The Comoros government is taking steps to improve medical waste management with its National Plan for Medical Waste Management (Pngdm) 2025-2029. The plan, currently in the dissemination phase, aims to address the country's challenges in handling medical waste, particularly from households. Expert Mariama Chabani, specializing in chemical and medical waste, emphasizes that the problem is as much logistical and institutional as it is technical.
According to Chabani, the Pngdm categorizes medical waste into hazardous categories, including sharp and infectious waste, as well as special waste such as pharmaceuticals and toxic substances. The plan specifically mentions commonly encountered waste like syringes, needles, and injectable vials, as well as compresses and other medical materials. A more recent document provides even clearer classification, taking into account the content and condition of waste, such as used serum pouches.
Chabani warns that the most significant risks come from sharp objects like needles and syringes contaminated with blood or other infectious agents. These can cause injuries and expose individuals to infectious diseases like hepatitis B, hepatitis C, and HIV. The expert identifies three main levels of risk: those associated with used needles and syringes, which can cause puncture wounds and blood exposure; those linked to infectious waste like soiled compresses and dressings; and those related to chemicals and expired medications.
To manage medical waste safely, Chabani advises households not to dispose of used needles, syringes, or serum pouches in regular trash or leave them unattended. Instead, they should be placed in a puncture-resistant container, stored out of reach of children, and handed over to a designated health facility or collection point. However, the Pngdm 2025-2029 does not describe a clear, operational door-to-door collection system for household medical waste.
Households are also advised on how to handle expired or unused medications. These should not be flushed down toilets or disposed of in sinks, yards, or nature. The Pngdm considers unused, expired, or spoiled medications as hazardous medical waste. The recommended approach is to store them separately and return them to a pharmacy, health facility, or official collection point. In Comoros, efforts are underway to strengthen institutional capacity, including the development of a national guide for the destruction of expired and spoiled medications.
While the Pngdm recognizes the importance of community involvement in medical waste management, its detailed provisions mainly focus on healthcare facilities. The plan does provide for awareness-raising campaigns, but a specific mechanism for household medical waste is lacking. Recent developments aim to strengthen the national system, including the acquisition of equipment for the pre-collection and collection of biomedical waste.
Once medical waste is handed over to a collection facility, it undergoes a series of steps, including separation, packaging, collection, transportation, temporary storage, treatment, and disposal. Hazardous waste is placed in adapted containers, and objects like needles and syringes are stored in puncture-resistant containers. The waste is then transported, stored temporarily, treated – often through incineration or other suitable methods – and finally disposed of according to the relevant regulations.
Key points
- The National Plan for Medical Waste Management (Pngdm) 2025-2029 aims to address Comoros' medical waste challenges through improved handling, collection, and disposal.
- Expert Mariama Chabani stresses that medical waste management requires a multi-faceted approach addressing logistical, institutional, and technical challenges.
- Households play a crucial role in safe medical waste management, including proper disposal of sharp objects and expired medications.
