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Environmental Mitigation & Monitoring Plan
HCW_Water & Sanitation Improvements for RBHS Healthcare Clinics
RBHS [email protected]
Blood borne disease
Ex: Hep A, Hep B, AIDS through needle stick injuries
Direct contact
Vector borne diseaseEx: malaria, yellow fever, sleeping sickness
Water borne disease
Ex: Typhoid, Colera, HepA
Air borne disease
Ex: TB
WATER All heathcare facilities need a clean water supply! Recent assessment reveal that many need new boreholes
installed down to the groundwater in the aquifer, costing approximately $8,000. Other clinics need repairs to the existing borehole, costing approximately $1-3,000.
Do we need to explore alternative?
MOVING WATER
Design of a typical shallow borehole and handpump
Design of a dug well with handpump
Sand filter rainwater to drinking water
Biosand filtersBiosand filters; Diffuser plate
Scum
SandSandSandCoarse sandGravel
Almost one third of the healthcare facilities reported not always having a water supply.
Rainwater is free and relatively good water quality.
Catching rain “free-falling” is usually better than from a roof yet there is no one right way, only what works best for your clinic at this time.
Rainwater Catchment
Simply roll out a sheet of plastic - cleaner surface area than most roofs !
- Improvised water storage bin constructed from local materials
Water Disease TriangleSource: WHO/UNICEF, 20005
!Ahh the many choices . . for more information visit www hesperian org
Latrines
Waste water treatment pond with reeds filtering and cleaning the water. Provides viable habitat for wildlife and esthetic view for people. Brocks Hill Visitor Center
Healthcare Waste is Dangerous!
If handled, treated or disposed of incorrectly it can spread disease - poisoning people, livestock, wild animals, plants and whole ecosystems.
The Waste Management Plan Steps to creating a best management plan at your
healthcare facility.
– The MSF Segregation Plan ! works well for them
IncinerationGlobal and local air pollution
DRUM BURNER – not effective but common
INCINERATION for disposal of highly hazardous waste is not the best “environmentally friendly” technology, but is appropriate for Liberia at this time. Use of functional, high-temperature structures is recommended by the MoH EPI.
General Waste
General waste (non-risk) including uncontaminated waste similar to domestic waste (paper, plastic wrappings, food waste); may represent about 80% of the total waste production from healthcare facilities.
Typical Percentages of Healthcare Waste
Hazardous Waste Infectious–
Wastes thought to contain low concentrations of infectious agents, such as disease causing bacteria, viruses, parasites, and fungi, that could spread the disease.
Examples; tissues, swabs, wound dressings, bandages; materials or equipment that have been in contact with infected patients; blood stained cloth, human excretions such as pus, feces and vomit from patients without highly infectious diseases; wash water.
Hazardous Waste
-PathologicalTissue or body fluids from humans or animals without highly infectious diseases
Examples; blood, body parts, organs, animal carcasses
Highly Hazardous WasteSharps Sharp objects that can easily cut or injure a handler.
Used hypodermic needles are the most common and dangerous, as they are often contaminated with highly infectious blood.
Examples; syringe needles, scalpels, knives, blades, infusion sets, broken glass
Highly Hazardous Waste
- Non sharps and highly infectiousContain high concentrations of highly infectious agents and pose an extreme health hazard.
Examples; body fluids, such as blood, from patients with highly infectious diseases; microbial cultures.
SUMMARY
Crushing glass
Red metal glass crusher and cardboard box of glass ampoules - waiting to be destroyed.
Wheintown dump
Example of a Sanitary Pit, unlined for large amounts of general waste - leaching into ground and decomposition will occur. For small amounts of general waste without plastics, a composting bin can be used. A lined sanitary pit would be with thick plastic, or bricks on bottom & sides of pit, for hazardous waste if incinerator is not available. Additions of lime or ash will inhibit decomposition.
, .A compost bin where waste is rolled not stirred• .The barrel is from a local hospital• 7. The frame is the roll bar from a Jeep CJ• . The steel bar going through the center is from a closet
!Recycle and reuse
Manufactured plastic compost bins
Wooden pallet composting bin
Rat deterring compost bin
Old drum compost bin
– Organic Waste Pit COMPOST Above or below ground
:RECIPE• Pathological waste• Air• Water until moist• Brown leaves• Thin layers of soil
, Mix well stir frequently then bake . in the sun
If buried or partially buried, be sure to be at least 1.5 m above the water table
Recipe:Cement 1 part Lime 1 partSand 4 partsWater 1/3 to ½ full
Encapsulation in a 55 –gallon drumof ashes, needles from incinerator and crushed glass.
--------- ¾ full of treated h.h. waste
Waste zone site element variables; Topography and hydrogeology size , shape and depth →
of pits Disinfection liquids; hydrogen peroxide, vinegar, bleach Lining of pits; clay, brick, cement, thick plastic Bottom of pits; gravel, stone, sand, brick Covers; types will vary depending on local goods Additions to decomposition process; wood chips, wood
ash, lime Fencing; local materials
Expired Pharmaceuticals – at JFK Hospital one of
. four containers
: Note NDS receives all .expired drugs
Sanitary Waste Pit
Organic Pit
Incinerator
Glass & Ash Pit
- x - x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x – x -
Xx-x-x-x
x-x-x-x-
Waste zone w/fence
Highly HazardousWaste
General Waste
Hazardous Waste
GlassGreen Bin
Red Bin
Yellow Bin
Black Bin
