Regional Awareness Program on Health Care Waste in MENA [Archives:2005/844/Health]

May 23 2005

By Amal Mohammed Al Ariqi
Yemen Times Staff

In the last few years there has been growing controversy over the incineration of health-care waste. Under some circumstances, including when wastes are incinerated at low temperatures or when plastics that contain polyvinyl chloride (PVC) are incinerated, dioxins and furans and other toxic air pollutants may be produced as emissions and/or in bottom or fly ash (ash that is carried by air and exhaust gases up the incinerator stack). Exposure to dioxins, furans and co-planar PCBs may lead to adverse health effects.

Medical waste is often described as any solid waste that is generated in the diagnosis, treatment, or immunization of human beings or animals, in research pertaining thereto, or in the production or testing of biologicals. Some examples of medical or health care waste are: blood-soaked bandages, discarded surgical gloves – after surgery, discarded surgical instruments, used needles, removed body organs – tonsils, appendices, limbs, etc.

In Yemen, and most of the other developing countries not much attention given to medical and health care waste management. This fact leads to transmitting infectious diseases such as hepatitis B and C and HIV between the public, besides the risk of infecting the medical staff and garbage collectors.

In this context, a Regional Awareness Program on Health Care Waste Management for North Africa and Middle East was held in Sana'a on 15th and 16th of May. The program was sponsored by the World Bank and World Health Organization WHO and organized by Sadat International, INC, SII with assistance of Health in Interaction organization.

The main objectives of this program, according to Safia Al-Arini extended term health consultant in WB is to raise awareness among decision markers and related partners (medical staff) about the importance of medical waste management, and to address the current situation of medical waste and come out with recommendations and solutions for the future.

The participants belonged to different sectors and bodies such as ministry of health, environmental protection agency EAP, doctors, directors of hospitals, and representatives of environmental organizations.

In spite of the fact that some incinerators specified for medical waste disposal exist, neither public nor private hospitals use any of those incinerators. Medical waste is mixed with other waste. This risk exposes the street cleaners, garbage collectors and even normal people to many dangers and environmental disasters in the future.

Dr. Nsiaf, of the Ministry of Health said that such incinerations are not used because there are no trainings or qualified people who can deal with such equipments. He added that many directors in hospitals ignore the importance of organizing a management system that manages the process of disposing of medical waste.

Eng. Ali Al-Dobhani, director of Toxic and Hazardous Waste in EPA, referred to the importance of returning to Basel strategy that explains how to manage and control the hazardous waste including the medical waste. This strategy could form as basis for any future action plan.

There was reference to the studies carried out by Social Fund for Development in this field. Besides that, the Social Fund works independently, i.e. without referring to the Ministry of Health or EPA, to construct an incineration for medical waste for some medical centers.

It was clear that there is no cooperation or coordination between the Ministry of Health and Ministry of Water and Environment in this regard. For example, the Ministry of Water and Environment has a Basel strategy but cannot apply it, while the Ministry of Health doesn't have even considered evaluating the situation, yet both ministries realize the risks of medical waste.

According to the presentations of Professor Lahbib Chibani, vice- presidents of SII, and Mr. Raki Zghondi, representative of WHO, the management of medical waste could be carried out in a developing country like Yemen through utilizing minimum resources and mechanisms available in health centers. Referring to the illustrations and examples of other countries' experiences, queries of the participants could be answered and useful information could be obtained to help the medical staff manage and process medical waste disposal.

Forming a National Committee consists of the concerned sectors (EAP, Ministry of health, local authorities tc) and appointed the council of ministers, was strongly recommended. The committee's tasks will be issuing legislations and supervising medical waste management.

The participants emphasized the importance of training the medical staff including doctors, nurses, and health care cleaners to use the minimum standard means and techniques in managing medical waste. The recommendations, according to Mr. R. Zghondi, will be taking in consideration and be forwarded to the concerned authorities.

Ms. Safia Al-Arini stressed on the importance of defining the responsibilities and the roles of the Ministry of Health and Ministry of Water and Environment saying that “WB supports and will continue to support this cause as long as there are responsible partners who sponsor the issue”.

Dr. L. Chibani said, ” I am very happy to see that the participants from Yemen were really ready for discussion. Our aim was to open a discussion for them and come out with suggestions for an action plan”

Worth mentioning that the workshop was organized very well by the Interaction in Development organization, represented by Mr. Khalid Al-Dabia who said to the Yemen Times :”Yemen undergoes a serious problem in medical waste management. There is no awareness of the consequences and risks of ignoring the medical waste, whether inside or outside the health centers. Therefore it was important to organize such workshops in Yemen like other developed countries ''

At the end of the workshop, the participants insisted on the urgency of applying the recommendations in reality and to take action as soon as possible.