Downscaling the need for common resources while saving money. Lessons from an innovative socio-sanitary structure run by a humanitarian NGO: Emergency’s Salam hospital in Khartoum, Sudan

A really equitable use of common resources is more and more a must to face the compelling issues of ecological sustainability and climate change, yet it also represents an often neglected responsibility to overcome a culture of social injustice, exploitation, and war at a global level. In the world of humanitarian NGOs, paradoxical counter-productive effects might follow frequently necessary monetary savings if a systemic vision is not adopted. For this research, an Italian NGO – ‘Emergency’ – has been chosen as a case study, for its undertaking a significant care for sustainability alongside an ethical spending sobriety, respectful of its donors. The emergy method has been applied to one of the hospitals that such NGO planned, built, and currently runs in areas of crisis: the Salam Centre for Cardiac Surgery in Khartoum, Sudan. The structure offers free high standard assistance to people from many African and non-African countries. On average, nearly 800 patients are admitted every year, and over 700 of these undergo an open-heart surgical operation. Sudanese nurses and medical doctors are also trained inside the Salam Centre. The functioning of Emergency’s healthcare provision system significantly relies on voluntary donations, whose flows have therefore been investigated and highlighted in this work. Among the research questions is the evaluation of the NGO’s efforts to save Commons since the planning phase until the everyday management of a complex structure in a complex environment. In addition to this, the whole ‘Emergency model’ is analyzed as a possible example for more applications in the sanitary and non- sanitary field. Building technologies, energy systems, hospital operations, and donation mechanisms are taken into account. A focus is dedicated to the architectural low-tech innovation while targeting energy efficiency. Parameters are proposed for the comparison with other structures, as well as for the assessment of socio-economic effects of the hospital in both its support and its benefit areas.