Heathcare Waste_Liberia

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Healthcare waste disposal in rural clinics in Liberia, West Africa

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  • Also plans for staff worker training
  • Heathcare Waste_Liberia

    1. 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
    3. 4. WATER <ul><li>All heathcare facilities need a clean water supply! </li></ul><ul><li>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. </li></ul><ul><li>Do we need to explore alternative? </li></ul>
    4. 5. MOVING WATER
    5. 6. Design of a typical shallow borehole and handpump
    6. 8. Design of a dug well with handpump
    7. 9. Sand filter rainwater to drinking water
    8. 10. Biosand filters Biosand filters; Diffuser plate Scum Sand Sand Sand Coarse sand Gravel
    9. 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
    10. 12. Simply roll out a sheet of plastic - cleaner surface area than most roofs !
    11. 13. Improvised water storage bin - constructed from local materials
    12. 15. Water Disease Triangle Source: WHO/UNICEF, 20005
    13. 16. Ahh the many choices ! for more information visit www. hesperian.org Latrines
    14. 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
    15. 19. Healthcare Waste is Dangerous! <ul><li>If handled, treated or disposed of incorrectly it can spread disease - poisoning people, livestock, wild animals, plants and whole ecosystems. </li></ul>
    16. 20. The Waste Management Plan <ul><li>Steps to creating a best management plan at your healthcare facility. </li></ul>
    17. 21. The MSF Segregation Plan – works well for them!
    18. 22. Global and local air pollution Incineration
    19. 23. DRUM BURNER – not effective but common
    20. 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.
    21. 27. General Waste <ul><li>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. </li></ul>
    22. 28. Typical Percentages of Healthcare Waste
    23. 29. Hazardous Waste <ul><li>Infectious – </li></ul><ul><li>Wastes thought to contain low concentrations of infectious agents, such as disease causing bacteria, viruses, parasites, and fungi, that could spread the disease. </li></ul><ul><li>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. </li></ul>
    24. 30. Hazardous Waste <ul><li>Pathological - </li></ul><ul><li>Tissue or body fluids from humans or animals without highly infectious diseases </li></ul><ul><li>Examples; blood, body parts, organs, animal carcasses </li></ul>
    25. 31. Highly Hazardous Waste <ul><li>Sharps </li></ul><ul><li>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. </li></ul><ul><li>Examples; syringe needles, scalpels, knives, blades, infusion sets, broken glass </li></ul>
    26. 32. Highly Hazardous Waste <ul><li>Non-sharps and highly infectious </li></ul><ul><li>Contain high concentrations of highly infectious agents and pose an extreme health hazard. </li></ul><ul><li>Examples; body fluids, such as blood, from patients with highly infectious diseases; microbial cultures. </li></ul>
    27. 33. SUMMARY
    28. 34. Crushing glass
    29. 36. Red metal glass crusher and cardboard box of glass ampoules - waiting to be destroyed.
    30. 37. Wheintown dump
    31. 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.
    32. 39. <ul><li>A compost bin, where waste is rolled not stirred. </li></ul><ul><ul><ul><ul><li>The barrel is from a local hospital. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>The frame is the roll bar from a Jeep CJ7. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>The steel bar going through the center is from a closet. </li></ul></ul></ul></ul><ul><li>Recycle and reuse! </li></ul>
    33. 40. Manufactured plastic compost bins Wooden pallet composting bin Rat deterring compost bin
    34. 41. Old drum compost bin <ul><li>Organic Waste Pit – COMPOST </li></ul><ul><li>Above or below ground </li></ul><ul><li>RECIPE: </li></ul><ul><ul><li>Pathological waste </li></ul></ul><ul><ul><li>Air </li></ul></ul><ul><ul><li>Water until moist </li></ul></ul><ul><ul><li>Brown leaves </li></ul></ul><ul><ul><li>Thin layers of soil </li></ul></ul><ul><li>Mix well, stir frequently then bake in the sun. </li></ul>If buried or partially buried, be sure to be at least 1.5 m above the water table
    35. 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
    36. 43. Waste zone site element variables; <ul><li> Topography and hydrogeology ->size , shape and depth of pits </li></ul><ul><li>Disinfection liquids; hydrogen peroxide, vinegar, bleach </li></ul><ul><li>Lining of pits; clay, brick, cement, thick plastic </li></ul><ul><li>Bottom of pits; gravel, stone, sand, brick </li></ul><ul><li>Covers; types will vary depending on local goods </li></ul><ul><li>Additions to decomposition process; wood chips, wood ash, lime </li></ul><ul><li>Fencing; local materials </li></ul>
    37. 44. Expired Pharmaceuticals at JFK Hospital – one of four containers. Note: NDS receives all expired drugs.
    38. 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
    39. 46. The end. <ul><li>[email_address] </li></ul>

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