Mahmoud Bakr looks into the latest measures to contain perilous medical refuse If it is not handled properly medical refuse can pose a huge threat to public health, as was evident in cases reported recently in Manshiet Nasser, Cairo, and the Ismailia Canal. Officials however say that strict measures are underway to minimise such health risks. According to Article 28 of the executive regulations of the environment law, medical refuse should be disposed of through in situ incineration or sterilisation. In cases where refuse cannot be handled within the same medical facility, the local authorities and the Egyptian Environment Affairs Agency (EEAA) may grant a special permit for the transfer of the refuse to the nearest disposal facility. Medical waste must be transported in sealed and sterilised containers, and incinerators must have filters to prevent ash or gas spreading outside the facility. Sterilisation equipment has to be tested regularly for traces of micro- organisms and any material containing pathological bacteria, sharp objects, insecticides, or radioactive material must be disposed of in a safe manner. "The Health Ministry has a special committee on hazardous waste and material, in which the Ministry of Environment is an active partner," Maged George, minister of state for environmental affairs, said. "The committee monitors medical refuse disposal on the national level and makes sure that disposal techniques are regularly updated." Plans to include university hospitals started with Cairo University and with hospitals that had already introduced a waste management project. "As part of this project, an incineration unit has been installed at Qasr Al-Aini Hospital and plans to produce incinerators locally are also underway," George said. The ministries of environment and health have already supplied 15 incinerators to national hospitals across the country, and 13 more incinerators are on the way at a cost of LE170,000 ($30,000) each. "The government is currently encouraging the private sector to invest in the medical waste disposal system. Burning medical refuse in well- equipped incinerators is one of the safest disposal methods," George added. The EEAA must approve each incinerator in advance to ensure that the location is appropriate and convenient for medical facilities in the vicinity. The ministry also inspects the incinerators to make sure that emissions are within acceptable limits and that the ashes are safely disposed of. "Disposal of medical refuse is of utmost relevance to public health, especially in low- income urban areas," Essameddin Anwar of the General Health Insurance Authority said. "The facility we run in Qalyubia has its own incinerator, but other clinics in Qalyubia and Banha could use similar facilities. Medical staff also need to be trained in the handling of medical refuse." The Ministry of Health has prepared a detailed manual on the safe disposal of medical refuse. In the government hospitals under Anwar's control it is standard practice to break the filters previously used in dialysis treatment before sending them to the incinerator so as to ensure that no one will be tempted to reuse them.
