Thursday, September 30, 2010

Successful Implementation of Medical Waste Treatment in Tanzania

Health Care Without Harm and partners today released a report showing how steam-based disinfection was used in an Tanzanian hospital to treat medical waste rather than incinerating it.

In many hospitals in the developing world, small scale incinerators are used to dispose of medical waste. Not so Bagamoyo District Hospital, on the coast of Tanzania in east Africa. Since October 2008, they have been using an autoclave and shredder to render their waste harmless before disposal.

Ruth Stringer, International Science and Policy Coordinator for Health Care Without Harm said “Poor or non-existant medical waste treatment is a threat to the health of literally millions of people worldwide, so we designed this pilot project to demonstrate a safe and sustainable way of treating it.” She also praised the many organizations who came together to make the project a success.

“From the Tanzanian Ministry of Health and Social Welfare, through UNDP/GEF, JSI, AGENDA, the local administration and the hospital staff themselves, everyone has played their part to show that this is a perfectly soluble problem.”

AGENDA, a Tanzanian NGO, provided much of the on-the-ground support for the technology. “The system passed every efficacy test we ran” said Jamal Kiama, who is trained as a chemical and process engineer. “There were also few very maintenance problems, and all were fixed by local engineers. This kind of technology will be applicable right across Africa”.

As well as the technology, the human side is essential too. “JSI’s Making Medical Injections Safer programme trained the staff in how to segregate and handle the waste properly” said the Country Director, Dr Ernest Chenya. “We have reached out across the country with our training in injection safety. It is important to see that syringes and infectious waste are also treated and disposed of safely and sustainably”.

Another advantage of steam based waste treatment is that it avoids the creating of toxic chemicals such as the dioxins and furans, which are emitted from incinerators. Jorge Emmanuel, Chief Technical Advisor to the UNDP/GEF Global Medical waste project, and expert advisor on the project, said “Tanzania is one of over 150 countries that has committed to try and eliminate dioxins and furans, which build up in the food chain and can have effects at doses measured in millionths of a gram. We can estimate that by installing this system, the hospital has avoided emissions of almost 4 grams a year.”

The hospital will continue to use the system, but the team members are already building on their success. The UNDP/GEF project is funding research at the University of Dar es Salaam which will improve on the design of the Bagamoyo system. Professor Jamidu Katima,Principal of College of Engineering and Technology at the University of Dar es Salaam is leading the development. “We have identified a number of modifications which will allow us to process the waste more economically and to make the machines more reliable and easier to maintain. The first prototypes are only a matter of months away.”

Health Care Without Harm is very excited to be part of the UNDP/GEF project, according to Stringer. “More and more people are interested in installing non-incineration medical waste management technologies” she says. “Autoclaving is already a dominant technology in Europe and the US. In Bagamoyo we have demonstrated how effective it can be in Africa. We envision more and more healthcare systems switching in the coming months and years.”


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