Waste management and sanitation
In low-income countries, over 90% of waste is often disposed in unregulated dumps or openly burned.
- World Bank, 2022
Figure 7
Common methods of waste disposal in low-income countries are burning and burying, but alternative technologies exist and should be considered in the design and planning of new or existing facilities.
Planning considerations:
Waste storage and segregation Assess the local climate risks and topography, ensure site is above flood levels, and provide sufficient space and processes to separate waste types to prevent cross-contamination.
Mortuary procedures Plan to use modular structures like shipping containers with air conditioning as temporary morgues to store corpses, especially during outbreaks of infectious diseases.
Overflow planning Consider storage for extra waste generated during outbreaks of climate-related events and sewers and septic tanks are built to be above expected flood levels.
Reduce reliance on burning Develop waste management plans incorporating appropriate infrastructure and invest in cleaner alternatives to incineration for waste treatment.
Design and delivery:
Sanitation facilities Make sure buildings have enough facilities to meet the needs of patients and staff.
Decontamination and disposal Use steam (e.g. autoclaving) or other non-burn technology for infectious waste. If non-incineration isn’t feasible due to lack of reliable resources, use autoclaves where possible, or an on-site incinerator as a last resort.
Decentralized wastewater treatment systems These on-site systems provide sanitation and use black water for below-ground irrigation to remove bacteria.
Incineration Ensure no open burning and choose the lowest emitting incinerator option feasible, such as controlled air, excess air, or rotary kiln incinerators. Place the incinerator chimney high enough to avoid intakes and conduct wind studies for optimal placement. Combine incinerator usage with renewable fuel or electricity if possible.
Waste storage Design a well-ventilated space and use strong and impermeable liners, implementing robust drainage systems, constructing protective barriers like berms, and incorporating monitoring systems to detect potential breaches or leaks.