Out of order: Careless disposal of masks poses new threat

An environmental crisis looms and, as per usual, people are to blame. But, this time around Covid-19 is giving them all the help they need.

Covid-19 has changed the world, quite literally, with masks becoming part of people’s attire. In the picture, are other personal protective equipment (PPEs) such as gloves, face shields, protective goggles, hazmat suits and hand sanitisers. These are all meant to check the spread of the virus by protecting people. Ironically, they have also become the new destroyers of the environment and disease avenue.

Everywhere you go, especially in cities and towns, you spot a face mask, a hand sanitiser bottle or gloves carelessly disposed of. This is a stark reminder of the current battle in a new world where walking in public without a face mask is considered a crime, and coughing or sneezing are frowned upon.

As if Kenya was not already in enough trouble when it came to disposal of medical waste, Covid-19 presents a new nightmare. Dumpsites in Nairobi and other major cities across the country tell a story of a struggle not only against an invisible enemy, but also medical waste.

TONNES OF MASKS

While the current change in social interactions and the way people do business might be the most uncomfortable thing for most people, conservationists have raised the alarm on another disturbing situation also attributed to the coronavirus. 

With millions of face masks and PPEs improperly disposed of daily, experts have warned that the effects of this trend will be felt for many years to come. “The situation is worrying because of the massive use of PPEs. We have a challenge with medical waste especially because some sub-county hospitals do not have incinerators,” the newly-appointed National Environment Management Authority (Nema) Director-General Mamo Boru told HealthyNation.

The situation is especially bad in Nairobi, Mombasa, Kajiado and Nyeri, where cases of Covid-19 are many, he added. In Kajiado, the problem is especially pronounced in Kitengela, Ongata Rongai and Ngong.

Since Covid-19 was first reported in China, several tonnes of face masks and other forms of PPEs have been dumped into the environment after use.

Surgical masks, the most visible weapon in the war against the virus, are single-use, meaning they are disposed of frequently. These masks are the most commonly dumped in open areas and have drawn the attention of conservationists.

These masks are non-biodegradable, and will remain in the environment for a very long time to come, considering their production includes the use of plastics. This will deal a blow to the government’s step in banning single-use plastic bags, as well as single-use plastic bottles and straws in national parks, beaches, forests and other protected areas.

TICKING TIME BOMB

Considering that Kenya has a population of 47 million, and wearing of masks in public places is mandatory, this is a ticking time bomb as was recently depicted by Health Chief Administrative Secretary Rashid Aman.

Not only are the dumped masks an eyesore, they may spread Covid-19, said Dr Aman.

Masks and PPEs are needed not only by healthcare providers, but also thousands of caregivers in home-based care and isolation. The caregivers also have to use latex gloves and other single-use PPEs.

Data by Gilbert Atuga, a research scientist at Kenya Marine and Fisheries Research Institute (KMFRI), showed that 23.8 million disposable masks are being used daily in the country. This means that 714 million masks are being used per month. Considering cases were first reported in March, this amounts to several tonnes of plastics.

“If we assume that only one per cent of face masks is not correctly disposed of, then 7.1 million masks are likely to end up on land monthly, with a bigger percentage in rivers and the ocean, mainly during storm water runoff,” said Atuga, the team leader at KMFRI’s macroplatics research group.
And things are about to get worse as masks are now being discarded in markets, by roads, on sidewalks, in railway and matatu stations, parks and construction sites, said Dr Aman.

If not collected and disposed of properly, the masks will clog drainage systems and lead to flooding during rainy seasons while several tonnes will end up in the rivers and the ocean or lakes. It is estimated that every year, some 13 million metric tonnes of plastics enter the oceans. Currently, around 150 million metric tonnes of plastics circulate in the marine environments. The World Economic Forum estimates that by 2050 “there will be more plastics in the ocean than fish”.

GARBAGE COLLECTORS

According to the World Wildlife Fund, plastic pollution is projected to double in the next 10 years, and the coronavirus pandemic has made a bad situation worse. “From preliminary information, some divers are seeing these PPEs at the bottom of the seabed,” said Atuga.

This will have a devastating impact on marine life because animals may mistake the plastics for food. The waste will have a ripple effect on biodiversity, said the researcher.

This is not the only problem. Atuga said the situation has been made worse by garbage collectors and recyclers, who fear getting infected with Covid-19 while handling waste and end up dumping it in open places.

Apart from being consumed by marine animals, the waste covers coral reefs and smothers them. These reefs are precious fish habitats and breeding grounds, and their degradation affects fish stocks, posing a threat to food security.

Coral reefs are also aesthetic and their destruction affects tourism. “The problem is exacerbated further by a lack of proper waste management systems in most counties,” Atuga said. 

According to him, the problem needs to be addressed from the source. “The waste is unique and should be recognised as an emerging problem amid the Covid-19 pandemic,” he said.

BLUE ECONOMY

The threat to aquatic life will consequently affect the Blue Economy, and will be the greatest undoing since Kenya started a campaign to ban plastic pollution in September 2017. “As an authority, we gave out a national guideline in collaboration with the Ministry of Health because we found out that many people were not properly disposing of this biomedical waste,” said Nema’s Mamo.

Nema’s concern is that the waste poses a health hazard as it is an avenue for the spread of Covid-19 among other diseases. “We also established that the waste could lead to a new stream of infections because it is biohazard,” said the director-general.

As such, the environment watchdog, in collaboration with county governments, Kenya Alliance of Residents Associations and Nyumba Kumi initiative, is currently mapping the most polluted areas and sensitising people against improper disposal.

The agency has been mapping the areas where open disposal of medical waste happens across the country for the past one month, so as to enforce the said guidelines.

Also involved in monitoring of the littering of medical waste is the Directorate of Criminal Investigations and Interpol.

YELLOW-CODED BAGS

According to Nema guidelines, to keep the environment clean and avoid disease spread, medical waste should be incinerated. “We are implementing the Waste Management Regulation of 2006 that addresses the issue of biomedical waste,”  said Mamo.

The national guidelines have been sent to all county directors of environment. “Counties should also provide yellow-coded bags for disposal of biomedical wastes,” he said.

The bags are supposed to be picked by county garbage collectors and taken to health facilities for incineration. Currently, the yellow-coded bags are being distributed by municipal garbage collectors. Distribution of the yellow-coded bags will soon be done at household level alongside the black paper bags, so that masks and PPEs can be put separately from other home waste.

“How else should the waste be managed? If we do not do that, PPEs will continue being mixed with other kinds of waste when they should not be disposed of in the general waste sites,” Mamo told HealthyNation.

To ensure compliance, Nema says it will deploy inspectors to monitor disposal and burning of waste. “The challenge we have at the home level is waste segregation. Kenyans have a very poor attitude towards the environment and do not do segregation of waste at household level,” he said.

The agency is working with Nyumba Kumi leaders to ensure that people get the relevant information on waste segregation at home level. “We have also asked the county governments to train the collectors on handling of biomedical waste,” says Mamo.

FEW INCINERATORS

Unfortunately, garbage collection is privatised in many urban areas, which may hinder distribution of the yellow-coded bags. “Even before Covid-19, we had a challenge of medical waste disposal because we have very few incinerators countrywide. The challenge is that heath centres do not have incinerators,” said the director-general. “We ask governors to make a provision for incineration in all health facilities.”

Speaking on the same issue, Dr Aman cautioned Kenyans against burning such waste in open-air places because it is “both risky and pollutes the environment”.

The experts want Kenyans to take personal responsibility on waste disposal.