Perceiving sustainability and practicing community based rehabilitation : a critical examination of the Western Cape Rehabilitation Centre (WCRC) as a case study

Mukanya, Ronald (2012-03)

Thesis (MPhil)--Stellenbosch University, 2012.

Thesis

ENGLISH ABSTRACT: Problem Statement: From a sustainability point of view, hospitals offer their services without taking into consideration their impact on the environment, the interplay between various sectors, key elements of sustainable development and interconnectedness. This study represents an attempt to design a “virtual” green hospital facility that does more with fewer resources. Aims and Objectives: Contribute towards achieving sustainable and better quality healthcare services. To generate evidence and increase our understanding of the sustainability of hospital resource flows. Design a “virtual” green hospital. Research Method: The research approach consists of a comprehensive literature review, mixed with substantiated field research and interviews. The literature review provided an understanding, recommendations and interventions for the virtual project. These can be used to promote greater sustainability through WCRC’s healthcare system, energy efficiency and green hospital buildings. Interviews and questionnaires were used to collect the qualitative data. The interpretive technique was used to analyse the collected data. Consumption statistics of electricity, water and waste were used to collect the quantitative data. It was analysed using the green building rating tool. The rating tool awards points according to incorporated measures, and arrives at a total score after appropriate weighting. The green building rating tool was used to establish the rating of WCRC as it stands and what it could ideally be as a retrofit? The data was presented as demographic information in tables, charts and graphs, drawn from the collected data. Findings: The findings that emerged suggest that: a) green hospital buildings promote greater sustainability than the current modern healthcare hospital buildings at WCRC and retrofitting would promote greater sustainability; b) the majority of WCRC’s current healthcare provision is done in the conventional ‘business as usual approach’; c) the greatest weaknesses of the hospital is its heavy dependence (95% average) on nonrenewable energy sources of fuel, electricity and water; d) procurement isn’t focused in the bio-region; e) sustainability isn’t viewed as the cornerstone to influence policy; and f) the flow of resources gets conducted through socio-economic systems. Conclusion: The current design of the hospital needs to be retrofitted into a green building, which will promote greater sustainability. A higher rated green star building for WCRC would promote greater sustainability. Healthcare provision is done in the conventional ‘business as usual approach’. Therefore the healthcare system faces threats in the immediate future, which include the impact of climate change, over dependency on fossil fuels and increasing urban sprawl. A virtual green hospital is designed to reduce the overall impact of its built environment on human health and the natural environment by: • Efficiently using energy, water, and other resources; • Protecting occupant health and improving employee productivity; • Reducing waste, pollution and environmental degradation. Recommendations: In this sustainability criterion, a paradigm shift is required for WCRC hospital to go green and become sustainable. At a local scale WCRC needs to green the current hospital building by retrofitting. WCRC needs to energy switch from nonrenewables to sustainable renewable resources. Bioregional consumption and procurement needs to be practiced whilst establishing a local health movement to engage suppliers and focus on sustainability.

AFRIKAANSE OPSOMMING: Probleem stelling: Gesien van volhoubaarheids oogpunt, bied hospitale dienste aan sonder om te besin oor die impak op die omgeweing, die tussenspel tussen verskeie sektore, sleautel elemente van volhoubare ontwikkeling en die onderlinge aanknopings. Hierdie studie verteenwoordig ‘n poging om ‘n skyn groen hospitaal te ontwerp wat meer kan doen met minder hulpbronne. Oogmerk en Doelstellings: Om ‘n bydrae te lewer om ‘n volhoubare en beter kwaliteit gesondheidsdiens te bereik. Om bewyse te genereer en begrip aangaande die volhoubaarheid van hospitaal bronne vloei to verhoog/ Ontwerp van ‘n “skyn” groen hospitaal. Ondersoek Metode: Die benadering in die ondersoek bestaan uit ‘n omvattende literatuurstudie met ondersteunbare veld ondersoeke en onderhoude. Die literatuurstudie voorsien in die begrip, aanbevelings en tussentredes vir die skyn projek. Dit kan gebruik word om groter volhoubaarheid van die WKRS se gesondheidsisteem, energie effektiwiteit en groen hospitale te bevorder. Kwalitatiewe data was ingewin met behulp van onderhoude en vraelyste. Interpretasie was die tegniek wat gebruik was om data te analiseer. Verbruikstatistiek van elektrisiteit, water en afval was gebruik on kwantitatiewe data te kollekteer. Die analise daarvan was gedoen deur die gebruik van die groen gebou graderingsinstrument. Die graderingsinstrument ken punte toe volgens opgeneemde maatreëls en bepaal die finale gradering na gepaste afwegings. Die instrument was gebruik om die gradering van WKRS te bepaal soos dit is en wat die ideale terugbou sou wees. Die data word in tabelle en grafieke voorgelê soos wat dit verkry was van die gekollekteerde data. Bevindinge: Die bevindinge wat na vore gekom het dui aan dat: Groen hospitaal geboue bevorder groter volhoubaarheid dan die huidige moderne hospitaal geboue van WKRS en terugbouing sal groter volhoubaarheid bevorder. Die meerderheid van gesondheidsdiensvoorsiening deur WKRS geskied volgense die konvensionele benadering van “besigheid soos normal” Die grootste swakheid van die hospitaal is die swaar afhanklikheid van die hospitaal op nie-hernubare energie (95%) soos brandstof, elektrisiteit en water, Verkryging is nie gefokus op die bio-streek nie, Volhoubaarheid word nie beskou as die hoeksteen om belied te beinvloed nie en Die vloei van hulpbronne word herlei deur sosio-ekonomies sisteme. Sluiting: Die huidige ontwerp van die hospitaal moet terugverbou word na ‘n groen gebou wat groter volhoubaarheid sal bevorder. ‘n Hoër groenster bougradering vir WKRS sal groter volhoubaarheid bevorder. Voorsiening van gesondheidsdienste volgens die “besigheid soos normaal” benadering veroorsaak dat die gesondheids-sisteem bedreigiongs in die gesig staar soos die impak van klimaatsverandering, oorafhanklikheid van fosiel energie en verhoodge stadspreiding. Aanbevelings: Volgens die kriteria is ‘n paradigma verskuiwing nodig by WKRS om groen en volhoubaar te raak. Op ‘n plaaslike skaal is dit nodig vir WKRS om die huidige hospitaal terug te bou om groen te raak. Dit is nodig om energie veranderings te ondergaan van nie hernubare tot volhoubare, hernubare energie bronne. Die Biostreek verbruiking en verkryging moet gepraktiseer word terwyl plaaslike gesondheidsbewegings gevestig word om te onderhandel met verskaffers en te fokus op volhoubaarheid.

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