Sri Lanka has witnessed a five-fold increase in clinical waste due to the pandemic situation which has overwhelmed existing limited infrastructure and resources for health care waste management, creating an additional burden on health care facilities, says a rapid assessment on Health Care Waste Management in healthcare settings.

The rapid assessment conducted by the United Nations Development Programme at the request of the Health Ministry in collaboration with the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) found that many steps have been taken by the ministry in recent times for effective health care waste management in the aspects of policy and regulation, resource allocation, standardization, establishing in-house treatment and disposal systems for health care waste management.

However, several critical challenges were also identified including a five-fold increase in clinical waste due to the pandemic situation which has overwhelmed existing limited infrastructure and resources for health care waste management, creating an additional burden on Health Care Facilities (HCFs) and the ministry to safeguard staff as well as the environment. The report also highlighted the gendered nature of health care waste management, with over 80% of sanitation workers being women, which is largely unrecognized with increased exposure to risks and solid waste contamination.

Based on the outcomes of the rapid assessment, key recommendations have been made for the consideration of all healthcare sector stakeholders. A few of the recommendations include among others formalizing clinical waste disposal by private practitioners including Ayurvedic treatment centers with a payment system imposed upon the waste generators; strictly enforcement of the prohibition of open burning of clinical waste and introducing suitable arrangements for waste treatment at HCFs; dedicated and appropriate budgeting for Health Care Waste Management (HCWM); Introducing a Management Information System on ‘Build, Operate and Transfer’ basis for HCWM; Regularizing functions and empowerment of the Infectious Control Units to streamline healthcare waste management; and awareness creation, education and certification of all categories (medical and non-medical) in HCFs (Government and private) to improve health and safety aspects of treatment facilities.

Unsound management of healthcare waste could cause “knock-on” effects on human health and the environment. COVID-19 pandemic has created quite a strain on healthcare systems in terms of healthcare waste management and Sri Lanka is no exception.

Safe handling and final disposal of the waste is therefore a fundamental step in the fight against the COVID-19 pandemic and whole product sustainability life cycle.

The report of the rapid assessment was handed over recently to Director General of Health Services Dr Asela Gunawardena by UNDP Resident Representative in Sri Lanka Robert Juhkam at a meeting attended by Deputy Director General – Environmental and Occupational Health, Dr. V.T.S.K Siriwardana, Consultant Community Physician of the Environmental and Occupational Health Directorate, Dr. Inoka Suraweera and other representatives from UNDP Sri Lanka.

Director General of Health Services, Dr Gunawardena, at the meeting said: “The Ministry is grateful to UNDP for carrying out the Rapid Assessment of Health Care Waste in Sri Lanka that has led to important findings and informed the developing of the Draft National Action Plan for Health Care Waste. I commend the progress made so far on the pilot project which will help to further improve the National Action Plan, and the Ministry looks forward to UNDPs support in the finalization and implementation of this Action Plan for Health Care Waste, at this critical juncture that the country is currently facing.”

UNDP Resident Representative,  Juhkam said: “UNDP is proud to support the Ministry of Health to help pave the way forward towards sustainable waste management in the health sector in Sri Lanka, bringing both environmental and safety benefits to communities and health workers. UNDP will continue its support to the Government through Health and Environment Ministries while bringing together relevant UN agencies and stakeholders to provide a well-coordinated effort in finalizing and implementing the National Action Plan for Health Care Waste Management.”