Sidestepping the blame game, a pioneering program is promoting environmental literacy in the health care sector.
By John Elkington
It truly wasn’t my fault. I was enjoying the Skoll World Forum in Oxford and Huffington Post publisher Arianne Huffington had to be interviewed early, so I was asked to come back for filming half an hour later— only to have one of the studio lights explode right by my face as I returned. A thin stream of chemicals and smoke wound up towards the ceiling and the fire alarms sounded right across the ultra-modern Saïd Business School.
Chemical World, Chemical Hazards
No doubt it proved another excellent networking opportunity for the social entrepreneurs, investors and business people forced to stand outside while the fire brigade worked out what had happened. But it reminded me of the ways in which our modern world exposes us to potentially hazardous chemicals, even when we think we are relatively safe, as in hospitals.
Elsewhere in the building, I suspect, all sorts of chemicals were on the point of being discharged to put out the imaginary fire, to protect lives, computers and student records.
Flame-retardants are also now added to a huge range of products used in institutions like hospitals, including TVs, computers, beds, waiting-room chairs and hospital curtains. Unfortunately many of these chemicals slowly leak into the air, dust and water, entering our food and bodies. At least one group of chemicals, brominated flame-retardants (BFRs), are known to cause health problems in children.
The breast milk of American women now contains the highest levels of BFRs in human breast milk found worldwide. Yet whose bottom line accounts for this shadow side of health? All of this had also flashed into my mind the previous day after I had walked into the wrong Forum parallel session.
Health Care Without Harm
I had meant to go to a session on new ways of thinking about how Gross Domestic Product should be calculated in future, but wound up hearing how social innovators are transforming the health economy.
And my mistake proved to be another case of serendipity in action. Chairing the discussion panel was one of my favorite social entrepreneurs, Gary Cohen of Health Care Without Harm. The Skoll Foundation gave him one of its coveted awards in 2010—and his extraordinary life-story illustrates the accidental, serendipitous routes so many social entrepreneurs travel to success.
I asked Gary how he got started on these challenges. The answer:
He began as a travel writer. Then his life turned inside out when he was researching a community guidebook about toxic chemicals. After meeting mothers fighting to protect their families against toxic dumps, he plunged into environmental health. He served as co-director of the US National Toxics Campaign and co-founder of the Military Toxics Project, also helping launch a free clinic to help survivors of the Bhopal disaster in India.
Using Consumer Power to Shift Health Care Toward Healthier Environmental Purchasing
Health Care Without Harm, which he founded in 1996, is now an international coalition of more than 500 organizations in over 50 countries, working to transform health care, exploiting the leverage of combined purchasing and lobbying to drive the process of detoxification — all without sacrificing (indeed often improving) patient safety and care.
When the Huffington Post named Gary as one if its 2011 Game Changers, it explained that:
"Health Care Without Harm strives to create a more sustainable, ecological environment — at lower costs — in hospitals and clinics across the world. The good news is that the health care sector can play a leading role in solving these problems. Due to its massive buying power, and its mission-driven interest in preventing disease, the health care sector can help shift the entire economy toward sustainable, safer products and practices."
‘Market gatekeepers’ like supermarkets increasingly pressure their suppliers to clean up their act. In the U.S., the defense industry also now pressures suppliers on energy efficiency and toxics, with some clearly declared zero footprint targets. And leading sportswear brands are now exploring ways to reach zero discharge of hazardous substances by 2020. So it’s a paradox that the health care industry, with so much of the medical profession committed to “do no harm,” continues to damage human health and the environment on such a scale.
To take just one example of the sector’s toxic footprint, the incineration of medical waste is a key source of dioxin and mercury. The giant and growing scale of the sector means that unhealthy practices — including poor waste management, use of toxic chemicals, unhealthy food choices and reliance on polluting products — have major negative impacts on health and the environment.
Hospitals purchase thousands of different products, requested by dozens of different departments. Often unknowingly, they buy items that are toxic to workers or patients, or that have serious environmental impacts. HCWH helps purchasing people specify cleaner, greener products — safer for medical staff and patients, less toxic and polluting, more energy efficient, involving less packaging and that with a higher recycled content, and fragrance-free.
Creating Environmental Literacy in the Hospital Sector
Reflecting on the implosion of the National Toxics Initiative, Gary had concluded that a less confrontational approach was needed. “I knew it was important to create a situation where everyone could save face, so we could get beyond shame and blame and find ways to succeed,” he said in a recent interview.
“So it was a conscious choice not to blame the health care sector. We said the sector is environmentally illiterate, and if we can make them literate and make them understand the issues, they will change.”
He and his team helped hospitals move away from incineration by demonstrating that autoclaving medical waste — that is, sterilizing it — and then disposing of it in a landfill was safer and cheaper than burning. Then he helped them reduce the amount of plastic waste they discarded by boosting recycling.
After the Forum closed, Gary emailed me a slide showing the number of U.S. hospital waste incinerators falling abruptly from 5,000 in 1994 to 83 by 2006. I am sure there are other pressures at work, but the direction of change seems both clear and hopeful.