Interview with Filip Maric

Filip Maric, physiotherapist and associate professor at the Arctic University in Norway, is the founder of the Environmental Physiotherapy Association. His interest is focused on exploring the more fundamental question of the relationship between physiotherapy, health and care, and the environment.

Filip Maric, UiT The Arctic University of Norway. Photo: Heike Jane Zimmermann.

Tell us briefly who you are and describe your role and history in the work on sustainable development within healthcare?

Originally, I trained and worked as a physiotherapist in Germany, with a fairly common focus on musculoskeletal and sports rehabilitation, whilst also harbouring a deep interest in philosophy and other such fields not commonly associated with my profession. During my PhD studies in New Zealand, I had an opportunity to bring these diverging interests together and explore the ethics of physiotherapy, and maybe healthcare more broadly speaking. This is where I was also struck by the apparent lack of ‘environmental concern’ in our conceptions of professional (healthcare) ethics, a kind of lack of concern or even responsibility for anything beyond the individual human in front of us during any given moment.

The lack of environment in the ethics of physiotherapy eventually made me really interested in exploring the more fundamental question of the relationship between physiotherapy, health and care, and the environment. It was on the ground of this question that I founded the Environmental Physiotherapy Association in August 2019 in collaboration with my dear friend and colleague Prof David Nicholls from New Zealand, to gather a group of people that might be equally interested in exploring the relationship between physiotherapy, health and care, and the environment.

I am grateful that I can now say that my work is nearly exclusively focused on the exploration of this relationship via environmental physiotherapy, planetary health, and similar developments. This is both in my role as the founder and chair of the EPA and in my role as Associate Professor in the Bachelor program in physiotherapy at UiT The Arctic University of Norway in Tromsø.

When I started all this work, I was feeling really discouraged by the minimal impact of my personal actions, when put in relation to the magnitude of the challenges we are facing. For this reason, it was a kind of relief when I realized that there might be an opportunity to get my entire profession involved in contributing to the health of people and planet alike. So, in addition to some fairly specific personal interests, a great deal of my work is still aimed at helping my colleagues around the world see the immense variety of possibilities for health and care that open up when we make our fundamental relationship to the environment a critical centrepiece of our thinking and doing.

"I am also glad to say that we have come an incredibly long way during a rather short amount of time, and this is largely a result of the indomitable passion and drive that everybody is bringing to this field."

Sustainability and environmental responsibility have entered the mainstream discourse of physiotherapy, the third-largest healthcare profession in the world, and is rapidly on the way of becoming a mainstay in physiotherapy education, research, and practice. And this comes with increasing and inspiring collaborations across all disciplines and sectors, always highlighting the incredible potential that is liberated when we work together. We are going in a good direction but, of course, more remains to be done and we always need more minds and hands on deck.

What would be the most important message to our staff at NVS about planetary health and sustainable healthcare?

Building on my own story and experience, a point that strikes me as particularly valuable is to remember that there is no need to get overwhelmed by the challenges we are facing, the magnitude of the tasks ahead, or even the currently exponential growth of sustainable healthcare, planetary health, and the likes, that can leave us wondering just where to start. And the two key reasons why there is no need to get overwhelmed is, firstly, because there are so many others working on the same issues that we are never actually alone in this and, secondly, because there are so many different starting points that it doesn’t matter where you start, just so long as you make a start somewhere (and with someone) and regardless of how humble those beginnings might be.

"The more you do, the more you will connect, the more you will naturally do, and so on. This is how we are finding ourselves in this huge global movement for transformation now."

What advice would you like to give to our staff at NVS who want to start contributing to changing education and research based on sustainable development?

My advice follows on what I have described in my previous answer: don’t be overwhelmed, just connect with a few people, and start somewhere. A lot will be done if you do that.

One additional point that I would emphasise is the importance of staying humble, and this is very much something I try to remind myself of all the time. I think this is important in way that is quite fundamentally related to the social and environmental challenges we are facing. Specifically, I would argue that a lot of our social and environmental challenges are fundamentally caused by human actions (not denying that these are predominantly very specific human actions) and, often, a kind of hasty and incessant doing. Always doing something, doing things quickly, and doing more and more and more. To me, this history also tells us that we need to learn to tread more lightly on this world, to be humbler and gentler in our interactions with it.

"Human exceptionalism, the view that we are better than others, has falsely led us to exert unspeakable injustice over other people and species and so we are in dire need of stepping away from this underlying attitude and all that comes with it, hopefully moving to a place of gentler and more expansive solidarity and mutual support."

It's very difficult, and seems almost contrary in today’s climate of urgency, but I’m inclined to think that whatever we do to advance the health of people and planet, we we’d also be well-advised to do it calmly and humbly.

Are there any important partners (for example outside academia) for us who work at a medical university that can give us important input in our work with sustainable development in education and research?

I think that one of the wonderful things that we can recognize as we engage in this work is that everyone can be an important partner and give us important input, and I mean this in a very expansive sense.

If we understand that health, environment, and society are inseparably related to each other, then, in academia, the most obvious step is to connect across those disciplines that have historically focussed on one or the other of these domains.

But, of course, and as you already allude to in your question, it is also critical that we connect with people outside academia. To be honest, though, I don’t think this is to be done in the standard way in which this is usually talked about, in the sense of concepts like inclusion, participation, and the likes. Rather, I think, we need to break down the simplistic distinction between the university and the public in a much more fundamental way. I think there is a lot to be explored here but I think this might lead to much more complex and interconnected understandings of the university and society, and much more diverse and colourful ways of working together.

"Finally, we also need to acknowledge that other-than-human forms of existence are equally important partners in our work for the health of people and planet, and this needs to fundamentally inform and transform our ways of health-related research, education, and practice."

I think that this point might be particularly challenging for the medical and healthcare sciences and professions due to our grounding in the natural sciences and all the legacy that comes with this. And so for this reason I also think that we will not be able to develop planetary health, sustainable healthcare, and the likes in a good way, unless we also connect with our colleagues in disciplines like philosophy, the humanities, and maybe particularly environmental humanities as of late, and unless we connect with people in more traditional and indigenous communities that have a strong and long-lasting history of living more in-tune with other-than-human forms of existence.

If an employee wants to know more about your work on sustainable development and healthcare - where can they turn? (e.g. a website, organization or specific publication)

I’m very happy for people to contact me via email or social media anytime and I always try my best to reply as quickly as I possibly can. Of course, a big chunk of the work that me and my colleagues around the world do can be accessed through Environmental Physiotherapy Association. There, you will find hundreds of blogposts on different topics, inspiration for planetary health/care education, a mushrooming variety of publications in several different languages, and a lot more as we continue to grow the field.

Selection of recent publications

Physiotherapy and ecosystem services: improving the health of our patients, the population, and the environment.
Stanhope J, Maric F, Rothmore P, Weinstein P
Physiother Theory Pract 2023 Feb;39(2):227-240

Ecological Bodies and Relational Anatomies: Toward a Transversal Foundation for Planetary Health Education
Richter R, Meric F,
Challenges, 13(2), 39

Healthpunk Vol 2: Healthcare + Fiction + You
Maric F, Nikolaisen L.J, Ntinga N.M, & Webb J. (Eds.)
Open Fysio

South African Healthcare Professionals' Knowledge, Attitudes, and Practices Regarding Environmental Sustainability in Healthcare: A Mixed-Methods Study.
Lister HE, Mostert K, Botha T, van der Linde S, van Wyk E, Rocher SA, Laing R, Wu L, Müller S, des Tombe A, Kganyago T, Zwane N, Mphogo B, Maric F
Int J Environ Res Public Health 2022 Aug;19(16):

Text: Emma Swärdh, May 2023.