Water Management by Healthcare Institutes

Introduction- Water is a major natural resource on our planet. All beings on this planet owe their survival to this life saving elixir. However point to remember is this elixir is in limited quantity at least for the foreseeable future. 75 % of our planet surface is covered with 97 % of available water, 1 % each is locked into North & South Pole ice caps. Balance 1 % is fresh water which is meeting needs of all the three main users, namely Agriculture 70 %. Industry 20 % and balance 10 % for domestic needs. Primary source of water is Rains. With Global Warming, extreme climate events are experienced all across the globe. 93 % of heat generated due to the global warming is absorbed by the ocean waters. One of the major fall out is distorted hydrological cycle which provides us monsoon rain, our life line. All the river systems & other water bodies in India are highly polluted, making surface water unfit for any consumption. With polluted surface water, deficit monsoon we depend more on groundwater resource. Our present attitude towards water Use & Discard needs to change to Use, Recycle grey/ hospital water, Reuse recycled water, Conserve available water, Recharge every drop of rainwater to improve rapidly falling groundwater aquifers, & Discard any balance water.

Role of Water in Healthcare Institutions- More than 2.2 million people die every year due to consumption of contaminated water. Healthcare Institutions require large amount of safe quality of water to meet their needs. Being the part of the society they too face water shortage. Lack of safe drinking water, adequate sanitation hygiene in healthcare is not acceptable, since patients are highly susceptible to infection. Simple thing like hand washing with soap is the single most important practice to reduce transmission of infection in healthcare. However it has been noticed all over in healthcare set up that hand washing compliance is very poor.  This is more prevalent in rural healthcare facilities. Average water consumption in the hospitals is around 750 litres per day per bed. It is used by

·       Sanitation & Hygiene -        40 %

·       Medical Process -                 15 %

·       Food services  -                     10 %

·       HVAC  systems  -                   20 %

·       Laundry    -                             05 %

·       Misc    -                                   10 %

Quality of Water- The quality of water supplied to the healthcare units affects every aspect of hospital operations. It is therefore essential that, water of suitable microbiological quality is provided for drinking, lab procedures & in medical / surgical treatments. Appropriate quality of water is essential for the medical equipment, dietary purposes etc. A regular inspection to check the source of water supply, quality of water transport system, storage & distribution network upkeep. The routine microbiological & chemical analysis of water is of utmost importance. The routine water processing programme in any healthcare unit includes treatment of water, de-ionisation, distillation, filtration & sterilisation.

Recycling of Hospital Water- Healthcare Institutions are significant consumers of water. They generate considerable amount waste water containing,

·        Pathogens & Bacteria

·        Virus

·        Pharmaceuticals

·        Toxic chemicals 

·        Heavy metals,  etc

Water  shortage is going to be routine in rural & urban healthcare centres due to factors like, climate change, rise in population, deficit monsoon etc. Recycling of hospital water attains important attention in water supply management to tide over water shortage. Recycling requires collection of hospital water & subjects the same in a specially designed recycling system. This system is different than normal domestic recycling system; it first uses chemical, agitation, and light processes to clean foul hospital water for gardening and toilet flushing. With, ultra-filtration and reverse-osmosis process the hospital water can be further cleaned to a level suitable for reusing this water in the Hospital’s laundry and cooling facilities. Waste water from the laundry should further be recycled resulting in zero discharge. Such a system require funds for installation & maintenance, but point to note that proper recycling of hospital water can reduce water bill by almost 40 %.

Recharging of Ground Water- local body govt supply of water & recycling of hospital water alone is not going to meet the water demands. Recharging of falling ground water table will be playing very important role in water supply management of every habitat. Somehow we have failed to understand the potential of Rain Water. A 1000 sq ft of catchment area like roof top receives 10,000 litres of rain water when rain fall is 100 mm. Pune receives around 750 mm of average annual rain fall, meaning, every 1000 sq ft of roof top receives 75,000 litres of rain water annually. Mumbai receives 3000 mm of annual average rain fall, amounting to 300,000 litres of annual rain water collection on 1000 sq ft roof top. Today in the absence of recharging of ground water systems this nature’s bounty is going waste. A old & renowned hospital in Pune was Tanker Water dependent to meet their water demands. 5 bore wells & one open well on the hospital campus had gone dry due to falling ground water level. Their annual tanker water demand was 1000 tankers, amounting to 1.20 crore litres of water. In 2006 the hospital installed Roof Top Rain water harvesting ( RWH ) system to recharge ground water through their 5 bore wells. The roof top area available for RWH system was around 27000 sq ft , collecting around 20 lakh litres of water annually. After recharge, the hospital was able to get their need of 1,20 crore litres of water from recharged bore wells. This made them tanker water free. This hospital received around 6 times more water than the amount of rain water channelized in to ground water through bore wells. This potential of rain water combined with RWH system will help meet water demands along with improving ground water table.

Rain Water Harvesting ( RWH ) – RWH is a simple methods we can recharge underground aquifers. Every type of infrastructure has got the basic components of a simple roof top RWH sys. The system has :

·       Roof as a catchment area to receive rain water

·       Down take pipes from roof top to drain out rain water

·       Storage- it can be any type of tanks to store rain water, or open/ bore wells to harvest rain water.

·       Simple RWH filters to filter out any dirt, leaves, twigs, bird droppings etc, from entering rain water storage.

·       Open space to construct recharge pits if surface water RWH systems needs to be implemented.

Since the rain water is directly injected in to aquifers, the 100 % soft rain water instantly raises the underground water level, another advantage is , as the rain water does not travel through the soil to reach the underground aquifers, this water does not absorb water soluble salts from the soil and hence does not get contaminated. Healthcare institutions also need clean water for its use. Also it is prudent to save & recharge every drop of rain water, when water shortage is being faced all over.

Emergency Water Supply Plan- In present global warming environment life saving natural resource WATER is going to be short supply. Recent NASA study shows that 4 billion people all over the world are facing varying degree of water shortage.  In order to maintain daily operations and patient care services, health care facilities need to develop an Emergency Water Supply Plan (EWSP) to prepare for, respond to, and recover from a total or partial interruption of the facilities’ normal water supply. Water supply interruption can be caused by several types of events such as natural disaster, a failure of the community water system, construction damage or even an act of terrorism. Because water supplies can and do fail, it is imperative to understand and address how patient safety, quality of care, and the operations of your facility will be impacted. Below are a few examples of critical water usage in a health care facility that could be impacted by a water outage. Water may not be available for: hand washing and hygiene drinking at faucets and fountains; food preparation; flushing toilets etc.

Conclusion- According to World Health Organisation every penny spent on Quality Water & Sanitation in Healthcare will generate at least FOUR times that amount through increased productivity. "The human right to water entitles everyone to sufficient, safe, acceptable, physically accessible and affordable water for personal and domestic uses" as per UN. Healthcare plays very important role in not only assuring sound health to every citizen , but also improves the economic growth of the Nation due to improved Man Days at the work places. Thus it is important that Healthcare institutions make use of all possible water resources like corporation water, Use of Recycled hospital Water, Water Conservation & recharging every drop of rain water to augment their water supply.