An initiative to make the National Conference on Safe and Sustainable Hospitals-2020 a clean and green event

Medical conferences are conducted to share and disseminate newer ideas, knowledge and practices. They fulfil an important role in the education of healthcare providers and healthcare leaders. The All India Institute of Medical Sciences (AIIMS), New Delhi, conducted more than 200 conferences, symposia, seminars and other such programmes during 2018–2019.¹ Most healthcare leaders opine that there is no substitute for live events, viz conferences, workshops, seminars and symposiums, which provide unique learning and career-building opportunities that cannot be found anywhere else, particularly in local settings and current classroom curricula.²

All such conferences leave in their wake a large amount of garbage and solid waste. When our department accepted the proposal from the Academy of Hospital Administration, Noida, to conduct the National Conference on Safe and Sustainable Hospitals (SASH-2020) at AIIMS, New Delhi, we decided to extend the ambit of ‘sustainability’ from the hospital to organization of the conference as well. We adopted several simple initiatives that directly impact our habitat and environment.

The challenge of scientists/researchers becoming environmentally sensitive and reducing their carbon footprints while attending conferences was first reported in the Nature in 2019.³ We believe other institutions and organizations could easily carry out such initiatives so that the same can be replicated in their campus(es). This effort shows how a simple environment-friendly initiative can have a force-multiplier effect, if organizers become aware of such initiatives. A key feature of Clean India Mission, one of the most applauded initiatives of the Government of India launched on 2 October 2014, is to focus on behaviour change.⁴ Behaviour change is a key contributor in the chain of efforts towards achieving ‘Clean India’. Behaviour change communication (BCC) is not a ‘stand-alone’ activity, but requires nudging communities into adopting safe and sustainable sanitation practices through effective BCC. The approach is based on the premise that ‘Cleanliness’ has to be everyone’s responsibility and not only of sanitation workers. The emphasis is placed on generating awareness, triggering mindsets leading to community behaviour change. The conference platforms, therefore, could be utilized as forums to initiate a wave of positive change among a group of leaders from diverse medical disciplines.

With an aim to invoke few ideas and practices in this direction, several environment-friendly initiatives were contemplated and integrated in SASH-2020 organized at AIIMS, New Delhi from 21 to 23 February 2020 in collaboration with the Academy of Hospital Administration, Noida. An innovative, attractive, reusable, environment-friendly registration kit was customized. Considering that each delegate could consume at least 3–4 L of water on each day of the conference, a copper bottle with a capacity of 650 ml was given in the delegate kit to avoid the use of single-use plastic cups/glasses. Around 450 delegates attended the conference and it was encouraging to see them fill their bottles, during the tea/coffee breaks, from water dispensers placed in the conference venue. This reduced the generation of single-use plastic bottles/glasses waste. Moreover, it helped us in substantially reducing expenses. The delegate could use the same bottle even after the conference. Reusable glass bottles and tumblers were also used for chairpersons and speakers.

The other inclusion in the kit was a plantable desk calendar. Each month’s sheet of the calendar when crushed and sown would sprout into a plant. The spirit was to flex the thought process of delegates to few simple practices, which if adopted, could go a long way in making the environment clean and green such as giving them an implantable calendar.

The certificates given to the oral and poster presenters were made of ‘recycled’ paper. All other delegates were sent e-certificates by email instead of paper-based ones. For felicitation, dignitaries were given potted plants.

The transportation of delegates within the campus, to lunch and dinner venues, on all three days was by electric battery-operated vehicles instead of petrol/diesel vehicles. It is now well established that transportation sector is one of the major sources of air pollution.⁵ Therefore, use of electric buses offered a method to mitigate emission concerns.^6,7 Delegates of the conference, who were desirous of visiting the city of Delhi, were encouraged to use the Delhi Metro Rail, the urban mass rapid transit system which has a station outside the AIIMS entrance.

The food waste, which constitutes a sizable chunk in any conference, was dealt with by involving the services of a professional agency––Innovate Green. The food waste generated during lunch, dinner and tea breaks on all the three days of the conference was segregated effectively at source. This ensured that the recyclable waste was collected separately and processed as per green practices for composting and subsequent use.

The idea was to bring into practice zero-waste initiatives based on the principle of three Rs, namely reduce, reuse and recycle. This marks a shift from the cradle-to-grave approach, which focuses on landfills and incineration, to a cost-effective cradle-to-cradle (or circular economics) approach for managing waste, where the waste from one product serves as an input for another, thereby negating the need for dependence on landfills and incineration as the only strategies for solid waste management.⁸ Zero waste is again a process, a way of thinking that could profoundly change our approach to resources and production. It is not about recycling and diversion from landfills but about restructuring production and distribution systems to prevent waste from being manufactured in the first place.⁹

The Ministry of Environment, Forest and Climate Change of the Government of India has revised the Municipal Solid Waste (Management and Handling) Rules, 2000 to Solid Waste Management Rules, 2016. The Solid Waste Management and Handling Rules, 2016 also prohibit organic and recyclable waste going to a landfill.¹⁰ Disposal of solid waste in a landfill is least desirable due to associated contamination of the soil, ground water and aquifers.¹¹ The preferred method for managing non-hazardous solid waste is to reduce the amount of waste produced. When this is not feasible, waste should be reused, recycled or composted, as applicable. Moreover, organic solid waste releases methane gas as it decomposes and is associated with global warming. The same rules have introduced Extended Producer Responsibility, where packaging companies are expected to develop a reverse logistics system for funnelling plastic waste back to recycling.

The key to greater adoption of an environment-friendly initiative is awareness of what it entails and of the benefits it brings. An environment-friendly initiative is a fiscally appropriate approach that leads to innovation which reduces the environmental impact and meets the social responsibilities each one of us owe towards our organization. While a section of society faces a lack of basic necessities, the high-consuming and unsustainable lifestyles of another section places immense stress on the social environment. Continuing education and training are important factors to successful implementation of good practices.

To conclude, the conference provided a platform for many simple, sustainable initiatives and take-home practices. These initiatives could offer environmental and financial benefits for organizations––benefits that will help hospitals and healthcare systems to thrive now and in the future. It is for hospital leaders to ask their management teams to assess the organization’s current approach to environmental sustainability and formulate an action plan for greater efficiency. The hospital leaders in pursuit of excellence can explore options and understand the steps needed to harness the strategic power of sustainability. What is described through this narrative is a basis for few simple green or sustainable initiatives, which could be adopted in our conferences to not only serve the purpose for that event but also to leave a legacy for meeting the ‘inter-generational equity’ principle.