Managing health care waste: Hospital workers unit

“All things are possible once enough human beings realize that everything is at stake.”
Norman Cousins

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.

I was elated to see that 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 HCW waste poses to hospital staff and their surrounding communities, but also that health care institutions (HCIs) are committed to reducing the potential impacts that HCW poses to enhancing a sustainable society.

During the first day, various presentations regarding HCW and incineration were conducted. During the workshop, I noticed that participants generally lacked an understanding regarding the management approach to HCW; these included segregation techniques, occupational health and safety; as well as waste disposal. They also expressed that at their institutions waste management was not being taken seriously. Although participants understood the difference between infectious and non-infectious waste, they did not know how to apply the principle of reducing, reuse and recycling of waste so as to generate income.

The common voice expressed by delegates was that if a waste reduction plan waste to be implemented at their institutions, the support from top management would be essential if it was to be a success. They also expressed that top management needed to attend such workshops being held at Edendale for education and awareness.

Delegates also had the opportunity to tour Edendale hospital as a model institution in terms of waste disposal. groundWork has since 2001, been working with Edendale hospital in Pietermaritzburg and Ngwelezane hospital at Empangeni to provide insights into proper waste management. The aim was to make these institutions model hospitals for others to follow. Delegates were amazed at the tremendous cost savings that had been achieved at both institutions, with costs reductions of up to 50% through simply segregating of waste.

On the second day, participants had the opportunity to visit the Ixopo incinerator. Delegates expressed shock that government had allowed such a poor managed incinerator to continue operating illegally without a permit. It was also atrocious for delegates to see that workers did not have the required protective gears and were being exposed to dangerous working conditions. Some workers spoke of wearing the same clothing that they used at home. Participants, however, did applaud the KZN department of health for its move to phase out incinerators in the province and noted that government needed to ‘walk the talk’.

During the presentation on alternatives, participants were glad to hear that the possibility for affordable alternatives to incineration existed for rural areas but did acknowledge that the implementation of a particular non-burn technology was part of a much wider solution to waste management and needed to be implemented after a proper waste reduction program had been implemented. Much interest was expressed in the low costs treatment technologies and the pilot projects being conducted in India, Swaziland and Kenya (for more information www.medwastecontest.org).

On the final day, groundWork launched its HCW manual entitled, “Managing hospital waste: A guide for Southern African health care institutions. The manual was a culmination of the work conducted at the model institutions. It was explained to delegates that through the manual, HCIs 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. Delegates did acknowledge that HCIs were the ones responsible for proper management and disposal of the waste they generated and that this manual would help increase employee confidence resulting from a healthier and safer work environment.

The workshop proved to be a major success. It is hoped that this manual will help many institutions in South Africa towards establishing improved HCW management practices, which will ultimately contribute towards sustainable development for the future generation. 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.

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