The Healthcare Paradox

The Healthcare Paradox

Over de thesis van Justine Hanssens


Waste management in Flemish hospitals: a case study. (2021)

Promotor(en) Katrien Verleye, Faculteit Economie en Bedrijfskunde
Redactie Justine Hanssens, Febe Visart

Healthcare waste contributes to the global climate footprint with 3%, which implies that the healthcare sector would – if it were a country - be the fifth-largest emitter on the planet. Therefore, the main goal of hospitals, to provide health services, is overshadowed by the negative implications for the environment. Subsequently, human health is infected by these massive amounts of medical waste. Which role does Flanders play in this worldwide problem? And even more importantly, what can we do about it?

The main goal of hospitals is to provide health services, but unfortunately these services have negative implications for the environment. Subsequently, human health is overshadowed by the massive amounts of waste that come along with offering healthcare services.

To give an example of the scope of the problem: one routine operation often produces more waste than a family of four people produces in an entire week. As a matter of fact, 10 to 25 percent of that waste is considered hazardous and may impose a variety of environmental and health risks.

In addition to the negative implications for the environment and human health, healthcare waste also has financial implications for healthcare organizations. If financial resources are insufficiently allocated to managing healthcare waste in the short term, there will be an even greater financial loss in the medium and long term along with higher morbidity, mortality and environmental damage.

In other words, human health will in the future be threatened by the way in which hospitals manage the waste that stems from delivering health services.

Rise of medical waste

Medical waste production increases steadily worldwide. There are four reasons for this. The first one is the income level of a country. The WHO states that high-income countries generate on average up to 0.5 kg of hazardous waste per hospital bed per day while low-income countries generate on average 0.2 kg.

This however, does not mean that the problem is only situated in the high-income countries. Partly, wealth can indeed be an indicator of the growth in medical waste since in wealthy nations, the population is rapidly aging, which imposes an increasing system usage. On the other hand however, middle- and low-income countries are also contributing to this increase due to the improved access to healthcare services.

Second, the more a country spends on healthcare, the more the waste arising from it increases. Third, life expectancy and CO2 emissions both positively affect the healthcare waste generation rates. Thus, the higher the life expectancy or the C02 emission of a country is, the higher the healthcare waste generation rate will be.

A last important contributor to the increase in medical waste production is the worldwide acceptance of single-use disposal equipment in healthcare.

The case of Flanders

When we zoom in on Flanders and its medical waste management, research is very scarce. Therefore, Justine Hanssens’ master dissertation provides insight in the current and future waste management practices in the Flemish hospital sector.

She identified several issues and classified them in six different categories: people related issues, operational issues, supplier issues, financial issues, governance policy issues and regulatory issues.

Consequently, she made six categories of solutions: awareness & engagement, training & education, rethink operations, diversified investment, audits and centralizing hospitals. She concluded that all issues, with the exception of the COVID-19 related ones and the supplier one, can be resolved or at least minimized by correctly introducing the identified solutions in the Flemish hospital sector.

It’s important to know that the given solutions are clearly an ‘and-and’ story. Introducing all solutions, across all policy levels, in the Flemish hospital sector, is key. In other words, what we need is a systematic approach. The government, personnel of the Flemish hospitals and the suppliers will all have to share their experiences and knowledge and combine their forces. Only then, this circular transition can lead to an overarching, safe and sustainable waste management in the Flemish hospital sector.

Impossible? Maybe not. Hanssens’ master dissertation starts with the following citation:

“The trick is to raise the standard of living around the world without increasing our impact on that world. That may sound impossible, but there are ways in which we can do this.” (David Attenborough, 2020)

And so she hopes, that by giving the reader some insights, we can, all together, raise the standard of living, without increasing our impact.

Want to know more about this research? Contact Justine Hanssens at

Over Justine Hanssens

Justine Hanssens is a freshly graduated Business Engineer. In August 2021, she started working at element61 as a Business Analytics Architect.
I hope that I am able to provide the reader of my master dissertation with some ways in which we, all together, can raise the standard of living, without increasing our impact.