Institutional Decarbonisation of Healthcare in Colombia – World Well being Group

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“Mental health clinics have long been stigmatized as dark, sad, and even scary places. We at the San Rafael de Pasto Hospital are convinced that this should not be the case. The symbiosis between a healthy environment and our patients' recovery processes is clear to us, and that is why we believe that environmental management is a crucial strategy that supports increasingly human and inclusive healthcare. ”

–Dr. Jorge Dario Duque Erazo, environmental manager of the San Rafael de Pasto hospital


Hospital San Rafael de Pasto is a mental health facility in the city of San Juan de Pasto, Colombia. The hospital consists of eight large buildings and treats over 23,000 patients each year. As an active member of the Global Green and Healthy Hospitals network, the hospital is committed to reducing its environmental footprint by implementing programs on issues such as water, waste and sustainable procurement.

The challenge

San Rafael de Pasto Hospital has been running an ambitious climate program for almost a decade and has been reporting on its greenhouse gas emissions since 2015. His focus was on replacing emitting technologies with cleaner ones and retrofitting the infrastructure to reduce overall emissions.

“We understood the close relationship between what we do and the damage it causes to the environment, as we require a significant amount of resources such as water, energy, food, technological equipment and various other inputs.”

–Dr. Jorge Dario Duque Erazo, environmental manager of the San Rafael de Pasto hospital

Climate and health solutions

The main interventions that the hospital has implemented include:

Efficient lighting and equipment: The installation of the LED lighting started in 2015; By 2019 over 90% of the lightbulbs had been replaced. As part of its sustainable procurement program, the hospital purchases all new electrical appliances with a certified level A energy efficiency label.

Switch to renewable energy sources: The hospital has started replacing the lighting in the hospital grounds and parking lots with solar-powered devices. In addition, all medical units now use solar collectors for hot water preparation (currently a total of 14 water storage tanks with 6 solar collectors each). The drying station was also converted to solar energy after washing and drying clothes and bed linen was identified as one of the most energy-intensive activities in the facility. The hospital invested in the construction of a drying station with passive solar architecture and air fusion through displacement technology, which has enabled the replacement of industrial equipment and the reduction of electricity, fuel and water consumption.

Fuel switchover and boiler modernization: Stationary combustion, mostly from diesel-powered boilers, also turned out to be the main source of emissions (43% in 2017). In 2018, the hospital bought a gas boiler, which, together with the solar drying station, saves the administration around USD 17,000 annually. The emissions from stationary incineration decreased by 45% in 2018 compared to the previous year, while electricity consumption decreased by 6.4% in the same period.

Nature-based solutions: The hospital participates in the local government's One Million Trees For Pasto initiative and has purchased 1 hectare of land that has planted nearly 6,000 native tree species over the past six years.

“As a healthcare facility, we were aware that the need for resources, their use and disposal contribute directly and indirectly to climate change. We had mitigation and control strategies in place, but it was only by estimating our institutional carbon footprint that we were able to determine and measure our impact on carbon emissions. At this point, we understood the need to reformulate our environmental strategy and make it much more meaningful and participatory, which we did through a project that had the input of our operational and technical staff. This project has made a significant contribution to the ecological and financial sustainability of our institution. ”

–Dr. Jorge Dario Duque Erazo, environmental manager of the San Rafael de Pasto hospital

Progress achieved

Since the introduction of these measures, the hospital's annual energy intensity has decreased by 42% compared to 2015, while between 2014 and 2018 this led to a reduction in emissions of 32% per hospital bed and 64% overall (Scope 1 and 2).

Some of the key steps the hospital has taken to achieve these results have been to appoint an environmental manager, set up a procurement committee to use its purchasing power to drive change in the supply chain, and work with local government from Pasto on sustainability projects.

The hospital is using its purchasing power to drive the transformation of its supply chain; By 2019, she had invested more than $ 5,000 in sustainable procurement purchases. Recently, Hospital San Rafael de Pasto joined the first cohort of health systems and facilities around the world to participate in the UNFCCC's Race to Zero campaign, pledging to achieve net zero emissions by 2050 and annually to report on their progress.

knowledge gained

Some of the key lessons learned from the San Rafael de Pasto experience are:

  • Information is key To make strategic decisions and maximize impact: Health Care Without Harm's carbon footprint tool enabled the hospital to understand its carbon footprint, identify key sources of emissions, and select key projects and interventions that would lead to the greatest emissions reductions.
  • Protecting the climate is critical to public health, but it is also a sound investment: The hospital was able to quickly amortize its investment and its new infrastructure and technology substitutions bring significant savings.
  • No healthcare facility is too small to drive big change: The hospital's impressive achievements have inspired many other healthcare facilities in the region. Since 2016, it has been regularly recognized for its leadership role and career by the Health Care Without Harm award program “Smaller Footprint, Greater Health” and in 2018 it was awarded the “Impulso Atures” award for the best climate initiative and became the first mental hospital in Latin America be certified according to the ISO 14001: 2015 standard.

“Our patients are our allies in our mission to educate, raise awareness and reduce environmental impact. We are aware of the significant environmental impact of health care and have made it our duty and obligation to drive change that enables better patient care while maintaining a balance with the needs of our planet. “

–Dr. Jorge Dario Duque Erazo, environmental manager of the San Rafael de Pasto hospital

More information

Read about San Rafael de Pasto Hospital's efforts in Healthcare Without Harms Report the Hospitals that Cure the Planet.

This story is part of a series of case studies on climate change and health. Case studies are designed to highlight the links between climate change and human health, and highlight some of the solutions that are being implemented by the health community. Case studies do not necessarily represent WHO or any of its Member States.


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