According to the Millennium Ecosystem Assessment conducted under UN supervision, in the last half of the 20th century, humans changed ecosystems rapidly and massively compared to similar periods of time in human history. This change is caused by the rapid growth of demands for food, clean water, wood, and fuel, which contribute greatly to the welfare of humanity. This change is paid for at a reasonable cost in the form of damage to ecosystems, resulting in large and irreplaceable losses in terms of the diversity of living things on Earth, threatening the well-being of humanity, increasing poverty in a group of people, and increasing the risk of unbalanced change. By looking at developing trends, ecosystem damage could worsen significantly during the first half of this century and become a barrier in achieving the Sustainable Development Goals (SDGs).

Data from WHO (2016) 23% of global deaths are related to environmental factors. Of the 12.6 million deaths per year, 8.2 million deaths are caused by non-communicable diseases. The 10 (ten) biggest causes of death are:

1. Stroke (2,5 juta),
2. Ischaemic Heart Disease (2,3 juta),
3. Unintentional Injuries (1,7 juta),
4. Cancers (1,7 juta),
5. Chronic Respiratory Diseases (1,4 juta)
6. Diarrhoeal Diseases (840.000)
7. Respiratory Infections (567.000)
8. Neonatal Conditions (270.000)
9. Malaria (259.000)
10. Intentional Injuries (246.000)

The emergence of a disease can occur due to environmental factors that originate directly from the place of residence, the community environment to the workplace environment. This will be enlarged and increased due to population migration that causes the lack of clean water and healthy and nutritious food, the need for shelter that is not suitable for humans, air pollution both indoors and outdoors, the use of chemicals and biological agents , exposure to radiation, ultraviolet and ionozing, community noise, occupational risks, use of pesticides in agricultural processing, and waste management. This can trigger extreme climate change, changes in ecosystems resulting in a shift in disease patterns.

In this case, the health sector, especially hospitals that provide health services to prevent and treat disease, sometimes sometimes indirectly contributes to health problems. Hospitals cause significant health impacts, both in the provision of health services through resources used, the occurrence of nosocomial infections (Healthcare Associated Infections / HAIs), transmission of disease infections to and from patients, staff, hospital visitors, to waste generated by hospitals also have a significant impact on the environment. And to date, very limited measurement tools can be used to assess the scale of the problem, but the data that appears provides justification for the magnitude of the environmental impact caused by the health sector.

In providing health services, hospitals use resources optimally in patient safety-oriented efforts in patient center care, with one of its main objectives being to reduce the incidence of Healthcare Associated Infections (HAIs) which are a serious and expensive threat to public health at home sick globally.

Hospitals and health systems everywhere have potential that must not only be able to adapt to the scourge of climate change, but also in the process, promote greater and more sustainable health rights equality and also environmental health through investments in healthier buildings, environmentally friendly spending, and implementation of sustainable actions. Hospitals and the health system can improve economic conditions and moral values ​​in a community, help achieve SDGs related to health and sustainability, and also help guard an environmentally friendly economy. Therefore, hospitals and workers in the health sector can become pioneers in environmental health , by giving examples of economic practices and preserving the environment to the wider community and the global community.

The principle of Green and Healthy Hospital is the hospital’s performance in providing health services ranging from inception, design, construction, commissioning, strategy, management, operation and maintenance, to actions that can recognize the relationship between human health and the environment, so as to reduce its contribution to emergence of disease.

According to the Global Green and Healthy Hospital, a green and healthy hospital is a hospital that continuously promotes public health to reduce the environmental impact and completely eliminate its contribution to the emergence of disease. A green and healthy hospital recognizes the relationship between human health and the environment, and shows understanding through its management, strategies and actions. This hospital connects local needs with actions and practices related to environmental sustainability, which mainly prevent prevention by actively maintaining community environmental health, equal health rights and an environmentally friendly economy.

To support efforts to promote the sustainability and health of a wider environment in the health sector, the Global Green and Healthy Hospitals Network (www.greenhospital.net) has 10 (ten) goal frameworks that are so interrelated, including:

1.      Leadership

Demonstrate leadership support for green and healthy hospitals so they can create long-term organizational culture changes, ensure the participation of hospital workers and the community, and maintain public policies that promote environmental health. In an effort to maintain a green and healthy hospital, leadership is needed on all fronts. This can be interpreted as creating environmental health, safety, and key organizational priorities that are sustainable. This can be achieved through education, setting goals, accountability, and incorporating these priorities in overall internal and external relations and communication. Leadership aims at a major change in organizational culture, whether in hospitals, the health system or in the ministry of health.

2.      Chemicals

Improve the health and safety of patients, staff, communities and the environment by using chemicals, materials, products and processes that are safe, exceeding the requirements of environmental standards.

3.      Waste

Reducing, handling and disposing of health service waste safely. Protect public health by reducing the volume and toxic content of waste produced by the health sector, as well as implementing the most environmentally friendly waste management and disposal options.

4.      Energy

Implement energy efficiency and clean and renewable energy generation. Reducing energy from fossil fuels as a way to improve and protect public health, maintain energy efficiency and use alternative and renewable energy with the long-term goal of 100% energy needs can be met by local energy sources or renewable energy sources in the community.

5.      Water

Implement a series of conservation, recycling and treatment measures to reduce hospital water use and waste water pollution. Embed the relationship between the availability of ready to drink water and health resilience to deal with physical, natural, economic and social disorders. Promote the environmental health of the community by providing them with ready-to-drink water.

6.      Transportation

Develop transportation and service delivery strategies that reduce hospital climate footprints and their effects on local pollution.

Improve transportation strategies for patients and staff

7.      Food

Reducing the footprint of the hospital environment when developing healthy eating patterns for patients and staff. Support access to local and sustainable food to the community.

8.      Pharmaceuticals

Reducing drug pollution by reducing the practice of making excessive prescriptions, removing inappropriate remnants of drugs, campaigning for manufacturer take-back, and stopping drug accumulation as part of disaster relief

9.      Building

Support the design and construction of a green and healthy hospital. Reducing the environmental footprint of health services, and making hospitals a healthier place to work and visit, by incorporating green building principles and practices into the design and construction of health facilities.

10.  Purchasing

Buy products and materials that are safe and sustainable Get a supply of a range of materials that are produced sustainably from socially and environmentally responsible vendors.

 Reference

Hatmoko, Adi Utomo. 2010. Arsitektur Rumah Sakit. Yogyakarta. PT. Global Rancang Selaras.

Zuckerman, David. 2013. Hospitals Building Healthier Communities. Embracing The Anchor Mission.  The Domocracy Collaborative.

Health Care Without Harm.  Global Green and Healthy Hospital “A Comprehensive  Environmental Health Agenda for Hospital and Health Systems Around the Wolrd

www.greenhospital.net

www.noharm.org