1. HOSPITAL WASTE MANAGEMENTPROJECT TRAINING FOR NURSING AND PARA-MEDICAL STAFF By: Alamgeer Memon Project Manager Mashriq Foundation Hyderabad 25 th February 2010

2. Mashriq Foundation Mashriq Foundation is an NPO and has a multi- dimensional focus on Environment and community health activities. Based in Hyderabad, Mashriq Foundation is currently executing following two projects 1.Hospital Waste Management (HWM) Project at 4 Taluka hospitals of Hyderabad District: 2.Hospital Waste Management (HWM) Project at DHQ Hospital Sanghar:

3. Some successes achieved:  Conducted awareness seminars  Baseline survey  Waste management team formation  Stakeholders integration, like EPA, Ministry of Environment, Municipal authorities, BP Pakistan, Civil society and Hospital Administration  Mass media coverage

4. How We conceived this project

5. Disposal Movie

6. Disposal

9. Disposal End …..

10. Carriers

11. Project Nexus  Burning of HW – dioxin formation  Exposure of hepatitis B & C through needle pricks  Contamination of Water canals

12. Hospital Waste Types:

13. Segregation/collection  The most important component of HWM is segregation.  Segregation is the process of separating different waste streams  Risk waste will be separated at source from non-risk waste

15. Color coding of Waste Bins  Red colored waste bins for Risk/infectious waste  Blue colored waste bins for Non-risk waste  Black colored dust bins for Garbage (fruits/food)

19.  BLUE COLORED WASTE BINS:  (NON-RISK WASTE)  Paper and cardboard, packing materials, empty bottles, used vials, used drips after cutting the drip sets and their needles etc.  RED COLORED WASTE BINS:  (RISK WASTE)  Infectious waste like blood soiled materials of all types, soiled used dressings/bandages, human blood and tissues/body parts from surgical OTs and Labor rooms, waste generated during minor procedures in OPD, body fluids of the patients, contaminated syringes and drip sets, I/V canulas, used catheters, NG tubes, removed stitches, used swabs, soiled or used protective equipments i.e. gloves and masks, waste generated during clinical examination, expired medicines & injections, spoiled pharmaceutical products, needles, sharps, broken glass pieces or any other thing that can puncture, chemical and radioactive waste from laboratories and radiology department, waste after procedure of dialysis, waste generated from ENT and Dental surgery departments during procedures etc.

20. Collection & Transportation  Collection will be on daily basis from specific color coded waste bins  Risk waste from Red-bins and non risk waste from Blue-bins placed at bed side, will be collected separately in the LARGE bins of same color scheme  Transportation of waste from wards to Central Storage Facility will be done by covered drums

21. Waste Transport

22. HW Storage  Mashriq Foundation suggests Central storage room facility with Incinerator.  CSF locations to store waste temporarily before Incineration and Land filling/Dumping  These CSF will be covered and having large containers for the waste storage

23. Earlier

24. Work in progress by Mashriq Foundation

25. HW Disposal:  Incineration for Risk/ Infectious waste  Land filling for Non-risk waste  Packing papers, plastic bags, empty bottles and other pharmaceutical waste of non-infectious type back to supplier

26. Story of Incinerator

30. HWM – Good and Bad practices

36. Injection Safety

37. Waste not to be Incinerated  Pressurized gas containers  Large amounts of reactive chemical waste  Radioactive waste  Silver salts or radiographic waste  Halogenated plastics (e.g. PVC)  Mercury or cadmium  Ampoules of heavy metals

38. Screening & Vaccination of staff  We recognize high importance of Screening and Vaccination of Hepatitis B & C, for hospital staff  Sanitary staff and waste handlers could be primary carriers for Hepatitis B & C  Other categories in service providers shall also be included

39. Sustainability:  HWM to be considered as a routine business of hospital rather than one-time project activity  WMT to own and execute “Waste Management Plan”  This Plan will be the actual document to achieve the desired goals under this HWM system