Quantification and characterization of solid waste generated within Mulago national referral hospital, Uganda, East Africa

Abstract

Hospital waste is a special category of waste that is quite detrimental as it may contain infectious and contaminated substances thus posing serious threats to the environment and public health. The knowledge of quantities and characteristics of hospital waste, helps in proper management. This study aimed at waste quantification, characterization, and assessment of the general waste management patterns at Mulago referral hospital, Uganda. The experiment was carried out for 30 consecutive days and solid waste generated within 24 hours were collected from different departments of the Mulago hospital in designated containers, sorted and weighed then grouped into general waste and clinical waste. The study established that general waste comprises 72% while clinical waste is 28% of the total waste generated in the facility. The average solid waste generation rate was found to be at 111.4kg per day with wards producing the highest quantities, followed by operating theatres, kitchen, public areas, laundry, and administration. Using the individualized Rapid Assessment Tool (I-RAT), it was found that Mulago hospital's authorities are aware of policies surrounding the handling and disposal methods of waste and gaps were observed in compliance. The average solid waste sorting compliance in the hospital was found very low, 37.4%, with the highest compliance in operating theatres at 62.8%, followed by the administration 51.7%, kitchen 32%, wards 27.3%, public areas 25.6%, and laundry 25%. The analysis of the discharged liquid waste revealed that Lead, Nitrate, COD, and BOD concentrations were beyond the permissible limits. Therefore, we recommend commitment on compliance with policies and legislation measures to safeguard the workers and environment. Technically, we recommend a bio-chemical pre-treatment of wastewater for the abatement of the pollutants prior to discharging it into the environment. Also, to minimize waste mixing and spillage at the waste generation points as a result of inappropriate bins, we recommend a combined 0.062 m3 capacity containers for general waste and 0.024 m3 for clinical waste in all hospital units.