Silent Threats in Our Hospitals: Why Medical Waste Management Matters for Health and the Environment in Cameroon

Hospital waste is one of the most overlooked environmental and public health challenges in Cameroon, yet it is one of the most critical challenges. Every day, clinics, laboratories, and hospitals produce tons of waste, ranging from used needles to soiled bandages, expired medications, plastics, and chemical substances. When this waste is not properly managed, it becomes a dangerous source of infections, pollution, and long-term environmental damage. Hospital waste management is all about handling hospital trash (needles, blades, infectious waste, chemical and even radioactive waste) safely so it doesn’t hurt patients, staff, the community or the planet. 

As a nurse volunteering with ISEC Cameroon, I believe that protecting human health goes hand-in-hand with protecting the environment. As the intersection between healthcare and environmental consciousness grows, hospital waste management has become an urgent priority for cleaner, safer, and healthier communities.

Overview of the Cameroon’s 2012 order on medical and pharmaceutical waste management 

In October 2012, the Minister of Environment, Protection of Nature and Sustainable Development issued an Order establishing clear conditions for the management of medical and pharmaceutical waste in Cameroon. This regulation is grounded in several national laws on environmental protection, public health, toxic waste, water resources, transport, and decentralization.

The Order defines key actors involved in hospital waste management, including waste generators (health facilities), transport operators, and recipients (treatment or disposal facilities). It introduces important concepts such as decontamination, waste traceability, certificates of prior acceptance, and certificates of destruction, all aimed at ensuring accountability throughout the waste management chain.

Medical and pharmaceutical waste is classified into four categories:

• Category 1: Potentially infectious waste, including sharps, pathological waste, and certain blood products.

• Category 2: Expired or unused drugs, chemical and biological products, genotoxic waste, and waste containing heavy metals.

• Category 3: Identifiable human or animal organs and tissues.

• Category 4: Waste similar to household waste.

  
  

Understanding the differences between these wastes ensures that each type is handled appropriately. It is unfortunate that most hospitals and some medical personnel don’t accord importance to these different wastes.

• The Order requires all healthcare facilities to establish an internal waste management system, including trained personnel, proper equipment, and record-keeping of waste quantities and types. Facilities producing smaller quantities of hazardous waste must still assign a qualified person and maintain a register.

• Strict rules are provided for sorting, packaging, storage, and color-coding of waste containers to reduce health and environmental risks. Waste must be sorted at the point of generation, placed in approved containers, properly labelled, sealed, and stored in secured areas.

• For transport, the regulation introduces a mandatory waste traceability manifest, ensuring that medical waste can be tracked from the point of generation to final disposal. Transport operators and disposal facilities must hold valid environmental permits, and all movements of waste must be documented and approved by environmental authorities.

• Regarding treatment and disposal, the Order requires that hazardous medical waste be treated using recognized and safe methods. Containers and vehicles must be cleaned and disinfected after use, and disposal facilities must issue a certificate of destruction once waste is treated. Only waste proven to be non-hazardous after certified treatment may be handled like household waste.

• Finally, the Order places legal responsibility on all operators involved in the waste management process and provides an 18-month transition period for existing facilities to comply. This regulation represents a key legal framework for improving hospital waste management, protecting public health, and safeguarding the environment in Cameroon

  
  

Gaps in the Cameroon’s 2012 order on medical and pharmaceutical waste management

Despite providing a comprehensive legal framework for managing hospital waste, the 2012 Order faces several practical challenges and gaps in implementation.

• One major lapse is weak enforcement and monitoring, as many health facilities do not fully comply with sorting, color-coding, record-keeping, and traceability requirements due to limited inspections and sanctions. Some health facilities do not sort their waste and some of these waste end up in dumping areas.

• Additionally, inadequate infrastructure such as the lack of authorized treatment facilities, incinerators, and controlled landfills which makes compliance difficult, especially in rural and semi-urban areas where they practice open burning.

• Another challenge is limited financial and human resources, as many hospitals lack trained personnel, dedicated waste management units, and funds to procure approved containers, storage facilities, and transport services. 

• The law also places heavy administrative and technical responsibilities on healthcare facilities without clearly outlining government support mechanisms or funding strategies. 

• Furthermore, poor awareness and training among healthcare workers leads to improper segregation and handling of waste at the source. In Cameroon there is no curriculum on waste management in most universities and higher institutions training nurses or other laboratory technicians. And very few hospitals organize workshops for waste collection and management, making healthcare workers unaware.

• The traceability system, though well defined, is often poorly applied in practice, with incomplete manifests, unlicensed transporters, and informal disposal routes still common. Talking about traceability, in Cameroon, culture also has its role to play as far as biological waste management is concerned. When there is removal of a body part from a patient, this part is often given to their family members to bury. This act makes it difficult to trace the proper disposal of this waste which falls under category 3 of medical and pharmaceutical waste classification.

• Finally, the Order does not sufficiently address emergency situations, informal health facilities, and community-level healthcare waste, creating regulatory gaps that continue to pose risks to public health and the environment.

These gaps highlight the need for stronger policies, capacity building, and community awareness.

Why does Hospital Waste Management Matters

There is no exact value on the quality of hospital waste produced annually in Cameroon. According to some research studies for academic purposes made in 2019-2020, an estimated value was calculated based on the quantity of hospital waste produced daily by general hospitals, central hospitals, regional hospitals, district hospitals and integrated health centers. This estimated value indicated that 15700 tons of hospital waste is produced annually. Managing this waste properly will keep the population and the environment safe. Below are some reasons why it is important to manage hospital waste.

1. To prevent disease transmission 

Medical waste, especially sharp objects and infectious materials, can transmit serious diseases including hepatitis B, hepatitis C, HIV, and other infections. Proper segregation and disposal reduce these risks for healthcare workers, patients, waste handlers, and surrounding communities. I remember a time when a colleague of mine got her finger pricked by a poorly disposed needle, luckily for her she was put on medications and months after, she was tested negative for HIV and hepatitis. There are many out who have been victims of such situations but their stories didn’t end well like that of my colleague.

2. To protect the environment 

Improper dumping or burning of hospital waste releases toxic pollutants such as dioxins, heavy metals, and microplastics. These pollutants contaminate the air, soil, and water, affecting ecosystems and public health.

3. To ensure community safety 

Communities living near healthcare facilities or waste disposal sites are vulnerable to exposure if medical waste leaks into the environment, especially for children. I have seen instances where children pick up hospital waste and play with them innocently not knowing the dangers behind it. So safe disposal helps maintain hygiene, prevents environmental degradation and keeps our communities safe.

Solutions and Best Practices

It is high time we all understand that improving hospital waste management requires collaboration between healthcare facilities, environmental organizations, and policymakers. By creating awareness, allocating resources for proper waste management procedures, holding health facilities accountable for irresponsible waste disposal. Some key measures include:

1. Training and Sensitization

Regular training programs for nurses, laboratory technicians, students, and waste handlers improve compliance with safety protocols. Education builds a culture of responsibility.

2. Waste Segregation at Source

Using color-coded bins (yellow for infectious waste, red for sharps, black for general waste, etc.) ensures proper handling and reduces risks.

3. Adoption of Eco-Friendly Treatment Technologies

Alternatives such as autoclaving, microwaving, and chemical disinfection reduce reliance on harmful open-air burning.

4. Recycling and Reduction Strategies

Non-infectious plastics, paper, and metal can be safely recycled or repurposed, reducing environmental impact and disposal costs.

5. Stronger Policies and Monitoring

Governments and institutions must enforce guidelines and monitor compliance to protect public health.

My Role

As a nurse, with the support of ISEC team which is a youth-led environmental organization with diverse works of life, we promote sustainable healthcare practices through:

• School and hospital outreach programs

• Tutorial sessions for nurses and healthcare students.

• Advocacy for safer waste management policies

• Community education campaigns

It is important that healthcare providers serve their purpose which is saving lives without harming the environment or themselves.

Conclusion

Effective hospital waste management is not just a healthcare issue; it is an environmental responsibility. By adopting safe disposal practices, empowering healthcare workers with knowledge, and raising public awareness, we can build a cleaner, safer, and healthier Cameroon.

At ISEC Cameroon, we remain committed to driving this change through education, innovation, and community action.

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Author: Merilyn Ngemukum

Edited: Harrison Ashangwa