Asia — Health Care Without Harm and strategic partners HealthCare Foundation Nepal (HECAF) and Toxics Link (India) participated in a three-day healthcare waste management workshop convened by the WHO Regional Office for South East Asia in December 2011. Participants also included government representatives from eleven countries.
Delegates visited two hospitals to see model systems in operation. HECAF has been developing the medical waste management system at the country’s oldest major hospital, the 460 bed Bir Hospital in Kathmandu, since 2010. Thanks to their intervention, the hospital is now almost completely mercury free and is autoclaving the infectious waste from the wards and chemically deactivating cytotoxic pharmaceutical waste. Thirty-five percent of the waste is sold for recycling and the food scraps, which represent a further 25% of the hospital’s waste, are now disposed of via a newly built anaerobic digester. This generates biogas which is projected to save the hospital US$1000 per year in fuel costs. HECAF, which has recently received a letter of appreciation from the Prime Minister in recognition of their work, also released an interim report on the Bir Hospital project during the workshop.
Dhulikel Hospital, 30 kilometers from Kathmandu, has been using reed beds to treat its wastewater since 1997. The wastewater first flows through a settlement tank for solids to sink to the bottom and then two beds of Phragmites reeds, planted in gravel, filter the water and extract both nutrients and pollutants from it before it is discharged to the river. The water flows horizontally through the first bed, maximizing the retention time and the removal of solids. It is then piped over the top of the second bed to be distributed evenly across its surface and flows down vertically through it. The system is very low maintenance. No chemical inputs are needed and the reeds only have to be lifted and replanted approximately every five years to make sure that water can continue to flow freely.
The final day of the workshop was spent on the development of draft national plans for medical waste management and mercury substitution, which were then reported back to the group and will be the basis of further work in 2012 and beyond. Ruth Stringer, Health Care Without Harm International Science and Policy Coordinator, praised the WHO SEA regional office for setting up the meeting “I have rarely attended such a productive and encouraging meeting,” she said. “The level of interest and engagement from the national governments, WHO representatives and everyone involved has been truly inspirational. Some countries are already making good progress to safe and sustainable healthcare waste treatment systems and mercury-free healthcare. I am looking forward to an increased level of interaction at the regional level and some great progress in 2012 and beyond.”
Participants included government representatives from eleven countries: Bangladesh, Bhutan, DPR Korea, India, Indonesia, the Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor Leste, as well as WHO advisors from county offices, the regional offices and headquarters and resources persons from NGOs, aid agencies and the US Centers for Disease Control.
HCWH staffers Ruth Stringer and Faye Ferrer were invited to speak about the issues and challenges relating to medical waste management and phasing out mercury on the first day, when country representatives also updated on the situation in their countries.