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December 4, 2022

Tesseract Architecture Analysis: Romania’s healthcare system is not ready to respond to climate change

Romania needs to renew its healthcare infrastructure, both to help mitigate climate change  and to cope with its effects, such as rising temperatures and heat waves

TESSERACT ARCHITECTURE, the single architecture studio in Romania specializing in medical design and one of the few of its kind in Central and Eastern Europe, draws attention to the impossibility of hospitals in Romania to cope with climate change, especially with rising temperatures and increasingly frequent heat waves.

As we are already talking about hospitals built several decades ago, the facilities were not foreseen for such situations, the whole hospital infrastructure is already outdated in terms of new construction norms and technologies that should be implemented.

According to the World Health Organization (WHO), between 2030 and 2050 human-induced climate change is expected to cause an additional 250,000 deaths per year worldwide due to malnutrition, malaria, and heat stress. This threatens years of progress in public health towards improved access to safe drinking water and adequate nutrition.

At the same time, a significant proportion of the medical industry contributes to the greenhouse effect, accounting for 5% of global carbon dioxide emissions. Compared to commercial buildings, hospitals are more than twice as energy intensive. A large amount of medical equipment and 24/7 lighting speak for themselves in this respect. Operating theatres generate up to 70% of a hospital’s total waste, depending on their number and size, and consume between 3 and 6 times more energy than the rest of the hospital. Although in some countries attempts have been made to reduce energy consumption by combining fresh air exchanges with a small percentage of recirculated air, the recent pandemic has dismantled this solution and other approaches are needed to reduce the carbon footprint of the healthcare sector.

“In terms of sustainable design, there is a lot of talk about construction methods: efficient building insulation, use of environmentally friendly materials, use of electrical equipment with minimal energy consumption. However, in relation to the medical field, indirect tools leading to minimizing consumption are often treated superficially. Of these, what particularly concerns us in medical design is shortening the time spent in hospital by the patient through the psychological factor.”

An important contribution to reducing greenhouse gas emissions is to reduce energy consumption through measures such as good thermal insulation, scheduling, and efficient use of heating and lighting. However, these measures need to be complemented by less obvious measures to prevent negative environmental impacts. For example, a Swedish study highlights telemedicine, which can help reduce carbon dioxide emissions associated with transporting medical staff. The partnership with local authorities should aim at providing efficient public transport and developing alternative transport infrastructure that does not pollute (e.g. bicycles, scooters, etc.).

Another principle is to create a human environment through architecture, which contributes to reducing the number of days spent in hospitals by patients. Since healing is correlated with the patient’s mood, creating friendly spaces that are both standard and functional can provide a more pleasant hospital experience.

At the same time, Romania needs as many hospitals as possible that can cope with the number of future illnesses associated with the climate crisis, from above-average temperatures to new viruses emerging due to climate change. The WHO scenario indicates that between 2021 and 2050 temperatures will be 1.5 to 2.5 degrees Celsius higher than between 1961 and 1990, while between 2061 and 2090 temperatures in our country will be 6 degrees Celsius higher. The air could become stifling and Romania’s climate will reach the same temperatures as in Kazakhstan.

“We always recommend the development of Master Plans and strategies for the development of healthcare infrastructure, so that there is a macro, long-term perspective. We need 3, 5, or 10-year plans based on the real need of the population segment addressed in the area and on a documented analysis of all the factors that can influence the functioning of a hospital”, says Raluca Soaita.


What are Romania’s healthcare system solutions to face the climate crisis?


  • Reducing the electricity consumption. As more and more efficient equipment is emerging that requires high consumption of electricity, it is necessary to address solutions that decrease consumption due to heating, ventilation, and lighting. The architectural solution plays a very important role, as the orientation of the building can provide a natural shading system, and an appropriate thermal insulation system, i.e. the use of materials that reflect and do not absorb the sun’s rays, can optimize the use of resources.
  • Use of renewable, environmentally friendly materials. An example of this is the use of finishes for floors, walls, etc. made from natural materials, with solvent-free binders and adhesives. These types of finishes have already been used internationally for some time and are increasingly being introduced in Romania by manufacturers investing in sustainability.
  • Flexibility in partitioning the interior spaces. During the life of a hospital, some wards may be moved, new treatments may be introduced, and new diseases may need to be reconfigured. Preventing future needs by designing a space that is adaptable as far as technically possible allows the space to be reused appropriately, without the need for a new building.
  • Allocate a budget for landscaping in new projects. Landscaping contributes both to the well-being of hospital users and to providing increased air quality, creating a natural shading system, and maintaining lower ambient temperatures.
  • Awareness on the importance of a pleasant environment for all users. A design that supports both a more pleasant working environment for staff and an environment that contributes to patient healing – is a solution that can also be implemented in existing healthcare facilities through rehabilitation projects that improve the conditions offered.
  • The use of telemedicine as an alternative to minimize the impact of polluting transport.

These solutions must, of course, be underpinned by an updated legislative framework governing the design of healthcare facilities and public-private partnerships to support climate change mitigation efforts.

TESSERACT ARCHITECTURE, the only local architecture studio specialized in the medical field, is the designer of the largest recent hospital project in Romania – Marie Curie Children’s Hospital, the first National Children’s Hospital for Cancer, Serious Diseases and Trauma. TESSERACT architects also sign two other large county hospitals currently under construction, in Sibiu and Focșani. TESSERACT has also designed the first modular hospitals in Romania for the care of Covid-19 patients, as well as numerous projects for clinics, hospitals, and other medical spaces for private operators.





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