The world's worst Ebola outbreak, finally being brought under control in West Africa, has posed huge challenges to the people and healthcare systems in the region. Treating the infected waste from the Ebola Treatment Units has proved a huge problem, with many ETUs being forced to burn or bury their waste in primitive fashion, through lack of other options. Others have low-tech incinerators, which fall far below international standards, and are not only highly polluting but potentially dangerous to operators whose personal protective gear is not heat resistant or non-flammable.
The following technical report from Jorge Emmanuel, Chief Technical Expert from the United Nations Development Program (UNDP)/Global Environment Facility (GEF) Global Healthcare Waste Project, and Babacar Ndoye, Waste Management and Infection Control Expert from Ministry of Health, Senegal, explains the situation on the ground in Liberia, Sierra Leone and Guinea, as part of their mission to install autoclaves to provide safer and more sustainable healthcare waste management.
It shows the environmental and other risks in Ebola Treatment Units where lack of alternatives options has forced workers to burn and bury infectious waste. It provides a detailed account and photos of the equipment and procedures in place, at the start of the mission to, and valuable data relevant issues ranging from from wastewater treatment and locally made alcohol hand rubs to the the susceptibility of Ebola virus to sunlight.
Last but by no means least, it serves to remind us all of the bravery of the people who have fought the outbreak and the enormous efforts that will still be required to completely stop the outbreak and rebuild the healthcare systems even after the subject has slipped out of the headlines.
Sharps waste on the grounds of hospitals treating Ebola patients in Liberia (left), Guinea (middle), and Sierra Leone (right)
Single-use sharps containers reused with no decontamination; note lack of cleanliness and physical integrity of containers.