Intended for healthcare professionals


To tackle the climate crisis, we need to transform systems according to ancestral original instructions

BMJ 2023; 383 doi: (Published 05 October 2023) Cite this as: BMJ 2023;383:p2202
  1. Rhys Jones, public health physician and associate professor in Māori health
  1. Ngāti Kahungunu iwi (tribe), Waipapa Taumata Rau/University of Auckland, Aotearoa/New Zealand

We must take a proper history in order to tackle the climate crisis, argues Rhys Jones

In Aotearoa (contemporary Māori language name for New Zealand) we’ve tended to view ourselves as relatively protected from the health impacts of the climate crisis, but earlier this year that complacency came face to face with reality. Floods and storms hit Te Ika-a-Māui, the North Island, leading to loss of life and major social, economic, and environmental upheaval. These extreme weather events triggered a public health crisis with serious and profoundly inequitable effects, while also serving as a warning of worse to come.1

Aotearoa’s susceptibility to climate related events is increased by changes in land use and in patterns of development that have occurred since European settlement. Settler colonialism, with its underpinning assumptions of superiority and resulting imposition of social, cultural, political, and economic systems, has transformed environments in ways that exacerbate the impacts of floods and storms.

An example of this can be seen in the intersection of market driven livestock farming and exotic plantation land use with severe weather events on the east coast of Te Ika-a-Māui. Logging native forests, draining wetlands, and clearing land for pastoral agriculture have led to erosion and soil loss, resulting in increased sediment in rivers, lakes, and coastal environments. Woody debris and sedimentation have choked waterways, increasing flood risk and resulting in widespread damage to property, infrastructure, and ecosystems. A recent ministerial inquiry reported that “an environmental disaster is unfolding in plain sight.”2

The fallout from extreme weather events is just one of the ways in which the climate crisis threatens our health and wellbeing. We have seen the dramatic consequences of heatwaves in the northern hemisphere this summer, and a wide range of other health effects will become evident as global heating progresses. Changing infectious disease patterns, water and food insecurity, forced displacement, and conflict will result in far reaching physical and mental health consequences.

It’s no surprise that the climate crisis has been recognised as the greatest threat to global health in the 21st century.3 But the characterisation of the problem, and therefore the proposed solutions (at least in dominant political and social discourse), fail to get to the heart of the matter. The diagnosis and treatment are limited by the frameworks in which we understand and seek answers to the problem.

As health professionals we are taught that the first step in diagnosing and managing medical problems is to take a history. Similarly, in order truly to understand and tackle the health impacts of the climate crisis, we need to take a proper history—one that goes beyond the presenting complaint and seeks to reveal the antecedents or root causes.

If we take a proper history, we can see that the immediate problem of excess greenhouse gas emissions is, at its core, created by the disruption of essential relationships. The predicament we find ourselves in is not some accident of history in which humankind inadvertently chose the wrong energy sources or food production systems. It is a direct result of globally powerful societies abandoning the fundamental principles that had guided and protected humankind since time immemorial.

Those fundamental principles, or original instructions, can be traced back to an understanding of humanity as embedded in and related to the Earth, sky, and everything in between.4 According to Indigenous natural or first law, human development is guided and informed by relational values and mutual responsibilities. Decision making is conducted with a critical awareness of our place in the greater scheme of things and considering the impacts on all our (human and more-than-human) relatives.5

Where those principles and laws have been abandoned, we can observe a pathological process that ultimately leads to ecological crisis. Once the Earth is viewed as a commodity to be exploited for human development, rather than an ancestor to be held in good relation, it becomes possible to extract, consume, and pollute in ways that disrupt natural planetary cycles.

This extractive worldview and way of being in the world is a feature of colonialism. As Davis and Todd note, “the ecocidal logics that now govern our world are not inevitable or ‘human nature,’ but are the result of a series of decisions that have their origins and reverberations in colonisation.”6

A detailed history therefore allows us to identify colonialism as a fundamental driver of the climate crisis (and myriad other ecological crises). Its associated capitalist systems are also responsible for modern health crises, including powerful commercial interests promoting products that are harmful to population health and acting to block or delay critical public health action.7 Colonialism and capitalism can also be seen to drive the unacceptable health inequities between and within countries.

Yet, too often, our proposed climate solutions are also situated in these systems. For example, electrifying the vehicle fleet may reduce greenhouse gas emissions, but it does nothing to solve the many other problems associated with a car dependent transport system, and inexorably leads to a range of other social and ecological harms.8910 The goal should not be a slightly greener version of multinational corporate exploitation, it should be to dismantle exploitative systems and rebuild relationships. That is the only way truly to solve the climate crisis—because it is a crisis of relationality, not of atmospheric chemistry.

What this means is that Indigenous ways of knowing and being must be central to climate responses. Critical actions include re-establishing the authority of Indigenous natural law, recognising the rights of nature, providing for Indigenous self-determination, and honouring Indigenous rights agreements.11

But the climate crisis is not a problem for Indigenous people alone to solve. For non-Indigenous people, it is a call to remember their own ancestral “original instructions” and revitalise their own ancient ways of knowing, being, and relating to Mother Earth and all her inhabitants before patriarchal colonial capitalism took hold.

There is no simple prescription for the deep rooted problem of the climate crisis. The recommended treatment regimen involves deep processes of decolonisation and transforming social, cultural, political, and economic systems according to the original instructions. Only then will we be able to repair the relational breakdown that lies at the heart of the intersecting crises we face.


  • Rhys Jones (Ngāti Kahungunu) is a public health physician and associate professor in Māori Health at Waipapa Taumata Rau/University of Auckland in Aotearoa/New Zealand. He is a passionate advocate for health equity, Indigenous rights, and climate justice. Rhys was the founding co-convenor of OraTaiao: the New Zealand Climate and Health Council, and is co-director of Climate Health Aotearoa, a national climate change and health research network.

  • Competing interests: none declared.