New campaigns adviser, Jenn Lawless and I were talking about NZNO’s recent submission on climate change and some of the many ways climate change will affect health in New Zealand/Aotearoa and the world. Jenn then went and wrote this scenario – she calls it a best case scenario; some of us are more hopeful. I hope you’ll love it as much as I do.

You have woken up in the future. The year is 2115, and you are getting ready to go to your nursing job at Auckland Central Island hospital.

5:00am Rise out of your sleeping pod you share with 25 other Critical Core Workers (CCW) so that you can catch the circular ferry as it stops in at the Southern Auckland Islands that used to be known as Mangere before the great Greenland Ice sheet collapse. You’re lucky you’re a CCW so you can stay in on the Southern Auckland Island so close to Central Island; if you were an unskilled worker or climate refugee you’d be stuck on the far Western Islands where there’s no daily ferry if there’s energy shortages.

7:00am Arrive at work and receive your morning food portion. Because of all the salt water getting into the soil and the summer cyclones there is never enough food for everyone. CCW’s get a basic nutrition package as part of their job. A regular part of your day is treating a variety of difficult health problems because of malnutrition, especially in children.

7:15am You are sent down to Refugee Arrivals for your first shift and jump on the medical barge. There isn’t space to dock all of the rickety ships from climate refugees or unload the undocumented families without land-passes or citizenship, so it’s a case of providing emergency relief on the water. Dehydration from months of dangerous travel at sea is the most common problem, but you can’t get onto the refugee ships- despite your full-body suit, the risk of unknown epidemic diseases to an already fragile population is too great.

12:30pm You recycle your haz-suit and get a few minutes of delicious cool in the air-conditioned Central Island staff lounge. At the same time you take your regular scan for skin cancer and cataracts– a real problem now with depleted ozone.

1:pm You get a call for overload help from General Population Medical. Lots of Land-Pass holders there have been waiting all morning and they are angry that refugees are getting any medical treatment at all when there is such a shortage of medicine and basic supplies. Because of the Oceanic Fresh-Water Wars, getting any medicine we can’t produce in New Zealand can take months by boat, to get around the no-sail and heavily pirated areas. You spend the afternoon doing what you can to treat the malaria, dengue fever, heat-stress and other tropical diseases with basic symptom management until the next medical supply ship gets through. Education about mosquito nets and natural repellent is just as important as treatment, but there is not much you can do about the malnutrition transfers from Northland. Expensive treatments like dialysis are out of the question; but patients might be lucky enough to win the 3D printed kidney lottery granted twice a year.

6:pm Passing back through the armed exit to Medical and Nutrition, you feel so lucky to be a CCW, but also sad about what more you could do for your patients if you had the resources that the Global-Pass holders have hoarded. It’s true they seem to keep everything running for the Land-Pass holders like yourself but you’re sure it didn’t used to be this unequal in the past…back in the Democracy. They were so lucky. But nobody saw this coming then. Did they?

The World Health Organisation has described climate change as ‘the greatest threat to human health this century’ and that 250,000 more people will die every year between 2030 and 2050. This imagined future is based on risks outlined in the recent New Zealand Nurses Organisation submission to ‘Setting New Zealand’s post-2020 climate change target’ run by the Ministry for the Environment.