Translator: Manu Palau Reviewer: Denise RQ
When I was growing up,
I had two experiences in hospitals that made a deep impression on me.
When I was twelve,
my dad went into the hospital for tests one day.
And that was the last time I saw him,
because the next day, he died because of a mistake,
because of the hospital staff.
Two years later, my brother who was was seven years old,
was hit by a car and spent 18 days in a coma in the hospital.
We all thought he was going to die,
but he came out of the coma, and he's still alive today.
And he's doing remarkably well.
So from an early age, I learned that hospitals could be dangerous places,
but also places where miracles could happen.
My first job out of college was writing guidebooks to fabulous places in Europe:
pub crawls in London,
restaurants in Paris, walking tours of Amsterdam.
After two years of eating and drinking my way around the world,
a friend asked me whether I'd write a different kind of guidebook.
This one to polluted places.
I said nobody wants to visit those places.
And he said the book would be a guide
to people who are living in contaminated communities
to help them address the toxic threats they faced.
The Union Carbide chemical disaster had happened in Bhopal, India,
and people were asking
whether a similar disaster could happen in their communities.
Like many people, I was horrified and moved by the photos from Bhopal
of thousands of people dead in the street or blinded by the toxic gases.
So I said I would work on the project.
Researching the book, I wanted to talk to people
who were living in these polluted places and to find out
what they were doing to address their problems.
So I sat around kitchen tables with mothers and fathers
who didn’t understand why their daughter had some rare form of cancer,
why their son woke up late at night choking for breath,
why the water tasted so bad.
They had nothing: they had no money, they had no technical skills,
they had no political power.
But they were demanding answers
and challenging the most powerful companies in their communities
because they were fighting for their families lives.
I was so impressed with their bravery
and with their fierce defense of their children.
And I could easily imagine
if it was my daughter who were sick
and poisoned by the factory down the street.
So I delved deeply into this issue.
And I joined a movement of people around the world
that are fighting to stop the toxics trespass in their communities.
And then in 1996, I heard something so absurd and disturbing
I didn’t believe it.
The US government reported that hospitals
were the largest source of dioxin contamination in the United States.
Dioxin is produced by burning chlorinated plastics,
like the kind in IV bags and tubing.
They go out into the environment.
They build up in the food chain, they build up in us.
And they're linked to cancer, and birth defects, and brain damage.
The health care sector devoted to healing
was itself a large source of contamination.
It stopped me cold.
But that was just the tip of the iceberg.
Because hospitals were also an enormous source of mercury contamination.
There's enough mercury in one thermometer to contaminate a 20-acre lake.
In 1996, there were millions of thermometers that were breaking
in American hospitals and winding up in our air, in our water,
and ultimately, into the fish we ate.
Around the world, there were tens of millions of thermometers
that were breaking and winding up in the environment.
The same year, the US government reported
that there was enough mercury in kids being born,
that a million kids might have learning problems later in life.
So the fact that hospitals were poisoning people
in service of healing them, was crazy.
How are we going to stop the epidemic of cancer and other chronic diseases
that we all face if the healthcare sector itself is contributing to it?
So I decided to start an organization called Health Care Without Harm
to heal the healthcare sector's pollution
and to put health back into the center
of healing and the healthcare sector.
What a concept!
But I had two problems in starting this organization.
One I told you about: I was frightened of hospitals.
I thought they were dangerous places.
And the other problem was
I hardly knew anybody who worked in the healthcare sector.
But besides these two small details,
I was totally ready to take on an industry
was 18% of the US economy, and 10% globally.
And then, I got lucky.
I met three women who actually worked in healthcare,
and they have been allies with me for the last 19 years.
The first one worked for Kaiser Permanente,
which happened to be
the largest non-profit hospital system in the United States.
The other two were Catholic nuns who worked for Dignity Healthcare,
which was one the largest Catholic hospital systems.
So right away, we had size and God on our side.
It was a miracle.
So we worked with their hospitals to show them how they could reduce their waste,
how they could recycle the noninfectious parts,
how they could save money in the process,
but most importantly,
how they could stop burning all this waste.
And they showed other hospitals how to do it,
and by 2006,
over 4,000 medical waste incinerators were shut around the United States,
and American hospitals were no longer a large source of dioxin contamination.
At the same time, we worked with Kaiser Permanente
to get them to phase out their use of mercury thermometers.
The problem with the mercury thermometers was they were cheap
and the alternatives cost a lot more money.
But here, size really does matter.
Kaiser's big: they have 11 million members.
They have enormous purchasing power.
So when they said that they would buy millions of non mercury thermometers,
the price for the alternatives went down,
and within a few years,
they had phased out mercury thermometers.
And then we leveraged that victory with 5,000 other hospitals,
and then 14 pharmacy chains, and then 28 European countries,
and then Argentina, and then the Philippines.
And then, by 2013, there was a global treaty signed
that phases out all mercury measuring devices by the year 2020.
These are early and important victories on the path to sustainable healthcare.
But the healthcare sector has a long, long way to go
before they truly embody the Hippocratic Oath to do no harm.
Here are some facts.
Hospitals use twice as much energy as commercial buildings,
and the vast majority of this energy is dependent on fossil fuels.
They're just as addicted to fossil fuels as the rest of the economy.
And that addiction is literally killing us.
Each year, more than seven million people die from indoor and outdoor air pollution
related to the burning of fossil fuels.
That is twice as many people that die from AIDS, tuberculosis, and malaria combined.
So climate change is bringing an entirely new reality to the healthcare sector
and a mandate to have a much broader healing mission.
Hospitals are still enormous consumers of toxic chemicals.
Some of those chemicals lead directly into vulnerable patients
when they're getting their fluids
from IV bags and tubing made of PVC plastics.
Some of the disinfectants are asthma triggers,
which could help explain why nurses have
some of the highest asthma rates of any profession.
And then there are the buildings themselves,
built with toxic building materials,
furniture drenched in toxic flame retardants,
toxic cleaners on the floor, depressing lighting.
They look bad, they smell bad, they feel bad.
It's as if the building themselves were on life support.
And so we challenged healthcare architects:
Can you build cancer centers without carcinogens?
Can you build children's hospitals
without chemicals linked to birth defects and asthma?
And healthcare architects came forward and worked with us to design a framework
that puts health at the center of building design.
And within a few years, hundreds of hospitals were coming up and being built
that used energy efficient technologies, that had natural light,
that used safer building materials.
And then, in Europe, and Latin America, and Southeast Asia, and around the world,
hundreds of hospitals were being built
that actually promoted healing as opposed to making us feel sicker.
But healthcare could do a lot better, a lot better.
They need to be anchors for community resilience,
and wellness, and sustainability rather than cathedrals of chronic disease.
Hospitals can be anchors.
They can be places of refuge in the coming storms of climate change.
They can be the last buildings standing in extreme weather events
so they take care of the people who are sick and wounded
by those extreme weather events.
They have enormous purchasing power;
they are economic engines
in our communities and in the economy as a whole.
So we're working with them to transform what they buy,
and to use the power of healthcare
to begin to bend the economy toward health and justice.
Here are a few examples that are promising.
Kaiser Permanente now has 50 farmers markets
in their healthcare facilities in the communities they serve.
And they and hundreds of hospitals are using their purchasing power
to support sustainable farmers in their communities,
to bring healthy food to their patients and employees.
Kiowa Hospital in Kansas was completely wiped out by a tornado several years ago;
but was rebuilt completely run on on wind power,
as is the whole town of Greensburg, Kansas.
The Swedish government requires all the pharmaceutical companies
to disclose their ecological impacts for their drugs
so that doctors can write prescriptions for drugs that are effective
but also don't pollute the environment.
And we're working with the United Nations to design environmental standards
that can transform all of their healthcare purchasing.
These are hopeful signs we can move healthcare upstream
to deal with the the social and environmental conditions
that are making people sick in the first place.
But there's still a lot of healing work that needs to be done.
Hospitals and clinics around the world can be powered by renewable energy
and can show the rest of us
how to make this critical transformation to a low carbon future.
Hospitals can lead the way
in defending the rights of our kids to be born toxic free,
to defending our rights to clean air, to clean water,
to healthy food, to safe products that don't poison our kids.
Healthcare can be critical in helping us to heal our relationship with nature.
They can help us understand
that you can't have healthy people on a sick planet.
Because healthcare is the one sector of the economy
that has healing as its mission.
We can transform hospitals
from being dangerous places to places where miracles can happen.
After all, isn't that what healthcare is for?
Thank you.
(Applause)