Medical waste is an environmental & public health nightmare

Musa Ndlangamandla – Yibutse Green Action Executive Director

Eswatini’s illegal dumping problem is not new. In fact, it is not an exaggeration to say parts of the country, particularly high-density areas, are getting buried in mountains of garbage. From plastic sweets wrappers littering the streets to builders’ rubble dumped on the roadside, some parts of Eswatini are drowning in waste.

Citing the  World Bank’s What a Waste 2.0 report, Richa Singh of the Centre for Science and Environment, says Eswatini’s waste generation was estimated to be 218,199 tonnes for the year 2016, with per capita waste generation at 0.45 kg/day. That equates to over 218, 000 one-tonner Nissan bakkies filled with waste.

Added to the illegal dumping conundrum is an emerging catastrophe of improper medical waste disposal.

Hospitals, clinics, pharmacies, dental practices, veterinary clinics, medical laboratories, and certain companies, generate an ever-increasing amount of waste, a large proportion of which is infectious, and toxic. These products are hazardous to health, public safety, and the environment. Put bluntly, this infectious waste can put, people, communities, and the environment at risk by potentially spreading infections and contaminating soil and groundwater.

Generally, medical waste is healthcare waste that may be contaminated by blood, body fluids, or other potentially infectious materials and is often referred to as regulated medical waste. 

“Medical products such as syringes, blood samples, and expired drugs, If not disposed of properly, pose a serious threat to the environment and residents  living in areas where there is the illegal dumping of medical waste, as they are placed at higher risk of contracting infectious diseases,” says Minister of Health Lizzie Nkosi.

Medical waste illegally dumped in Ezulwini (Photo courtesy of EEA)

“Improper management of discarded needles and other sharps can pose a health risk to members of the public, particularly children. These also place waste workers, including municipal refuse collectors at great risk of needle stick injuries and potential infection. People risk injury if loose sharps poke them, exposing them to serious threats, such as HIV and hepatitis,” Minister Nkosi says.

“We should all work together to strengthen medical waste management in the country. Effective management of biomedical and health-care waste requires appropriate identification, collection, separation, storage, transportation, treatment, and disposal, as well as important associated aspects including disinfection, personnel protection, and training.”

Minister Nkosi alluded to the fact that the Ministry of Health is able to deal with most of the waste, but the challenge is that this exercise requires high-spec infrastructure. However, she says, the ministry works hard to ensure medical waste is properly disposed of in a safe and environmentally friendly manner.

Meanwhile, a 44-year-old refuse collector from the USA was stuck in the leg by a needle from someone’s waste refuse bag. A year later, he started having stomach pains. His doctor told him that he had caught Hepatitis C, probably from being stuck by the needle. According to a report by the U.S. Environmental Protection Agency, doctors have not been able to help him, and he is now in chronic liver failure. He will likely die from this disease.

It is worth emphasising that it is not just refuse collection workers who are at risk of needle sticks—it’s also children, neighbours, workers, and domestic animals. That is why used needles should not be thrown in the waste bin.

The problem is compounded by the fact that some municipalities, and the majority of waste entities in the peri-urban and rural areas, do not have adequate infrastructure and systems to properly manage and dispose of such waste.

Even in those urban areas where waste management services exist, Singh observes, waste collection efficiency is only 50–60 percent.

Among the myriad of challenges is how Eswatini safely handles and disposes of the staggering amount of infectious bio-medical waste that was generated as a result of the Covid-19 pandemic.

The alarming rise in the improper disposal of medical waste has prompted the Eswatini Environment Authority (EEA) to issue a red alert on the impending disaster.

In an interview, EEA CEO Gcina Dladla said whilst the organisation has acted quickly to address this situation,  the sheer magnitude of the problem requires action from all fronts.

“There is an urgent need for more support, and ordinary citizens, NGOs like Yibutse Green Action and others, public institutions, and the private sector are well-positioned to join forces with the EEA to provide lasting solutions to the challenges of improper medical waste disposal. We all have a common responsibility to protect the environment from the hazards associated with medical waste,” said Dladla.

Medical waste illegally dumped in Ezulwini (Photo courtesy of EEA)

In a red alert issued last week, the EEA wrote:

“Dear clients and stakeholders. The EEA is noting with great concern a worrisome spike in the cases of mismanagement – particularly indiscriminate dumping – of special (i.e. hazardous and clinical) waste in different parts of the country. A plea to you all: please continue assisting the EEA in identifying the perpetrators of this reckless and inconsiderate infringement of both the environment and citizens’ universal right to a clean, healthy and sustainable environment. Citizens are urged to pay particular attention to the activities of healthcare facilities (including hospitals, clinics, pharmacies, etc), laboratories, medical supply systems, and the whole value chain. Our ability to serve you better is significantly improved by the continual flow of support (particularly reports) we receive from you.  If you think something is fishy, something may really be fishy hence do not hesitate to inform us about your observations and suspicions. To those who have waste: if you are not sure where your disposal method is in line with legal requirements, our office is readily available to assist you. We thank you in advance for your relentless support.”

Against this backdrop, the Centre for Science and Environment recommends that public awareness and behaviour change are paramount if the country is to meet its national and international targets for proper waste management.

“The government will have to put much more effort into environmental education and awareness to empower not only local government authorities but also communities which will have to practice sustainable management and use of natural resources in rapidly changing rural and urban settings. This can be done by extensive information education and communication activities and capacity building programmes,” wrote Singh.

To report any illegal waste dumping please immediately contact the Eswatini Environment Authority EEA:

·         Call:  (+268) 2404 6960/7893

·         Email:

·         Facebook: @EswatiniEnvironmentAuthority

·         Twitter: @EnvironmentSWD

·         Instagram: @eswatinienvironmentauthority

·         YouTube: Eswatini Environment Authority