The problem of disposing medical waste in South Africa gives government sleepless nights. The average patient produces 400g of it daily and in 2010 reportedly 42 200 tons of medical waste is generated annually which is 6 000 tons more than our facilities can handle. Not only are the volumes of medical waste beyond our man-power to deal with but according to the Green Scorpions, 75% of all medical waste-disposal companies in South Africa face (or have faced) criminal charges for violating medical waste disposal laws.
Rural areas in particular suffer the brunt of these inefficiencies. Poor infrastructure; the high costs of transportation; compounded by the lack of training provided to staff at rural health centres – who often mix medical and general waste – is enough to make solving this toxic mix seem impossible.
One enterprising non-profit established in the Moutse District in Limpopo has for the last two years been trying to let government know that there is a solution. Since 2008, the Ndlovu Care Group (NCG) has been incinerating its own medical waste at its clinics in Elandsdoorn, Limpopo and Bhubezi, Mpumalanga in a safe and environmentally-friendly way. The T2 Micro Medical Waste Incinerator™ or “T2” was developed by NCG founder and medic, Dr Hugo Tempelman and engineer, Tim Simons, CEO of Ultrafurn, a commercial producer of kilns and furnaces for the mining, laboratory and ceramic industry.
These two “mad scientists of social innovation” did it despite others saying it wasn’t possible. The T2 has a capacity of approximately 8 kg to 10 kg and one medical waste incineration cycle takes four hours. It contains a microprocessor-based temperature control system that mitigates complications that could arise from the complex incineration mechanism. This “computer-brain” ensures that the internal chamber heats to approximately 1000 degrees celsius which obliterates medical waste into an ash volume that is less than three percent of the initial volume inserted, weighing approximately 150 grams. The additional “chimney furnace” above the internal chamber of the T2 can heat the toxic fumes generated from burning the waste up to 13 000 degrees celsius. This critical second system through which the fumes pass, ensures that any toxic substances like dioxin and furan are destroyed and only a small white plume of smoke is released into the atmosphere
Development started in 2002. Six years, 30 re-designs and R3 million later Tempelman and Simon now have a model that can function for two years – 7 days a week – without any maintenance or repairs. Powered by electricity, the T2 requires no major infrastructure. If replicated the T2 would cost approximately R185 000 to make. If manufactured on a mass scale, the costs could be reduced by 30 to 40%.
Comparing the cost-effectiveness of the T2 model with traditional methods of medical waste incineration would be like comparing apples with oranges. The T2 pioneers a new way of disposing medical waste. Its method of small-scale and continuous incineration decreases the amount of toxins released into the air. As clinics can do it autonomously, the exorbitant costs of transporting the waste from remote communities are reduced not to mention the high cost associated with this toxicity affecting the health of the poor.
Communities are safer, the environment is conserved and health workers are empowered around an often neglected aspect of quality health care provision. The health departments of Botswana and Namibia have shown interest in the T2 – so where is our national Department of Health on this?
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