Healthcare without harm

In early November, the entire body of world leaders, think tanks, civil society members, NGOs, academics and researchers arrived in the idyllic imperial city of Marrakech for a climate change conference.

It was in this historical setting that they pledged their commitment to save the planet from the ravages of climate change for the generations to come. This world forum is dedicated, more so now than ever, to mitigate and adapt to climate change. As a public health professional, my primary interest is to know the outcome of such meetings, since health and security are at the core of these debates.

Even if we do a cost-benefit analysis of the mitigation and adaptation measures to be taken by both developing and the developed countries, no one can put a cost on human life. The risk and cost equation has now been determined, and clearer than ever. In the words of Dr Margaret Chan, the director general of the World Health Organization, “Global agreement on climate change is a global agreement on health”.

In the aftermath of the conference, it is imperative to reiterate that we have done enough research to conclude that climate change has detrimental effects on human health. It is now time to work forward and formulate strategies to adapt to these changes and, at the same time, try to mitigate them. One theme which kept resonating throughout the conference was the reduction of the carbon footprint of the healthcare industry.

We are living in an era where public health and the environment are emerging threats. The crosscurrents of disease and ecological deterioration are increasingly damaging the very fabric of our society. Climate change, unsustainable resource use, air and water pollution are all magnifying threats to the existence of humans on this planet.

Paradoxically, the health sector itself is contributing towards these very environmental health problems even though it is attempting to address their impact. Through the resources it consumes, the waste it generates, the technologies it employs and the buildings it constructs, the health sector is inadvertently contributing to climate change and environmental pollution. It is the primary goal of the health sector to prevent and cure diseases. However, the delivery of health services, especially at hospitals, contributes to the problem. Hospitals generate significant environmental health impacts, both upstream and downstream from service delivery.

The health sector in the industrialised world as well as a number of developing countries consume significant amounts of energy. As the health sector expands in many developing countries, its energy consumption grows as well. Standard operating procedures for most large hospitals require significant energy use for heating water, temperature and humidity controls for indoor air, lighting, ventilation and numerous clinical processes with associated significant financial costs and greenhouse gas emissions.

This can be tackled by using alternative forms of clean and renewable energy, such as solar and wind and biofuels that do not undermine local food production or community land tenure. These energy options are viable in both environmental and economic terms, especially when the financing mechanisms are structured to support this shift. Given its formidable energy demands, the health sector’s investment can play an important role in shifting the economies of scale and making alternative energy more economically viable for everyone. For regions that have no access to electricity, alternative energy sources can fuel primary healthcare facilities in remote areas. In energy-poor settings, the advent of low-energy and no-energy medical devices can be harnessed with the use of renewable energy sources to improve access to basic health services. Alternative sources of energy also give health facilities an advantage in terms of disaster preparedness, since they are less vulnerable to disruption than traditional fossil fuel systems.

There is a need to systematically measure and benchmark the health sector’s energy consumption and GHG emissions around the world. Greater efficiency and a smooth transition to using clean, renewable energy sources can significantly reduce greenhouse gas emissions while protecting public health.

There is no global standard that defines what a green and healthy hospital is. Such hospitals promote public health by reducing its environmental impact and eliminating its contribution to the burden of disease.

Hospitals can leverage their economic positions and moral standing in the community to help achieve the Sustainable Development Goals (SDGs) related to health and foster a green economy.

Email: mmujt001@fiu.edu