Working in modern North American health care, we hear more and more about reducing waste and working efficiently as an important way to both reduce cost and improve patient satisfaction. For instance, reducing the notoriously long times patients often have to wait for service in a hospital’s Emergency Department both increases the number of patients the hospital serves with a given amount of resources and makes patients and families happy. And happy patients return to the hospital the next time they need emergency care.
One of the major systems for accomplishing this transformation is called “Lean”. Although many of the people who developed Lean were from the US, the philosophy took root in post World War II Japan because the US manufacturing community rejected it as unnecessary and undoable. Thus arose the long domination of Japanese manufacturing. Fortunately for the US economy, US companies like GE and Motorola eventually “got it” and Lean is now even fully visible in Detroit.
One of the resistances to Lean or any other waste reduction and efficiency enhancing philosophy is that we in developed countries are so used to being wasteful that it seems completely natural to us. We find it much easier to dispose of unused material rather than find uses for it, to build vast product distribution networks which add to cost and resource usage rather than produce and use local products, and to tolerate and accept a certain amount of error in any system as inevitable rather than embrace the idea that systems can be error proofed. For someone like me who has lived in a first world country all of his life, it is easy to accept the idea that waste is just a natural part of the way the world is.
A recent visit to Tanzania in East Africa reminded me that the natural world is, in fact, structured to minimize waste and to use all resources fully. The ubiquitous acacia tree is a good example. The tops of the trees are reserved for the baboons that eat the blossoms and fruit. The next lower level provides food for the giraffe that can reach very high but cannot conveniently reach lower branches. Elephants feed on the next lowest level which is too low for the giraffe but too high for the taller antelope who enjoy the next lowest level. Finally, the lowest branches provide food for the tiny Dik Dik, the region’s shortest antelope. No part of the tree goes unused but also the tree is not totally consumed so that it produces food again the following season. When branches and trees do die, they provide the most common source of firewood and even building material. They do not accumulate on the forest floor and provide fuel for fires.
The carnivores have a similar system. The lions get to eat any dead animal first but male lions are territorial so the “meal” is restricted to the pride whose territory the dead animal is on. Also, the lions will only eat if they are hungry- unlike many humans- so there is often much left over. The hyenas and jackals go next. Finally, the vultures and other birds that are well suited to picking at hard to reach tissue clean up. At the end, nothing edible goes uneaten and every group has a chance at the table.
The lesson for me is that at least much of the natural world is naturally Lean. Just maybe finding ways to eliminate waste is the way the world was created to be.