1. Lebanese Steriliz zation Network of
Potentially Infectious Health Care Waste:
s
creation and man nagement system.
Dr Dan El-Obeid
ny El Obeid
Fourth Kuwait waste management
Octo
ober 2011
1

2. Out
tline
1. Introduction
2. The Lebanese Steriliz
zation
network Lebanese for PIHCW
r
3. Non Governmental or rganization
aec
4. Conclusions
2

3. Introduction
uction
u
3

4. Introd
duction
 Five treatment centers coverin the country
ng
 Eighttons of PIHCW collected a and processed every day
 More than 7,000 people traine in the management of PIHCW
ed
 Creation of a steering committee composed of key
stakeholders in the issue of hos
spital waste
 integration of a specialized cours on PIHCW in the curriculum of
se
Nursing
 awareness campaigns for the ge eneral public and in schools
 R and D unit
 Law amendments
4

5. international agreements
and prin
nciples
Stockholm Conventio
on
Basel Convention
Polluter Pays Principle
y pe
Precautionary Princip
ple
Duty of Care Principle
e
Proximity Principle
5

6. national context
Public health and environment
The decree 13389-2004
The accreditation system f hospitals of the Ministry
for
of Health in 2000.
Ethics
6

7. hospitals res
sponsibilities
Reduce PIHW generation [ <10% ] by preventing
contamination of ot ther types of waste using
sorting at the source
g e.
Ensure the processin of their PIHCW
ng PIHCW.
Prevent other hazar
rdous HCW causing pollution o
the environment [ a water, soil ] or harm to
air,
human health 7

8. PIHCW treatment techniques
NCINERATION[ T ≥ 800ºC ]
Toxic emission to air if no c
control devices
CHEMICAL DESINFECTION
May introduce strong chemicals into the
environment
MICROWAVE DESINFECTION
Expensive
AUTOCLAVING COUPLED TO SH
HREDDING [ Tº ≤ 200ºC ]
8

9. PIHCW tr
reatment
techn
niques
AUTOCLAVING COUPLED TO SH
HREDDING [ Tº ≤ 200ºC ]
Environmentally friendly
Low investment and operating
g
costs
Proper sterilization in 40 minute
p es
Volume reduction of 80%
Unrecognizable ground waste
U i bl d t
assimilated to domestic waste
9

10. who must treat PIHCW?
 care facilities are intended to treat p p and not to treat waste
people
 it is virtually impossible to return the transaction by treating only waste
produced by the establishment, only one solution: the economy of scale
y
...
Only a service p provider can treat
 the control is difficult, because the sa organization that produces, sorts,
ame
the P
collects, (treats), maintains and manPIHCW
nages ...
10

11. who must treat PIHCW?
 chronic economic crisis: challenge t persevere and make a p
g to p profit ...
[upward trend of prices of private se
ector]
 the awareness and training in reducing the amount of Infectious Medical
Waste Only a non lu
d th th ucrative service
W t generated, and thus the expe t d benefits, iis against nature for a
t d ected b fit i t t f
provider recognized as a public
profit provider ...
 Western experience: they are p c-interest NGOs that have the market
p y public
share ... utility can t
tilit treat PIHCW
t
11

12. who must treat PIHCW?
 how to justify a multitude of investme
ents by several providers, so that the
entire L b
ti Lebanese production of DASR iis - 0 4% of solid waste ...
d ti f RI 0.4% f lid t
 Only a non lu ucrative service
how many provider could invest in e essential quality equipment, while
provider recognized as a public
remaining profitable and efficient ...?
gp
 what to do in case of failure of mach hine? without a unified national
utility,Working on a national
g
network, even in the presence of willingness to cooperate, no one ignores
difficulty successful k ca t
network, an treat PIHCW
t t
the diffic lt of s ccessf l coordinatiion bet een se eral parties
between several
competing ...
12

13. who must t
treat DASRI?
•cost Control, Economy of scale
•competition Control
•ensuring Public funding
•global & national solutions
g
inappropriate •a
awareness and training
assignment zone •e
ensuring Quality Service
performance zone
= monopole of a profit-
making company =
financial blockade
failure zone zone
= several profit-making =s
several non profit-making
companies organizations
13

14. The Lebanese Sterilization
e
network Leban
nese for PIHCW
14

15. Arcencie centers
el
Zahlé
Hôtel-
Hôtel-Dieu
Jisr el Wati
Zgharta

16. 16

17. Seminars and trainings

18. 18

19. Awareness campaigns

20. Non Governmen organization
ntal
ae
ec
20

21. aec
a non-lucrative Leb
banese organization
created in 1985 wit and for any
th y
person in need of h
help
recognized as a pu
ublic utility service
provider since 1995
21

22.  Environment program’s mis
ssion is :
preservation and developm ment of
natural resources
22

23. Conc
clusions
 Five treatment centers covering the country
i i
 Eight tons of PIHCW coollected and processed
every day ( ≈ 0.55$/kilo
o)
 More than 7,000 peopl trained in the
le
management of PIHCW W
 Creation of a steering committee composed
c
of key stakeholders in t
the issue of hospital
waste
23

24. Conc
clusions
 C
Creation of a steering com itt
ti f t i mmittee composed of key
d fk
stakeholders in the issue of hospital waste
 integration of a specialized course on PIHCW in the
curriculum of Nursing
 awareness campaigns for th general public and in
p g he g p
schools
 research and development of solutions for other types of
t
hazardous waste
h d t
 presentation of proposed a amendment of laws
 Trainings and capacity bu
uilding in different Arabic
countries
 Research regarding differe HCW
ent
24

25. We shall never stop ou journey
ur
we are commit
tted
to Participate in the development
25