By Victor Bwire
The decentralisation of service in Kenya, starting with the introduction of the Constituency Development Funds (CDFs) and County Governments following the requirement of the 2010 Constitution, saw a tremendous growth in the number of health facilities across the country.
With two national referral hospitals, 47 County Referral hospitals and a host of other health facilities provided by National Government, County Government and other non-state actors, and the effort by the Government through the National Health Insurance Fund (NHIF), the number of Kenyans accessing health services has grown. The concern however is that the growth of the health sector has not been matched with the same zeal to establish proper functioning structures for medical waste disposal, which endangers the lives of many.
The medical and related wastes, even with available technologies and players with expertise in the country to assist, continue to pose serious environmental challenges as many of the health facilities lack incinerators and related disposal facilities thus dump them in the open in contravention of national guidelines. It has been reported that medical wastes comprises up to 25 per cent hazardous material which can be infectious and can cause injuries.
The Government released national guidelines for safe management of healthcare waste that stipulate that every facility must have a proper health care waste management plan — including packaging, segregation, labeling, transportation, storage, tracking, treatment and disposal. The guidelines require that health facilities treat healthcare waste prior to disposal to ensure protection from the potential hazards posed.
Health facilities wastes include and are not limited to infectious, pathological, sharps, pharmaceutical, radioactive, noninfectious, pressured containers, chemical waste and heavy metals. The constitution under the “Bill of Rights” Article 42 provides that “every person has a right to a clean and healthy environment”. Additionally, Article 43 provides for the highest attainable standards of health.
Waste management is a devolved function and authority for enforcement has been provided for under The Public Health Act Cap 242 and other relevant legal statutes. The Ministry of Health and WHO standards in medical waste disposal require that hazardous medical waste be burnt in incinerators that reduce them to ashes and currently there are several companies in Kenya that have the expertise to do such work.
The companies provide services in handling including collecting, sorting, packaging, transporting, aqueous treatment and disposal of medical wastes. Hospital facilities must be made to obey the law, by putting in place mechanisms, and resources to dispose of medical wastes within the approved national laws. Those unable to do it by themselves should spare resources in their budgets and outsource the services to competent service providers to do the same.