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Assessment of the management
and disposal practices of medical
    waste in the Hospitals of
    Mogadishu city, Somalia
          (2011-2012)
               by
 Ahmed Adam Mohamed Warsame
 M.Sc. In public and environmental health

                  2012
Introduction
The safe and effective disposal of medical waste starts with the
health care practitioners, and there is a very need to reduce
both the cost and environmental impacts arising from the
generation and disposal of waste in the hospitals.
Doing further researches in this field is very crucial to explore
more about the risks of the medical waste in Somalia,
identifying the health problems due to the mismanagement of
the medical waste in the hospitals, this even could participate
rising the awareness of the people towards the great risks of the
medical waste and unsafe disposal practices.
This study aims to assess the medical waste
management and the safe disposal in the
hospitals of Mogadishu city, examining the
medical waste practices in Somalia and revising
the plans and procedures for medical waste
management, And insuring if there is a policies
procedure, rules and regulations set forth by the
ministry of health or hospital directory to be
followed for managing medical waste in the
hospitals, and discovering the obstacles and
problem for proper medical waste management.
Medical waste definition
Very broadly medical waste is defined as any
solid or liquid waste that is generated in the
diagnosis, treatment or immunization of human
beings or animals, in research pertaining thereto,
or in the production or testing of biological” (BAN
& HCWH, 1999)
Medical waste classification
The World Health Organization classifies medical or
healthcare waste into communal waste or general waste and
special waste. Communal or general waste is all solid waste
not including infectious, chemical, or radioactive waste. This
waste stream can include items such as packaging materials,
bedding, waste water from laundries, office supplies and
other substances that do not pose a special handling
problem or hazard to human health or the environment
(WHO 1999)
Objectives


General objective:
The main objective of this study is to assess the
medical waste management practice, safe disposal
of medical waste in the hospitals of Mogadishu city.
Specific objectives

To indicate mismanagement practices of the
medical wastes at the hospitals of Mogadishu
city.
Investigate the problems and constrains in
managing medical waste.
Insuring the existing policies and procedures for
the medical waste management
3.1 Study design

Type of the study was cross-sectional
    retrospective hospital based
3.3. Data analysis

The analysis is essentially descriptive
data; the analysis was extracted from
questionnaire and personal interview
carried out by the researcher.
Methodology

In the research it is used the descriptive
method, aiming at collecting data from the
hospital staff (doctors, medical assistants
and cleaners) by using questionnaires.
Objective observations and interview also
where used, then analyzing the data in
statistical software.
Location
Mogadishu Bandir region Somalia
Result
The department which generates
  the highest amount of waste.
The department which generates the
  lowest amount of medical waste.
Existence of medical waste
             committee.

           Frequency          Percent%




No             30                 100.0
Segregation of the waste in the
           hospitals
Segregation   Frequency   Percent %



    No           30         100.0
Disposal methods

Disposal Method   Answer

   Autoclave            N

  Incineration          N

 Land disposal          Y

    Burial              Y
Mostly used facilities
Symbol labeling of the waste


Symbol   Frequency    Percent %


 No          30         100.0
management process when dealing with broken
   bags and waste and then decontaminating them

                         Process                        Answer

Identification of waste type                             No

Separation of non-infectious or general waste from       No

infectious waste.



Transferring all waste bags on wheeled containers and    N0

using utility gloves



Packaging.                                               No
Registration of waste

Registering Frequency   Percent %




   No          30         100.0
Mismanagement acts of medical
             wastes
The administrators of the three hospitals have
agreed that there is mismanagement acts of medical
waste management, and they justified that they
don’t have the disposal technologies and educated
staff for medical waste management and safe
disposal. Also the administrators indicated that
none of the hospital provides annual education or
training on waste management for the employees.
Conclusion
Medical waste must be separated from municipal waste, but in
many parts of Africa it tends to be collected along with the rest of
the waste stream. Poor management of medical waste has serious
health implication to health workers, patients and the public; also,
due to the toxic nature of medical waste, improper handling may
lead to serious health problem, destruction of natural
environment and disturb the balance of the ecosystem. This study
examined the medical waste management practices in three of
the major hospitals in Mogadishu city Somalia, from the results of
the study; it is obvious that medical waste management is not
practiced according to WHO,s recommended standards, where
medical wastes are not properly managed. It is imperative for
significant investment in the proper management of medical
waste in order to reduce the health risk it poses. The researcher
hopes that this study will create the awareness regarding the
problem of medical waste management in hospitals and will
generate interest for systematic control efforts for effective
medical waste management.
Recommendations
                            .

•There must be a separate unit for medical west
management in the hospitals
•Ministry of health should set regulations for
managing medical wastes to be applied in all the
hospital of the country.
•The hospitals should develop clear policy and plans
for proper management of medical waste.
•Ministry of health should supervise a regular
training and education of all workers in dealing with
medical waste, from doctors to cleaners.
•It is very important to measure and quantify the
amount of medical wastes generated by each unit
of the hospitals to specify which department or
unit generates the highest and lowest amount of
medical wastes.
•Proper segregation is needed for the general
waste and medical wastes as well as infectious
medical waste and non infectious medical waste.
•The study recommends farther researches in this
area of study.

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Assessment of medical wast practices and disposal in hospitals of Mogadishu (Somalia)

  • 1. Assessment of the management and disposal practices of medical waste in the Hospitals of Mogadishu city, Somalia (2011-2012) by Ahmed Adam Mohamed Warsame M.Sc. In public and environmental health 2012
  • 2. Introduction The safe and effective disposal of medical waste starts with the health care practitioners, and there is a very need to reduce both the cost and environmental impacts arising from the generation and disposal of waste in the hospitals. Doing further researches in this field is very crucial to explore more about the risks of the medical waste in Somalia, identifying the health problems due to the mismanagement of the medical waste in the hospitals, this even could participate rising the awareness of the people towards the great risks of the medical waste and unsafe disposal practices.
  • 3. This study aims to assess the medical waste management and the safe disposal in the hospitals of Mogadishu city, examining the medical waste practices in Somalia and revising the plans and procedures for medical waste management, And insuring if there is a policies procedure, rules and regulations set forth by the ministry of health or hospital directory to be followed for managing medical waste in the hospitals, and discovering the obstacles and problem for proper medical waste management.
  • 4. Medical waste definition Very broadly medical waste is defined as any solid or liquid waste that is generated in the diagnosis, treatment or immunization of human beings or animals, in research pertaining thereto, or in the production or testing of biological” (BAN & HCWH, 1999)
  • 5. Medical waste classification The World Health Organization classifies medical or healthcare waste into communal waste or general waste and special waste. Communal or general waste is all solid waste not including infectious, chemical, or radioactive waste. This waste stream can include items such as packaging materials, bedding, waste water from laundries, office supplies and other substances that do not pose a special handling problem or hazard to human health or the environment (WHO 1999)
  • 6. Objectives General objective: The main objective of this study is to assess the medical waste management practice, safe disposal of medical waste in the hospitals of Mogadishu city.
  • 7. Specific objectives To indicate mismanagement practices of the medical wastes at the hospitals of Mogadishu city. Investigate the problems and constrains in managing medical waste. Insuring the existing policies and procedures for the medical waste management
  • 8. 3.1 Study design Type of the study was cross-sectional retrospective hospital based
  • 9. 3.3. Data analysis The analysis is essentially descriptive data; the analysis was extracted from questionnaire and personal interview carried out by the researcher.
  • 10. Methodology In the research it is used the descriptive method, aiming at collecting data from the hospital staff (doctors, medical assistants and cleaners) by using questionnaires. Objective observations and interview also where used, then analyzing the data in statistical software.
  • 13. The department which generates the highest amount of waste.
  • 14. The department which generates the lowest amount of medical waste.
  • 15. Existence of medical waste committee. Frequency Percent% No 30 100.0
  • 16. Segregation of the waste in the hospitals Segregation Frequency Percent % No 30 100.0
  • 17. Disposal methods Disposal Method Answer Autoclave N Incineration N Land disposal Y Burial Y
  • 19. Symbol labeling of the waste Symbol Frequency Percent % No 30 100.0
  • 20. management process when dealing with broken bags and waste and then decontaminating them Process Answer Identification of waste type No Separation of non-infectious or general waste from No infectious waste. Transferring all waste bags on wheeled containers and N0 using utility gloves Packaging. No
  • 21. Registration of waste Registering Frequency Percent % No 30 100.0
  • 22. Mismanagement acts of medical wastes The administrators of the three hospitals have agreed that there is mismanagement acts of medical waste management, and they justified that they don’t have the disposal technologies and educated staff for medical waste management and safe disposal. Also the administrators indicated that none of the hospital provides annual education or training on waste management for the employees.
  • 23. Conclusion Medical waste must be separated from municipal waste, but in many parts of Africa it tends to be collected along with the rest of the waste stream. Poor management of medical waste has serious health implication to health workers, patients and the public; also, due to the toxic nature of medical waste, improper handling may lead to serious health problem, destruction of natural environment and disturb the balance of the ecosystem. This study examined the medical waste management practices in three of the major hospitals in Mogadishu city Somalia, from the results of the study; it is obvious that medical waste management is not practiced according to WHO,s recommended standards, where medical wastes are not properly managed. It is imperative for significant investment in the proper management of medical waste in order to reduce the health risk it poses. The researcher hopes that this study will create the awareness regarding the problem of medical waste management in hospitals and will generate interest for systematic control efforts for effective medical waste management.
  • 24. Recommendations . •There must be a separate unit for medical west management in the hospitals •Ministry of health should set regulations for managing medical wastes to be applied in all the hospital of the country. •The hospitals should develop clear policy and plans for proper management of medical waste. •Ministry of health should supervise a regular training and education of all workers in dealing with medical waste, from doctors to cleaners.
  • 25. •It is very important to measure and quantify the amount of medical wastes generated by each unit of the hospitals to specify which department or unit generates the highest and lowest amount of medical wastes. •Proper segregation is needed for the general waste and medical wastes as well as infectious medical waste and non infectious medical waste. •The study recommends farther researches in this area of study.