DR GEORGE MUKHARI HOSPITAL UPGRADE SHOWCASES SPECIALTY SPECS

Leading consulting engineering and infrastructure advisory firm Zutari has registered the first Green Star-rated hospital in South Africa. “With regard to sustainability, we have an excellent track record in green building, with over 100 registrations to date,” comments mechanical building services associate Willie Kotze.

When Rand Merchant Bank’s Pandemic Intervention & Relief Effort fund required assistance to boost the country’s critical care capacity during the Covid-19 pandemic, it turned to Zutari.

The consultancy assisted with heating, ventilation and air-conditioning (HVAC) upgrades at Livingstone Hospital in Gqeberha, Eastern Cape and King Edward VIII Hospital in Durban, KwaZulu-Natal. Zutari was also tasked with completely refurbishing the high-care unit (HCU) and intensive care unit (ICU) at Dr George Mukhari Hospital in Ga-Rankuwa, Gauteng.

At Livingstone, the installation was undertaken in an active Covid-19 ICU ward during hard lockdown. In contrast, at Dr George Mukhari, the ICU wards could be handed over for complete refurbishment.

Zutari collaborated with SM Maré & Associates Quantity Surveyors and principal agent Osmond Lange Architects

+ Planners at Dr George Mukhari. Its scope of work was structural, electrical electronics, wet services, fire engineering and HVAC.

The time-frame was April 2021 to the beginning of 2022, with the HCU and ICU refurbishments running in parallel. However, the hospital had to maintain its ICU capacity due to Covid-19, meaning this portion of the project was extended to September 2022.

Technical director Leon Esterhuizen, who has two decades’ experience in electrical engineering, explains that the refurbishment had to be designed in accordance with R158, the Department of Health’s specification for private hospitals.

“We carried out an assessment of the portion of the bulk infrastructure that supplied these wards to establish what was happening upstream,” he says. In the end, this portion – along with the electrical installation of the wards – was replaced completely to ensure compliance.

Other requirements were special lighting to allow medical staff to visually identify patients’ conditions, such as a blueish colour indicating oxygen deprivation. The facility also had to remain fully functional, even during power disruptions.

Civil engineer Vincent Gieselbach says the refurbishment elevated a public-sector hospital to a private-sector level. “Building it up to that standard was the challenge,” he adds. Zutari quickly ascertained that the existing sewer and water mains required additional repairs.

In terms of fire engineering, in ICU and HCU facilities, critical patients must be evacuated in their beds by nursing staff or fire-fighting personnel in the event of a fire. Therefore, escape routes had to be widened to accommodate beds. In addition, the entire facility must contain the spread of fire and smoke.

The building was deemed to be non-compliant, as the x-ray and HCU units were connected via ceiling boards, which meant a new firewall had to be constructed. There were numerous ramps throughout the site due to the high number of level changes, which required careful consideration of fire door placement and operation.

There were also various challenges in terms of the wet services installation due to the age of the existing infrastructure. To ensure that plumbing installation of the two units was upgraded to modern standards, all new hot and cold water pipe materials, with a new central hot water generating plant to SANS-XA, were installed.

The wet services engineering team was co-ordinated with the other disciplines’ engineering teams to ensure there were no clashes. Another major challenge was the decades-old external reticulation, for which no as-built information was available, thus requiring a detailed assessment before work could commence.

Structural engineer OJ Ojayi says the main challenge was that the hospital remained functional during the refurbishment. “We had to pay close attention to where the existing services were located so that we didn’t disrupt them,” he explains. Trusses had to be checked structurally to ensure that they could accommodate extra loadings, such as a new ceiling and additional services, and reinforced where required.

“We had to try to re-use as much of the existing material as possible,” points out Ojayi. Instead of breaking down the entire structure and rebuilding it from the bottom up, Zutari came up with an elegant solution for lateral reinforcement of the brick walls by adding external fins. Another major challenge was the decades-old plant room, for which no as-built information was available, thus requiring a detailed assessment before work could commence.

HVAC was an important consideration regarding infection control via pressure cascading, air movement, humidity control, dilution and filtration, adds Kotze. No water cooling was opted for and no ozone-depleting refrigerants were used, while heat pumps were selected, rather than resistance heating.

“Co-ordination between the extensive number of services was critical to provide easy access for future maintenance,” says Kotze. In addition, robust new systems provide simplified maintenance over the long term.

Despite the pandemic having subsided to manageable proportions, Kotze says that the healthcare sector presents major opportunities for Zutari’s specialised multi-disciplinary skills set, especially in HCU and ICU facilities. “This is one of the most interesting and rewarding sectors in terms of engineering, as well as being essential to meet the healthcare needs of SA’s growing population,” he observes.

Afrimat’s Nkomati Anthracite mine in Mpumalanga officially opened the newly renovated and extended Steenbok Clinic, in partnership with the Mpumalanga Department of Health and the Department of Mineral Resources & Energy.

Stakeholders who attended the event included the Mpumalanga MEC for Health Sasekani Manzini, the executive mayor of Nkomazi Local Municipality Cllr PP Magagula, the Speaker of the Nkomazi Local Municipal Council Cllr HV Nyambi and Inkosi of the Kwa-Lugedlane Traditional Council Inkosi Ngomane.

Afrimat Nkomati Anthracite spent R3 800 00 in funding the construction of an additional wing and a total facility upgrade of the clinic.