title: An innovative national health care waste management system in Kyrgyzstan.
abstract: A novel low-cost health care waste management system was implemented in all rural hospitals in Kyrgyzstan. The components of the Kyrgyz model include mechanical needle removers, segregation using autoclavable containers, safe transport and storage, autoclave treatment, documentation, recycling of sterilized plastic and metal parts, cement pits for anatomical waste, composting of garden wastes, training, equipment maintenance, and management by safety and quality committees. The gravity-displacement autoclaves were fitted with filters to remove pathogens from the air exhaust. Operating parameters for the autoclaves were determined by thermal and biological tests. A hospital survey showed an average 33% annual cost savings compared to previous costs for waste management. All general hospitals with >25 beds except in the capital Bishkek use the new system, corresponding to 67.3% of all hospital beds. The investment amounted to US$0.61 per capita covered. Acceptance of the new system by the staff, cost savings, revenues from recycled materials, documented improvements in occupational safety, capacity building, and institutionalization enhance the sustainability of the Kyrgyz health care waste management system.
authors: Health Care Waste Management Project, financed by the Swiss Agency for Development and Cooperation (SDC) and implemented by the Swiss Red Cross, Bishkek, Kyrgyz Republic nurjan.toktobaev@gmail.com.
authors: Nurjan
authors: N
authors: Toktobaev
authors: E & ER Group, Hercules, CA, USA.
authors: Jorge
authors: J
authors: Emmanuel
authors: Republican Centre for Infection Control, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan.
authors: Gulmira
authors: G
authors: Djumalieva
authors: Republican Centre for Infection Control, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan.
authors: Alexei
authors: A
authors: Kravtsov
authors: Health Care Waste Management Project, financed by the Swiss Agency for Development and Cooperation (SDC) and implemented by the Swiss Red Cross, Bishkek, Kyrgyz Republic.
authors: Tobias
authors: T
authors: Schüth
mesh_terms: D003365:Costs and Cost Analysis; D006780:Hospitals, Rural; D007707:Kyrgyzstan; D017744:Medical Waste Disposal / Q000191:economics / Q000379:methods*; D059027:Recycling / Q000191:economics
chemical_list: D017744:Medical Waste Disposal
keywords: Hospital/medical waste; Kyrgyzstan; autoclave treatment; cost survey; recycling; sustainable healthcare waste management