Auditor General exposes lax waste management across hospitals

Nov 08, 2022 News

Kaieteur News – An audit into the management of healthcare waste at five main hospitals in the country was conducted between the period January 2017 and July 2019, found lax measures to properly store and dispose of the waste.

The used syringes and needles in plastic bottles with original labels that was highlighted in the report which was found at the Georgetown Public Hospital Corporation. (Photo: Audit Office of Guyana)

The five health institutions that the audit examined were: West Demerara Regional Hospital, Georgetown Public Hospital Corporation, Diamond Diagnostic Centre, New Amsterdam Regional Hospital and Linden Hospital Complex.

The Auditor General (AG), Mr. Deodat Sharma reported that the reason for the Performance Audit was to focus on whether these hospitals managed healthcare waste efficiently and effectively to mitigate health and environmental risks. He noted in his report that the audit is important because Guyanese need assurance that hospitals have managed healthcare waste and that the findings of the report may help other health facilities better manage their waste as well.

According to the audit findings, at these main health institutions, sharps containers with infectious waste were everywhere and that inadequate storage space and poor storage practices resulted in large amounts of sharps containers and boxes stowed haphazardly at these hospitals. Sharps containers with untreated infectious waste were also found to be stock-piled for months in rooms and hospital compounds, the report noted.

On the issue of sharps containers, the audit found also that the containers were not puncture-proof. “Used syringes and needles were in plastic soda bottles used as sharps containers. We found this practice when hospitals were out of stock of the required containers. For example, the Georgetown Public Hospital Corporation used Coca-Cola bottles with original labels to collect sharps waste,” the report stated.

The bottles, the report made mentioned of were not labeled and sealed to prevent persons from removing the used syringes and needles and as a result, the used syringes and needles were easily accessible to persons, which could have resulted in theft and infections if used. Another finding was equipment to protect employees, which was not always available. The Audit Report stated that prolonged stock-outs caused by shortages or short supplies led to personal protective equipment being unavailable to waste handlers. Waste handlers, the Auditor General found, wore part and sometimes none of the personal protective equipment when executing their duties. “Management’s failure to monitor waste handling activities resulted in waste handlers’ exposure to infections,” the AG highlighted.

Sharps boxes & containers stored in and out of incinerator room at the West Demerara Hospital. (Photo: Audit Office of Guyana)

Another significant finding, the audit found was that waste was being dumped on the floor after treatment. “We found that this unsatisfactory situation at the Georgetown Public Hospital Corporation was because the shredder and belt of the autoclave were out of order. The machine was not working at capacity, which caused containers of untreated waste to accumulate, resulting in health and environmental risks to waste handlers,” the report explained.

Sharma noted in his Performance Report that policies and plans at these hospitals were not established to efficiently and effectively manage waste activities, resulting in a lack of coordination among officials. “The absence of waste collection schedules and monitoring at each hospital led to ad hoc collection patterns which put at risk the health of patients and workers. Poor segregation systems resulted in injuries to workers from sharps in bags. The audit work was repeatedly delayed because hospitals did not provide requested documents and did not always respond to the audit findings,” the report explained.

With the findings highlighted, the Audit Office noted that 18 recommendations were made to deal with the causes of lax waste management by establishing and implementing national and hospital policies, monitoring all activities, using recommended containers and bags, and reviewing the collection and storage of waste. These recommendations should be addressed urgently in the short term, the Auditor General stated.