WASTEWATER
facilities within South Africa. This system is one that can be scaled up to national and international levels with relative ease. The reason for the implementation of
this system was to stop the water wastage, and it was finally approved during a water crisis that Cape Town went through in 2019 where there were, at times, only a few days left of water in the city dams.
System description The reason that the system is unique, in my understanding, is that a system to capture, stores and reuse the wastewater generated by an autoclave during the sterilising cycle had not been tried previously – especially within the government sector, although I had described the principle of the innovation to my managers as early as 2002. It was not seen as necessary due to the low cost and ready availability of clean potable water. The system is a front-line engineering
approach to saving water and creating a robust system that ensures the continued function of sterilisation in a hospital even if the municipal water supply fails. The innovation is easy to install and maintain with limited infrastructure work and financial resources. Combined with the water savings, there is an inherent reduction in the overall carbon footprint, as every kilolitre of potable water saved = a saving of 0,149CO2e. We are saving on average 1000kl per week or 149kgCO2e at our hospital.
What is the current status of this project? The current status of the project is that it is in daily use and constantly providing water savings to the hospital. The Project at Groote Schuur Hospital
was commissioned a few years ago (2017) as previously mentioned and has been running without hassle ever since. We have not had any operational issues with the system bar for one of the pumps that needed to be replaced. To date, it has saved Groote Schuur
Hospital roughly 340,053 kl of water and managed to reduce our carbon footprint by roughly 50 668kgCO2e as of the 30 September 2024.
Project development Collaborations and partnerships The project was funded by Groote Schuur Hospital, Local Government of the Western Cape: Department of Health and installed by a third party company.
Users, stakeholders, and beneficiaries The citizens of Cape Town have had improved healthcare due to the monies saved. Groote Schuur Hospital has benefitted
from the lower potable water expenses and a more robust sterilising system.
IFHE DIGEST 2025
The objectives and goals of the system are to reduce the amount of water used in hospitals
Civil society organisations have not
benefited. The company that installed the system
benefited once by means of payment for the installation.
Results, outcomes, and Impacts At the onset of the installation of the water saving and recycling project for the hospital sterilising department, I insisted that a water meter be installed so that we would be able to quantify the savings made by the system. These water readings, taken from the water meter, were taken on a weekly basis initially and subsequently to currently on a monthly basis. The readings showed that we were saving between 900kl and 1300kl weekly, depending on the uses of the autoclaves in the sterilising department. We have averaged out the savings to 923kl per week or 48,000kl per year, as we must take into account the de-escalation periods of the hospital.
Challenges and failures The only challenge that we have experienced was that we were not able to get the buy-in earlier (i.e. between 2002 and 2018) as water savings were not high on the list of priorities of the government, as municipal water was reasonably priced and freely available. Sadly, it took a natural disaster where
we in Cape Town were looking at the very real possibility of our taps running dry – this was known as ‘Day Zero’. With the approaching water shortage, the City of Cape Town did all it could to force the citizens to use less water. Some of these measures were the rapid increase in the cost of potable water and the implementation of a sewerage tariff. It was only at this point that water
saving initiatives received funding for implementation.
Conditions of success In order for this innovation to be successfully rolled out, it needs the complete buy-in of the hospital in which it will be installed as the support of the hospital technical team. The installation of this system will not
require huge infrastructure work nor a large financial outlay but instead will require a reasonably small footprint, area for installation as well as trained technical staff.
Leadership, personal values and
motivation are qualities that must be present in the institution’s technical team as a dedicated and committed team need to monitor the system and do the savings calculations. Guidance can come from on-site visitations by those who understand the system and its function or via electronic communication like ZOOM.
Replication This innovation has been installed at a number of state hospitals throughout the Western Cape as a result of the ‘Day Zero’ threat, and, to my understanding, has been installed at Mediclinic and Netcare (both private healthcare groups within South Africa) hospitals within the borders of South Africa.
It is the ease and relatively low cost of
installation that makes this innovation so appealing. The return on investment can range from 18 months to three months (this is dependent on the size of the installation, more autoclaves serviced = faster ROI). The system is definitely something that should be rolled out to countries and stated where reliable quality potable water is not easily available or is very costly.
Lessons learned Do not over-complicate your designs and keep them simple, as a complex system will require complex maintenance and often costs a lot more, as well. I have always been a person who believes in design and install for ease of maintenance and simplicity. This has resulted in, like the innovation at hand, a low installation cost that requires little to no maintenance and will ensure savings for the duration of its often long operational life. Simple design also means that an engineer with basic tools will be able to install and maintain the system without the need for specialised training or tools, again saving on costs and ensuring the longevity of the system.
Anything else? I am strong believer that, in this world where potable water is scarce resource, we need to find ways to save and introduce robust innovations that will ensure the safeguarding of water supplies into the future. If we could install systems – like the one
that I have put forward – that are simple to install and robust in design, we will potentially be able to improve healthcare availability, especially in areas of the greatest need. I wish to share this innovation to those
who would like to use it, through both the Southern African Federation of Healthcare Engineering as well as the International Federation of Healthcare Engineering.
IFHE 75
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96
