Managing Hospital Waste: A guide for Southern African Health Care Institutions (2004)

Executive Summary

Health Care Waste is a mounting problem in South Africa as in many other countries. Health Care Waste problems in South Africa have reached uncontrollable proportions. Desktop studies show almost half of health care waste generated in KwaZulu-Natal alone cannot be accounted for, suggesting that it is being illegally dumped, buried or burnt somewhere, thus affecting the health of people and the environment. Some other common problems connected with health care waste include inadequate waste management, lack of education about the health hazards, insufficient financial and human resources and poor control of waste management.

Wastes from health care facilities can pose a risk to health care workers, patients and local communities. While there is much concern about the possible spread of disease (especially from contact with “sharps” such as needles), the treatment of those wastes, through incineration, can release an array of hazardous pollutants into the air and water.

However, it is obvious that the problem of health care waste will not disappear overnight. It is imperative that all stakeholders involved take ownership and responsibility. These include medical practitioners, healthcare administrators, hospital waste collectors, municipalities, waste collection companies, regulatory bodies, government as well as civil society. Just as a chain is strong as the weakest link in it, so all personnel need to be involved. But the prime responsibility lies with the generator of the waste. It was with this idea in mind that groundWork has published this manual, so as to tackle the root of our health care waste problems being experienced.

It is also important to stress that health care waste at our hospitals is a management problem as opposed to a technological one. Technology, however, is not to be totally dismissed but must be viewed as part of a much larger solution. Training for segregation for all hospital personnel encompassing elimination, reduction, reuse and recycling of materials is the way forward if the problem of health care waste is to be accomplished.

Once segregation has occurred and a hospital has its proper waste minimization plan in place, can an environmentally friendly alternative technology be considered. However, the continued use of incinerators in many hospitals is attributed by misleading information on this outdated technology. With markets dying in the north for incinerators, industries are therefore pushing their attention to the south. Health care facilities need to adopt more sensible practices if improvements are to be made.

This manual presents an adequate coverage of the health care waste management and commonly acceptable practices to meet the requirements of existing laws and regulations. A step-by-step process of developing a health care waste environmental management plan is discussed in the manual. Waste prevention and minimization techniques are also presented in an effort to improve healthcare waste handling systems within the healthcare facilities.

Hospitals and other healthcare establishment have the responsibility of certifying that there are no adverse health and environmental consequences of their handling, treatment and disposal of healthcare waste. Through this manual, healthcare institutions will be able to install a more appropriate waste management system that could provide benefits such as an improved regulatory compliance; protection of human health by reducing the exposure of employees to hazardous waste in the work environment; enhance community relations by demonstrating a commitment to environmental protection; economic benefits resulting from pollution prevention products that reduce and recycle waste; avoidance of long-term liability. Healthcare establishments are the ones responsible for proper management and disposal of the waste they generate and this will increase employee morale resulting from a healthier and safer work environment.

It is hoped that this manual will help many health care institutions in South Africa towards establishing improved health care waste management practices, which will ultimately contribute towards sustainable development for future generation. The target groups of this manual are individuals and groups responsible for overseeing the health care waste stream. This manual must however not be seen as an end in itself since each hospitals waste management plan will not be identical to another hospitals plan and will need to be implemented accordingly. It is hoped that the experience is rewarding.

(2004) Managing hospital waste: A guide for Southern African health care institutions, Pietermaritzburg, South Africa, Arrow Print, 83 pages.

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