Health care professionals carry out one of the most noble of missions: to protect and restore health and save lives. While doing so, treatment after treatment, the health facilities where they fulfill their duties are left with waste which requires adequate treatment and disposal in the most environmentally friendly manner possible. Unless this is done, waste may pose direct and indirect risks to public health. A risk that is now greater due to COVID-19 with healthcare facilities producing more waste than usual, including masks, gloves and other protective equipment that, if not managed soundly, can lead to public health risks.
To ensure health care without harm, WHO is developing a comprehensive healthcare waste management plan that will improve sustainable waste management at most health facilities in Ukhia and Teknaf, in Cox’s Bazar district.
“The Health Sector in Cox’s Bazar is responding to an increased demand for health services that come both from host communities and refugee camps. While supporting the Health Sector coordination and the improvement of service quality, WHO wants to ensure that all health care facilities address management of health care waste”, explains Dr Kai von Harbou, Head of WHO Cox’s Bazar Emergency Sub-Office.
Over 300 health facilities provide health and lifesaving treatment in Cox’s Bazar. They are operated by the Government of Bangladesh, development partners and international agencies helping support the displaced population, and the private sector. All generate waste, which includes infectious materials, sharps such as syringes, pathological and chemical wastes.
“In theory health care facilities in low and middle-income countries should generate only a few hundred grams of hazardous waste per bed each day, far less than high income countries. However, in low income countries health care waste is often not separated into hazardous or non-hazardous wastes - making the real quantity of hazardous waste much higher”, explains Ruth Stringer, International Science and Policy Coordinator at Health Care Without Harm.
Hospital staff carrying waste at Upazila Health Complex in Teknaf, Cox’s Bazar - WHO Bangladesh/ Tatiana Almeida
Health Care Without Harm (HCWH) is an international nongovernmental organization (NGO) that works to transform health care worldwide so that it reduces its environmental footprint. In Bangladesh, as in other parts of the world, HCWH is providing support to help WHO and its partners address key issues such as climate change and health, sustainable procurement in the health sector and sustainable healthcare waste management.
A rapid review in Ukhia and Teknaf conducted by the Department of Public Health Engineering and WHO indicates that the largest healthcare facilities can treat the healthcare waste that they and their neighbors produce.
“At our health facility in Teknaf, we have one officer responsible for infectious waste control”, tells Dr. Istiaq Mahmud Dowallah from International Centre for Diarrhoeal Disease Research in Bangladesh (icddr,b). “We send our sharp objects to be disposed in Dhaka because there we have a much more organized system. But in fact, we are considering establishing our own disposal facility in the future”, he adds.
Infectious waste control officer at icddr,b Diarrhoeal Treatment Center in Teknaf during WHO assessment - WHO Bangladesh/ Tatiana Almeida
Many health facilities in Cox’s Bazar, still require further strengthening in their waste management and disposal systems.
However, under the current COVID-19 scenario more emphasis has been given to infection, prevention and control. WHO has provided training to over 1000 personnel on IPC, and contributed with supportive supervision on healthcare waste management during the outbreak. Many healthcare facilities have been making remarkable efforts to institutionalize best practices, improve waste management and reduce associated risks.
WHO is engaging stakeholders around a sound healthcare waste management strategy for the Rohingya camps and surrounding areas in Cox’s Bazar. Technical and management data is being combined to create a plan for the implementation of a safe and sustainable healthcare waste management system through 2022 to serve the whole population of the area.