AIDSTAR-One Success Story. Recycling Plastics Health Care Waste

President's Emergency Plan for AIDS Relief-funded project through the U.S. Agency for International Development, initiated an intervention to reduce the amount of used plastic containers littered around health facilities in central Uganda. The project aimed to engage hospitals in plastics recycling activities, providing much-needed additional income and nearly eliminating the open burning of plastic to improve the environment. Black fumes used to rise from the incinerators operated by hospitals in and around Kampala, Uganda, polluting the air with cancer-causing chemicals and endangering local communities. The culprit was plastics, which were routinely mixed with infectious hospital waste that required incineration. Much of the health care waste generated in Uganda is made from recyclable plastic, including used infusion bottles, radiographic films, plastic medicine containers and caps, and bottles from water and soft drinks. When this non-hazardous waste is mixed with materials that have contacted blood or body fluids, it must be reclassified as hazardous and dealt with in the same manner as infectious waste. AIDSTAR-One met with the proprietor of the Kampala plastic recycling plant to encourage the plant to collect plastic waste from hospitals within the central region. The plant evaluated the available plastics and found that 90% were suitable for recycling. The recyclable plastics included bottles for infusion fluids, plastic cups and plates, and empty soft drink, water, and juice bottles. AIDSTAR-One organized awareness sessions for hospital administrators in the central region, discussing the benefits of collecting and recycling non-infectious plastics generated in the hospitals. The proprietor of the recycling plant offered special containers for collecting plastics and agreed to pay the hospitals a small sum for each kilogram of plastic handed over. Each hospital selected a waste management focal person, who was trained in waste segregation and spearheaded campaigns within their hospitals to target health workers, patients, patient attendants, and visitors, asking them to place all used plastics in designated containers. The plastics are collected from each participating hospital by a truck from the plastics recycling plant, which weighs the plastic for payment to the hospital administration. Most administrators use the fees they receive from the recycling plant to motivate waste handlers by giving them a bonus and to procure protective gear for this cadre of staff. Over 14 hospitals in Kampala are now collecting and handing over their non-infectious plastics for recycling. The black clouds of carcinogenic smoke that were endangering the community have been reduced. In addition, the hospitals have not only reduced their costs of disposing of health care waste but have even earned a small amount of money that they can use to protect and motivate their waste handlers. Sister Ruth Nkwangu of Rubaga Hospital stated that the company that recycles plastics provides them with waste nets that they use for segregating the plastics, and they are paid for each kilogram they hand over. Fifty percent of the generated resources are used to buy waste bin liners, while the other fifty percent is used to motivate the waste handlers.