Healthcare waste management in developing countries
Practical Action
the minimum requirements to be followed. In addition, it is recommended that healthcare waste
is deposited in a shallow hollow excavated in the mature municipal waste or in specially
constructed small burial pits. Burying inside the premises of the healthcare facilities is also
often practiced in low and middle-income countries. Encapsulation is another containment
process, which involves filling containers with waste, adding an immobilizing material, sealing
the containers and disposing of them.
Advantages and drawbacks of these three categories of treatment are illustrated in Table 3.
Category
Wet thermal
process
Treatment or disposal
method
Autoclaving
Advantages
- Efficient.
- Environmentally sound.
- Relatively low investments
and operation costs.
Chemical
Chemical disinfection
- Highly efficient
process
disinfection under good
operating conditions.
- Some chemical
disinfectants are relatively
inexpensive.
- Drastic reduction in waste
volume.
Containment Landfilling in municipal - Low cost.
processes
disposal sites
- Relatively safe if access is
restricted.
- Effective biodegradation
of the biological
components of healthcare
waste.
Safe buying inside
- Low cost.
premises
- Relatively safe if access is
restricted and natural
infiltration is limited.
Encapsulation
- Low cost.
- Simple and safe.
- Also applicable to
chemicals and
pharmaceuticals.
Table 3: Advantages and drawbacks of other treatment processes
Drawbacks
- Qualified operators
essential.
- Inadequate for wastes not
designed as recyclable items
and for waste that is not easy
penetrated by steam.
- Capacity for treating limited
quantity of waste.
- Highly qualified technicians
essential
- Comprehensive safety
measures necessary.
- Inadequate for
pharmaceutical, chemical,
and some types of infectious
waste.
- Conditions for safe
landfilling seldom met and
difficult to assess.
- Access restrictions not
always guaranteed.
- Risk of pollution.
- Difficult to prevent access
and scavenging.
- Not recommended for non-
sharp infectious waste.
Other treatment options, such as solar-powered autoclave-style sterilizers, boiling chambers with
mechanical grinders and compactor or enhanced recycling technologies are currently under
research and testing (Batterman, 2004).
‘De Montfort’ incinerators
‘De Montfort’ incinerators were designed by the Innovation Technology Centre – now called
Applied Sustainable Technology Group - at De Montfort University (Leicester, UK). The objective
was to meet a need for cheap but effective healthcare wastes incinerators which could be built in
almost any developing country, but would meet the criteria of a temperature of above 800°C with
a residence time of over 1 second (Picken, 2007). As described in the Guidelines on How to
Construct, Use, and Maintain a Waste Disposal Unit (WHO et al, 2005), The incinerator
comprises primary and secondary combustion chambers (see Figure 1) and it is made of
firebricks and prefabricated metal components, which can be manufactured locally or imported.
Information about construction details – namely, on guidelines, materials, tools and standard
problematic areas – are provided on ‘De Montfort’ website [http://www.mw-incinerator.info].
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