Bio-hazardous
waste poses a public health threat and
environmental problem to many Liberians, who
are unaware of the severe nature of the
danger they present. Healthcare waste (HCW)
for instance is usually disposed of in the
municipal waste stream, although most
facilities have gone the extra mile to
ensure that their particular wastes are
treated safely and appropriately.
However, once
the waste leaves the protectorate of the
facility, untrained workers treat it in a
variety of ways due to the lack of
standards, and management protocols. Proper
procedures are usually not put in place or
implemented system-wide, as a result,
hygiene and medical waste collection and
disposal are so low that the Ministry of
Health needs to launch a nationwide clean-up
and awareness campaign instituting standards
for collection, disposal, safety and
training.
Bio-hazardous,
medical or healthcare wastes are defined in
this paper as, infectious waste,
pathological waste, sharps, pharmaceutical
waste, hazardous waste, genotoxic waste,
chemical waste, heavy metals and pressurized
waste.
Almost 30
percent of medical waste produced in
hospitals in Liberia is hazardous, according
to the World Health Organization (WHO) in
Liberia. The reuse of dirty syringes causes
new HIV infections every year nationwide, as
well as thousands of cases of hepatitis B
and C, says an expert at the Ministry of
Health in Monrovia. Given these facts and
statistics, there exist no legislation to
regulate this serious form of waste, nor is
there a national healthcare policy plan in
this direction, which would necessitate an
enforcement regime. Many healthcare
facilities in Liberia do not segregate
bio-hazardous waste due to the lack of
proper facilities to handle or transport
such. In almost all communities, there exist
very poor commitment or motivation to manage
bio-hazardous waste due to the lack of
skilled manpower to address these challenges
in a meaningful way.
Consideration
also needs to be given to eliminate from
healthcare practices throughout the country,
improper hygiene protocols which add risks
to patients’ health as well as to the
general public due to improper disposal of
this type of waste. Although it is not the
norm, usually, healthcare waste (HCW) is
found mixed-in with municipal solid waste (MSW),
which cause tremendous health, social and
economic burden to a country just emerging
from almost two decades of vicious civil
war.
In fact, many
Liberians are unaware of the hazardous
nature of healthcare waste. Maybe, it is due
to our literacy rate or flaw social habits
or a patronage system that have gone amok.
The lack of awareness puts many Liberians at
a disadvantage. Many do not realize that
they are at very grave risk of infection
every time they seek medical treatment, even
though the extent to which facilities are
contaminated has yet to be properly
researched and documented by the Ministry of
Health.
In a recent survey conducted by DUCOR Waste
Management in several community health
centers in the Monrovia Metropolitan Area (MMA),
most of the infections appear to occur
because medical wastes were not properly
collected or disposed of as health workers
do not follow established norms properly,
due to lack of regular training and
established procedures. When health
institutions and healthcare workers ignored
basic rules of hygiene, it constitutes a
danger to the general public.
For example, at
a well known hospital in the Borough of New
Kru Town, healthcare workers were observed
by a DUCOR guest intern washing latex gloves
for reuse. This practice is unacceptable in
the profession, period. In another small
clinic in Wrotto Town market, near Sinkor
airfield, healthcare practitioners were
observed boiling hypodermic needles in a
utensil fuel by generator power, which could
hardly had reached the recommended
temperatures to destroy tiny organisms such
as virus, protozoan or bacterium.
The new government policy being written by
the World Health Organization (WHO), and the
Ministry of Health should make medical
institutions responsible for setting
standards and implementing proper procedures
and rules of engagement to deal with this
persistent challenge. At the same token,
healthcare workers should be made more aware
of how to collect and dispose of medical
waste and how to keep health facilities more
hygienic for patients, guests and workers.
At the end of the day, what must become
widely accepted is that medical waste
handling, collection and disposal practices
should be standardized throughout the
country.
Advocates and
practitioners will agree that there exist an
unhealthy and hazardous environment in
healthcare facilities around the country,
due to indiscriminate collection and
disposal procedures, protocols and
practices. But, what is widely accepted in
the solid waste and healthcare sectors is
that medical waste collection and disposal
practices are inadequate throughout the
country.
The Ministry of
Health has a wonderful opportunity to level
the playing field by setting standards,
while the national legislature have
favorable conditions at this time in history
to seize the moment and rise up to the
occasion for Liberia and promulgate
effective legislation that set standards and
deal with bio-hazardous or healthcare
wastes.
Francis
Nyepon is managing partner of DUCOR Waste
Management in Liberia. He is a policy
analyst and vice chair of the Center for
Security and Development Studies, and serves
on several boards of humanitarian,
environmental and human rights organizations
in the United States and Liberia. He can be
reached at francis.nyepon@Gmail.com
