Dubai — HCWH and Health Care Foundation Nepal have presented the results of their latest collaboration on sustainable healthcare waste management with Bir Hospital in Kathmandu.
Coordinated by the World Health Organization (WHO), the "Safe Injection Global Network" (SIGN) was established in 1999 as a voluntary coalition of stakeholders aiming to achieve safe and appropriate use of injections throughout the world. Every year, SIGN meets to facilitate collaboration and synergies among participants of the safe injection global network.
HECAF have been working on medical waste management in Nepal since 1999 and their Director, Mahesh Nakarmi was invited to the meeting by WHO to present an update on the situation in the country and a report on their recent projects.
In Nepal, there is little infrastructure for dealing with waste on any type. Some hospitals have small scale incinerators, or burns it in the open, which WHO recognize as the most polluting way of handling it. Other hospitals dump waste in their grounds or send it for disposal with municipal waste, where rag pickers will search through it for usable materials, including used syringes.
Today, largely as a result of HECAF’s hard work, the first hospitals in the country are operating non-incineration medical waste systems and more are keen to follow.
HECAF are currently setting up an integrated system at Bir Hospital, in Kathmandu. Bir Hospital, which has over 450 beds, was established 121 years ago and is home to the country’s National Academy of Medical Sciences.
The waste management system incorporates waste segregation, autoclaving and recycling. Both HCWH and the WHO South East Asia Regional Office (SEARO) have been supporting HECAF in their work. The hospital’s senior management, housekeeping section and maintenance sections are all taking a strong role in making the project a success. Ruth Stringer, HCWH’s International Science and Policy Coordinator, recently visited to help initiate the system and to test and validate the waste autoclaves.
HECAF have also been helping the hospital to implement mercury substitution and injection safety. Bir Hospital recently became one of the first hospitals in the country to commit to becoming a mercury-free zone and HECAF are helping the hospital make the transition.
Last, but by no means least, every ward will soon be trained in injection safety. Unsafe injections cause literally millions of infections every year. The very latest data from WHO, also presented at the SIGN meeting, shows that 32% of injections in South Asia are carried out with reused equipment, and that 36% of HIV infections, 36% of hepatitis B infections and 10% of hepatitis C infections are a result of unsafe injections.
Some of these unsafe injections occur as a result of poor practice in the hospitals, but rag-pickers also search for syringes to sell. Not only do they often suffer potentially life-threatening needle-stick injuries, but the syringes they collect may be washed, repackaged and sold back to the unsuspecting public.
To make sure that no syringe can be used, either intentionally or accidentally, HECAF is making sure that every treatment trolley has a needle cutter on it. These not only remove the needle so that it cannot injure anyone, but it also cuts off the “hub” of the syringe so that a new needle cannot be attached.
The project at Bir Hospital will be completed in 2011, but already it is attracting a lot of attention, with visitors from the government and health care facilities all over the country. Both Mahesh Nakarmi and Ruth Stringer will also be presenting their work to the first National Workshop on Health Care Waste Management and Mercury Free Health Care, which is to be held by the Nepal Ministry of Health and Population. The example Bir Hospital staff and the team at HECAF are setting is on course to have positive repercussions the length and breadth of Nepal.