The cost to make improvements across areas including lighting, cooling, pumps, fridges, insulation, electric vehicles and solar panels was US$ 11.7 million. These sums (along with no-cost changes to the uses of anaesthetic gases) were projected to reduce AKHS’s carbon emissions from 12,385 to 5,311 tonnes or by 57 percent overall. With current energy and fuel costs, this would translate to a little over a five-year payback – a 20 percent annual return on investment.
At a time when the health sector was preoccupied with the pandemic, were colleagues able to engage with the climate initiative?
It's remarkable that staff have done what they've done in the face of COVID-19. They've had calamity after calamity to surmount. Staff were working flat out, with safety concerns for themselves, their patients and their families. But people have understood that the story of COVID-19 is directly related to the problems of our planet and that health workers will continue to face problems if we don't get our act together.
I'm a believer in working with people to identify solutions that are based on capacities and realities. There wasn't a single person I spoke to that didn’t share concerns. As well as establishing systems for collecting data and identifying what needed to be done, we jointly identified pet projects around staff interests and capacities that they could take forward, turning concerns into something positive. We set up WhatsApp groups and I’d write up what they were doing and share it with focal points, which helped with establishing a dynamic community. Keeping up the dialogue and interpersonal exchanges was also important for all of us to stay buoyant in the face of frequently depressing items in the news.
To go from measuring to strategic implementation depends on raising awareness and creating a staff movement. Changing behaviours needs broad understanding and buy-in, it’s a buzz that everyone has to be part of. We have a core list of about 150 people directly responsible for various aspects of this work across AKHS, and there are many others engaged too.
We went through a blue skies exercise with the teams asking: “If money were no object, what could we do to reduce our footprint?” The measures they came up with amounted to reducing our footprint by 60 percent. We haven’t completed the exercise – there is much more we can do before we will likely need to consider insets or offsets to get all the way to net zero.
Not all ideas could be automatically translated into action at the beginning as finances were needed in many cases. As such, while we made progress with no- or low-cost interventions, things didn’t move quickly. But now we've turned a corner through presenting the best of business case investments and received funding to get moving. We’re also progressing with training others to use our methods and have developed stand-alone training materials for this to facilitate wider impact. For our own staff, we’re building systematic training, as part of career development, and experimenting with how best to formalise what people do on this agenda as a formal part of their job descriptions and performance evaluations so that there’s full recognition for what has so far been volunteer work.
Staff have been writing abstracts for conferences and applying for prizes for their work. I've had the British Medical Journal and The Lancet ask me on behalf of AKHS to write pieces for them. I know where our results show promise and are good to profile and share with others. With support, our staff have drafted such publications and we’ve just learnt that two additional papers have been accepted, which is great.
Our staff on the ground are also making presentations to governments, and are rehearsing to do orientations in their own countries and languages. We're building a formidable number of champions within the network. All of this has been made possible through the active support of leadership, particularly Gijs and our regional and country CEOs – there has been a lot of staff time invested in this work.
How are you using the tool to take action?
We expect to make dramatic carbon reductions ourselves, particularly in primary healthcare settings. We’re in a good position to persuade policy makers and investors to adopt similar approaches and to take them to scale. We've got high visibility and are participating in influential discussions and fora – our long-built positions of trust of our host governments and the public will help. We also have, through AKDN’s network, many opportunities for innovation and creative thinking.
We have just started opening our doors to the public, and we are prepared to handle high interest. We have a step-by-step manual and we’re working on a series of videos to go with it. We’ve had about four orientation sessions and hope to keep these going on a regular basis. So far, people who’ve attended and asked for the tool include universities such as Yale and the London School of Hygiene and Tropical Medicine, consultancy groups, C40, a network of cities that now has 96 members, Standard Chartered Bank, the Clinton Health Access Initiative and the Global Fund. I’m on the governance committee for climate action of the International Hospitals Federation, which works in 92 countries. They’ve developed an initiative to examine how they can get all their members to be involved in “greening up” health care. I’m hoping to interest them in using the tool – benchmarking is something that increasingly all health operations will be asked to do. And in a couple of weeks, the WHO is hosting a meeting with more than 25 countries represented (ministries of health and the environment) and we're providing a training of trainers workshop for all of them.
The emissions tool is free to use and open to all. Learn more with our guide, or to access the tool, write to firstname.lastname@example.org