Generation, management practices and rapid risk assessment of solid medical wastes: a case study in Burundi

Abstract

Management of solid medical waste (SMW) is receiving greater attention due to potential health and environmental risks arising from inappropriate disposal and treatment of the waste. Generation of medical wastes and their management practices as well as risk from generation to storage in 12 healthcare facilities (HCFs) in Bujumbura, Burundi, were assessed. Current classification system of SMW in the national guidelines was not appropriate for safe collection and disposal. Pathological wastes, pharmaceutical wastes and discarded medical plastics, and absorbent cotton and placenta were main types of SMW, accounting for 84.4% from the HCFs. No HCFs followed the national guidelines completely, and most medical wastes have not been properly managed from the source separation stage. The generation rate per bed and the amounts of medical wastes per health care worker were 3.6 and 5.9 times higher in public HCFs than those in private HCFs, respectively, while the management practices of public HCFs were worse than those of private HCFs. Storage of medical wastes was the least managed step in the HCFs. All SMWs, HCFs, and people involved in SMW management were at very high risk or high risk. This study showed that Burundi’s overall SMW management should be urgently improved.