Health care waste in Nepal is part of a larger global problem. The Stockholm Convention on Persistent Organic Pollutants (POPs) was established by the UNEP in 2001 and cites medical waste incineration as one of the major source of hazardous dioxins and furans. In addition, health care waste incineration may release heavy metals into the environment, including mercury from broken thermometers, or lead or cadmium from plastics. The specific conditions within Nepal that have led to medical waste being handled and disposed of in inappropriate and inadequate ways include lack of infrastructure and lack of resources especially in rural areas. Hospitals have linked into a waste management system that is inadequate even for standard waste and certainly for the hazardous materials that are a part of medical waste. There is also a lack of knowledge both about the dangers of medical waste and safe ways to dispose of it.

Although national guidelines for health care waste management exist, there has been little implementation of non-incineration disposal methods outside of HECAF?s efforts. While there is a great deal of interest by both hospitals and the government to work with HECAF, neither hospitals nor the government have provided funding for HECAF; HECAF has either found its own funding or projects have been shelved. Government and hospitals lack the practical experience for implementation. So while there is the desire for change, numerous conditions have caused the situation to remain largely stagnant.
The proposed project will be led by Health Care Foundation of Nepal (HECAF) with the following collaborating entities: Gunja Man Singh Hospital (GMS) in Pithuwa Village in the Chitwan district of Nepal, and Health Care Without Harm (HCWH), an international NGO based in the United States. This project will address the improper disposal of health care waste. A year ago, health care waste was identified as a serious worldwide problem by Calin Georgescu, the United Nations Special Rapporteur on human rights and toxic waste. The proposed project will:

1) demonstrate and test waste treatment technologies
2) create new comprehensive models for health care waste management?thus reducing POPs from burning waste and capturing methane from food waste to use as fuel?that are appropriate for rural clinics and small hosptials in Nepal
3) implement the model in one rural clinic?Gunja Man Singh Hospital (GMS)
4) train staff members of five additional regional clinics in order to spread the model; local populations, including waste pickers and students, will also receive training
5) disseminate the model and assist the five additional clinics with implementation
6) use GMS as a hub for on-going implementation of the project in Chitwan, including using GMS as a place where local clinics can test the effcacy of their autoclaves