Fiona Armstrong

Do no harm is the decree exhorted of all health professionals when they first begin practice, but is the practice of healthcare itself damaging public health?

An unnecessary trade-off is being made by health care providers: in the delivery of healthcare, significant amounts of greenhouse gases and huge volumes of waste are produced, contributing to ill-health in the community.

The World Health Organization estimates one-quarter of all diseases are caused by modifiable environmental causes.

Now, the health care industry has begun its own sustainability health check to see if as well as saving patients it can also save the planet.

The environmental impact of healthcare in Australia is not well quantified but we know something about its carbon footprint – with early estimates suggesting the health sector is responsible for seven per cent of carbon emissions from all buildings. The National Health Service in UK calculates its carbon emissions as 25 per cent of total public sector emissions. In the US, the healthcare sector is believed to be responsible for eight per cent of the country’s total emissions.

Reducing environmental harm from healthcare can reduce the burden of disease. Evidence of improvements in health and wellbeing from creating healthy environments in healthcare include reducing anxiety, lessening pain, lowering blood pressure and reducing hospital stays.

There is also the overarching imperative to contribute to a reduction in national emissions, given the threat that climate change poses to health and health systems, and the failure to date of Australian governments to either appreciate the risks or develop strategies to respond.

Which is why networks such as the Climate and Health Alliance are helping to raise awareness about “green healthcare”, driven by concerns about the health risks of climate change and the desire to realise the significant health benefits available from reducing greenhouse gas emissions.

CAHA, with its stakeholders, support an emerging trend towards “green healthcare” in addressing environmental issues. A diverse range of service providers from across the health care spectrum are beginning to realise good health requires embracing the environment.

One regional health care service in Victoria has made great strides towards sustainability by adopting a “social model” of healthcare that goes beyond the medical perspective to consider the social, environmental and economic factors that affect health and wellbeing of the community.

Located in South Gippsland, just south east of Melbourne, the farming region of Koo Wee Rup is home to a community of around 3000 people. The Kooweerup Regional Health Service includes an acute hospital (12 beds), residential care, and community care comprising district nursing and allied health services.

Importantly KHRS also includes health promotion, and with the appointment of a full time health promotion officer in 2007, KRHD extended beyond the traditional role of a health service provider to become a local hub that supports healthy and sustainable lifestyles across the community.

Gardens at Koo We Rup

The hospital grounds have been invigorated into a vibrant hub of community engagement for diverse groups in the region: it includes a community garden and kitchen, recycling depot, play group and a Mens’ Shed.

While the community garden promotes mental health and connectedness, hospital patients also benefit from fresh fruit and vegetables grown on site. One Men’s Shed initiative has men working alongside local school boys to share their wood working skills and make toys for disadvantaged children in time for Christmas. Active promotion of health and sustainable lifestyles in the broader community has also meant the establishment of walking groups, Quit Smoking programs and the support of local environmental campaigns, such as Lock the Gate.

Although focused on the local community, KRHA has linked nationally and globally for inspiration and support for their sustainability initiatives. Wanting to explore how their environmental platform could be strengthened by connecting with like-minded groups, they sought help from Global Green and Health Hospitals.

Global Green and Health Hospitals is an international network of health care providers committed to reducing their environmental footprint and promoting environmental health worldwide.

A multilingual online platform to support the network, GGHH Connect, provides a virtual community for hospitals, health systems and organisations around the world—currently across 53 countries— to work together to share progress, co-create solutions and help accelerate global best practice. The idea is most health care sustainability challenges are common despite different cultural contexts – so if you have a problem someone in the network has already solved that problem and is willing to share how. A global group of experts are also on hand to provide advice and resources.

GGHH focuses on 10 action areas, including reducing waste, increasing energy efficiency minimising the use of harmful chemicals, and buying safer and more sustainable products.

When an organisation like KRHS joins GGHH, it chooses two goals on which to focus its efforts. KRHS chose energy and water.

Global Green and Healthy Hospitals have a goal community for each of the target areas, providing a global network of healthcare professionals with whom Koowerwup can engage, share idea, ask questions, and solve problems, allowing them to often leapfrog challenges they would otherwise face alone.

KRHS has found that many of its initiatives, while meeting environmental goals also help improve their financial bottom line. Solar panels installed more than five years ago have dramatically reduced the costs and environmental impact of the large amount of hot water used in the laundry, kitchen and patient care.

The network is growing rapidly, with over 40 major hospitals and more than 100 other health services in Australia joining 9000 hospitals as part of the Global Green and Healthy Hospitals network.

The vision for this network is to drive transformational change in the delivery of healthcare to create healthier health systems that contribute to, rather than harm, public health, as well as developing a powerful network that can influence supply chains to deliver low carbon products and services, so the health sector can be one of the greenest, healthiest industries in the world. It all offers the chance to save money, and the planet, without (and despite) government policy to support it. A bold vision, but who could argue its anything less than a vital one?

Check out this report from the recent Think Tank on Greening the Healthcare Sector. For more information see or

Fiona Armstrong is convenor, Climate and Health Alliance