4.2. The situation of management of MSW in Health-care facilities in Yen Bai city
4.2.2. Transportation, treatment, and equipment
+ Within the hospital
The collection, transportation of MSW within hospitals is mainly done by manual methods. Some hospitals use hand trolleys or wheeled containers to transport MSW, however, mostly hand-held to transport MSWs from departments to temporary storage areas before processing;
Manual handling of HMSW handbags is highly contagious for hospital staff, patients, visitors, and at risk of cross infection for treatment patients. In addition, in the process of collection, transportation also causes the problems such as scatter garbage, drop wastewater discharge, and odors during transportation, also to leak garbage water from the containers.
+ Transportation by Nam Dinh ETC Company and Nam Thanh Company Means of transport: Closed box trucks;
Transportation: HMSW is packed in sealed containers with guaranteed structure in accordance with Joint Circular 58/2015 / TTLT-BYT-BTNMT. In the course of transportation, ensuring the HMSW is not dispersed on the road.
b. Treatment and technology - For HMSW:
Currently, in total 08 hospitals in Yen Bai City, 05 hospitals have been invested in HMSW treatment technology, 03 hospitals have not yet invested are Pediatric Hospital, Endocrinology hospital, and Provincial General Hospital (equipped with incinerators but not ensure environmental safety so it is not be put into operation yet).
In particular, except for the Transportation Hospital which is equipped microwave, the remaining hospitals have applied the technology of solid waste
incinerator to treat MSW. The incinerators of the hospitals in the city are mainly CHUWASTAR ovens, specifically (Vu Thi Huyen Trang, 2016):
- Furnaces are insulated with water (even in the combustion chamber), which helps reduce the temperature of the furnace surface, ensuring the incinerator longevity and safety for the operator; With two separate combustion chambers, the combustion controller makes complete combustion, utilizing heat to heat the incoming air. Heat and steam are used for dust extraction, increase the efficiency of dust treatment before discharging into the environment, and also reduce the temperature of exhaust smoke quickly and limit the possibility of forming dioxin and furan;
- The structure of the incinerator allows creating negative pressure in the pyrolysis chamber, ensuring that the flame does not flush out when it is necessary to open the furnace door during the combustion process. It is possible to periodically put garbage into the furnace when burning, saving reduce operating costs, increase economic efficiency. Waste gas after formation in the first stage combustion chamber continues to be completely burned in the secondary combustion chamber at temperatures from 1050 degrees Celsius to 1200 degrees Celsius.
Incinerators are equipped with a dust and exhaust gas treatment system to ensure that the waste from the furnace does not affect the surrounding environment.
The capacity of the above mentioned environmental treatment equipment (incinerator and steam-oven) ensures that the total volume of hazardous wastes generated by the hospitals is treated. Those details of form and processing capacity are shown in table 10:
Table 10: Situation of MSW treatment at hospitals in Yen Bai city
No. Hospital Forms processing
Handling capacity (ton/day)
1 City General Hospital
MSW is burned at the hospital's incinerator
160
2 Traditional Medicine Hospital
MSW is burned at the hospital's incinerator
160
3 Transportation Hospital
MSW is treated at the hospital's microwave
50
4 Mental hospital
MSW is burned at the hospital's incinerator
160
5
Hospital for Tuberculosis and Lung Disease
MSW is burned at the hospital's incinerator
160
( Department of Natural Resources and Environment, Yen Bai province, 2016) Presently, Endocrinology Hospital rents Mental Hospital to treat their MSW due to the lack of waste treatment equipment. Similarly, Provincial General Hospital rents Nam Dinh ETC Company and MSW from Pediatric Hospital is treated by Nam Thanh Company.
Through observation and survey, the remaining waste after MSW was treated by incinerator or steam-oven, disinfection is managed as follows:
- For hospitals using the burning technology, after burning ash as buried as prescribed.
- Transportation Hospital using steam-oven sterilization technology which makes HMSW after have been treated, the remaining waste is nonhazardous. The hospital hired Nam Thanh Energy and Environment Joint Stock Company for transportation and treatment as for domestic waste.
- For Ordinary Medical Waste:
At present, almost OMW is collected and treated together with HMSW, except for OMW from the office and patient's daily activities which are transported and treated by Nam Thanh Yen Bai Energy and Environment Joint Stock Company.
c. The shortcomings
In addition to the above results, the treatment of MSW in hospitals in Yen Bai City also has some limitation such as:
• Due to long-term investment and lack of funds for renovation and maintenance, so far, HMSW incinerators of some hospitals in the city have degraded, affecting the quality of treatment;
• 03 hospitals have not yet invested in the waste treatment equipment;
• Despite MSW have been classified but most hospitals treat OMW and HMSW together which has led to the incinerators have to operate more, wasting money and labor force;
• There is a case of HMSW after treatment by steam-oven and sterilizing technology but it is still hazardous, affecting human health and surrounding environment but is still being transported, treated as the same with domestic waste.