Health care waste management in Cameroon: A case study from the Southwestern Region

Healthcare waste streams are persistent waste streams and which are consistently increasing in volume and complexity in developed and developing countries. When poorly managed, through inappropriate health care waste management systems, they can cause adverse effects to human health and the environment. This paper presents an evaluation of health care waste management systems in Cameroon, based on a survey of five health care facilities in the Southwestern Region of Cameroon. It is established that health care waste collection and handling systems including containers and bins for segregated wastes are generally in a poor state. A proportion of the waste stream is disposed of in open dumps in combination with municipal solid wastes while some are disposed of in incinerators which are often poorly designed. The waste stream is complex and heterogeneous with an average waste generation rate estimated at 4.4.9 kg/day equivalent to over 16 tonnes/annum comprising 49%, 16% and 14% of general, infectious and sharps respectively for a typical Health Care Facility in Buea which is a medium densely populated town. There is the potential to recover materials from this waste stream. if adequate waste management systems are developed and implemented. Separately recovering the uncontaminated general waste stream for a secondary market ultimately contributes to resource efficiencies and conservation of scarce natural resources. Reducing the waste quantities being incinerated results in less potential for persistent organic pollutants (POPs) and greenhouse gases to be released into the environment, thus contributing to global environmental benefits through climate change mitigation and pollution reduction. The study establishes that the little attention given to medical waste management results from a lack of an integrated approach to policy making at the highest level of decision-making. There is the need for legislation to allow for a more defined roles and responsibilities for health care personnel responsible for the handling and disposal of the waste streams at the point of generation in the health care facilities. Overall, there is the need to formulate more sustainable health care waste management legislation. (C) 2011 Elsevier B.V. All rights reserved.