The Issue

Medical waste can cause pollution and disease if it is not handled properly. Infectious waste, especially sharps, poses a risk to anyone who comes into contact with it. The WHO estimates that 40% of hepatitis cases and 12% of HIV cases worldwide are caused by occupational exposure.

Hospitals also produce small amounts of chemical, pharmaceutical and radioactive waste, which need specialist handling. Added to this, there will be large amounts of more ordinary trash — including packaging, paper and food — which can make up around 80% of the waste stream. A large hospital can produce a tonne of waste every single day.

In many developing world hospitals, all of this trash is mixed together and burned in low tech, highly polluting incinerators, or in the open with no controls whatsoever. It is now well established that incinerating medical waste produces large amounts of dioxin, mercury and other pollutants. These end up in the air, where they can be transported thousands of miles to contaminate the global environment, or in the ash, which is frequently dumped without thought for the load of persistent toxins that it carries.

If it is not burned, medical waste can end up dumped with municipal garbage. Wherever this happens, rag pickers face a daily danger, especially in those countries where it is possible to resell some components of the waste — for example, syringes — for illicit re-use.

One of the difficulties with ensuring medical waste is properly dealt with in poorer countries is the lack of funding. Many donors that conduct essential work to strengthen healthcare services, provide medical supplies or organize immunization programs do not include any provision for medical waste management.

In its Core Principles for Management of Health-Care Waste, the World Health Organisation has called on all donors to make sure they provide an adequate budget for this to prevent the possibility that people or the environment suffers from the waste that these vital projects create.

Health Care Without Harm is working with partners around the world to counter the threat from medical waste:

• Waste Minimization
  We are helping hospitals to reduce the amount, toxicity and impact of the waste they produce through training on segregation and choosing low waste, low-toxicity products.
• Alternative Technologies
  HCWH has produced reports on the various non-burn technologies that are available for medical waste and manufacturers supplying to some 60 countries.
• Training, research and model hospitals
  We are working with the World Health Organisation, UNDP and network members to train healthcare workers, develop new technologies and implement sustainable practices in hospitals across the Global South.