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Climate change is the biggest challenge for human health in our time, yet this is a topic rarely discussed in the field of surgery, anesthesiology or obstetrics. Currently, approximately five billion people across the globe do not have access to safe and timely surgical and perioperative care.  As a result of climate change, the quantity and severity of conditions that require surgical, obstetric, and anesthesia (SOA) care will increase substantially, exacerbating existing access issues.  However, SOA care is also resource-intensive and contributes significantly to the greenhouse-gas emissions that drive climate change.  In other words, the carbon footprint associated with the delivery of surgical care potentially harms the very patients we seek to help. 


The time is now for the SOA community to support the development of global surgery and anesthesia infrastructure that is both environmentally sustainable and adapted to the future challenges of climate change.  The Climate in Obstetrics, Anesthesia and Surgery Team (COAST) is a research collaboration between the Program in Global Surgery and Social Change at Harvard Medical School and the Center for Surgery and Public Health at Brigham and Women’s Hospital.  We focus on developing research and policy recommendations to support environmentally sustainable and climate-ready surgical care delivery across the globe. 

The organization consists of 2 pillars: research and education/advocacy


Are you interested in getting involved?

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Tropical Leaves



  • To assess the impacts of climate change on surgical disease and surgical care delivery

  • To analyze strategies to deliver surgical care sustainably

  • Emphasize a global perspective in assessing the relationship between climate change and obstetric, anesthesia and surgical care


  • To host webinars through CSPH and PGSSC on climate and surgery

  • To interface with medical students, preparing the health workforce for climate and surgery/anesthesia, and integrating climate-specific competencies in surgical and anesthesiology curricula

  • To address the financial benefits of being conscientious of sustainability

Peer Reviewed:
  1. Climate change: challenges and opportunities to scale up surgical, obstetric, and anaesthesia care globally. Roa L, Velin L, Tudravu J, McClain CD, Bernstein A, Meara JG. Lancet Planetary Health, 2020.
  2. Empowering Surgeons, Anesthesiologists, and Obstetricians to Incorporate Environmental Sustainability in the Operating Room. Yates EF, Bowder A, Roa L, Velin L, Goodman A, Nguyen L, McClain CD, Meara JG, Cooper Z. Annals of Surgery, 2021.
  3. Principles of environmentally-sustainable anaesthesia: a global consensus statement from the World Federation of Societies of Anesthesiologists.  White SM, Shelton CL, Gelb AW, Lawson C, McGain F, Muret J, Sherman JD, representing the WFSA Working Group on Environmental Sustainability in Anaesthesia.  Anaesthesia, 2021. 
  4. Building sustainable and resilient surgical systems: A narrative review of opportunities to integrate climate change into national surgical planning in the Western Pacific region. Qin RX, Velin L, Yates EF, Omrani OE, McLeod E, Tudravu J, Samad L, Woodward A, McClain CD. The Lancet Regional Health - Western Pacific, 2022
  5. The Connection between Climate Change, Surgical Care and Neglected Tropical Diseases. Shirley H, Grifferty G, Yates EF, Raykar N, Wamai R, McClain, C.D. Annals of Global Health 2022.
  1. Global Surgery: A Forgotten Piece of the Health Puzzle. Shirley H. Public Health United, December 2019. 
  2. The intersection of climate change and surgery. Asfaw S, Dilger A, Tummala N, Yates EF. ACS Bulletin, Sept 2021.  3. 
  3. Lessons from Covid-19: Why adaptation is necessary for surgical climate readiness. Yates EF, Nguyen LL.  ACS Bulletin, Sept 2021.
  4. In health sector, surgery is major contributor to climate change. 
  5. Läkare måste kräva en ambitiös klimatpolitik. Velin L.
  6. Luftföroreningar är vår tids rökning. Velin L.
  7. Climate Change and Global Surgery: Competition or Synergy? Hey MT, Shoyombo I, Yates EF, Anderson GA. 
  8. From Scalpels to Security. Forbes C, Naus A, McLeod E, McClain CD.
Webinars and Talks:
  1. G4 Alliance 10th annual Meeting of the Permanent Council presents “Surgical, Obstetric, Trauma and Anesthesia Car for All”.  We moderated and were panelists for “Climate Change and SOTA Care”.  Yates EF, Qin R, Hey M, and McClain CD.  November 5, 2021
  1. Global Scalpels: Lotta Velin & Lina Roa.  Feb 5, 2021.
  2. Climate Change and Patient Outcomes: How can we make an impact? Yates EF, Nguyen LL. World Extreme Medicine Podcast, Sept 2021.
  3. Empowering Surgeons, Anesthesiologists, and Obstetricians to Incorporate Environmental Sustainability in the Operating Room. Behind The Knife (BTK) Podcast, Jan 2022. 
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