Healing collective trauma at the community level, and planetary health are now becoming part of the DNA of the healthcare system, and that gives me an enormous amount of hope.
Thirty-five years ago, I was a writer of guidebooks. I could tell you where to get the best cannoli in New York’s Little Italy, find an undiscovered bistro on the Left Bank, or sign up for the coolest walking tour in Amsterdam. I travelled in India for two years looking for the best Indian sweets and the sacred geography of enlightenment. Then I got a call that changed my life. A close friend asked me to write a guidebook to toxic chemicals and communities impacted by chemical contamination.
I was a guidebook writer, so I said yes.
As I began traveling around America, I met people sitting around kitchen tables, moms and dads, who were asking, “Why does my son wake up coughing? Why does the water taste so bad? Why does my daughter have a rare form of cancer?” They knew they were living down the street from a toxic dump, or incinerator, or chemical plant, or factory that was contributing to their child’s illness. They had no money, no technical expertise and little political power, but they were brave and tenacious because they were fighting to protect their family’s health.
In December of 1984, a Union Carbide pesticide factory in Bhopal, India blew up and killed thousands of people in one night. That chemical disaster was a threshold event for me. It was the Hiroshima of the chemical industry, causing both immediate deaths and long-term impacts that have led to decades of trauma in that community.
While the Bhopal disaster was called an “accident,” there’s nothing accidental about the system that created it. It begins by externalizing the harm to the community and internalizing the profit. That means environmental harm, social harm, or human rights abuse don’t show up on the balance sheet. It’s not even a cost of doing business. And it makes people expendable.
As a Jew growing up in the post Holocaust generation, learning what can happen when people are made expendable by either governments or corporations operating outside any moral parameters deeply impacted me. The imperative to “never forget” and the refrain “never again” were central to the social justice values that I grew up with.
As I became immersed in the environmental health and justice movement, I asked myself: what institution in society is powerful enough to bring a more evolved ethic into this collective trauma? Over time, I realized the answer: the healthcare industry. It is the one sector of our society that has a healing mission. It has an ethical framework. Its practitioners follow the Hippocratic Oath: first, do no harm.
But the sector also replicates all the contradictions of an economy built on fossil fuels, toxic chemicals, and industrial agriculture. It’s a major polluter, poisoning the environment and communities and contributing to the very diseases that its facilities are set up to treat.
Four decades ago, medical waste incinerators were the largest source of dioxin emissions in the United States and a significant source of mercury pollution. Healthcare is also a major user of fossil fuels and a significant contributor to the climate crisis.
So, in 1996 my colleagues and I founded Health Care Without Harm to heal the healthcare sector. We brought environmental health issues to their doorstep and made them impossible to ignore. Our premise was simple: you can’t have healthy people on a sick planet. To have healthy people, healthcare has to clean up its act, heal its facilities, heal its supply chain, and by extension, heal the economy.
What does ‘first, do no harm’ mean in a world where kids are being born with toxic chemicals in their bodies? What does ‘first do no harm’ mean where a food system is actually manufacturing disease as opposed to providing healthy food? What does the Hippocratic Oath mean in a world where climate disruption produces millions of refugees every year?
What if the health sector supported green chemistry instead of the toxic plastics that are in all of these hospitals? What if it ran on renewable energy and solarized its clinics all over the globe? Can we build cancer centers without carcinogens? Can we build children’s hospitals without chemicals linked to birth defects? How can we help people have more healthy housing and healthier food so we can prevent diseases from emerging in the first place? How can we start to use our power, our political power, our purchasing power, our investments, our messaging to create healthier communities and a sustainable planet?
We have begun working with the healthcare sector to position it as the centerpiece of a much broader healing, so it can go beyond treating individual sick people to healing communities and healing the planet. Healthcare can be that lever. It’s 18 percent of the US economy and represents 10 percent of the global economy.
Over the last year, we have seen how the healthcare sector sits at the epicenter of collective trauma, taking care of people infected with the coronavirus and risking their lives to save others. We have also seen that the virus has exposed the incredible racial and health inequities in our society, so that Black people are dying at twice the rate of white people. People who live in communities with polluted air are more likely to have a serious COVID reaction because their respiratory systems are already compromised.
In this moment of collective trauma, in this moment of global ecological crisis, I see positive change accelerating at the same time. When we started Healthcare Without Harm there were almost 4,500 medical waste incinerators in the United States. A decade later, there were less than a hundred. When we started HCWH, mercury thermometers were the gold standard in the healthcare sector. Now they are being phased out all over the world.
Hospitals are realizing they also need to address the racial inequities in their communities by providing more jobs to people of color, providing more contracts to BIPOC companies, and investing in parts of their communities that have suffered from decades of disinvestment. It’s part of their role as anchor community institutions because in many cities the life expectancy gap between white neighborhoods and BIPOC neighborhoods is 15 to 25 years.
I am now seeing health professionals utilize their power as trusted messengers to become advocates for climate solutions in the policy realm. I see hundreds of hospitals changing their purchasing practices to buy renewable energy or purchase sustainably grown food to feed their patients and help heal the food system. I feel like we’re on the right track.
That’s the power of collective healing that needs to happen. Our mission of healing collective trauma at the community and planetary health is now becoming part of the DNA of the healthcare system, and that gives me an enormous amount of hope.
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