Written by: Luqman Yesufu, GGHH Campaign Manager, Membership Outreach and Engagement in South Africa, groundWork

groundWork, HCWH’s strategic partner in South Africa, together with the Gauteng Directorate of Health Care Waste and Occupational Hygiene Risk Management, hosted the “2017 GGHH Waste Exchange” on 23-24 October 2017 for South African members. 25 delegates from four provinces in the country – Gauteng, Free State, Western Cape and KwaZulu-Natal- attended the event.

The purpose of this exchange was for participants to learn about and share experiences on sustainable health care waste management. Over the two days of the event, participants heard presentations on the topic and discussed innovative approaches to waste management. They also visited several hospitals and an alternative health care waste treatment facility to see successful programs first hand.

Day 1

The first day took place in the Directorate of Health Care Waste and Occupational Hygiene Risk Management of the Gauteng Health Department and featured a series of presentations and discussions on health care waste management from groundWork as well as representatives from Gauteng Province. These were:

  • Global Green and Healthy Hopitals– Overview and examples of success from South Africa, by Luqman Yesufu
  • Technical Specifications for Healthcare Risk Waste Management Services and Healthcare Waste Contract Management by Zamokuhle Mntambo, Chief Health Care Waste Officer, Gauteng Directorate of Health Care Waste and Occupational Hygiene Risk Management.
  • Implementation of the Occupational Health and Safety Information System (OHASIS) in Gauteng by Rudo Samudzi, Assistant Director: Research, Policy & Capacity Building, Gauteng Directorate of Health Care Waste and Occupational Hygiene Risk Management.
  • Healthcare Waste Management; Rollout to a Reusable Waste Management System by Kathie Jansen, Assistant Director – Sub-directorate Health Care Waste, Gauteng Directorate of Health Care Waste and Occupational Hygiene Risk Management.

The presentations and presenters were really interesting and participants learned a great deal from them. Following the presentations, we had a lively question and answer session and group discussion. The various coordinators from the GGHH member institutions that participated established a very strong stand on how healthcare waste should be handled. They all agreed that community health is very important and should be considered at every stage of waste management.

Finally, we visited both Steve Biko and Tshwane District Hospital to conduct a site inspection of the waste management area using an observational checklist. After the site inspection, we went back to the boardroom to discuss our findings. It was great to note that they were able to identify key waste management structures that were absent and those present. Overall it was a useful activity that was aimed at training the GGHH coordinators on how to conduct a walk through survey as well as identifying hazards and risk in their environment.

Day 2

The following day we visited a Buhle waste treatment plant in Polokwane to observe the alternative method called the “converter” in action. The equipment can be installed onsite at a hospital facility and has the ability to process 200kg of waste per hour. It processes all health care waste, except for anatomical and pharmaceuticals’ waste, and just needs water and electricity to run. With the Water Recirculation System the consumption can be lower to ZERO.

The advantages of this treatment process are numerous. I was particularly impressed by the fact that it uses less water, which can be re-used, produces no emissions whatsoever, and the waste product after treatment is reduced in volume and totally harmless. One negative is that the by-products from this waste treatment plant still go to the hazardous waste landfill. However, this is dictated by government legislation in South Africa.

Overall, the GGHH waste exchange for 2017 was a huge success. GGHH champions learned a significant amount on this topic, which they will take back to their various hospitals and colleagues.

Quotes from participants

“The general experience on last-week’s waste exchange program was that it was very informative and eye opening. I especially enjoyed learning about the logistical aspects of Health Care Risk Waste (HCRW) at Steve Biko Academic Hospital, including the storage and record keeping of HCRW consumables i.e. sharps, boxes etc. My “Aha” moment was at Polokwane, at the Buhle Medical Waste Treatment Plant.  We in the Free State we are interested in implementing/piloting the use of onsite treatment of HCRW using non-burn technology and now I know it is possible.

“I was highly impressed with the Buhle plant in Polokwane. I was amazed that healthcare waste treatment water can be generated rather than consumed. The evaporation and condensation of water from the waste, which is then treated before being distributed by the municipality is great to learn, especially given that climate change is having major effects on potable water supply”, Melana de Beer, Chief Food Service manager at Khayelitsha Hospital.

“I have gained so much knowledge from the GGHH waste exchange. I learned a great deal from colleagues who also participated, particularly in the areas of auditing, recording and monitoring of waste generated in your hospital. I was also fascinated by the biodigestion presentation and how placentas can be used to generate gas. It showed that nothing can really be categorized as waste just yet. At the Polokwane Treatment plant, it was good to see where all of the waste generated from our facility ends up and that it has been treated in an environmentally friendly manner“, Zama Cele, Environmental Health Practitioner at Bertha Gxowa Hospital.

“I found the exchange program to be a valuable learning experience. I had the opportunity to visit Steve Biko Academic Hospital where I observed first hand best practices that are measurable and effective in achieving our common goal, which is to reduce our carbon footprint as healthcare facilities. It was awe inspiring to witness the compressor/convertor at the Buhle Waste Plant in Limpopo. I was encouraged to know that we as a country do possess the technology needed to convert and sterilize medical waste. If only this technology would become the standard practice throughout the country, what a significant dent we would make with regards to preventing further harm to our land. I felt inspired and motivated in knowing that Grey’s hospital is not alone in this pursuit for change and there are others in other provinces that are also persevering in this pursuit”, Shireen Arends, Quality Assurance Manager at Greys Hospital in KwaZulu Natal.