
This article was exclusively written for The European Sting by Mr. André Felipe is a Brazilian medical student at the Federal University of Rio Grande do Norte (UFRN). He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.
“People are having heart attacks… because of the heat.”
My grandmother is 80 years old. She has spent her life working the land in Brazil’s semi-arid region – planting, harvesting, raising animals, and depending on rains that have become increasingly unpredictable. She does not speak the language of climate science, yet her perception is unequivocal: since the early 2000s, “the temperature has risen” and today “the heat no longer allows anyone to work all day.”
Her testimony reflects the cruel reality of the Anthropocene, not as an abstract geological category, but as a historical process shaped by unequal power relations. Climate change cannot be understood in isolation from the social and economic structures that have distributed environmental harm unevenly across the globe[1]. In this sense, it is not only global, it is stratified.
In the semi-arid Global South, these transformations are embedded in everyday life. My grandmother describes soils that have become “too dry”, irregular rainfall, and an increase in agricultural pests that now require pesticides once unnecessary. Adaptation, here, is not innovation – it is survival under constraint, carried out with limited institutional support.
Yet, what is most politically revealing is how these environmental shifts translate into health. “People are having heart attacks,” she insists, linking extreme heat to illness in a way that collapses the barrier between environment and body. This perception aligns with evidence showing that rising temperatures are associated with increased cardiovascular mortality. Vulnerability, however, is not evenly distributed: children and the elderly are more susceptible due to limited adaptive capacity; pregnant women face additional physiological strain; outdoor workers are continuously exposed to adverse conditions; and populations in lower-income settings experience greater risk due to both environmental exposure and restricted access to healthcare[2].
In this sense, her experience embodies this convergence. As an elderly rural woman who spent decades working outdoors with minimal access to healthcare infrastructure, she occupies multiple axes of vulnerability simultaneously. What appears as an individual narrative is, in fact, a structural condition.
This is where climate justice becomes unavoidable. My grandmother has contributed virtually nothing to global emissions. Yet, she bears those consequences directly – through her labor, her body, and her community. Such asymmetry is not accidental; it is produced by systems that externalize environmental costs onto those least responsible for them.
For future healthcare professionals, this demands more than awareness, it requires political positioning. Climate change must be recognized as a determinant of health that intersects with gender, age, and territory. Symptoms such as fatigue, dehydration, or cardiovascular events cannot be fully understood without considering the environmental conditions that shape them.
Listening to voices like my grandmother’s is not an act of sentimentality – it is an epistemological shift. It challenges dominant frameworks of knowledge and forces a reconsideration of whose experiences are legitimized in global health discourse. In unequal heat, there is no neutral care.
References
[1] Santos, B. C. S.; Santos Junior, A. P. What Is Heating Up Our Earth? The Heat Between the Anthropocene and Colonization. Mediações. DOI: 10.5433/2176-6665.2022v27n1e44980
[2] Singh, N. et al. Heat and Cardiovascular Mortality: An Epidemiological Perspective. Circulation Research. DOI: 10.1161/CIRCRESAHA.123.323615
About the author
André Felipe is a Brazilian medical student at the Federal University of Rio Grande do Norte (UFRN) and Local Coordinator of the International Federation of Medical Students’ Associations (IFMSA) at UFRN. His academic trajectory is marked by interdisciplinary interests, ranging from socio-environmental health and climate change in the Anthropocene to infectious diseases and laboratory research. He has experience in scientific research through the Socio-Environmental Analysis Center at IFRN and currently works with One Health approaches, investigating zoonotic diseases. His work is driven by a broader interest in global health, health inequalities, and the relationship between environmental change and human health.
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