January 21, 2024 at 11:41 am Update: 8 minutes ago
Every year in the Netherlands the healthcare system produces millions of tons of CO2 emissions and hundreds of millions of kilos of waste. This can and should be done differently, says surgeon Schelto Kruijff: “As a lung doctor you cannot tell yourself not to smoke, but at the same time dump all kinds of chemo into the wastewater.”
Kruijff gave his inaugural lecture last Friday as professor of surgical oncology at the University of Groningen. His research focuses on sustainability in the operating room, where he also works regularly.
In 2022 Kruijff received the first innovation prize from UMC Groningen, for the plan to reduce the use of so-called cellulose mats. The hospital purchases 325,000 a year. “It’s kind of like a plague, they’re literally meant to keep your feet warm when they’re actually meant for childbirth.”
When you enter the operating room, what kind of sustainability issues do you encounter?
“Where do I start? You enter an operating room where the air intake was left open all night, while there was no operation. This is one of the most energy-consuming machines in the hospital. It was hot the whole time at night, so someone arriving injured doesn’t calm down. While this only happens very occasionally.”
“The patient is then anesthetized with gases that are much more polluting than CO2. During the operation, all types of nets containing sterilized instruments are used. They are opened completely, but sometimes only 10 percent is used and then everything is washed thoroughly. new. From the dogma: ‘The surgeon must have everything, if necessary.'”
“Then there’s all kinds of technology and equipment that ultimately gets unpacked and thrown away unused. The patient is covered with 10,000 cloths, whereas this could be done with as little as 20 or 30 percent of that. We wear gowns, hats and disposable gloves face masks, which have never been shown to contribute in any way to the outcome of the operation… I could go on.”
So why is all this happening? Is it purely out of habit?
“There’s a lot of culture and drama. The disposable trade and industry have come in the door and created a problem that doesn’t really exist. They’ve sold a lot of disposable waste and we’re completely done with it.” lovers.” .”
“If you were to stop this, which you have to, then you would hit the next obstacle. It’s the regulations. They date back to the last century, when there was a lot of fear.”
“For example, we have those blue barrels that have needles and things with blood in them. They go in a special truck, about one barrel at a time, to a special place to be burned. And then they get buried somewhere in Zeeland. That’s extremely polluting , but it is done out of fear of contagion. Even if the danger is not great, in reality something like this has never happened.”
They sold a lot of disposable waste and we are completely sick of it.
Schelto Kruijff, surgeon
In your inaugural lecture you refer to the video of the artist Maria Koijck, who, after a mastectomy, surrounded herself with all the disposable objects used during the operation. So most of this was unnecessary?
“No, there are blue gloves there, which are necessary if, for example, there is a risk of transmitting bacteria. When there is an open wound, or something like that. But not if you simply have to lift or examine a patient. You can do this without wearing gloves and then wash your hands.”
“But after the coronavirus, the use of those gloves increased even more. Those kinds of habits are incredibly contagious. If you don’t do it, everyone looks at you like, ‘What an irresponsible person you are.'”
How can you change something like that? I can imagine that you will soon encounter concerns about patient safety.
“In the healthcare sector, apparently, if you want to use more things, everyone is fine with it and you don’t have to prove anything. But if you want less, then everyone starts to react. It’s strange, because there are also costs there and not They’re that bad.”
“We could be trailblazers. As doctors we have the image of a saint, with our white coats. We tell people what not to do. You can’t do this all day and in the meantime make a mess of your own.”
“I try to convince them with this combination. As a pulmonary doctor you can’t go out on the street and tell them not to smoke, but at the same time dump all kinds of chemo into the wastewater. I don’t think it’s a great match.”
According to her, the lack of sustainability of healthcare even conflicts with the Hippocratic Oath, the promise of doctors to act ethically. Because it pollutes the earth and causes climate change, making people unhealthier again. But doesn’t that oath also mean doing everything possible to help the patient?
“There is obviously something romantic in this attitude that everything is justified for the patient. But we all know that is not realistic. We have to think about tomorrow too. It is also my responsibility that the hospital is still open tomorrow.”
“Ultimately, the most important thing in healthcare is support. I just had Lyme, a bad disease, for two years. The fact that the doctor had pills that worked well was obviously very nice. But the fact that I could go there, if occasionally I couldn’t make it. what I wanted, that inspiration and that support, for someone to show me the way… That’s the power of medicine.”
“One day we will all meet our end. Of course we have all developed excellent treatments to postpone this, but we can do it in a much more conscious and sustainable way.”
The fact is that we cannot act like polluters by selling health.
Schelto Kruijff, surgeon
She argues that innovation can lead us towards a much more sustainable healthcare system. But hasn’t this innovation led us in recent years to deal much more at higher costs, simply because it is possible?
“Innovation is not something that falls from the tree. You have to do it with a vision. If you innovate for the sake of innovating, you actually create garbage. We see this with the surgical robot. Very nice, but does it offer more health? Twenty years later the answer is no.”
“When you use something like that, you think, ‘Wow, that’s cool.’ But if it becomes clear that it’s not of much benefit to the patient, then there needs to be a system to put the brakes on it.”
Is it possible to bring sustainability awareness into hospital life?
“It’s a process, but I notice it is decreasing. The fact is simply that we cannot act as polluters while selling health.”
“Many doctors think that sustainability in healthcare means: turning all the buttons back, nothing is allowed anymore. I actually try to remove that fear, because it’s actually a lot of fun to do. Innovation and sustainability go well together, in fact: they don’t they can live without each other.”
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2024-01-21 10:41:09
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