Zeroing in on Waste
Netcare Blaauwberg Hospital in Cape Town cut its landfill refuse to achieve Net-Zero Waste, setting a high bar for sustainability initiatives in the healthcare sector.
In March this year, Netcare Blaauwberg Hospital in Sunningdale, Cape Town, was certified Net Zero Waste: Level 2 – Operational Waste (Measured) by Green Building Council South Africa (GBCSA), making it the first hospital in the country to achieve this accolade. The certification is valid until 2029, whereupon it can be reassessed and certified for a further three years. To achieve this milestone, the hospital reduced its general waste to landfill by more than 90%. The required diversion rate was achieved through in-house waste management strategies, without purchased offsets, and is deemed to be in line with global best practice.
The certification
The GBCSA’s Level 2 Net-Zero Waste certification process measures and analyses an existing building’s operational waste streams. The goal is to ensure that waste is reduced, reused and recovered. This certification lasts for three years and then requires re-certification to take place to ensure that the project’s waste performance is being maintained. Level 1 Net-Zero Waste is a separate category for new builds and measures waste produced during the construction period of a building’s lifespan.
Netcare’s bold ambition
The Netcare Group first implemented its environmental sustainability strategy in 2013, and then, as Environmental Sustainability Manager for the Netcare Group André Nortjé explains, became the first healthcare institution on the continent to join the United Nations’ Race to Zero 2050 campaign in 2021.
Nortjé explains that the Netcare Group publishes details of its progress and performance in the sustainability area, including waste-management progress, in the Group’s annual integrated report. The Group has adopted a strategy that focuses on waste diversion from landfill across all its facilities and they are currently achieving around 85% landfill diversion, while maintaining a steady focus on achieving zero waste to landfill across all their facilities. “Many of the principles implemented at Netcare Blaauwberg Hospital (including separation at source, staff engagement, recycling partnerships and operational monitoring) are scalable and can be adapted across facilities of varying sizes and resource levels,” says Nortjé. “The initiative also supports Netcare’s broader environmental commitments relating to responsible resource management, circular economy principles and reducing the environmental footprint of healthcare operations.” At the end of the 2025 financial year, the cumulative waste savings for the Netcare Group amounted to R94 million, according to the annual report.
“Only by setting ambitious environmental objectives can these goals be achieved. Alongside Netcare’s strategic efforts to improve energy and water efficiency and reduce reliance on non-renewable resources across our operations, minimising waste to landfill is a fundamental component of minimising our operations’ footprint on the planet,” Nortjé continues.
The process to accreditation
The Accredited Professional (AP) on this project – Jaybe van Rooyen, Operations Director at Zero Waste Technologies – explains that to achieve a certification like this, organisations need to move beyond simple recycling and embrace the “waste hierarchy”. This, he says, means considering three main areas: upstream procurement and reduction; behavioural change and culture; and specialised downstream off-takers.
Van Rooyen explains that the top priority in the waste hierarchy must be an intensive look at upstream procurement and reduction. “Achieving net zero is not merely about diverting waste from landfill or increasing recycling rates.” he says. “It involves rigorous upstream planning to procure alternative sustainable materials that eliminate waste before it enters the hospital.” This foundation of reduction and reuse ensures that the later waste management is more effective.
Because this process focuses on operational waste, the next step in the waste hierarchy is to change the behaviour and culture of the people within the organisation, who produce the waste and discard it. “True waste diversion requires intensive on-site awareness training. Shifting organisational culture and driving daily behavioural change among staff is one of the most challenging, yet vital, components of promoting strict on-site source separation,” says Van Rooyen.
Once the quantity of waste has been minimised at source and the remaining waste has been carefully sorted on site, the last phase of the waste hierarchy considers the downstream diversion of the waste components. Van Rooyen highlights both the importance and the complexity of this process when he says that “finding compliant, specialised recyclers and sustainable off-takers for diverse, non-hazardous operational waste streams is a highly intricate process”.
Power in partnerships
Transforming sustainability targets into verifiable realities like this is not possible by working in isolation. Van Rooyen highlights the importance of integrated partnerships with waste management teams who share the vision and have the right technical expertise.
Dimakatso Nhlapo, Netcare’s National Lead on Integrated Waste Management, concurs that establishing the necessary waste management partnerships, and robust infrastructure, is key to the success of this kind of initiative. She explains: “There were upfront implementation and operational costs associated with infrastructure, training, auditing and waste handling processes,” but these investments “were aligned with the Group’s broader environmental sustainability strategy and long-term waste management objectives”.
Nhlapo explains further that they developed on-site waste sorting systems and improved recycling processes for materials such as paper, cardboard boxes, plastics, textile waste and e-waste. She adds that they identified items in common use in the hospital that could be reused safely and implemented systems to enable these items to be properly cleaned and disinfected before being reused. A composting system was also implemented for organic waste such as food scraps and garden waste.
The challenges
“Achieving a Net-Zero Waste certification is a phenomenal milestone,” says Van Rooyen. “The sheer complexity of reaching this standard in a healthcare facility, where operational demands are high and waste streams are complex, requires an extraordinary level of dedication from both the hospital staff and waste management team.” Nortjé states that the hospital is currently achieving between 95% and 97% waste diversion from landfill. “The remaining portion primarily consists of non-recyclable items, contaminated waste streams or material for which there are currently limited recycling solutions or no available service providers in the Western Cape.”
One of the biggest challenges in achieving 100% waste diversion in a hospital environment is the portion of waste considered hazardous or high risk (including blood-contaminated items and pharmaceuticals). Nortje explains that healthcare-risk waste is currently excluded from the certification’s diversion rate calculation, as its treatment and disposal is strictly regulated. Netcare is proactive in its exploration of other solutions to reduce this waste. “Currently more than 40% of healthcare-risk waste across the group is being repurposed or beneficiated through approved processes,” he says. Netcare is also engaging with various stakeholders, including the Department of Forestry, Fisheries and the Environment (DFFE) to discuss possible future solutions to the reduction and repurposing of different types of waste.
Nhlapo highlights that another significant challenge was “embedding consistent waste separation practices across a complex 24-hour healthcare environment”. She adds that this was only achievable through ongoing staff awareness campaigns, behavioural change initiatives, continuous training and close operational monitoring to ensure that waste streams were separated correctly at source.
The future
Alan Abrahams, Netcare’s Regional Manager and General Manager of Netcare Blaauwberg Hospital, commends the teams involved in achieving this milestone: “This Net-Zero Waste certification reflects the commitment of our teams to embedding sustainable practices into daily healthcare operations. This milestone demonstrates what can be achieved through collaboration, staff engagement and continuous innovation in responsible waste management.”
Each new success story sets a new benchmark and encourages others to follow or improve on the newly set records and targets. Nortjé highlights this when he says, “We anticipate that many of the learnings from this first hospital’s Net-Zero Waste certification will be replicable across other Netcare hospitals, and will inspire other healthcare providers and corporates to seek ways to reduce landfill waste through similar initiatives.”
Abrahams encourages other healthcare institutions to follow Netcare’s leadership and adds, “Caring for people and caring for the environment should be indivisible, yet progress towards sustainability requires commitment to measurable steps leading to the goal of Net-Zero Waste within the broader aims of the global Race to Zero.”
