Abstract

This study, aimed at assessing effectiveness of medical waste management, was carried out in the South West Region, Cameroon, with objectives to: identify medical waste management systems in three healthcare centres/hospitals in Buea; assess methods of waste management systems and compare these management systems with WHO standards. Health care centres were selected based on availability and closeness to the area of study. Scientific knowledge and know-how on concepts of modern medical waste management were tested.

All aspects and equipment used in medical waste management were examined. Results revealed that medical wastes produced from different departments of the three healthcare centres were poorly managed. Separation was applied only for sharp wastes, collected in special sharp boxes after use.

Waste storage time (in plastic and metal containers with or without plastic lining and biohazard symbols) was less than 48 hrs. Collection was done first by medical staff, and then transported, with other waste by cleaners. Waste bags were constantly subject to tear and consequently spilling of the waste.27% of the respondents were aware of a temporal storage site, 33% had no idea and 27% were ignorant about a storage site in the hospitals. Training courses and awareness programs on medical waste management for health care providers and workers at hospitals were limited or not provided.

Medical wastes management was not judiciously planned; hence they were not treated and disposed of in accordance with Schedule I, and not in compliance with the standards prescribed in Schedule V of WHO standards.

However, the health care centres have set up some requisite bio-medical waste treatment facilities (in accordance with time-schedule), like incinerator, autoclave, microwave system for treatment of waste, and ensure requisite treatment of waste at a common waste treatment facility or any other waste treatment facility. Bio-medical waste is not segregated into containers/bags at point of generation in accordance with Schedule II prior to storage, transportation, treatment and disposal.

CHAPTER ONE

INTRODUCTION

1.1. Background of the study

Over the years, the world has witnessed a rapid population growth in different patterns which has equally led to extraordinary waste generation. In many developed and developing countries, collection, transportation, treatment and disposal of waste are the major challenges for government, organizations and other institutions (WHO, 2012).

Medical waste or clinical waste is classified as one of the most hazardous wastes in the world. Clinical waste refers to any waste that is generated during medical activities such as diagnosis, monitoring, and immunization or treatment of human beings or animals (Rutala and Mayhall, 1992). It includes viruses and bacteria that potentially cause diseases which are produced by hospitals, clinics, and other types of healthcare institutions. Medical care is vital for our life, health and well-being.

The waste generated from these medical activities can be hazardous, toxic and even lethal because of their high potential for diseases transmission. These wastes also present additional risks to staff of healthcare facilities, patients and the community if the wastes are not managed properly (Bavejaet al, 2000; Silva, 2005). The risk results from poor handling, improper disposal of medical waste which include open dumping and uncontrolled burning which increases the risk of spreading infections and of exposure to toxic emissions from incomplete combustions. According to Hakim et al, 2014 medical waste management has recently emerged as an issue of major concern not only to hospitals, primary health-care centres and nursing home authorities but also to the environment.

Advances in medical facilities and the development of more sophisticated instruments have increased the waste generation per patient in health-care units worldwide. According to the World Health Organization (WHO, 2012), high-income countries generate on average up to 0.5 kg of hazardous waste per hospital bed per day. Although the figure for low-income countries is only 0.2 kg per hospital bed per day, healthcare waste is often not separated into hazardous or non-hazardous wastes, making the real quantity of hazardous waste potentially much higher.

Hakim et al, 2014 also said clinical solid waste is a particular challenge in most health-care facilities of the developing world. Poor handling practices and inappropriate disposal of hospital waste is an increasing health hazard in these countries. For example, hazardous and medical wastes are handled and disposed of together with domestic wastes, thus creating a health risk to municipal workers, domestic animals, the general public and the environment. In developing countries where some efforts have been made to tackle the problem, waste disposal options are limited, and small-scale incinerators are used as an interim solution.

1.2. Problem Statement

In the past, the quantity of medical waste produced in health care canters in Buea was barely managedwithout a major call for concern. However the rapid increasein population in recent years correlates with an increasing number of patients (Ikome, 2011) without a collaborative increase in technological development of medical waste management, hence presenting the problem of improper medical waste management.

If patients are to receive health care and recover in safe surroundings, medical waste must be disposed off safely (WHO, 2012). The paradox here is that the healthcare delivery system, which is establish to provide treatment and safeguard the health of the people against illnesses, has becomes a source of infection and means of spreading diseases in the process of healthcare delivery. Health care institutions/facilities generate different types of infectious and/or hazardous medical waste that poses enormous risk to patients, healthcare providers, waste pickers, the environment and the community at large.

In Buea medical waste management in health care canters has not been well documented and it is not clear how these medical wastes are being managed. Therefore it is very important to know how these hospitals, clinics and health care centres in Buea manage/handlethe medical wastes they produce before it presents a threat to the population health of buea. A successful management of medical waste must be understood and addressed by everyone working in the health care services from those washing the floor to senior administration.

1.3. Objective Of Study

1.3.1.   Main objective

The main objective of this study is to assess the effectiveness of medical waste management in three healthcare centres/hospitals in Buea, namely: Regional Hospital, Mount Mary Clinic and the Buea Seventh Day Adventist.

1.3.2. Specific objective

The specific objectives of this study are as follows:

1. To identify the methods of waste management systems in three healthcare centres/hospital in Buea.
2. To assess the methods of waste management systems in three healthcare centres/hospital in Buea.
3. To compare these management systems with the WHO standard for medical waste management.

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