Hospitals are making the planet sick, but one is showing a way out
An aerial view of the rooftop solar installation at Aga Khan Hospital Kisumu on November 2, 2026, overlooking Lake Victoria and surrounding buildings. The facility is embracing clean energy as part of its commitment to cutting carbon emissions and achieving sustainable healthcare.
What you need to know:
- From the towering smokestacks of medical waste incinerators to the invisible gases vented from operating rooms, the very institutions dedicated to healing are contributing to a global environmental crisis.
- The healthcare sector is responsible for roughly five per cent of global greenhouse gas emissions.
- If the global healthcare industry were a country, it would rank among the top 10 climate polluters on the planet.
A modern hospital is defined by the steady hum of life-support machines, the sterile gleam of stainless steel and the rhythmic hiss of ventilators. Within these walls, everything is meticulously engineered to save human lives. Yet just outside, a devastatingly different story unfolds.
From the towering smokestacks of medical waste incinerators to the invisible gases vented from operating rooms, the very institutions dedicated to healing are contributing to a global environmental crisis. The healthcare sector is responsible for roughly five per cent of global greenhouse gas emissions. If the global healthcare industry were a country, it would rank among the top 10 climate polluters on the planet.
This harsh reality exposes a profound paradox: in treating the sick, modern medicine is inadvertently making the planet, and, by extension, humanity more vulnerable.
The footprint begins long before a product reaches a patient's bedside. Hospitals strain the environment through a hyper-industrialised supply chain in which every single-use plastic syringe, wrapped surgical tray and dose of medication carries a hidden ecological cost. The extraction of raw materials, intensive plastic packaging and global shipping create a vast web of carbon emissions.
Then there is the hidden danger inside the operating room. During routine surgeries, patients inhale volatile anaesthetics such as desflurane and isoflurane to remain unconscious. When they exhale, these gases are rarely captured; instead, they are vented straight into the atmosphere. Pound for pound, these halogenated gases and nitrous oxide trap heat at rates thousands of times higher than carbon dioxide.
The damage extends beyond the atmosphere. Hospitals are massive engines of physical waste and chemical pollution. Every day they generate mountains of hazardous debris such as discarded personal protective equipment, plastic packaging and contaminated surgical tools. While a fraction is classified as infectious, the vast majority ends up in landfills or incinerators.
When medical waste is burned, medicine trades one hazard for another. Incineration releases a toxic cocktail of carbon monoxide, heavy metals such as mercury, lead and cadmium, and highly carcinogenic dioxins into surrounding communities. The crisis also flows into water systems, as active pharmaceutical ingredients bypass standard filtration, altering aquatic life and accelerating antibiotic resistance.
The medical community is beginning to confront its footprint. In a move reshaping healthcare sustainability in East Africa, the Aga Khan Hospital in Kisumu is steering the region's medical sector toward a net-zero future. By combining a globally recognised emissions tracking tool with pioneering green logistics and solar installations, the hospital is proving that cutting carbon in low- and middle-income countries is not just environmentally vital; it makes clear financial sense.
Jane Wanyama, the hospital's chief executive officer, describes it as transformative climate action. She says Kenyans cannot sit back and wait for the worst, and that healthcare workers are on the frontline of the climate crisis and must ensure continuity of essential services under all circumstances.
"Under all circumstances, we have to deal with patients that have negative health outcomes, whether it is pregnant women or children or people that have been affected by pollution through asthma. We also have to be responsible citizens and try to reduce our own contribution to climate change," she says.
Globally, 4.5 per cent of greenhouse gas emissions come from the health sector. At COP26 in 2021, the World Health Organanization (WHO) launched a call for countries to develop climate-resilient and low-carbon sustainable health systems. More than 100 countries have committed, with Kenya among the first.
The Aga Khan Hospital began its decarbonisation journey in 2019 by incorporating green initiatives into daily operations. In 2020, it partnered with Jerome Baddley, seconded from the UK's National Health Service, to develop the AKDN Carbon Management Tool, a spreadsheet-based carbon accounting workbook. In 2021, the entire Aga Khan Development Network (AKDN), including AKH-Kisumu, committed to achieving net-zero carbon emissions by 2030.
"This data enabled us to take a concrete, evidence-based decision," Wanyama says.
The tool, now endorsed by the WHO and integrated into the Alliance for Transformative Action on Climate and Health, operates under Greenhouse Gas Protocol Scopes 1, 2 and 3. It is pre-loaded with grid emission factors for every country, accommodates up to 30 sites per country, and automatically filters out errors and double-counting. It has been tested across 800 facilities in eight countries and is freely available.
"In 2023, the WHO tested our carbon management tool and endorsed it for global use. To date, we have trained participants from more than 60 countries globally, including Kenya. In June 2023, we trained 34 Ministry of Health partners from 18 health facilities," Wanyama says.
Using the tool, AKH-Kisumu established that medical and staff transportation accounted for 17 per cent of its Scope 1 emissions, a major challenge given its hub-and-spoke model serving 12 of the 14 counties in the Lake Region Economic Bloc (LREB). The hospital first cut transit emissions by 25 per cent through carpooling and virtual meetings by late 2022.
The breakthrough came on August 30, 2023, when it acquired a 100 per cent electric JAC T8-EV double-cabin pickup, the first operational electric vehicle deployed in both the LREB and North Rift regions. Kenya's green grid, heavily reliant on geothermal and hydro power, ensures exceptionally low emission factors. The hospital also benefits from reduced maintenance costs and insulation from volatile fuel prices.
Other interventions include waste reforms such as modifying kitchen portions, composting green waste and substituting sodas with homemade juices, which have diverted 3.2 tonnes of waste annually, avoiding emissions equivalent to 2.9 tCO2e. The hospital has also invested in solar power, energy-efficient air conditioners and refrigeration, and green architecture with low-carbon HVAC systems and LED lighting.
According to Wanyama, true sustainability must begin at the blueprint stage. "If we are going to go that way, we have to start from project planning," she says.
The hospital also runs an "Adopt a Tree" programme. Since 2023, every baby born at the facility has been gifted a seedling for the family to plant at home.
"Today, some of the first families that participated are now enjoying fruits from those trees. We also plant trees within our facilities where possible, as greenery helps patients recover and captures carbon," Wanyama says.
As a result, AKH-Kisumu has reduced its direct Scope 1 and 2 emissions by 21 per cent between 2021 and 2025. Globally, AKHS has cut emissions by 53 per cent.
"These carbon reduction interventions have also saved us on our costs. With solar production, electric vehicles and energy-efficient ACs and fridges, these energy costs have reduced," she says.
While many sectors view climate adaptation as a financial burden, Wanyama says it is both an economic hedge and an ethical imperative. "It is important to note that in addition to doing the right thing, it's actually the ethical thing to do for sustainability. By investing in going green today, we are protecting the future of our children," she says.
Kenya's Climate Change and Health Strategy 2024–2029, which includes solarisation of off-grid facilities and non-burn technologies such as microwave shredders, shows the country is on the right track, she adds.
On the hospital's rooftop, solar panels have been installed to provide power for everyday operations.
