A five-fold increase in clinical waste due to the pandemic situation has overwhelmed existing limited infrastructure and resources in the health care waste management system of the country, a UN agency commissioned assessment report revealed recently. This has created an additional burden on Health Care Facilities (HCFs) and the Health Ministry to safeguard staff and [...]

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Heavy increase in clinical waste an additional burden on healthcare system

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Waste disposal at a hospital Pic by Eshan Fernando

A five-fold increase in clinical waste due to the pandemic situation has overwhelmed existing limited infrastructure and resources in the health care waste management system of the country, a UN agency commissioned assessment report revealed recently. This has created an additional burden on Health Care Facilities (HCFs) and the Health Ministry to safeguard staff and the environment, the report also revealed.

According to the Central Environmental Authority (CEA), it is estimated that daily clinical waste generation is around 25 Metric Tonnes (MT) in the country.

UNDP in Sri Lanka at the request of the Health Ministry in collaboration with the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF), conducted a rapid assessment of healthcare waste management in healthcare settings in Sri Lanka from August 2020 to March 2021.

“Unsound management of healthcare waste could cause “knock-on” effects on human health and the environment. COVID-19 pandemic has created quite a strain on healthcare systems in terms of healthcare waste management and Sri Lanka is no exception. Safe handling and final disposal of the waste is therefore a fundamental step in the fight against the COVID-19 pandemic and whole product sustainability life cycle,” the report said.

Earlier this month, the completed report was handed over to Health Services Director General Asela Gunawardena by UNDP Resident Representative Robert Juhkam.

The report found that many hospitals, particularly regional and base hospitals lack adequate resources for proper medical waste disposal, so they burn clinical waste openly, instead of incinerating such waste.

“Though the medical staff is well aware of the consequences of not doing proper incineration, finance and admin officers do not fully understand the implication and hence tend to give low priorities,” the report said.

The report also highlighted the gendered nature of healthcare waste management, with more than eighty percent of sanitation workers being women, which is largely unrecognised with increased exposure to risks and solid waste contamination.

In 2019, the National Audit Report on Health Care Waste Management (HCWM) pointed out that healthcare waste and solid waste management is a major social and environmental challenge in Sri Lanka which needs urgent attention.

Based on the outcomes of the rapid assessment, key recommendations have been made for the consideration of all healthcare sector stakeholders. A few of the recommendations include: Formalising clinical waste disposal by private practitioners including Ayurvedic treatment centres with a payment system imposed upon the waste generators, strictly enforcing the prohibition of open burning of clinical waste and introducing suitable arrangements for waste treatment at HCFs.

For the collection of data for the study, health care facilities in the country were divided into three groups; Group 1 – State sector large scale hospitals above base hospitals, Group 2 – State sector small scale hospitals below divisional hospitals and Group 3 – Private health care facilities.

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