A Gap Analysis in Selected Asian Countries, 3R Knowledge Hub ...

Findings
On-going difficulties in solid waste
management can be attributed to shortage in
skilled and experienced human resources to
manage and operate waste management
systems; appropriate equipment to ensure cost
effective collection and transportation of waste;
accessible finances due to inefficient revenue
generation; and remuneration of workers to
encourage effective operation.
In the past, recyclable materials were kept and
either used, sold or exchanged. However as
progress is made and consumption grows,
disposal practices are changing with growing
volumes of waste being dumped everywhere.
Unfortunately, this has been paralleled with a
contraction in the recyclable materials markets.
Materials, which were previously exported to
neighboring countries where the systems are
present to undertake commercial recycling have
either disappeared or shrunk in most cases,
except for the very high value materials
(aluminum and other selected metals).
Additionally, export duties have been
introduced which makes the recycling markets
uneconomical. This has led to an increase in the
volumes of waste being dumped.
HEALTHCARE WASTE
The Ministry of Health is responsible for
healthcare throughout the country. Hospitals,
by and large, have facilities with more than 50
beds and are publicly owned. On the other
hand, health centers generally have less than 50
beds and are often publicly owned. Clinics and
polyclinics are usually under the private sector
and only offer outpatient services. Most
hospitals and health centers were constructed
during the 1950s and 1960s, while a number of
polyclinics and clinics are presently built to
meet the dramatically increasing population,
particularly in Phnom Penh.
Limited information is available regarding the
management of healthcare waste in Cambodia.
The World Health Organization has conducted
a survey in 44 healthcare facilities; 10 hospitals,
14 polyclinics, 12 clinics, and 8 health centers
(WHO, 2003). The results of the survey indicate
that hospitals, polyclinics, clinics, and health
centers generate about 825 kg of solid waste per
day. Of these, about 403 kg is considered
medical waste, and the rest is considered
general waste.
The survey also reveals that most hospitals,
polyclinics, clinics, and health centers do not
have their own systems for waste segregation.
Different types of wastes, including infectious,
sharp, and pathological waste, are placed in the
same bin or container, which is not colored and
labeled. However, waste segregation is carried
out by some hospitals and polyclinics. Syringes
are stored separately from other waste at the
point of generation. For instance, some facilities
put the syringes into bottles of pure water,
while others put them into safety boxes.
A secondary collection system normally is
carried out by the PSBK Company, which was
given this responsibility by the Municipality of
Phnom Penh. The company uses compactors for
the collection and transportation of waste from
hospitals, polyclinics, clinics, and health centers.
The frequency of collection is once a day, except
national holidays and weekends. Ironically, the
categories of solid waste to be collected by the
company have not been clearly defined in the
contract. In other words, the company is
entitled and responsible to collect all categories
of solid waste within the city.
Cambodia presently does not have a special
treatment facility or central incineration plant
for treatment of medical waste. A large amount
of general and medical waste produced by
hospitals, polyclinics, clinics, and health centers
is collected by the PSBK Company and disposed
at an open dumping site known as Stung Mean
Chey. The site has been used since 1960 and has
an area of about 8 ha. It is not equipped with
appropriate technologies for solid waste
management. The leachate from this site is
discharged directly into the public sewer.
A few hospitals are equipped with conventional
incinerators for burning healthcare waste. It has
been reported that the operating temperature in
those units ranges from 350 0 C to 600 0 C. It has
also been determined that the healthcare wastes
cannot be completely destroyed at these
temperatures.
Chapter 3: Country Analysis
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