Author ~ Funmi Akindejoye
There is a strong link between the health of a nation and the state of its environment. What this means is that in achieving the third goal of the United Nations Sustainable Development Goals (SDGs) – SDG3 – ‘Good health and wellbeing’, it is important to apply an all-inclusive approach that supports the realisation of the other SDGs, especially SDGs 6 and 7 – ‘Clean water and sanitation’ and ‘Affordable and clean energy’, respectively. Therein lies a strong endorsement for the integration of sustainability within the healthcare sector where sanitation and affordable energy can save or cause the loss of millions lives.
Hospitals, pharmaceuticals, and other healthcare establishments are responsible for treating the sick, promoting good health, preventing diseases and supporting the elderly and weak among other functions. While the healthcare sector has been of immense benefit to the world’s population, through which cancer has been treated, sight restored, organs transplanted, conjoined babies separated, HIV/AIDS managed, blood transfused and conjoined babies birthed through in vitro fertilization, there are many everyday hospital footprints that contribute to environmental pollution including general waste, clinical waste, hazardous materials, incineration, mold, and germs found in hospital environments. All of which when viewed through sustainability lenses cause for healthcare delivery to be its own rival, no doubt quality and affordable healthcare practices is crucial to sustainable development.
Infrastructure
If one would take a critical look at the Nigerian healthcare sector, one would immediately identify that it is plagued with inadequate facilities, outdated technologies, insufficient medical supplies, poor attitude and quality of healthcare personnel, shortage of healthcare workers, poor infrastructure, sharp differences in the accessibility and availability of medical facilities across the country resulting from policy disconnection, inadequate capital spending and low remuneration of public healthcare workers, among other problems.
Improving the health of Nigeria would require an integrated approach; more focus having been given to curative medicine, rather than preventive healthcare; neglecting public health. The provision of basic amenities such as water purification systems for clean water by local governments in strategic communities will help eliminate many water-borne. Even better, government’s public health measures aimed at improved sanitation, regional fumigation, the use of ITN (insecticides treated nets) should be encouraged.
Lack of motivation
To be truthful, the troubles within the sector do not fall within the purview of government only, although it can be argued that frustration from a less than efficient system and inadequate medical supply and equipment greatly impact on other factors, such as attitude and motivation of medical personnel. Years of poor attitudinal problems, particularly in the public sector, has further endangered lives of patients. Due to the shortage of workers in health facilities, available personnel become overworked and in the process become inured to suffering and sanitation.
The environment
Beyond the social dimension of healthcare, the activities of hospitals constitute a large environmental footprint. Although we do not have the data for Nigeria, Michael Bendewald and Kendra Tupper report that healthcare facilities are among the most energy-intensive facilities in the U.S. According to the 2003 Commercial Building Energy Consumption Survey (CBECS), the average hospital spends $675,000 on energy costs annually, exceeding the per-building energy costs of other building types by a factor of 10.
Evidently, the non-stop function of hospitals is the reason for its high energy consumption. Such consumption can, however, be managed responsibly with the use of high performance lamps, energy saving bulbs, and renewable energy in areas of the hospital that must be lighted 24 hours. Also, energy cost of medical machines can be controlled during the purchase procedure by taking into consideration the life cycle cost analysis, energy consumption, energy efficiency etc.
Waste management
According to official data from the World Health Organisation (WHO), 25 million people have been infected with hepatitis viruses C and 260,000 with HIV, as a direct result of the inappropriate management of health-care waste. Healthcare facilities use a multitude of cleaning chemicals which result in potentially hazardous wastewater effluents. The hazardous chemicals used for anaesthetics are often vented, creating potentially hazardous air emissions. Other hazards may include physical contact with sharp objects, physical injuries from waste collection and handling and intoxication from chemical waste.
What can be done?
Clearly, for a healthier, happier population, focused initiatives on improving facilities within primary healthcare centers, staff training and benefits, environmental protection and energy provision and management.
Even as important is the need to constantly motivate, incentivise and re-orientate healthcare workers.
Also, the status quo where people go to secondary healthcare (SHC) for their primary health care needs as a result of inconsistent implementation of healthcare structuring and inadequate provision of medical supplies and personnels due to diversion of funds to recurrent spending, causes SHC doctors to devote a large amount of their time on outpatients’ departments of hospitals rather than focus on more severe cases. The 1988 health policy refined in 2004 which has been described as suitable for the provision of standard healthcare in a growing nation, which has the three-tier health structure, with primary healthcare (including refined traditional medicine), secondary health care, SHC, with (general hospitals and others) and tertiary healthcare (university teaching hospitals, federal medical centres and specialty hospitals at the apex), should be revisited and properly implemented.
Moving forward, unnecessary bureaucracy in Nigerian hospitals is a major concern to patients especially during cases of emergency, the endless form-filling and box-ticking is viewed as burdensome, and time consuming and can inevitably lead to the death of loved ones. Most times the information requested by these national bodies for providers to collect and record does not add value. It is important for the bodies involved to device a technique that will reduce excessive time and effort expended in hospitals especially through the utilisation of appropriate technology and IT systems.
Reference
- Chioma Obinna (Septer 6, 2011). How poor attitude of health workers is killing healthcare delivery in Nigeria. Vanguard.
- https://www.vanguardngr.com/2011/09/how-poor-attitude-of-health-workers-is-killing-healthcare-delivery-in-nigeria/
- Guidelines for Energy Efficiency in hospitals developed by EPTA Ltd, 2007, LIFE04 env/gr/000114, http://ec.europa.eu/environment/life/project/Projects/files/book/LIFE04ENVGR114-EE.pdf
- Guide for sustainable waste management in the Health-Care Sector by EPTA Ltd, 2006, LIFE04 env/gr/000114, http://ec.europa.eu/environment/life/project/Projects/files/book/LIFE04ENVGR114-EE.pdf
- Janet Howard. 10 reasons health care needs sustainability treatments. 2014 https://www.greenbiz.com/blog/2014/02/12/10-reasons-health-care-needs-sustainability-wake-call
- Michael Bendewald and Kendra Tupper, A positive diagnosis: How hospitals are reducing energy consumption. 2013
- https://www.greenbiz.com/blog/2013/11/21/health-care-energy-consumption-retrofits
- Nasir El-Rufai (2014). Nigeria’s Health Sector Challenge and Solutions That Work. Omojuwa.com http://omojuwa.com/2015/02/nigerias-health-sector-challenge-and-solutions-that-work-nasir-el-rufai/
- William A. Suk, Hamid Ahanchian, Kwadwo Ansong Asante, David O. Carpenter, Fernando Diaz-Barriga, Eun-Hee Ha, Xia Huo, Malcolm King, Mathuros Ruchirawat, Emerson R. da Silva, Leith Sly, Peter D. Sly, Renato T. Stein, Martin van den Berg, Heather Zar, and Philip J. Landrigan. Environmental Pollution: An Under-recognized Threat to Children’s Health, Especially in Low- and Middle-Income Countries. 2016. Environ Health Perspect, Volume 124 | Issue 3