Location: Talca, Chile.
Summary: The Communal Department of Health is an outsourced service dedicated to managing the public health centers of Talca’s municipality. In 2011, the health system embarked on a plan to improve its environmental performance in several areas, such as waste management and mercury-containing medical devices, among others.
This case study was first published in the Hospitales que curan el planeta report, produced by Health Care Without Harm Latin America.
The Communal Department of Health is an outsourced service dedicated to managing the public health centers of Talca’s municipality. The commune has eight Family Health Centers (CESFAMs, in its Spanish acronym), three Family Health Community Centers (CECOSFs), one Rural Health Post, two High-Resolution Emergency Services (SARs), four Primary Healthcare Emergency Services (SAPUs), and three dental units. These centers provide health care to approximately 90% of Talca’s population.
In 2011, the health system embarked on a plan to improve its environmental performance in several areas, such as waste management and mercury-containing medical devices, among others.
In 2017, the Environmental Health Unit was created, and all health centers decided to join the Global Green and Healthy Hospitals Network.
In 2018, the Department of Health started participating in the Sustainable Procurement project1, with the mayor of Talca’s municipality, Mr. Juan Carlos Díaz Avendaño, formalizing his commitment by signing the Memorandum of Understanding.
As a member of the GGHH, the health system has been working hard to include environmental criteria into the department’s products and materials procurement processes as part of its 2017-2020 Environmental Healthcare Agenda.
In 2020, as a result of its participation in the procurement project, a major environmental milestone was achieved: the Sustainable Public Procurement Guidelines of Talca’s Communal Department of Health were approved by Municipal Decree #2847. These guidelines, «regulating the sustainable procurement process within the municipal Department of Health», came into force in December that same year.
Meanwhile, in September 2020, all health centers’ environmental committees on sustainable procurement were trained, as well as all teams in the different sub-units: financial management, clinical management, staff management, logistics management, etc.
Guidelines highlights include:
«Every purchase of goods and services by the Communal Department of Health shall include sustainability considerations and criteria as defined in these Guidelines, which all parties involved in the procurement process shall comply with.»
«This type of purchase shall not be understood as an end in itself, but as a means to achieve not only the country’s goals as stated in its Sustainable Development Policies, but also the SDGs and NDCs, reducing the carbon footprint and greenhouse gases emissions, and joining the adaptation efforts to fight the climate crisis and the mitigation efforts to reduce its effects on our communal territory.»
«Traceability of service acquisition or contracting shall be therefore considered, internalizing the costs of operation, maintenance, repairing, and waste streams management, such as waste, climate emissions and liquid waste discharges into the sewage system, where applicable, including treatment and final disposal; and the negative externalities, as well as costs avoided due to the mitigated impact on the environmental and public health of the commune.»
The specifications stated in the Decree include energy-efficiency criteria, restrictions on the use of harmful chemicals, and social inclusion aspects, including the following:
- Recruitment of differently-abled persons, and other high social impact actions relative to persons deprived of their liberty, young people, women heads of households, socially vulnerable people, etc.
- Local production.
- Environmental labels: Empresa Mujer label, PROPYME, Cooperativa label.
- Clinical supplies: free from mercury, polyvinyl chloride (PVC), bisfenol A (BPA), latex, and triclosan.
- Cleaning and disinfection supplies: free from chlorine and heavy metals, aerosol containers, recyclable packaging, etc.
- Paper supplies: free from chlorine, at least 50% recycled-material content, FSC or PEFC label (from sustainable forest management).
- Electric and electronic equipments and luminaires: mercury-free, Energy Star label or equivalent, at least A+ energy-efficiency, LED technology.
- Catering service: 0% disposable table linen, foodware and cutlery; reusable drinking containers (tea, coffee, sugar, etc.); coffee and sugar bulk packaging (instead of individual); tea bags in paper packaging (instead of plastic); better contracting conditions and salaries; recruitment of differently-abled persons, and others.
«For Talca’s Communal Department of Health, being part of the Global Green and Healthy Hospitals Network, under the leadership of Health Care Without Harm, and specifically, having the opportunity to participate in the Sustainable Procurement project has provided us with invaluable support to monitor the environmental health as a means to improve our performance in the different areas of everyday activities in each of our health centers. Also, we see how our communities have involved themselves in a transformation that goes beyond healthcare: we are leading and witnessing a profound change in the collective socio-environmental awareness, in hope of quality, systemic and resilient health for our users, getting to know us again, learning, appreciating and respecting all forms of life with whom we share our common house, in harmony as the wholeness we are and will be.»
Marcela Zuñiga, head of Environmental Health, Talca’s Communal Department of Health
1. More information at: https://lac.saludsindanio.org/compras-sostenibles-en-salud-proyecto-shipp