Healthcare provider cracks secret of eternal life

By Phil Crawford

One of the largest hospitals in the world is looking after the health of the planet as well as taking care of its patients. Every year it diverts thousands of tonnes of waste from going to landfill so it can be recycled and given another chance at life. That’s just what the doctor ordered and it’s happening right here in Aotearoa.

There’s a good chance that 12 months ago you’d never heard of the term ‘personal protective equipment’ also known as ‘PPE gear’. Now items like face coverings, medical gowns and gloves are playing a vital role as we protect ourselves from Covid-19.

While tight measures around infection control mean many of those items are dumped, some innovative healthcare providers are working hard to divert other waste streams from landfill.

Back in 2015 Auckland District Health Board (DHB) started an ambitious programme to reduce its landfill to zero by 2040. That’s a massive undertaking for an organisation that every year clocks up about 1 million patient contacts and spends half a billion dollars on clinical supplies.

Auckland DHB provides and funds public health services to the 494,000 people living in central Auckland, as well as regional services for Northland and Greater Auckland and specialist national services for the whole of New Zealand.

It operates Auckland City Hospital, Starship Children’s Hospital, Greenlane Clinical Centre and several community-based services and employs more than 11,000 staff. It is a major teaching institution and annually provides training for more than 1000 doctors, nurses, midwifes and other health professionals.

It goes without saying that 2020 was a challenging year for Auckland DHB. With heightened awareness around infection control some avenues for recycling were temporarily closed. This meant there was an increase in waste going to landfill. However, about 25% of all waste was recycled – a total of 1,200 tonnes (if that’s hard to imagine, try picturing more than 200 elephants balancing on your bathroom scales).

Auckland DHB Sustainability Manager Manjula Sickler says the organisation is proud of the results it has achieved in recent years while acknowledging the size of the job ahead.

“We want to do more. We know that we can do better and this is just the tip of the iceberg,” she says.

So, how has the DHB got this far?

Manjula says the waste reduction programme has wide support across the organisation and an increasing number of Auckland DHB suppliers.

“Kaitiaki is one of our key principles. We’re working with iwi and preserving our environment and resources that future generations will need. It’s not about bolting on something because it looks and feels good. It has to be authentic.”

Auckland DHB is a strong supporter of product stewardship. That means putting systems in place to reuse and recycle products so they live on and on. That’s a big shift for the healthcare sector which relies on a huge range of single-use products.

“We are working towards embedding a stewardship model into the procurement process so suppliers understand they have to work with us to divert as much as we can from landfill and reprocess it.”

This approach started more than five years ago following a trial by international healthcare company Baxter to recycle its PVC fluid bags. Baxter collected the used bags so they could be recycled into playground mats and exported to North America. Due to a change in regulations that market is no longer open so other recycling options are being explored. Manjula says this highlights the challenges of plastic recycling.

“The ideal solution is to reprocess plastics and use them again in New Zealand. That’s going to foster innovation, create jobs and help the economy.”

The Baxter trial proved successful and the programme was rolled out across all district health boards in New Zealand as well as private hospitals. Auckland DHB now diverts more than 15,000 tonnes of PVC away from landfill for recycling every year (that’s about the same weight as three elephants).

Since those early days the pilot method has been repeated for a range of products with encouraging results. For example, Johnson & Johnson ran a trial for recycling its single-use medical instruments and later included other metal items. This innovative project was so successful that Johnson & Johnson has rolled the programme out across New Zealand, Australia and Europe. Auckland DHB has since fully implemented this initiative across the organisation and has diverted more than two tonnes of medical devices from landfill.

Other programmes introduced by Auckland DHB include recycling electronics, batteries, aluminium bottles and cardboard. It has switched from single-use plastic drug trays to a New Zealand made, fully compostable product made from potato starch. Over the past year that’s saved 10 tonnes of plastic going to landfill.

In 2020 Auckland DHB composted 93,000 kilograms of food waste (think 18 elephants). It also ran pilots for composting paper hand towels with Asaleocare and recycling BD plastic syringes into fence posts. Recently it launched a pilot with Medsalv which involves reprocessing single-use patient transfer mattresses.

Manjula says staff have embraced the challenge to make these changes.

“Without the frontline actually driving this in order to test these pilots and ironing everything out we wouldn’t be able to do this. They’re just incredibly passionate people. It’s not only about looking after our patients, they’re also incredibly passionate about the environment. And they’re driven by doing the right thing.”