Kathy Gerwig and Verónica Odriozola
Credit: Marianela Jarroud/IPS
Hospitals Working to Reduce Their Ecological Footprint
Marianela Jarroud interviews KATHY GERWIG and VERÓNICA ODRIOZOLA of Health Care Without Harm
In the United States, hospitals are the third
largest user of energy in the commercial buildings
SANTIAGO, Aug 13 (Tierramérica).- Medical care is associated with images of
cleanliness and good health. Today’s hospitals,
however, are major sources of pollution and
consume large amounts of valuable resources, like
Often this pollution leads to illnesses which must
be treated by the same hospitals that contributed
to causing them, the co-director of Health Care
Without Harm in the United States, Kathy Gerwig,
The problem is that "environmental health is
usually not taught in medical schools," added
Gerwig, vice president of workplace safety and
environmental stewardship officer for Kaiser
Permanente, one of the United States’ leading non-
profit health care providers.
But hospitals are beginning to address the issue
of their ecological footprint.
Health Care Without Harm has attracted more than
3,500 institutions throughout the world to the
Global Green and Healthy Hospitals Network. In
Chile, network members include the hospitals in
Illapel, Salamanca and Los Vilos and the
Provincial Health Department of Choapa, a province
in the Coquimbo region.
In order to join, institutions merely need to
commit to at least two of the ten goals
established in the network’s global agenda, in the
areas of leadership, chemicals, waste, energy,
water, transportation, food, pharmaceuticals,
buildings and purchasing.
The global agenda is a voluntary initiative. Its
aims include the total elimination of mercury, a
potent neurotoxin used in a variety of products
including thermometers, sphygmomanometers (blood
pressure meters) and various electronic devices.
The campaign to ban mercury has been joined by
hospitals and national and provincial authorities
in numerous countries in Latin America, such as
Argentina, Brazil, Chile, Uruguay and Nicaragua,
biologist Verónica Odriozola, the regional
coordinator of Health Care Without Harm, told
Gerwig and Odriozola spoke with Tierramérica
during the Hospitals of the Future conference held
in Santiago on Aug. 9.
TIERRAMÉRICA: What are the most significant
environmental impacts of hospital systems?
KATHY GERWIG: In Kaiser Permanente we prioritize
five areas: energy and climate change, chemicals,
water and sustainable food,
There are diseases that are the result of
environmental exposure, for example, cancer.
Hospitals sometimes have vinyl floors, and when
vinyl is manufactured or incinerated it releases
dioxins, which are carcinogens.
A second example is energy use. Energy from
petroleum products is responsible for climate
change, and the health effects of climate change
include more infectious diseases, while severe
weather like heat waves, fires or floods can
Hospitals use energy 24 hours a day, seven days a
week, and in the United States hospitals are the
third largest user of energy in the sector of
So hospitals use energy, energy causes climate
change, climate change causes disease. We need to
prevent that disease by being smarter in how we
TIERRAMÉRICA: What does Health Care Without Harm
Propose in terms of hospital waste?
KG: There are two issues about medical waste in
which Health Care Without Harm is most interested.
First, treatment. Incineration often is hazardous
to environmental health, so we are looking for
alternatives. For example, in my organization most
medical waste is being treated by steam
The second big issue about waste is the volume. We
do three things: one is to be smarter on
purchasing, by not buying things that you just
come to throw away; we also want to maximize
recycling, and we reuse materials as much as
TIERRAMÉRICA: What are some concrete examples of
good practices in certain hospitals?
KG: Let's talk first about energy. We focus on
reducing our energy use, and using more renewable
energy, like solar. A specific example of reducing
energy is lighting. We adopted a standard in our
operating rooms, in all Kaiser Permanente
hospitals, to use only LED lights, which reduce
energy use. We are now changing the lighting
across all of our hospitals. The lights themselves
use less energy, and they are not as hot so you
don't need to cool as much as with other lighting.
Another example is food. We have farmers markets
at every hospital of Kaiser Permanente now,
usually once a week. Environmentally that means
that we are supporting local farms, and those
farmers then have reliable incomes; the farmers
who want to provide local food have a better
opportunity to be profitable because large
hospitals can consume a lot of their products. It
also means hospital staff can buy their food, and
sometimes in our communities it is an important
source of locally grown food for people who live
In the United States about three percent of the
total fresh fruits and vegetables are organic, and
about six percent of the food we serve our
patients is organic. All the diary products
consumed at Kaiser Permanente hospitals are free
of added hormones and we are working on menus that
rely on less meat.
TIERRAMÉRICA: What percentage of hospital systems
in the world have joined the network?
VERÓNICA ODRIOZOLA: It’s difficult to say right
now, because we are in the stage of adding
members, and new members join as founding members.
But there are a number of big members, such as the
public health system in the Mexican capital, and
the national health system in England. And then
there are individual hospitals and hospital
TIERRAMÉRICA: And in Latin America?
VO: Some countries stand out because we haven’t
had the opportunity or capacity to reach them all.
There has been considerable progress in Brazil,
Argentina and Mexico. In Chile, the campaign
against mercury, which began with a few pilot
hospitals, eventually led the Ministry of Health
to adopt a commitment that now encompasses 90
percent of public institutions.
We are also working in Costa Rica, and starting
out in Nicaragua, where the health care system is
already mercury-free thanks to our work.
TIERRAMÉRICA: In the recent health reform in the
United States, were these issues addressed?
KG: Some of them. They are not exposed, but there
are a lot of opportunities that the new law offers
to the environment. For example, it requires
electronic medical records instead of paper. Not
only do you save paper, but it allows hospitals to
provide more efficient health care. If you can e-
mail your doctor you might avoid a car trip to
Another interesting concept in health reform is
that it provides incentives to prevent diseases.
The better you are in preventing diseases, the
less you are required to use resources to treat
TIERRAMÉRICA: Are your campaigns aimed at changing
public policies, or are you content with voluntary
VO: We work with actors in the system and in the
long run our aim is for the changes to become
public policy, because it would be difficult for
us to go after every single hospital to bring
But sometimes these changes work better from the
bottom up, as we saw in Chile with regard to
In this case, our work now is to try to help this
voice reach the current international negotiations
for an agreement on mercury, in which the health
care sector can say, “These products contain
mercury and can be globally banned; we have
already tried it and confirmed it.”