Health Calls

Environmental Considerations for Global Health

Episode Summary

As health care systems look to develop healthy partnerships across the globe, environmental impacts must become a factor to consider. How do we partner with organizations in a way that isn’t harmful to communities already experiencing the effects of climate change?

Episode Notes

As health care systems look to develop healthy partnerships across the globe, environmental impacts must become a factor to consider. How do we partner with organizations in a way that isn’t harmful to communities already experiencing the effects of climate change?

Erica Smith, Executive Director of Hospital Sisters Mission Outreach, and Bruce Compton, Sr. Director of Global Health and International Outreach at CHA, join Health Calls to discuss their recent international visits, developing partnerships that focus on lessening environmental impacts and how to effectively and safely donate material goods.


Visit Hospital Sisters Mission Outreach website

Check out CHA’s Medical Surplus Recovery resources

Episode Transcription

Brian Reardon (00:00):

Hey, Bruce.

Bruce Compton (00:01):

Hey Brian. How are you?

Brian Reardon (00:01):

Doing well. So have you been to any interesting places as of late?

Bruce Compton (00:06):

Yeah, this summer I was at the World Health Assembly in Geneva, Switzerland, and last week I was at the UN General Assembly in New York. In both cases working on collaborations, this most recent one around the workforce, the global health workforce, and the challenges with international recruitment and potential for capacity building.

Brian Reardon (00:28):

And was there any discussion, I'm guessing there was, about the environment?

Bruce Compton (00:32):

Absolutely. There was much activity around General Assembly last week and sustainability, and it's a very important topic for global health.

Brian Reardon (00:43):

Well, and that's what we want to talk about in this episode. This is a second episode that we're taping during Season of Creation again, which began in September and goes through the Feast of St. Francis. And our focus really is on environmental sustainability and stewardship, particularly in Catholic health care. And Bruce, who I'm going to introduce in a moment, very involved in global health from a Catholic health care perspective. And so Bruce, if you're ready, let's get the conversation going.

Bruce Compton (01:09):

I'm ready.

Brian Reardon (01:15):

This is Health Calls, the podcast of the Catholic Health Association of the United States. I'm your host, Brian Reardon, and as mentioned this episode, we're going to look at environmental impacts and considerations for global health. And I have two guests today. Joining me is my colleague Bruce Compton. He serves as senior director for Global Health and International Outreach for CHA. Bruce, great to have you back on the show. I know we've talked a number of times, and again, our focus this time is going to be a little bit more specific around environmental impact. And we're going to be joined in a few minutes by Erica Smith. She's Executive director of Hospital Sisters Mission Outreach in Springfield, Illinois. And Erica's going to provide some more details and perspective on how we are very good environmental stewards when we were doing various global health outreach and initiatives. So we'll talk to Erica in a minute, but Bruce, let me start with you. As we look to develop various partnerships around the globe, again, the work you do for CHA and our members really is about that increase to access to health care around the globe. And one of the realities we're facing, I think let's just set the context, is the effects of climate change. Can you give us some practical examples about how the changing environment is impacting people around the globe?

Bruce Compton (02:35):

Yeah, Brian, thanks for this opportunity and for highlighting an issue that's really important and that we can impact through our global health initiatives. To your question, I think climate change affects the social and environmental determinants of health, the clean air, safe drinking water, sufficient food and secure shelter, all of those, of course have health impacts if people don't have access to those things between 2030 and 2050. The WHO estimates that climate change will cause approximately 250,000 additional deaths per year because of malnutrition, malaria, diarrhea, and heat stress. So it's very important topic, and I think what they're doing at Hospital Sisters and Erica is doing truly important in helping Catholic health care be as good as they can when they're donating in-kind donations.

Brian Reardon (03:41):

And so last year, CHA released a video, I think it was called Cash is Best. And the idea really was about when we're working to support partners around the globe, particularly in response to disasters, monsoons, droughts, war, you name it, it just seems like in any given day there's a need out there. The principle that yeah, we want to donate surplus medical supplies and equipment, but sometimes it's not always the best way to do it. And so can you explain what environmental impacts or considerations some of these donations that are well-intended might have particularly in recipient countries?

Bruce Compton (04:22):

Yeah, Brian, we did have that Cash Is Best, it was released around the time of a humanitarian crisis, the war in Ukraine, because those are especially instances where there's often issues with the donations because people do it out of emotion. Cash is best for most people and however that cash needs to go to agencies and one of those agencies that is doing work and is hospital sisters health system. But again, to your question, when I was Haiti in Haiti, my personal experience unloading containers that were shipped overseas, overseas on ships and then a high percentage of the stuff that was shipped was unusable. And then I watched the sisters really agonize over what they were going to do with that stuff and how they might use it so that it didn't go to waste even though it wasn't going to be used for what it was meant for.


But even then there was a lot of waste. And while I was there, I saw medical waste coming up on the beach. I saw X-ray machines in public areas where people could play with them because they weren't appropriate or uninstalled because they didn't have all the parts and those have radioactive material. So there was that. And those are huge environmental crisis that we would not stand for in our own health system here in the US when it comes to Ukraine. I heard firsthand from our Catholic partners as part of Catholic response for Ukraine, which was organized at the behest of the Dicastery for Integral Human Development, that unsolicited and unnecessary items took up valuable space and time that kept those agencies that we support from providing the appropriate donations.

Brian Reardon (06:26):

And I think that's a great opportunity now to bring in Erica. Erica Smith is executive director again of Hospital Sisters Mission Outreach. I've known Erica for 15 years. We actually used to work together at HSHS. And so Erica, it's great to have you on the show. How are you doing?

Erica Smith (06:41):

Great. It's good to talk to you, Brian.

Brian Reardon (06:43):

So Erica, you heard Bruce kind of explain some of the challenges here for people who are not familiar with mission outreach. Tell us a little bit about that and then maybe share a little bit about the processes and procedures related to addressing some of these environmental considerations. When folks, again have good intentions, want to help out, what should they be aware of? So I guess first just tell us a little bit about Mission Outreach.

Erica Smith (07:10):

Sure! Mission Outreach was founded in 2002 by the Hospital Sisters of St. Francis. And we are a medical supply and equipment recovery organization. So we collect surplus but usable supplies and equipment from 81 hospitals and clinics around the Midwest. We bring them back to our warehouses in Springfield, Illinois. We sort inventory, test and package the supplies and equipment and make them available for distribution to hospitals and clinics and low resource areas around the world. And over the last 20 years, we've worked in 97 different countries and we've done about 700 more than 740 foot container shipments. So we do have a longstanding tradition here. We have a lot of experience, but we also know there's always ways that we can grow and improve. And

Brian Reardon (08:05):

I think the thing that Mission Outreach does so well is really set up a process. So again, I'm just going to use an example of a St. John's Hospital in Springfield, Illinois, a member of HSHS. They have surplus medical supplies, let's say. They might typically just get rid of it, throw it in a landfill or that where it would end up throw it away. And understanding what's usable and what is not, I think is kind of a key point of mission outreach and really having a process to make sure that stuff that is good that hasn't expired and that could be used overseas is basically curated and then set up. So can you tell us a little bit about that process and why it's so important for folks that want to, again, do good and not throw something away that could be usable?

Erica Smith (08:54):

Sure. So we work very, very closely and extensively with both our material donors and also our international partners who are going to be receiving the items. And there's a lot, as you said, that goes on in those processes to ensure environmental responsibility and sustainability. When it comes to working with our hospitals and clinics that are donating, we try to help them understand best practices around the donation process and why. So for example, there's an idea that, oh, anything is better than nothing When you're sending donations, it's absolutely not true. Sending anything is really helpful to anybody. So the first thing that we have to figure out is what do our international partners want and need and what can they not only use but safely dispose of? So that's the first part. I think the second part is understanding that we cannot send things that are expired.


We cannot send certain chemicals. Bruce had mentioned there are the machinery that has radioactive materials or requires chemicals. We have to be very careful about that. So we work with our donors to help them donate things to get rid of their surplus, which can be a cost to them, but also ensure that we have what we need to send that's sustainable for our international partners as well. When we start looking at a potential recipient or international partner, we ask them a lot of questions. So mission outreach, first of all, never just sends stuff. We have a pretty complicated ordering process. It's a lot like Amazon you order from us, we ensure that what you order is exactly what you get. So we don't just send a box of respiratory, you order in quantities and in very specific items. So that's very important. But also we have a biomedical engineer on staff and a very experienced operations manager who specializes in recipient services, who works extensively to understand the needs, the capabilities, the staffing, and also the disposal methods available in that particular community.


So we look at all of that. The thing to answer this part of the question that I'll say is mission outreach, and I think rightly so, has touted in the last 20 years, we've saved 10 million pounds out of the landfill of things that are perfectly usable. And that's a great thing, but for me that's an incomplete statement because when we send things, they don't just disappear. They're still items that are going to have to be disposed of. So just getting things out of our landfill is not good enough. We have to really think about the sustainability and the safety of how those things are going to be disposed of after they are used wherever we send them in the world. So we really work hard. I would say access to health care and health outcomes for individuals and communities is number one for us, but a very, very close second, if not almost another number one is ensuring environmental sustainability and safety of what we do too.

Brian Reardon (12:20):

So when you talk to a recipient clinic, do you have guidelines or so they get a shipment that comes over, they have things they're going to need to be disposed of after they're used. How do you work with them to make sure that those items are disposed of properly?

Erica Smith (12:36):

We do that before we even will send the shipment. So the application process involves an application, but also an interview with them and they have to be able to demonstrate that they have that capability before we will send it after something is sent. Most of the time it's too late. I think overall medical MSOs and medical supply recovery organizations need to do a much better job of following through with shipments, but a lot of times that's very difficult. So it's important that we do that before we send things because if you wait until after you've sent it, it's too late to ask those questions most of the time. And

Brian Reardon (13:17):

The other thing that I've always just been fascinated when I visited the warehouse in Springfield is how precise your team is in loading shipping containers. So you think of the cost involved of sending a large shipping container to Africa, for example. Tell us a little bit, share with our listeners how really detailed you guys aren't packing those containers. I mean, I don't think there's a square inch of space that goes to waste.

Erica Smith (13:47):

No, there's definitely not. So it's a process that takes months oftentimes when you're talking about one of those 40 foot containers. So we have a packing list of items, and we just sent a container to Bolivia a couple months ago that had about 2,500 items on that container. And it's a 40 foot container that's eight feet tall, so it's quite a bit of space. So every single item that is on that packing list is in that container. And it has to be, that has to match perfectly. You don't put extra stuff in and you don't have things that aren't on the list. And the reason that we do that is actually to help our international partners get everything through their customs and avoid fees and delays on their end, but also because all of that stuff has been carefully ordered and it's what they need.


Again, reducing that risk of sending things that they don't need that they're going to have to try to figure out, we don't know what to do with this. And for some of our partners, that container that they get this year might be the only source of medical supplies or equipment that they have until they get another container. I think that's another topic. If we're talking about sustainability overall, we need to address and capacity building, but the reality is that that is the truth for some of our partners right now. So we really want to make sure that you can't even get a piece of paper in there because it's really important that we use that space, those resources if we're going to ship things that we really maximize that shipment.

Brian Reardon (15:23):

And for this last part, I want to bring Bruce in and have you both respond to this, and that's getting back to again, a health care provider in the us. I think Erica, you mentioned there's 80 different organizations you've worked with, but if you haven't worked with an organization, an MSO, like Mission Outreach, what are some of the tips you would provide in getting started and understanding, kind of evaluating what's worthwhile to collect and donate what's not worth the effort? Can you just give a very overview of, I guess tips for those that might be interested in making donations for either supplies or equipment that could be sent overseas?

Erica Smith (16:01):

Well, Mission Outreach actually has created tools for our hospital and health system partners. We have a guidebook on donations that is in print or we can email it that we can send our procurement team, which does include our biomedical engineer is glad to meet with supply chain leaders or administrators to answer any questions. We also have a really, it's a cool just one pager. It's called our Disposition matrix tool. And it's a snapshot with four quadrants that will tell a potential donor what equipment to sell, what equipment to donate and what equipment just to dispose of based on both resale value for the health system, which we're very aware that this is a financial issue and we're respectful of that. But also there are things that if a health system is reselling, they're not going to get much for but are incredibly valuable to our international partners and make a huge difference in access to care and clinical health outcomes. So we have those tools available that we're happy to share with anybody.

Bruce Compton (17:08):

And Brian, CHA has also done some research on this and we have a site on our global health focus area at titled Medical Surplus Recovery, where you can see that original survey of members and what they were doing. You can see a book that says Assessing and selecting high-quality SROs, which we will be revisiting in the near future as we begin a community of practice for in-kind donations at CHA that I'm working with Erica and a consultant and Susan Huber from Ascension on getting off the ground. So there's lots of resources on CHA's website working with an organization like HSHS that does this on a daily basis and really understands the ins and outs of that donation process, the incoming and the outflowing, and has the capability to assess the capabilities of those whom they're sending so important and so often overlooked as we take this on from an empathetic view of people having nothing. Eric said earlier that something isn't always better than nothing, and that's absolutely true in this situation. So those resources that Erica spoke of and ours and this impending community of practice, which will be starting later this year, early next year, are really important for our members and others to join and to look at and learn about.

Brian Reardon (18:48):

Yeah, and we'll have links to both Mission Outreach and CHA resources on the podcast page below where you can access this episode. So we'll look for that. But Erica, before I let you go, you're also going to join CHA for a webinar coming up. Preview that for us, would you?

Erica Smith (19:05):

So I will be visiting Ukraine from October 14th through the 29th. We did a shipment to Ukraine in partnership with the International Catholic Migration Commission, CHA, and also the Knights of Columbus. And so I will be in Ukraine to follow that shipment and really learn about how those items are being used and how we can further support our Ukrainian partners now and God willing soon with recovery and rebuild. But on October 26th, there's going to be a webinar live from Ukraine and I will be a speaker Monsignor Robert Villo, who's the Secretary General of the International Catholic Migration Commission, will be a speaker. Bruce on here is a moderator and Christian Costco from Catholic Response for Ukraine. And we're going to be talking about the effects of donation and what it looks like specifically in Ukraine and also that larger issue of donations during times of crisis and how to do that responsibly.

Brian Reardon (20:10):

Great. Well we look forward to that. Erica Smith, she is the Executive Director for Hospital Sisters Mission Outreach. Erica, always great to talk with you. Blessings on your trip. Safe travels to Ukraine. We'll look to see you on that webinar on the 26th of October. Bruce Compton, again, he's our Senior Director of Global Health and International Outreach for CHA. As always, a pleasure to have you as a guest on Health Calls. Take care of both of you and thanks for being with us.

Erica Smith (20:35):

Thanks, Brian.

Bruce Compton (20:36):

Thank you, Brian.

Brian Reardon (20:38):

And this has been another episode of Health Calls, the podcast of the Catholic Health Association of the United States. I'm your host, Brian Reardon. Our producer is Josh Matejka. Our engineer is Brian Hartmann here at Clayton Studios, just outside St. Louis. Always appreciate their hospitality Here at Clayton Studios. You can download and listen to podcasts, of course, at the website or on your favorite podcast apps. Thanks for listening.