As Lebanon struggles to find solutions to its municipal waste problems, other waste-related issues are coming to the surface, from improper dumping of industrial waste leading to major environmental damage to the environment to the never-ending predicament of how to hanle medical waste. An article recently published by The Executive Magazine called The Dirt Beneath the Stretcher sheds light the issue of medical waste in Lebanon and does not present a pretty picture.
Prior to 2002, infectious medical waste has traditionally not been sterilized in Lebanon and was instead disposed with regular municipal waste in open dumps throughout the country. During an environmental impact assessment study for a hospital, Ecocentra visited a model facility in the South to obtain information on how medical waste is ideally separated, treated and disposed of. The hospital had recently implemented an effective medical waste management system through a UNDP-funded project. However, prior to that, the situation had been dire. The QA Director at the hospital informed us that waste was disposed with normal municipal waste and that their cleaning staff had on several occasions been exposed to hazards, such as injury from used needles.
Today, some hospitals treat their waste in-house while others outsource this process. There are two organizations that treat medical waste in Lebanon; the Arcenciel which handles 80% of the treated medical waste in Lebanon and Safe which treats waste in the southern district of Tyre. Medical waste facilities require a lot of investment and bureaucratic red tape from the Ministry of Environment and municipalities have prevented new firms to enter the market. Arcenciel is a registered non-profit NGO that has commonly relied on contributions from donors to purchase equipment, in addition to charging hospitals a fee for treating their waste. This creates a strong barrier for any private entity to enter the market practically rendering the NGO a monopoly.
Today, not all medical waste in Lebanon o is treated. This is a truly worrying fact. But if the existing medical waste treatment facilities cannot treat all the medical waste, why are there obstacles for new firms to enter the market? Untreated medical waste has been spotted in different areas of Lebanon. Last December, the Ministry of Environment warned of untreated medical waste being disposed in coastal and mountain areas. A few months ago, the Lebanese Professional Divers’ Syndicate retrieved 6 cubic meters of medical waste 4 km off the coast of Sidon.
The Lebanon Environmental Assessment of the Syrian Conflict & Priority Interventions is a report that was published by the Ministry of Environment assessing the environmental impact of Syrian conflict in Lebanon. The report found that infectious medical waste has increased by 420 tons/year as a result of the Syrian crisis. Of this waste, 18% is being disposed in the environment without treatment. In 2012, only 32% of public hospitals treated their infectious waste compared to 54% in private hospitals. With the dramatic increase in population, these figures are probably lower now. Arcenciel are currently overwhelmed and their treatment facilities are operating 24 hours a day, compared to 12 hours before the crisis.
Similar to many of Lebanon’s problems, there are laws preventing the disposal of untreated medical waste. However, these laws are not enforced. Law 444 and Decree 13389 defines infectious waste and sets guidelines on how this waste should be treated. In 2010, the Ministry of Environment sued 88 hospitals for not complying with protocol. Despite the lawsuits, none of the violators were fined. The Ministry is understaffed and do not have the resources to continue to inspect these hospitals on a regular basis. To make things worse, the Ministry of Public Health, which is in charge of all public hospitals in the country, does not differentiate between hospitals that segregate and treat their medical waste and those that dump them with the municipal waste, relying solely on the Ministry of Environment efforts to follow up on this matter.
Untreated medical waste being dumped has serious environmental and human health implications and could cause some serious problems in a country that is already has its fair share of those. Implementing existing laws and facilitating the entry of new firms to treat medical waste is necessary to completely halt this problem.