SUPPORT OF THE DANISH GOVERNMENT THROGH THE

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8 Νοε 2013 (πριν από 3 χρόνια και 1 μήνα)

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SWAZILAND ENVIRONMENTAL AUTHORITY (SEA) WITH THE
SUPPORT OF THE DANISH GOVERNMENT THROGH THE
DANISH CO
-
OPERATION FOR ENVIRONMENT AND
DEVELOPMENT (DANCED) DEVELOPED A NATIONAL SOLID
WASTE MANAGEMENT STRATEGY (NSWMS)


NSWMS serves as an enabling mechanism for the implementation of
the Waste Regulation 2000.


The National Solid Waste Management Strategy vision

for Swaziland:



“To develop, implement and maintain an integrated Waste
Management System that will reduce the adverse impact of all forms
of solid waste so that social and economic development in Swaziland,
the health of its people and the quality of the environment and its
resources benefit” (refer NSWMS draft I & II).


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The strategy applies to all government society at large

and to all activities that impact on waste management.



Health Care Waste Management was initiated by SEA in
collaboration with the Ministry of Health & Social
Welfare.



To test the relevance of the NSWMS in urban hospital.



To assist the SEA in developing approaches for the
installation of Waste Management System in areas not
currently serviced.

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Health Care Waste Management Pilot Project


Mbabane Government Hospital



National Referral Hospital


Has total of 500 beds


Occupancy rate of 110%


Has 18 operational units


Has one local incinerator.

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Situational Analysis:

Mbabane Government Hospital (November 2001)
Findings:


No system in place to manage waste.


Shortage of equipment, lack of understanding and weak
supervision resulted in poor segregation of waste.


No secure storage areas for HCW awaiting collection.


General public were exposed to potentially harmful
properties of HCRW.


Local incinerator was in poor condition with incomplete
combustion.

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Operational Objectives



To develop a Waste Management Plan for the
Mbabane Government Hospital.


Implement Waste Management System at the
Mbabane Government Hospital covering all
aspects of HCWM.


Capacitate and train hospital personnel to
implement the system.


An awareness campaign on health care risk waste.

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System Development:

Three (3) Principles applied in Development of the
System:

A.
Legal framework presently existing in Swaziland:



Environmental Management Act. The precautionary principles,
polluter pays principle and duty to care principles are applicable.




Waste Regulation 2000:


Under these regulation Mbabane Government Hospital as a waste
generator and with a treatment/disposal facility is required to apply
for
:


* Environmental compliance certificate.


* A waste Management license.


* A facility operating plan.






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B.
Multi Disciplinary Approach:


* Interaction at all levels with the hospital.


* Collaboration with external relevant organisation/institutions.



C.
Segregation at Source:



* Provision of sufficient colour coded and labeled equipment.


* Minimum handling of waste.



Decision Making Processes:



To facilitate the decision
-
making in the development of the system,
the following structures are in place:

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HCWM Steering Committee:


Comprised of representatives from Swaziland

Environmental Authority, Ministry of Health,
Mbabane

City Council, Hospital Management, Regional

Environmental Health office, Stores, Biomedical

Engineering Department, Regional Health Educator.


Outputs:


Waste Management System.


Implementation Plan for the hospital.


Sustainability of the system in the hospital etc.


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HCWM Operational Committee:


Consisted of Unit Managers, Matrons, Stores, Senior

Orderly, Biomedical Engineering Department, Waste

Management Officer, and Hospital Administrator.


Outputs:


Implementation of the HCWM system at unit
level.


Decide on positioning of equipment in units.


Decide on equipment specification and quantities.



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HCWM Training Task Team:



Comprised of staff from the in
-
service training
office, Health Education Officer, WMO,
Representative from Nursing Cadre.



*

Responsible for the development of a plan to

address performance gaps, identified under

three (3) main categories knowledge skills,

changing attitudes and behaviour.



*

Develop HCWM training and awareness

material.

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Classification of Waste:



Health Care Waste classified into two categories.


Health Care General Waste (HCGW).


Health Care Risk Waste (HCRW).

The waste regulation and World Health Organisation

requirements were considered.


Colour Coding and Labeling:


Two colour and internationally recognised labeling/symbols

are used:
-


Red


HCRW


Black


HCGW

These two colours are observed on the plastic liners fitted on

the re
-
usable containers.


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Equipment, Design and Specification:


When designing the system the following aspects
were of key importance:
-


For the system to be sustainable the consumable
items must be readily available to the facilities.


Specification for the equipment must be in line
with international standards and guidelines.


Affordability without compromising the minimum
specification.


Equipment must be robust to withstand rough
handling.

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Monitoring and Evaluation:



The main reason for the project was to inform the National
Solid Waste Management Strategy and from the lessons
learnt make recommendation for implementation.


Specific Objectives for Monitoring the Project at
Institutional

levels:
-


To assess whether the health care waste is disposed of
safely and in an environmentally friendly manner.


To assess the variability of the new system for the whole
hospital in terms of human resources and equipment.


To assess the cost effectiveness and benefit to the hospital.


To assess the level of commitment and awareness.

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Monitoring tools used:



Performance check list forms.


Inspection report forms


Questionnaires.


Constraints:


No separate budget allocation for HCWM.


System require specific equipment which is not locally
available


sharp containers and speci
-
cans.


Resistance in behaviour change among the personnel.


Health Care Risk Waste Treatment remains an
environmental challenge


incineration.

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Way forward:


For the Ministry of Health to expand the project to other health care
facilities in the country there is a need to:



Conduct a National HCWM Rapid Situational Assessment.


Develop a national HCWM Policy and Legislation.


Allocate Separate National Budget for HCWM Initiative.


Invest more on HCWM treatment technology and human resource
development
.



THANK YOU.