Jordan, Ein Al-Basha – Public health workers are at the frontline in managing the process of medical waste disposal. Medical waste management is a critical process which needs to comply with high safety standards at hospitals across Jordan. On a daily basis, Jordan produces 10-15 tons of medical waste.

While Covid-19 has been spreading rapidly, it has become even more important to ensure compliance with best practices for disposal of medical waste to protect front line staff in hospitals as well as residents of Jordan from harmful and infectious diseases including the transmission of the novel coronavirus. 

Prince Hussein Hospital is a hospital located in Ein Al-Basha area in Northwest Amman. At this local hospital,28-year-old Nada, a public health worker, is managing the process of safely disposing of medical waste. Medical waste treatment is undertaken at a specific area within the hospital premises away from health care personal, patients, and visitors to prevent potential health hazards from exposure to infected materials.  

Most commonly, medical waste is disposed of through incineration. This also used to be the case at Prince Hussein Hospital. “The process was long, complicated and unsafe for me and my colleagues. At some point we couldn’t even handle the amount of waste generated. Along with Covid-19 and the increase in medical waste, this is just one of the serious issues we are facing”, Nada said.

She continues to explain that previously, it was also common that medical and non-medical waste were mixed and then burned in old incinerators with no proper control of emissions. This is harmful to the environment as improper and uncontrolled incineration results in emitting many Persistent Organic Pollutants (POPs), carbon dioxide, and other toxic elements being released into the earth’s atmosphere which highly contributes to climate change.

Managing medical waste may look like a basic process, but it is long, critical, and risky. “Managing medical waste at Prince Hussein Hospital is a long process. In the morning, I walk around the hospital to make sure health workers and other frontline staff stick to regulations on how to manage medical waste including separation from non-medical waste to avoid contamination. Once we know the volume of waste by weighing it, the waste is sometimes transported to other hospitals for incineration if our own waste facility is not coping with the quantities”, Nada said.

Transforming how we manage waste

The United Nations Development Programme (UNDP) in partnership with UNDP-Global Environment Facility (GEF) has implemented the Reduction and Elimination of Persistent Organic Pollutants Project to enhance medical waste management in different healthcare facilities in Jordan using non-combustion sterilization devices equipped with pre-shredders also known as Autoclaves.

“I was thrilled when the waste facility at the hospital was restructured and improved. Now everything is in place, clean, and systemized. This waste facility is a huge support for me as a public health worker”, Nada said. The autoclave uses high-temperature and pressure to sterilize medical waste and is equipped with pre-shredding technology that is used to reduce the amount of waste before it is disposed into landfill. Nada and her colleagues also participated in technical training on segregation, proper handling of waste storage, waste treatment, and other disposal techniques.

“The use of Waste incinerators is a complicated process in Prince Hussein Hospital, especially since most of the area surrounding the hospital is farmland and this present a wider implication. After we started using the autoclaves things have greatly transformed and the process is now safer and easier”, Nada added. Up until mid-November 2020, the Autoclave at Prince Hussain hospital has treated more than 24 tons of medical waste, one ton of these medical waste were from Covid-19 isolation rooms.

The autoclaves have made the process easier for Nada and her team. One of the most positive outcomes is that now medical waste can be treated close to its source rather than transporting it to a different location which may be risky. Autoclaves are a safe and the most cost-effective technological method currently on the market. Moreover, the technique is completely free from harmful emissions that affect public health and the environment.

In the future, it is crucial that safe and environmentally friendly waste management disposal processes are integrated into the Jordanian healthcare system. This is especially important to manage the surge in medical waste amidst Covid-19.