Kathy Pryor sits in the lobby at Bellevue's Overlake Hospital, one of the few in the state committed to serving what is called “sustainable” seafood, an amorphous concept that means everything from local fish caught with hook and line, to healthy wild stocks, to avoiding fish caught with bottom trawling or from stressed marine ecosystems. Pryor is at the hospital as a representative of Washington Healthy Food in Health Care. The effort is a national initiative of Health Care Without Harm whose mission is to get hospitals to use their purchasing power to invest in foods that heal. "That could be healing the patient,” says Pryor. “It could be healing the earth. It might even be healing the communities that they're purchasing food from.”
Hospitals' economic activity represents close to 18 percent of the gross domestic product, meaning their purchasing could be a driving force in the sustainable food movement, says Pryor. “The interesting thing is they are the only sector of the GDP that really has a moral imperative which is to, 'First do no harm.' ”
It might seem intuitive for institutions engaged in healing and helping people recover from trauma to want to nourish them with local and organic food, cage-free poultry and sustainably caught seafood. But their commitment is relatively new and the drive to source sustainable seafood even more recent, says Pryor.
Existing contracts with food distributors that may not offer sustainable options and a lack of know-how about accessing alternative local foods keep many hospitals on the industrial-food treadmill. Fletcher Allen Hospital in Vermont was one of the first in the nation to break the pattern. Today some dozen hospitals in New England pride themselves on sourcing local, wild-caught and under-utilized species.
Overlake and Seattle's Virginia Mason are leading the way among Washington's 108 hospitals. Overlake began purchasing large quantities of hook and line, wild-caught Coho salmon from Bellingham's Seafood Producers Cooperative after meeting one of the fisherman at a Seattle Chefs Collaborative event. Overlake Executive Chef Chris Linaman says the hospital goes through about 500 pounds of Alaska Coho salmon every two weeks. "If it's pink, especially in the Seattle area, people will eat it.”
Linaman serves it seared as a filet and even as a grilled salmon BLT. But the biggest thing, he says, was getting the hospital away from farmed Atlantic salmon and farmed Columbia River steelhead. “A lot of that fish is fed fish chow full of genetically modified ingredients and other garbage that I don't want to eat. So why would I serve it to my customers?”
In August, Overlake began to purchase wild albacore tuna from the Seafood Producers Cooperative and also serves Oregon shrimp certified by the Marine Stewardship Council, the world's leading seafood certifier. And that's where determining what's “sustainable” runs into head winds for hospitals and consumers alike. Last year MSC came under criticism by environmental organizations and researchers for slapping its blue-and-white fish logo on fisheries that, the critics said, were not always sustainable because they ignored fishing methods and ecosystem health.
Claire Christian, director of the Antarctic and Southern Ocean Coalition, was a leading critic. On Oct.1, the MSC released a new standard for fishing practices, which Christian says represents an improvement over fishing based on strictly mathematical and science based models. Targeted fish populations are now treated in a more precautionary way. “Precaution might mean that you don't take the entire catch that the model says that you do because you leave a little extra in case there's an environmental change, an El Niño or oceanographic patterns that may influence what happens in a fishery.”
MSC relies on third party certifiers to determine whether a fishery is sustainable. As of this month certifiers can consider whether a species is endangered, threatened or protected. Previously, species had to be defined in these categories by national legislation or international agreement. Christian can't vouch for all the fisheries certified by the MSC, but she says Alaska salmon and other domestic fisheries, which consider the entire ecosystem a fish comes from and avoid by-catch, are safe choices.
Sheila Bowman with Monterrey Bay Aquarium's Seafood Watch says any hospital trying to source seafood sustainably and move fisheries toward more ecologically sustainable practices stands out. The MSC label may not be the gold standard, she says, but it's “a bronze.” For a half-century, fishing has been done by whoever had the biggest engine, biggest hydraulic winches and biggest nets, she adds. “We've become sort of super predators and when you see that happening you're going to see fish populations take in some cases really catastrophic dives.”
Seafood Watch categorizes fish with traffic signal green, yellow or red. Green means go and stands for “best choice”. Yellow means “good alternative” and red means stop or avoid. Marine Stewardship Council-certified fish usually fall in the yellow category, says Bowman. But the stewardship's requirements for chain of custody and traceability standards are a unique strength.
Seattle's Virginia Mason Hospital became the first independent hospital in the world to achieve MSC certification; it serves everything from Alaska cod and British Columbia chum to West Coast ground fish, which recently made a comeback after years of collapse. Bowman of Monterrey's Seafood Watch says, “They now have assurances that when they're serving, for example, a grouper that's come out of the Gulf of Mexico that somebody along the supply chain isn't substituting some crazy fish from another part of the world.” Crazy, as in full of contaminants, says Bowman, or rife with problems because of how it was caught. Does this kind of thing happen? Much of the fish in sushi bars is not what you think it is, she says. For instance, you may think you're buying skipjack or albacore tuna when you're actually getting yellow fin, which is on Seafood Watch's list to avoid. “So it's not always clear where in the supply chain that sort of mistake gets made. But you know it's consistent enough that we're eating fish we didn't intend to.”
That's part of what hospitals engaged in good faith efforts to serve "sustainable” seafood are trying to change. Chefs and food purchasers at Overlake and Virginia Mason are the ones behind changes in how their hospitals purchase seafood, says Washington Healthy Food in Healthcare's Pryor. The next step is getting hospital administrators on board. The Washington State Hospital Association just endorsed the Healthier Hospitals Initiative, a national campaign that hospitals, Health Care without Harm and others created. Healthy and sustainable food is one component of the initiative. Pryor says, “We need CEOs and CFOs to acknowledge that health and sustainable food is just as important as to their mission of healing as excellent care and patient services.” That's the next frontier, she says, one that needs to become central to the notion of healing.