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Heathcare Waste_Liberia

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Healthcare waste disposal in rural clinics in Liberia, West Africa

Healthcare waste disposal in rural clinics in Liberia, West Africa

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  • Also plans for staff worker training
  • Transcript

    • 1. Environmental Mitigation & Monitoring Plan HCW_Water & Sanitation Improvements for RBHS Healthcare Clinics [email_address] RBHS
    • 2.  
    • 3. Direct contact Blood borne disease Ex: Hep A, Hep B, AIDS through needle stick injuries Vector borne disease Ex: malaria, yellow fever, sleeping sickness Water borne disease Ex: Typhoid, Colera, HepA Air borne disease Ex: TB
    • 4. WATER
      • All heathcare facilities need a clean water supply!
      • Recent assessment reveal that many need new boreholes installed down to the groundwater in the aquifer, costing approximately $8,000. Other clinics need repairs to the existing borehole, costing approximately $1-3,000.
      • Do we need to explore alternative?
    • 5. MOVING WATER
    • 6. Design of a typical shallow borehole and handpump
    • 7.  
    • 8. Design of a dug well with handpump
    • 9. Sand filter rainwater to drinking water
    • 10. Biosand filters Biosand filters; Diffuser plate Scum Sand Sand Sand Coarse sand Gravel
    • 11. Almost one third of the healthcare facilities reported not always having a water supply. Rainwater is free and relatively good water quality. Catching rain “free-falling” is usually better than from a roof yet there is no one right way, only what works best for your clinic at this time. Rainwater Catchment
    • 12. Simply roll out a sheet of plastic - cleaner surface area than most roofs !
    • 13. Improvised water storage bin - constructed from local materials
    • 14.  
    • 15. Water Disease Triangle Source: WHO/UNICEF, 20005
    • 16. Ahh the many choices ! for more information visit www. hesperian.org Latrines
    • 17.  
    • 18. Waste water treatment pond with reeds filtering and cleaning the water. Provides viable habitat for wildlife and esthetic view for people. Brocks Hill Visitor Center
    • 19. Healthcare Waste is Dangerous!
      • If handled, treated or disposed of incorrectly it can spread disease - poisoning people, livestock, wild animals, plants and whole ecosystems.
    • 20. The Waste Management Plan
      • Steps to creating a best management plan at your healthcare facility.
    • 21. The MSF Segregation Plan – works well for them!
    • 22. Global and local air pollution Incineration
    • 23. DRUM BURNER – not effective but common
    • 24.  
    • 25. INCINERATION for disposal of highly hazardous waste is not the best “environmentally friendly” technology, but is appropriate for Liberia at this time. Use of functional, high-temperature structures is recommended by the MoH EPI.
    • 26.  
    • 27. General Waste
      • General waste (non-risk) including uncontaminated waste similar to domestic waste (paper, plastic wrappings, food waste); may represent about 80% of the total waste production from healthcare facilities.
    • 28. Typical Percentages of Healthcare Waste
    • 29. Hazardous Waste
      • Infectious –
      • Wastes thought to contain low concentrations of infectious agents, such as disease causing bacteria, viruses, parasites, and fungi, that could spread the disease.
      • Examples; tissues, swabs, wound dressings, bandages; materials or equipment that have been in contact with infected patients; blood stained cloth, human excretions such as pus, feces and vomit from patients without highly infectious diseases; wash water.
    • 30. Hazardous Waste
      • Pathological -
      • Tissue or body fluids from humans or animals without highly infectious diseases
      • Examples; blood, body parts, organs, animal carcasses
    • 31. Highly Hazardous Waste
      • Sharps
      • Sharp objects that can easily cut or injure a handler. Used hypodermic needles are the most common and dangerous, as they are often contaminated with highly infectious blood.
      • Examples; syringe needles, scalpels, knives, blades, infusion sets, broken glass
    • 32. Highly Hazardous Waste
      • Non-sharps and highly infectious
      • Contain high concentrations of highly infectious agents and pose an extreme health hazard.
      • Examples; body fluids, such as blood, from patients with highly infectious diseases; microbial cultures.
    • 33. SUMMARY
    • 34. Crushing glass
    • 35.  
    • 36. Red metal glass crusher and cardboard box of glass ampoules - waiting to be destroyed.
    • 37. Wheintown dump
    • 38. Example of a Sanitary Pit, unlined for large amounts of general waste - leaching into ground and decomposition will occur. For small amounts of general waste without plastics, a composting bin can be used. A lined sanitary pit would be with thick plastic, or bricks on bottom & sides of pit, for hazardous waste if incinerator is not available. Additions of lime or ash will inhibit decomposition.
    • 39.
      • A compost bin, where waste is rolled not stirred.
            • The barrel is from a local hospital.
            • The frame is the roll bar from a Jeep CJ7.
            • The steel bar going through the center is from a closet.
      • Recycle and reuse!
    • 40. Manufactured plastic compost bins Wooden pallet composting bin Rat deterring compost bin
    • 41. Old drum compost bin
      • Organic Waste Pit – COMPOST
      • Above or below ground
      • RECIPE:
        • Pathological waste
        • Air
        • Water until moist
        • Brown leaves
        • Thin layers of soil
      • Mix well, stir frequently then bake in the sun.
      If buried or partially buried, be sure to be at least 1.5 m above the water table
    • 42. Recipe: Cement 1 part Lime 1 part Sand 4 parts Water 1/3 to ½ full Encapsulation in a 55 –gallon drum of ashes, needles from incinerator and crushed glass. --------- ¾ full of treated h.h. waste
    • 43. Waste zone site element variables;
      •  Topography and hydrogeology ->size , shape and depth of pits
      • Disinfection liquids; hydrogen peroxide, vinegar, bleach
      • Lining of pits; clay, brick, cement, thick plastic
      • Bottom of pits; gravel, stone, sand, brick
      • Covers; types will vary depending on local goods
      • Additions to decomposition process; wood chips, wood ash, lime
      • Fencing; local materials
    • 44. Expired Pharmaceuticals at JFK Hospital – one of four containers. Note: NDS receives all expired drugs.
    • 45. Sanitary Waste Pit Organic Pit Incinerator Glass & Ash Pit - x - x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x - Xx-x-x-x x-x-x-x- Waste zone w/fence Highly Hazardous Waste General Waste Hazardous Waste Glass Green Bin Red Bin Yellow Bin Black Bin
    • 46. The end.
      • [email_address]

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