I am a proud Pakistani Hoosier.

My father immigrated from Pakistan in 1992 in search of a better life than what was possible back home. After moving around for work in those early years, my parents settled outside Indianapolis when I was four years old, and Indiana has been home ever since. As I now pursue my medical education, I find myself thinking often about the two places that shaped me and the surprising ways in which their futures are bound together.

Two countries, united by a common malady. In 2022, Pakistan experienced one of the most catastrophic climate disasters of the modern era. Record-high temperatures triggered a heat wave that caused glaciers to melt at unprecedented rates, feeding an unusually intense monsoon season. The resulting floods and landslides displaced more than 33 million people, killed over 1,700, injured nearly 13,000, and submerged nearly one-third of the country, a nation roughly the size of Texas, underwater. Pakistan is home to the largest concentration of glaciers outside the polar ice caps, and as those glaciers retreat, the people who live downstream pay the price of a warming world they did little to create.

While Indiana may not have glaciers spanning tectonic plates, we are poised to contribute more than our fair share to the same warming that drove those floods. Amazon recently announced plans to invest $15 billion in Northern Indiana to build data center campuses. This is an initiative that would dramatically expand our state’s carbon footprint. Data centers demand staggering amounts of electricity, often drawn from fossil fuels, alongside vast quantities of water for evaporative cooling. The result is more air pollution, more strain on local resources, and a real setback for any meaningful movement toward environmental sustainability. To their credit, the residents of Starke County recently banded together and successfully advocated for a 12-month moratorium on data center construction. This is a huge win for Hoosiers across our state, and proof that organized communities can still hold corporations accountable.

But what comes next? As a medical student, I increasingly think about what it means to care for patients in a world reshaped by climate change and pollution. Extreme heat and worsening air quality translate directly into rising rates of heat-related illness, acute kidney injury, cardiovascular events, worsening inflammatory skin disease, asthma exacerbations, and even certain cancers, burdens that fall hardest on low-income communities and people of color. The exam room is where the abstract politics of carbon emissions become a child wheezing through an inhaler, an outdoor worker collapsing from heatstroke, or a farmer presenting with a skin cancer that should have been caught years earlier. My patients in Indiana and my family’s neighbors in Pakistan will not feel these consequences differently because of geography; they will feel them because of choices being made right now.

Pakistan and Indiana sit on opposite sides of the globe, yet when it comes to environmental safety, they are inextricably linked. Both bear the weight of corporate agendas, unchecked greed, and the quiet devastation of local communities. It doesn’t matter where you were born. Everyone who cares about the safety and longevity of Indiana is a Hoosier to me. And so I am calling on Hoosiers around the globe to keep standing strong for your communities, because you are the only ones who will.

Umayr R. Shaikh is a medical student.