Gary Cohen « Skoll Foundation

Health Care Without Harm

Skoll Entrepreneur(s): Gary Cohen
Focus Area(s) Addressed: Healthcare Access and Treatment
Award Year: 2006

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DESCRIPTION:

Gary Cohen was a travel writer whose life was changed by an assignment to draft a community guidebook about toxic chemicals. After meeting mothers working to protect their families from toxic dumps and other chemical threats, he devoted his life to the field of environmental health. He was first co-director of the National Toxics Campaign and cofounder of the Military Toxics Project, then helped launch a free clinic serving survivors of a chemical disaster in Bhopal, India. When he returned home, he co-founded Health Care Without Harm (HCWH) in 1996. Since then, HCWH has become a worldwide phenomenon, moving markets and changing practices through partnerships with major hospital systems and their institutional buyers.

IMPACT AS OF JAN. 2013:

HCWH has built a collaborative network of 500 organizations in 53 countries to raise awareness, create new messengers for environmental health and develop tools and strategies to transform the health care industry.
Health Care Without Harm and the World Health Organization are co-leading a global initiative to achieve virtual elimination of mercury-based thermometers and sphygmomanometers over the next decade and their substitution with accurate, economically viable alternatives.
Practice Greenhealth and the Center for Health Design launched the Healthier Hospitals Initiative with 11 of the leading hospital systems in the US. Together they represent over 500 hospitals nationwide— 10% of the entire hospital market.
In July 2012, Cohen addressed senior administration officials at the White House about Greening America’s Hospitals, and wrote about the topic on the White House blog.
HCWH helped close more than 90% of medical waste incinerators in the U.S. and virtually eliminated mercury medical products from U.S. and European hospitals. They also promote safer technologies and waste management practices around the world.
HCWH developed a framework for building healthy and green hospitals that is being adopted as the basis for the LEED for Healthcare by the U.S. Green Building Council. HCWH is working to assist hospitals to reduce their greenhouse gas emissions and purchase a greater percentage of renewable energy to run their facilities.
They initiated a Green Building program specifically geared to hospitals.
HCWH is working with hundreds of hospitals in the U.S. to bring local and sustainably produced food to patients and health care workers.
In Dec. 2012, CleanMed 2013 was chosen as the “Emerging Green Conference” by the Capital Chapter of the Professional Convention Management Association (PCMA). CleanMed is the nation’s preeminent conference for health care sustainability co-sponsored by Health Care Without Harm.
In Nov. 2011, Health Care Without Harm urged Senators to act on testimony presented at a U.S. Senate Environment and Public Works Committee hearing in support of the Safe Chemicals Act (S. 847), which would substantially amend the Toxic Substances Control Act (TSCA).
Learn more: http://www.noharm.org/all_regions/about/history.php

SEE THEIR WORK IN ACTION:

When we started Health Care Without Harm in the mid-nineties, we understood that the health care sector was enormous part of the economy, and had an enormous environmental footprint.

Every year, hospitals generate millions of tons of waste, and much of it is toxic.

The most amazing thing we learned was that the health care sector was the largest source of dioxin emissions in the country for medical waste incinerators. It was responsible for a large amount of mercury pollution.

Hospitals were also damaging the environment in a number of other ways. Ranging from the way they designed and build their facilities, to the chemicals they use.

So, that was an incredible irony, and a teachable moment .

Because, if you want to detox the entire economy, where do you start? You start with the sector and with people who have an oath to do no harm .

Back then in 1997 heath care people like myself had no idea that we were contributing in such an incredible way to a very toxic environmental problem. Health Care Without Harm's first target was polyvinyl chloride, PVC, the most widely used plastic in medical devices like IV bags.

When it's burned in incinerators, PVC creates highly toxic dioxin, so health care without harm encouraged hospitals to use autoclaves instead of incinerators. Kaiser Permanente and Catholic Health Care West and some other systems said we don't want to be poisoning people in the name of healing them.

And so they took up these issues, it created a momentum to get many other system on board and within a seven year period we went from 5000 incinerators to 83.

But then Health Care Without Harm came to us and said, there is another chemical that's being used in IV bags and tubing that's pliable, and if it leeches into the human that's receiving the healthcare then it can have harmful effects.

And so we also then took it upon ourselves to transform the market for several plastics.

If you're an individual hospital you don't buy much of anything on your own. There's about 7 or 8 really large group purchasing organizations that are managing the collective supply chain for healthcare.

We realized early on that if we could galvanize the power of those group purchase organizations we can change the market wholesale.

One of the most influential group purchasing organizations was Consorta. Consorta was able to work with Health Care Without Harm to really come up with alternative products.

So I think everyone won. From the standpoint that we now had two viable suppliers of product in the market for these PBC-free products.

And now we're creating the market momentum to make this the standard for all health care in the United States and in Europe and, increasingly, globally.

And not just for plastics. Health Care Without Harm has also helped create markets for safer gloves, flooring, cleaners, electronics and healthier food. And it's transforming the way hospitals are designed and constructed to reduce their impact on our environment and climate.

But some of its biggest successes have come in its fight against mercury.

When we started, the largest problem that was being reported to poison control center around America was spilled mercury thermometers."

"You can't destroy mercury, it just circulates in the environment. And there is so much in the environment, that it's impacting our health. And so we said, 'This is a problem that we can eliminate.'"

"By working with Health Care Without Harm, we were able to educate our members and take products containing mercury off our contracts. Those products were no longer visible to our members, and they were able to buy alternative products that did not contain mercury."

More than 5,000 health care facilities in the United States are moving to eliminate mercury, and every major pharmacy chain has stopped selling mercury thermometers.

Now, Health Care Without Harm is turning it's attention to the rest of the world.

"The use of mercury in health care is very widespread here in the Philippines.
If we keep on using it We keep on burning it, if we keep on dumping it, we are the victims, but at the same time we are the culprits.

That's why the phasing out, and the elimination is really the call of all international organizations and we are part of that health care without harm.

If we are not going to act now something is going to happen to this generation.
Being an institution of taking sick patients, so we should be at the fore forefront of preventative action.

Mercury is considered now an anathema to my institution.
Mercury is forbidden.

We've been able to then take that progress in the Philippines and bring it to other countries in the region Vietnam, Malaysia, China So, we started with a single thermometer in a Boston hospital 12 years ago, and now we're at a scale where we can partner with the World Health Organization to eliminate mercury medical devices globally."

"Ultimately, what you want is to replace mercury with safer products. And the safer products with substitutes are available, so we can do really."

Today Health Care Without Harm is a global coalition of almost 500 organizations in 50 countries, working to ensure that the health care system no longer harms human health and the environment.

Now, is tackling the problem of global warming.

"The call of the challenge now is what is health care's contribution in terms of global warming or climate change importance of health care without harm is telling that health care sector and the health care industry to be responsible in the bigger community .

We can no longer support healthy people on a sick planet. If we are going to hope to support the conditions for people to be healthy all over the world , we have to have a clean environment.

It's not an option anymore.

Health care can be a driver for that transformation, and should be, in the name of healing.

Skoll Foundation

Health Care Without Harm

CONTACT INFO

LOCATION

Kimberly Tripp on How to Scale Impact

Healthcare Helping Reduce Greenhouse Gas Emissions: Gary Cohen

Health Care Without Harm's Visit to Our Offices

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