D5.3 Medical Waste Management Guidelines - Policy Brief

This document is a deliverable of the WORM Project, funded under the European Union’s Horizon Europe research and innovation programme under the grant agreement No 101135392. The WORM WP5 Guidelines offer a comprehensive framework for improving waste management in humanitarian field hospitals by embedding sustainability and operational coherence into emergency medical missions. Developed under the Horizon Europe-funded WORM project, the guidelines advocate for an Integral Waste Management (IWM) approach that aligns waste reduction, risk mitigation, and environmental stewardship with core humanitarian principles.

The document emphasizes that waste management should not be treated as an isolated technical task but as a shared responsibility integrated across all functional areas—from procurement and logistics to clinical care and WASH (water, sanitation, and hygiene). Field hospitals, especially in conflict or postdisaster zones, generate significant amounts of waste, including hazardous medical waste, in settings with minimal or non-existent infrastructure. Improper handling, such as mixing infectious and non-infectious waste, leads to elevated health risks and environmental harm.

To address this, WORM outlines a three-phase model:
1. Planning involves estimating waste types and quantities, anticipating local constraints, mapping local waste infrastructure and actors, and drafting a waste management plan using risk-based segregation and treatment methods.
2. Preparation focuses on installing infrastructure (color-coded bins, reminder posters), designating waste storage areas, and conducting training to embed daily waste management routines.
3. Execution operationalizes waste cycles from segregation to treatment and disposal. It includes daily monitoring, adaptive management in response to workload shifts or new risks, and an exit strategy that ensures continuity and safe closure.

The guidelines offer practical tools, such as waste stream classification tables, treatment decision trees, pre-packed waste kits, visual training materials, and monitoring checklists. Specific recommendations target common weaknesses: overuse of single-use items, inadequate staff training, reliance on PVC materials, and lack of coordination across agencies. The document concludes with strategic calls to action:
• Make waste management a mission-critical function;
• Train and involve all staff;
• Strengthen procurement practices by avoiding PVC and promoting reusable items;
• Build international-level support units with mobile treatment capabilities

The overarching goal is to ensure that waste is managed safely, sustainably, and efficiently supporting both health outcomes and the humanitarian sector’s commitment to "Do No Harm."