On 2 July 2026, leaders from over 60 countries joined Teach to Reach 15, the peer learning event convened by The Geneva Learning Foundation, for the launch of the first report to document what health and humanitarian workers are already doing in response to climate crises that harm health. Teach to Reach is where frontline health workers share what they see and do in their own communities, and where that experience is gathered, read back, and treated as evidence. This is the first article in a series of six built from that convening. It sets the frame for everything that follows: what the network on the call already knew, and a plain question about what kind of knowledge that is. The next Teach to Reach, number 16, takes place on 6 August 2026.
On 2 July 2026, leaders from over 60 countries joined Teach to Reach 15 for the launch of the first-ever report documenting what health and humanitarian workers are doing in response to climate crises that harm health. This is the first of a series of articles built from that convening. It reads what the network on the call already knew, and asks a plain question about what that knowledge is.
The floods took the roads first.
In Kolda, in southern Senegal, the tracks that pregnant women used to reach the health centre washed out in the rains, and the appointments stopped happening.
Not slowed.
Stopped.
So Malick Ndome, a project manager there, put phones in the middle.
Midwives gave advice down the line to women in labour they could not yet reach in person, and a clinical relationship survived water that had cut everything else.
Nobody at Teach to Reach 15 spoke about climate change in the future tense.
They spoke the way Ndome did, from inside a problem they were already solving.
Lillian Mutua, who coordinates health promotion for Nairobi City County, described what she saw during the short rains.
More than 100 people lost in the central business district.
Houses along the riverbanks swept away.
Schools flooded.
Pipes carrying clean water broken and mixing with grey water.
Registers and patient cards lost to hard-copy damage.
Kaiser Parvez, at the Ministry of Health in Riyadh, described a 55-degree afternoon and the caseload that came with it: sunstroke, dehydration, hypoglycaemia, construction workers in the emergency room.
Then he said what he did.
He bought trees, and he and his team planted them.
Noelly Zola, a physician in the Gombe health zone in Kinshasa, described a city where the drains that should carry wastewater to the river are clogged with rubbish.
The blockages create larval breeding sites, and the anopheles reach the pregnant women and the children under five.
Even in the dry season, she said, the mosquitoes have not left, and the malaria rate keeps rising.
Muhammad Hashim, from Pakistan, told the room that his village on the bank of the Chenab river was fully damaged, its mud houses, food security, settlement, and animals gone at once.
Emmanuel Bisimwa in Bukavu described dry seasons that stretch until drought forces households to draw water from marigots and the lake, water that is not potable and brings cholera.
Odilon Baruti, a physician in Tanganyika, put it in one sentence: the greatest challenge for us is floods, especially in the villages along the lake.
The same story came from Ghana, Bauchi State, Côte d’Ivoire, and Burkina Faso.
This is not a projection.
This is the intake list.
What kind of knowing is this?
The reader who has never joined a Teach to Reach event has one fair question.
What kind of knowledge is this, and is it worth attending to, or is it just a series of anecdotes?
Learn more: What is the pedagogy of Teach to Reach?
The honest answer starts by conceding the point.
These accounts are self-reported.
They have not been independently verified.
The people who spoke chose to speak, which means they are not a random sample of health workers everywhere.
TGLF’s own reports say so, plainly, in every edition since its first report in 2023.
The interesting question is what happens after that concession.
Mutua’s account of a flooded facility, or Zola’s account of malaria climbing in the dry season, is not a claim about global temperature.
Rigorous climate science has already settled that01822-1).
What these accounts do is record what an old disease is doing in a new pattern, in a specific place, on a specific date, and what a specific health system did next.
They are, in the terms of Reda Sadki’s essay on anecdote or lived experience, an early-warning signal a surveillance dashboard cannot produce on its own, because the dashboard needs years of data before it knows a shift has happened.
The framing that runs through TGLF’s climate work says this cleanly.
Climate change is not producing exotic new diseases.
It is amplifying familiar ones: malaria arriving earlier and lasting longer, cholera after every major storm, malnutrition after the crop cycle breaks, respiratory illness from harmattan dust that reaches further each year.
The people best placed to see the pattern shift are the people already watching those diseases every day.
TGLF’s Charlotte Mbuh first said this in one sentence at COP28 in December 2023.
“Unlike scientists or global agencies, we cannot be dismissed as experts from on-high. What we know, we know because we are here every day. We are part of the community.”
The claim is not that health workers are climate scientists.
It is that their authority comes from being present, and presence is exactly what a report from a research institution in a high-income country cannot substitute for.
The local solutions the room recognised
The report the Foundation launched on 2 July carries 100 detailed accounts of local innovations led by health workers, in response to climate change.
Learn more: New insights report: Health workers are leading community responses to climate change impacts on health
Ten such local responses were read out on the day.
The point was not the ten.
The point was what the room did with them.
- Young men in Cameroon turning a flooded bridge into a rescue service, and others clearing the drains for free.
- A women’s fund in Lomami province of the DRC that paid for pregnant women to reach the maternity ward when the river cut the road.
- A community in the DRC that pooled its money, bought land, and built its own health centre.
- A village that rebuilt its clinic in ten days after a storm destroyed it.
- A whole neighbourhood that dug its own drainage system when the road flooded.
- A public health team in Yopougon, Côte d’Ivoire, that switched dengue and malaria surveillance from weekly to daily when the rains kept coming.
- Village midwives in Burkina Faso trained locally so childbirth would not wait for the rains.
- Fishermen in Taraba State, Nigeria, lending their boats so mobile clinics could reach the villages the water had cut off.
- The midwife in Kolda, Senegal, using a phone as her lifeline to women in labour when the tracks washed away.
What the room said in response, over and over, was… that this is not surprising.
Tina Iroghama Agbonyinma, an SBC facilitator with the polio programme in Nigeria, said it first.
“These are not quite surprising because this is part of our daily work as field workers. We always face the challenges, and local solutions are the first steps that every health worker is supposed to provide to secure the health and well-being of the community.”
That sentence deserves more than a nod.
Twenty of these accounts, or fifty, would still be at risk of reading as vignettes.
What Tina names, when she says this is our daily work, is a pattern the workforce recognises across contexts: the first response to access collapse is always local and improvised, and the formal system depends on it without ever naming it.
Rameaux Nkollo, a community facilitator in Cameroon, gave the pattern its texture.
“Communities knew how to seize the challenge and turn it around. They stopped just shouting at each other and started looking at how to use the means at hand. Once we work inclusively, all together, each with a small idea, we move forward better.”
Joyce Mongeau, a nurse in a Cameroon health centre, said the shortest version.
“Civilians have will.”
Olivier Tshibangu Meji in the DRC named the accountability angle.
“What surprises me is this capacity not to give up, to keep thinking and find some kind of solution even when it looks hard. These young people who volunteered to unblock the drains, what a serious way to take care of their own health and that of others.”
Nathan Binene Kayeye added the finance and mandate observation.
“No funding, no guidance, just an initiative to use local means. There is a will.”
Eric Hafashimana, a nurse in Bujumbura, sharpened it.
“The community looks for solutions without even pleading its needs before the government.”
Brahima Rouamba, a nurse in Ouahigouya, Burkina Faso, put it flatter still.
“Health workers acting without help from the authorities is very common in our health centres.”
Six workers from six countries, in the same hour, describing the same shape.
Why “not surprising” is the strongest kind of finding
The skeptical epidemiologist may want to hear surprise as the signal of new information.
If the room finds nothing surprising, has it learned anything?
Recognition is a stronger claim than surprise.
A finding that everyone in a room of frontline workers recognises has passed a test surprise cannot pass, which is that the pattern holds across contexts the researcher does not control.
Mutua’s Nairobi, Nkollo’s Cameroon, and Rouamba’s Burkina Faso are not comparable in any conventional sense.
The systems differ, the languages differ, the pathogens differ.
That all three name the same shape of response, in the same hour, without prompting, is exactly the evidence TGLF’s listening events are designed to surface.
The recognition also refuses a story the sector often tells itself, that health workers need to be taught about climate change.
On 2 July the sequence went the other way.
Health workers taught the room what climate change looks like in the health facility they run.
The room’s own local action
The read-aloud solutions came from the earlier cohort.
The room on 2 July added to them.
Albert Shongo, who leads a partnership organisation in the DRC, described erosion that almost swallowed his neighbourhood, and young people organising to dig drains, redirect the water, and fight it back.
Dr Luc Kahiwa, in Beni, described the population of the Oninga health area contributing funds themselves and building semi-permanent structures.
Yves Ifefa, at the Kinshasa provincial health division, described a task force led by an army commander to clean the city and reduce mosquito breeding sites.
Euphrasie Kitapindu, in Kingabwa health zone, described communities that now organise their own sanitation work when the Foundation provides the materials.
Alexis Mbumb, in Lubumbashi, wrote about the flood studies he had run, with many malaria and cholera patients on his hands and a need for technical and financial partners.
Ariss Idrssa Issaka, in Niamey, mentioned a five-year study on the effects of climate change on malaria incidence.
Remy Musafiri wrote about a knowledge, attitudes and practices study in Dakar on the environmental sustainability of health care.
These are not passive observations.
These are health workers already running the study, digging the drain, building the wall, planting the tree, and pooling the money.
One tension the room did not resolve
The room also did what a good peer learning event has to do.
It disagreed.
Noelly Zola made a strong claim about how the drains get blocked in the first place.
The community, she said, throws its own waste there, intentionally, harming its own health, and the consequence in her zone is the anopheles that reach pregnant women and children under five.
Amevi Agbomedji, a Togolese trainee based in Cameroon, wrote back.
“Can the population really throw waste intentionally into its own environment to pollute it? There is a need to educate the population, and offering them a way to solve this would also restore their dignity.”
Two voices, both grounded in their own experience, disagreeing on the shape of the community’s agency.
A report cannot resolve this on paper.
Neither can a global framework.
What the peer learning course the Foundation opened at the same event can do is stage the disagreement so that practitioners work out, case by case, what it means to work with a community they can describe both as the source of the problem and as the source of the response.
The costs that no one is counting
One finding the room heard in the second half of the day was the one Tina Iroghama Agbonyinma had already been circling in the chat.
Who pays for all this improvisation?
The record answers plainly enough.
Kaiser Parvez planted trees out of his own pocket.
Luc Kahiwa’s community contributed the funds and built the structures.
Almustapha Mustapha in Katsina State described what he would do with unlimited resources, then, in the same message, described the pieces he is already doing with the resources he has.
Alexis Mbumb wrote out loud that he needs partners for flood studies he is already running.
TGLF’s 2024 essay on the workforce crisis meeting the climate crisis gave this pattern its name.
The dedication of frontline staff is a hidden subsidy to the health system, mostly paid by workers who cannot afford it.
On 2 July, the network confirmed it in a second cohort, in real time, on the same call.
That is the second reason the “not surprising” response matters.
If the finding were a research surprise, the appropriate response would be more research.
Because the finding is a recognition, the response is different.
It is to build the reimbursement line.
It is to name the fisherman in the district plan.
It is to authorise the improvisation before the flood, not to run after it once the crisis has passed.
What a local solution is, on the evidence
A local solution is not what happens when the formal system arrives.
It is what people do while they are waiting for it, or while it is being rebuilt, or in the years when it has not yet come.
The eight findings the report drew from the cohort, and that the 2 July room recognised, all point at some version of that sentence.
Communities are not waiting for external help.
The first responder to access collapse is local.
Community financing is already health financing.
The personal cost is absorbed.
The hazards are integrated.
The point is not that the local solution replaces the formal system.
Nobody in either room made that claim.
The point is Charlotte Mbuh’s from COP28, stated more sharply: the formal system needs the health worker because the health worker is there every day, and better science and better policy will never reach a community that has no trusted local messenger to carry them.
That is what the ten accounts read out on 2 July are, on the evidence.
They are the trusted local messengers, telling the network what the messenger role now looks like when the road floods, when the drain blocks, when the rain does not come, and when it comes too hard.
Malick Ndome, back where this article started, did not wait for the road.
He picked up the phone.
The next article in this series reads the findings and the recommendations, and what the room said back to those.
The moment a health worker hears her own knowledge named
Halfway through the session, Reda Sadki stopped reading findings and asked the room a question he already knew would produce something the slides could not.
What surprised you?
Betty Koech answered like the researcher she is, from the Kenya Medical Research Institute.
“What surprises me is the level of flexibility that exists within the structures, the ability to change very fast and adapt.”
She had come expecting accounts of hardship.
She left having noticed something about capacity.
That small pivot, from cataloguing damage to recognising ability, was the real work of the afternoon, and it happened again and again in different voices.
From “this is just my daily work” to “this is worth funding”
The accounts read aloud were new only in being gathered, named, and handed back.
Tina Iroghama Agbonyinma made the tension explicit.
The ten local solutions did not surprise her, she said, because improvising is what field workers do before anyone else arrives.
She is right, and that is exactly the problem the session was built to solve.
When the thing you do every day has no name, no evidence trail, and no line in a budget, it is invisible to everyone who funds and plans health systems, and it disappears the moment you stop doing it for free.
Naming it is not flattery.
It is the first step in making it real to a system that has been running on it without acknowledgement, which is why the report insists that a worker’s real-time protocol change is evidence the whole system needs, not a private workaround.
You could watch the recognition arrive in real time.
Chigozie Anyasor, a radiographer in Nigeria, listened to the accounts and concluded that “the efforts needed to solve these problems are not far-fetched.”
Louise Kusu, a nurse and midwife in South Africa, said what surprised her was “how creative and resilient communities can be when facing the health impact of climate change, using the resources they already had.”
Neither learned a new fact about climate science.
Both left holding a different estimate of what they and their peers are capable of.
The academic who came for data and left with something else
Catalina Croitoru teaches two university courses on climate change and health in Moldova.
If anyone in the room had a reason to be unmoved by testimony, it was her.
“Scientific papers provide data and statistics,” she said, “but today we heard the human side.”
Later, in a closing comment, she went further, and Charlotte Mbuh flagged it as the note the session should end on: the workers’ accounts were there to confirm what the scientific research already shows.
That is not a soft observation.
It is a claim about evidence.
The people closest to the crisis are producing the same conclusions as the literature, from inside the wards, without the instruments, and often before the studies.
The recurring question in this body of work is why global health reifies “lived experience” while dismissing the “self-reported anecdote” when they are frequently the same thing.
Croitoru, teaching the peer-reviewed version, said the frontline version was what changed how she saw it.
What happens to knowledge once it has a name
Lul Omar Ulusow arrived at the session for the second time and, by her own account, came to listen.
She manages maternal and reproductive health at the regional level in Somalia.
“I take lessons from this and I will apply them in my community,” she said, “because always, always I face a flood.”
She did not describe a new technique she had learned.
She described a shift in what she thought her own situation permitted.
Hearing a peer in the DRC route pregnant women around a flooded river, or a colleague in Senegal keep midwives on the phone, told her that her floods and roadblocks were not the end of the story but the start of one she could act on.
That is the difference between a worker who has knowledge and a worker who knows her knowledge counts.
The first keeps her head down.
The second builds something and tells the next person how.
This is the quiet engine underneath the whole exercise, and it is worth being precise about.
The session did not teach health workers what climate change is.
It changed their relationship to what they already knew, moving them from private coping toward public leadership.
That shift is what TGLF’s new local leadership competency framework is trying to produce, and the session produced it in an afternoon, live, in front of anyone watching.
The trap the good news sets
The danger in a room full of impressive self-reliance is that observers admire it and conclude nothing more is required.
Reda Sadki said as much when he set out the double-edged sword that has run through the recent funding conversations.
Teach to Reach surfaced not dozens but hundreds of local solutions, most of them financed by communities themselves.
What could be more sustainable, he asked, than local actors who are not asking anyone for money.
Then he turned it over.
Self-reliance that no one matches becomes a cost the poorest absorb alone.
Invest in better policy and better science without matching investment in communities, and in five, ten, or fifteen years those communities will reject both.
The session’s audit of out-of-pocket costs, the motorbikes, the four-day journeys, the savings groups, is what that warning looks like from the ground.
The route from a flooded clinic to a funder’s desk has already been built once.
More than 60 percent of the responses to the largest climate and health survey of its kind came through this same network of health workers, and stripping it out would have cut African representation by roughly three quarters.
The knowledge exists.
The people exist.
The connective tissue exists.
The open question, as a new funding call reaches these workers, is whether the money will travel the same road the listening did, or whether it will be designed by people who never heard Lul Omar Ulusow say “always, always I face a flood,” and so will miss the very communities that already know what to do.