The ultimate aim of these Guidelines is to protect and promote public health. Adequate capacity is required at the national level to maximize the benefit of the use of wastewater, excreta and greywater in agriculture and aquaculture, to minimize the health risks involved and to promote proper environmental management, ensuring long-term sustainability. An essential element of this national capacity consists of an enabling policy environment. This chapter summarizes the information needed to formulate decision-making criteria, establish decision-making procedures and create effective institutional arrangements for their implementation.
The issue of medical waste management was first taken up in India around 1995.A lot has changed since then in the way medical waste is handled, stored, treated and disposed.
An important catalyst to this change have been the Bio-medical Waste (Management &Handling) Rules 1998. Framing the rules was one important aspect of waste management, but implementing the rules required that the medical fraternity understood the rules and adopted them into their professional environments. This was possible only through large-scale training of medical staff. Considering the geographical spread of India, and the size of its medical sec-tor, this has been, and continues to be, a challenging task.
Srishti, a programme of Toxics Link, has played its part in training healthcare professionals regarding medical waste management and the implementation of management systems in hospitals and other medical institutions. Srishti emphasises the importance of managerial interventions and staff dedication to bring about efficient waste management practices. It works towards dispelling the belief that technology is the only solution for medical waste management.
As our work with various hospitals has progressed, the training needs have also increased. As a result, training has gradually become one of our focal areas. We have learnt from each training session; every hospital has its unique problems and challenges. As we attempted to resolve particular problems, and respond to the queries of the hospital staff, we enhanced our understanding of the practical problems and the unique needs of healthcare institutions. This helped us evolve our training methodology as well as its content.
Apart from training hospital staff, we have also conducted various Training of Trainers(ToT) programmes all around the country, in association with various hospitals and Pollution Control Boards/ Committees. These programmes create a brigade of trainers who act as ambassadors and take the message of waste management forward.
By the end of such sessions, trainees are exposed to a lot of information, but they do not have enough time to assimilate everything. Once they return to their workplaces, they have ex-pressed the need for a comprehensive resource on training. This manual has been compiled to fulfill their requirement.
The main aim of the manual is to ensure that every healthcare worker and other stakeholders are aware of the hazards associated with improper bio-medical waste management.
The manual has been produced to provide a convenient, up-to-date training resource that will allow interested people and trainers to increase awareness on waste management and related issues at every level in their organisation. The Training manual has six sections and each section has slides on a particular topic. Most of the points in the slides are self explanatory, but some of them, which may need explanations, have descriptive notes. This manual would keep evolving to address newer issues as experience in this field grows. Your suggestions and comments on the manual would therefore be highly appreciated.
The discovery of a variety of pharmaceuticals in surface, ground, and drinking waters around the country is raising concerns about the potentially adverse environmental consequences of these contaminants. Minute concentrations of chemicals known as endocrine disruptors, some of which are pharmaceuticals, are having detrimental effects on aquatic species and possibly on human health and development. The consistent increase in the use of potent pharmaceuticals, driven by both drug development and our aging population, is creating a corresponding increase in the amount of pharmaceutical waste generated.Pharmaceutical waste is not one single waste stream, but many distinct waste streams that reflect the complexity and diversity of the chemicals that comprise pharmaceuticals. Pharmaceutical waste is potentially generated through a wide variety of activities in a health care facility, including but not limited to intravenous (IV) preparation, general compounding, spills/breakage, partially used vials, syringes, and IVs, discontinued, unused preparations, unused unit dose repacks, patients’ personal medications and outdated pharmaceuticals.
In hospitals, pharmaceutical waste is generally discarded down the drain or landfilled, except chemotherapy agents, which are often sent to a regulated medical waste incinerator. These practices were developed at a time when knowledge was not available about the potential adverse effects of introducing waste pharmaceuticals into the environment.
The Strategic Plan on Management of Mercury in Artisanal and Small Scale Gold Mining (SPASGM) was prepared by the Department of Environmental Pollution Control (DEPC), the Ministry of Environment (MOE), with support from the United Nations Environment Program (UNEP). This strategic plan was developed in response to various concerns on safe use and sound management regarding intentional mercury use in Artisanal and Small Scale Gold Mining (ASGM). This SPASGM is also developed and implemented to support existing legal frameworks, national strategies, action plans and many other relevant technical papers. Technical support for this development was administered by the UNEP Chemicals Branch through the Artisanal and Small Scale Gold Mining (ASGM) Project with in-kind contributions from the Royal Government of Cambodia.
This Strategic Plan is published in Khmer and English versions by the Department of Environmental Pollution Control (DEPC), the Ministry of Environment (MOE) of the Royal Government of Cambodia. This is to provide a practical framework on sound management of chemicals, including mercury and mercury containing wastes in Cambodia, with full participation from all levels of Government and civil societies in implementing it.
This document presents the ndings of a study on sanitation nance in Cambodia conducted for the Water and Sanitation Program (WSP) with support from the Asian Development Bank (ADB). The overall objective of the assignment was to consider sustainable sanitation nancing options with a focus on promoting access for the poorest.
This guidance note contains an introduction on sanitation nancing and subsidies, stating the cases for subsidies as well as some of their practical pitfalls. The study used data (as of late 2009) from two case studies of rural sanitation nance in Cambodia to illustrate the practical issues, sup-plemented by preliminary data from two sanitation marketing projects. The study also examined the potential use and effectiveness of (hardware) subsidies, conditional cash transfers (CCTs), and other nancing approaches relevant for sanitation improvement.
The document ends with recommendations for improved sanitation nance, including practical suggestions for sanitation programs in Cambodia. These recommendations bear particular relevance for the ADB’s Second Rural Water Supply and Sanitation Sector Project, which commenced in 2010.
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