Medical Waste Management and Disposal Practices of Health Facilities in Kumbo East and Kumbo West Health Districts

Vol. 9(1), pp. 1-11, January 2017 DOI: 10.5897/IJMMS2016.1272 Article Number: E48C9DB62188 International Journal of Medicine ISSN 2006-9723 Copyright © 2017 and Medical Sciences Author(s) retain the copyright of this article http://www.academicjournals.org/IJMMS Full Length Research Paper Medical waste management and disposal practices of health facilities in Kumbo East and Kumbo West health districts Lanyuy Gillian Dzekashu1, 4, Jane Francis Akoachere2 and Wilfred Fon Mbacham1,3* 1Department of Health Economics Policy and Management, Catholic University of Cameroon, Bamenda, Cameroon. 2Department of Microbiology and Parisitology, University of Buea, Cameroon. 3University of Yaounde I, Pubilic Health Biotechnology, Cameroon. 4Ministry of Secondary Education, Cameroon. Received 10 October, 2016: Accepted 28 November, 2016 The provision of healthcare generates waste which can be detrimental to health and the environment. Management of healthcare waste is still a challenge in developing countries as practices, capacities and policies on waste disposal are grossly inadequate and require intensification. With the growing trend of biomedical services in Kumbo Cameroon, the medical waste management practices in this area was investigated to generate data that could guide policy in planning for an effective and sustainable waste management program. A qualitative cross sectional study was conducted in 30 of the 52 health facilities in study area. Participating facilities were selected by convenience sampling and personnel by random sampling. Data was collected using questionnaires, interviews and direct field observations and results analyzed using SPSS V 17.0. P-values <0.05 were considered significant. Participants aware of the existence of a national policy guide on waste management were mostly administrators (66.7%). Only 2 (6.6%) health facilities had a copy of this document. None of the participating facilities kept records of their medical waste management practices. All participants were aware of the health risk of healthcare waste. Use of PPE varied among participants and was highest among employed waste handlers (EWH) (100%) and laboratory technicians (100%) while the lowest (69%) was among pharmacy attendants. Gloves were the most commonly used PPE. Most of the EWH (55.6%) used examination gloves which was inappropriate. Not all participants segregated or disinfected waste. Waste bins were not colour-coded and all facilities had appropriate safety boxes for sharps. In 86.7% of health facilities, waste disposal was by burning in pits located within 400 m away from the facility. These pits were not protected from scavengers. Only 4 facilities had incinerators and all did not meet the required standards, as none was equipped with a scrubber. Even after segregation at the point of generation, wastes were mixed at the point of final disposal. Waste management practices in study site did not meet standard practices. There is an urgent need for proper medical waste management in Kumbo East and Kumbo West to minimise threats to human health and the environment. Regular supervision and enforcement of policy on medical waste management is paramount. Key words: Medical waste, medical waste management, disposal, Kumbo. INTRODUCTION Medical care is vital for life and health, but waste generated from medical activities has become a serious 2 Int. J. Med. Med. Sci. concern because of its composition. It has a high potential This involves reducing the generation of hazardous of carrying micro-organisms that can infect individuals waste, strictly controlling the storage, transport, exposed to it, as well as the community at large if it is not treatment, reuse, recycling, recovery and final disposal of properly disposed (Babanyara et al. 2013). Medical waste wastes (UNEP, 2000). With the growing concern on is the second most hazardous waste after radioactive medical waste management, some developing countries waste. Being hazardous and infectious, medical waste have recently implemented interventions that have also pose serious threats to public and environmental improved their waste management practices (Kumar et health as it may pollute air and contaminate soil and al., 2015; Tabash et al., 2016; Awodele et al., 2016). water sources. Thus, to protect human and environmental Although, there is very limited information on health health, healthcare waste requires specific treatment and care waste management in Cameroon, few studies management prior to its final disposal. Enormous effort is conducted report medical waste management as a needed to establish the provision of effective and challenge in both primary and tertiary care facilities universal healthcare and with it the safe and effective (Doumtsop, 2014). Because resources allocated for disposal of clinical waste. The last decade has witnessed healthcare are limited, health care waste management an increase in the number of health care facilities not only has received less attention and priority than it deserves. as a result of demographic development but mainly due Most healthcare facilities lack an incinerator and in some to aid from international commitment to eradicate and it is broken down and non-functional. Waste is burnt in control many infectious diseases. This has led to a pits situated within the facility. Burning in waste pits concomitant increase in medical waste generated releases toxic gases into the air that could endanger the (Doumtsop, 2014). Efforts to manage such wastes have ecosystem (Manga et al., 2008; Muchungong, 2010). In differed between countries, the worse scenario being in the Northwest region of Cameroon, poor waste developing countries where such wastes are handled management practices observed in some health care haphazardly (Pruthvish et al., 1999; Harhay et al., 2009; facilities has been attributed to lack of sufficient Walkinshaw, 2011) with no systematic management of awareness on environmental and public health impacts of healthcare waste. In many developing countries, poor clinical waste disposal (Muchungong, 2010) and regulations governing safe disposal of healthcare waste most health workers were not aware of the existence of is either lacking or poorly enforced. In these countries, policy-national or international- on safe clinical waste poor clinical waste management, and especially management. Another study (Muluken et al., 2013), inefficient segregation, treatment and disposal method reported that the working conditions of waste pickers in threaten the environment, occupational and public health health facilities are precarious and this endangers not and increases the potential for the transmission of blood only their health but also that of their families. Although, borne pathogens (Solberg 2009, Babanyara et al., 2013). resources are scarce in Cameroon like in most An assessment by WHO revealed that in twenty two developing countries, there is need to prioritize medical developing countries, the proportion of healthcare waste management to prevent future use of scare facilities that do not practice proper healthcare waste resources to treat health related problems arising from management ranges from 18 to 64% (WHO, 2004). In the poor medical waste management. African continent, solid medical waste management in most countries is substandard. In a recent review of solid METHODS medical waste management in Africa (Udofia et al., 2015), only 30% of countries met half of WHO’s Study area recommendations on medical waste management (Chartier et al., 2014), with the greatest compliance This study was conducted in Kumbo East and Kumbo West health recorded on daily collection of waste from points of districts in the North West region of Cameroon. Kumbo, the second largest town in North West Cameroon and capital of Bui Division is generation (100%). In addition to the fact that waste is located 110 km away from Bamenda, capital city of the North West never segregated and poorly handled in these countries, region (Figure 1). The town of Kumbo has a population of over uncontrolled and sub-standard burning is widely practiced 100,000 inhabitants with a female dominance of 52%. It shares creating additional environmental problems including boundaries with Nkum-Mbam in the North, Mbiame in the East, emission of toxic air pollutants (particularly dioxin) and Oku-Noni in the West and Dzekwa in the South. It enjoys a tropical heavy metals which might be present in gaseous and climate common to most parts of Cameroon with two seasons: the dry and rainy seasons. Its geographical coordinates in decimal solid by-products (Pruss et al., 1999). Sound degrees (WGS84) are: Latitude 6.200 and Longitude 10.667. management of medical waste is highly necessary to With regards to health care delivery, Kumbo has two health protect human and environmental health. districts: Kumbo East and Kumbo West, with 30 health areas and a *Corresponding author. E-mail: [email protected]. Tel: +237675459092 Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution License 4.0 International License Dzekashu et al. 3 total of 52 health facilities. These health facilities comprise public practices of health facilities. Observations during field visits were (state-owned=25), lay private (owned by individual=5), community- guided by an observation checklist so that key aspects to be owned (2) and confessional (owned by religious body=20). Kumbo evaluated could be noted down in a systematic manner. East has 20 health

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