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Nepal - Health Sector Program Project : environmental framework (Vol. 2) : Vulnerable community development plan (Английский)

This environmental assessment for the Nepal Health Sector Program Project discusses likely environmental impacts regarding health care waste management and establishes a strategic framework for action plans to improve waste management including proposed measures to mitigate negative impacts. Health care waste is categorized as follows: infectious waste (bandages and cotton and paper tissue with blood), pathological waste (including body parts, fetus and placentas), sharps ( injection needles, scalpels), pharmaceutical waste (outdated and spilled medicines), genotoxic waste (including waste from cancer treatment), chemical waste (discarded solid and liquid chemicals from laboratories, insecticides), waste with high content of heavy metals (broken mercury thermometers, chemicals for developing x-ray photos), pressurized containers, and radioactive waste. The framework presents a risk assessment of the present state of health care waste management and presents findings according to each step in the management process: waste generation, waste segregation, containerization, internal transport and storage, external transport, treatment, disposal, and wastewater. Risks cited at every step were: the absence of incentives to minimize the volume of waste; risk of infection from the steam sterilization of needles, syringes, and surgical gloves; the absence of regulation of particular hazardous materials such as mercury, and other heavy metals, chlorinated compounds; the lack of awareness of the need to consistently segregate medical wastes from domestic waste; the absence of lids and lack of plastic lining of waste containers, increasing the risk of spreading infectious micro-organisms both during waste transport and cleaning of the containers; cases where waste is transported manually implies a risk of infection to the sweepers if they are not wearing protective clothing; the transport of waste in uncovered vehicles posing a risk as well as a nuisance to the public; the dumping of waste out in the open before being transported to the dumpsite where scavengers (including children) scrounge around for recyclable material; the generation of noxious gases from burning wastes in open fire; the burial in the ground of pathological waste; the decomposition of the organic content of waste in the ground, generating leachate that will flow into the river; the absence of sanitary landfills in Nepal with that could protect against groundwater pollution; and the risk of discharge of treated and untreated wastewater may pose risk to people collecting water for households, fields and gardens, washing, playing, for religious purposes, and spreading ashes from cremation. To minimize some of these risks the report suggests: "green" procurement (purchasing substitute items posing less risk to the environment), waste reduction, recycling, and reuse; quantitatively assessing waste products; waste segregation, handling, transport, treatment, and disposal practices, pollution prevention; and training staff and educating the public about proper waste management.

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