By Swaliha Shanavas

There is a need for a sustainable business approach to facilities management (FM) and one cannot emphasize enough this fact when it comes to healthcare FM. Providing sustainable facilities management solutions within hospitals and other healthcare facilities would help achieve multi-million dollar savings through efficient energy, water and waste management practices, says Markus Oberlin, CEO of Farnek. Though these buildings operate like any other, healthcare facilities need specialist health and safety, cleaning and waste management solutions. Energy savings in hospitals can be made through the reduction in carbon emissions – in many cases electricity bills can be slashed by 15 percent with the implementation and monitoring of A/C modules, therefore becoming more cost efficient, he notes. Another vital area is medical waste. Hospitals, clinics and pharmacies in Dubai produce about six tons of medical waste every day, or 120 tons per month. Research by Johns Hopkins Medicine highlighted the multi-million dollar savings, hospitals can make by incorporating sustainable practices such as reducing waste. The UAE has introduced various waste management initiatives in recent years. Dubai for instance, has set a target of zero landfill waste by 2030, which is challenging, especially when you consider that in 2013 Dubai sent 2.6 million tons of waste to landfill of which an estimated 15-25 percent was medical-related waste such as glass and laboratory equipment, says Oberlin. Dubai Municipality is also contemplating increasing its landfill fees. “Moreover, due to the HSE issues surrounding medical waste, hospitals can be fined as much as AED 200,000 for failing to handle and segregate their waste prior to collection. By outsourcing waste management, hospitals in the UAE can let expert facility managers take on the responsibility for optimising waste segregation and promoting a reduce, reuse and recycle philosophy to ultimately cut down the overall amount of waste generated, as well as ensuring hazardous waste is treated responsibly,” he remarks. Their operational audit team highlights the areas where improvements can be made to essentially reduce the volume of waste generated that would ordinarily go to landfill, he states. “We also offer advice on responsible disposing and how to segregate waste efficiently, maximising the amount of cash rebates available from the companies that pick-up and dispose of waste.” Touching upon the major risks associated with waste management in a healthcare facility and the importance of proper waste management in making the operations safe, the CEO says the main risk involves the actual handling of medical waste. “Medical waste requires due care and caution not only in its handling but also in its specialised disposal. This is critical to ensure there is no risk of contamination at any stage given that almost all of the medical waste is infectious. If healthcare waste is not managed properly it proves to be harmful to the environment. It not only poses a threat to the employees working in the hospital, but also to local residents.” So, what amount of medical waste is being generated in the UAE and how is it being dealt with by the healthcare sector at present? “According to the UAE National Bureau of Statistics, the UAE generated 5,905 tonnes of medical waste in 2014. Dubai alone produced 2,632 tonnes of medical waste in 2014,” says Oberlin. In 2009, the first of its kind incinerator for medical waste was commissioned in Jebel Ali. It employs the world’s latest vertical incineration technology; with the best emission norms to decompose medical waste through thermal incineration. The incinerator has a capacity of incinerating medical waste of 19.2 tonnes daily. Specialised waste management companies are contracted by healthcare facilities to collect medical waste and deliver it to the facility for treatment, he explains. With regard to the key challenges faced by hospitals in dealing with medical waste, Oberlin opines that “in general, lack of awareness about the health hazards related to healthcare waste, inadequate training in proper waste management and the absence of proper waste management and disposal systems are the most common problems connected with healthcare waste.” A popular solution, he says, is to train the employees on the importance of segregation and on methods to separate different types of medical waste in the safest possible manner – i.e., those acceptable to the prevailing authority. “It is also advisable to engage with a cleaning/FM partner who understands and manages waste efficiently at all operational levels (not just at the collection point), who can appoint a professional waste collection company, while also providing vital waste management analysis and consultancy,” he remarks. There are also directives that stipulate proper segregation and treatment of medical waste in the emirates. The transport and disposal of the same “is strictly regulated in accordance with Local Order 115 of 1997 for the Management of Medical Waste in the Emirate of Dubai,” he notes. All medical waste must be deposited directly by doctors and nursing staff into yellow bags or sharps boxes. The storage area for the waste awaiting collection, if outside the hospital/clinic must be secure and lockable. The storage area should be air-conditioned or chilled depending on the expected time period over which the waste is to be stored. More importantly, hospitals in Dubai can be fined heavily if they are found to be bypassing the regulations for handling, segregating and storing waste, says Oberlin. The collection of medical waste is undertaken by vehicles fitted with temperature-controlled equipment; the vans are maintained at a temperature between 18 and 20 degrees Celsius and drivers have to undergo various vaccinations such as hepatitis B. Speaking from experience with this sector, in Farnek’s capacity not only as FM company but also as auditing agency, the CEO says the existing regulations in the UAE for managing medical waste and stiff penalties for violators do ensure that a majority of heathcare facilities follow the correct procedures. However, in his view, “many facilities in the UAE could still segregate waste into a number of additional waste types than they currently do, which in turn could enable them to benefit from rebates from their waste collection companies.” The categories include hazardous waste, plastics, carton and paper scrap, all of which are not directly related to the actual care of the patient, but mostly to those visiting patients or general operational waste. He advises that it is important for FM companies servicing this sector to familiarise themselves with the existing legislation and requirements of the emirate they are operating in. Staff training and education about the proper management and handling of medical waste is also of significance, he adds. “Healthcare facilities will have strict procedures in place for handling medical waste and FM companies should work with the operators and management to ensure these procedures are adhered to.” the CEO underlines.