Iraq News Now

Shafaq News/ Iraq is facing a critical issuewith the improper management of its medical waste, posing serious health risksand environmental threats. The failure to address this problem has led to agrowing public concern and has worsened the health of communities across thecountry.

According to the World Health Organization’s2023 report on health system challenges in Iraq, the country's medical wastemanagement remains inadequate, largely due to limited resources, politicalinstability, and an overburdened healthcare system.

Abu Ghraib Hospital: A Health Crisis

One glaring example of Iraq's struggles withmedical waste management is Abu Ghraib General Hospital, located west ofBaghdad. This hospital, like many others in Iraq, has adopted a dangerous andenvironmentally hazardous practice of burning medical waste in open pits. Theburning takes place in the heart of a residential neighborhood, directlyaffecting local communities.

From 5:00 p.m. until the early hours of themorning, toxic fumes pour into the air, exposing residents to dangerouspollutants such as dioxins and furans, which are carcinogenic and havelong-term health consequences.

According to witnesses, toxic gas emissions fromAbu Ghraib General Hospital have caused some residents to flee the area.

Activist Jamal Al-Tai shared the alarming impactof these emissions, "These toxic fumes affect those with chronic illnessesand the general population in the area, to the extent that residents are unableto go outside due to the smoke. The incinerator is positioned right in themiddle of a residential neighborhood".

In response to these concerns, the IraqiMinistry of Environment issued Instruction No. 3 in 2015, mandating the propersegregation, collection, and disposal of medical waste. This includes theisolation of hazardous waste from other materials, proper processing, anddisposal at specialized facilities like high-temperature incinerators. However,as demonstrated by the Abu Ghraib situation, these guidelines are not alwaysfollowed, particularly in hospitals with limited resources or lack ofinfrastructure, as noted in a 2015 review by the Iraqi Ministry of Environment.

Nature And Classification Of Medical Waste

Medical waste is divided into two primarycategories: liquid and solid waste. Liquid waste includes materials such aslaboratory water, fixatives, and diagnostic chemicals, all of which must betreated before being discharged into sewage systems to prevent contamination.

Solid waste is further divided into regular andhazardous types:

• Regularwaste: Non-hazardous items like paper, packaging, and plastic, managed throughstandard disposal practices.

• Hazardouswaste: Includes potentially infectious materials, sharps (such as needles andscalpels), pharmaceutical residues, chemical agents, and radioactive waste, allof which require specific treatment methods to prevent contamination and healthrisks.

According to Louay Al-Mukhtar, spokesperson forIraq’s Ministry of Environment, healthcare waste is legally recognized as aseparate category that demands meticulous management based on its nature andrisk.

Al-Mukhtar emphasized, "Any human activityproduces types of waste that have characteristics related to that activity.Medical waste, or 'healthcare facility waste,' is a special category that requirescareful management according to its nature," as reported to Shafaq News.He also explained that hazardous medical waste requires specific treatmentmethods, including high-temperature incineration, autoclaving (steamsterilization), and microwave sterilization to safely neutralize the materials.

In Iraq, the treatment methods for hazardousmedical waste are often less advanced compared to those used in many developednations. For instance, while many hospitals around the world rely onhigh-temperature incinerators that burn medical waste at temperatures exceeding1000°C, Iraq still faces significant challenges in implementing suchtechnology. Instead, many healthcare facilities in Iraq resort to burning wastein open pits or using outdated incinerators, which can release harmfulemissions like dioxins and furans, substances that are linked to cancer andother long-term health issues. This method is not only inefficient but alsoenvironmentally damaging, as toxic smoke affects nearby communities.

Many other methods are also applied globally,yet not in Iraq. Along with the high-tech incinerators already mentioned,autoclaves and other chemical treatments are proven to be effective.

For example, in Europe and North America, wasteis often segregated at the point of origin into categories like sharps,pharmaceutical waste, and biohazardous materials. These items are then treatedaccording to their specific risk level. Autoclaving, which uses high-pressuresteam to sterilize waste, is commonly employed for biohazardous waste, whilepharmaceutical waste and sharps are typically incinerated at very hightemperatures to ensure the destruction of harmful agents. These methods preventthe release of toxic substances into the environment and protect public health.

In contrast, Iraq’s medical waste managementsystem lacks the infrastructure and resources to implement these global bestpractices. Although the Ministry of Environment has issued guidelines on wastesegregation and disposal, including the use of designated containers forhazardous waste and the construction of specialized treatment units, thecountry's hospitals often lack the required technology and trained personnel tofollow these protocols effectively.

Al-Mukhtar’s statement on the importance ofspecialized bags, containers, and trained staff underscores the difficulty Iraqfaces in addressing these issues. "Each category requires specific bagsand containers for collection, and it is essential to have an administrativestructure and trained personnel in every healthcare institution," he said,referring to the Ministry's 2024 guidelines.

Ultimately, the gap between Iraq’s medical wastemanagement practices and those followed in more developed countries highlightsthe urgent need for investment in waste treatment technologies, staff training,and better infrastructure to protect both public health and the environment.

Impact Of Medical Waste In Iraq

Iraq generates approximately 0.5 kilograms ofmedical waste per capita daily, as estimated by the Iraqi Ministry of Health,which is significantly higher than the global average of 0.3 kilograms incountries with comparable healthcare infrastructure. However, the absence ofeffective waste management systems means much of this waste is mishandled,leading to widespread contamination, particularly in urban centers like Baghdadand Basra.

• Healthrisks to humans: Healthcare workers, waste handlers, and residents living nearhealthcare facilities are at constant risk of exposure to infectious materialsand hazardous chemicals. The World Health Organization (WHO) reported that 32%of healthcare workers in Iraq experienced needle stick injuries or exposure tocontaminated waste materials in 2023, compared to the global average of 18% inlow-income countries. This elevated risk creates a substantial threat ofdisease transmission, including HIV, Hepatitis B, and Tuberculosis.

A healthcare worker in Baghdad interviewed bythe WHO stated, "We handle medical waste with limited protectiveequipment, exposing us to infections daily. The system urgently needsreform."

• Environmentaldegradation: Improper disposal practices significantly harm Iraq's environment.Hazardous waste, including pharmaceutical residues, heavy metals, and toxicchemicals, often seeps into soil and groundwater supplies. The Iraqi Ministryof Environment's 2024 report revealed that 25% of groundwater samples nearhealthcare facilities in Baghdad and Basra contained detectable levels ofpharmaceutical contaminants, including antibiotics and cytotoxic drugs. Inrural areas, these contaminants threaten agricultural productivity and foodsecurity. Additionally, the open burning of medical waste releases dioxins andfurans, both classified as carcinogenic by the WHO, further polluting the airand contributing to higher rates of respiratory illnesses.

• Publichealth crisis: Iraq’s fragile healthcare infrastructure exacerbates the dangersposed by improper medical waste disposal. According to the WHO's Global PublicHealth Report (2023), over 5.2 million deaths annually worldwide are linked toinadequate medical waste management, and Iraq is disproportionately affected.Communities near dumping sites report a 45% higher incidence of respiratoryillnesses and gastrointestinal diseases compared to those living further away,as detailed in a 2023 study by the Iraqi Red Crescent.

One resident from Al-Sadr City, where untreatedwaste is routinely dumped, lamented, "Our children are always sick becauseof the waste. We are surrounded by contamination, and no one helps us."

• Vulnerablepopulations: The burden of improper medical waste management disproportionatelyaffects vulnerable populations, including children, the elderly, andindividuals with chronic conditions. According to a 2023 UNICEF report,children living within 1 kilometer of open medical waste dumping sites in urbanareas such as Al-Sadr City are 70% more likely to suffer from developmentaldisorders due to prolonged exposure to contaminated air, water, and soil. Inrural regions, the elderly and immunocompromised individuals face elevatedrisks of respiratory diseases caused by toxins released from burning waste.

Governmental And Non-Governmental Efforts

Efforts to tackle Iraq’s medical wastemanagement crisis have involved both governmental and non-governmentalorganizations (NGOs). While some progress has been made, challenges likepolitical instability, resource shortages, and inconsistent enforcement havehindered substantial improvements.

The Iraqi government has implemented severalinitiatives aimed at addressing the medical waste crisis, led by the Ministryof Environment and the Ministry of Health. Instruction No. 3, issued by theMinistry of Environment, outlines procedures for waste segregation, collection,transportation, and disposal, marking a step toward formalizing wastemanagement standards. Additionally, the Ministry of Health, in partnership withthe United Nations Development Programme (UNDP), secured a $25 millioninvestment in 2023 to establish specialized incinerators and medical wastetreatment units in urban areas.

However, progress has been uneven. According tothe UNDP's 2024 report on Iraq's health infrastructure, only 25% of hospitalsin Iraq have been equipped with modernized waste disposal systems. Many facilitiesstill rely on outdated practices, such as open burning or uncontrolled dumping,which exacerbate environmental and health risks.

Majid Shangali, Chairman of the ParliamentaryHealth and Environment Committee, highlighted this disparity in an August 2024interview with Shafaq News, stating, "Despite progress in some areas, themajority of hospitals lack access to specialized treatment facilities. Our goalis to establish waste treatment units in key locations, such as Medical Cityand certain sectors managed by the Popular Clinics."

In addition to infrastructure development, theIraqi government has launched pilot programs for training healthcare workers onwaste segregation and safe disposal techniques. These programs, however, havebeen limited in scope and lack sufficient funding to ensure nationwideimplementation.

NGOs have also played a critical role inaddressing the gaps left by government initiatives. Organizations such as theGreen Iraq Foundation and The Iraq Environmental Conservation Network havelaunched public awareness campaigns emphasizing the dangers of improper medicalwaste disposal. These campaigns aim to educate both healthcare workers andlocal communities about the health and environmental risks posed by poor wastemanagement practices.

The Green Iraq Foundation, in its 2024 campaignreport, detailed its efforts to distribute over 10,000 medical wastesegregation bins and provide protective gear to healthcare workers inunderserved areas. Additionally, the organization has funded small-scale wastetreatment projects, including autoclaving units in rural clinics wheregovernment resources are scarce. These efforts have helped mitigate risks inregions most affected by inadequate waste management systems.

NGOs have also invested in capacity-buildingprograms, offering workshops to train healthcare professionals on the propertechniques for waste handling. In an official statement, a representative fromthe Iraq Environmental Conservation Network noted, "Our goal is to bridgethe gap where governmental systems are failing, empowering healthcare workersto manage medical waste safely and effectively."

Despite these efforts, progress remains slow,with significant shortcomings in regulatory enforcement and infrastructuredevelopment. A 2024 survey by the Iraqi Ministry of Health revealed that 40% ofhealthcare facilities lack adequate segregation practices, while over 60% ofmedical waste continues to be burned in open pits or dumped in municipallandfills. Furthermore, many rural and conflict-affected areas are excludedfrom both government and NGO programs, leaving millions of residents vulnerableto the health and environmental impacts of improper waste disposal.

Corruption and inefficiency further exacerbatethe issue, with a 2024 Transparency International report indicating that fundsallocated for waste management projects are often mismanaged or diverted,"We are forced to reuse protective equipment and handle medical wastewithout proper disposal facilities. Promises are made, but we see little changeon the ground", a healthcare worker from Mosul told Shafaq News.

Activist Voices And Calls To Action

Through protests, public awareness campaigns,and collaboration with international organizations, activists have pushed forsystemic changes to improve the safety of healthcare workers, residents, andthe environment.

Activists have used social media and communityoutreach to highlight the dangers of improper medical waste disposal. Throughplatforms like Facebook, X, and Instagram, activists have shared graphic imagesand stories from local communities affected by hazardous waste practices. Theyhave also organized public forums and workshops to educate healthcare workersand the general public on the risks of improper waste management, as noted insocial media campaign reports from 2023.

Moreover, in 2023, a series of protests eruptedin Baghdad and Basra, calling for urgent government action to address themedical waste crisis. Activists demanded that the government increaseinvestment in modern incinerators, enforce existing environmental regulations,and allocate more funds to hospitals for waste treatment facilities. Theseprotests, backed by local communities, have forced the issue of medical wastemanagement onto the national agenda.

Activists have also called for greatercollaboration with international organizations to secure funding and expertisefor medical waste management projects. They have specifically requestedtechnical assistance from WHO and the United Nations Environment Programme(UNEP), as well as funding for waste treatment infrastructure. These activistsbelieve that with proper international support, Iraq can overcome the barriersto effective waste management, as stated in their joint statements with theseinternational organizations.