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Tough life of hospital waste handlers
A peep into the burden of hospital waste handlers

By AGAPTUS ANAELE (agaptus@yahoo.co.uk)

The tone in his voice spells pity and hopelessness.  37 year-old Samuel Emehin talks about what he has to go through as a medical waste handler everyday. Emehin works at the Lagos University Teaching Hospital, (LUTH) Idi- Araba.

“If I had a choice, I would have quit the job. All the people who started with me have quit, because everyday we are pricked by needles and sharp objects”.

Emehin is one of many men and women who handle decomposing corpses, body part and other medical wastes including used injections generated at hospitals nation-wide. “Sometimes, I am summoned to pack decomposing corpses especially new born babies. The moment I see corpses and human parts, the first thing I do is to pack it first before other things. I don’t enjoy it but what can I do,” Emehin shrugged his shoulders.

Emehin knows the dangers associated with his job, but he says his options are limited. “I don’t have any choice because that is the only work I can do to survive. When I came to Lagos in 1999, I stayed with one of my relations in Mushin, where I learnt furniture work but there was no money to settle for my graduation or start my own, so I started working with drivers as a conductor. That could not help, so I quit and began another job search for over a year before my in-law assisted me to get this job at LUTH.”

Health experts say needle prick injuries are common with jobs like these.  They say improper disposal of contaminated needles and syringes results in the increase rates of infectious diseases. They include, HIV, Hepatitis B and C, and Liver Cancers.

Between 2004 and 2006, Emehin says he was pricked many times -- a common occurrence among health care providers and waste handlers. “I have been pricked by needles over ten times, but the most painful was my experience in 2004,” Emehin recalls. Pointing to his left foot, where the needle stuck him after piercing through his protective boots, Emehin said that was the beginning of his knowledge of how dangerous his work is. “I was very scared when they directed me to do an HIV test, because I thought I had been infected through that needle. All my body was swollen and I developed rashes all over. After three days treatment, it refused to heal, so I reported back to the doctor, he discontinued the treatment and gave me another therapy that lasted up to one week.”

Brimming with smile, he said “I was very happy when they told me that the HIV test was negative.”

But Emehin says things are changing for waste handlers at LUTH, “Shortly after that my accident, the LUTH management organized training for doctors to put needles separately and they now give us hand gloves and other protective measures.”

At the Aminu Kano Teaching Hospital, (AKTH), a slightly different story unfolds everyday. On assumption of work every morning, waste handlers at the hospital change first into fitting and protective gears before starting their daily routine of collecting medical and municipal wastes from the wards.

The dress code is part of the standard operating waste disposal procedures in practice recommended by the World Health Community. The procedures include the use of hand gloves in picking wastes, use of protective foot wears and the colour coding of waste bins to differentiate harmful waste from ordinary or municipal wastes.
When this reporter visited the hospital July 26 this year, waste handlers were seen picking wastes, wearing protective boots and gloves. At the incinerator Mallam Abdulahi Sani had on his apron, nose mask, boots and gloves.

Sanusi Datti is the head of the environmental health department at AKTH. He’s also a member of the Infections Diseases Committee. “The hospital management takes the issue of waste disposal seriously. We have an Infectious Disease Control Committee that meets regularly to ensure that universal safety precautions are strictly adhered to.”

But not all hospitals are like Aminu Kano Teaching hospital. Dawakin-Kudu Local Government Area General Hospital is a case in point.  Located about thirty kilometers away from Kano city, this hospital does not have in place any waste management procedure. Yahaya Mohammed is the Chief Nursing Officer of the hospital.  “We have shortage of manpower. We don’t have staff dedicated to waste transportation and this is one of the reasons why we don’t evacuate our waste everyday. We assign our staff to carry the waste to the local dump that serves as our incinerator and after sometime we burn the debris. Those that carry it, don’t wear gloves. They carry it like that.”

 Mohammed admitted there are shortcomings in the hospital’s waste  disposal practice, but he blamed it on poor funding, “Before now, government officials just allocate fund to the hospital without input from the hospital on our priority areas. If we were consulted, we would make suggestions on our priority areas and modern incinerator is one.”

However, he is optimistic that with the change in the pattern of budgeting in which government officials seek the input of the hospital administration, would improve help solve some of their problems.

"This year, government representatives visited us and we discussed extensively with them. We are hoping that the situation will change. Increased funding will translate to training for staff. At present, many of the staff is ignorant of the risks associated with our current practice. It will also help us to procure a disinfectant that is a criterion for good hygiene.”

Folasade Adegoke works with the Federal Ministry of Health in Abuja. She says the absence of a policy on hospital waste management in the country is responsible for the uncoordinated practice in hospitals. She says this has put both hospital staff and the community at risk.
However, she is optimistic a draft policy on the standard for universal precautions and health care waste management practice now been considered by government, will put a stop to the poor waste disposal practice.

At the 50th regular National Council on health meeting held in Abuja in January 2007, the council approved a National policy on Injection and medical waste management.

According to Adegoke “By 2008, every teaching hospital, specialist and federal medical centres and other similar health facilities with more than 200 beds shall provide within their premises a modern incinerator which complies with World Health Organization standard on air pollution emission.”

WHO stipulates that pre-coded plastics garbage systems should be used to dispose of medical waste that has been contaminated by blood or body fluid and that no hazardous trash should be put into a different colour bag.

A US-based non-governmental organization, John Snow Incorporated, JSI, is working with government on the policy. Its Country Director is Dr Abimbola Sowande. JSI is implementing a project call Making Medical Injection Safer, MMIS.  Dr Sowande says proper disposal of hospital waste is very important. “The hospital waste should not just be allowed to go into the river. It should be treated before you let it out.”

These wastes include body fluids, sharps like used injections and body parts. “It also includes radio active waste, expired drugs, pharmaceutical waste, cytotoxic wastes, which are generated from cancer patients that are on treatment. Even urine that comes out from cancer patients on treatment has radioactive element and must be properly taken care,” Sowande added.

For LUTH waste Samuel Emehin, standards or guidelines, his daily survival is what is important to him. He says whatever brings food on his table, risk or no risk, he has to eat.

ENDS