Alternatives for the treatment and disposal of healthcare wastes in developing countries.

Waste production in healthcare facilities in developing countries has brought about a variety of concerns due to the use of inappropriate methods of managing the wastes. Inappropriate treatment and final disposal of the wastes can lead to adverse impacts to public health, to occupational health and safety, and to the environment. Unfortunately, most economically developing countries suffer a variety of constraints to adequately managing these wastes. Generally in developing countries, few individuals in the staff of the healthcare facility are familiar with the procedures required for a proper waste management program. Furthermore, the management of wastes usually is delegated to poorly educated laborers who perform most activities without proper guidance and insufficient protection. This paper presents some of the most common treatment and disposal methods utilized in the management of infectious healthcare wastes in developing countries. The methods discussed include: autoclave; microwave; chemical disinfection; combustion (low-, medium-, and high-technology); and disposal on the ground (dump site, controlled landfill, pits, and sanitary landfill). Each alternative for treatment and disposal is explained, including a description of the types of wastes that can and cannot be treated. Background information on the technologies also is included in order to provide information to those who may not be familiar with the details of each alternative. In addition, a brief presentation of some of the emissions from each of the treatment and disposal alternatives is presented.