medications. They also impact staff and volunteers (and their households), and agencies that provide palliative care services.  They seriously reduce operating efficiency or disrupt service provision altogether.


A global template for action to address climate change was delineated in the 2021 COP26 Glasgow Climate Pact.  Each of us working in specific contexts may benefit from contacting our country representatives to that conference, as well as the funders that pledged actions in certain countries and continents.  Here are some basic mitigation strategies that are relatively easy to initiate and manage.
If your country or locale is climate vulnerable, you are advised to take immediate action with a view to real-time disaster response, and strategic planning to reduce adverse environmental impacts over the long term.

  • COMMUNITY INCLUSION: Top priority is ensuring your palliative care program is enmeshed in the broad community served by the program.  Active participation in community networks will ensure that the broader community sees your program as a program that matters regarding the needs of the most vulnerable.
  • IMPACT MAPPING: Clearly identify areas likely to be impacted, threatened transportation routes, location of patient and staff households, most vulnerable communities, etc.
  • EMERGENCY RESPONSE DIRECTORY: Listing and contact information for all medical and social aide emergency response personnel that may be needed in times of disaster. All relevant resources, including governmental, non-profit, corporate, church, and community players.
  • DISASTER PLAN: Your agency/organization plan for disaster response. There are many online examples of such plans, for all sizes of organizations, with all levels of technology.  These include mobilization plans, short term relief plans, plans for remote operation and communication, etc.
  • PALLIATIVE CARE PROVISION PLAN: These are the services that your organization can provide to support all victims of natural disasters and adverse weather events. These may include trauma support and debriefing services; crisis management palliative care for impacted clients and households; palliative care members of emergency response teams; medical management of symptoms where treatment disruption has occurred; deployment of staff, volunteers, space, or vehicles to assist in community response; counseling and grief support; participation in community rescue teams; access to back-up water and food supplies; etc.
  • COLLABORATIVE RELATIONSHIPS: Reach out and form working relationships with key players in disaster management and emergency response for your offices and for your clients. Be proactive in letting them know how you can help identify and assist with the most vulnerable
    persons, and what you expect from them for your offices and clients when disasters occur.
  • EXPERTISE: Have a standard, updated training program for all staff on emergency response and trauma relief. Focus on key issues that may impact staff themselves, the clients they serve, and your offices and infrastructure.
  • RENEWABLE ENERGY: Do everything possible to install back-up systems for electrical energy and to maximize renewable energy. Many parts of the global south are sunshine high regions – ideal for solar energy. Most countries now have reliable local solar contractors, many of whose families may have used hospice and palliative care services.  Specific grant sources may exist for renewable energy projects (Green Energy Funds), and local donors  and corporations may respond well to becoming funding partners in renewable energy projects for their communities.
  • SATELLITE WiFi. Research affordable ways to access reliable satellite WiFi when it comes to your country.
  • MESSAGING: Develop scripts for outreach, social media, and presentations about the impact of climate change on your clients. Use compelling stories of vulnerable individuals that you serve to enhance effective messaging.  Be proactive in generating public awareness on this issue.




In the UGU Health District of  KwaZulu Natal in  South Africa, a major renewable energy and water initiative was launched after the severe rains and flooding in early 2022.  Emergency international support was garnered to replace the damaged water thanks that the inpatient unit relied on.  The Kath Defilippi Fund was created to fund a major electricity back-up system, conversion to solar power, installation of an on-site borehole, continuation of a water distribution system to impoverished water-insecure households, and supports for vulnerable rural mental health patients and a relocation house
for stable mental health patients returning to their community.  Kath Defilippi was the founder of South Coast Hospice, a prime mover in the Hospice and Palliative Care Association of South Africa, and the first Board Chair of APCA.  As a patient in the inpatient unit she founded, Kath inspired the renewable energy and water project before her death.

Please help us honor Kath, and realise the goals of this project, by considering a personal or organizational gift to the Kath Defilippi Fund.  Donations may be made by visiting the websites of APCA, South Coast Hospice (, or GPIC (Global Partners in Care).  Thank you for any support possible!
Together our patients and families globally can benefit from wise investments, un-disrupted services, and collaborative partnerships that ensure quality of life and reduce suffering.  The worsening impacts of climate change are daunting – let’s do what palliative care does, and use our expertise and teamwork to meet the needs of the most vulnerable!

Phil Di Sorbo, MS, BCPA
Phil is the former Executive Director of Community Hospice and the Foundation for Hospices in Subsaharan Africa (FHSSA). He is a long time hospice and palliative care consultant in the United States and multiple African countries.  He can be reached at:     +518-755-1806

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