Taking on Toxics II: Health Care without Harm
Cray, Charlie, Multinational Monitor
ENVIRONMENTAL AND PUBLIC HEALTH ACTIVISTS were astonished to discover in the mid-1990s that U.S. Environmental Protection Agency (EPA) analysis showed that medical waste incinerators were the biggest source of dioxin in the United States.
"The irony that the health care industry should be the leading source of one of the most toxic substances around seemed extremely compelling," says Charlotte Brady, a registered nurse and organizer with the Center for Health, Environment and Justice. "It was an extraordinary organizing opportunity because we knew that most health care professionals who knew about the issue would want to do something about it."
Soon Brady and others from 28 organizations -- a core of environmental activists, nurses, doctors and public health advocates -- formed Health Care Without Harm (HCWH), a broad-based campaign designed to reform the environmental practices of the health care industry.
"Health Care Without Harm is driven by the fundamental notion that the health care industry has a particular ethical responsibility to minimize adverse impacts on public health and the environment," says Dr. Ted Schettler, science director of the Science and Environmental Health Network. "The health care industry can play a leadership role by looking beyond regulatory compliance and doing what's necessary to prevent illness rather than working only to treat it after it occurs."
The organization has developed quickly. In just five years, HCWH has grown to represent nearly 300 organizations in over 25 countries, including more than 88 health care institutions, health-affected constituencies (groups representing people afflicted with cancer, endometriosis and other diseases, as well as children's health advocates), associations of health professionals, religious organizations and many local and national environmental organizations.
Organized into various work groups, the campaign has deployed a flexible matrix of strategies to force the health care industry to apply its ethical commitment to "First, Do No Harm" to the environmental and occupational impacts of the technologies and materials used in health care. The result has been a holistic and sophisticated pollution prevention campaign that has forced the closure of hundreds of medical waste incinerators, motivated countless hospitals to conduct waste audits and establish recycling programs, and catalyzed the use of replacements for toxic materials used in medical devices, such as mercury and polyvinyl chloride plastics (PVC).
Incinerators were HCWH's first target. In addition to supporting local community-based campaigns that have shut down over 20 medical waste incinerators since the campaign began, HCWH has stigmatized incineration in general and moved hospitals and clinics towards waste segregation, recycling and the selection of safer infectious waste treatment methods.
"Working with nurses and others who knew health care institutions from the inside, we often did for the health care industry what EPA wasn't doing through their new incinerator regulations," says Tracey Easthope of the Ecology Center of Ann Arbor, Michigan. "We even provided information demonstrating how waste reduction and alternative treatment technologies could save them money."
While learning to use such carrots, the campaign also wielded a big stick, working to strengthen U.S. EPA's new medical waste incinerator regulations. The stricter emissions standards forced hundreds of additional hospitals to choose between paying to upgrade their facilities with expensive new emissions control equipment or stop burning their waste and seek viable alternatives.
With the help of Essential Action, a project of Essential Information, the publisher of Multinational Monitor, the anti-incineration effort has also expanded abroad, to India and other countries where incinerator manufacturers migrated after the U. …