1. Medical waste management & Corpses

2. Risk Incorrect management of health-care waste may:
> Expose people to health-care associated infections:
Health staff
Patients and visitors
> Be the cause of disease outbreaks:
People who live around the health centre
People who recycle health-care waste 2

3. Objectives of medical waste management
1. Handle and store wastes in a safe way
2. Make wastes:
> Non-contaminating
> And/or inaccessible
> And, if possible, non-reusable 2

4. Classes of health-care waste
Sharps (needles, scalpels etc.), which may be infectious or not
Non-sharps infectious waste (organics) (anatomical waste, pathological waste and dressings)
Non-infectious non-sharps waste (paper, packaging etc.)
Dangerous wastes (laboratory waste, expired drugs, radiological waste etc.) 2

5. Principle of managing medical waste
> Management in the health-care setting if possible
> Minimum handling
> Simple, robust and widely applicable
> Appropriate – technically, socially and legally
> Effective
> Affordable and sustainable 2

6. Management steps 2

7. Sharps Recycled drugs container MSF Reusable Sharps Container
Commercial sharps container 1

8. Sharps 1

9. Sharps
Minimum 1.5 m
Water table
Drainage
Ground level 1

10. Non-Sharps Non – Infectious waste1

11. Non-Sharps Non- Infectious waste
Incinerator:
Reduction of volume
Renders unusable
Decontamination
Renders inoffensive
Burner: Reduction of volume 1

12. Non-Sharps Infectious waste1

13. Non-Sharps Infectious Waste1

14. Non-Sharps Infectious Waste
Ground level
Lining
Minimum 1.5 m
Water table
Drainage 1

15. Dangerous Wastes > Manage case-by-case
> Follow national regulations
> Seek guidance from WHO 2

16. protected from the rain Waste bins storage place
Waste treatment area
Washing area
Incinerator,
protected from the rain
Waste bins storage place
Drains
Sharps pit
Organic waste pit
after 2 years
Ash pit
Ash pit,
Fence
Water supply 1

17. Management issues 2

18. Training and protection of personnel1

19. Minimum standards Storage and collection
1 set of three segregated containers per 40 beds
Transport
Transport of 0.5 litres per bed
Disposal
Original pit volume of 400 litres per bed
Incinerator 5 m from nearest habitable building
Pit 50 m from nearest habitable building

20. Disposal of dead bodies
‘The myth that dead bodies cause a major risk of diseases as reiterated in all large natural disasters, is just that, a myth’ (Goyet, 1999)

21. When corpses represent a risk
Medical epidemics where corpses play a key role in diseases transmission are rare, excepting:
Cholera
Ebola
Typhus and plague

22. Handling of the dead
Cultural practices: Respect the wishes and social customs
Body dressing (body bags)
Disinfection (chlorine solution)
Protective clothing
Transportation
Burial sites (at least 50 m from groundwater sources and 500 m from the nearest habitable building). An area of 1500 m2 is required per population.
Burial depth (covering soil of at least 1 m) and 1.5 m from groundwater table
Cremation (only if traditional method)

23. Cholera / Ebola / Typhus outbreaks
Funerals can contribute to the spread of the disease
Limit funeral gathering, ritual body washing and funeral feast.
If funeral feast can not be avoided, then special attention on food preparation needs to be placed.
Embalming should not be carried out
Bodies should be placed in body bags prior to burial (minimize the contact with the body)

24. Thank you……….