Author: Austin

Sustainable Healthcare: New Betio Hospital

Austin /

Sustainable design is the co-existence of manmade buildings and the natural world. Sustainable design has recently made its way into the field of healthcare. The nation of Kiribati, a collection of 32 islands with a total population of 110,000, is located halfway between Australia and Hawaii. The New Zealand Ministry of Foreign Affairs and Trade hired a team of health planners and architects to plan to renovate the healthcare system and facilities across Kiribati. In 2018, the designers began working on a new hospital in Betio on an island called South Tarawa in Kiribati.

The team in charge of the project utilized sustainable design when planning out and constructing the hospital. Because the islands of Kiribati are so remote, have no natural source of fresh water, and the sea level is expected to rise 5.5 inches in the next 30 years, the team implemented a few different strategies to combat these environmental issues. Firstly, to combat the rising sea level, the team significantly rose the ground plane of the building. Secondly, the team used ventilation and solar power to lessen energy consumption. They also used sustainable building materials and set up a system to harvest rainwater for flushing and irrigation. Finally, they did some landscaping work to increase the surrounding biodiversity and to help passively cool the hospital interior.

The previous design choices helped to address environmental sustainability, but the team went further to address social, economic, and some other general amenities. In a healthcare context, social sustainability is the of the institution to increase the health and overall well-being of the population. They implemented a few design initiatives to improve the general level of care for the patients. Firstly, they created a large open courtyard in the center of the hospital to make the building less institutionalized. Additionally, the team focused on the most vital hospital departments first as well as decentralizing the hospital into various small sites around the island.

In terms of economic sustainability, the designers sought to design the healthcare system in a way to combat poverty which is contributing factor to bad health outcomes in society. They utilized local workers to construct the hospital to increase the skill of local laborers and support local employment. Further, they used renewable energy throughout construction and minimized waste products which reduced the total operational cost. Finally, increased the capacity of clinical workers with improved services.

An analysis showed that, although sustainable practices are usually perceived to be more expensive, the construction of New Betio Hospital was more cost-effective than if unsustainable practices were used.

As someone who has worked in four different hospitals and under three unique healthcare systems, I was very impressed with the design of New Betio Hospital. For me, two standout features were the variety and creativity of sustainable energy consumption as well as the large open courtyard area where people could meet and talk outside of their rooms. Hopefully, New Betio Hospital can serve as an example of sustainable healthcare in action and other hospitals can adopt some of their successes.

Citations:

https://www.ache.org/blog/2021/designing-for-healthcare-sustainability-a-framework

https://www.worldatlas.com/maps/kiribati

Sustainability in Developing Nations

Austin /

           In 2019, the United Nations established an agenda for all countries to achieve 17 sustainable development goals, or SDGs, by 2030. They made this as a part of a program to promote economic, social, and environmental development across the world. These goals range from ending poverty to climate action to making clean energy affordable to gender equality. Although they do not give countries a concise “how,” they allow every nation to establish objectives that can guide them forward in a sustainable way. While each of these goals is important, some have criticized the United Nations for not laying out a clearer framework for which goals should be accomplished first.

           The difficulty lies in the pressure these goals place on developing nations to switch to more sustainable laws. When a country lacks the infrastructure and economic stability to support sustainable practices, it cannot achieve the previously mentioned SDGs. In a sense, these developmental goals act as a limitation on nations that are desperately trying to expand economically. For example, if a country does not have reliable energy, it is challenging to implement clean energy laws effectively. Despite this, sustainable development goals are a worthy pursuit. In the wake of unprecedented damage from humans to the planet, we need every country to work towards a future that accounts for environmental impact.

         More developed nations, like the United States, need to take responsibility to move towards environmentally based SDGs because they have the economic stability to do so. Developing nations need to focus on policies that improve living conditions and education. The only way for nations to prioritize things like clean energy programs is for them to have the reliable infrastructure to make the transition. If not, poverty will increase, and sustainability efforts will fail. The chart below commonly referred to as “The Doughnut” helps one visualize the balance that must be struck between social factors and environmental factors as driving forces for action. In an ideal world, a nation could achieve all 17 SDGs and make advances in the ecological ceiling while maintaining a strong social foundation. The social foundation is not present across all countries, especially in developing nations. Regardless, it is necessary before countries can effectively tackle issues like climate change.

 

       The goals proposed by the United Nations help to shed light on issues of poverty, education, and urbanization in developing nations. It also helps remind people living in developed nations that even the ability to embrace sustainable programs is an economic privilege and not one to be taken for granted.

 

Citations

Sachs, J. D., Schmidt-Traub, G., Mazzucato, M., Messner, D., Nakicenovic, N., & Rockström, J. (2019). Six transformations to achieve the sustainable development goals. Nature sustainability, 2(9), 805-814.

SDG, U. (2019). Sustainable development goals. The energy progress report. Tracking SDG, 7.

Hák, T., Janoušková, S., & Moldan, B. (2016). Sustainable Development Goals: A need for relevant indicators. Ecological indicators, 60, 565-573.

Cobbinah, P. B., Erdiaw-Kwasie, M. O., & Amoateng, P. (2014). Rethinking sustainable development within the framework of poverty and urbanisation in developing countries. Environmental Development, 13, 18–32. https://doi.org/10.1016/j.envdev.2014.11.001 

El Rifai, Ayman Ramon. (2021) Sustainable Development in Developing Countries. Circle of Sustainable Europe. https://cose-eu.org/2021/10/11/sustainable-development-in-developing-countries/.