Hesperian Health Guides
Do a Health Care Waste Assessment
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Evaluating how health care waste is created, handled, and disposed of can help everyone in a health center find ways to work more safely. An assessment can identify the problems in how waste is created and handled, and can help find solutions.
- Meet and discuss problems with all health care staff.
- List what is in the pharmacy and supply room.
- Make a map of the center.
- Walk through the health center and note problems.
- Learn about different choices for treating and disposing of waste.
- Find out how waste is handled and disposed of, both at the health center and in the community.
- Take action!
- Regularly educate and train all workers.
Since most materials are ordered through the pharmacy or supply room, start your assessment by making a list of what you find in those places. As you look at each item, ask what kind of waste will be produced, and how harmful it will be.
Can disposable items be replaced with things that can safely be reused? Can fewer or safer chemicals be used? Can the center use less plastic, fewer items that contain mercury, or make any other changes to reduce the amount of harmful waste?
Show all rooms, doors, and windows, and note what each room is used for. Use different colors to mark places where waste is created, where waste containers are kept, and where waste is stored as it is collected and transported from its source to its final storage or disposal site. This map can be changed as the group walks through the health center. After the assessment, make a new map to show any changes that have been made. Notice especially where containers are kept for collecting waste.
Visit all the areas where waste is produced. Look in the trash bins and note what kinds of waste are there. Do this walk-through several times over the next few weeks, and try to do it at different times of day. Then you can see the waste in different conditions and how it is handled throughout the day.
Do the walk-through with different workers. Cleaners will see things differently from doctors and nurses, and each may have important ideas about how to best handle waste.
After several walks through the health center, have a group discussion about the problems and possible solutions. Solutions do not have to be expensive or technical. Most solutions require only organization, cooperation, and commitment. Try to make a plan that starts with the most harmful waste — sharps — and then chemicals, blood and other body fluids, and so on. The goal is to improve your entire system, not just 1 part of it.
Follow waste from where it is made, to where it is stored, and where it leaves the health center. Is the waste picked up regularly? How is it collected? Do waste handlers wear gloves, shoes, or other protective clothing? Is it transported in safe containers?
Is the waste taken to a dump site or an incinerator? If possible, visit the place where waste is dumped. Does it remain separated, or is it mixed with other kinds of waste? Does it lead to health risks for the community, such as sharps in an open dump site?
What happens in the health center eventually touches everyone in the community. Taking even small steps to make waste handling safer will reduce harm to people and the environment. Which improvements are possible for the health center to make now? How can the health center influence what happens to waste once it is taken away to a landfill or incinerator?
The success of any safety plan relies on continuing to educate and train everyone who handles and creates health care waste. It is easy to become careless with safety practices when nothing harmful seems to happen. Repeating a waste assessment every year can help remind people of the importance of being careful.