Copenhagen Regenerative Sustainability Course Reflection

Sustainability is integral to all planning (whether explicitly discussed or not) and crucial to those who have a stake in the future. Sustainability is more than carbon foot reduction; it is fundamentally about the judicious utilization of resources and understanding the consequences. Regenerative sustainability asks, how might we ensure that the future we desire is achievable and durable? Though this question is expansive, as a US MD-MBA candidate, my focus is healthcare.

One of the most interesting concepts of the Copenhagen course was ecosystem services; there are so many hidden roles and resources that the environment provides which are taken for granted. Consider the horseshoe crab, a living fossil with blue blood (from the copper in hemocyanin used to transport oxygen). This creature’s blood is medically pertinent because it contains limulus amebocyte lysate (LAL), which is used to detect microbial endotoxins in vaccines, instruments, and other health applications. There is tremendous global demand for LAL, which underpins the safety of many essential health interventions. We acquire LAL via harvesting horseshoe crabs by the thousands, removing ~30% of an individual’s blood, and returning it to sea where there is a 10-30% chance of immediate mortality. The horseshoe crab is now a threatened species, and it has proven highly difficult to raise in captivity.

Imagine a world in which we could no longer detect microbial contamination. Would you risk surgery on an immunocompromised patient if it was unknown whether the anesthesia and equipment are sterile? Beyond carbon footprint and the waste of our health infrastructure, regenerative sustainability has implications for maintaining our medical advancements.

Making changes toward sustainable practices requires making the right thing the easiest thing. Copenhagen demonstrates this in its transportation mix: the bike paths and and available parking are faster and more convenient than driving cars. Consequently, 65% people ride their bikes to work and school on a daily basis. Relying on individuals to actively make their life harder for a result that is not readily felt is not scalable.

This concept applies to the Kalundborg Symbiosis: companies, through proximity, leverage each others’ waste as resources. Instead of paying for disposal, they can be paid for the heat, steam, and bio-waste they produce. Healthcare has many opportunities for a similar setup. In many places, including Austin, Texas, there are health districts that encourage the development of interrelated companies. Presently, most collaboration occurs with pooled talent and financial resources, but this could be expanded to other resources.

The architecture itself can be more efficient. The newer health district buildings have green roofs with a variety of plants to support local biodiversity. In addition to bringing more green space into urban environments, green roofs facilitate stormwater management via reduced runoff (which has secondary implications to improve water quality with reduced purification requirements), reduce heat generated by buildings, increased roof longevity, mitigate city noise pollution, and--of course--sequester carbon emissions. This substantial benefit employs ecosystem services.

Another architectural innovation is using sensor data to regulate the temperature of spaces. In Texas, if the power grid is overwhelmed, it is almost certainly during the summer resulting from heavy AC use across the city. By tracking people in a building, rooms and sections can be cooled appropriately and avoid wasted power.

An open question is what do hospitals (or other healthcare organizations) generate that can be used by other companies? There are many considerations that challenge reusability of waste, such as biological contamination with blood product. Though it is certainly true hospitals create a lot of plastic waste, most is unsuitable for recycling like sharps which are typically sent to a disposal site and burned. Kalundborg, being a largely industrial site, benefitted from several companies using or generating heat, electricity, and steam. Hospitals and downtown companies tend to be services companies that do not produce large quantities of particular substances but rather a multitude of breakdown products. Determining what synergies exist and developing a feasible configuration will be critical to replicating the success of Kalundborg to healthcare.   

Going forward, as a result of this exposure in Denmark, I intend to make several changes. First, as an individual, I started walking to places more. Pretty much any place that is within a mile, I’ll make the trek on foot. To the mild chagrin of my friends, I’ve been forcing groups to walk longer distances between restaurants and pubs to avoid calling a ride. My go to refrain: “let’s be Danish.”

Taking advantage of ecosystem services can occur as a small level too. One study found that a single tree can clear one third of the micro particles within one hundred meters. NASA found that a single house plant in a room will clear eighty-seven percent of air toxins within 24 hours. This is remarkable. We should have trees and plants all over hospitals for healthier patients and staff. Additionally, a 2010 study found the mere presence of greenery is both psychologically and physiologically calming: people subjectively report feeling less stress while having measurable decreases in cortisol production and blood pressure.

Bottom line: regenerative sustainability means addressing our consumption today in a way that maintains or augments our outcomes.

#StudentVoices @kristjan jespersen @Copenhagen Business School @CBS PRME