YEKATIT 12 HOSPITAL MEDICAL

COLLEGE

IV. Waste Management

Health) Nebiyou Tafesse (PhD Candidate in

Water, and Public

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 Waste Management
• A. Human waste disposal
– Definition of terms
– Health importance of excreta
– Proper disposal methods of excreta
 B. Solid waste disposal
◦ Definition of terms
◦ Classification by source and characteristics
◦ Importance
◦ Processing of wastes
◦ Proper disposal methods
 C. infectious waste
◦ Definition of terms
◦ Characteristics of hazards and infectious wastes
◦ Control of hazards and infectious wastes

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 A. Human waste disposal

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 Definitions
• Sanitation refers to waste management,
particularly management of human waste (Solid
and liquid).

 Basic sanitation: refers to the management of

human faeces at the household level. It means
access to a toilet or latrine.

 Onsite sanitation Vs offsite sanitation???

 Q. which one is common in Ethiopia?

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 INTRODUCTION

one gram of faces can contain (UNICEF).

• 10,000 viruses
• 1,000,000 bacteria
• 1,000 parasitic cyst
• 100 parasitic eggs

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 Barriers for prevention of faecal-oral disease

Primary Vs Secondary barriers

Which one is feasible and cost effective?

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 Hygiene & Sanitation performance Indicators
• Safe disposal of Human excreta
• Hand hygiene (Hand washing at the critical times) 3A’s & 3B’s
– Before eating
– Before feeding a child
– Before food preparation
– After defecation
– After cleaning child bottom
– After cleaning house/animal dung
• Safe water storage (SWS)
– Narrow necked storage container
– Covered container
– Placed off floor
– Cleanly kept
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 12 countries account for almost three-quarters of the
people who practice open defecation:

1. India (626 million) 7. − Nepal (15 million)

2. Indonesia (63 million)8. − China (14 million)
3. Pakistan (40 million) 9. − Niger (12 million)
4. Ethiopia (38 million) 10. − Burkina Faso (9.7 million)
5. Nigeria (34 million) 11. − Mozambique (9.5
million)
6. Sudan (19 million)
12. − Cambodia (8.6 million).

The WHO/UNICEF (JMP) 2012

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 Sanitation in Ethiopia
• According DHS 2011.
– A HH is classified as having an improved toilet
if it is used only by members of one HH (that is,
it is not shared) (WHO and UNICEF, 2010).
– 8.8 % ?????? (18 % in urban and 7 % in rural )
of HHs use improved toilet facilities.
• 82% of HH used non-improved toilet facility such
as
– 44% used an open pit latrine or pit latrine without
slabs
– 38 % of households have no toilet facility
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 Facts about sanitation

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 B. Solid waste management

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 Definitions
Solid wastes:
◦ All the wastes arising from human & animal
activities that are normally solid & that are
discarded as useless or unwanted.
◦ The term may be used like Refuse (Garbage,
Rubbish). Eg Plastics, bottles, cans, papers,
scrap iron, & other trash
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 Definitions
Solid waste management
 A systematic administration of activities that
provide for the collection, source separation,
storage, transportation, transfer, processing,
treatment and disposal of solid waste.
 It is a discipline associated with the control of
generation, storage, transfer and transport
processing and disposal of solid waste
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 Functional elements of MSWMS

1. Waste generation

2. On-site handling, storage, & processing

3. Collection

4. Transfer and transport:

5. Processing and recovery

6. Disposal
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 Solid Waste management hierarchy
• Prevent the production of waste, or reduce the amount
generated.
• Reduce the negative impacts of the waste that is
generated.
• Reuse in their current forms the materials recovered from
the waste stream.
• Recycle, compost, or recover materials for use as direct or
indirect inputs to new products.
• Recover energy by incineration, anaerobic digestion, or
similar processes.
• Reduce the volume of waste prior to disposal.
• Dispose of residual solid waste in an environmentally
sound manner, generally in landfills.
Source: UNEP, 2009
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 Main sources of solid waste Disposal Methods
(waste generation)
1. Residential( domestic)  Source Reduction,
2. commercial Reuse, Recycling
3. Institutional 1. Sanitary landfill
4. Construction 2. Incineration
Demolition 3. Composting
5. Municipal services 4. Dumping in to sea
6. Treatment plant sites 5. Discharge to sewers
7. Industrial 6. Open dump
8. Agricultural

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 Solid waste collection in Addis Ababa
 What types of hazard are occurred during
handling of Solid wastes?

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 Solid waste disposal site in Addis
Ababa

Aerial View of Reppi /Koshe Solid Waste Disposal Site,

Addis Ababa, Ethiopia
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 Solid waste disposal site in Addis
Ababa

Reppi Solid Wste Disposal Site, Addis Ababa, Ethiopia

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 Solid waste disposal site in Addis
Ababa

• Addis Ababa land fill, Ethiopia

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 C. Infectious wastes
 Wastes that require special handling due to serious
threat to human health and the env’t if
mismanaged

 Why Infectious Waste is Regulated?

 A. To minimize the spread of disease from a

medical setting to the general public

 B. To protect the environment

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 The 10 categories of HCW
• 1. Infectious waste
• 2. Pathological and anatomical
waste
• 3. Hazardous pharmaceutical waste
• 4. Hazardous chemical waste
• 5. Waste with a high content of
heavy metals
• 6. Pressurized containers
• 7. Sharps
• 8. Highly infectious waste
• 9. Genotoxic / cytotoxic waste
• 10. Radioactive waste

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 Actors in the HCWM process
• Who should involved in the
management of HCW?
– Health care facilities.
– Service providers who collect the
waste from the healthcare facilities
and transport it to the treatment
facilities;
– Treatment facilities that process the
waste to make it safe for final
disposal.
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 Risks associated with HCW
• Who are at risk?
– Medical staff:
– In and out-patients
– Workers in support services
– Workers in waste disposal
facilities,
– The general public and more
specifically the children.

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 Risks associated with HCW
Acquiring of diseases caused by Blood borne
Pathogens. Example;
 HIV / AIDS  Hepatitis C
 Hepatitis B  Malaria
 Brucellosis  Rabies
 Syphilis
 Viral Hemorrhagic Fevers

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 Risks associated with HCW
Con’t
• Poor management of health-care waste
exposes
– Health care workers Infections,
– waste handlers Toxic effects
– Patients Injuries
– the community

• Studies revealed that from HCW who had HBV

and HCV, of these :-
 33% of HBV Direct or indirect
 42% of HCV exposure to
infectious wastes.
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 Strategies
Strategies forfor avoiding
avoiding risks
risks associated
associated
HCW HCW
1. Changing behavior of HC workers, patients
& community.

2. Ensuring availability of equipment &

supplies

3. Safe and appropriate management of HCW

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 Healthcare wastes containers

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