Gigi Wong discovered that pharmacy had a role in environmental action and sustainable health care as a student pharmacist. “I was traumatized by the drug waste I observed during a hospital rotation,” she remembers. “I was shocked that medications that could be reused were not… The amount of and the frequency of drug waste really bothered me and stuck with me.” Her inquisitive mind led her to learn of the impacts of pharmaceuticals on fauna, including fish populations that became all female, or abnormal fish that had both sex of male and female sex organs.
Of note, she learned about how diclofenac, an anti-inflammatory drug that may be used to treat pain or symptoms of arthritis (amongst other uses) in humans and animals, has nearly exterminated vultures. Gigi shares that “99.9% of vultures were killed in the lightening speed of 15 years, due to consumption of livestock carcasses treated with diclofenac, resulting in kidney failure and, eventually, death.” Confronted with how drugs interrupted the circle of life, Gigi was shocked and devastated. It took some time for her to digest what she had read.
I realized the implications of drugs entering the environment. In addition to the patient needing the drug, the reality is that the drugs become contaminants to our shared environment.”
Gigi has now been a professional pharmacist for 13 years. She is a Clinical Pharmacy Specialist for Quality with Lower Mainland Pharmacy Services (LMPS), and is currently working on a project to ensure safe sterile drug preparations, including intravenous antibiotics. This project is considerable in scope and depth, impacting 25 hospital pharmacies across four health authorities.
Her work has a wide impact, so she is intentional about integrating “green pharmacy” principals and jumpstarting sustainability projects. Some greening pharmacy initiatives that Gigi has been involved with include capturing the volume and cost of pharmaceutical waste in an inpatient hospital pharmacy; eliminating the cover page from patient status faxes since September 2013 which saves about 12.4 trees per year, a total of 118 trees to date; and ways to reduce drug waste by comparing different dispensing cycles and its impact on drug returns. “In a publicly funded system, it makes little sense to waste as it disrespects so many things: the item itself, the cost, the time, the effort,” she notes.
In 2014, Gigi joined the Green+Leader community to connect with others who wanted to take meaningful action. “I remember feeling excited and energized,” she recalls. The program showed her that there were other health care staff interested in greening health care. Gigi’s profile as an advocate for greening the pharmacy is on the rise. In 2022, she gave several presentations about the impact of drugs (pharmaceuticals) in the environment: she presented at a webinar to the Canadian Society of Hospital Pharmacists – British Columbia Branch spoke at the conference for Pharmacy Technician Society of British Columbia on the impacts of inhalers and anesthetic gases on the climate crisis.
What’s next? Gigi hopes to integrate planetary health and continued stewardship for pharmaceuticals in the environment into the LMPS pharmacy residency program, a highly coveted, competitive accredited Canadian hospital training program for pharmacists.
What’s most rewarding about taking a leading role in reducing the environmental impact of pharmaceuticals is “when I learn that my work was the foundation for, shaped, or informed the work of others,” Gigi says. To that end, Gigi plans to continue sharing her story about why she cares in the hopes of ignite someone else’s passion and bolstering their confidence to make a change. She believes there are many “intelligent, caring clinicians” who can and want to take action for the environment. This might become be their motivation too.
Once someone cares, they will find a way to move forward.”