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About us

This document is less than three pages long. Below you will find

• A brief description of who we are
• How the health care sector unintentionally harms human health
• Our guiding principles
• Our campaign goals
• A description of a few of our successes
• Our strategy for change

Who we are

In 1994 the US Environmental Protection Agency found that US hospitals were responsible for 40% of the total amount of atmospheric dioxin pollution in the United States.

Shocked by this discovery, a group of environmentalists and health care workers together launched a unique coalition to tackle environmental problems in the health care industry.

That was in 1996. Today Health Care Without Harm is an international coalition of over 440 organisations in more than 50 countries, with regional bases in Europe, the US, Asia and South America.

Our mission is to transform the health care industry worldwide into an environmentally sustainable system which is no longer a source of harm to human health or the environment, without compromising patient safety or care.

Unintentional harm and the health care sector

The last thing hospitals should be doing is contributing to a world in which people need more medical care, not less.

Nevertheless, some of the ordinary practices of health care are contributing to the spread of some of the illnesses the medical profession is trying to cure. Without meaning to, hospitals are putting patients and workers at risk.

In Europe, Health Care Without Harm is especially concerned about the following:

Waste incineration: Many European hospitals burn their waste. Incineration creates hazardous ash and releases dioxins, heavy metals and other toxic chemicals into the environment, adversely affecting the health of local communities and contributing substantially to pollution levels.

Use of dangerous materials: Medical devices made from PVC can leach the toxic phthalate DEHP into patients. PVC devices also release dioxins when burned as medical waste. Mercury, used in pressure and temperature measuring devices, is a potent neurotoxin.

Poor food quality: The value of good nutrition to the healing processes in the human body are well-known. Yet many hospitals still fail to provide patients with adequate nutrition, and often don't even prepare fresh food on site. Hospitals also contribute to air pollution and global warming by having food transported to them over large distances.

Environmentally unfriendly building standards: Hospitals consume much more energy and water than other facilities - yet few people think of energy efficiency or using renewable resources when running a hospital. Old-fashioned building design reduces available natural light and causes poor indoor air quality.

Our guiding principles

The philosophy of the Hippocratic Oath is to first, do no harm. It is therefore ironic that the healthcare sector is such a significant burden on the environment and human health. Removing this contradiction from health care is the main aim of our work.

We know that a clean and healthy environment reduces the incidence of many preventable illnesses such as birth defects, cancer, fertility problems and allergies.

We believe that the best way to solve these problems is for people with practical experience to group together and share their understanding of how problems in health care might be solved. As a coalition, this is what we are encouraging people to do.

In the final analysis, there is no difference between the health of the environment and the health of human beings: for a health care system to function properly, concern for health must incorporate concern for the environment.

Our goals in brief

To be successful, we need a conceptual shift in medical care. Where prevention is currently neglected in favour of treatment, there should in future be a health care system that looks after people's health whilst they are still healthy - not just when they are sick.

We are working to

• Introduce policies and create markets for safer materials and chemicals in health care.
• Eliminate the incineration of medical waste and minimize the amount and toxicity of all waste generated.
• Ensure that health care practices and technologies that create environmental problems are not displaced from one community or country to another.
• Transform the design, construction and operations of health care facilities to minimize their environmental impact and foster healthy, healing environments.
• Encourage the purchase and consumption of healthy food from sustainable sources.
• Guarantee that all people have full access to information about chemicals used in healthcare, so are informed and able to participate in decisions about reducing exposure to harmful chemicals.

Some of our successes

United States: The number of medical waste incinerators dropped from 4,200 in the mid 1990s to about 100 by 2004. Very few pharmacies continue to sell mercury thermometers. Mercury is being phased out from hospitals.

European Union: Laws banning new mercury thermometers and the export of mercury have been proposed. The European Parliament has adopted a resolution urging a ban on phthalates and mercury use in medical devices, especially those used on children.

Central and Eastern Europe: In Austria, the Vienna Hospital Association Pediatric Clinic Glanzing became the first PVC-free neonatology unit. The Association is now tendering for PVC-free medical devices for all of its 18 hospitals. In Poland in 2004, we proved in pilot hospital projects that waste management costs can be cut by 70%.

Philippines: In 2004 we worked with the Philippine Health Ministry and WHO to vaccinate 18 million children without incinerating a single item of medical waste. Our demonstration projects consistently support the country’s national ban on incineration.

Our strategy

The health care industry - in both its public and private manifestations - is one of the largest market forces in Europe, and has the economic potential to produce major changes in the practices of the business sectors with which it interacts.

From all around the world, large purchasing organisations, hospital trusts, construction firms, architects, building companies, scientists, health care workers, patients and those affected by hospital practices such as incineration are working together through the HCWH coalition, sharing their understanding and skills in order to make health care healthy and sustainable.

By educating healthcare workers about greener hospital practices and encouraging them to advocate for environmental health and justice, HCWH influences the environment policies of hospitals and positions doctors and nurses to lead the way to environmental sustainability.

Health Care Without Harm