Introduction
Inter Care is a charity based in an industrial area of Syston, Leicestershire. The charity’s core activity is to procure surplus health care goods (HCG) and medicines for the two-fold purpose of sending regular consignments of vital medical aid to rural health units across sub-Saharan Africa, whilst at the same time reducing the quantities of medical waste that is incinerated or sent to landfill. We recognise that our activities have environmental impacts, both positive and negative. This Environmental Policy outlines our organisation’s goal to operate in an environmentally sound manner, to comply with all legal regulations, to prevent waste, and to continually improve.
Areas of Operation
Our areas of operation that have environmental impacts can be categorised into the following activities:
- Procurement of Medicines and Health Care Goods (HCG)
- Shipments to Africa
- African Visits
- UK Operations
The environmental impacts of these activities and the measures we are taking to minimise them are outlined below.
Procurement of Medicines
For most of its history Inter Care’s main area of operation was recycling patient-returned medicines obtained mainly from GP practices. These were supplemented by relatively small-scale purchases of medicines from UK wholesalers. However new legislation introduced in 2013 prohibited the use of patient-returned medicines so now our main sources are surplus (new) medicines donated by pharmaceutical manufacturers, some UK purchases as before, and in-country purchases of medicines from accredited local organisations.
The re-use of surplus medicines prevents waste, conserves the energy and raw materials used in manufacture and avoids the use of energy that would otherwise be used in incineration. Purchasing medicines within the African countries we supply avoids the energy usage and carbon emissions associated with air freight from the UK.
We will continue to maximise the use of donated medicines, use in-country purchases where appropriate and minimise UK purchases where possible.
Procurement of Health Care Goods (HCG)
Almost all of our HCG are obtained as surpluses from a variety of sources which again, conserves the energy and raw materials used in manufacture and avoids incineration and landfill. We will continue our efforts to increase the amounts of HCG we obtain from UK manufacturers, the NHS, the general public and other donorsto maximise the environmental benefits.
In a normal (i.e. non-Covid) year Inter Care re-uses or recycles around 10 tonnes of medicines and HCG. The CO2 equivalent emissions saved by avoiding incineration or landfill are around 215 kg per year.[1] Savings in energy and raw materials used in manufacture are additional to this.
Shipments to Africa
In the past Inter Care’s outputs were mainly recycled medicines with only small (and light) items of HCG. These were all sent by air freight to ensure that they arrived at our partner clinics with at least 12 months left before their expiry date. In the last 4 years we have significantly increased the amounts and types of HCG that we send, meaning that shipping costs were rising rapidly because of the increased weight of the parcels. However, the generally longer expiry dates of HCG meant that we could consider sending consignments by container ship, both reducing costs and allowing us to send larger items of equipment.[2] Air freight is still used for medicines dispatched from the UK warehouse to ensure prompt delivery and compliance with Good Distribution Practice (GDP) as defined by the terms of our MHRA licence. In Malawi and Tanzania we are able to purchase medicines from a trusted, audited source (a locally based international NGO). These replace medicines purchased from UK wholesalers and so eliminate the carbon emissions from air freight.
Sending goods by sea instead of by air reduces the carbon impact by a factor of around 37 times1 on a per tonne basis so we will continue to increase the use of shipping containers whenever possible. We will also continue to purchase medicines in-country to supplement UK-sourced medicines when required, and when we can be sure of the local source.
Improvements in electronic communications with many clinics in rural Africa means that we can be increasingly selective in deciding what to send to our African partners. This avoids donation of goods that for various reasons they are unable to use and prevents avoidable waste disposal problems in Africa as well as the carbon emissions associated with shipping.
African Visits
Historically we have aimed to visit all of our partner organisations on a three-yearly basis (though this has not always been achieved in practice for the most rural locations). The main reason is to assess their continuing capability to handle and dispense medicines and use the HCG in an appropriate manner. All prospective new partners where possible receive a visit before being accepted for donations. This has usually entailed at least two visits to Africa each year, normally with two or three members of staff/volunteers for practical and/or safety reasons[3]. The main environmental impact of this policy is the carbon emissions associated with international travel. There is also some impact from travelling within country but this is minimal compared with the air travel.
[1] UK Government GHG Conversion Factors for Company Reporting: https://www.gov.uk/government/publications/greenhouse-gas-reporting-conversion-factors-2019
[2] As of May 2021 we have sent three containers to Sierra Leone and Malawi and we are currently working on a fourth.
[3] Covid-19 has prevented any visits during 2020 and will probably do so throughout 2021
The improvements in electronic communications have meant that it has been possible for some elements of the assessments to be carried out remotely, though it is generally felt that this is no real substitute for ‘being there’. The main reason for visiting now is to actively audit the site and to carry out a monitoring and evaluation visit. We will continue to use electronic means to reduce the need for air travel whilst accepting that this is still a necessary part of our operations. We will also minimise the number of people travelling from the UK consistent with safety, operational and staff/volunteer development needs.
UK Operations
Inter Care operates from one office and an associated warehouse in Syston. The main environmental impacts are from energy use in the buildings and recycling of waste.
Both the office and warehouse are rented and so we have had no influence on the heating and lighting equipment already installed nor the levels of insulation. However, when equipment is replaced we will endeavour to install the most energy efficient alternatives (e.g. LED lighting). The boiler in the office and the heater in the warehouse are both fired on natural gas and the office boiler has time and temperature controls that are set to match the hours of occupation. The warehouse heater is left on 24/7 to maintain a temperature range of 8oC to 25oC for the storage of medicines to comply with GDP regulations. The temperature is increased only when the warehouse is occupied to ensure staff/volunteer comfort. We already have procedures in place to ensure that all lighting and office equipment is switched off when the building is not in use. It is therefore difficult to see how further savings in energy usage can be made until equipment is replaced.
The waste produced is mainly paper, cardboard and plastics. All of these materials are separately collected and placed in the appropriate bins provided on site. Waste electrical items (such as print cartridges) are sent to appropriate recyclers. The small amounts of residual waste (e.g. food waste) are placed in the appropriate site bins for disposal. We therefore believe that our recycling efforts are already appropriate to the operations and the amounts of waste produced.
The remaining environmental impact from UK operations is in transporting medicines and HCG to Syston. This is normally by road by the donors. We have no influence on the mode of transport used, nor the distance travelled so it is not possible to make direct savings in this area.
There is some environmental impact from staff and volunteers travel to Syston. However, all live locally so this impact is small. During the Covid pandemic the staff have been mainly working from home and no volunteers have been coming to the site so the environmental impact has been almost zero. It will increase again once the lockdown rules are eased but there will still be significant working from home so the impact will be lower than before the pandemic.
Carbon Footprint
From the data we hold it is possible to estimate the carbon footprint of Inter Care’s operations. This is illustrated in the pie chart below.
As can be seen our total CO2 (equivalent) emissions are around 52 tonnes per year[1]. Of these just over half come from shipments of medicines and HCG to Africa (with almost 97% of this from air freight). African visits account for 26%, followed by energy use in the office and warehouse (14%) and shipment of incoming medicines and HCG (7%). For context, 52 tonnes of CO2 is around 6.5 times the amount produced by the average UK household[2]. Although we will continue with our efforts to reduce our carbon impact, we believe that this is an acceptable level of carbon ‘expenditure’ for the benefits gained by our African partners.
Summary
This Environmental Policy for Inter Care outlines the environmental impacts (positive and negative) of our operations and the measures we are taking to minimise the negative impacts. We will continually monitor our environmental performance and take appropriate steps to improve wherever possible. We will ensure that all employees and volunteers are aware of this policy and are fully trained to meet their environmental responsibilities.
Responsibility for establishing and implementing this policy is carried by the General Manager. The charity is committed to providing sufficient resources to monitor and improve its environmental performance.
This Policy was approved by the Trustees on 18th May 2021. It will be reviewed every two years.
[1] All CO2 conversions factors are derived from https://www.gov.uk/government/publications/greenhouse-gas-reporting-conversion-factors-2019
[2] Committee on Climate Change (www.theccc.org.uk)