5. #LowCarbonHealthCare
CS 1 - Food:
Vegetarianism and Utilization of Reusable Food Containers reduces Carbon Emission
https://gghhconnect.cisconetspace.com/group/food/case-studies
CS 2 - Water: A precious Commodity
Conserving and Reducing Water Consumption through Using Recycled Reject Water Processed
from Water Treatment System
https://gghhconnect.cisconetspace.com/group/water/case-studies
CS 3 - Waste: Reduce, Re-use, and Recycle For Our Future Generations
https://gghhconnect.cisconetspace.com/group/waste/case-studies
CS 4 - Energy :
The Implementation of Energy Saving Practices Optimizing Consumption and Reduction of
Carbon Dioxide Emissions
http://www.greenhospitals.net/case-studies-3/#energy
6. #LowCarbonHealthCare
Buddhist Tzu Chi Dialysis Centre
- policy requiring all employees to bring only vegetarian food
in reusable containers to work
“ONLY VEGETARIAN FOOD POLICY”
- implemented since 1997
7. #LowCarbonHealthCare
Duration Plastic bags saved Average plastic wt – 10 g Reduction of CO2 emission
(1 Kg of plastic: 6 Kg of CO2 )
Computation
Process
(days * average
plastic consumption)
(average no. of plastic
containers * Average plastic wt)
(total plastic weight * CO2
Emission of Plastics)
1 Day 200 bags 2 Kg 12 Kg CO2
25 Days 5000 bags 50 Kg 300Kg CO2
300 Days 60,000 bags 600 Kg 3,600 Kg CO2
Carbon Emission Reduction through reduction of plastic bags
100 Employees & Patients = 2 plastic bags each
Food packed in reusable containers
by patients & Employees
8. #LowCarbonHealthCare
A matured tree - 22 kg of carbon
dioxide per year and 1 ton of carbon
dioxide by the time it reaches 40 years
old.
By reduction of 3,600 Kg CO2, it is
equivalent to planting/saving 163
trees in a year
( considering on the working days of
300 days)
11. #LowCarbonHealthCare
Waste generated by a single
haemodialysis treatment was
substantial
While this waste production
cannot be eliminated, there are
measures that can be taken to
substantially reduce
12. #LowCarbonHealthCare
Clinical Waste Management:
In Malaysia, the clinical waste being classified as scheduled waste that is
controlled under the Environmental Quality (Scheduled Wastes) Regulations,
2005.
All healthcare establishments in Malaysia adopted the standard colour
coding which is widely accepted:-
BLACK : General wastes
YELLOW : Clinical wastes for incineration only
26. #LowCarbonHealthCare
Water – A Precious Commodity:
HD Treatment – 120 L dialysis fluid/session
(4 hours)
*** Generally the production of RO ( Reverse Osmosis) water
– averagely 40-60% rejection rate
50% - 300 L raw water
( preparation and reprocessing of dialyser)
28. #LowCarbonHealthCare
Water Control System Average Daily Usage Total Water
Usage
Water Saved Total Water Saved (for 100
persons)
RM Saved
Water Control
System
Average Daily usage Total water
usage
Water
saved
Total water saved
(for 100 persons)
Standard Tap
(15 L/Min) 5 times
(10 secs) / person /
day
12.5 L 9.5L 950 L
Controlled Flow
Tap (4L/Min) 3.0 L
Single Flush System
(12L/ Flush) 5 times / person /
day
60 L 40L 4000 L
Dual Flush System
(4L/ Min)
20 L
Comparison of Water Consumption Base on Water Control System
Installed - Water Taps and Toilet Flush
Tzu Chi Dialysis Centre is registered under the NGO and we were the 1st in Malaysia to provide 100% free HD treatment to the under privileged group irrespective of race, religion …….the free treatment also include EPO injections, blood tests and other subsidies e.g transport and medication or other medical aids
We have 3 Dialysis centres – all in the northern part of peninsula Malaysia….total of 300 over patients.
We too provide subsidies to 150 patients doing dialysis in hospitals or other centres
Tzu Chi means COMPASSION RELIEF
Tzu Chi missions are a network of universal love. Tzu Chi works in the missions of charity, medical, education and humanitarian – Tzu Chi Dialysis centres are under the Medical mission
Other than 4 Missions, TC are actively involved in International relief, Bone marrow registry, community volunteerism and environment protection
In line with this mission, Tzu Chi dialysis centre participated in Global Green Healthy Hospital - GGHH and be a member since September 2016 with initial commitment in Waste, Energy, Water and Food out of the 10 Goals set by GGHH
Since then we had 4 case studies being published .
1st was on FOOD
2nd was on Water
3rd was on Waste
4th was on Energy
The carbon emission of plastic is about 6 kg CO2 per Kg of plastic.
A normal plastic bag used for food packaging is about 5 g -20 g depending on size and thickness. For the computation we used 10g and 100 pax
100 Employees and patients = 2 bags each pax ….
In Malaysia if we pack noodle for a person, we get 3 bags (at least) – 1 for the noodle, 1 for the soup/gravy and another to put those 2 in….that did not include if the noodle comes with sauces or additional ingredients.
200 bags/day !!!
In a year we can saved up to 600 kgs of plastic waste and reduction of 3,600 Kg CO2
With every employee and patient putting effort into practice – by not using plastic bags in food packaging we are able to reduce so much of carbon emission – 3,600 Kg which is equivalent to 163 tress being planted or saved.
And not forgetting the reduction in the landfill too…..
We do not only encourage our staff to eat vegetarian meals but also to all our visitors and patients….we are protecting the environment , reduce water pollution and deforestation and also reduce animal cruelty, suffering and deaths of countless animals.
With this practice we are improving our individual health by eating responsibly and ethically.
We do not face any issues of rejection or anyone against this policy, as we all respect and understand its implementation- even visitors from other countries …example here the nurses from Nepal, they too were so willing to learn and accepted the culture and policy.
We also actively participated in activity like Ethical Eating Day which involved all our employees/nurses, patients and family and volunteers
In this activity we not only promote vegetarian food but …..ethically and healthily
1. Waste not/eat less
2. Eat local produce
3. CHOOSE WHOLE FOODS - instead of processed food
4. grow own
5. Eat at home when possible.
The appropriate handling and disposal of clinical wastes generated from hospitals and other health care institutions and facilities is essential in order to mitigate against adverse health and environmental consequences.
ISO SINCE 2003 – ISO 9001/ MSQH –ACCREDITATION
There are items that we can control and prevent them from being thrown as waste and end up in the landfills.
Other than the segregation of the recyclable items – we used them for posters, decorations and teaching materials
In Malaysia we have many festivals and we celebrate all festivals because our patients are from different races and religions.
We also use the recyclable items to make cards and decorative items as gifts
Recycle: to re-use the item and create something else with it.
Refuse: to avoid buying products that are not sustainable or recyclable
Reduce: use less of something.
Reuse: to put into action or service again.
Repair: to repair products rather than buy new ones.
Re-gift
Respect: treat with consideration • • Rethink: to think about how you can reuse a product or its materials •
For every HD treatment – we use about 120 L of dialysis fluid/4 hrs /session ( which based on 500mls/flow rate per min)
On average, the RO water treatment system produces about 40-60% of rejection rate.
So if we take 50% rate – for each patient we will require about 300 L of raw water.
100 patients = 30,000 L of Raw water – that’s a lot of water requirement. In Tzu Chi Dialysis centre, ** The reject water are all reused for toilet flushing, cleaning of premises
This saved up a lot of water but we do not stop there…..
Even though we are re- using the water, we still encourage all our staff to save water in every way we can…this is an on-going campaign
. In addition to the Water Treatment System which allows us to utilize reject water, we are also implementing controls to reduce water consumption. These controls are as follows: Volume Controlled Faucets:
typical taps discharge 15 to 18 liters per minute compared with low-flow and aerating models which use as little as 4 litres per minute depending on the intended application
Taps with an aerator or flow restrictor may reduce flow to less than one third of the standard taps.
Dual Flush Toilets
an old-style single flush toilet can use up to 12 liters of water in one flush, whereas more water efficient dual flush toilets average less than four liters
By using the controlled flow tap and dual flush toilets, on average of each visit to the washroom enable us to save 9.9 L of water. With the total occupant of 100 people and on average of 5 visits per person to the washroom, we are able to save 4,950 L of water per day,
