Waste management is a growing issue in a growing world. And as developing countries become more modernized, their need for safe and healthy waste disposal becomes of paramount concern to the growth of the city and its inhabitants. Often, what comes alongside the growth of these cities is increased need for other public services such as healthcare. So here we have an interesting juxtaposition: an expanded healthcare system that services more patients will also produce a growing amount of waste. What then is the best method for its safe handling and disposal?
In Lao’s People Democratic Republic (Lao PDR), researchers investigated various methods for the proper disposal of healthcare waste (HCW) which consists of sharps, blood, body parts, chemicals and pharmaceuticals. HCW is predominately considered highly hazardous, so it must be handled with extreme care. The researchers’ study focused on the treatment and transportation of HCW to the nearest processing facilities from the medical center of origin. Lao is a landlocked country in Southeastern Asia and is bordered by China, Vietnam, Burma, Cambodia and Thailand. The country is home to more than 6 million people. Comprised of 18 provinces, there are nearly 700 healthcare centers in the nation, and their annual production of infectious and recyclable waste is 1,020 kilograms (kg) and 720 kg respectively.
The methods used in the study relied heavily on GIS to demonstrate the planning of waste collection operations; the analysis of optimal treatment locations; and the identification of routes for waste transportation. A model was designed to establish optimum routing, and then it was tested for accuracy. To do this, the healthcare facility locations were plotted to gain an understanding of clustering and distribution within the provinces as well as differentiation between the identified routes. Amounts of both recyclable and hazardous waste were calculated, and then the facilities with the highest production of HCW were documented to establish them as high-priority service centers. The majority of these were within, or nearby, the capital city of Vientiane.
After the highest producers were established, these facilities were considered as sites for new treatment centers to cut down on transportation costs and unnecessary human exposure. Findings from their study indicate that proximity and quantity of wastes are crucial in determining costs associated with their transportation; and that due to travel distances in some areas, regional treatment centers would not be cost-effective. In some instances, treatment costs were considered best to be used in-house. Ultimately it was recommended that (1) facilities generating more than 10 kg of infectious waste should use the nearest incinerator facility; (2) the most-productive provinces and the capital should rely on collection vehicles; and (3) remote, low-producing facilities should rely on an autoclave and deep burial system for treatment of their medical wastes.