Belgian Doctor Journeys to Lithgow & the Blue Mountains to Learn More About Planetary Health

Louis Wauters

Louis Wauters outside Lithgow Hospital (Photo supplied)

Story by Louis Wauters

A Belgian medical doctor has journeyed to Lithgow and the Blue Mountains to learn more about Planetary Health and, while spending time at the University of Notre Dame’s Clinical School in Lithgow, has also explored Lithgow Hospital’s use of geothermal ground-source heat pump technology as part of its strategy to provide ‘green power for health’.


Key Points:

  • Belgian doctor Louis Wauters is keen to tackle the root causes of our 21st Century health challenges, so has travelled to Lithgow and the Blue Mountains to explore how Planetary Health is being implemented in local government.
  • With health systems in developed nations contributing about 5-8% of global greenhouse gas emissions, he was also interested to learn more about Lithgow Hospital’s use of geothermal ground source heat pump technology.
  • Geothermal heat pump technology can be retrofitted into homes and will pay for itself in 8-18 years.

Last year I graduated from medical school at the University of Ghent in Belgium, and during my clinical rotations I had the feeling of not getting to the root cause of the problems we were confronting. There is a Dutch saying that describes how I felt: that we were just mopping up water while the tap was on and the water kept running. Wouldn’t it be great to, where possible, prevent people from becoming sick instead of just treating sick people. Wouldn’t it be great to turn off the tap and not need to keep mopping!

This feeling led me to the area of preventive healthcare. With the biggest health threats of our time being climate change and ecosystem changes, I then ended up looking into Planetary Health.

Planetary Health is a discipline that sees the health of people intrinsically connected to the health of the planet: the ecosystems, the climate, and all of nature surrounding us. If we foster a healthy planet, we also foster our own health.

I started to delve deeper and had the opportunity to undertake an internship with the Planetary Health Alliance, the leading global body on Planetary Health. I learned so much from this experience but felt that it only catered to academia. This didn’t leave me satisfied, as I wanted to know how Planetary Health could make a difference in people’s lives.

I searched for where Planetary Health was being used as a framework to guide policy for communities and found that Blue Mountains City Council was the only place in the world that appeared to be doing this with its Planetary Health Initiative in Katoomba. I contacted the Initiative and arranged to come to Australia to learn from the work being done here.

Louis Wauters at the Planetary Health Initiative in Katoomba

I received a warm welcome on my arrival from Lis Bastian (left) and Saskia Everingham (right) from the Blue Mountains Planetary Health Initiative (Photo: Lis Bastian)

Two weeks ago I arrived in Australia and made my way to the Blue Mountains. The University of Notre Dame kindly provided me with accommodation near the hospital in Lithgow. I got to know people at the University and medical students who were having their rural rotations in the Lithgow area.

Staying near the hospital I discovered that it uses geothermal ground source heat pump technology to cool the hospital during summer and heat it during the winter. I was intrigued by this cost-effective sustainable energy solution and investigated further.

Geothermal ground source heat pump technology for heating and cooling Lithgow Hospital (Image supplied)

Instead of using an external cooling tower, the geothermal system runs water through an underground loop and uses the stable temperature of the earth to gain or lose heat before running through 75 heat pumps to provide air conditioning. The stable ground temperature at around 50-100 meters below the earth’s surface will remain almost constant at 15-17°C during the whole year.

The earth acts as a heat source or a heat sink for the hospital by running 96 pipes filled with refrigerants, a type of fluid that acts as a conductor to transport the energy, through a closed pipe system. The system is drilled into the earth to a depth of 110 meters under the hospital’s car park. This was done over 25 years ago, to allow for easier future access and to limit interference with the construction of the hospital in 1998.

In 2023 the original system was replaced with more efficient units including a modern control system and new refrigerants with low Global Warming Potential values.

During the summer months, when cooling is needed, a heat pump takes the heat from the air and stores it in the refrigerant. The refrigerant then passes through the underground pipes and is cooled due to the surrounding lower temperature. During the winter months, when heating is needed, this same heat pump will take the heat from the ground, through the refrigerant, and dissipate it through the air in the hospital. This system gives sustainable heating during the winter, and sustainable cooling during the summer.

The closed loops provide enough capacity for 67 air conditioning units and 11 water-to-water units. The water-to-water units produce chilled and heated water to the operating theatre air handling units, heated water for kitchen space heating and the hydrotherapy pool, and process cooling for the central sterilising unit. The heat pump still uses electricity but for every kWh of energy used it provides up to 2-4 kWh of energy for cooling and/or heating.  

how geothermal heat pumps work

How geothermal heat pumps work.

This system can be an alternative to, or supplement solar panels., as it does in Lithgow. The added benefit is that it is more resilient in the face of external weather conditions. Unlike solar, it works as well during rainy or smoke-filled months or during winter when there is less sun.

Lithgow Hospital’s infrastructure includes a 367-kilowatt solar photovoltaic system, and 1,563 LED lighting upgrades. On a bright summer’s day between 9 am and 3 pm the hospital’s entire electricity usage can be covered by green power. Some energy can even be sold back to the grid.

According to Scott Hanson (formerly Nepean Blue Mountains Local Health District):

“A traditional hospital air-conditioning system relies upon natural gas for large boilers to constantly heat water and electricity for air compressors to cool air.  The biggest advantage with the Lithgow Hospital geothermal system is that no natural gas is required.  All the heating and cooling of air is performed at the reverse cycle air compressors using electricity.  In addition, the water used is pumped through the geothermal loop underground to use the consistent temperature of the earth to gain or lose heat naturally, thereby reducing the load at the compressor.  Finally, the 367 kilo-Watt roof mounted solar panel system provides enough electricity to power the system entirely for most of the day for free.  The geothermal system reduces the reliance upon fossil fuels by eliminating gas for the system altogether and reducing reliance upon electricity.”

lithgow hospital solar energy production graph

Producing more energy than the hospital consumes on a sunny day (Image: supplied)

367 kilowatts of Solar panels installed across Lithgow Hospital

367 kilowatts of Solar panels installed across Lithgow Hospital (Photo supplied)

The geothermal heating comes with a high capital cost for residential buildings, estimated between $15,000 and $40,000, but has low running costs as you get free energy from the ground up and it will pay for itself in about 8-18 years. It is not only possible in new homes but can also be retrofitted in existing homes as the pipes don’t need to be directly under your house.

In Europe, geothermal heat pump technology is used more commonly. In Belgium, up to 50% of new homes being built use this system, facilitated by government subsidies. There is even a debate going on about making this technology mandatory for new homes.

It was great to see these economically beneficial energy systems which help address the current ecological challenges. The geothermal heating system provides cleaner energy and saves money for the hospital at the same time. Added benefits of using geothermal for air conditioning in the hospital include eliminating noise and the risk of Legionnaires disease.

I will be looking further for other initiatives that pique my interest while staying here in Lithgow and learning more about the beautiful Blue Mountains region.


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This story has been produced as part of a Bioregional Collaboration for Planetary Health and is supported by the Disaster Risk Reduction Fund (DRRF). The DRRF is jointly funded by the Australian and New South Wales governments.

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About Louis Wauters

Louis Wauters has recently graduated from medical school in Ghent, Belgium, where he lives. At the beginning of his clinical career he has come here to learn about Planetary Health and all its benefits. He is a strong believer in preventive medicine, and wants to strengthen social and environmental health by helping to rebuild the communities and an ecological lifestyle in society and healthcare.

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