20082009

HospitalWaste Management
ProjectCompletionReport

Umeed Foundation in collaboration with UNDP GEF Small Grants Programme completed the one year project on Hospital Waste Management at Liaquat UniversityofMedicalandHealthSciencesJamshoroandHyderabad.

UmeedFoundation
Bungalow No. A-56 Zubiada Bungalows Muhammadi Town Qasimabad Hyderabad, Sindh +92-22-2655924

www.umeedfoundation.org

TheGEFNGOSmallGrantsProgramPAK/98/G52

ProjectCompletionReport HospitalWasteManagementatLiaquatUniversityofMedicalandHealthSciences Jamshoro&Hyderabad Publication#/ID Date: Theinformationofthisdocumenthasbeengatheredfromprojectactivities,studies,interactionsthat werepureandoriginalsourceandarethepropertyofUmeedFoundation. Anyuseofthisinformationisforpurestudypurpose.However,theauthormustbeacknowledgedand sightedproperly. www.umeedfoundation.org2009UmeedFoundation

HospitalWasteManagement|ProjectCompletionReport

ExecutiveSummary
Sincebeginning,thehospitalsareknownforthetreatmentofsickpersonsbutwe areunaware about the adverse effects of the waste generated from them on human and environment. RisingincidenceofHepatitisB,andHIVareassociatedwithusedandillegallyrecycledsyringes. In this context, Umeed Foundation initiated the project on hospital waste management in Liaquat University Hospitals (LUH) Jamshoro and Hyderabad, with the cooperation of UNDPs SmallGrantProgrammeunderGlobalEnvironmentFacility(UNDPGEF/SGP).Theprojectwasof oneyearduration(June2009May2008). According to the baseline data obtained from the two hospitals, pressure on both hospitals is increasing tremendously and as such 15 % growth is seen in last 5 years in terms of OPD and hospitalization numbers. This eventually means a direct increase of hospital waste. When Umeed Foundation undertook this project, all waste generated in the Hospitals was being dumped on the bank of a flowing water body, phuleli canal. It was also found that the Hospital owns a high quality brand new incinerator which was installed in Jamshoro Hospital, some7yearsagohaveneveroperated. Withthisbackground,UmeedFoundationconvincedHospitaladministrationtoformandnotify Waste Management Team (WMT) to meet a requirement as set in the relevant laws of Pakistan. Hospital Waste Management Rules 2005 requires all hospitals to form a WMT, to be headed by the Medical Superintendant. The Waste Management Team participated in taking steps towards better system of waste management with Umeed Foundation. Later in the course of project implementation, nonfunctional incinerator eventually started its operations, whichisabigachievementoftheWMT. Apart from institutional engagement, awareness seminars, staff orientation sessions and trainings for medical, paramedical and sanitary staff were organized. Umeed Foundation constructed a waste storage room in Civil Hospital Hyderabad. It comprises of two compartmentstostoreinfectiousandnoninfectiouswaste. As Hospitals also lacked waste bins to facilitate good waste segregation, Umeed Foundation distributed color coded waste bins of small and large sizes across all Hospital wards and waste generating units. The red and blue color bins were used as the first step of segregating the infectious and noninfectious waste. Additionally, syringe cutters were provided to hospital to eliminatetheriskofsyringescavengingandrecycling.

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Theintervention,altogether,achieved the goal of improving healthcare waste management practices. A functional Incinerator at LUH Jamshoro, waste segregating means and a dedicated wastemanagementteamarethemainachievementsoftheproject. There is further need of such planned and organized efforts in public sector healthcare units. Proper waste management practices can be achieved by longer term interventions and better trainingopportunitiesformedicalstaffandrelevantstakeholders.

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Contents
Acknowledgements .......................................................................................................................................7 1. 2. 3. Background...........................................................................................................................................9 ImplementationPlan.......................................................................................................................... 10 Activities..............................................................................................................................................11 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 4. 5. 6. Baseline.......................................................................................................................................11 AwarenessandIntroductorySeminar........................................................................................ 13 InaugurationCeremony&SeminaronCentralWasteStorageFacility......................................13 HospitalWasteManagementTeamFormation .......................................................................... 13 Trainings......................................................................................................................................14 ProvisionofCentralWasteStorageRoom.................................................................................. 15 MakingIncineratorFunctional.................................................................................................... 15 ProvisionofWasteManagementKits......................................................................................... 16 ScreeningandVaccinationofSanitaryWorkers......................................................................... 18

Challenges...........................................................................................................................................18 Recommendations.............................................................................................................................. 19 Annexure.............................................................................................................................................20

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Acronyms
AMS GEF Gyne HWM HWMP LUH LUMHS MS NGO OPD PEPA SEPA SGP SWM TMA TMO UF UNDP WHO WMO WMT AssistantMedicalSuperintendant GlobalEnvironmentFacility Gynecology HospitalWasteManagement HospitalWasteManagementPlan LiaquatUniversityHospital LiaquatUniversityofMedicalandHealthScience MedicalSuperintendant NonGovernmentOrganization OutPatientDepartment PakistanEnvironmentProtectionAgency SindhEnvironmentProtectionAgency SmallGrantsProgram SolidWasteManagement Taluka/TehsilMunicipalCorporation TalukaMunicipalOfficer UmeedFoundation UnitedNationDevelopmentProgram WorldHealthOrganization WasteManagementOfficer WasteManagementTeam

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Acknowledgement
Acknowledgements
Thefollowinggroupsandindividualscontributedtotheplanningandimplementationof HospitalWasteManagementprojectatLiaquatUniversityHospitalsHyderabadandJamshoro. Theiradviceandassistanceisgratefullyacknowledged.
LiaquatUniversityHospitals

DrGhulamMustafaAbbasi DrInayatullahMemon DrAbdulJabbarshaikh DrManzoorMemon ProfMumtazAliMemon DrMoulaBuxThebo DrNaeemZia

MedicalSuperintendent AddMedicalSuperintendent(G) ExMedicalSuperintendent ExMedicalSuperintendent ChairmanPhysiologydept AddMedicalSuperintendent RMO IncineratorOperator

Mr.Bilawal(Chhotoo)
UNDPSGP/GEF

MasoodA.Lohar

NationalCoordinator ProgramAssistant

AshfaqueA.Soomro
UmeedFoundation Dr.GulzarUsman

Administrator ProjectOfficer Accountant OfficeAssistant/DataEntryOperator Intern Officeboy/Chowkidar

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InayatullahMemon AmmarYasir ArshadAli

Dr.TehsinMemon MuharramAli

Otherindividualsandorganizations Mr.IrfanAbbassi RegionalInchargeHyd

EPA,Sindh EPA,Sindh

Mr.ImranAbbassi

AssistantDirector

Mr.EngrRoopChand Mr.Engr.AltafShaikh Mr.AltafAShaikh Mr.RafiqueJunejo

FreelanceHWMExpert SeniorEngineer DirectorFinance CEO

SSGCQasimabad,Hyderabad MUETJamshoro PEHIFoundation,Hyderabad MUET,Jamshoro

Prof.RasoolBuxMehr

HODEnvironment

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1. Background
Umeed Foundation launched Hospital Waste Management (HWM) project in June 2008 by hiring staff with appropriate expertise in health, environmental and community mobilization, detailed Project plan and staff training along with the stakeholders groups on board. These includeDoctors,HospitaladministrationofLiaquatUniversityHospitalandSindhEnvironmental ProtectionAgency(SEPA). TheprojectsfirstactivityappearedintheformofaSeminarwithtitleIntroduction,Awareness & Advocacy of Hospital Waste Management, which was conducted successfully in Liaquat UniversityHospitalHyderabadinJuly2008.Theseminarprovidedalinktoamajorachievement at its early stages that helped in the formation of Waste Management Team (WMT) in the hospitals, which is a regulatory requirement in accordance to the Hospital Waste Management Rules2005. Umeed Foundation also initiated a baseline study at the target hospitals. The baseline report identified facts helpful in qualifying the focus of project. The initial meetings with the stakeholders, senior health officials, scavengers, visit to various sites where hospital waste is dumpedanddiscussionswithhospitalstaffwerethepartofthebaselinestudy. As a part of communication strategy and advocacy, meetings were held with Provincial Minister of Environment, Secretary of Environment, Regional Incharge of Pakistan Environmental Protection Agency (PEPA), Taluka Municipal Officer (TMO), UNDP/GEF partner organizations working on similar environmentalissues,administratorsofvariousotherhospitals and Waste Management Team of LUMHS. The hospital staff wasalsotrainedonthebetterpracticesofwastemanagement and the use of waste management kits provided by Umeed Foundation in the two target hospitals.Thesekitsincludedthesyringecutters,wastebagsandcolorcodedwastebins. ProjectsmajorachievementwasthefunctioningofIncinerator,whichremainedunoperational for almost 6 years (since its installation in 2003, the incinerator could not operate for a single day until Umeed Foundation took this as a deliverable) due to lack of trained staff, non availability of fuel and lack of transport means to transport infectious waste from civil hospital Hyderabad. Umeed foundation with the help of Hospital Waste Management Team made it functional. Civil Hospital Hyderabad particularly lacked any formal place to store collected waste and as a result one could find hospital waste being littered in open dump at prominent hospital places. Umeed Foundation provided the infrastructure in the form of waste storage facility.

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2. ImplementationPlan
Theprojectwasimplementedwithfocusedinterventionsandclearvision.Followingtablecanhelplearntheoutcomes: Objectives Interventions/Strategies Outcomes Understand Hospital waste Baselinesurvey Availability of situational analysis document helpful in management picture in true designingfutureinterventionsofsimilarnature context through a robust baseline Statusofhospitalswastemanagementpractices study. Sensitization the need of hospital Meetings with various stakeholders Introductionoftheproject waste management to its primary foradvocacyandawareness Realization of the need of better HWM practices and and secondary stakeholders and Orientation and Inauguration motivation amongst medical and paramedical staff by capacity building to achieve Seminars showingtheirattendanceintrainingsandseminars project objectives and future Training of Medical and Availability of the literature for the references of sustainability Paramedicalstaff projectsofsimilarnature Availabilityoftrainedstaff Reduce contaminated streams of Provision of Waste Management Kits Wastetreatmentandsegregationatwardlevel Hospital waste by applying waste including color coded waste bins, waste Initiatethewastemanagementpractices segregationprinciple bagsandsyringecutters Reducedthescavengingandillegaluseofsyringes Develop systems and process to Construction of Central Waste Wastesegregationandtreatmentatsecondarylevel eliminate where possible or StorageRoom Availability of functional waste management materially reduce bad or illegal FunctioningIncinerator infrastructure practices involved in the Hospital Waste Management Life cycle process Integrate HWM requirements in Formation of Hospital Waste FulfilledrequirementofHWMRules2005 the context of Hospital Waste ManagementTeam Outlined roles and responsibilities of relevant Management Rule 2005, in the Development of Hospital Waste stakeholdersinHWM normal business of Hospital Managementplan AdministrationatLUMHS

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3. Activities
3.1 Baseline

Theobjectiveofthebaselinestudywastoexamine,analyzeanddocumenttheexistinghospital waste management practices in Liaquat University Hospitals (Jamshoro & Hyderabad). The basic aim was to understand the extent of problem from technical, environmental, social, and administrative aspects and build a Hospital Waste Management Project deliverables accordingly.Inaddition,thebaselinestudywastofurtherdefinethescopeandextentofHWM project at LUMHS Hospitals (Jamshoro & Hyderabad), which serve large city of Hyderabad and about 12 nearby districts of interior Sindh and a catchment population of several millions as mostprominenttertiarytreatment. Accordingtocollecteddatafromhospitals,pressureonbothhospitalsincreasingtremendously and as such 15 % growth is observed in last 5 years in terms of OPD and hospitalization. This eventuallymeansadirectincreaseofhospitalwaste.
BaselineFindings:

In Hyderabad different agencies and organizations are working for Solid Waste Management (SWM) including three Taluka Municipal Corporations (TMA City, TMA Qasimabad and TMA Latifabad) and Cantonment Board. The municipal waste collection vehicles include open and covered refuse trucks, compactors, multi loaders and arm roll containers. The municipality collects the solid waste from the streets and disposes it to the dumping sites located near Channel,HalaNaka,AghaKhanMaternal&Childhealthcarecentreandotherplaces. TherearemanysiteswherethewasteisdumpedbyvariousconcernedagenciesofHyderabad, like: 1:Halanaka 2:OldpowerhouseTalpurcolony 3:BacksideofRajputanahospital 4:GTCTgroundLatifabadgulcenterroad 5:Bakramandibusstand 6:NearAgakhanhospital
Satelliteviewofwastedumpingarea

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In addition, there are many informal dumping sites as well, which are spread over in various parts and outskirts of city. The municipal system of Hyderabad is divided in three Taluka MunicipalAdministrations(TMAs): 1:Hyderabadcity 2:Latifabad 3:Qasimabad The waste that was generated from hospitals was being thrown outside the hospitals main building but in the premises. It was then collected by a Suzuki pickup to dump it to distant location calledPhuleliCanal,whichisaflowingwaterchannelandserves as a source of life to the nearby living families. The Phuleli due to thisactivityismuchcontaminated. ThemajorfindingofthebaselinewastohighlighttheavailabilityofanonfunctionalIncinerator ofRs.5.5Million.Thehospitallackedthetechnicalexpertiseofusingthevaluableequipment. The baseline also showed that the hospital staff was not fully aware of the waste management practices in a formal way. Though they did care for cleanliness but it was superficial. The study also presents that the formal methods of disposing sharps were not in practice. For example, therewaszerouseofsyringecuttersinOPDandinsidehospital. wasteatthetimeofprojectstartup
Inappropriatetransportationofhospital Wastesituationacrossthetwocivil hospitalsinHyderabadandJamshoro

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3.2

AwarenessandIntroductorySeminar

An Awareness and Introductory Seminar at Liaquat University Hospital Lecture Hall was conducted, which was the formal start of the activities of the Umeed Foundations Hospital Waste Management (HWM) Project, funded by United Nations Development Program (UNDP) GlobalEnvironmentFacilityGEF/SmallGrantsProgram,Pakistan. Theseminarwasattendedbymorethan200participantsincludingtheHospitaladministration, Professors, Doctors, Medical students, Nursing and Paramedical staff and sanitary staff of LUH. The focus of this seminar was the Hospital Waste Management Project that is the unique and firstattemptofitstypeinLUHs.

3.3

InaugurationCeremony&SeminaronCentralWasteStorageFacility
The inauguration ceremony of the Central Waste Storage Facility was lead by Mr. Imtiaz Inayat Ellahi, the Federal AdditionalSecretaryforEnvironmentandGEFOFPon15thApril 2009.

Beforeinauguralceremony,therewasanawarenessseminaron Hospital Waste Management system. This awareness seminar was attended by Liaquat University Hospital administration, doctors,paramedical&nursingstaffandgeneralpublic. The UNDP GEF Focal point and Additional Secretary of Ministry of Environment Mr. Imtiaz Inayat Illahi was the chief guest of the seminar and Mr. Masood Lohar, the National Coordinator UNDP GEF/SGP Pakistan was the guest of honor. From Liaquat University hospital administration, Dr. Ghulam Mustafa Abbasi, theMedicalSuperintendentofLUH,participatedinthisevent. The event was recognition for both the hospital and Umeed Foundation of their planning, coordination and hard work. Further details of Central Waste Facility are described in Section 4.6ofthisreport.

3.4

HospitalWasteManagementTeamFormation

It would not have been possible for Umeed Foundation to implement projects activities without active support of hospital management. In order for this project to be sustainable, an institutionalarrangementhadtobemadesothatafterprojectcompletion,theactivitieswould continueandthereisownershipfromwithintheinstitution.

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Considering this aspect, Umeed Foundation stressed hospital administration on the formation ofWasteManagementTeam(WMT)whichisarequirementbythelawofPakistan.HWMRules 2005,requireallhospitalstoformaWMT,headedbythehospitalMS. In recognition to these efforts, the MS of LUHs issued a formal notification announcing formation of WMT. The WMT had a focal person, equivalent to AMS level officer as a formal Waste Management Officer (WMO), who later became a focal contact personwithUmeedFoundationandUNDPGEF/SGP The WMT had then conducted various formal meetings. In one of the meetings, Umeed Foundation representative and regional In chargeofSindhEnvironmentalProtectionAgency(SEPA)werealsoparticipated.Itwasdecided toconductsuchmeetingsonquarterlybasisevenaftertheprojectcompletion.Onekeysuccess ofthecollectiveeffortsofWMTwastomaketheincineratorfunctional.

3.5

Trainings

In order to accomplish the project objectives, training of various groups at various stages were organized and conducted. The mode of the trainings was mostly participatory and much time was paid to plan and learn the real situation in terms of needs and their compliance of the targetgroups. The main objective of the trainings besides capacity building / imparting the technical knowledge was creating the mindset of the participants about the hospital waste management andsharingtheinformationwithothersociallyandprofessionallylinkedindividuals.
i. StaffOrientation

TrainingArea:

OrientationWorkshop

TrainingInstitutes: UmeedFoundation Rationale and Methodology: One day workshop on project activities, key deliverables and projectplanwasconductedbytheProjectDirectortotheallprojectstaff.
ii. HWMforMedicalStaff

TrainingArea:

HospitalWasteManagement

TrainingInstitutes: UmeedFoundation Rationale and Methodology: The training sessions of medical staff held were to introduce scientific methods for handling hospital waste and disposal practices at the Liaquat University Hospitals Jamshoro and Hyderabad branches. Lecture through power point presentations and discussionswerethemeanstoconductthissession. TheContentsofTrainingwere:
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iii.

Workplan Schemeforsegregationofthewasteatthepointsofgeneration. Colorcodingsystemofwastebins. Safepracticesofhandlingthewastethroughpropercollectionandstorage. Finaldisposalmethods. Risksofreuseofsyringes,collectionbyscavenger Riskofcontaminatedsyringesprickstothemedicalstaff

HWMforNursing,ParamedicalandSanitaryStaff

TrainingArea:

HospitalWasteManagement&UseofKits

TrainingInstitutes: UmeedFoundation Rationale and Methodology: The training sessions of medical staff held were to introduce scientific methods for handling hospital waste and disposal practices at the Liaquat University Hospitals Jamshoro and Hyderabad branches. The usage of Kits provided were once of the main rationale of this training. Lecture through power point presentationsanddiscussionswerethemeanstoconductthissession.

3.6

ProvisionofCentralWasteStorageRoom
As per scheduled program activity and recommendation of LUH Waste Management Team, it was decided to make some arrangements for the collection and storage for the hospital wastebeforeitsfinaldisposal.

The Medical Superintendent of LUH granted permission to construct a Waste storage room at Hyderabad hospital. The place was identified by hospital administration and initial planning, architectural designing and leveling of the site was done through building & construction experts. The MS also visited the site and took keen interest in this activity. The Central waste storage facility has two compartments / portions each to house infectious waste and noninfectious waste. First the waste is being collected from the wards in color coded waste bins (provided by Umeed Foundation) and dumped in the store room according to the segregation method. The infectious waste is then transported to its final disposal, i.e. IncineratoratLUHJamshoro.

3.7

MakingIncineratorFunctional

Incinerator started working at Liaquat University Hospital Jamshoro under HWM Project, in collaborationwiththeUNDPGEF/SGPandLiaquatUniversityHospital. TheIncineratorisequipmentwhichdestroysthewasteatveryhightemperaturewhichensures complete destruction of waste material. As a result of this ultra high temperature brining,
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emission of dangerous gases like dioxin and furan is reduced to fractionsofit,ifburntinopendumps. The incinerator was installed in the LUH Jamshoro at a cost of Rs 5.5 million as far back 2003, but it did not function even for a singleday. Themainreasonsofitsnonworkingstatuswere: Lack of understanding of its functionality by the Hospital Administration and no system of wastesegregationatsource. Unavailabilityoffueli.e.gassupplyoftheequipmentwascutoff Noproperfacilitytotransportthewasteuptoincinerator NoanytypeoftrainingsystemforHospitalstaffregardingIncineratoroperations Noanysystemofwastesegregationi.e.separationofRiskandNonriskwaste

AttherequestofWMT,UmeedFoundationmadevariousinterventionssuchas: Umeed Foundation done all the logistical efforts to restore the gas connection of the incinerator. LUH administration was pursued to arrange vehicle to transport infectious waste from Hyderabad. Hospital staff dealing with incinerator was properly trained on use / operational aspects of theincinerator. Colorcodedwastebinsprovidedbyprojecthelpedinachievinggoodwastesegregation.

The incinerator with its 150 kg/hour capacity of burning waste operates 3 hours daily (the recommendedoperationhoursare4to5in24hours)

3.8

ProvisionofWasteManagementKits

As per decisions of WMT meeting in which initially two wards were selected as Model Wards to start the HWM Practices, and commitment made by Umeed Foundation, almost 50 units of colourcodedwastebinsand6unitsoflargestoragebinswereprovidedtoGyneunitIIcity,and SurgicalunitIVJamshoro. Each ward was also provided with 3 units of syringe cutters to make syringes unable to be reused. Another stock of 25 packets of waste bags was provided to LUH administration for the continuation of the segregationandsafetransportationoftheinfectious/riskwaste. In second phase, Umeed Foundation provided a bulk of 500 color codedsmallwastebins, 100largewastebinsand100syringe/needle cutters to LUH administration to disburse the same in all wards of CityandJamshorobranches.
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Abreakupofthesekitsisgivenbelow:

ThesekitswerehandedovertotheWasteManagementOfficer,whowasthefocalpersontoo. The kits were enlisted in hospital inventory and kept in store room. The store keeper with the permission of AMS / Waste Management Officer would issue the kits once the request is receivedfromwards.
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3.9

ScreeningandVaccinationofSanitaryWorkers

Umeed Foundation while working on the major aspect of waste management in hospitals did not forget the sanitary workers, who are the major actors in this process. They are the part of hospitalsandifinfectedmaybecalledthecareersofdiseasesthataremostlikelytobecaused duringtheirinvolvementinimproperwastemanagement. With the efforts of Umeed Foundations project team, the hospital administration was motivatedandpromisedtoprovidefreevaccinationandscreeningofHepatitisBandCtoabout 200 sanitary workers of LUH. The hospital management showed full cooperation and appreciatedtheidea.

4. Challenges

The projecton Hospital Waste Management was one of its unique types of intervention in LUH Jamshoro and Hyderabad. Following challenges were faced during the implementation of the project: Shortdurationofproject,i.e.oneyear Limitedinfrastructuralsupport NopriorknowledgeandworkdonebytheHospitaladministrationonthesubject Startingfromthescratchi.e.poorwastehandling

The baseline survey conducted by Umeed Foundation as the opening activity identified a number of issues that were not part of initial project scope. For instance, existence of non functionalIncineratorandalmostnoexistenceofwastemanagementpracticesinstaff.

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5. Recommendations
Long term intervention strategy For a project of this nature, an intervention of one year is diminutive. Because of the nature of government institutes, changes and sustainability could be achieved at a relatively lower pace. What Umeed Foundation could deliver in one year time was a symbolic change. In order to sustain the project result, it is recommended to find a donor to continue project activities for duration of 3 years. A long term intervention strategy would not only provide the baseline but willalsobeabletocovertheaspectsofwaste managementinhospitalsthatarenotaddressed duetoshorttimeboundaries. Trainings Thecapacitybuildingprogrammeforallworkersfromdoctorstowardboys,tolaborersandrag pickers should be continued by the Hospital management / WMT to keep up to the understandingoftherisksthatwastesposes.. Making it reach to others

UmeedFoundation,byimplementingasuccessfulprojectonHWMhasprovedthattheissueof Hospital Waste can be addressed. However this is not the issue of one hospital. There is a dire needofcollectiveeffortsinotherpublicaswellasprivatehealthcareunits.Theseinterventions canbeclusterbasedandmustincludeownershipatpolicylevel.

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6. Annexure
(a) Work Plan
Jul-08 Activities / Milestones 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Project team / office setup Stakeholders / ownership by Hospital Administration Situation Analysis / baseline report Review of existing laws / regulations Waste Management Team Formation Commissioning of Incinerator Training of staff for incinerator operation Waste Management Seminar-1 Dialogue with external stakeholders (City Govt, EPA etc) Training for medical and paramedical staff Training for scavengers and sanitary workers Environmental & Social Assessment of disposal sites Hospital Support - Provision of waste bins & Syringe cutters Hospital Support Central Storage Facility Waste Management Seminar-2 Hospital waste management plan Final evaluation of project Mass awareness on Hospital waste management (target hospitals, other hospitals, public in general) 1 Aug-08 2 Sep-08 3 Oct-08 4 Nov-08 5 Dec-08 6 Jan-09 7 Feb-09 8 Mar-09 9 Apr-09 10 May-09 11 Jun-09 12

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(B) LUH consent letter

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Newspaper cuttings: formation of WMT & issue of waste management

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Waste management team

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screening and vaccination of sanitary staff at luh

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permission of training to medical and other staff

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pictures of phuleli canal

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pictures of training of medical team

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pictures of seminars

picturesofcentralwastestorage

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pictures of medical waste kits

incnerator functioning

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HospitalWasteManagement ThepictureBefore&After
ThisisaspecialvideoCDpreparedbyUmeedFoundationtoshowthecondition of waste management in LUMHS Hyderabad and Jamshoro. The video focuses on the picture before and after the intervention of Umeed Foundation with its oneyearprojectonHWMfundedbyUNDPunderitsGEF/SmallGrantsProgram. Chaptersofthisvideoare: WastepracticesatLUMHSHyderabadandJamshoro ActivitiesbyUmeedFoundationtoaddresstheissue Theshiftinscenario Whatisneedednext?

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UmeedFoundationProfile
UmeedFoundationisaNonGovernmentalOrganizationandhasamultidimensionalfocusonenvironmental andcommunityhealthactivities. OurMission Umeed Foundation is guided by the belief that all lives, no matter where they are lived, have equal value. Our mission is to encourage and stimulate the welloff sector of society to come forward and participate in providingmaterialsupporttosuchindividuals. PROJECTS HospitalWasteManagement(HWM)Project Umeed Foundation is currently executing a UNDP's Global Environmental Facility (GEF) / Small Grants Projects (SGP) funded project at Civil Hospitals Hyderabad and Jamshoro on Hospital Waste Management (HWM). The aim of the project is to bring radical changes in HWM practices in the Civil Hospital Hyderabad and Jamshoro. Umeed Foundation is focusing implementation of Hospital Waste Management Rules 2005, the onlyformallegislationonthesubject. By the way of implementing HWM Rules 2005, the target Hospitals will not only be the leading hospitals in the country complying applicable national laws, but also become a center of excellence for other Public and privatesectorhospitalsinPakistan. KifalatProject The situation demands our welltodo sector of the society to contribute and help those poor families, which areunabletoearnenoughtofeedandeducatetheirchildren.MostofthefundsareZakatdonations. PatientsSupportProject Thousands of peopleloose life or limb from injuries and disease that is preventable and treatable, just because they have no access to money and / or resources. The Quality of health care supposed to be providedbyorpublicsectorisfarfrombeingsatisfactory. Forfurtherdetailscontactusat:

UmeedFoundation
Bungalow No. A-56 Zubiada Bungalows Muhammadi Town Qasimabad Hyderabad, Sindh +92-22-2655924OrVisitusatwww.umeedfoundation.org

HospitalWasteManagement|ProjectCompletionReport