By Syriacus Buguzi The Citizen Correspondent Dar es Salaam. As healthcare facilities continue mushrooming in the city and other urban centres, local environmental health experts have warned against a major public health challenge that comes with it. They say, in most developing countries, including Tanzania, the sharp medical garbage generated from these health facilities poses a human health disaster that neither government authorities nor owners of healthcare facilities have invested enough to avert. ''There are documented cases of people who have acquired Hepatitis A and B from using recycled syringes which had been previously used at hospitals,'' according to Dr Larama Rongo, an expert in Environmental and Occupational Health from Muhimbili University of health Sciences in Dar es Salaam. Dr shares his sentiment with most other pundits who spoke to The Citizen on Sunday recently, as they brought to light the health risks associated with poor disposal of sharp medical waste and the likely dangers emanating from hospital litter in general. "Hospital litter is a nuisance; imagine if human body parts were to go beyond the confines of the hospital?'' he posed. Recently, it came to the attention of this newspaper that unscrupulous people are benefiting from poor handling of medical waste at local health facilities whereby cases of recycling dangerous hospital waste like used syringes, gauze as well as expired medicines are said to go unreported. He remarked: "We need a well-established system that will deal with all weak points that permit infectious waste to cross the hospital boundaries. Otherwise I see no end to this problem.'' Furthermore, it is reported that most health facilities still burn medical waste in poorly designed incinerators located near human settlements and that they emit chemical substances known to cause cancer. In his reaction, the Chief Government Chemist, Professor Samuel Manyele. who has done extensive research on healthcare waste said: ''The idea of constructing more incinerators as a way of disposing medical waste is also getting obsolete''. ''We eye more environmentally friendly methods instead of incineration,'' he said. "Most of our incinerators are of poor designs. They emit dioxins and furans which are known to cause cancer and worse still, they are located near human settlements. This is very dangerous,'' added the chemical engineer. Professor Manyele has endeavored to address this situation on many platforms, including in the media. He published an article in the African Newsletter on Occupational Health in which he recommended the use of cleaner technologies in order to reduce the amount of pollutants and waste production from incinerators. The don out that that this could make a more efficient use of raw materials, energy and utilities, thus reducing environmental impact. The professor's position on the matter is backed by concerns among environmentalists, given a warning from The World Health Organization (WHO) that substances emitted with the smoke that the incinerators generate, were linked with cancer. Studies conducted in Dar-es-salaam which show that there is poor management of health care waste in the city have addressed the health impact of the medical waste among the health care providers and the general public. A study titled: ''Current status of sharps waste management in the lower-level health facilities in Tanzania,'' concluded that sharp waste management in Lower level health facilities of Ilala Municipality in Dar es Salaam is poor, which puts health workers, the public and the environment at risk of exposure to blood-borne diseases. Published in the Tanzania Journal of Health Research, the study recommends that the municipality should establish a waste processing centre, to be located far away from human settlements. which will collect and incinerate all sharps medical waste. With rapid urbanisation in the developing world, the cities are experiencing rapid population growth and the local governments are often not able to provide for even the most basic needs for their citizens, including waste collection disposal and management. However, environmental health experts are taking the matter with concern. That's why they are currently raising their eyebrows on proper treatment and disinfection of healthcare waste in most sub-Saharan African countries. This has been in response to the high incidence of HIV, Hepatitis A and B and other infectious diseases that can be spread by infectious waste.
