The Isipingo Declaration
on eliminating the harmful impacts of Health Care Waste and Incinerators
in Southern African communities
Monday, April 8, 2002
We, the under-mentioned Southern African organisations represented at
the National Civil Society Workshop on Health Care Waste and Incineration
held in Isipingo, South Durban, South Africa, from April 5-8, 2002 make
this declaration:
Noting the following challenges to the safer management of health
care waste:
· The large percentage of health
care waste which goes unaccounted for;
· The frequency of illegal
dumping of health care waste on general landfill sites, unregistered dumps
and open plots of land, exposing the public and especially children to
harmful health threatening diseases;
· The lack of separation occurring
in SA health care facilities leading to infectious waste, pharmaceutical
waste and general waste being mixed together;
· The amount of state money
which hospitals pay to private companies to remove and incinerate the
hospital waste which can be excessive;
· The continued use of mercury
in health care facilities, e.g. in thermometers, blood pressure cuffs,
dental procedures and medicines;
· The use of IV bags containing
PVC and other PVC containing products in health care facilities;
· The inadequate contracts
which exist between the relevant government departments responsible for
health care waste and private waste contractors;
And noting the following challenges to waste incineration:
· That our governments’ have
signed the United Nations Stockholm Convention on Persistent Organic Pollutants
(POPs) which seeks to eliminate certain pollutants including those which
are formed during waste incineration processes;
· That the Stockholm Convention
names incineration processes as one of the processes which leads to the
formation of new POPs;
· That the more than 130 countries
who have signed the Stockholm Convention recognise the need to investigate
and promote safer, non-combustion processes for decontaminating waste;
· That there is a growing move
in both Northern and Southern countries towards the banning of incineration;
· That ALL incinerators are
polluting – no incinerator is able to achieve 100% Destruction Reduction
Efficiency;
· That waste incinerators emit
over 100 different chemical pollutants including dioxins, furans, mercury
and other heavy metals;
· That very serious health
effects are associated with exposure to incineration pollution, including
cancers, birth defects, lowered sperm count, compromised immune systems,
still births, learning problems and even death;
· That dioxins have been described
as “the most toxic chemical known”, and that there is no safe exposure
limit for dioxins – exposure to even miniscule amounts of dioxins can
have adverse health effects;
· That the US EPA has found
that as many as 1 in 5 cancers in the USA could be attributed to dioxin
exposure;
· That the USA EPA has found
that waste incineration is the main source of dioxin pollution;
· That incineration competes
and undermines waste minimisation and waste reduction practices;
· That incinerators require
vast capital investment and other resources but do not lead to significant
sustainable job creation or significant revenue for local economies;
We call on our Governments to:
· Fulfil their obligations
to the Stockholm Convention by taking the necessary steps to ratify the
Convention, by putting in place action plans and time frames for the phasing
out and eventual elimination of dioxins and furans, and by compiling an
inventory of all POPs sources and stockpiles;
· Seek to implement integrated
waste management systems which promote waste minimisation followed by
waste prevention, recycling and re-use;
· By 2006, to have closed down
and dismantled all waste incinerators and replaced them with alternative,
non-combustion technology, such as autoclaves and sterilizers;
· Ban the construction of new
waste incinerators;
· Introduce legally enforceable
standards for the safe establishment, operation and decommissioning of
treatment facilities.
· Establish effective monitoring
and enforcement mechanisms for waste regulations.
· By 2006 to have phased out
the use of mercury and PVC in all health care institutions;
· Develop national guidelines
for the safe management of health care waste;
· Allocate increased funding
to the relevant departments of health for the purposes of implementing
these guidelines, education and awareness;
· Provide education and awareness
for all health care workers on safe health care waste management, particularly
on the need to sort and separate;
· Develop and maintain strict
tracking systems of health care waste from point of generation to final
disposal;
· Be proactive in the resolution
of health care waste problems that health care institutions face;
· Prescribe procurement practices
for health care facilities that would ensure that unnecessary pollutants
do not enter the facilities (eg. Excess plastic packaging, mercury-containing
products etc);
· Review and reassess contracts
between private waste contractors and government departments responsible
for dealing with health care waste;
· Develop mechanisms to ensure
that private practitioners, small health care operators and rural health
care facilities are registered and are following the necessary legal requirement
in dealing with health care waste;
· Establish regional (district)
advisory forums to deal with health care waste, particularly for rural
facilities;
· Develop an independent standards
and authorities directorate/agency to monitor the procurement of health
care waste equipment and resources.
· Governments to work together
to establish common standards and norms to deal with health care waste.
· Government will not import
and/or export waste and damaging technologies to deal with waste.
Adopted by:
Anti Incineration Alliance (AIA)
Earthlife Africa (Johannesburg)
Edendale Hospital
Environmental Justice Networking Forum (Western Cape and KwaZulu-Natal)
Fairest Cape Association
Global Anti Incineration Alliance (GAIA)
groundWork
Livaningo (Mozambique)
Ngwelezane Hospital
Sasolburg Environmental Committee (SEC)
South Durban Community Environmental Alliance (SDCEA)
Wentworth Hospital
Wildlife and Environment Society of South Africa (WESSA)
Yonge Nawe (Swaziland)
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