Healthcare waste management in developing countries
Practical Action
Model
Capacity Remarks
Mark 1
12 kg/h
Basic model; now superseded by Mark 8a
Mark 2
12 kg/h
Larger combustion chamber compared to Mark 1; only used for
experimental purposes
Mark 3
50 kg/h
Designed for large hospitals (up to 1000 beds); now superseded by
Mark 9
Mark 5
50 kg/h
Higher chimney compared to Mark 3; design currently under
modification
Mark 7
12 kg/h
Specifically designed for use in emergency situations
Mark 8 and 8a
12 kg/h
Similar to Mark 7, but with a brick-built body. Mark 8a recommended
for most applications
Table 4: Capacity and remarks for the different models of ‘De Montfort’ incinerator
The construction and implementation of Mark 8a ‘De Montfort’ incinerators in Hargeisa
(Somaliland) is illustrated in Box B.
Operation and maintenance
As described by WHO et al, 2005, some operator-related measures should be adopted to ensure
a good performance of the incinerator. Only a trained, qualified and equipped operator should
operate the incinerator, the operator must be on-site while the incinerator is functioning and
must be motivated to follow best practices. It is underlined that operators must have long-term
contracts or be permanent hires, since training efficient operators is time-consuming and
expensive, and operator knowledge and commitment are essential for good incineration
practices. Even if operators are well-trained, supervision is essential. Each primary health facility
should designate a supervisor for healthcare waste management, responsible for instance for the
training of all primary health facility staff in healthcare waste management practices, the control
on segregation practices, the coordination and supervision of waste transportation, packaging,
storage and handling, the monitoring of waste incineration practices. Detailed information on
operation practices is available at http://www.mw-incinerator.info/en/401_operation.html.
Regular maintenance is needed to ensure that the system will continue to work properly and to
prolong the life span of the incinerator. Before each operation, it must be checked that all the
ash has been completely cleared from the grate and floor of incinerator and that the loading door
closes properly onto the sand seal in an air-tight manner. As well as regular maintenance, annual
inspections and rectifications are of the utmost importance to guarantee that the incinerator
performs well. They concern the chimney, top sand seals, ash door and brickworks. Checking and
rectifying practices are presented at http://www.mw-incinerator.info/en/402_maintenance.html.
6