During a stay in hospital, have you ever wondered what happens to all of the gloves, masks, cotton wool swabs, needles and masks used by medical staff during your treatment?
For many the initial answer might be a rubbish bin, right? Correct, but not just discarded into your average rubbish bin.
With SA fighting the spread of Covid-19, the safe and hygienic disposal of medical waste is a priority. Even people discarding single-use or surgical masks should think twice before throwing them into the trash and placing refuse collectors at risk.
Along every step of the journey, the way soiled medical equipment and accessories — including disposable face masks — are handled and disposed of could have devastating effects on health and safety in a hospital ward and the community it serves.
There have been incidents in which hazardous medical waste was found dumped or scattered on local dump sites. But there are stringent measures in place to prevent this from happening.
TimesLIVE spent a day with Compass Medical Waste Services to observe how medical waste, specifically equipment associated with Covid-19, should be disposed of safely.
Upon arrival at the Zuid-Afrikaans Hospital in Pretoria, two men clad in personal protective equipment — white overalls sealed at all openings, latex and rubber gloves, boots, goggles and N95 respirator masks — led us (similarly attired), to a secure central storage area — that can only be unlocked by authorised personnel.
A staff nurse and a man wearing an orange apron and red rubber gloves on top of more safety gear meet us. A scale is set up inside the secure room before work begins. Three Compass employees get to work. One writes down the weight of all medical waste leaving the facility. The other two, helped by a hospital orderly, then move the waste to a nearby truck.
First to be moved is the “normal” medical waste stored in red wheelie bins. Once emptied, the bins are washed and thoroughly sterilised before being sent back for re-use.
The procedure is different for waste potentially tainted by Covid-19. In accordance with national health department instructions issued in March, Covid-19 waste is double bagged and stored in single-use boxes, each bar coded for traceability and labelled “Covid”.
Compass employees scan, weigh and fill in a manifest declaring that Covid-19 waste has been collected in the presence of a hospital witness. Once the waste is loaded into the truck, Compass employees remove their protective gear and place it into a medical waste container with the rest of the materials to be destroyed. The doors are sealed and secured with a padlock. Each truck is equipped with spill kits as an additional safety measure should it be involved in an accident on the way to the treatment plant.
Covid waste is offloaded first at the plant in Clayville. Boxes sealed in bright red plastic bags labelled “danger” are put into large bins. A new production line begins, with one person holding a clipboard and a pen, as they go through the process of weighing, scanning and logging again.
After a thorough screening process, the bins are loaded by forklift into a giant autoclave machine used to sterilise Covid waste through a steaming process. The steam cycle runs at 140°C for 25 minutes to kill off bacterial spores.
As autoclave door opens, steam billows through the facility. Some employees are tasked with sweeping up, into the plant drain, pools of water that form around the machine due to condensation. The room heats up and a forklift transfers the sterilised bins to an industrial shredder which turns the waste into unrecognisable fragments of red, blue and brown. These fragments, now harmless, are tipped into a skip. The process continues until three skips are filled and the treated waste is taken to a landfill site allocated for safe disposal.
The white PPE suits, bright red bins, clouds of steam crushing jaws of the machines could be likened to a scene from a science fiction movie. But then, so could the global affect of the coronavirus pandemic.
While the wearing of masks (cloth is recommended but people also use disposable ones) is compulsory and SA grapples with Covid-19 and a potential second wave of infections, a medical expert believes that government should put more energy into educating citizens about the correct disposal of masks.
Dr Angelique Coetzee of the South African Medical Association (Sama) said the proper storage and disposal of medical waste is important to contain the spread of disease.
Coetzee said masks should not be thrown in a rubbish bin with normal waste — they should be treated as medical waste.
“As we know, the virus stays for quite some time and if a contaminated mask is not disposed of correctly, this could infect whoever comes in contact with it,” she told TimesLIVE.
Coetzee says there is a lack of dedicated waste bins where people could take soiled items such as masks. “People can’t keep soiled masks in the same containers where they store any other waste,” she explained.
Coetzee said it was mandatory for all medical facilities to separate medical waste.
The Western Cape and KwaZulu-Natal governments have offered additional tips on how to dispose of gloves and masks in the home or work environment.
“In your household or workplace you can dispose of gloves and masks in your normal refuse, but you can wrap the gloves and masks in newspaper before putting it in the bag.
“If you have been in contact with an infected person, then your domestic waste must be double-bagged and stored in the sun for a period of three to five days before placing it in the general waste bin for collection by the municipality,” the provincial governments advised.
— Additional reporting by Belinda Pheto
