In the 1980s, the American Gary Cohen was living in London, writing guidebooks for a living. He wrote for tourists trying to find the best restaurants, provided tips on getting around and taking public transportation, and gave out many bits of helpful information to make people’s lives a bit easier.
He returned to the United States at around the time the gas leak tragedy in Bhopal, India was hogging headlines all over the world. He was commissioned to produce another guidebook—this time on toxic substances.
His research yielded information so compelling that Cohen then realized he wanted to do more. At that time, he did not know where his strong feelings about the environment would take him, but he was sure he was being led to do something else, something bigger.
Fast forward to 2013, in Quezon City, Philippines: Cohen is talking to some members of the media during the 10th anniversary of Healthcare Without Harm, the organization he co-founded. HCWH is now in 53 countries.
Cohen looks back on the issues that his team initially brought to the world’s attention—mercury, and the treatment of medical waste. Cohen says it was a challenge because people knew nothing about these issues at that time. Many did not know that the widely used mercury had adverse health effects, and that the use of incinerators also had a negative impact on the environment.
There’s been considerable success. Mercury-based thermometers have been banned in many countries. In fact, more than 140 countries just this month signed the Minamata Treaty (named for the mercury contamination tragedy in Minamata, Japan), setting a deadline of 2020 to phase out numerous mercury-based products.
The burning of medical waste has also been discussed more openly even as the challenges of continuing education of hospitals and the availability of alternative technology remain.
Now however, a new environmental issue has emerged—climate change. It becomes more urgent as more and more people experience its effects first hand—extreme weather conditions, more devastating and more frequent typhoons and consistent flooding, as well as governments’ lack of capacity to respond to these effects.
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Nobody in Cohen’s family is a doctor, but one does not need a doctor in the family to know that health care professionals frequently interact with the general public and enjoy high credibility among the people.
They would hence be the best instruments in creating awareness of and popularizing environment and health issues, according to Cohen, who is also an Ashoka Fellow—innovators, social entrepreneurs, “a bunch of people trying to change the world.”
And yet, there is some irony in the industry. Medical professionals swear to “first, do no harm”—but in their exercise of this altruistic profession, hospitals inadvertently still contribute to the environmental crisis the world is facing.
For example, according to HCWH, the National Health Service in England emits 18 million tons of carbon dioxide a year, representing 25 percent of total public sector emissions. The Brazil healthcare sector eats up 10 percent of the country’s energy consumption. The US healthcare sector is the largest consumer of carcinogenic chemicals. And China spends $10 billion a year on health care construction.
As it celebrates its 10th anniversary, HCWH recognizes that hospitals and health systems around the world have been consciously reducing their carbon footprint, contributing to public health and saving money. At the same time, more things need to be done. HCWH reiterates the responsibility of the health care sector in addressing this concern and has offered a ten-point plan.
First, leadership. Prioritize environmental health as a strategic imperative. Second, substitute harmful chemicals with safer alternatives. Third, reduce, treat and safely dispose of healthcare waste. Fourth, implement energy-efficient and clean renewable energy generation. Fifth, reduce hospital water consumption and supply potable water.
Sixth, improve transportation strategies for patients and staff. Seventh, purchase and serve sustainably-grown and healthy food. Eighth, prescribe appropriately, safely manage and dispose of pharmaceuticals. Ninth, support green and healthy hospital design and construction. Finally, buy safer and more sustainable products and materials.
These ten points entail simple action items that can be done every day, in small “doses,” by hospital administrators and health care professionals alike.
HCWH has seen many significant developments in the past ten years. Cohen and the organization he leads look forward to seeing more. All it takes is willingness to listen to the message, adopt a green perspective, and break old habits.
There’s some extra motivation for hospitals as well: Aside from the knowledge that you are helping the environment, “going green is also a lot more inexpensive in the long term,” says Cohen. “It’s good for business.”
Take it from somebody who used to make a living dishing out practical advice.