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Decarbonize health care at the facility level in Colombia

“Mental hospitals have long been branded as dark, sad and even frightening places. At San Rafael Hospital in Pasto, we are convinced that this is not the way it should be. The symbiosis between a healthy environment and our patients’ recovery processes is clear to us, and therefore we believe that environmental stewardship is a crucial strategy that supports increasingly humane and inclusive healthcare. “

–Dr Jorge Dario Duque Erazo, environmental manager of San Rafael de Pasto hospital

Background

San Rafael de Pasto Hospital is a mental health facility located in the city of San Juan de Pasto, Colombia. The hospital consists of eight large buildings and takes care of more than 23,000 patients each year. As an active member of the Global Green and Healthy Hospitals network, the hospital is committed to reducing its environmental impact by implementing programs on issues such as water, waste and sustainable purchasing.

The challenge

San Rafael de Pasto Hospital has been running an ambitious climate program for almost a decade and has been reporting greenhouse gas emissions since 2015. Its goal is to replace high-emission technologies with cleaner technologies and to modernize infrastructure to reduce global emissions.

“We understood the close relationship between what we do and the damage it creates on the environment, as we demand a significant amount of resources such as water, energy, food, technological equipment and various other inputs. “

–Dr Jorge Dario Duque Erazo, environmental manager of San Rafael de Pasto hospital

Climate and Health Solutions

Some of the main interventions that the hospital has implemented include:

Efficient lighting and equipment: The installation of LED lighting started in 2015; in 2019, over 90% of light bulbs had been replaced. As part of its sustainable procurement program, the hospital purchases all new electrical equipment with a certified level A energy efficiency label.

Switch to renewable energies: the hospital has started to replace the lighting of the hospital grounds and parking lots with solar-powered devices. Additionally, all of its medical units now use solar panels for water heating (currently totaling 14 water storage units with 6 solar panels each). The drying station also switched to solar power, after washing and drying clothes and linens was identified as one of the most energy-intensive activities at the facility. The hospital invested in the construction of a drying station using passive solar architecture and displacement air fusion technology, which made it possible to replace industrial equipment and reduce the consumption of electricity, fuel and water.

Fuel switch and boiler modernization: stationary combustion, mainly from boilers running on diesel, also proved to be a major source of emissions (43% in 2017). In 2018, the hospital purchased a gas boiler which, along with the solar drying station, saves the administration around US $ 17,000 per year. Emissions from stationary combustion fell by 45% in 2018 compared to the previous year, while electricity consumption fell by 6.4% over the same period.

Nature-based solutions: The hospital participates in the local government’s “One Million Trees for Pasto” initiative and has purchased 1 hectare of land where, over the past six years, nearly 6,000 native tree species have been planted.

As a healthcare institution, we were aware that the demand for resources, their use and their final disposal, directly and indirectly contribute to climate change. We had mitigation and control strategies in place, but it was only after estimating our institutional carbon footprint that we were able to determine and measure our impact in terms of carbon emissions. It was then that we understood the need to reformulate our environmental strategy and make it much more meaningful and participatory, which we did through a project that included contributions from our operational and technical staff. This project has greatly contributed to the environmental and financial sustainability of our institution.

–Dr Jorge Dario Duque Erazo, environmental manager of San Rafael de Pasto hospital

Progress made

Since the implementation of these measures, the hospital’s annual energy intensity has been reduced by 42% from 2015 levels, while it has led to a reduction in emissions of 32% per hospital bed. and 64% in total (scopes 1 and 2) between 2014 and 2018.

Some of the key actions taken by the hospital to achieve these results have been the appointment of an environmental officer, the creation of a procurement committee to leverage its purchasing power to drive transformational change in the supply chain and engagement with the local government of Pasto on sustainability projects.

The hospital uses its purchasing power to drive the transformation of its supply chain; in 2019, it had invested more than $ 5,000 in sustainable procurement purchases. Most recently, San Rafael de Pasto Hospital joined the first cohort of healthcare systems and facilities in the world to participate in the UNFCCC’s Race to Zero campaign, pledging to achieve net zero emissions by 2050 and reporting annually on its progress.

Lessons learned

Some of the main lessons learned from the San Rafael de Pasto experience include:

  • Information is the key to make strategic decisions and maximize impact: using Health Care Without Harm’s carbon footprint tool, the hospital was able to understand its carbon footprint, identify its main sources of emissions and select projects and key interventions that would produce the greatest emission reductions.
  • Mitigating climate change is crucial for public health, but it is also a wise investment: the hospital was able to recover its investments quickly, and its new infrastructures and technological substitutions allow significant savings to be made.
  • No healthcare facility is too small to make big changes: The impressive achievements of the hospital have served as inspiration for many other health establishments in the region. Since 2016, he has consistently been recognized for his leadership and career through the Health Care Without Harm rewards program, “Smaller footprint, better health“, And in 2018 received the”Impulso Atures”For the best climate initiative, and became the first psychiatric hospital in Latin America to be ISO 14001: 2015 certified.

“Our patients are our allies in our mission to educate, raise awareness and mitigate environmental impacts. We recognize the significant environmental burden of healthcare, and we have made it our obligation and commitment to drive changes that allow better patient care while balancing the needs of our planet.

–Dr Jorge Dario Duque Erazo, environmental manager of San Rafael de Pasto hospital

More information

You can read more about the efforts of San Rafael de Pasto Hospital in Healthcare Without Harm’s report, Hospitals That Heal the Planet.

This story is part of a series of case studies on climate change and health. The case studies aim to highlight the links between climate change and human health and present some of the solutions implemented by the health community. Case studies do not necessarily represent WHO or any of its Member States.


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