Safe and environmentally friendly medical waste management in Nepal

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This solution helped transform the waste management of hospitals in Nepal towards a safe and environmental system using awareness and capacity building of the public through training and media campaigns, as well as training of healthcare practitioners. Three model hospitals inspired others to consider safer and environmentally sound ways to deal with hazardous and non-hazardous healthcare waste. All activities combined contributed to the enactment and implementation of national waste management policies across the healthcare sector, and resulted in three international and national awards.

Reduce water pollution, minimizing hazardous chemical releases , Good Health and Well-Being , Reduce deaths, illnesses from pollution and contamination , Clean Water and Sanitation , Sustainable Cities and Communities , Responsible Consumption and Production , Life below Water , Achieve environmentally sound chemical, waste management , Reduce adverse environmental impact of cities , Reduce waste generation through reduction, recycling, reuse , Reduce water pollution, minimizing hazardous chemical releases

Hospitals in Nepal generate thousands of tons of non-hazardous and hazardous healthcare waste. It’s not uncommon to see clinical waste disposed of as regular city garbage. Only a few hospitals have separate waste collection, transportation, storage and treatment. They also use incinerators to reduce the volume of clinical waste. A practice that has been retired decades ago in most developed nations because of its negative effects on people’s wellbeing and in the environment. In addition, in Nepal, mercury-based medical devices and practices are still the norms, although they pose serious threats to human health. This goes against the Basel, Rotterdam and Stockholm Convention on Chemicals and Minamata Convention on Mercury, which Nepal agreed to follow.

With financial support from the GEF Small Grants Programme, implemented by the United Nations Development Programme, the Center for Public Health and Environmental Development started by raising awareness about the importance of clinical waste management.

A series of briefing papers, fact sheets, posters, guidelines and manuals were developed and helped convince healthcare practitioners to consider new methods for clinical waste management.

An active presence in the media helped to bring the problems of clinical waste management to the attention of the general public. In 2 years the press published more than 100 news articles on the topic.

After people became aware of the situation, it was time to build the capacity of hospitals and health clinics to remedy their problems with clinical waste and mercury-based practices.

Nearly 800 health workers joined formative training and workshops across the country where they learned about safe and environmentally sound waste and chemical management in healthcare.

The turning point happened with the installation of full waste management systems in three hospitals. A series of affordable solutions like separated bins for hazardous and non-hazardous waste transformed these facilities into model hospitals. 

The same happened with a number of metal workshops where the use of polychlorinated biphenyl was replaced by dry welding significantly reducing the impact of waste treatment on people’s health and the environment.

Practitioners who have visited the model hospitals and metal workshops are now working to replicate the waste management model in their own practices and other hospitals, clinics and waste facilities across the country. 

All these efforts contributed to the enactment of the Solid Waste Management Act and Regulation in Nepal, and informed the development of a national health care waste management guideline currently followed by all hospitals in the country.   

The project received international and national awards including the Stockholm Convention PCB Elimination Network Award, the Grill Traders National Award, and the Environment Conservation National Award.     

Nepal

UNDP GEF-Small Grants Programmee , Ministry of Health and Population of Nepal , Ministry of Federal Affairs and Local Development of Nepal

Center for Public Health & Environmental Development 

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