Netcare water sustainability initiatives in the Western and Eastern Cape

Netcare’s sustainability strategy takes cognisance of the fact that South Africa is a water scarce country

Monday, February 19 2018

The Netcare Group has embarked on key sustainability initiatives more than five years ago, including reducing electricity use, exploring the use of alternative electricity sources, reducing healthcare risk waste, generating less and recycling general waste, using water sparingly and the implementation of a grey water strategy.  The cumulative aim of these initiatives is to reduce our Group’s carbon footprint and utilising water in a sustainable way.

Netcare’s sustainability strategy takes cognisance of the fact that South Africa is a water scarce country and therefore our specific water sustainability strategy is not only aimed at the current crisis but ultimately at finding long term sustainable solutions. Therefore Netcare is well prepared for the water shortage currently being experienced in the Western and Eastern Cape.

Our water conservation strategy resulted in the implementation of low flow shower heads, reducing baths in preference for showers and introducing volume restricted aerators on taps. Furthermore our gardens are planted with indigenous plants and utilise grey water for gardening purposes. As such, our five hospitals in the Western Cape have achieved a reduction in their water usage of 45% since 2015.

We have a dedicated task team to specifically address the maintenance of a sustainable water supply to our hospitals in Cape Town and surrounds, Port Elizabeth and Uitenhage.  These include Netcare Kuils River, Netcare Blaauwberg, Netcare N1 City, Netcare Christiaan Barnard Memorial, UCT Private Academic, Netcare Ceres, Netcare Greenacres and Netcare Cuyler hospitals.  Our plans to ensure an on-going sustainable water supply also extend to all of our Group’s Medicross family medical and dental centres and National Renal Care dialysis facilities in these areas.

Netcare has furthermore initiated its national disaster plan which directs, measures and has as its core the aim of minimising the impact of the critical water shortages on the provision of essential healthcare services at the aforementioned Netcare facilities in the Western and Eastern Cape.

On a daily basis Netcare ensures the safety of our patients and the sustainability of our business through the Netcare major incident response team and technical teams by managing water and power outages.

The Netcare water task team has worked closely with the Western Cape provincial disaster management team to ensure that rapid appropriate emergency action is taken by hospital management when and where needed.

The members of the Netcare water task team are in contact at all times and meet on a weekly basis to ensure that the Group’s national disaster plan for water at Netcare is being closely monitored and adjusted to ensure compliance to standard operating procedures.

Water usage per facility is closely monitored on an on-going basis to ensure a proactive rather than a reactive response to increased demand and usage is followed.  Water usage is measured daily via monitors that have been installed and there is a focus on the detection of anomalies which may point to leaks. All of our hospitals are benchmarked to ensure constant conservation of and reduction in water usage.

A project to increase the water storage capacity at our Western Cape hospitals is underway, with scheduled completion by 28 February 2018.

Boreholes have been drilled at Netcare Kuils River, Netcare N1 City and Netcare Blaauwberg hospitals, and water purification plants will be introduced to ensure the quality of the potable water. These facilities will have adequate back-up water for at least four days in the event that municipal water to a hospital is disrupted. Further desalination treatment will be required at Netcare N1 City and Netcare Blaauwberg hospitals due to the salinity of the borehole water at these facilities. Boreholes and other alternative water sources are being investigated for Netcare Cuyler and Netcare Greenacres hospitals.

However, Netcare is mindful of the underground water resource capacity of the boreholes and of possible constraints. Therefore a water desalination plant is currently being manufactured and will be installed and functional at Netcare Christiaan Barnard Memorial Hospital by March 2018. The cost of Netcare’s investment in this specific project is R5.5 million.

Netcare has applied to the authorities for the required licence to utilise borehole water and seawater as potable water after desalination and purification. Until such time as the licence is issued, these water sources may only be used after Day Zero. The desalination plant will produce water which is in line with South African National Standard (SANS) 241 regulations, which set out potable water quality requirements.

The desalination plant will use groundwater that is currently pumped out on a daily basis from the basement of Netcare Christiaan Barnard Memorial Hospital on the foreshore, which is reclaimed land and reaches approximately 10 metres below ground level.

The desalination plant will produce sufficient water not only for the hospital itself but also for the other Netcare hospitals, Medicross and National Renal Care facilities in the Western Cape. The water will be trucked to the other facilities.

In the event of Day Zero, Netcare will ensure that our staff members and doctors will have facilities at the hospitals to freshen up and we will allocate 25 litres per person. Disposable uniforms (scrubs) will also be made available to staff members and doctors alike.

Some of the other initiatives implemented in response to the water restrictions in the Western Cape, which have helped to reduce water consumption are as follows:

  • Raised awareness amongst patients, allied health professionals and staff on how they can contribute to water conservation.
  • The replacement of traditional hospital curtains with disposable curtains in specialised units.
  • The closing of certain water outlets, restricted access to water points and strict management of all water outlets within the hospitals.
  • Tap closure of 30% of all taps in all facilities following the city’s reduction of water allocation to 50 litres per person per day.
  • Encouraging and teaching of the enhanced use of alcohol rub for hand hygiene within our hospitals.
  • The reduction of unnecessary laundry and introduction of disposable linen where practical.
  • The introduction of waterless bathing, using specially designed patient bath wipes.
  • The introduction of the World Health Organization’s (WHO’s) recommended waterless scrub technique for doctors and staff in theatre.
  • A strategic plan to manage patients requiring dialysis, to reduce the water usage and water waste.
  • The introduction of waterless cooking methods and disposable crockery and cutlery.
  • The removal of food substances that use water for reconstitution, such as jellies.
  • The introduction of strict water restrictions in terms of dishwasher usage (disposable cutlery and crockery).
  • The reduction of drinking water wastage by removal of water jugs at the patient bedside and facilitation of required water as needed on a glass-by-glass basis.
  • Increasing bottled water supply for the hospitals.
  • Increased visible signage in all hospitals to enhance compliance to water restriction practices.
  • Enhanced security plan and measures to ensure the safety and sustainability of the water supplies to the hospitals, and the safety of patients and staff.
  • Procurement initiatives that reduce water usage.
  • The harvesting of grey water from autoclaves, air conditioning and other equipment within the hospital where the by-product of its function is water, for channelling the water back into the system after appropriate filtration and/or treatment.
  • Fire training has been enhanced in all our facilities and we have increased the number of fire extinguishers to ensure that during this period the risk of fire due to reduced water pressure is adequately mitigated.

Currently the Group’s water usage in its Western Cape hospitals has been reduced from over 500 litres per bed per day in 2013 to approximately 300 litres per bed per day.

Netcare continues implementing water initiatives in all its hospitals to reduce consumption, prevent wastage and harness efficiencies.  Further long term strategies related to water usage and conservation are in development, including the recycling and purification of waste water.

Statement by Jacques du Plessis, managing director of Netcare’s hospital division