The first reported cases of COVID-19 in Madagascar have led health facilities to step up protective measures. Among those, two university hospitals, Joseph Raseta Befelatanana (JRB) and Joseph Ravoahangy Ampefiloha (JRA), are resorting to autoclaves instead of usual incineration to sterilize and manage COVID-infected tests and equipment. A third medical facility, the Morafeno health, center is tasked with managing COVID-19 cases only. 

As part of the Global Environment Facility (GEF)-supported project on reducing chemicals and mercury releases from the health sector in Africa, UNDP provided personal protective equipment (gloves, masks, protective glasses and suits), recycling bins and waste shredders to prevent risks of contamination and protect healthcare workers to those health centers.

The JRA University Hospital’s autoclave is the country’s largest non-incineration medical waste treatment facility in the country. Operational since August 2018, its capacity tops 1,300 liters per day. The autoclave is currently sterilizing up to 210 kg of COVID-contaminated waste per day, 35% of the total waste treated. Four cycles are now being carried out daily for an appliance that would only run once every three days in usual times.

"Recruiting new agents helped us to strengthen our team. It ensured that every stage of waste treatment – from collection to segregation – is carried out in accordance with hygienic and environmental standards. We also process waste received from houses and hotels where tests are administered by the Stop COVID-19 team since early March,” explains Fanja Rasendranomenerilala, the project's focal person at JRA Hospital.

Equiped with a smaller autoclave, the JRB’s waste treatment centre in Befelatanana sterilizes the infectious and non-infectious waste it receives from its 6 services departments, including pediatrics. 

The health center’s team recently hired 3 new agents tasked with sanitizing and cleaning household waste such as bed linen and cutlery.

“We inform patients and their families of the advantages of using disposable cutlery and tissues to ease the disinfection process. We also train medical staff on waste segregation practices,” says the project focal person at JRB hospital, Noeline Ravololoniaina. “For instance, the yellow bin is used for COVID-19 infectious waste and should only contain this type of waste”.

All personnel handling and treating COVID-19 contaminated waste wears personal protective equipment at all stages of the process.