HEALTHCARE WASTE MANAGEMENT: ASSESSING ITS IMPACT ON ENVIRONMENTAL HEALTH OF CAMEROONIAN HOSPITALS

CHAPTER ONE

INTRODUCTION

Background of the Study

Generally, healthcare is essential for life and health, but because of its chemical composition, waste from medical operations has grown to be a major problem. If it is not disposed of properly, it has the potential to harbour microorganisms that can infect both the community at large and those who come into contact with it (Babanyara et al. 2018). After nuclear waste, healthcare waste is the second most dangerous waste. In addition to being dangerous and contagious, medical waste can contaminate land, water supplies, and the air, posing major risks to human and environmental health. The MW produced at healthcare institutions is influenced by a variety of items, including sharps, human body and tissue parts, blood, chemicals, pharmaceutical waste, medical gadgets, both hazardous and non-hazardous, and radioactive materials (Das et al., 2021). However, hospitals and other health facilities are not the only places where MW is generated. The World Health Organisation (WHO) states that human diagnosis, treatment, and immunisation  sometimestake place at home, which may also be a possible source of MW. Even while only 10% to 25% of garbage is classified as hazardous, improper handling of this waste can result in a number of problems, such as the spread of infectious diseases, contaminated neighbourhoods, and various forms of environmental pollution (Rai, Kothari& Singh, 2019;Lemma et al., 2022). 

Ever since the COVID-19 pandemic broke out, there have been numerous negative effects on the environment, the economy, and society, putting the global health system in jeopardy (Ranjbari et al., 2022). The continuously evolving COVID-19 genome and higher risk of infection have led to a significant rise in the likelihood of confirmed cases and deaths from the virus. The steps adopted to combat this extremely contagious virus have resulted in a huge increase in the amount of dangerous microwave radiation emitted. Consequently, there has been an unanticipated growth in the use of disposable personal protective equipment (PPE), including breathing circuits, plastic syringes and needles, surgical masks, air-purifying respirators, gloves, and high-flow nasal cannulas (Shammi et al., 2022). The global pandemic has presented numerous obstacles to the current management of waste (MWM) legislation and practices, including variations in the quantity and composition of waste created, the frequency and timing of disposal, the allocation of trash, and the danger of infection (Farughi et al., 2020). 

Notably, when waste management practices deviate from WHO standard criteria, there is a significant danger of exponential disease transmission to patients, carers, waste collectors, and the society at large (Das et al., 2021). Sadly, MW is often collected with municipal solid garbage in emerging economies and dumped in open dumps that are widely accessible to both the general public and stray animals. The chance of the virus spreading across the population is increased because this waste disposal system is not as strong and well-regulated as those in industrialised countries (Yazdani, Torkayesh & Chatterjee, 2020; Zhang et al., 2019). Moreover, MW incineration frequently takes precedence over recycling. Because it releases a number of harmful chemicals that are clearly harmful to both human health and the sustainability of the environment (Ye, 2022). 

Pitiably, emerging economies do not yet have access to various environmentally sustainable methods of disinfection and disposal, such as chemical disinfection, pyrolysis, autoclaving, microwaves, etc (Wang et al., 2020). Because of this, numerous academics have emphasised that the MWM is a crucial issue in the context of growing economies (Shammi et al., 2022; Chen et al., 2021; Wang et al., 2020). Therefore, it is essential to dispose of MW in an emergency in a fast, organised, efficient, and safe manner to protect human health, the environment, and sustainability. Therefore, before it is finally disposed of, medical waste needs to be carefully treated and managed to safeguard both human and environmental health. The establishment of efficient and universal healthcare, as well as the safe and efficient disposal of clinical waste, need a great deal of work. Therefore, a survey will be conducted in order to assess the impact  of   healthcare waste management on environmental health of Cameroonian hospitals

Statement of the Problem

The past decade have seen a rise in the number of healthcare institutions, mostly as a result of foreign assistance in the fight to eradicate and control several infectious illnesses, as well as demographic development. As a result, the amount of medical waste produced has increased concurrently (Doumtsop, 2019). The way that these wastes are managed varies from nation to nation, with developing nations experiencing the worst situation as they deal with these wastes in an unorganised manner without any systematic approach to managing healthcare waste (Pruthvish et al., 2019; Harhay et al., 2019; Walkinshaw, 2021). Regulations pertaining to the proper disposal of medical waste are either nonexistent or inadequately implemented in many developing nations. 

Ineffective clinical waste management, particularly ineffective methods of segregation, treatment, and disposal, endangers public health, the environment, and workplaces in these nations. It also raises the risk of blood-borne disease transmission (Solberg 2019, Babanyara et al., 2018). According to an evaluation conducted by the World Health Organisation (WHO, 2010), between 18 and 64 percent of healthcare facilities in 22 developing nations do not follow appropriate protocols for managing medical waste. The majority of African nations handle solid medical waste in inadequate ways. Only 30% of African nations complied with half of the WHO's medical waste management recommendations (Chartier et al., 2018), with daily garbage collection from sources of generation showing the highest level of compliance (100%), according to a recent analysis of solid medical waste management in the continent (Udofia et al., 2018). 

Apart from the inadequate handling and lack of segregation of waste in these nations, unregulated and substandard burning is a common practice that leads to further environmental issues such as the release of harmful air pollutants, especially dioxin, and heavy metals that may be found in gaseous and solid byproducts (Pruss et al., 2019). Medical waste must be managed carefully in order to safeguard public health as well as the environment. This entails lowering the production of hazardous waste and tightly regulating waste's handling, storage, transportation, treatment, recovery, and ultimate disposal (UNEP, 2020). Some developing nations have lately developed initiatives that have improved their waste management practices in response to the growing concern over the management of medical waste (Tabash et al., 2018; Awodele et al., 2019).Hence, it is in the light of these that the study seeks to assess the impact of  healthcare waste management on environmental health of Cameroonian hospitals

 1.3  Objectives of the Study

The main purpose of this study is to assess the impact of healthcare waste management on environmental health of Cameroonian hospitals.  Specifically, the study will;

Assess the healthcare waste management practices adopted by Cameroonian hospitals.

Assess the impact of healthcare waste management practices on environmental health within hospital settings.

Assess the environmental health issues associated with inadequate healthcare waste management.

Proffer strategies for improving healthcare waste management practices to mitigate environmental health risks in hospitals.

1.4  Research Questions

The following questions have been prepared for the study:

What healthcare waste management practices are adopted by hospitals in Cameroon?

How do healthcare waste management practices impact environmental health within hospital settings in Cameroon?

What environmental health issues are associated with inadequate healthcare waste management in Cameroonian hospitals?

What strategies can be proposed to improve healthcare waste management practices and mitigate environmental health risks in hospitals?

1.5 Research Hypotheses

H0: Healthcare waste management practices in Cameroonian hospitals do not have a significant impact on the environmental health of surrounding areas.

Ha: Healthcare waste management practices in Cameroonian hospitals have a significant impact on the environmental health of surrounding areas.

1.6 Significance of the Study

The results of the study will help improve healthcare waste management procedures, lower the dangers to the environment and public health that come with inappropriate waste disposal, and support the development of a safer and more sustainable healthcare environment in Cameroon. 

Moreover, the research will enhance existing theoretical frameworks about the integration of environmental health practices into healthcare systems and the perspectives of healthcare practitioners regarding effective waste management. Nevertheless, subsequent researchers will use it as a literature review. This means that other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review.

1.7 Scope of the study   

The scope of this study is boarded on the impact of healthcare waste management on environmental health of Cameroonian hospitals. Empirically, this study will assess the impact of healthcare waste management practices on environmental health within hospital settings, the environmental health issues associated with inadequate healthcare waste management and proffer strategies for improving healthcare waste management practices to mitigate environmental health risks in hospitals.

Geographically, the study will be delimited to some selected hospital in Cameroon.

1.8 Limitation of the study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

 1.9 Definition of Terms

Healthcare waste: Any waste material generated from healthcare activities, including the diagnosis, treatment, and immunization of humans or animals, research activities, and the production or testing of biologicals.

Healthcare Waste Management: process of handling healthcare waste, from its generation to its final disposal.