No time to waste
Transforming healthcare waste management for a healthier, more sustainable Nepal
Published by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, May 2020
This publication describes the beginnings of a movement to address the adverse effects of healthcare waste on both people and the environment in Nepal. Healthcare waste refers to all waste generated in healthcare facilities, research centers and laboratories. It includes a broad range of materials, from potentially hazardous items, such as used needles and syringes, soiled dressings, body parts and blood, diagnostic samples, chemicals, pharmaceuticals and medical devices, to general waste, such as kitchen scraps and packaging.
The safe treatment and disposal of healthcare waste is rising on the agenda in Nepal as the country works towards the achievement of Sustainable Development Goal (SDG) targets related to health (SDG 3) and water and sanitation (SDG 6). Improvements in healthcare waste management are also relevant for the attainment of other goals, including sustainable cities and communities (SDG 11), responsible consumption and production
(SDG 12), and climate action (SDG 13).
Nepal faces significant challenges in its quest to ensure that all public and private healthcare facilities adopt safe waste management practices. However, a number of factors work in its favour. First, low-cost, appropriate and environmentally friendly technologies are available which can help healthcare facilities and service providers safely segregate waste at source and transport, treat and dispose of infectious waste. These are being successfully employed in Nepal in a small, but growing number of healthcare institutions. Second, there are some dynamic pockets of innovation in Nepal in the fields. of healthcare waste management, municipal solid waste management, commercial recycling and waste minimisation. New models for managing healthcare waste are being tested, some of which bring together municipalities, healthcare institutions and private companies in mutually beneficial partnerships.
Third, there is growing political will to tackle environmental health risks, such as those posed by poor healthcare waste management, and a policy and legislative framework in which to do so. Among the important recent developments, the country’s Healthcare Waste Management Guidelines have been revised to bring provisions in line with Nepal’s new federal structure and a policy on pharmaceutical waste is being formulated for the first time. And finally, people across Nepal increasingly expect that something be done to improve healthcare waste management — and many are ready to be part of finding solutions. The conditions are therefore ripe for major progress in this field.
In December 2019 a national workshop was convened to discuss, for the first time, what an integrated model of healthcare waste management at the local level could and should look like in Nepal, and how to foster effective partnerships towards this end. The gathering brought together hundreds of actors from across the country to share their experiences and to learn from others about waste management initiatives underway within the health sector and beyond it. The event generated enormous interest — not only among those who attended in person, but also among thousands of members of the public who followed it online and through the media — and has helped to catalyse a broader movement on healthcare waste in Nepal.
This publication offers a snapshot of the challenges, as well as the progress being made in healthcare waste management in Nepal at the current moment in time. It distils some of the key themes and learnings from the national workshop, provides examples of diverse healthcare waste management initiatives, and presents the views of some of the healthcare workers, government officials, entrepreneurs and activists who are testing out ways to transform waste from a problem into an opportunity.