Sound systems for disposing of medical waste

Have you ever wondered what happens to the syringe after your doctor gives you a shot? Who handles used syringes, and how are they—and other potentially infectious medical waste—destroyed?

In industrialized nations, doctors and nurses are trained to handle used needles properly, and there are elaborate systems for safe disposal. But in the developing world, staff may not have the necessary training, and health care facilities may not have adequate supplies of clean syringes or reliable systems for disposal.

As a result, syringes are often reused, mixed in with everyday garbage, or even abandoned in public areas, exposing health workers, patients, and communities to unnecessary risk—and contributing to the estimated 23.5 million new HIV, hepatitis B, and hepatitis C infections transmitted every year through needle reuse and accidental needlestick injuries. And as developing-world health systems grow stronger and better care reaches more people, castoff medical waste is increasing.

Through new technologies and strategic partnerships that strengthen systems for managing medical waste, PATH is working to make injections safe for health workers and communities.

Disarming medical waste

PATH is a pioneer in developing and introducing innovative technologies that make it easier to safely handle and dispose of medical waste. We look for ways to take syringes out of action from the second after they’re used until incineration has permanently disarmed them. Our experts develop and advance technologies that:

• Make needle reuse impossible. Autodisable syringes, like our SoloShot™ device, cannot be used more than once—and therefore cannot carry infection from one patient to another. Under the US Agency for International Development–funded HealthTech program, PATH both develops these devices and collaborates with the private sector to make sure they are affordable and available in low-resource settings.
• Take the sharp out of sharps waste. Needle removers “de-fang” syringes, immediately removing the needles after injection and isolating them in secure containers. The syringe cannot be reused, and there’s no risk of accidental needlesticks. PATH works with private-sector manufacturers to evaluate and improve needle removers that are already on the market, so that these tools reach the health workers and clinics where they’re most needed.
• Keep needles away from vulnerable hands. Special stickproof containers capture used needles and other medical waste until they can be destroyed. PATH is working to increase access to these “safety boxes,” identifying low-cost options and making them available for all types of injections.

Tools like these give health workers a safety net, so that they don’t have to choose between their own health and the health of those they serve.

Partnerships that protect

New and better tools for safer injections and waste disposal are only part of the puzzle. PATH is collaborating with health workers and ministries of health to improve waste disposal practices—reinforcing critical resources that can ensure every injection is safe.

Many countries in Africa, including Kenya, Nigeria, Mozambique, Botswana, Ethiopia, Rwanda, and Uganda, are using guidelines we developed to train health workers in safer waste management practices, and we also provide technical assistance to teams in-country. Together, we identify safe and practical systems to segregate, handle, and destroy health care waste.

We also work with ministries of health to develop national policies that encourage better health care waste management—policies for allocating resources to purchase autodisable syringes, safe boxes, and incinerators and for identifying and resolving weakness in health systems that lead to poor management of medical waste. Our expertise helps countries build plans that address the infrastructure, supply, and human resource needs of both small rural facilities and national hospitals.

Making it safe to give good care

Health workers shouldn’t have to be afraid that saving another’s life will endanger their own. Nor should communities pay for better health care with medical waste they aren’t yet able to manage. PATH is integrating our experience in designing tools for low-resource settings, developing training programs, and supporting system-wide change to make sure that high-quality care does not come with a deadly price tag.

SoloShot is a trademark of BD.

Photo: Jessica Fleming.