Ronnie Lettsome, PAHO Consultant CDM Conference, Hilton Rose Hall Montego Bay, Jamaica. Funded by DFID and Implemented by PAHO

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1 Ronnie Lettsome, PAHO Consultant CDM Conference, Hilton Rose Hall Montego Bay, Jamaica Funded by DFID and Implemented by PAHO 1

2 Project Summary Is a new initiative to promote safe and climate smart health care facilities All new health facilities and retrofitting projects should be environmentally friendly and disaster resilient. 'Smart Health Care Facilities Annex' to accompany national building standards and codes. Smart Hospital Toolkit to guide the implementation of climate change mitigation measures in existing and proposed facilities. Cost benefit analysis to show savings on energy and water usage, reduced greenhouse gas (GHG) emissions, improved air quality, access to safe water and safety conditions. 2

3 Demonstration Component To implement sustainable, green retrofits to health facilities in 2 countries Tools were developed to undertake assessment of facilities Selection Criteria Smart Hospital Baseline Assessment Tool Georgetown Hospital in SVG and Pogson Hospital in SKN were chosen 3

4 Government Commitment In SVG: Energy Unit, Energy Policy and Strategy exists Evidence of alternative energy system in SKN 4

5 Georgetown Hospital and Clinic

6 Pogson Hospital 6

7 Facility Evaluation: SVG Georgetown Hospital is located on Windward Side of the island In 2011 MOH applied Safe Hospital Index high level of risk to volcanic eruptions and hurricanes Special attention is being paid to the design and retrofitting of the roof 7

8 Building Details: Georgetown Hospital 3 buildings: Hospital, Clinic and new Dialysis Building (under construction) A 25 bed facility serving 9,800 persons Energy Usage for 3 years was 103,255 kw or EC$97, Water Usage for 3 years was 4,895, staff members Lacks basic amenities and does not meet code standards 8

9 Occupancy Satisfaction Survey SVG Georgetown Hospital Issues related to indoor environmental conditions Did not consider the building to be sturdy or safe Desired operable windows and doors and reliable water supply, improved lighting and reliable energy supply 9

10 Safety Analysis No recycling or composting. No fire extinguishers exist; exterior doors are damaged and not fire rated; security risk is high; no smoke detectors or fire alarm system is present. LPG Bottles are not properly secured. No evacuation plans or maps exist and no training is provided 10

11 Recommendations for Georgetown Overhaul the electrical system Roof strengthening and waterproofing Roof Mounted, grid tied photo voltaic (PV) system Replacement of doors with fire rated safety exterior doors and hygienic featured interior doors. Replacement of windows with hurricane rated, glazed windows with security features. Establish a rain water harvesting system with purification/filtration mechanisms Energy efficient and water conserving fixtures Installation of Solar Hot Water heater Improvement in fire safety and egress Provision of Standby Power Improved lighting, accessibility, handicap compliance and flooring 11

12 Facility Evaluation SKN Pogson Hospital is located on western side of the Island of St. Kitts. Safe Hospital Index has not been applied to this 12

13 Building Details: Pogson Hospital Serves 3,125 (2001 census) Has the potential and capacity for significant energy and water consumption levels based on the type of equipment present A 12 bed facility, with 24 full time staff. 13

14 Site Photographs :Pogson 14

15 15

16 Occupancy Satisfaction for SKN Pogson Hospital Majority did not understand the concept of Greening buildings but they did practice energy and water conservation Did not consider the building to be sturdy or safe from tropical systems Desired improved lighting, operable windows, air conditioning, reliable energy and water 16

17 A look at the Inside 17

18 Indoor Environmental Quality: Pogson The lighting of the Pogson Hospital is within the acceptable range in most cases Relative humidity levels in the clinic are lower than in the hospital 18

19 Safety Analysis No recycling or composting. Pogson is outfitted with extinguishers, fire hoses, fire/smoke alarms, a fire control alarm system and a security system with cameras. Emergency /exterior doors that are not fire rated and have no crash bar safety mechanism. LPG tanks are not properly secured. They are exposed to the rain and direct sunlight. No evacuation plans or maps are available at Pogson, but the staff has received some training in emergency evacuation procedures. 19

20 Emergency Equipment 20

21 Recommendations for Pogson Thorough inspection of the electrical system. Roof Mounted, grid tied photo voltaic (PV) system to off set electricity usage Outfit windows with hurricane protection; replace exterior emergency exit doors with fire rated crash bar doors. Establishment of rainwater harvesting system with purification/filtration mechanisms Energy efficient light bulb and fixtures & Water conserving fixtures Improve safety to include evacuations maps and plans; overhaul the fire and security control systems Thorough inspection and maintenance of the emergency generator Assess and repair the existing sewer manholes and sewer lines and complete the installation of the existing wastewater treatment plant. Assess and cleanout the existing drainage system. 21

22 Progress to Date Inspection report completed and approved by steering Committee Inspection of Roof and Electrical Systems completed As Built Drawing prepared for Georgetown Hospital Tender Process near completion for SVG; commenced for SKN Drawings presented to MOH; meeting held with selected contractors in SVG PR components commenced Draft Tool Kit near completion Annex to Building Code in development stage Economist Identified for Cost Benefit component 22

23 Conclusion The project will increase knowledge about climate adaptation linked to risk reduction for natural hazards Training would be provided to illustrate how cost benefit analysis methodologies can be applied to projects of this kind. Once the tools are validated, and the PR components are developed they can be applied in other countries in the Caribbean The BVI has already began adopting some components of the project and have developed a Green Checklist to be applied to their Safe Schools initiative. 23

24 Thank You! 24