Environmental and Human Health Problems Associated with Hospital Wastewater Management in Zimbabwe.

PURPOSE OF THE REVIEW: Wastewater is a term used to describe water that has undergone degradation in quality owing to anthropogenic activities or natural processes. Wastewater encompasses liquid waste originating from academic institutions, households, agricultural sector, industries, mines and hospitals. Hospital wastewater contains potentially hazardous substances including residues of pharmaceuticals, radioisotopes, detergents and pathogens, with detrimental impacts to the environment and human health. Nevertheless, studies related to hospital waste management are limited in Africa, particularly in Southern Africa. This research offers an overview of aspects surrounding hospital wastewater in Southern Africa, focusing on Zimbabwe. Already published and grey literature was reviewed to compile the paper. RECENT FINDINGS: Number of patients, nature of medical services offered and hospital size influences generation of hospital wastewater. Partially and non-treated hospital wastewater is managed together with municipal wastewater. Management of hospital wastewater is impeded by shortage of resources, lack of co-ordination among responsible authorities and ineffective legal framework enforcement, among other challenges. Inappropriate hospital wastewater management results in environmental contamination, causing human ailments. Attainment of sustainable hospital wastewater management requires clearly defined and enforced legislation, collaboration of accountable stakeholders, sufficient resources and enhanced awareness of involved stakeholders. Application of technologies that uphold recycling and reuse of wastewater is essential to reach Sustainable Development Goals, Zimbabwe Vision 2030 and National Development Strategy 1 targets, particularly those dealing with environmental protection while upholding human health.

A review towards developing a hierarchical model for sustainable hospital solid waste management in rural areas of Zimbabwe.

Management of solid waste from rural hospitals is amongst problems affecting Zimbabwe due to diseases, population, and hospital increase. Solid waste from rural hospitals is receiving little attention translating to environmental health problems. Therefore, 101 secondary sources were used to write a paper aiming to proffer a hierarchical model to achieve sustainable solid waste management at rural hospitals. Rural hospitals' solid waste encompasses electronic waste, sharps, pharmaceutical, pathological, radioactive, chemical, infectious, and general waste. General solid waste from rural hospitals is between 77.35 and 79% whilst hazardous waste is between 21 and 22.65%. Solid waste increase add burden to nearly incapacitated rural hospitals. Rural hospital solid waste management processes include storage, transportation, treatment methods like autoclaving and chlorination, waste reduction alternatives, and disposal. Disposal strategies involve open pits, open burning, dumping, and incineration. Rural hospital solid waste management is guided by legislation, policies, guidelines, and conventions. Effectiveness of legal framework is limited by economic and socio-political problems. Rural hospital solid waste management remain inappropriate causing environmental health risks. Developed hierarchical model can narrow the route to attain sustainable management of rural hospitals' solid waste. Proposed hierarchical model consists of five-layered strategies and acted as a guide for identifying and ranking approaches to manage rural hospitals' solid waste. Additionally, Zimbabwean government, Environmental Management Agency and Ministry of Health is recommended to collaborate to provide sufficient resources to rural hospitals whilst enforcing legal framework. Integration of all hierarchical model's elements is essential whereas all-stakeholder involvement and solid waste minimisation approaches are significant at rural hospitals.

Applicability of the Life Cycle Assessment Model in Solid Waste Management in Zimbabwe.

Solid waste increase is inevitable globally due to anthropogenic activities. This adds burden to waste management systems in developing countries including Zimbabwe. Currently, life cycle assessment (LCA) model is used to achieve sustainability and circular economy (CE) in solid waste management. Therefore, the main goal of this paper was to unearth LCA model applicability in solid waste management in Zimbabwe. Data sources were retrieved from databases like Scopus, ScienceDirect and Springer, although government documents were also used. In Zimbabwe, organic and inorganic solid waste is generated from various sources, namely industries, institutions and households. Solid waste management in Zimbabwe is based on traditional linear approach where waste is collected and disposed through landfilling, burning, incineration, burying, open pits or illegally. Most disposal approaches occupy base of waste management pyramid, hence posing detrimental impacts to human health, terrestrial, aquatic and atmospheric ecosystems. Management approaches are far from Agenda 21, Sustainable Development Goals (SDGs), Zimbabwe Vision 2030 and National Development Strategy 1 demands. Literature revealed that LCA model can be utilised to achieve sustainable solid waste management in countries like Zimbabwe. LCA model is essential in management of solid waste in Zimbabwe, since it assists decision makers in selecting management approaches with less environmental health impacts. Moreover, LCA enables application of waste material reuse, recycle, repairing and recovery, thus narrowing the gap to achieve CE and economic growth in Zimbabwe. Owing to LCA model implementation of waste management legislation and policies which support energy recovery and circular economy became easier in Zimbabwe.