Josh Karliner

Health Care Without Harm USA

Global Green and Healthy Hospitals

Acting Together for Environmental Health

 Ecological Deficits

We Know That the Environment is a Major Social Determinant of Human Health

Environmental Factors = of global burden of disease ---WHO

 ongoing development crisis

2 billion people without access to clean cooking fuels

More than 1.5 billion people without electricity

More than 1 billion have poor access to fresh water

About 800 million people chronically undernourished

2 million children die per year from diarrhea

30,000 deaths each day from preventable diseases

5

Nearly one-tenth of all preventable deaths in 2004 were caused by toxic substances -- WHO

Majority of Cancers in Low and Middle Income Countries

CHINA

Cancer mortality rates have risen 80% over 30 years.

Cancer is now the leading cause of death.

In cities, toxic air; in the countryside, it's the water.

More than 70% of the country's rivers and lakes are polluted.

Almost half may contain water unfit for human contact.

Climate change amplifies existing health risks

Source: Living Water International / Flickr www.water.cc

Heat-related illnesses and death Extreme weather-related injuries and mortality Aggravated chronic illnesses Infectious diseases: vector -, zoonotic-, water- and food- borne diseases

Asthma, respiratory allergies, and chronic respiratory disorders

Malnutrition and child development complications Stress-related and mental health disorders Population displacement and migration Instability and conflict
8
Source: Sabbir, Wikimedia Commons

What is the role and the responsibility of the health sector in addressing the most profound crisis of our time?

The health sector must add its voice loud and clearwe must fight to place health issues at the center of the climate agenda. We have compelling reasons for doing so. Climate change will affect, in profoundly adverse ways, some of the most fundamental determinants of health: food, air, water.
- Dr. Margaret Chan, Director General of the World Health Organization, December 2007

Freedigitalphotos.net, Danilo Rizzuti, Jscreationzs, Carlos Porto

10

Hospitals--- from part of the problem to part of the solution

The Paradox: Hospitals Create Environmental Health Problems

NHS in England, is responsible for 26% of total public sector GHG emissions. Eight percent of US emissions are from healthcare. Ten percent of Brazils energy consumption comes from hospitals. The U.S. healthcare sector is the largest consumer of carcinogenic chemicals. China spends $10 billion a year on health care construction. Half the worlds population is exposed to the negative health impacts of medical waste.

How do we break the vicious circle?

Hospitals Can Lead by Example and Promote Public Health by Reducing their Environmental Footprint

Hospitals Around the World Are Already Going Green

Global Green and Healthy Hospitals Agenda: 10 Goals

Leadership

Chemicals

Waste

Energy

Water

Transportation

Food

Pharmaceuticals

Buildings

Purchasing

Building the Global Green and Healthy Hospitals (GGHH) Network

A worldwide community of hospitals, healthcare systems and organizations dedicated to reducing the ecological footprint of healthcare operations, while promoting environmental and public health in their communities.

GGHH Objectives
1. To serve as a vibrant virtual community for hospitals and health systems seeking to reduce their environmental footprint.

2. To chart progress in achieving measurable outputs, while sharing best practices, finding solutions to common challenges, and raising the bar.
3. To mobilize health care around the world to work together toward and advocate for greater environmental health, locally and globally.

19

Categories of Membership
Hospital Members Health System Members Health, Professional and Academic Organizations Members Membership in GGHH is free of charge.

20

How to Join GGHH

1. Endorse the GGHH Agenda 2. Hospitals and Health Systems commit to work on at least 2 goals. 3. Organizational members commit to promote it to the hospitals and health systems they work with. 4. Report on Progress after one year.

21

GGHH Founding Members

Government agencies, hospital associations, health organizations, systems and individual hospitals representing the interests of more than 4,000 hospitals from every continent. These include 1. National hospital associations in China, Indonesia and Australia; 2. National or municipal health authorities in Argentina, Chile, England, Mexico and Thailand; 3. Hospitals and health systems in Brazil, India, Nepal, Korea, New Zealand, the United States and more;

22

Rolling Launches Around the World

White House Launch Healthier Hospitals Initiative

25

Australia Launch
Australian Hospitals and Healthcare Association

Hospitals act to cut dangerous waste

China Launch Chinese Hospital Association

Brazil Launch
More than 100 Hospitals Join

South Korea Launch

Philippines Launch

Your picture here -

Some Examples from GGHH Members

Englands National Health Service

Footprint: 18 million tons of CO2 per year, 26% of public sector emissions Target Reduction: 10% by 2015 26% by 2020 80% by 2050

Barts Health NHS Trust

GGHH Case Study: Water

Reduced water consumption by more than 30%, saving 100 million liters of water in three years-- equivalent to reducing the shower time of every Londoner by 10%. Annual Savings of $460,000. Donated some savings to water projects in developing countries.
Reduced CO2 emissions across all services including energy, waste, water, travel and procurement Reduced its building energy emissions by 43%.

13 Major U.S. Health Systems, 700 Hospitals

 LED lighting in all new ORs Elimination of vinyl floors and finishes Blue wrap reduction and re-use OR-kit reformulation Single-use device reprocessing

Hospital Fernandez, Argentina

400 bed public hospital in Buenos Aires Mercury-free Substituting dental amalgam in most cases Eliminated various cancercausing chemicals DEHP-PVC, BPA, gluderaldehyde Green cleaning

Rosario Health System-- Argentina

Public health system 5 hospitals, 52 health centers Mercury-free Substituting other hazardous chemicals Waste management

Hospital CLVV San Ramon, Costa Rica

Mercury free

Green purchasing policy

Onsite waste water treatment plant Worm composting for food waste

Butterfly garden for patients and staff

Waste segregation and autoclaving Paper, glass and electronics recycling Energy conservation Green garden management Environmental education for the community.

Hospital Universitario San Vincente de Paul

41

Condisegno with Perkins+Will Rionegro, Colombia 67,100 m2

Taiwan National Cheng Kung University Hospital

GGHH Case Study: Energy
Lighting System Renovation Heat Pump Hot Water System Air Conditioning Renovation Total annual savings: 5259 tons of C02 $625,000

Korea: Severance Hospital

GGHH Case Study: Energy

Expense reduction in 2011: 1,901,686,000 won ($1,730,000)

GHG emission reduction: 5,316 tons of CO2

Philippines: SPC Health Care Ministry

16 Hospital Catholic system Mercury substitution Autoclave waste Vermiculture Food cultivation Trash to works of art

So Much Good Green Hospital Work in Philippines

Share your examples with the global GGHH Community!

Bir Hospital, Nepal before

HCWH collaboration with Health Care Foundation Nepal

Bir Hospital- afterwards

New technologies- biodigestion

Bir Hospital 2011

New technologies- biodigestion

Established for food Designs for large and small facilities Biogas renewable fuel Slurry can go to sewer Testing to come for pathogens, esp TB Negotiating with first maternity hospital Vermiculture worm composting for soft waste

Recycling garden built on top of biodigester at Birthe house in the background is for safe

GGHH TOOLS AND ACTIVITIES

Public events. Case Studies A suite of PR and media tools for members Technical tools (coming soon) *Self- assessment check list *Guidance documents for each goal Worldwide webinars with experts on goal areas (coming soon)

An Awards Program that recognizes world leaders in sustainability in healthcare (coming soon)
52

GGHH Connect.

GGHH CONNECT
A Skoll Foundation supported, Cisco powered internet platform, that combines social networking, content creation, and integrated real-time communications to enable GGHH members around the world to connect, share, and work together to achieve their sustainability goals.

54

GGHH CONNECT
allows members to organize themselves into communities based on goals, language, region, nationality, etc. as well as across these borders.
provide expert support and advice for members provide tools for implementing GGHH goals foster learning, communication, collaboration, synergy and innovation among members.

55

PILOT AND PHASE 2

At the end of May 2013 we launched the pilot of GGHH Connect, our new, innovative social media platform supported by Skoll Foundation and Cisco Systems.
On GGHH Connect members can connect, learn, and collaborate with each other to support and inform their efforts toward improved sustainability and environmental health.

A core group of 40 GGHH members representing 12 countries on 5 continents is participating in the pilot.
The platform will be opened up to the entire GGHH membership over the course of 2014.

PARTICIPATION & LANGUAGES

England

United States
China, Korea, Philippines

Australia, New Zealand Argentina, Brazil, Colombia, Costa Rica, Mexico

Spanish, Protuguese and English. More Languages to come!

GGHH GOALS

COMMUNITY ARCHITECTURE
Goal Communities Role Communities

Regional Community

Membership Support Communities

GGHH CONNECT

GGHH CONNECT - EXAMPLES

1 Question by Expert received 10 comments, replies and image 4 institutions, 2 different languages

GGHH Exchange

GGHH Exchange

The Health Sector Can Help Lead the Way to a Green and Healthy Future