/ 22 July 2011

Medical waste crisis threatens Gauteng hospitals

Medical Waste Crisis Threatens Gauteng Hospitals

Government hospitals in Gauteng have been sitting on hundreds of tonnes of hazardous uncollected medical waste for at least three weeks, putting the health of staff and patients at risk.

The contracted service provider, Buhle Waste, said that the delay was due to the “unavailability of sufficient licensed treatment [incineration] facilities”, which has had a knock-on effect on collection.

The provincial agriculture and environment affairs department had also taken an “unfortunate and inordinately long” time to issue it with a temporary permit to dispose of the built-up waste at a landfill site without having to treat it, said Buhle Waste owner David Sekete.

Sekete added that it was “still owed a huge amount of money” by the province’s centralised contracting department which “is putting a lot of pressure on the business”.

The Mail & Guardian understands that the lack of treatment facilities is a nationwide problem, and that it has led to Gauteng having to endure recurring collection backlogs.

Time limit

Health department spokesperson Simon Zwane said that provincial regulations allowed for a 90-day storage period of general medical waste under “controlled circumstances, which we have in our facilities”.

But Gauteng provincial regulations state that medical waste may not be stored onsite at hospitals for longer than 30 days, with the exception of sharps (needles and scalpels) and pharmaceutical waste (expired medicines) which can be stored for 90 days.

The M&G has seen communication between private service providers who exchanged information about the mounting medical waste collection crisis last week. It reveals not only the scale of the backlog, but also attempts by unlicensed operators to piggyback on the crisis.

One such operator, Jannie MacKay, wrote to KwaZulu-Natal-based company Compass Waste: “We have started an audit of medical waste stored at hospitals [in Gauteng]. The stack at the moment is equal to 35 days of transport and clean-up using 10 x 8-ton trucks.”

MacKay told Compass that he had transport, but needed Compass to help treat the waste.

“The information provided is highly confidential and none of what is being disclosed here should be disclosed or revealed to any other sources,” MacKay wrote. He asked that “every member” of Compass sign a confidentiality agreement, but Compass refused.

Compass’s director, Ian du Randt, said: “What is a guy with no experience of handling medical waste doing approaching us?”

Sekete confirmed that MacKay was operating without a permit, and that he had reported MacKay to the Green Scorpions, a unit which polices environmental laws.

“These are people who, if you’re not careful, end up taking away your waste and dumping it in the bush somewhere,” Sekete said.

The Green Scorpions are currently investigating a case of illegal dumping — unconnected to the Gauteng backlog — in the Free State in 2009, which is believed to be the biggest in South African history.

MacKay told the M&G that he was trying to find “a proactive solution” to the backlog, “based on information that came to us from a source”.

He would not reveal who his source was, who he is working for, or about his background in medical waste, saying: “I don’t need to answer any of your questions.”

Slow improvement

Senior administrators at three major Gauteng hospitals confirmed that collections had been slow or nonexistent for several weeks, but that the situation had begun to improve.

Dr Trevor Fisher, chief executive officer at the 1 644-bed Dr George Mukhari Hospital in Pretoria, said that the hospital produces 420 boxes of medical waste a week “which needs to be collected as fast as we produce it”.

Hospital in-patients produce an average of 400g of medical waste per day.

Fisher said that Buhle’s collections had slowed to 300 boxes a week, which led to a “cumulative backlog” of uncollected medical waste at the hospital over a three week period.

An administrator at the 1 200-bed Charlotte Maxeke Johannesburg Academic Hospital, who asked not to be named, said the situation had been “very, very bad”.

He was echoed by a colleague at the 310-bed Far East Rand Hospital, who said that a week’s backlog was cleared by Buhle waste staff “working very late hours” last week.

Sekete said the backlog would be cleared by the end of this week [Friday July 22], but warned that “government needs to licence more incinerators”.

The M&G Centre for Investigative Journalism, a non-profit initiative to develop investigative journalism in the public interest, produced this story. All views are ours. See www.amabhungane.co.za for all our stories, activities and sources of funding.