Digging up the dirty on medical waste

By Lionel Faull

On page 12 of this week’s Mail & Guardian, there’s a photo of a man in a dark blue overall directing a digger as it excavates several tonnes of medical syringes and needles from the brown earth. The man is a cop, and the label on the right-hand breast of his blue overall reads: Crime Scene Management.

Yup, this is a crime scene, because hazardous medical waste cannot just be buried underground in the veld somewhere.

And this is no ordinary crime scene — the digger has just unearthed the biggest illegal medical waste dump in South African history — 180 000 tonnes of medical waste and infected soil had to be cleaned up, at a cost of R55 million.

The dumps, unearthed in the Free State in 2009, were traced back to medical waste-management company Waste Man.

Late last week the case against Waste Man, conducted by elite environmental investigators The Green Scorpions (a division in the department of environmental affairs) was struck off the court roll.

It was a temporary set-back — but a stinging one — in the Green Scorpions’ bid to rein in a rogue industry.

The Green Scorpions told me that 75% of all medical waste-disposal companies in South Africa face (or have faced) criminal charges for the kind of violations seen outside Welkom two years ago.

I have a list of all the cases — company names, case numbers and locations — and it makes for uneasy reading. The rot has spread to every province.

What’s the big deal, you ask?

Well, medical waste is highly dangerous stuff. It includes any material — human anatomical, or otherwise — that is thrown out on a daily basis from our hospitals and clinics.

And there’s a hell of a lot of the stuff: the average patient produces 400g of medical waste daily.

Picture it: amputated limbs, organs, aborted foetuses, placentas, bloody bandages, pus-soaked swabs, needles, scalpels, any clothes or bed sheets that have come into contact with infectious patients, chemicals and radioactive waste.

It can’t just be tipped into a landfill site and covered over with soil. It has to be separated, stowed in category-specific containers, transported in specially-identifiable trucks, and treated (basically, incinerated) under very specific conditions.

Given the complexities of medical waste disposal, the tenders issued by government are worth big bucks but the number of competitors is small (less than 50, according to the Institute of Waste Management).

In the scramble to out-bid one another for tenders, companies inevitably cut corners — supplying inferior containers, providing insufficient protective gear for their staff, not incinerating the waste properly and, in the worst-case scenario, adopting an “ag, fuck it” approach and making it someone else’s problem by dumping it somewhere.

Medical waste dumps — and their hazardous, infectious contents — can then be dispersed by insects, vermin, human beings searching through it, or simply by seeping through the soil into nearby aquifers.

The paradox is that medical waste disposal is one of the most highly regulated industries in South Africa, governed by 18 different national laws, and a plethora of regional and municipal by-laws.

While the sheer number of laws that apply testifies to how dangerous medical waste is, and how complex and difficult it can be to dispose of, it is also in and of itself a problem. If each municipality and each province has slightly different laws, it creates an absolute warren of loopholes for unscrupulous medical-waste companies to exploit.

Attempts at reforming the industry have been slow, and fraught with politicking.

The medical-waste branch of the Institute of Waste Management of Southern Africa split in 2009, with a breakaway faction claiming that reforming the institute was impossible from within.

The group, which calls itself the African Medical Waste Association, took about one-fifth of the institute’s medical-waste members with it. Small, perhaps, but the association insists that only members with a clean record can join it.

The institute, meanwhile, has refused to recognise the breakaway faction, but has taken the rare step of suspending Waste Man — for the time being.

The good news is that the Green Scorpions are working — slowly, but methodically — to hold offenders to account.

And so are we.

Lionel Faull is an investigator with amaBhungane, the M&G Centre for Investigative Journalism.