When government decided to purchase bio-medical waste incinerators, the strategy was to effectively and safely dispose toxic substances that may be harmful to human health. However, the plan did not mature as expected. 

The Ministry of Health had initially spent about Rwf1.5 billion on supply and installation of incinerators in seven hospitals and Mageragere site, but the incinerators are either not in use, have broken down or are emitting toxic smoke that is dangerous to human health, the Auditor-General’s 2012/13 report indicates. 

Concerns

Besides the Mageragere bio-medical incinerator, incinerators at King Faisal Hospital Rwanda, Central University Teaching Hospital of Butare (CHUB), Kabaya, Munini, Kibirizi and Ntongwe hospitals had problems and were not working since installation. 

The Auditor-General expressed concerns about the incinerators and particularly said that they are emitting smoke that is dangerous to children and pregnant women. 

The head of Rwanda Health Communication Center (RHCC) in the Rwanda Biomedical Centre (RBC), Nathan Mugume, confirmed that the ministry is drawing up plans for proper management of the incinerators. 

"Just a few days before the findings of the Auditor-General, the Ministry of Health had, through our routine monitoring and evaluation, discovered the same concerns. As a solution to ensure that this does not happen again, we have put in place measures to handle the issue,” Mugume said. 

"We have signed contracts with districts  on proper use and follow up on the incinerators. We are finalising arrangements with a private entity that will manage the incinerators.”

However, Mugume did not divulge the private entity that would manage the incinerators.

Mageragere incineration plant 

AG Obadiah Biraro also lamented delays in the completion of Mageragere incineration plant, whose construction was not executed despite a Rwf363-million agreement signed in September 2011. 

"The incinerator equipment acquired from BIA South Africa at Rwf329,783,857 and supplied on May 19, 2011, had not been fully installed by the time of audit in January 2014,” reads the report. 

"Due to this delay, some parts supplied were damaged and the Ministry of Health incurred an additional Rwf8,819,131 to replace the damaged parts.” 

Incinerators at CHUB and King Faisal Hospital have been operational for a year, but pose a serious health and environmental hazards, the AG said. 

"Incinerators in the two hospitals emit heavy black smoke that is polluting the surrounding atmosphere. The emission of black smoke from the incinerators is a sign that the incinerator is either inadequate or is not being operated properly,” reads the report. 

"The continued unchecked emission of black unfiltered smoke from the incinerators pollutes the environment with substances such as dioxins, furans and mercury. These chemicals are known to be particularly toxic to children and pregnant women. 

"Incinerator emissions are also known to have the capability to spread hundreds of miles from the source as well as accumulate in water bodies and foodstuff.”

The hospitals 

The New Times was unable to access King Faisal Hospital incinerator yesterday as officials demanded an official written request for access and any other information. 

At CHUB, the head of technical services, Jean Claude Mwumvaneza, said the incinerator broke down on April 17, and attempts to repair it were futile. 

Currently, CHUB has a pile of bio-medical wastes that awaits disposal. 

"The incinerator was burning 50 kilogrammes of waste per hour. The part that got spoilt is the upper section (secondary chamber) that burns the smoke from the lower section to filter out toxic,” said Mwumvaneza. 

The AG had expressed concerns regarding the combustion temperatures used, saying they were below the required standards and that most of the incinerators are not equipped with filters that retain or significantly reduce the amount of smoke emitted from the chimney. 

A lot of medical waste being incinerated still contains a significant amount of plastics, the report says. 

The Director-General of Rwanda Environmental Management Authority, Dr Rose Mukankomeje, said she has previously intervened to stop some incinerators because of gas emissions. 

"I had a meeting with concerned authorities and they promised to workout a way of managing these incinerators,” Dr Mukankomeje said, declining to go into specifics of the hospitals.