Eye care and the carbon foot print

Sir,

I applaud the authors for summarizing their initiatives in this elegantly written manuscript on “Eyecare and the Carbon Footprint.”^[1] The health-care sector is just waking up and realizing its contribution towards climate change. At present, healthcare is the second-largest greenhouse gas emitter (GHGE) after the food industry, contributing to almost 4–6% of carbon emissions globally.^[2] We are aware of the detrimental effects of climate change and public health and ironically, we are responsible for this decline as well.

As ophthalmologists, it is time to recognize our role in GHGE, since we have the highest surgical volumes and turnover compared to any other specialty. The 5 Rs of sustainability may be applicable in this scenario: Reduce, Recycle, Reuse, Rethink, and Research. We should consider a reduction in energy consumption, water wastage, paper, and one-time use disposables. Recycling of plastic, paper, and wastewater is important. We could reuse several materials in the operating room and other areas. Our efforts should also concentrate on research toward novel ways of reducing the carbon footprint and rethinking various strategies which we currently employ in our day to day activities in efforts to reduce wastage.

At the LVPEI, we commenced our journey toward a net zero eye care service in 2017 with the installation of our first rooftop solar energy system but greater momentum was gained in 2021 with the establishment of the “Green LVPEI” initiative. Since then we have adopted a multi-pronged approach with the installation of over 1100 kw of solar energy across 23 sites in our network and the aim of providing 50% of our energy supply through green energy, the establishment of rainwater harvesting systems, recycling of sewage water for use in the gardens, conservation of energy by switching to 5 star rated products wherever possible and replacing CFL with LEDs, conservation of water by repairing leaky taps and installation of aerators and auto push taps, the introduction of electronic medical records to reduce paper waste, waste management by recycling at source and compost pit creation and construction of green buildings as per the Indian Green Building Code. The pandemic was “beneficial” in reducing GHGE by forcing us to set up a robust tele ophthalmology platform (Connect Care) which markedly reduced patient footfalls to the Institute during the lockdown while enabling continuity of care and a drastic drop in air travel. However, increasing awareness among our staff, patients, and other stakeholders is paramount to create a ripple effect on this long journey toward a sustainable environment for future generations.

We have a long way to go as the above measures would help in the reduction of emissions directly from our health-care facilities which contribute to 17% while indirect emissions from the electricity we purchase and air conditioning systems would contribute 12%.^[1] However, 71% of the emissions are from the supply chain, that is, the production, transport, storage, and utilization of various materials, agricultural sector, transport, and pharmaceutical industry and hence this is an area which we all have to pay much greater attention.

Eye care organizations, therefore, have the great responsibility of influencing their peers, other health-care organizations, and the government to transform society into a cleaner greener one.