According to a recent report by the medical journal, The Lancet, greenhouse gas emissions by the healthcare sector were 9.5% higher in 2021 than in 2020. Overall, the sector accounted for 4.6% of the global emissions in 2021. 

Health Sector’s Impact 

Tshepo Mokhadi is an environmental health practitioner and a member of The Next Generation Foresight Practitioners. He says the biggest contributors to greenhouse gas emissions in the health sector are energy consumption, waste production, water use and supply chain. 

“Hospitals require large amounts of energy for lighting, heating, cooling and powering medical equipment. This often results in significant greenhouse gas emissions especially if the energy comes from non-renewable sources,” he explains. 

He adds that healthcare facilities generate substantial volumes of waste which include hazardous, chemical and general waste. This leads to improper disposal which, in turn, can release pollutants.

“Large volumes of water are used, contributing to resource depletion and energy use for water heating and treatment,” he says. 

Mokhadi says the activities driving carbon emissions in the healthcare sector are high energy consumption, especially in theatres, where heating and cooling technology is used. 

“The third one is packaging material from unsustainable procurement practices which results in a lot of single-use plastics,” Mokhadi says. 

Poor Waste Management

Azeeza Rangunwala is a medical scientist and Global Green and Healthy Hospital Coordinator at the environmental advocacy organisation, groundWork. She explains that some hospitals had incinerators, and many of these incinerators were not fully compliant with quality standards and treated medical waste on-site. After the Air Quality Act was passed and the on-site treatment was decommissioned, service providers were used. 

“But only in certain provinces, there was a transboundary movement of medical waste. We also have a proximity principle that recommends that treatment and disposal of hazardous waste take place at the closest possible location to its source to minimise the risk involved in its transport,” she says. 

She mentions that another challenge is that elements of healthcare waste management, including segregation, are not always done accurately. Not all facilities have the structures for waste clarification, waste minimisation, containerisation, colour coding, labelling, signage and handling, and transport storage. 

“There is also treatment and final disposal. Right now the treatment that is used is incineration which is the meta source of air pollution,” she says. 

She adds that pollutants from incineration facilities have an impact on nearby communities too whether directly through inhalation or indirectly via food and water.

Reducing the Sector’s Emissions 

Mokhadi says in South Africa the Department of Health has done a lot of work to support the sector to reduce carbon emissions. 

“There are different programmes being implemented by hospitals to support eco-friendliness in healthcare practices. We have about 74 hospitals in South Africa that have joined the Network of Global Green and Healthy Hospitals and are actively participating in writing case studies about sustainable health practices. The Centre for Public Service Innovation is also unearthing some of the sustainable innovations in health,” he says. 

He says the National Health Insurance also paves the way for more strategic programmes and concepts such as net zero, decarbonisation and just transition in health.-Health-e News