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Chapter One of Hospital Waste Management Practices in Nigeria (a Case Study of Uyo Teaching Hospital)
The sustainable management of Healthcare Waste (HCW) has continued to generate increasing public interest due to the health problems associated with exposure of human beings to potentially hazardous wastes arising from healthcare (Tudor et al., 2005; Ferreira, 2003; Da Silver et al., 2005). Presently considerable gap exist with regard to the assessment of healthcare waste management practices particularly in Nigeria and in several other countries in sub – Saharan Africa. The nature and quantity of healthcare waste generated as well as institutional practices with regards to sustainable methods of healthcare waste management, including waste segregation and waste recycling are often poorly examined and documented in several countries of the world despite the health risks posed by the improper handling of HCW (Farzadika et al., 2009; Oke, 2005). It is also of serious concern that the level of awareness, particularly of health workers regarding healthcare waste has not been adequately documented. HCW are a special category of waste because they often contain materials that may be harmful and can cause ill health to those exposed to it. The World Health Organization estimates that each year there are about 8 to 16 million new cases of Hepatitis B virus (HBV), 2.3 to 4.7 million cases of Hepatitis C virus (HCV) and 80,000 to 160,000 cases of human immune deficiency virus (HIV) due to unsafe injections and mostly due to very poor waste management systems (WHO, 1999; Townend and Cheeseman, 2005). In developing countries like Nigeria, where many health concerns are competing for limited resources, it is not surprising that the management of healthcare wastes has received less attention and the priority it deserves. Unfortunately, practical information on this important aspect of healthcare management is inadequate and research on the public health implications of inadequate management of healthcare wastes are few and limited in scope. Although reliable records of the quantity and nature of healthcare wastes and the management techniques to adequately dispose of these wastes has remained a challenge in many developing countries of the world, it is believed that several hundreds of tones of healthcare waste are deposited openly in waste dumps and surrounding environments, often alongside with nonhazardous solid waste (Alagoz and Kocasay, 2007; Abah and Ohimain, 2010). A near total absence of institutional arrangements for HCW in Nigeria has been reported by others (Coker et al., 1998). Various methodologies have been used all over the world to assess and quantify HCW. They include the use of physical observation, questionnaire administration and quantification (Adegbita et al., 2010; Olubukola, 2009; Phengxay et al., 2005), as well as checklists (Townend and Cheeseman, 2005) and private and public records (Coker et al., 2009). Recent studies in Nigeria has estimated waste generation of between 0.562 to 0.670 kg/bed/day (Longe and Williams, 2006) and as high as 1.68 kg/bed/day (Olubunmi, 2009). As reported in the literature, there may not be much of a difference in the way and manner wastes generated in various health care institutions are managed in Nigeria. A good example is given by the findings of the study in Lagos by Olubukola which reported the similarity in waste data and HCW management practices in two General hospitals, characterized by a lack of waste minimization or waste reduction strategies, poor waste segregation practices, lack of instructive posters on waste segregation and disposal of HCW with general waste (Olubukola, 2009).
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