GREEN and CLEAN Hospitals: A Tool for Climate Mitigation in Health Sector

Institute of Advanced Sustainable Studies, Potsdam Germany

12-13 November 2018

Workshop on Human health, global environmental change and transformative action:

The case for health co-benefits

Ms. Siriwan Chandanachulaka

Director, Bureau of Environmental Health

Department of Health, Ministry of Public Health Thailand

Outline

1. Backgrounds I nformation

2. Development & Concepts of GREEN and CLEAN Hospitals in Thailand

3. Key of Success

4. Opportunities & Challenges

5. The Way Forwards

6. Conclusion

1. Background I nformation

Location : Southeast Asia Area: 513,115 Square Kilometers 77 Provinces Population : 66.19 Millions (2017)

THAI LAND

Max. temp. Mean temp. Min. temp.

Reference :Atsamon,2016

Temperature Trends in Thailand

Observed Modeled

GFDL (B2)

MM5 (A2, A1B)

RegCM3(A1B)

PRECIS (A2)

2100

2.0

3.0

2050

4.0

Simulation of Thailand’s surface air temperature during 21st century

compared with past changes

Reference : Atsamon, 2015

Changes in Surface Air Temperature in Thailand: Past-Future

Annual max. temp. in the beginning, middle and end of 21st century simulated by PRECI S regional model under A2 scenario.

Source:: SEA START

Future changes in surface air temperature in Thailand

THAI LAND and Climate Change Policies

“Thailand intends to reduce GHGs Emission by 20%

from BAU level by 2030”

The level of contribution could increase up to 25% subject to adequate & enhanced access to technology development and transfer ,financial resources

and capacity building support through a balanced and ambitious global agreement under the

UNFCCC

H.E. Gen Prayut Chan-o-cha,

Prime Minister of Thailand

Climate Change Master Plan 2015 – 2050

Mitigation Adaptation

Capacity Building

Draft

Adaptation Plan on

Climate change

and Health 2018 - 2030

3 Keys approach 1. Flood & drought & water

management

2. Agriculture& Food

security

3. Tourism

4. Public health

5. Natural Resource

management

6. Human Settlement & security

National

Regional

Provincial

District

Sub-district

Community - Primary Health Care Center / Village Health Volunteers

- 9,763 Sub-district Health Promotion hospitals

- 983 District Public Health Offices

- 882 District Hospitals

-76 Provincial public health office

- 76 General hospitals+ XX Special Hospitals

-Regional public health office

- Regional hospital

MOPH /Departments

Plan /strategy

R&D

Surveillance

system

EH service

Early warning

& disaster response

Capacity

Building &

Raise awareness

GHG

mitigation

1 MOPH Hospitals 958

2 Other Hospitals 123

3 Private Hospitals 363

4 Sub-district Health

Promotion Hospitals 9,763

Total 11,209

Health Care Facilities

Health System related to Climate Change

• 100% Universal Coverage for

entire population achieved in 2002 (NHSO)

• 5 leading causes of deaths

1. Schemic heart disease

(13.7%)

2. Stroke (10.3%)

3. Lower respiratory

infections (9.4%)

4. Road injuries (5%) 5. COPD (4.7%)

(WHO ,2016)

2. Development and Concepts of GREEN & CLEAN Hospitals in Thailand

New Delhi Declaration on the I mpacts of Climate

Change on Human Health

WHO/ SEARO organized Health Ministerial Meeting

- Addressing the challenges posed by global

warming and climate change

- Recognizing the need for accelerating

actions to reduce the health impacts from

climate change

- Called for leadership role of health sector

2008 2010-2016

Reduce Global Warming through Sustainable and

Ecological Sanitation Project Minister’s policy

- All hospitals have to sign as one of Performance Agreement I ndicator

- I nnovation Competition in 2018

2017-2019

GREEN and CLEAN Hospitals Project

Development of GREEN and CLEAN Hospitals Project

DOH I nitiative - Health care facilities were encouraged to

join the project - Voluntary Basis - 814 hospitals, 3400 Sub-district Health

Promotion Hospitals involved - 190 model hospitals

GREEN Activities

14. Create network for GREEN Communities

1.Effective environmental management within hospitals

2.GREEN Health Sector 3.Expand to GREEN &

CLEAN Communities 4.Social benefits

C : Communication L : Leader E : Effectiveness A : Activities N : Network

GREEN & CLEAN Hospital Concept/ Results

13. I nnovation

CLEAN Strategies Results

Results

(2017-2018)

Targets

(2019)

Basic level 194 Hospitals (20.25%) 144 Hospitals (15%)

Good level 388 Hospitals (40.50%) 354 Hospitals (36.96%)

Best level 376 Hospitals (39.25%) 383 Hospitals (40%)

Best Plus - 77 Hospitals (8.04%)

1.

Garbage - Solid waste management

3R’s Principle – Reduce, Reuse, Recycle

Organic Waste

Recyclable Waste

“Recycling Waste Bank” with fully active participation

Composting fruit to make toilet detergent Growing Earthworm to compost organic waste

Reduce: Green Office, Green Meeting, Green

Procurement

Reuse

- Paper less - QR Code - No foam - No Plastic - Healthy Break

Use both sides of A4 paper

Restroom Improvement

Reduce chemicals consumption in restroom – detergent, refresher

Use herb – Kaffir lime, Pandan leaves Reduce electricity for lighting

Reduce tissue paper Using natural detergents

Energy Efficiency

1. Energy Reduction Campaign

3. Encourage using bicycles between building,

visiting communities

2. Promote walking up/ down stairs

4. Promote alternative energy use – Solar Cell, Biogas

Solar energy for oxidation in

waste water treatment

plant

Solar energy for water

heating

Biogas compost from

organic waste

Environmental design and landscape

Better environment with green space and increase CO2 absorption

Clean environment

Nutrition – Promote local food/products

GREEN Market in hospitals – promote local products &

food safety, increase income for local farmers, reduce

health expenditure

Purchase community products for I npatient food

Encourage hospital staff to grow vegetables in hospitals

I nnovations

Products from recycle used water

bottles

Solar energy for

clothes drying

Bed for bedsore patient made from used

cooling gel

Arm sleeve to protect intravenous fluid patient made

from used saline bottles

3. Key of Success

Clear policy message

Leadership and Teamwork

Easy to achieve result/ gain

benefits

4. Opportunities and Challenges

Opportunities

• Sufficiency Economy Philosophy of His Majesty the Late King Bhumibol Adulyadej

• National policies on solid waste management, food safety

• Trend of GREEN products and consumer protection

Challenges

• Continuity of policy

• How to measure direct/ indirect benefits

• Find new tactic/ strategy

5. The Way Forwards

Apply climate mitigation and

adaptation measures to improve health

services

Introduce new tactic or strategies

- Programme for Carbon Footprint

calculation

6. Conclusion

Thank you very much for your kind attention

Ms. Siriwan Chandanachulaka

Director, Bureau of Environmental Health

Department of Health, Ministry of Public Health Thailand

E-mail: siriwan9@gmail.com

Success Stories of GREEN and CLEAN Hospital Practice in Thailand