Uganda: Hospital Stuck With Faulty Incinerator for Two Years

Masaka Regional Referral Hospital is struggling to dispose of medical waste after the incinerator at the hospital broke down two years ago.

Although Masaka Municipal Council authorities are currently collecting domestic waste generated within the hospital premises, the biomedical waste such as syringes, scalpels, blood, and waste from theatres is disposed of through open burning.

Mr Edward Kabuye, the hospital principal administrator, says they have resorted to open burning of waste because they have no other option and that other options are costly.

The hospital spends at least Shs100,000 on purchasing fuel every week to burn close to two tonnes of medical waste.

Mr Kabuye says neighbouring health units have continued to dump medical waste at the facility and have to incur extra costs to burn it.

He, however, says the hospital is in the process of fencing off the site to keep away strangers.

Fencing off the hospital

"We believe this (fencing off) will offer a solution since unknown people usually bring waste at our dumping site at night when guards are away guarding wards and other parts of the hospital," he says.

Masaka Regional Referral Hospital serves eight districts -- Masaka, Rakai, Lyantonde, Lwengo, Sembabule, Bukomansimbi, Kalungu and Kalangala -- taking care of more than two million people, according to hospital authorities.

The records from the same hospital indicate that its average daily contact with patients is about 2,000.

The hospital director, Dr Nathan Onyachi, reveals that this financial year, they have allocated Shs400m towards construction of a modern incinerator, which will help in addressing the challenge of medical waste management at the facility.

"Lack of an incinerator is a problem we have lived with for some time, but we are optimistic that we shall get a new incinerator in the next six months. Currently, we are inconveniencing our neighbours with smoke and fighting off dogs that usually roam around the dumping site," he says.

He adds: "An incinerator has higher capacity burn rates and consumes the higher volume wastes."

Mr Andrew Kayiza, one of the neighbours to the hospital, says stench from the rotting waste is unbearable and the situation worsens when the hospital burns it since all the smoke ends up in their homes.

Poor medical waste management is affecting most health facilities in greater Masaka and most of the proprietors of private clinics use open burning to dispose of the waste which is hazardous to the neighbouring communities.

A proprietor of a private health unit in Kijjabwemi, a Masaka Town suburb, who preferred anonymity to speak freely about the matter, says they usually bury some medical waste although sometimes they are forced to dump some (non-hazardous) at garbage skips in the area.

According to Environmental and Public Health Journal published in 2016, Uganda biomedical waste management practices are so poor especially when it comes to segregating the waste.

Air pollution

Disposal practices are still an issue since most hospitals burn waste in open causing air pollution, which causes health hazards to people living in the vicinity of healthcare institutions.

The Stockholm Convention on medical waste management necessitates all countries to treat biomedical waste before disposing off. Medical waste which contains toxic elements and radiotherapy material are dangerous to human health.

In the past, countries that lacked technology to manage waste were allowed to export to other countries, but this is no longer the case.

The Convention lists nine dangerous chemicals which must be managed well to avoid degradation of environment.

They include, among others, Dichloro diphenyl trichloroethane (DDT), mercury, endosulfan compound commonly used as an agricultural insecticide, Lindane used for coating seed, polychlorinated biphenyls used as lubricants in transformers, Perfluorooctane, Polybrominated diphenyl ethers used in electronic equipment, Organochlorine pesticides and Lead.

What the law says

Improper waste disposal contravenes Section 12 (1) of the National Environment Waste Management (Nema) Regulations, 1998 which states: "An industry shall not discharge or dispose of waste in any state into the environment, unless the waste has been treated in a treatment facility and in a manner approved by the lead agency in consultation with the Authority."

The authority in this case is Nema.

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