ASSESSMENT OF HEALTHCARE WASTE MANAGEMENT PRACTICES IN URBAN AREAS OF CAMEROON

CHAPTER ONE INTRODUCTION 1.1 Background of the Study Hazardous waste, as described by Gillian, Akoachere, and Mbacham (2016), comprises all infectious and toxic materials that are generated through the use of medical supplies and equipment in hospitals, health centers, and diagnostic laboratories. This category of waste is commonly known as hospital waste. According to the World Health Organization (WHO), around 75–90% of the waste generated in healthcare settings is generally considered non-hazardous. However, the remaining 10–25% poses significant health and environmental risks and should not be neglected (Ali, Wang, Chaudhry, & Geng, 2017). Globally, waste management continues to be a serious environmental and public health issue, particularly in low-income and developing countries. There are several methods available for disposing of healthcare waste (HCW), such as encapsulation, compaction, reverse polymerization, microwave sterilization, autoclaving, chemical disinfection, sanitary landfill, and plasma pyrolysis. Choosing the most appropriate and safe method for HCW disposal is critical to safeguard both the environment and public health, especially to prevent air pollution and the spread of dangerous diseases (Sawalem, Selic & Herbell, 2018). Each HCW disposal method has different economic, environmental, technical, and social implications, making it a complex decision that requires careful evaluation. Despite the introduction of modern disposal technologies, traditional methods like landfilling are still widely used in many healthcare facilities. The mixing of hospital and domestic waste poses serious health risks, especially when potentially recyclable household waste is processed into urban compost. This improper handling can lead to the spread of life-threatening illnesses such as typhoid, cholera, tuberculosis, AIDS, and diarrheal diseases (Jahandideh, 2019). Alarmingly, approximately 2.5 million people die each year from diseases caused by poor waste management practices. Similar to many other developing countries, Cameroon faces significant challenges in managing medical waste, particularly in urban areas. Although there are laws and regulations aimed at ensuring proper hospital waste management, enforcement is often weak. Many healthcare facilities in the country lack the necessary infrastructure, trained personnel, and resources required to handle waste appropriately. Moreover, the situation is made worse by limited government oversight, inadequate support, and a lack of public awareness regarding the dangers of improper waste disposal. Given these concerns, there is an urgent need for research that examines how healthcare waste is managed in Cameroon's urban areas. 1.2 Statement of the Problem Healthcare waste management remains a vital public health concern, especially in densely populated urban areas with high demands on healthcare services. Health facilities generate various types of waste — some infectious, some hazardous, and others non-hazardous — all of which require safe and systematic disposal to protect both the environment and public health. Nevertheless, many cities around the world, including those in Cameroon, continue to experience serious problems related to improper waste disposal. This has resulted in increased health risks and environmental degradation (WHO, 2018). The complexity of managing healthcare waste in urban settings arises from the concentration of healthcare institutions and the large volumes of waste they produce. Common but improper disposal practices such as open dumping, burning, and mixing of medical waste with household waste contribute to environmental pollution and raise the risk of disease outbreaks (Manga, Forton, & Read, 2017). These problems are often linked to poor infrastructure, ineffective enforcement of environmental regulations, and insufficient training for healthcare staff on waste management procedures (Abor & Bouwer, 2018). In light of these issues, this study seeks to evaluate how healthcare waste is disposed of in the urban environments of Cameroon. 1.3 Objective of the Study The primary objective of this study is to assess the methods used for disposing of healthcare waste in urban areas of Cameroon. Specifically, the study aims to: i. Examine the level of awareness among healthcare workers about proper healthcare waste disposal practices in Cameroon. ii. Identify the various types of healthcare waste generated in urban health facilities across the country. iii. Evaluate the consequences of improper healthcare waste disposal on urban environments in Cameroon. iv. Explore the challenges healthcare institutions face in implementing effective and safe waste disposal systems in Cameroon. 1.4 Research Questions The following research questions have been formulated to guide this study: i. What is the current level of awareness among healthcare professionals regarding appropriate healthcare waste disposal practices in Cameroon? ii. What types of healthcare waste are typically generated in urban medical facilities in Cameroon? iii. What are the impacts of improper healthcare waste disposal on urban settings in Cameroon? iv. What challenges do healthcare institutions encounter in trying to implement safe and effective waste disposal methods in Cameroon? 1.5 Significance of the Study This study holds importance for several stakeholders, especially the Ministry of Health. Effective waste management is essential to protect public health, as improper disposal can lead to the spread of infectious diseases, injuries, and other long-term health hazards, particularly affecting healthcare personnel, waste handlers, and surrounding communities. The findings of this research will assist policymakers and health authorities in developing strategies to reduce these health risks, ultimately safeguarding urban populations. Furthermore, the study will be valuable to the academic community. It contributes to the body of existing research on healthcare waste management and offers a useful reference for future researchers interested in environmental health and public safety. 1.6 Scope of the Study This study focuses on evaluating the methods used for disposing of healthcare waste in Cameroon's urban environments. In particular, the research will investigate healthcare workers' awareness of proper waste disposal techniques, identify the types of waste produced in urban health facilities, analyze the consequences of improper waste disposal, and uncover the obstacles that healthcare institutions face in managing waste safely. Geographically, the study is restricted to Douala General Hospital in Cameroon. 1.7 Limitations of the Study As with any research effort, this study faced several limitations: Time Constraints: The researcher had to balance the study with other academic responsibilities, such as attending lectures and completing coursework, which limited the time available for fieldwork and data analysis. Financial Constraints: Conducting the study involved additional costs, including printing, sourcing reference materials, and managing data collection logistics. Limited Access to Materials: Obtaining relevant literature was challenging due to the limited availability of published research on the topic, especially within the context of Cameroon. 1.8 Definition of Terms Healthcare Waste: Refers to any waste generated within healthcare settings, including hospitals, clinics, laboratories, dental offices, and research institutions. This waste can be hazardous (e.g., infectious, chemical, pathological waste) or non-hazardous (e.g., administrative waste). Waste Disposal Methods: These are the various procedures used to manage and eliminate waste. In healthcare settings, these include incineration, autoclaving, chemical disinfection, and landfilling, all aimed at safe and effective waste removal. Urban Settings: Areas characterized by high population density, infrastructure development, and concentrated healthcare facilities. In this study, it specifically refers to cities or major towns where waste management challenges are more prevalent due to increased waste generation. Hazardous Waste: This is a category of waste that poses significant risks to human health or the environment. It includes infectious materials, toxic substances, sharp objects, and radioactive materials. Infectious Waste: A type of hazardous healthcare waste that contains pathogens capable of causing disease. These pathogens are present in amounts sufficient to infect susceptible individuals.