The Sunday News
Fortunate Muzarabani, Correspondent
For Lucky Moyo (41), a municipal worker employed by Bulawayo City Council (BCC) as a refuse collector, going to work is now a matter of gambling with his life and dicing with death.
Moyo is living in fear after suffering a cut by a surgical blade in a black refuse plastic while loading waste into a refuse truck in Bulawayo’s central business district. Describing his job as risky Moyo said:
“Being stabbed by sharp objects, pricked by used injections and cannulas or grazed by sharp surgical blades is becoming a common occurrence in my job”. He said this is owing to a growing problem of medical waste management in the country, which has been exacerbated by the Covid-19 pandemic.
With the Covid-19 pandemic and mass testing, and the rush towards herd immunity characterised by the roll out of vaccination programmes globally, it has been projected by the UNEP (United Nations Environment Programme) that medical waste will increase globally by over 50 percent, and that many municipalities will struggle to cope.
According to research by WHO, in 2020, the global medical waste management market size is projected to reach USD 9 billion by 2025 from USD 6.8 billion in 2020, at a compound annual growth rate (CAGR) of 5.6%.
Environmentalists and health activists alike have called for careful consideration of waste management strategies to ensure that the Covid-19 pandemic does not stir a global medical waste crisis. “To be honest, I now drag my feet when I come to work. I do not feel safe at all, and I am not the only one,” said Moyo. “We have a serious problem here with clinical waste. We are finding it all over mixed with regular waste.”
He added: “While we fear infection from Covid-19, we are being exposed to much more than this virus as all sorts of diseases could be in this clinical waste we find here, and we are not sure if these things are disinfected by the companies or not. I fear for my life and that of my family, should something happen to me, what will become of them?”
Moyo said refuse collectors were finding used Covid-19 tests kits, sharps, pricking needles for the RDT test, injections, scissors, masks, drips, and cannulas, especially in the waste collected in the Central Business District. “This is dangerous to my health. While I have been tested for Covid-19 at work before, I’m not sure if I have contracted other diseases from these things that I do not know about yet”.
Environmental Management Agency (EMA) national Spokesperson Mrs Amkela Sidange said an estimated four million masks would pollute the environment daily in the country owing to the pandemic. “It is estimated that over 4,2 million masks will end up in our environment and water bodies daily, presenting a potential to becoming a health and ecological disaster,” said Mrs Sidange.
Horrendous as it may sound, some of these used Personal Protective Equipment are finding themselves in the street-markets. Investigations by Sunday News established that some second-hand surgical masks are sold in Bulawayo, collected by scavengers at the city’s largest landfill site Ngozi Mine, and those in the business seem indifferent about the implications of their actions, as they are too desperate to fend for their families.
“Sometimes, we are lucky enough to find a whole bag of surgical masks from hospitals. Because they are used once and the hospital is a clean environment, they do not look dirty so we collect them and keep a few for personal use, the rest we resell them,” said Esther Chikoto from Cowdray Park suburb.
“Doctors say Covid-19 does not survive on surfaces for many days so by the time we sell them, we think they will be fine. We have to wash only a few that will be having lipstick and make up, otherwise the rest will be ok.” She said one mask costs 50 bond, or a dollar for two masks, so she can make 20 dollars from selling 40 masks. “Business used to be high last year when Covid-19 started but more people are using cloth masks now so our business is getting low but still viable,” she added.
Public hospitals seem to be coping with clinical waste, with the United Bulawayo Hospitals (UBH) Acting Chief Executive officer, Dr Narcius Dzvanga saying the hospital was incinerating its medical waste while following municipal regulations on the rest of the waste generated at the hospitals.“We have the best incinerator in the country so this helps us to effectively manage clinical waste,” said Dr Dzvanga.
“We also offer services to other health institutions in need of the service, at a fee of course. They pay an initial Z$2000 registration fee, which is paid annually and then they pay fees every time they want to use the incinerator, and they are charged by weight. Of course, some will not want to pay and will irresponsibly dispose of waste, yet services are available. UBH is a public institution and services are available for those who need them. The user fees are minimal, so that the service provision is sustained.”
When the Sunday News crew visited the municipal landfill site at Ngozi Mine, medical waste had been irresponsibly disposed of, putting the environment and its inhabitants at risk. Bulawayo Health Services Director, Dr Edwin Sibanda confirmed that there was irresponsible disposal of medical waste by some medical facilities in the city, although he could not be brought to name and shame culprits, saying the municipality was engaging them and the matters were sensitive.
He however said, it was a matter of negligence and arrogance, coupled with irresponsibility as the city had ‘adequate’ services on offer for the disposal of medical waste. “The city has enough facilities for medical waste disposal, however, some facilities are failing to comply with regulations. This has been happening even before the pandemic,” said Dr Sibanda. “We have received complaints from our staff responsible for waste collections and have traced the waste back to its origins and unfortunately some of it has been from very reputable medical institutions in the city.
Dr Sibanda said culprits had been fined and there were still cases under investigation. He said Council was working with EMA, which was intervening with higher penalties for offenders, which had proven to be effective in curbing the dumping of hospital waste. He said while a boom in medical waste generation is expected with the ongoing vaccination programme, the city was ready as the project had been planned and budgeted for.
A nurse working at a local surgery shed light on how small health facilities were disposing of medical waste, saying her employers stopped paying for disposal services in June 2020. “From July 1 in 2020, we started discarding all our waste the same way after we last paid for medical waste removals in June the same year. My boss had said the fees were an unnecessary expense since the surgery was not very busy during lockdown.” She said while business had normalised after the relaxation of Covid-19 regulations the medical facility had not renewed its contract with the waste disposal company.
Bulawayo is not the only municipality battling with medical waste disposal from unscrupulous health toilets. Recently, Harare municipality refuse collectors engaged in industrial action, in protest over surgeries in Eastlea and the Avenues mixing regular and medical waste. This affected residents in the same streets, as refuse was no longer being collected from residential flats.
“I stay in Eastlea and council workers are shunning our street as they say that surgeries in our street are putting injections and other medical waste together with regular waste. While we understand their plight, we are in a tight situation as we have to endure weeks with uncollected garbage,” said Ruth Mpofu, a resident. Challenges of waste management globally, particularly third world countries are not a new phenomenon as mounting levels of medical waste were a concern before the pandemic added piles of personal protective equipment to the global crisis. Before the pandemic, the issue of medical waste was being recognised as an increasingly urgent problem with global consequences.
While tangible statistics for a comparative analysis for the situation in Zimbabwe remain sketchy as responsible authorities are allegedly still compiling evidence, in the city of Wuhan, China, where the first Covid-19 case was recorded, between 40 and 50 tonnes of medical waste was being generated per day from December 2019 to January 2020, however three months into the health crisis, the figure had spiked to 247 tonnes a day around February 2020.
The health sector can and needs to improve its waste management regime for reduced environmental impact. The environmental and human cost of this waste crisis cannot be downplayed, as some health service institutions remain defiant of regulations on the disposal of medical waste, risking the lives of refuse collectors and other community members.
This article was made possible by assistance from the Voluntary Media Council of Zimbabwe Investigative Fund.
