Introduction

Dr. Avriel Diaz 0:03

Welcome to Expanding Health. I'm Dr. Avriel Diaz, a planetary health scientist, bringing you conversations with leading experts to explore how our changing world is shaping your health. We've gotten incredibly good at measuring health through numbers, infections, mortality, blood pressure, risk. But our health is also shaped by things that are much harder to measure. The environment around us, the stability of our communities, the relationships we have, whether we feel connected and supported, and maybe even whether we experience joy, purpose, kindness, and love. My guest today is someone incredibly special to me. Dr. Anna Stewart Ibarra began as a mentor, became a close friend, and is one of the people who most shaped the scientist I am today. And the path that brought me to this work. She has spent her career exploring health from many of those different angles. Dr. Anna Stewart is a climate and health expert. She spent more than 15 years working across Latin America and the Caribbean at the intersection of climate, infectious disease, public health, and community resilience. Her career has taken her from research and academia to leading international science and building partnerships among communities, governments, and researchers. And more recently, her journey has brought her into work centered explicitly around three ideas we don't often discuss in science and health: humility, kindness, and love. So today we're going to talk about climate and health, why everything around us matters to our well-being, what communities can teach us, and things that health data may never fully capture. And whether understanding health also requires us to talk about joy, meaning, connection, and even spirituality. Anna, welcome to Expanding Health. Thank you, Avriel. It's such a joy to be here with you. Anna, we've worked together for almost 10, no, 10 years now. And we met in Ecuador in a little coastal city, four hours north of Guayaquil. And that was such a tremendous experience for me. And it really shaped where I am today. And you've spent so much of your career uh on climate and health and thinking about all of these different interconnected pieces that sometimes we forget about. I'd love to know from you, was there a moment that you realized that climate change wasn't just an environmental issue, but a deeply human health story?

Climate affects everything around us.

Dr. Anna Stewart Ibarra 2:36

Well, climate, I mean, affects everything around us, the air that we breathe, the food that we eat, the water that we drink. Whether or not we realize it, we are at every second of our life affected by our climate and the world that we that we live in today. We have this false idea that somehow we are separate or that humans can create a built environment with climate controlled and we can engineer our way into the perfect conditions. But at the end of the day, we are completely dependent on what Mother Earth provides us with. And so this is something that's been a part of my being, I think, since I was a child. You know, I grew up in upstate New York with parents who were environmental biologists and scientists. We spent a lot of our summers out with, you know, in the field, in the adirondacts, in the mountains, spending time outdoors as a kid just playing outside. And so I think in my being, again, since I was a child, I was always very deeply connected to the earth and to what we call the environment or our mother earth. And you know, climate is just one piece of that. Climate is one aspect, one way that we can see how the earth reacts and how the earth interacts with us and shapes our lives. So I think it's again always been a part of our being. Um, but I want to zoom into that story that you began with, Avriel, talking about in 2016, 10 years ago when we met. And that's such a great example of when this hit home for me, also. Because at the time um I was living and working in southern coastal Ecuador, we had a research program that had begun a number of years ago, and we were doing studies at the time on mosquito-borne diseases and diseases, a brand new disease that was very scary for most people called Zika. You remember all 10 almost 10 years ago now, the Zika spread around the world. It was what we call a pandemic because it affected so many countries around the world. And Zika was a mosquito, uh trans a disease transmitted by mosquitoes. So you get it by the bite of a mosquito, but what was especially scary about Zika at the time, first it was unknown, so we didn't know what was happening, and it was causing congenital effects, so problems with babies and pregnant moms. So again, this is why Zika got so much international attention. And we were beginning, we were doing studies with the Ministry of Health and local communities. And Zika is a perfect example of a disease that is affected directly by our local climate and local weather. So moms, babies, families were incredibly concerned about the health and well-being. And this was, you know, directly linked to the rain, how much it rained around us, the temperatures, um, because those affect mosquitoes and how the mosquitoes can uh lay their eggs and grow and develop and transmit these diseases. But what and you know, this was all very, I would say, it touched me, you know, in my heart, but also, you know, as a scientist, I was thinking about all these questions and ideas and how we could come up with solutions. But when this really, I think, hit home and became a human issue, as you're talking about Avriel, at a deeper level, is at that moment in 2016 when we were in Ecuador and we experienced a 7.6 magnitude earthquake in the northern part on the northern central coast of Ecuador. And that earthquake completely changed my life. We immediately stopped everything we were doing. We got in a truck in the middle of the night and joined a convoy of trucks from the municipal government, the local government, they were heading northward, carrying supplies, water, blankets, food for people who had been devastated. And we just showed up with no agenda other than say, you know, we work in public health. How can we help? We're here. Our hands, our hearts, our minds are here to serve. How can we help? What can we learn? And we began to work with the local communities that had been affected by the earthquake. And again, that's where we saw how climate was affecting, you know, climate, environment, earthquakes, all of these things had come together and were directly impacting people's day-to-day lives, the amount of stress that they were under, their feelings of survival, their feelings of fear, but also the new friendships. Like there's also the joy. There's always in any chaos, any crisis, things, you know, unravel and break down. And then you see the rebirth that happens. And so we witnessed that. And we were part of this whole process with you, Avrielle, as we, you know, joined with local the local communities, the ministries of health and NGOs that were there to serve these communities. And again, we were experiencing this in the middle of the Zika pandemic. And so Zika was sweeping through these communities that had just been hit by an earthquake. Their homes had been devastated. They were directly exposed to the elements. And so you it was undeniable that we could see the linkages between climate, you know, weather, our local weather, and everyone's day-to-day livelihoods. And that may be an extreme case. But if we look around us, you know, many people in the US are quite concerned about heat these days, looking at weather, you know, heat in the summertime. We're almost at the end of summer now, but every time there's a heat alert, you know, this is becoming, I think, part of our consciousness. Like everyone's more aware that the weather and heat or extreme storms affect our health and our well-being. And so we can't uh we can't escape the fact that our lives are completely dependent, also in good ways, in wonderful ways. You know, again, our food, our water, our air, everything depends on the weather and the climate around us, along with the harmful outcomes that can happen when we have extreme cases of heat waves or or hurricanes. And these extreme events are unfortunately becoming more frequent due to changes in our global climate. And so uh this awareness, I think, is growing. Uh and nobody, uh nobody can escape the uh the effects of climate and health. And on the other side, we all benefit from the client effects of climate and health. It's just a part of being alive on this planet.

Super El Niño: how different parts of our environment are connected to health.

Dr. Avriel Diaz 8:31

That balance is so important, right? And I think we've had a lot of conversations about the interconnectedness of it all. And both you and I um were trained as systems ecologists, so thinking about how different parts of the system are interacting. And so I think it's it when you're trained in that, you you see all of those connections so so vividly. You mentioned the earthquake, you mentioned the climate. Um, you know, one of those things that we were also dealing with in 2016 was a str uh a strong El Nino event. And this year we're entering a super El Nino. I'd love if you could talk to me a little bit about how that has shaped, you know, your thought process in maybe preparation. I know in the past you've done a lot of work into doing trainings and capacity building also for many um public health agencies around the world. But can you talk to me a little bit about what we might expect from a super El Niño or why this matters to people in different parts of the world?

Dr. Anna Stewart Ibarra 9:35

Yeah, great question. So just taking a step back, maybe a lot of us have heard the words El Niño or La Niña. Uh, but what let's think about what this really is. We have these events, these periods called El Niños or La Niñas, when you have parts of the ocean in the Pacific Ocean that are becoming warmer than average, like warmer than what we had in the past, or cooler. When we have a warming period, we have an El Niño, when the ocean gets warmer, when certain parts of the ocean, and when it gets cooler than average, cooler than what we're used to, then we have La Niña events. And this is important because this cooling and warming, you know, the ocean is this huge mass of water. And so it holds heat and affects weather and climate conditions, weather conditions, local weather conditions around the world. So when you have this warming of the ocean, like during an El Niño event, for example, in Ecuador, where we were living at the time, it causes heavy rainfall, even very could be very devastating heavy rainfall and flooding. It can cause also an increase just in the average daytime temperature. This combination of uh changing temperature and rainfall can lead to mosquito-borne disease outbreaks if you're creating just the right conditions for more mosquitoes to reproduce and to to spread these um diseases that cause illness. In other places, though, you might have uh drought. So the effects of El Nino on local weather vary depending where you are in Central America, which has uh serious concerns about food, food production, and food security and agriculture. They tend to see drought conditions during an El Nino. And so there are major concerns about um hunger during El Nino events in Central America. So every place around the world, you have different effects of El Nino events, but what happens is that you have something that's different than what we're used to expecting. So maybe you know what we're used to in a normal year. And again, this can affect people's food, access to food, water, um, disease, or even things like heat stroke if it's exceptionally hot. So El Niño and La Niña events tend to cycle in, let's say, maybe three to five years, or in that period of time, it's not a set schedule, but every few years we'll see these major events that happen, Riva El Nino and La Niña events. And as you said, we're going into an El Nino event. And what's what's interesting to note is that the climate scientists understand this very well, that you can begin to measure the changes in the ocean temperature. Uh, and then months later, we see the changes in the climate conditions. And so this gives you a window of time in which you can begin to prepare. So you already know this is coming. You know that there will likely be an increase in rainfall or warmer temperatures, for example. And with the public health uh professionals that we work with, you could begin to say, okay, knowing that we're likely going into an El Nino event, let's begin to prepare for mosquito-borne disease epidemics. Let's make sure that we buy the right supplies, that we get the medications or the diagnostic supplies that we need in the laboratories to be able to test for these viruses. Let's make sure our nurses and doctors and community health workers are trained and they're ready, they're familiar with the symptoms. Um, so uh that we do major public awareness campaigns with community members so that they don't have water, standing water in containers around the home that increase the likelihood of mosquitoes reproducing there. All these sorts of things you can begin to do when you have several months to prepare. And so this is one of the reasons why climate science and people who study El Niño and La Niña are also very important because they can give us this what we call a lead time or you know, sort of a predictive time. You get several months where you can prepare and begin to put in place measures to then save lives. So if we had done nothing and we were just hit with the epidemic, you know, this many more people would be have fallen ill or have been hospitalized or may have died. But if we're able to prepare, then we hope to have fewer cases of illness, you know, healthier people, healthier communities.

Who counts as an expert?

Speaker 13:35

Thanks for explaining that. I think a lot of times we hear these words and people don't really understand or may not have heard what it can do in different areas of the world. You know, you've worked with so many people around the world, um, from ministries of health to international organizations like the World Health Organization. I'd love to hear also who you think counts as an expert when you're trying to solve the health problems that we face, especially when it comes to implementing some of these solutions.

Speaker 1 14:14

So this is a good question, you know. Uh and the answer is everyone who is affected by the issue at hand. Um, when we do research and science that has a direct application, in this case, for example, we're trying to understand maybe how an Al Ningua uh event affects disease outbreaks because we want to then uh support creating, you know, programs, local communities to prevent and improve local health. You need to include everybody in that spectrum in the process. So be it from the climate scientists to the local public health leaders to the community members who would be receiving and responding to the information and who may who will know more about what's happening in their local community. So the term expert becomes anyone who has knowledge and who is a part of the process and who will contribute to the solution. And this is uh fairly revolutionary because it says what you know and what you say matters, and we want to listen to you. And the role of the scientist then becomes the role to listen, at least some of us, not every, you know, there should be some scientists on the team whose job is just to listen deeply and to create spaces where people can come together, can work together collaboratively, can truly hear each other, and you try your best to reduce any barriers to communication, which could be things like hierarchies, like, oh, I know more, I'm the expert because I have such and such authority in such and such position. And so you have to have people who are very skilled facilitators who can hold this space, who can bring people together, and again can create spaces so that all of this really important knowledge and perspective can come to shape the best possible outcome for the communities. And this requires a tremendous amount of humility because it means that everybody has to be willing to uh step outside of our own egos and say, Oh, I have something to learn from you. I have something to learn from everyone here, and together we'll get to the best possible solution.

Dr. Avriel Diaz 16:17

Have you seen a solution change because the people who are experiencing it or the problem was actually involved or had the power to design it? Can you think of maybe a story to share?

How can climate data help public health?

Dr. Anna Stewart Ibarra 16:29

Yeah, so I think there are so going to the area that I've worked in for a number of years and worked with you, Avriel, thinking about how we can use climate and climate information to better shape local public health uh solutions. We've seen many, many, many, countless, thousands of examples in scientific uh and scientific literature and the studies that are published where there is very little to no engagement or participation of people who are outside of your very narrow specialization. So maybe it's just the scientists or the data experts, you know, speaking amongst each other, sort of at the very academic level. Um and and there is a role for that because they're generating knowledge. But what we see is that when it stops there, that that knowledge rarely gets taken to produce solutions at the local level. And actually, of the thousands of studies that we've seen, we did an analysis of this a few years ago, most of the studies, most of the science stops there. So you it's actually a huge loss. It's a huge um, it's a huge loss, like the opportunity. Like there is all this knowledge that's being produced that could have a positive impact to help people's local livelihoods and well-being and health, and it's not. And on the flip side, when we've worked together, you know, from the beginning of the project with the public health leaders, with the local people in the governments who are going to be uh actually implementing the programs and developing different climate and health programs for local communities, the outcome is completely different. But the process is also different. You know, it means that we sit down from the beginning, we talk to each other, we develop those relationships and trust, we take the time to get to know each other, and we ask the people who are in the communities, you know, what they need. Again, it's a very it requires again humility and listening. What do you actually need? And then how can we work with the scientists and the technical experts to produce what you need? How can we, and it changes how we do the science, but it means that the science that's produced has much more of a direct impact on the local communities. And this is something that I think we've seen quite successfully through our collaborations, working in the Caribbean region, in Barbados and other countries, through relationships, again, that have been developed over almost a decade now, having this ongoing dialogue, listening, and uh, you know, having the scientists sitting at the table with the people from the communities and the ministries who will be implementing the projects. This is not that common, although we're starting to see more of it, more examples, because people are, I think, beginning to realize that we need to change how we work if we want to have uh an impact in the local level. But I think still still not enough. There's still a lot of work to be done. So we can we can all learn about how how we can change how science is produced, how knowledge and information is produced so that we can better serve each other, better serve the communities that we live in.

Dr. Avriel Diaz 19:28

So I just got back from Barbados last night, and um we were having so many of these same and similar conversations about how the word, we we say the word co-production a lot in the sciences, which is just how are we collaboratively working on building out solutions, right? And so many of these topics came up time and time again. I I want to zoom out a bit here though, because I think a lot of times when we are talking about science and health, there's a lot of things that we're not measuring in terms of health impacts, right? And so I'm interested to know what you think after years of studying disease risk and resilience. What have you learned about what people need, not just to survive, but to thrive? And how can science play a part in that?

Dr. Anna Stewart Ibarra 20:20

So I think what we need to thrive, certainly you ask a hundred people and they might give you a hundred different answers. And yet we need human, we need connection, we need time, we need time, we need to take time in our day to slow down, to go within and to connect with ourselves so that we can develop a much more loving and peaceful relationship with ourselves, because only if we do that will we be able to better relate with everyone around us. And this is so fundamental that this is to me now in my life, you know, you could call it meditation, you could call it just you know, contemplation, you could call it just coming in and connecting with yourself, taking that pause. But to me, it's as important as eating, sleeping, drinking. This is like to be a person in the world, to be able to live from my authentic self and do my work in the world, whatever work it is. Like we need to be able to you know come into a deeper place of being and beingness. And this is something that is not going to be understood through analysis and research in the mind. This is something that is experienced. This is something that we feel when we sit and watch a sunset, or that we sit when we put our feet in the ground and walk to the park, or you know, these moments of of feeling alive and connected. The the you know, we we could have the the best possible, you know, I'm thinking like on paper, the best. Possible diet, the best possible, you know, outcomes of your blood test, and everything could look good in terms of your health, but many people still feel empty inside and anxious and depressed and uneasy. And so, what health is that? What, you know, is that really the way to live? Is that well-being? And yet, most of the world pushes us to just focus on those external attributes, those external measures of health and well-being. Because those other attributes that we're talking about, you know, feeling that peace and connection within, you can't sell someone that there's no way to market it. And so we don't focus on it. And yet at the end of the day, that's truly what will make someone, will make any all of us, you know, live happier and more fulfilled lives. And it's accessible to anybody anywhere at no cost. That's the magic.

The importance of humility, kindness, and love in health.

Dr. Avriel Diaz 22:53

I love that. You know, your path has taken you uh from climate science and mosquito-borne diseases and global health work to work that is centered specifically on humility, kindness, and love. And I'd like to know what experiences along your journey made those ideas feel essential to you.

Dr. Anna Stewart Ibarra 23:17

So I think looking back like as a scientist over the last 10 years, I think that in the end, towards towards the end of the time that I was really active as a scientist, I became completely focused and fascinated by partnerships, which means how we work together, how we treat each other, and how sometimes how the dysfunction happens also, right? Like where is it working well and where is it not working well? And at the heart of that is truly kindness, love, humility. It's how we treat each other. And what I saw was that, you know, the science, the rel the projects that we did that had the greatest impact had this human quality at the heart of it, you know, and it was often implicit. It wasn't explicit. It was just kind of bringing the right people together who shared the right values, who treated each other, you know, again with humility and kindness. But there was such a, it was um, it felt so different to be in those projects and those spaces. And those were the projects that you wanted to do. Those were the projects that ultimately were more successful in the long term. Those were the projects that that brought joy and that you know people were so committed to. And so these are things that go far beyond typical outcomes of science, like, you know, how many publications, how many papers did we generate, or you know, how many new grants, or you know, how many specific, let's say, technological innovations were we able to patent. It was this like the joy of the human relationship and how we worked together that was the true motor to carry out these long-term scientific collaborations. Even when the going got rough, right? You know, we went through pandemics, we went through different um political or economic shocks, and yet the teams that were grounded in humility, kindness, and love could weather these difficult moments and could see the big picture and stayed committed to really serving the communities that they felt so deeply committed to serve. And so this brought me to this understanding that it's not it's not what we're doing, it's how we're doing it. You know, it's it's how we do what we do, anything that we do. And I realized this afterwards looking back, I'm like, oh, that was about how we become humble, kind, and loving, and how we share that with others and how we treat each other, you know, how how we act at every moment. It has a huge, it's like it feels different. There's a different feeling when you're in a space of people who are aligned with the right values. Um and I think now I understand that to be true of every aspect of life, be it in your family, your community, your workplace, your neighbors. Uh so I think it's a profoundly um transformational like lens of seeing the world and helps me and helps others to like bring our best selves to whatever we're doing at all times.

Dr. Avriel Diaz 26:14

What would it look like to incorporate kindness, design it into our health systems?

The power of kindness and compassion in health systems.

Dr. Anna Stewart Ibarra 26:21

So, first, the people who are leading the health systems and the people so at all different levels, we need to have them experience kindness. You know, you can't do kindness outside unless you deeply feel and experience kindness within you, and even you know, within and with yourself and and with you know your family and your like it has to start within, has to start very local, because otherwise we're just pretending, we're just acting. You know, and actually a lot of times people talk about acts of kindness. And at the heart, if it's just an act of kindness, then that's fake. It's not profoundly kind because it means, oh, I'm gonna do an act of kindness over here, and then I'll go on with my life and do unkind over things over here. No, like what is that? That's not what we're talking about. We're talking about having a mind where your thoughts are kind, your words are kind, and your actions are kind at all times. And so this is a practice, like this is something that requires work. Again, we through the Humility, Kindness, and Love Foundation, where I'm now focusing my efforts, we share very simple reflection and meditative exercises so that every day people can stop, pause, reflect, and come within to cultivate these virtues, we say, virtues that are within all of us. It's already within everybody. It's just reconnecting because we've become so distracted and so lost in the hustle bustle of the world and the responsibilities and our stress and our anxieties that we've forgotten that we have kindness within us. It's there. It's it's not something that you have to take from outside or that someone has to teach you. No, it's there. But we need to take those little moments and we have to prioritize, like, oh, this is important. I do want to take the time to cultivate this. The same way I would go and take the time to go to the gym and you know, take care of my physical body. I need to take care of my spiritual and emotional body. And it won't just happen by itself. You know, you have to make it a priority in your life. And so in the health systems, we would, I would think about designing programs to work with healthcare professionals at all different levels so that during the workplace, we could have people experience simple meditative practices, have them then, you know, think about over time. It's not something that happens in one day. You have to kind of walk with people over a few weeks or a few months to see how this is changing, how they feel inside their, you know, are we kind to ourselves? No. Most of us are, you know, very harsh, very critical, very judgmental. So how could we possibly be genuinely kind to someone else if we can't even be kind with the person who's closest to us, ourselves? You know, do we begin our morning and our day speaking sweetly, lovingly, and kindly to ourselves? Or do we begin with, you know, this whole barrage of ideas about what I did or didn't do or what I should like this just goes on and on. And this is not, this is all of us, right? This is this is not just one person. We all have these challenges. And certainly the healthcare professionals, it's such a beautiful place to focus on because healthcare professionals work with patients, work with communities, you know, are directly in the field of service to serve is a part of being humble, kind, and loving. We are serving, you know, from an utter place of humility, kindness, and love. It's such a beautiful way to serve. So, how would our whole health system change if we had people who were serving from a place of humility, kindness, and love? I think it would revolutionize our health systems. And this is something we're beginning to do through the HKL Global Movement is to develop training programs for small businesses through corporations to bring humility, kindness, and love into the workplace.

Dr. Avriel Diaz 29:53

That is something we need more and more of, right? I want to talk about the word love. And I had the privilege of getting to meditate with you and your community and and friends when I was visiting you in Panama. And something that struck me was this feeling of love in the circle that we were there. And I think it's a word that we hear even less in science and climate and health and policy, right? And one of our good friends, Dr. Valerie Lucetis, she has an organization called Heart Forward Science. And so I'm thinking about what does love have to do with health?

Love has to do with everything.

Dr. Anna Stewart Ibarra 30:33

Love has to do with everything. I would say at a I'll I'll come at it from a the spiritual side, say love is in all life. Love is like the life force that runs through all of us, through all living beings and the whole universe. And certainly we all have our own experiences of love and of pain. Um in the the context of heart-centered science, I think, and Valerie could speak for herself, but what I'm understanding is that it's about connecting with the heart. So again, coming within and connecting with um not just the mind which is chattering away. So not just the mind, which is again often running us through the past or the future, our anxieties, our doubts, but as we connect with the heart, then we can be in the present and we can be much more focused. Imagine this conversation, you know, that I see you, Avriel, I feel connected with you with my heart. How different is this conversation if I was just thinking from my mind and just analyzing and trying to jump to my next answer? You know, this is a very different way of relating and being and treating each other. So this it's just about being fully present, right? And as you're fully present, quality and the depth of what emerges and the creativity. So now here coming to the science, the ideas and the creativity that emerge, be it by yourself, your journaling and your writing, or be it when you're sitting around with other people, it's like another level, right? Because you're able to tap into a much deeper connection, which is not just everything. Um it's not just this discourses running through the mind. So we can kind of settle and connect from here and talk and still analyze and talk about whatever the issue is at hand. They're very serious issues that we need to deal with from a public health perspective. Um, but the whole conversation changes if we're doing it where we're centered at our heart instead of just here. Um and to when we think about love, I'll go back, I'll take a step back. I think of love again, it's not an act. Love doesn't mean I love this person and not that person. Love is just a way of being, like your essence, your whole being, your whole consciousness becomes filled, and you are a loving being. So that everyone who is in contact with you at all times, they just feel good in your presence. They don't even know why. They feel uplifted, like they just feel your love radiating out. You don't even have to say a whole lot. And so it's about connecting with that, again, which is already within all of us. This is not something that we have to invent or you know, go to a certain, you know, ashram in a certain part of the world to learn. No, like it's already within all of us, and it's deeply within all the nature around us. Look at any tree, any bird, any stream rushing by. You can see and feel love. And yet it has been um covered with so many layers of confusion and distraction in the world that we live in today. And so as we move into being love, we are a being and consciousness of love. Then again, everything we see and do is love. And one of my teachers said, love is it can be like a river that comes down, a flood. It touches everything and everyone, you know. When you are a being of love, it's not like you only love this rock that's in the river and not this other. No, you are flood and you touch everything and everyone. So every child you see, you see it as it is your child, you know, it it is, and you love them the same. Again, how would that completely revolutionize health? Well, we would truly care about every person's health and well-being. You know, we would have a much deeper, profound concern for the health and well-being of every person on this planet, every being. We would not sleep at night knowing that our brothers and sisters and our children around the world were suffering.

Dr. Avriel Diaz 34:24

I want to dive in more to this science and spirituality conversation. You know, your science has been grounded in evidence and data, and I'm wondering how that may have also shaped your own spiritual journey or your understanding of something larger than ourselves.

Science and spirituality are not separate.

Dr. Anna Stewart Ibarra 34:44

So science and spirituality are not separate. Science is just one way of knowing the world, and it's a beautiful and important way, and will continue to be that. But I think what I began to understand is that if you think about there are you know infinite ways of knowing and understanding the world, science is one slice of that, and it gives us important insights, but it is not the only way of knowing and understanding the world. And just because science has not yet discovered, I put that in big quotes, science has not figured out how to explain certain phenomena also doesn't mean that they're not there or they're not real, right? So this is where, again, many spiritual experiences come in. You can say, I have lived these things that I could not explain, or that modern science is maybe just beginning to catch up and explain now. For example, you know, native uh peoples have spoken for millennia about how the work that we do through any kind of personal healing will affect our generations, you know, seven generations back, seven generations forward. Epigenetics is saying that same thing. We carry our intergenerational memories in us that we can activate and heal and transform. Okay, so science is catching up with things that many spiritual traditions have known for a long time. And that's true in many different aspects. If you look at, you know, around physics and and other fields of study that are beginning to understand how we have sort of vibrational fields of consciousness and universal fields of consciousness. These are things that as a scientist, I became very humble to know that science is great, but it is limited, and that's okay. Like science and the data will tell you this, and that can be helpful in a certain moment. But just because science, there is also it's important to know when, uh, what is the use for science, and not to exclude every other way of knowing and being as also valid and important and legitimate. Uh, so there's a tendency in science to be overly arrogant and to say, oh, this is what the science said, and this is what science knows, and therefore what you say and know is wrong, or I am an expert and you're not an expert. And this is then a big error of science, um, which could lead to the downfall of modern science, unless modern science can, as I say, wake up and realize and embrace, as scientists like Valerie is doing, you know, that there are other ways of knowing and being. And so we can, rather than saying, I'm the only one with the expert in the knowledge and none of you know that, say, let's come to the table together. I see that. That is, there's a shift. There is at least part within a part of science and scientists who are making that shift. As again, we talked about earlier in the conversation, just recognizing that different ways of knowing and perspectives are valuable, listening to others, that science and knowledge is not limited to the ivory tower and to academia, you know, that we need to bring all of these other ways. And so this is, I think, an important place where science and spirituality intersect as well and complement each other. You know, many uh people who I work with now also, I'm thinking of people who are working with indigenous peoples and communities, uh, scientists, profoundly respected experts of their own right, they would open a meeting with their colleagues with a prayer, with some sort of invocation, with some sort of connection to recognize that what they are doing is for a higher purpose, that what they're doing is to serve all of their people. They may ask for guidance and say, please let the work that we are doing here serve humanity. Please guide us. And then they go about their scientific work and their collaboration. Great. Like these things don't have to be separate. It's not for, I'm not saying it's for everyone and certainly um, you know, disciplinary, very focused. Scientists will continue to do their thing and that's okay. But we don't have to have this war of science versus spirituality. Rather, I think some people are beginning to find ways that they can come together, coexist, and truly um come to a greater and a better solution, you know, come up with solutions that are more meaningful and have a better impact and may resonate also with the people who you're serving.

Dr. Avriel Diaz 38:52

And after working across science and government and this deeply human work now, focused on how we're going to bring in humility, kindness, and love, what do you think we're still doing wrong right now with health that we could improve on? How can we actually design the system to begin to think more and more about connecting these, right? Bringing in our heart, bringing in our expertise and this battle, like you're saying. How are we going to break this down and actually change how society is thinking about health systems and improving these health outcomes?

Its all about the people in the system.

Dr. Anna Stewart Ibarra 39:30

I I think any system is really about the people in the system. So even any system is only as good as the people in the system. So we can talk about systems and policies, but in the end, it's about the people who are there. And so working with people and oftentimes the younger generation, and it's not exclusionary, but oftentimes I've found people in the younger generation tend to be a bit more open and receptive to thinking about things differently than others who have been in the system for a long time say, well, this is just how it is, and I'm going to keep doing how it is. So finding people who are open and receptive to learning and to considering different ways of doing and being. And I would say thinking about how you could bring in uh values directly into health systems in a way that's more explicit. So, you know, humility is one of the virtues that is, I think, most under misunderstood, undervalued. You and the world we live in today, um, the ego is what is promoted. And even as a scientist, I was taught to inflate my ego. I was trained that if I did not have, um if I did not see myself as an expertise, expert, as the expert, if I did not promote myself as an expert, be it to my colleagues, like in public or in conferences or on social media, that then my career would fail. So I was explicitly trained to focus on truly like an ego-focused approach. This is part of the culture of a lot of science, and probably in health systems as well, in terms of when you get to higher levels of medical specialists, I would say, especially. So even bringing into medical schools and public health training, you know, what is humility? What does that even look like? How do we role model that? What does it mean? Again, I think there's a lot of confusion that humility is not about being stepped on or being abused. Humility is about, you know, again, bowing your head and saying, I have something to learn from you. Like I it's about coming to another person from a place of openness. And only when you come from that place of openness can can we begin to again be genuinely kind and loving as well. So I would imagine that we need to work within the within the systems that exist. You could have trainings, you could have, you know, workplace development, you could also go to the medical schools, public health professional schools. As you talk about climate and health, can you explicitly bring in trainings and discussions and examples about now what are the virtues or the values that we want to uplift and how do we role model those? And interestingly, in I think in my work as a scientist, this became a lot of the focus sort of in the last few years when I was working more with young science policy leaders across all of the Americas. We had a fellowship program at our organization to train people who were scientists who wanted to now serve outside of academia in the public sector. And a lot of what we did, again, it was often, it was often implicit, but it was a lot about values. It was about how do we come together? How do we work in teams? How do we listen to each other? How do we work across cultures and languages and disciplinary differences to come to serve the greater good? And it was incredibly profound. And the people who went through these training programs felt so moved and passionate and connected and wanted to keep doing this work because there was this focus on the quality, like the human quality. The human aspect was put at the center and not as something peripheral. It wasn't like, oh, we need to focus on the technical aspects of writing a policy brief or developing a program. No, it said, okay, let's do that and bring your humanness and everything that that involves to the center of the program. And that humanness or the heart is what has been taken out of most training programs and most workplaces, honestly. And so there are people though who want this change. You see it. There's a shift and there's a hunger. I think people see and there's a need for this. Um, even again, the small businesses we are talking to, they said we want our employees, you know, to be happier, healthier, less stressful people. So this is not uh for for pardon the phrase, this is not rocket science. This is not that that complicated. Like we know that people are beginning to wake up and say we need to change something in the systems that we're in. We can't keep going. And if we're able to be better, you know, within ourselves and if we can treat our colleagues better. And certainly the work that we do in the world is better, be it tackling the climate and health crisis, working with our patients as nurses, like how we would be able to, you know, be so much more peaceful and kind with our patients if we're not dealing with conflicts and fighting between, you know, my my coworkers in the background, or we're not feeling that we're in this toxic work environment that's just squeezing me because there's a value on ego and greed rather than on truly serving humanity.

The role of motherhood in health, science, and the environment.

Dr. Avriel Diaz 44:29

When you started talking about humanness and heart and bringing this into changing workplaces, it made me think of your relationship with your son. And I'm interested to know how motherhood has played a role in how you now think about health and science and climate and the environment. Um, you know, your son was here visiting uh in New York City just uh a couple days ago, and he was with my husband, and his joy, you know, just oh what I heard, I was not there, but it lit up the room. And so I'm wondering, has that shaped your image or how you think society should be thinking about health?

Dr. Anna Stewart Ibarra 45:14

Well, I think, and probably most parents can attest to this that having a child, it is transforms you, it changes you. And I will say, from my experience, is one of the best ways to hammer your ego. Because, you know, to just the children are there and and you are there to serve, you know, from the most loving, kind place. I'm there serving my child, serving this little being who has come into my life at all times. And so becoming um much more focused on what it feels like and what it looks like to serve and to serve from a place of deep love, another person certainly has changed me and also made me so much more aware of um this is a bit of a sidetrack, but the importance of children and everything we do. I think that wasn't sort of front and center when I was thinking about my climate and health work before, but thinking about mothers and children as like one of the most important entry points to think about any climate and health issue, because a mother, a pregnant woman, is carrying the whole future of humanity inside of her, right? And every single person is born of a mother. And so what that mother experiences, what that woman experiences before, during, and after pregnancy, those first fews of life will affect the trajectory of, let's say, all of humanity, the next generation. And women and small children are just so often left out of these conversations about climate and health. So that more from sort of the science and public health side totally shifted my perspective on just the importance and also how how women and children are often again excluded and not talked about, or it's very like superficial and how profound that is, because it it changes everything. And being a mother can be either the most beautiful and empowering experience, or it can be very traumatic and stressful, and and many women struggle tremendously because uh of the world that we live in, which does not value and uphold and and cherish mothering as an important as important for humanity. And I think more generally, you think about being a mother and and a child, and it also connected me much more deeply with with my own family, with my own mother, but also with you know, this feeling of being a mother to all, being able to love all, you know, to care for all life, to care for all beings, as your sons and daughters, as I mentioned before, and the connection with Mother Earth, with with our mother, this being the earth that we stand on. Every day we stand on the earth, and whether or not we recognize or not the earth we're standing on, they are there providing for us, not asking for anything in return, you know, giving day and night, giving us air, water, food, soils. And so this profound feeling of being a mother, how we can I can now experience that, like, and have such deep gratitude and love for everything that I receive now from Mother Earth has also been a huge, a huge change in me. And I think again, being a mother in my experience just helped to open my heart to connect with the heart.

What is one thing you wish more people understood about what shapes our health?

Dr. Avriel Diaz 48:30

I love that. I really love that. Anna, I want to thank you for such a beautiful conversation. I I really I always love getting to sit down and talk with you. So this was very special to me. Before we close, I ask all of my guests the same questions. And it's what is one thing you wish more people understood about what shapes our health?

Dr. Anna Stewart Ibarra 48:56

Our relationship with ourselves. Again, how we treat ourselves, how we talk to ourselves. Do we treat ourselves again with kindness and love? I think that's probably one of the most important things that affects our health because that will if we treat ourselves in kindness and love, then we would make good decisions about our bodies. You know, I couldn't possibly put something toxic or bad in my body if I truly love and care for my body. You know, I I prioritize, I I see how much I love myself, and so I make good decisions. And I that includes, you know, what I watch, what I hear, the people I surround myself by, everything that I ingest because I love and I know that my body is so important and I'm so grateful to this body that I have been given to walk in in this in this life. Thank you. Thank you for that. I think I'm trying to think, like one thing I can add is that I think scientists, like young people who are coming up as scientists in their training. I talk to a lot of people who pretty quickly start to feel that something is off, you know, that they don't feel comfortable in the scientific academic environment. And I see this is where your heart, your heart sensors coming in and saying, uh, something's not quite right. Why? Like, and this is important to listen to. And in this case, usually those students, those young leaders, and the future of all science often will leave science, leave academia, or just uh like shut it down, you know, ignore that voice, sort of compartmentalize and take that piece and that side out. You know, it's like, oh, that doesn't belong in academia. That's that's not valid. And I think that is what has to change and is changing in certain pockets, but has to rapidly revolutionize so that young people who want can want to and can bring their whole selves to what they do, they feel safe, they feel empowered, and they feel that this is a place where I can be myself. So the whole model of science, modern science, is still quite antiquated. Again, there are always people in pockets where this is changing more rapidly. Um, but we are losing people who are going into the scientific field. Like I think fewer and fewer people are looking to become and be scientists. Maybe part of that is because it doesn't feel like the way the model is currently set up resonates with the younger generations that are coming through. But if we can think about also changing within science, within the system, you know, again, putting values, putting people's, putting people within back into science and saying, you know, how you're thinking, how you're doing, your own ideas and creativity are important. This is often just completely shut out in science. That's been my experience, again, with few exceptions. What would happen if all, you know, young scientists were able to have training as part of their orientation, not just on lab safety, but on how to be humble, kind, and loving, you know, in their day-to-day lives, in their lab teams, in the collaborations, in the work they do in the world. This sort of foundational training and exposure also to role models, to ways of being is sorely lacking in science. A lot of us will put this in the bucket now of what we call transdisciplinary science or co-production. There's sort of different fields of science that are looking at this. But I think it could be much more broadly brought in to say, you know, we need to think about different ways of doing science so that we can have the best possible outcome. Because at the end, most young people I see who go into science go because of the love, the curiosity, but also because they deeply want to serve and they want to bring their skills and ability to make the world a better place. And yet often by the time they get to the end of the PhD, that last piece has just been pushed out and it said, how many more publications can we get out the door so that you can advance in your career? And then many people say, Well, this isn't for me. So again, thinking about how we can change the experience in an authentic way, not just uh, you know, not fake, right? Either people will, it'll feel if it's if it's fake, it will feel fake. Like it has to be genuine, like more profound trans transformation within the scientific and academia. Then the people who come out and who are trained and who later train and mentor the next generations can um can do it differently. There's a lot of work to be done there.

The attack on science.

Dr. Avriel Diaz 53:23

How would you balance that with the attack on science right now?

Dr. Anna Stewart Ibarra 53:26

I would say science isn't being attacked everywhere in the world. Like take a step back. Maybe things look bleak in the US, but the rest of the world is not necessarily attacking science. So find global partnerships, find global partners, like global collaborations, like look beyond just what's happening in the US. Because otherwise, if we're focused just on the US, it's very easy to go into this narrative. The science, you know, is spiraling downward. And well, there is truth to that within the US setting. There are, um, you look at colleagues, for example, in Brazil who faced tremendous attacks on science and they went through it and they persevered, and then the government swung this way and that way. And so what's happening in the US in some ways happens in other countries too. Obviously, maybe not at the same scale as what we're experiencing now. Um, but there's a lot we can learn about perseverance, reaching out, you know, actually forging by now necessity partnerships with colleagues around the world, different universities and countries, so that we can have a more global view instead of just looking at what's happening in the US, because that global view is what will help to be to bring resilience so that the science, the collaborations, and the work continue for decades to come. I love that. Thank you. And be hopeful. Stay hopeful, read less news, watch less lotion social media, and just stay hopeful and spend more time with people other people who are uplifting and hopeful. And that's it. You just keep doing the good work. I could not agree more. We have more than enough work to do in this lifetime, so we do. Don't get bogged down by the media, which will always want us to feel that things are worse than they actually are, which is why we need this podcast.

Dr. Avriel Diaz 55:14

I have a couple of hot take questions for you now. So the first question I have is can healthcare make us healthy if our environment is making us sick?

Dr. Anna Stewart Ibarra 55:27

No. You want me to expand on that? Yeah, expand on it all. No, I mean, if if you live in an environment that is poisoning you, and the environment includes, again, what we eat, what we drink, what we see, what we hear, and the people around us, if that is poisoning us, then going to a doctor's appointment or having the best possible public health system cannot undo the damage that we are surrounded by. And so our own environment is what's most important at the end of the day. Yeah.

Dr. Avriel Diaz 55:59

And I know we went over this question a little bit more in depth, but uh what's one way you would design the health system to incorporate kindness?

Dr. Anna Stewart Ibarra 56:11

I would begin by working with the frontline people who are working with patients, thinking of nurses, community health workers, doctors, so that they can have the experience of um what true deep kindness feels like, and that they can cultivate that within, share that with their colleagues in the workplace, and then share that with the patients and the community members they interact with every day. And you could do that through um simple meditation exercises that anyone can do.

Dr. Avriel Diaz 56:40

Can you be healthy without feeling connected, supported, and loved?

Dr. Anna Stewart Ibarra 56:45

I don't think so. But we as humans we need to first feel connected with ourselves and connected with um connection doesn't just mean connected with another being. For me, connection feel means connected with my higher purpose, connected with uh, you know, the divine within. And when I feel connected with myself and with this divine, with my spirituality, I connect more deeply with my family members, community members, and workplace. But if I am not connected within, I can't connect with anybody else, and I can't be happy because I there's this emptiness inside.

Dr. Avriel Diaz 57:21

Have we medicalized problems that are actually environmental or social?

Medical industry and profit.

Dr. Anna Stewart Ibarra 57:27

I think the medical industry will look for ways to make money. That's generally their profit, that's their focus. And so things that don't cost any money, like going and sitting in a park or again, sharing a simple meditation exercise that's free and available to all is not going to be promoted and yet could help you to lower your blood pressure, um, could, you know, prevent different chronic diseases, could increase, you know, your your overall well-being, which would reduce the stress and anxiety, so you don't need to take medications. So definitely I think that the medical industry focuses on what we can sell to you to solve these short-term fixes without getting at the root root causes of health and wellness or or disease.

Dr. Avriel Diaz 58:13

Most people hear El Nino and think weather issues, not hospitals. What's one very real everyday health consequence of El Nino that you wish every family understood?

Dr. Anna Stewart Ibarra 58:26

So El Nino affects different communities differently depending on where you are in the world. But uh if you're sitting in uh the coastal Ecuador or Peru, it means that you'll have heavy flooding and warm temperatures leading to mosquito-borne disease outbreaks. If you're a family in Central America, you may face issues with food and access to food because there are drought conditions. So depending on where you are, El Nino will affect people's day-to-day lives. So you should definitely check, you know, your local weather news authorities and see how what and what to expect with El Nino in the coming months.

Dr. Avriel Diaz 59:04

We're having serious issues in the United States with people trusting in science. How do we change that? Loaded question.

Dr. Anna Stewart Ibarra 59:17

I think there are different sides to that. One, science, scientists can build trust by working with community members and working outside of academia and you know, building those trusting relationships. But on the other side, and probably more troublesome, is that we are being fed massive amounts of misinformation. Um, these campaigns that are essentially brainwashing people. So, unless you can unplug from social media or you know, really filter the information you're getting, then it's going to be difficult to push back on this wave. Um, I personally left all social media over a year ago because of because I didn't find it brought any true value into my life. Uh, and this is even when I was leading a major international organization that I felt that the negative content was more than the positive. Scientists are just people. We're all people. So if scientists can also get out in their communities, you know, be active and be a part of making their communities bigger, stronger, more beautiful places, then that is the best way to build trust at the local level. We just know that we're all just people at the end.

Dr. Avriel Diaz 1:00:29

And does science ignore what it can't easily measure?

Dr. Anna Stewart Ibarra 1:00:34

Science has a tendency to claim exclusive ownership of knowledge and expertise and to say that everything else that cannot be defined, explained, or measured doesn't exist and is not valuable and doesn't count. That is a big problem because there are so many ways of knowing and being around the world that fall outside of traditional bounds of Western science in particular, then science is putting itself into this hole, right, of like becoming more isolated or separate from the rest of many people around the world. One of the other issues also is that in most sort of Western science, they say anything that's not published or done in English doesn't exist. You know, this is a pretty big issue. Certainly the Chinese are showing us that a lot of science is being produced in Chinese and other languages. But if you just look at that assumption, you know, people have been producing knowledge in all languages around the world since the beginning of time. Whether or not you want to put it in the box of modern science or some other box, it's kind of irrelevant. But what does matter is that we can recognize the value of many different ways of knowing and being and producing knowledge. Thank you.

Recap.

Dr. Avriel Diaz 1:01:50

So, some of the themes that we cover today, we took a deep dive into how climate change is shaping our health and how our health is connected to so many things that we usually don't think about. We talked about community, who holds expertise, knowledge, and areas of health that sometimes we fail to measure, like hope, joy, love. And we dove into conversations about what some consider controversial topics, but we've heard here today they shouldn't be controversial topics, science and spirituality. We also talked about how sometimes in our environment we can focus more on the medical industry or not so much of these interconnected woven ideas. And so I just want to take a moment to thank you so much for being on our show. Thank you, Gabrielle, and thanks to everybody who's listening. Such a joy to be with you. If you enjoyed this conversation, subscribe, leave us a comment, and share it with someone you think would enjoy it too. It will really help us to grow, expanding help.