1. Guidelines for Sustainable Health Care Waste Management in Gauteng Presented by - Albert Marumo, Gauteng Department of Health - Niels Juul Busch, RAMBØLL A/S. Danida

2. What is the objectives of the Guidelines ? Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 2) Improved occupational health and safety Public health Environment Financial savings Meeting legislative requirements Improving working conditions Improve the image of the health care sector. Danida

3. Why prepare Guidelines ? Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 3) 1.For the authorities to decide on level of standards for HCWM 2.To consult the practical implementation of HCWM with stakeholders 3.To communicate - to the involved staff - ways and means to improve HCWM. Danida

4. What is sustainable Health Care Waste Management ? Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 4) Integrated “cradle-to-grave” system Environmentally sustainable Occupationally healthy and safe Financially viable Institutionally feasible Operationally practical. Danida

5. The process of preparing the Gauteng Guidelines Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 5) 1.Establishing an overview of present state of HCWM, the Status Q 2.Establishing of a working group 3.Discussions of objectives, scope and target groups 4.Linking with Policy, Strategy, Feasibility Study etc. 5.Structure of the Guidelines 6.Prepare draft Guidelines 7.Testing Guidelines in Pilot Project 8.Consultation of Guidelines 9.Revising Guidelines 10.Implementation. Danida

6. Target groups ? Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 6) All stakeholders involved from cradle-to-grave: Provincial and national health authorities Provincial and national environmental authorities Representatives of health care facilities Representatives of the various staff groups Service providers for transport and treatment of health care risk waste Service providers for disposal Designers of equipment and materials for health care. Danida

7. Structure of the Gauteng Guidelines: Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 7) Danida ModuleContentMain target groups Module 1General introduction.All readers. Module 2How to organise health care waste management systemsSenior managers and other managers at health care facilities. Module 3How to reduce waste generation and improve segregation and containerisation. Managers and supervisors at HCF’s. Module 4Internal collection, transport and storage.Managers and supervisors at HCF’s. Module 5Collection and transport of HCRW.Managers and supervisors at transport service providers. Module 6Treatment of HCRW with emphasis on environmental aspects. Managers and supervisor at treatment facilities. Module 7Proper handling of HCRW residues.Managers and supervisor at landfills

8. Module 1: General introduction Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 8) Overview of other modules Reader’s guide Definition of waste categories Basic data and cost estimates Overview of legislation List references, abbreviations & glossary. Danida

9. Module 2: Planning for improved health care waste management Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 9) What should the management of the health care facility do ? Analyse the present state of the HCWM Establish a Steering Committee Establish a firm organisational structure Implement “green procurement” Develop Technical Specifications for waste handling equipment etc. Implement tender procedures Develop training programmes for the staff Conduct audits of the HCWM system  Danida

10. Module 3-7: Technical recommendations for the HCWM from-cradle-to-grave. Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 10) Waste generation (waste minimisation) Containerisation Intermediate storage Internal collection and transport Centralised storage External transport Treatment Disposal. Danida

11. Structure of the technical modules: Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 11) Objectives Target groups Scope Reference to other Modules Technical recommendations Specification of equipment Costs Examples of equipment etc. Annexures: information material, templates for reports etc.. Danida

12. What is the next step ? Guidelines for Sustainable Health Care Waste Management in Gauteng (Slide 12) Implementation of permanent environmental management system, e.g. accord to ISO 14001, that includes all environmental aspects. Danida