In his 20 years as a hospital doctor, Mark de Souza was increasingly seeing victims of a warming climate.
- Staff at an NT hospital are volunteering to green their workplace to make it hospitable in a warming climate
- Thermal imaging in hospital car parks has shown temperatures exceeding 60C in December
- Local Indigenous elders have been consulted on plant species
"The 20-year-old tradesman who's got no family history of this but he's had three kidney stones. This poor man is just daily, chronically dehydrated," he said.
"You see more and more kids who are fainting during their recess breaks.
"You see these new recruits in Defence who are having syncopal [fainting] episodes.
"From my perspective, as a doctor and an NT health worker, [my obligation] is to mitigate the health impacts of climate change and help us adapt to a warming climate so we can have prosperous lives, but not at the sake of our environment."
A planting spree
Royal Darwin Hospital is a 1970s concrete monolith surrounded by acres of bitumen car parks and adjacent buildings.
It's a carbon copy of Canberra Hospital, so not at all designed for the tropical climate.
The grounds are landscaped, but shade is lacking in many places.
Dr de Souza, an emergency specialist, has been involved in NT Health's Sustainable Health Care Committee which, in the past year, has started a planting spree around the hospital.
Committee members are nurses, surgeons, engineers, infection control staff, janitors, pharmacists, and trainees.
"People are starting to hear sprinklers, to smell water on the grass; they are feeling their skin immediately cool and become moist as they walk through a place where there is evapotranspiration," Dr de Souza said.
"They're hearing bird life. They're smelling flowers. They're seeing a wide variety of leaf structures and flowers.
"People are going for a little walk during their breaks to just defrag after a busy shift or after a difficult patient encounter.
"Or they're [members of the public are] dealing with a loved one who's sick on the ward or they've just had bad news or they're uncomfortable or feeling unwell. They want to get outdoors because the natural environment is really restorative for humans.
How to drop the temp by up to 20C
CSIRO thermal imaging from December showed hospital car parks reaching 60 degrees Celsius.
With the CSIRO's Darwin Living Lab, the committee and interested parties recently walked the grounds for an hour and "chalked the campus" to identify hotspots that could be mitigated.
Coordinator Stephen Cook said the aim was to understand the journeys of patients and staff around the campus.
"We have got a good set-up and a really engaged group of people with some great ideas, really highlighting some of the challenges they face moving around the campus and how heat impacts them on a day-to-day basis," he said.
"A cool, well-irrigated area will immediately drop the temperature by up to 20 degrees.
Minor changes make big difference
Some quick projects which the committee has underway include trees planted adjacent to sun-soaked buildings, planter boxes and a fledgling native woodland.
There are plans for native creepers on trellises along shaded walkways, and better bike and pedestrian infrastructure.
"This is a great example of how with some minor adjustments at very cost-effective prices, we could transform the structures into things that are cooling and shading throughout the day," Dr de Souza said.
"We've been working with Larrakia elders to commission them to provide their plants of cultural significance, particularly those plants that are traditionally healing or have bush tucker heritage with them.
"Indigenous people on the whole don't like to be in really air-conditioned environments, and they go outdoors regularly, [where it] … can be difficult to deliver care, especially when they've got a drip in their arm and they need regular observations.
"Some patients are actually leaving the hospital before their treatment is complete. And that can lead to really poor health outcomes and sometimes even death.
A "Smoker's Pavilion" is not a place one might expect health professionals to spend their gardening time, yet the committee believes it's an important part of the precinct and worthy of being surrounded by native trees.
"It's actually one of the loveliest spaces to be during the day," Dr de Souza said.
Future projects include improving the cycle and walking paths around the hospital to discourage car use.