Ugandan Waste Disposal Workers Collect more than they Bargain for

Medical waste handlers in Uganda know that their job is dangerous. The waste they pick up from health facilities is biohazardous, containing contaminated items like needles and body tissue that can spread infection. But staff from Green Label Services, Ltd. (GLSL), a sub-partner of the Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree) Project, were still unpleasantly surprised by what they encountered this July—a venomous snake. 

While loading waste into their truck, workers discovered a snake (which resembled the mamba pictured below) camouflaged in the waste pile. And this wasn’t the only snake that GLSL workers found this summer. Another time, a snake hitched a ride in waste collected from eastern Uganda and was discovered during unloading. 

Jameson’s mamba, a venomous snake found in Uganda. Photo Credit: Greg Hume

Snakes make homes in waste that is improperly stored in piles outside hospitals and clinics. The large, sun-warmed piles of waste have plenty of nooks and crannies that appeal to the cold-blooded reptiles. This puts people who collect the waste at risk—as well as staff and patients at the health facilities—of a deadly bite. 

Snakes or no snakes, hazardous medical waste is dangerous and must be properly disposed of to prevent and control infections and avoid environmental contamination. AIDSFree has worked on ensuring safe collection, transport, and disposal of medical waste in Uganda since 2015. The project facilitated collaboration between the Ugandan Ministry of Health (MOH), district governments, and GLSL to find a sustainable solution to the management of health care waste in southwestern Uganda. These efforts are critical to ensuring the quality and function of the health systems themselves—and the health of the community members who rely on them.

GLSL trucks picking up health care waste. Photo Credit: AIDSFree

AIDSFree established a public-private partnership with GLSL to help the MOH implement a national plan for health care waste management. AIDSFree contracted the company, established in 2012 and which the U.S. Agency for International Development had contracted previously to support waste disposal in eastern Uganda, to create a regular disposal schedule for clinical facilities in certain districts. Working with AIDSFree, GLSL’s coverage increased from six districts in eastern Uganda to 88 across the country. 

Under AIDSFree’s management, in just over two years GLSL disposed of more than 4.7 million kg of waste from 375 facilities, over half of which was classified as highly infectious. From pickup to transportation and delivery, all health care waste collected by GLSL between March 2017 and June 2019 was treated and appropriately disposed of in accordance with public health and environmental management best practices. 

Even with regular waste pickup, however, health facilities struggle with limited resources and space for storage until pickup, leaving it to collect outside in piles that attract snakes. AIDSFree has raised this storage problem with stakeholders in the hope that with further support, the festering piles of hazardous waste—and the snakes that dwell in them—will be a thing of the past.

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