DENTON SMITH – HEAD OF ENGINEERING, GROOTE SCHUUR HOSPITAL, SOUTH AFRICA WASTEWATER
Recycling of autoclave wastewater case study
Denton Smith, head of engineering at Groote Schuur Hospital, Cape Town, South Africa explains how the use of autoclave machines could improve healthcare availability in areas of great need.
An autoclave is a machine that uses steam to provide a sterilising environment for the sterilising of surgical implements in hospitals. These machines use a lot of potable
water during the course of the sterilising cycle, and this water goes to waste. South Africa – and Cape Town in particular – is now a water-scarce area, and wastage of water cannot be sustained. It is for this reason that we developed a system to re- use the wastewater generated by autoclaves over and over in a closed loop, thus saving millions of litres of potable water annually.
Project overview The problem that this project sets out to solve is the rampant wastage of clean potable water. Clean potable water is becoming scarce worldwide, and hospitals are huge potable water consumers. One of the areas where this water is consumed is in the steam sterilising departments of hospitals. Steam sterilising machines rely on vast amounts of clean potable water – on average 500 litres of water per cycle – to produce both steam and a vacuum during the sterilising cycle. This ‘water wastage’ is not ideal in any part of the globe, and it can be greatly reduced as a direct result of installing a simple autoclave water recycling system.
Implementation of an Autoclave
Wastewater Catchment and Recycling System captures the water that is discharged by the autoclave during the sterilising cycle then stores this water ready for re-use in the next cycle of the machine. The objectives and goals of the system are to reduce the amount of water used in hospitals, thus improving the efficiency of the sterilising process and reducing both the heavy reliance on municipal supplied
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potable water and the overall running costs of the hospital through not having to constantly pay for municipal water which comes at a premium cost. The system, while saving money on the municipal bill, allows us to redirect funding to other patient services improving the overall patient experience it also ensures that we have a supply of clean potable water for the sterilising process, mitigating potential down time due to potential municipal water quality and/or supply problems. Another of the objectives of the system were that it must be easy to install by anyone with a good plumbing background and that it must be simple to operate and maintain as well as have a good longevity. At the end of the day, it is the hospital that benefits from the financial savings,
and subsequently, the patient as the end user of the medical facility. How does the patient benefit from the water savings? Well, the savings realised on the municipal water budget are redirected to improving the theatres, ICUs, High Cares, and wards, and to purchase new medical equipment, ultimately saving lives and improving the overall patient experience. This installed system is extremely simple in nature and requires minimal capital input, as it requires three small pumps, some copper pipework, some simple electrics, a water meter, and a few storage tanks. As a result, this innovation is easy to replicate at any medical facility with an autoclave and it has already been rolled out to a number of government medical facilities within the Western Cape as well as a few of the private medical
Denton Smith
Denton Smith is the chief engineer at Groote Schuur Hospital. In 2007, he was appointed to the engineering department as the head of medical gasses and was responsible for the maintenance, management, and installation of medical gas systems and reticulation. In 2011, Denton he was appointed as acting head of engineering and
officially appointed to the role in 2013. He has made it his mission to improve systems within the hospital in order to improve the overall efficiency of the building. As a result, the engineering department has won awards for energy efficiency and innovation, including the coveted AEE (Association of Energy Engineers) Sub Saraha Africa Region
Institutional Energy Management Award. Denton is a regular speaker at the South African Federation of Healthcare Engineering (SAFHE) and at IFHE Conferences, and serves on the Executive Committee of SAFHE as well as the IFHE Committee.
IFHE DIGEST 2025
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