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  2. Supply chain and logistics
  3. Friday, 13 July 2007
POST 01121E : WASTE MANAGEMENT Follow-up on Post 01111E 13 July 2007 _____________________________________ Modibo Dicko's message generated three contributions. The first is from [log in to unmask]">Henrique Menezes d'Alva, from Angola. [log in to unmask]">John Lloyd, from PATH/France, then asks judicious questions and replies are expected from authors. Finally, [log in to unmask]">Bibata Paré from Burkina Faso shares her opinion, giving Haïti as an example. _____________________________________ Dear Colleagues, Many thanks to have shared with us these experiences. I think that the comments made by our Colleague Dr Modibo Dicko around this subject are very important for all of us who have been dealing with this kind of matter. I support these comments and initiative for engaging all process in this way. I think that it will be useful for all the needed countries if we can be able to implement these proposals to available them with these kinds of equipments which supposed to be installed in countrywide at all District level. Implementing that in practice we can save a lot of resources as it was raised in comments, as well as the environment and be able to equip all health structure with tools to be used for a long period. Warm regards. Henrique Eng. Henrique MENEZES D’ALVA EPI Logistician / Vaccine Manager WHO-Angola Luanda-Angola --------------- We are very supportive of the principle that immunization campaigns should be used as an opportunity to build and reinforce the permanent infrastructure of infectious sharps waste disposal. But industrial kilns achieve higher temperatures and have less emissions than WDUs, so surely this is a better option if transport costs allow it? I wonder what was the cost breakdown in these two countries - between the cost of collection and the cost of incineration - both for the industrial kilns and for the WDU network? Maybe the network of WDUs might be the most economic for x% of sites and industrial kilns for y% of sites? A hybrid solution, different in urbanised and in rural zones - not just a 'single solution fits all'? Transport is often the critical cost factor (South Africa too): if dedicated vehicles are provided with drivers by a private sector enterprise for waste collection, the cost can be prohibitive for routine waste collection. But if vehicle use is shared between immunization supplies/vaccine distribution and collection of safety boxes, this integrated system should have lower costs attributable to waste collection. The interval between collections will also be kept low (monthly) so storage of filled safety boxes can be minimized. The critical issue is - how are we going to achieve safe shared use of vehicles? - by partitioning? (not very flexible) - by routine disinfection? (without rotting the vehicle floor!) - by trailers? (good roads only?) - by roof-racks? Low transport costs will permit better centralization of waste desruction and therefore better environmental emission control. Any ideas out there? John Lloyd PATH ------------------------- Indeed, with campaigns imminent, all kind of strategies for the destruction of waste are under consideration (sometimes without due regard to cost), provided we get rid of the waste by all means! I find very interesting indeed Adama Sawadogo’s idea. Instead of using industrial kilns at exorbitant costs for one-off destruction of waste, the could be used to purchase more durable equipment for health centres. Because management of routine immunisation waste is a real headache! However, a great deal of work is still to be done in order for countries and partners as well, to be aware of the problem. I still remember that when a similar suggestion was made in Burkina Faso, immunisation officials did not accept the idea. They still preferred industrial kilns. Where are we today? If we managed to order these prefabricated Waste Disposal Units (WDU), that would solve the problem of waste disposal for a long time. Haiti quickly understood and just received 10 WDU procured by UNICEF at a cost of US$ 44400. Ten more are expected by the end of July. There is a planned users’ training session in the days to come, in preparation for the measles/rubella campaign scheduled for October this year. Isn’t it a good example to follow? Mrs. PARE Bibata EPI Logistics /Burkina Faso ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. 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