The Clínica São Vicente is a partner of the Instituto Ecológico Aqualung (Aqualung Ecological Institute) in the Beach Cleanup Project. This involves providing environmental education and cleaning up the busiest areas, such as beaches, rivers, lakes and ponds. The aim is to remove very small pieces of litter (cigarette butts are the most common at world level according to the United Nations Environment Program (UNEP), bottle caps, straws, cotton swabs — which arrive on the beach from the waste discharge pipes — wooden skewers used for shrimp and cheese snacks, tinfoil for wrapping sandwiches). These materials can only be removed by hand. About 10,000 volunteers take part and around 200 coordinators have been trained under the international standards for handling volunteers. Four large initiatives are undertaken a year as well as organizing particular campaigns.