Month: June 2005

Health Care Waste in Southern Africa: A shift from waste disposal to waste management

Health Care Waste is a mounting problem in South Africa, Mozambique, Swaziland and Uganda as in many other countries. Over recent years there have been numerous press statements of medical waste being disposed of in an incorrect manner. The people that have been most affected by medical waste have been the poor disadvantaged members of society. The incineration of medical waste has also caused much concern. Numerous studies indicate that incinerators have been associated with a wide variety of health problems such as disrupting the bodies hormonal, immune and reproductive systems, and have caused cancers. Previously, civil society had not been given a platform to voice their concerns regarding the health impacts that health care waste and incineration has had on their quality of life, and only recently has civil society taken a stand to state that “enough is enough”, and have to sort ways to voice their concerns in a legitimate manner.

Desktop studies show that almost half of health care waste generated in the province of 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. Wastes from health care facilities 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, releases an array of hazardous pollutants into the air and water, thus affecting the health of our communities. There is also the lack of capacity in South Africa to properly dispose of the large unnecessary amounts of health care waste being generated. There have been numerous instances where health care waste has been dumped in residential areas, thus posing a hazard to the community and environment.

Health Care Waste project

Due to the fact that health care waste and incineration problems in South Africa have reached uncontrollable proportions, groundWork a young South African NGO committed to the process of reducing the impacts of health care waste and incineration and the potential impacts that it poses towards enhancing a sustainable society decided to initiate the Healthcare waste and incineration project. This project uses the twin prong strategy of working both with medical waste institutions to assist them in reducing their wastes, as well as with communities affected by the unsafe dumping or burning of health care waste.

This project aims to reduce and, where possible, eliminate the harmful effects of both health care waste and incineration on human health and the environment in Southern Africa. groundWork has since 2001 worked with two under-resourced hospitals to make them model institutions for other hospitals to follow. The aim was to help the institutions to reduce the amount of waste produced thereby saving costs and increasing occupational health and safety. The hospitals initially identified for greening are Ngwelezane hospital at Empangeni as well as Edendale hospital in Pietermaritzburg. This had commenced with a skillshare by groundWork and the international network Health Care Without Harm (HCWH ) in 2001 for the two hospitals so as to provide insight into proper health care waste management.
Improvements at Ngwelezane and Edendale hospitals

The number of red bags (containing infectious medical waste) generated at Edendale Hospital daily has dropped from an average of between 250 to 300 to around 70 bags a day. This has resulted in a cost saving for the hospital of between R35 000 and R40 000 a month compared to the R90 000 that was spent before the program was started. At Ngwelezane hospital, costs have reduced from R55 000, 00 per month to R35 000,00 per month. These have been significant cost savings for these government hospitals. Both hospitals, after the program was launched, now seem to see medical waste as a serious issue that needs to be tackled, and hold regular meetings to discuss progress and discuss further methods for improvement.

National Health Care Waste workshop and manual launch

It was on the 5-7 May 2004, that groundWork hosted a health care waste (HCW) and incineration workshop, which took place at Edendale hospital in KwaZulu-Natal. The intention of this gathering was not only to highlight the problems regarding HCW and incineration but also to launch groundWork’s HCW manual regarding waste management. Over 130 participants from hospitals all over the KwaZulu-Natal province had attended. This excellent turnout was not only an indication of the serious concerns that health care waste poses to hospital staff and their surrounding communities, but also that health care institutions are committed to reducing the potential impacts that HCW poses to enhancing a sustainable society.

The manual launched was a culmination of the work conducted at the model institutions. With the manual, health care institutions would be able to install an 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, enhance community relations by demonstrating a commitment to environmental protection, economic benefits resulting from pollution prevention products that reduce and recycle waste, and the avoidance of long-term liability. The intention is to use this manual for a roll-out campaign for other hospitals in South Africa with the aim of establishing improved HCW management practices. The manual is available for free to any individuals and institutions wishing for improved waste management.

Conclusion
It is a fact that every health care facility can take immediate steps to reduce the environmental harm that results from purchasing and waste disposal practices. This must be seen as a front-end solution to the waste problems that are being experienced in our societies. The idea is to tackle the root of the problem by moving away from incineration and implementing the three R’s (reduce, reuse and recycle). This would have to firstly be followed by prevention. Once a proper waste management plan has been implemented at institutions it would pay handsomely (i.e. financial benefit, improved staffed morale, increased occupational health and safety, improved regulatory compliance and the strengthening of relationships with the surrounding community). It is, however, important to stress that the problems of health care waste are greatest in rural areas that are constrained by a lack of resources and it is at these levels that immediate intervention is required. It is essential that we tackle the root of the problem if any positive long-term sustainable solution is to be reached.

Deputy Minister Says No Too Burning Hazardous Waste in South African Cement Kilns

groundWork has been working for more than three years now, trying to convince the government that incinerating hazardous waste in cement kilns is not an option in waste management. In April, groundWork held a cement kiln meeting with the Wildlife and Environment Society of South Africa (WESSA – Port Elizabeth) and Earthlife Africa (Johannesburg branch) to formulate a collective strategy response of how to resist the practice of burning hazardous waste in cement kilns.

This debate came to a head at the first Conference of the Parties (COP1) of the Stockholm Convention on Persistent Organic Pollutants (POPs), held in Punta del Este, Uruguay, 2nd to 6th May 2005. The Stockholm Convention is the first global, legally binding instrument aimed to protect human health and the environment by controlling production, use and disposal of toxic chemicals.

Two of these chemicals, dioxins and furans, will be created when hazardous waste is burnt in cement kilns. African NGO’s intensively lobbied their government delegates at COP1. Of particular concern for the African groups were the approaches made to the South African government by the cement industry to incinerate hazardous waste in cement kilns. These approaches have been made by Holcim Cement in the Northern Cape and in the North West province, as well as Natal Portland Cement (NPC) in Kwa Zulu-Natal (KZN). In KZN, government officials have requested NPC to burn agricultural waste in their cement kiln. African delegates were concerned that if the cement industry is successful in South Africa, other African countries will be next on the cement industry’s agenda.

The African delegates distributed an African position paper on this issue to African governments using South Africa as a case in point, noting that major cement firms in South Africa were seeking permission to burn hazardous waste as an alternative fuel source.

The South African delegation (groundWork and Earthlife Africa) and the Global Alliance for Incinerator Alternative (GAIA ) met with the Deputy Minister of Environmental Affairs, Rejoice Mabudafhasi. The Minister expressed concern that other African governments were questioning the SA government on the burning of hazardous waste in cement kilns as a result of the African position paper. The minister reassured us that the South African government would never allow for the burning of hazardous waste in cement kilns and would meet the obligations enshrined in the Stockholm Convention.

People’s Action – Columbia says no!

The resistance to this practice is widespread. Holcim Cement in Columbia proposed to burn hazardous waste in their local plant in Nobsa, Boyaca. As a result of intense local community protest against this, the Columbia Ministry of Environment rejected Holcim’s proposal. It is noteworthy that the Columbian Ministry took the concerns of communities into account. It is hoped that our government will follow suit since our National Environmental Management Act (NEMA) 1998, emphasises that people’s needs must be put at the forefront when matters of environmental management are considered.

Keep the promise!

Prior to the COP, the International POPs Elimination Network (IPEN), a network of civil society groups, held its General Assembly in Montevideo, from 29th April to 1st May. The aim of the assembly was to strategize and prioritise areas and issues of intervention at the COP for successful outcomes to eliminate POPs. “Keep the promise” was the rallying cry from the NGO’s. Priority issues included the continued use of DDT for malaria control, Best Available Techniques and Best Environmental Practices (BAT/BEP), guidelines to reduce releases of dioxins and the Basel Convention POPs Waste Guidelines and the identification of new POPs.

African countries were represented by Tanzania, Egypt, Senegal, Kenya, Mauritius, Gambia and South Africa to voice concerns regarding POPs issues. It was encouraging to observe a room of international social groups mobilising together to voice their concerns legitimately.

During the general assembly, groundWork and Earthlife Africa delivered a paper detailing the experiences of civil society with regard to the National Implementation Plans (NIPs) and the African Stockpiles Program (ASP) in South Africa and the fact that civil society was unsupported as an equitable stakeholder in this process. We were not surprised to hear from other groups about similar experiences were communities were being used as part of rubber-stamping procedures.

The IPEN assembly agreed for more strengthened global collaboration and local NGO action to improve efforts to eliminate POPs. IPEN also signed a communiqué with the Global Environmental Facility Small Grants Programme (GEF SGP) that will make it easier for IPEN participating organisations to apply for small grants on POPs issues. This would ensure that the goal of global POPs elimination can be realised much sooner.

One of the major successes of the meeting was the inclusion of four new chemicals in the treaty including pentabromodiphenyl ether (penta-BDE), lindane, chlordecone and hexabromobiphenyl. The COP established a POPs Review Committee from world regions to evaluate additional chemicals that could be added to the initial list of 12 POPs listed by the Convention. African State members in this Committee include Chad, Côte d’Ivoire, Ethiopia, Mauritania, Burkina Faso, Morocco, Sierra Leone and South Africa. The Committee will meet at least once a year and is open to observer experts to be invited by the Committee.

Finally, it was encouraging for NGOs to hear the United Nations Environmental Protection (UNEP) acknowledge the role played by NGOs in focusing governments and the public on the need to tackle POPs. It is important that authorities see civil society as equitable stakeholders in decision-making processes who are able to inform and shape policies so that they meet the needs of citizens disproportionately burdened with hazardous toxins. It is hoped that our government will keep the promise to establish an effective, transparent, and participatory process for civil society to ensure effective implementation of NIP’s in future.

Deputy Minister Says No To Burning Hazardous Waste in South African Cement Kilns

groundWork has been working for more then three years now, trying to convince government that incinerating hazardous waste in cement kilns is not an option in waste management.  In April, groundWork held a cement kiln meeting with the Wildlife and Environment Society of South Africa (WESSA – Port Elizabeth) and Earthlife Africa (Johannesburg branch) to formulate a collective strategy response of how to resist the practice of burning hazardous waste in cement kilns.

This debate came to a head at the first Conference of the Parties (COP1) of the Stockholm Convention on Persistent Organic Pollutants (POPs), held in Punta del Este, Uruguay, 2nd to 6th May 2005. The Stockholm Convention is the first global, legally binding instrument aimed to protect human health and the environment by controlling production, use and disposal of toxic chemicals.

Two of these chemicals, dioxins and furans, will be created when hazardous waste is burnt in cement kilns.  African NGO’s intensively lobbied their government delegates at COP1. Of particular concern for the African groups were the approaches made to the South African government by the cement industry to incinerate hazardous waste in cement kilns.  These approaches have been made by Holcim Cement in the Northern Cape and in the North West province, as well as Natal Portland Cement (NPC) in Kwa Zulu-Natal (KZN). In KZN, government officials have requested NPC to burn agricultural waste in their cement kiln.  African delegates were concerned that if the cement industry is successful in South Africa, other African countries will be next on the cement industry’s agenda.

The African delegates distributed an African position paper on this issue to African governments using South Africa as a case in point, noting that major cement firms in South Africa were seeking permission to burn hazardous waste as an alternative fuel source.

The South African delegation (groundWork and Earthlife Africa) and the Global Alliance for Incinerator Alternative (GAIA[1]) met with the Deputy Minister of Environmental Affairs, Rejoice Mabudafhasi. The Minister expressed concern that other African governments were questioning the SA government on the burning of hazardous waste in cement kilns as a result of the African position paper. The minister reassured us that the South African government would never allow for the burning of hazardous waste in cement kilns and would meet the obligations enshrined in the Stockholm Convention.

Peoples Action – Columbia says no!

The resistance to this practice is widespread. Holcim Cement in Columbia proposed to burn hazardous waste in their local plant in Nobsa, Boyaca.  As a result of intense local community protest against this, the Columbia Ministry of Environment rejected Holcim’s proposal. It is noteworthy that the Columbian Ministry took the concerns of communities into account. It is hoped that our government will follow suit since our National Environmental Management Act (NEMA) 1998, emphasizes that people’s needs must be put at the forefront when matters of environmental management are considered.

Keep the promise!

Prior to the COP, the International POPs Elimination Network (IPEN), a network of civil society groups, held its General Assembly in Montevideo, from 29th April to 1st May. The aim of the assembly was to strategize and prioritise areas and issues of intervention at the COP for successful outcomes to eliminate POPs. “Keep the promise” was the rallying cry from the NGO’s. Priority issues included the continued use of DDT for malaria control, Best Available Techniques and Best Environmental Practices (BAT/BEP), guidelines to reduce releases of dioxins and the Basel Convention POPs Waste Guidelines and the identification of new POPs.

African countries were represented by Tanzania, Egypt, Senegal, Kenya, Mauritius, Gambia and South Africa to voice concerns regarding POPs issues. It was encouraging to observe a room of international social groups mobilizing together to voice their concerns legitimately.

During the general assembly, groundWork and Earthlife Africa delivered a paper detailing the experiences of civil society with regard to the National Implementation Plans (NIPs) and the African Stockpiles Program (ASP) in South Africa, and the fact that civil society was unsupported as an equitable stakeholder in this process. We were not surprised to hear from other groups about similar experiences were communities were being used as part of rubber-stamping procedures.

The IPEN assembly agreed for more strengthened global collaboration and local NGO action to improve efforts to eliminate POPs. IPEN also signed a communiqué with the Global Environmental Facility Small Grants Programme (GEF SGP) that will make it easier for IPEN participating organisations to apply for small grants on POPs issues. This would ensure that the goal of global POPs elimination can be realized much sooner.

One of the major successes of the meeting was the inclusion of four new chemicals in the treaty including pentabromodiphenyl ether (penta-BDE), lindane, chlordecone and hexabromobiphenyl. The COP established a POPs Review Committee from world regions to evaluate additional chemicals that could be added to the initial list of 12 POPs listed by the Convention. African State members in this Committee include Chad, Côte d’Ivoire, Ethiopia, Mauritania, Burkina Faso, Morocco, Sierra Leone and South Africa. The Committee will meet at least once a year and is open to observer experts to be invited by the Committee.

Finally, it was encouraging for NGOs to hear the United Nations Environmental Protection (UNEP) acknowledge the role played by NGOs in focusing governments and the public on the need to tackle POPs. It is important that authorities see civil society as equitable stakeholders in decision-making processes who are able to inform and shape policies so that they meet the needs of citizens disproportionately burdened with hazardous toxins. It is hoped that our government will keep the promise to establish an effective, transparent, and participatory process for civil society to ensure effective implementation of NIP’s in future.

[1] GAIA is an expanding international alliance of individuals, non-governmental organization, community-based organizations, academics and others working to end the incineration of all forms of waste and to promote sustainable waste prevention and discard management practices. Since GAIA members are committed both to ending incineration and to promoting alternative safe, economical and just discard management systems, the name GAIA represents both a Global Anti-Incinerator Alliance and a Global Alliance for Incinerator Alternatives.  www.no-harm.org