Sunday, January 28, 2018

What does hygiene in health facilities mean?

Imagine this: you’re at the doctor, sitting on the crunchy paper, reading a National Geographic, and listening to the woman in the room next to you have the coughing fit of the century. “I sure am glad I don’t have that,” you think to yourself, as you read about Polynesian seafaring before your annual physical. When the doctor finally comes in to your room, she’s already wearing a pair of gloves, and begins performing all the duties of your routine checkup – checking your pulse, inspecting your tongue, ears, and nose, and taking samples of your blood with the same pair of gloves she’d been using on the last patient, who was already sick! When you ask her to explain herself, she says that there wasn’t a trash can in the other room, so she just left her gloves on. A few days later, you’ve got the same ailment that your thundering neighbor-patient had a few days before.

As much as we’d never allow such a situation to happen to us, it can be unavoidable for patients in developing countries like Cameroon simply because of a lack of resources and training for the staff at a given medical clinic.

In this six part blog series, we’ll take a close look at each of the six key areas for medical waste management in any medical facility, with particular respect to those in the developing world. With it, we hope to communicate the motivation for our newest project, Healthy Hospitals Cameroon, the first site visit for which will be in early 2018 in Douala, Cameroon.

So what are the key ingredients to Part One, the patient room, the source of all infectious waste and the earliest opportunity to mitigate its negative effects on facility personnel, patients, and visitors? When we talk about “infectious waste”, it’s important to realize that there are two broad categories: sharps and non-sharps. The sharps, obviously, are needles used to puncture the skin, and should be disposed of in a tough-sided box. The infectious non-sharps are things like gloves, bandages, gauze, bedsheets, mop heads used to clean bodily fluids, and so on – anything a sick patient (or his or her fluids) has physically interacted with. Non-sharp infectious waste should be disposed of in a lined, specially-marked, covered waste bin. Finally, general waste that’s not been touched by a sick patient should simply go in a separate lined, covered waste bin. Waste should be discarded in the room in which it’s produced.

With two waste bins and a sharps box in every single room, we’re well on our way to making a much healthier hospital room. We still, of course, need to provide training to the staff so that they know which types of waste go in which receptacle, and we’ve assumed so far that the nastier types of ailments involving diarrhea, vomiting, and other bodily fluids are being cleaned up appropriately with disinfectant before they’re being disposed in the correct receptacle.

But we can’t let all that nasty stuff pile up in the different trash cans. Who’s going to pick it all up, and what are they going to do to protect themselves and their surroundings as they begin the process of relocating the waste to be destroyed? Find out next time in Part Two: Collection.

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