On the occasion of World Environment Day, Union Health and Family Welfare Minister, Dr Harsh Vardhan, has announced his resolve for greening the health care and to converting All India Institute of Medical Sciences (AIIMS), New Delhi into a “green hospital”, here today. With environmental degradation and environmental risks emerging as the single biggest source of diseases –from ordinary water borne diseases to cancers –the Health Minister has announced plans for setting up a network of capacity building institutions all over India modelled on the line of All India Institute of Hygiene and Public Health, Kolkata, and the Centre for Occupational and Environmental Health in Delhi’s Maulana Azad Medical College.
Dr Harsh Vardhan expressed concern at the insufficient data available with health authorities in India on the adverse health outcomes and disease burden attributable to various environmental hazards. There is scant information available on the adverse impact on health caused by ecological and environmental deprivation at local, regional and national scale, he stated. The movement of masses and a sizable population of migrant labourers make this mission difficult without inter-sectoral and inter-state coordination, he said.
For this purpose the Health Minister announced that a Management Information System using IT tools would be developed for the benefit of central and state health departments. The Minister said, “The United Nations, WHO and all international institutions have warned of the dangerous link between deteriorating environment and disease outcomes. We need to fight this negative impact by applying established tools to gather information and sharing it with community for involving them in this movement of creating healthy and safe environment. We also need to undertake a massive capacity building exercise to create a pool of trained manpower to achieve this mission.”
Green AIIMS—a statement of intent
Addressing a distinguished gathering at Vigyan Bhavan today, Dr Harsh Vardhan said that his plan to “green” AIIMS is based on the government’s determination to showcase its determination to fight climate change. For this to happen the country’s premier medical facility should move away from using conventional energy that is responsible for polluting environment and adding green house gases, Dr Harsh Vardhan said. Healthcare institutions should strive to reduce their energy consumption and maximise use of solar energy and other similar sources, he said.
Dr Harsh Vardhan stated that the new-look AIIMS will have water conservation and waste water recycling systems in place. There must be regular energy audits and a phased renewal plan must be developed with a view to making the buildings on the complex more energy efficient, he said. Its entire waste generation including medical waste generation must be brought down by an approach of reduce, reuse and recycling of waste. A scavenging system to deal with nitrous oxide and other waste anaesthetic gases is also the need of the hour, he added. The plantation around the hospital should be of a nature so as to capture particulate pollution preventing harm to the hospitalized patients, the Minister said.
The health Minister further added that it is not uncommon to see many buildings being singled out and awarded for their efforts for energy conservation but the hospitals are never seen in the list. Why should not hospitals try to get such awards sending out positive signals and becoming the brand ambassadors for environmental protection and preservation adding to the improved health of community, he questioned. “The unattractive facade of government hospitals should become a thing of past. We do not have to be ostentatious to do that. . Beginning with AIIMS-New Delhi, I want all public hospitals to resonate with inclusivity and enlightenment,” Dr Harsh Vardhan said.
Public Health Institutions
The Health Minister further said that the health infrastructure of India is inadequate to fight the impact of environmental degradation and consequent adverse health outcomes. The government has therefore decided to focus on expanding the human resource base. The pyramidal structure of the public health system of the country will soon be equipped with capacities to combat diseases caused by environmental risks and a preventive attitude would be encouraged, Dr Harsh Vardhan said. Addressing a distinguished audience at Vigyan Bhavan today attended by senior health professionals, health secretaries, DGHS, representatives from WHO, United Nations, UNICEF and other UN organisations, the Minister said the government was considering a slew of measures including setting up of institutes for capacity building of health professionals in environmental health, public health, environmental sanitation and sanitation engineering.
“The country’s present health infrastructure is unfortunately inadequate at present. We need to quickly develop more trained health workers –whether doctors with post-graduate degree, specialised doctors or nurses or public health engineers – for combating the effects of climate change on human health,” Dr Harsh Vardhan said. The Minister said he would disclose his plan at the next meeting of the Central Council of Health and Family Welfare. The participation and cooperation of the states would be crucial because there are numerous possibilities of synergy, he noted. Highlighting the contribution of the All India Institute of Hygiene and Public Health, which was set up in 1932 in Kolkata with funding from the Rockefeller Foundation of the United States, Dr Harsh Vardhan said the country needs many such bodies but must add to their agenda and programme the activities to address environmental health concerns. He said that he has already firmed up plans to set up public health institutes in the six new AIIMS which are in different stages of completion. Harvard School of Public Health is already collaborating with two AIIMS- at Jodhpur and Raipur for public health activity As Delhi’s Health Minister (1993-98), Dr Harsh Vardhan had established the first specialised Centre for Occupational and Environmental Health in a government hospital at the Maulana Azad Medical College. He said, “What an irony it is that Delhi, a city regarded by WHO as having high levels of air pollution, has only one public hospital with such a specialised centre. We must have more such centres not only in Delhi but all over the country.”
Information is power
Dr Harsh Vardhan lamented the inadequacy of data hampers the efforts of the health administrators, whether at the centre or in the states to address the emerging environmental health threats that now need urgent attention and proactive approach. As an example he cited a typical case of silicosis, a disease that has resulted in profound morbidity and mortality but with little information at hand as to its magnitude and size. A man arrives from eastern Uttar Pradesh, finds work in the capital’s construction sector and soon gets T.B. and silicosis. When he gets sick and cannot work anymore then he returns to native place with no one realizing the true nature of his health problem, he stated.
The Minister commented that the Health Ministry and its satellites in the states need an institution like the Indian Agricultural Statistics Research Institute. So for the short term he has decided to commission a Management Information System (MIS) using Information Technology tools which would, at the click of a mouse, make available a host of valuable data gleaned from computers at every tier of the health infrastructure. “My ideal is to create an aggressive data collection system and research organization for the health sector which would preferably be autonomous. I will take up this matter with the Prime Minister soon and involve the state governments in the endeavour,” Dr Harsh Vardhan added. Dr Harsh Vardhan also announced a sanitation drive for a week in the government hospitals run by the Central Government in the Capital and declared that he shall soon visit these hospitals to monitor the sanitation drive.