Case Studies
All waste from the district hospital is gathered and thrown into piles behind the main hospital building. Every six months, the hospital director hires some laborers to shovel the waste into trucks and cart it off to the closest dump, which is located in a neighboring town. Frequently, people pick through the waste looking for items that they can use or sell, children play near the waste, and dogs are commonly seen poking their noses in the piles.
Who is at risk of infection from these practices?
How can the waste-disposal problems here be solved?
Ms. Gomez is a new district supervisor making her first visit to the Turtle Clinic. The sanitation officer takes her on a tour of the facility, explaining all the waste-disposal functions in each area. Upon visiting the waste-disposal site, Ms. Gomez finds a large pit that is less than half full, with a layer of leaves and other garden debris visible. While talking to the sanitation officer, she sees a gardener dump a wheelbarrow full of branches, leaves, and other debris into the pit. Then, against the outside of the fence, she finds a pile of what looks like recently dumped medical waste, complete with bloody dressings and exposed needles attached to IV tubing.
What are the waste-disposal issues here?
What should be done about this situation?
Ms. Oludara is a nurse-midwife at the Yaro Clinic, a small but busy maternal/child health clinic. She recently attended an infection prevention training course where she realized that she did not know where medical waste was disposed of at her clinic. Upon returning to the clinic, Ms. Oludara discovers that the area designated for waste disposal is a shallow pit in the trees behind the clinic. She notices that there are many plungers for the syringes but not the barrels. She questions the doctors, midwives, and housekeeping staff, but no one can explain what is happening to the syringe barrels. The providers say that after using the syringes and needles, they remove the needles, place them in empty bottles, and throw the syringes in the trash can. Ms. Oludara then asks the man who collects and disposes of the medical waste about the barrels. He tells her that he once saw some teenage girls who lived near the clinic collecting the syringe barrels to use as rollers for their hair. He had thought it was a clever idea.
What are the waste-disposal issues here? Who is at risk of infection or injury, and why?
What should be done about this situation?
Dr. Asante is the director of the Suta Clinic, which is holding a community health fair. During the opening session, many more community members arrive than the space can accommodate, and they spill out into the bushy areas. As the opening speech is being given, a painful wail is heard from the back of the crowd: a man has stepped on a needle and syringe, which is now sticking out of his foot. Upon inspection of the area where the man has been standing, Dr. Asante finds a pile of fresh medical waste at the base of a tree. He becomes angry and confused--since the clinic has an incinerator, he does not understand why the medical waste was dumped there. He discusses the issue with the staff responsible for waste disposal and running the incinerator, who tell him that they often receive more waste than the incinerator can handle and sometimes have to dump waste in the trees.
What are the waste-disposal issues here?
What can be done about this situation?
Mr. Andreyev is conducting an infection prevention training for 20 newly hired staff in the new children's unit at Comoto Hospital. During the module on waste disposal, he asks the supervisors what happens to the waste that is generated at the clinic. Everyone looks at one another and replies, "It is burned in an incinerator, of course." But when Mr. Andreyev asks where the incinerator is located and whether he can see it, he discovers that no one present has ever visited it. He decides they should visit the waste-disposal site and asks one of the workers to take them there. Upon arrival at the site, they find no incinerator. They do find a very large dumpster, which is overflowing with contaminated waste, including IV fluid containers, tubing with needles still attached, bloody gauze, and syringes with needles sticking up.
What are the waste-disposal issues here?
What should be done about this situation?
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