The reality of hospital waste disposal and collection in a rural Nicaraguan town

Hello from from rainy Nicaragua!  

UVa has had several projects over the past few years in the rural municipality of Siuna. There was one a couple of years ago where a group of students built a garbage station at the local hospital to make the disposal of hospital waste safer, easier, and more convenient. My project during my brief two-week stay in Siuna would be to collect data and observe how much waste is generated by the hospital, what kind of waste it is, and how is that waste disposed of. And as I near the end of my stay, I can tell you that nothing is what I expected it to be. In fact almost all of my assumptions about what things were going to be like were proved false.

Siuna is a bustling little town that you can explore in about a day. Being in the large north east province of Nicaragua, the province is self-governed with little oversight by the main Sandinista government which governs the rest of Nicaragua. That said there is a more visible military force here since the town is very close to the border of Honduras where there was resistance activity during the Contra scandal where the U.S. funded Nicaraguan resistance back in the 80’s. While the town is not large the surrounding area is quite expansive with communities as far as 2 hours away still considered part of the municipality. Trash is visibly a large problem in town as there is only garbage truck and lots of trash is either thrown in the streets or creeks and rivers nearby.

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Morning in Siuna

The hospital here was quite surprising as well. It was a collection of about 5 or 6 one story building all brightly painted in blue, green, or pink and lined with palm and coconut trees. These buildings house administration, the visiting/registration center, the sick wards, kitchens, and a couple others I never learned about. There is also a garbage disposal area, and incinerator. What I quickly learned however is that things in Siuna are very unpredictable. My meeting with the hospital administrators was moved back several days once I arrived in Siuna giving me free time to explore the city and the surrounding communities. Next the hospital administrator with whom the project was previously explained had been moved to another position so I had to meet with a new hospital administrator to explain the project again so I could have access to the disposal area. Once I was given permission I quickly found out that much of the trash was not being disposed of correctly. Almost all of the hospital trash including gauzes, bandages, and used medical bags were mixed in with regular waste making it impossible for me to measure how much of each category they were generating. While the more dangerous hospital waste was to be put in the incinerator. I found that vultures had found their way into the incinerator and thrown trash everywhere. Finally, the garbage trucks schedule was just as unpredictable leaving me waiting for half a day before giving up.

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The Siuna Hospital just inside the entrance

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The new garbage station

All these challenges required unique solutions to make sure I can collect as much data as possible in a safe manner. My complete lack of Spanish is another challenge and while I am learning as much as possible I still rely heavily on a translator who is extremely helpful.  Everyday can bring its own unique challenges to overcome and I have learned quite a bit about learning to expect the unexpected. I guess that sort of chaos is just part of the whole learning experience!

Take Care everyone,

Serge

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