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Q: plz tell me about the state and impact of Vietnam Medical Waste ( Answered 5 out of 5 stars,   2 Comments )
Subject: plz tell me about the state and impact of Vietnam Medical Waste
Category: Science > Earth Sciences
Asked by: nobleresearcher-ga
List Price: $50.00
Posted: 13 Oct 2004 08:37 PDT
Expires: 12 Nov 2004 07:37 PST
Question ID: 414241
Plz tell me in detail
Subject: Re: plz tell me about the state and impact of Vietnam Medical Waste
Answered By: pafalafa-ga on 14 Oct 2004 09:07 PDT
Rated:5 out of 5 stars
Thanks for posting such an interesting question.

Medical wastes can be a significant concern because, in addition to
conventional toxic pollutants like mercury, chlorinated plastics, and
solvents, medical wastes also include a fair number of exotic
materials not found in typical waste streams.  Of special concern are
infectious tissues, and radioactive materials used for diagnostics and

Rapidly developing economies like that in Vietnam are trying to enter
the arena of global commerce without repeating many of the mistakes of
their more-developed neighbors, and that includes increased attention
to matters of environmental and public health concern.

Vietnam is increasingly focused on issues pertaining to the
manaagement of medical wastes from hospitals and other health care
facilities.  I've listed several key sources of information below.  I
cannot reproduce the materials in full (most are copyrighted, except
the US government report cited at the end of the list), but I've
included brief excerpts to relevant materials from the articles.

I trust this information will fully meet your needs.  But before
rating this answer, please let me know if you require any additional
information.  Just post a Request for Clarification and let me know
how I can further assist you.



[recent news story on medical waste in Vietnam, although the percent
figures given seem an overstatement to me...]
September 14, 2004

New VN incinerators toast medical waste

...On average, medical stations nation-wide, excluding those at
commune-level, discharge more than 240 tonnes of solid waste daily,
accounting for 20-40 per cent of total public waste. The research
group said it would also produce smaller incinerators with capacities
of 0.3kg per hour.

Hai Phong gets medical waste plant 

HAI PHONG ? A medical waste treatment plant using foreign-made
equipment has been put into use in Hai Phong City.

The VND3.2 billion (US$209,000) plant is able to treat 400kg of
materials per day. It is expected to help solve the city?s
long-standing problem of medical waste...Following the plant?s
opening, the Hai Phong Environment Sanitation Company signed contracts
with five local hospitals to collect and treat waste materials.

Policy Responses

Box 7: Disposing Infectious Medical Wastes

Recognizing the pollution and health threats from improper
disposal of medical wastes, the Government of Vietnam has
recently invested in the collection and treatment of medical
hazardous waste. Hanoi City has built an incinerator in Tay Mo
with a capacity of 4.8 tons/day for burning hospital solid waste.
HCM City and the Province of Tien Giang also have built their
own incinerators for hospitals.

In 2000, the Government approved a project costing over
$5 million which finances 25 incinerators in 25 provinces. In
addition, some provinces have invested in their own facilities
for treating medical waste. For example, the province of Binh
Dinh has built an incinerator with capacity 400-500 kg/h for
burning hazardous waste from a hospital for tuberculosis

Most of these incinerators are in a pilot phase, and will need
some time to reach full capacity.


Table 22: Nation-wide generation of solid waste

Medical hazardous waste (tons/day)
1997 -- 240
1998 -- 252
1999 -- 277

[out of total solid waste generation of about 20,000-25,000  tons/day]

Hazardous solid wastes largely untreated ? Hazardous
wastes are comprised of wastes from industries and
infectious medical waste from hospitals. In the four largest
cities (Hanoi, Haiphong, Danang, HCMC) industrial solid
waste comprises around 15-26 percent of municipal
solid waste. Of this, 35-40 percent is considered hazardous.
In 1999, the total industrial hazardous waste generation
was 109,469 tons ?an increase of 33 per cent over 1997.
Over 90 per cent of this generation comes from industries
in HCMC, Dong Nai and Hanoi....Light industries
contribute more than half of these wastes, while
mechanical and chemical industries contribute 18 and 16
percent respectively.

The daily production of hazardous infectious medical
waste from hospitals is estimated to be about 50-75 tons,
which is a quarter of all hospital wastes generated in the


State of the Environment in Vietnam

Medical waste 

The daily production of hazardous waste from hospitals is estimated at
about 50 - 75 tones (comprising 22 % of hospital waste). Medical Waste
composition from different regions in Vietnam- 1998 is shown in table
6.3....Average bulk density of the hospital waste is 150 kg/m3; Water
content is 42%; Calorific value is 2,150 kcal/kg.

[The Table of "Hospital Waste Composition" provides some additional
details on the components of medical waste in the country.  About half
of is considered "organic waste", while the remainder is largely
medical materials, such as used bandages, syringes, cans and cartons,


"Building Capacity for Comprehensive Medical Waste Management in Asia" 
US-Asia Environmental Partnership (US-AEP)

Medical waste management is becoming a high-priority environmental
concern in developing countries in Asia. The United States-Asia
Environmental Partnership (US-AEP), a public-private initiative
implemented by the U.S. Agency for International Development (USAID),
has played an important role in promoting the establishment of medical
waste management practices over the past seven years. Through its
integrated approach to activities in this sector, US-AEP has
successfully assisted developing countries in Asia to advance
awareness of medical waste issues and gain access to technology
solutions for effective medical waste management.

...Demand for medical waste equipment is rising in developing
countries throughout Asia. For example, it is estimated that 1998
medical waste legislation in India will result in collective spending
of $2 billion over the next decade by 11,000 Indian hospitals and
27,000 nursing homes... Similarly, in Taiwan, where 42 tons of
infectious medical waste is generated per day, the market for
alternative non-incinerator treatment technologies is opening... The
government of Ho Chi Minh City, Vietnam, has identified medical waste
management to be a main focus of its current five-year plan,
implemented by the Department of Health..


Prepared by Nguyen Thi HoanDirectorate for Standards and Quality,
National Environment AgencySolid Waste Management in Vietnam

In the face of urgent demand for solid waste treatment, especially of
medical waste, somedomestic manufacturers have urged the Vietnamese
government to provide them withproduction license. At present, 15
local manufacturers have been granted the necessary licenses. The
government has just published temporary stipulations on
incinerators,including technical standards, assessment methods and
waste gas examination...


Vietnam, Franco-Vietnam Hospital
Funding Institution: IFC 
Env. Classification: B
Project ID: 10559 
Document Date: June 5, 2001
Waste Stream: Healthcare waste 
Sector: Health Care
Approval Date: October 11, 2001, Invested: May 30, 2002
Quote: "Infectious, hazardous and other hospital waste will be
segregated in color-coded containers for treatment and disposal. Human
anatomical wastes, blood and fluids, microbiological waste and other
biotechnical waste will all be incinerated. Other wastes will be
handled and disposed of according to international standards according
to procedures laid out in the HHWMP. The hospital is designed to store
medical waste safely until it can be removed for incineration.
Incineration will be at an off-site facility, owned by the Urban
Environment Company. F-V Hospital is required to use this facility.
The facility collects waste from all Ho Chi Minh City hospitals. The
incinerator is manufactured by Hoval of Lichtenstein. It employs a
gas-fired pyrolytic chamber that produces heat sufficient to avoid the
release of dioxins into the air."


[This market study prepared by the US government includes details
about the business aspects of overall waste management in Vietnam, and
includes a section specific to medical wastes]:



Vietnam has experienced rapid industrialization after adopting an open
door economic policy (known as doi moi) in 1986. Industrial output
expanded at an annual rate of 8.6 percent in the period 1989 to 1993.
This trend has continued at a greater pace in recent years. As a
result, the generation of industrial waste including hazardous and
toxic waste is increasing at an alarming rate, and Vietnam does not
have the ability to deal with this hazardous waste. Such rapid
development without planning creates potentially serious environmental

...Industrial wastewater discharged from industrial enterprises is
currently inadequately treated. Large amounts of toxic chemicals are
discharged without monitoring. Infrastructure for waste treatment is
either absent or of poor quality. No municipal and industrial
wastewater treatment systems are available in urban areas. Only 60
percent of industrial waste from factories is collected and this waste
is disposed with household waste at poorly designed landfills. Most of
the landfills in Vietnam are dumpsites rather than sanitary landfills
equipped with liners. This continues to cause great harm to the

...Along with rapid industrialization comes escalating urbanization,
especially in Hanoi and Ho Chi Minh City. Many factories that were
previously located far from populated areas are now inside urban areas
creating unhealthy air quality due to industrial emissions, coal
combustion, and exhaust from the increasing number of vehicles.
Overall exposure to particulate matters, carbon monoxide (CO), carbon
dioxide (CO2), sulfur dioxide (SO2), and nitrogen oxide (NOx) exceeds
permissible levels in many urban locations. The industrial zones also
have serious air and water pollution problems. Industrial pollution
control and environmental management in most industrial areas is, for
the most part, non-existent or ineffective. Lack of waste treatment
facilities together with outmoded production technology has damaged
the environment and caused health problems for local residents.

...Although national hazardous waste management regulations were
enacted in July 1999, untreated hazardous waste is still being
discharged with other waste. Poor compliance with the law is
attributable to the regulation's weak enforcement. Budgetary
constraints, lack of human resources, lack of pollution monitoring
equipment, and overlapping, uncoordinated and poorly defined
government responsibilities are among the major barriers to effective
enforcement.  In addition to these factors, the absence of facilities
for proper hazardous waste treatment prevents full compliance with the
law. Hazardous waste from agricultural activities and domestic sources
is a growing problem since no control system exists at this moment. 
Medical waste from hospitals and clinics is also another point of
concern. Currently, there is no hazardous or toxic waste inventory
created in the country although Vietnam has been a party to the
Stockholm Convention on Persistent Organic Pollutants (POPs) since May

...Vietnam now recognizes the need to balance industrial growth with
proper disposal of hazardous waste. Major cities have made industrial
waste control and management the top priorities for their urban
development strategies. For instance, Ho Chi Minh City's authorities
have started a relocation program to move polluting factories from
residential areas to other regulated zones or industrial parks.
Recently, privatization has been encouraged in some public works
services such as solid waste treatment, composting, waste collection
and transfer, and other areas to share the waste management
responsibility with government companies.

...Official Development Assistance (ODA) is the major source of
financing for most of the environmental protection projects in
Vietnam. During the 1990's, Vietnam spent around US$100 million of its
annual budget each year (0.3 percent of the country's Gross Domestic
Product) on environment related activities. This number has almost
tripled in recent years, especially in major cities such as Hanoi, Ho
Chi Minh City, Hai Phong, and Danang. There has been a demand for
incineration systems to treat hazardous and toxic waste from
industrial, agricultural, medical sources. Although incinerators with
low capacity can be produced locally, major components still have to
be imported. Local scientists and environmental experts agree that
specific incineration systems for industrial waste disposal have to be
imported. There is debate, however, among scientists and
environmentalists over the use of incinerators for the disposal of
hazardous and toxic waste since these systems emit toxic air

Medical waste:

...Medical waste in both liquid and solid forms is treated improperly.
About 10 tons of medical waste is discharged from city hospitals,
medical centers, and clinics every day. This figure is likely a low
estimate since many types of waste are not separated and are disposed
together. In Ho Chi Minh City, for example, hospital waste is
collected and burned at the incinerator in Tan Binh district. The
incineration system has a capacity of 7.5 tons per day (financed by
Belgian Development Aid in 1999). Most hospitals in the country are
not equipped with waste treatment facilities. There are no strict
control measures on the disposal of radioactive waste from X-ray
machines or other medical equipment that uses radiation methodologies.

...There are 36 centrally and locally owned hospitals in Hanoi. None
of these are equipped with hazardous treatment facilities and only 22
of the 36 have signed contracts for waste collection with URENCO.
These hospitals generate a total of 5,000 cubic meters of waste per
month. Hazardous wastes from hospitals can be categorized into 2
types: cut body parts and other solid pathological discharges like
gauze, bandages, casts, etc. Hospital liquid waste is not treated
before it is discharged into the city's drainage system. Management of
hospital solid waste is at a preliminary stage lacking immediate
treatment and adequate separation. Large hospitals, such as Viet Duc
and Bach Mai, have installed incinerators, but they have not been
functioning for many years

...Most incinerators were imported under ODA projects of Belgium and
Austria. The existing incineration facilities are used to treat
medical waste, not industrial waste. In addition to incineration
methods, which have raised concerns regarding toxic gas emissions,
other technologies to treat medical waste have also been introduced in
Vietnam such as autoclave, roto-clave, and hydro-clave. Some
incinerators with low capacity have been manufactured domestically to
serve the demand of local hospitals and medical centers. However, some
concerns have been raised that these locally made incinerators are not
free from toxic gas emissions and are not durable. There is
controversy over the cost effectiveness of imported versus locally
made incineration systems. Using existing cement kilns to destroy
several types of industrial refuse and pesticides has been suggested
recently by some local scientists.

...Ho Chi Minh City has planned to establish a second incineration
plant in the city. The existing incinerator with a capacity of 7.5
tons per day was constructed last year under a program financed by the
Belgian government to treat medical waste discharged from city
hospitals, clinics, and medical centers. As the city's incinerator is
now operating in full capacity, concerns have been voiced by
authorities on the accumulation of waste during downtime for
periodical maintenance or repair. They feel that it is necessary to
have a standby system available to take over the service when the
present plant is out of order. In order to make the proposed
incinerator more effective, some have proposed that the second
incineration plant would also be utilized to treat industrial
hazardous waste discharged by small- and medium-sized industries
within the city. The new system must be capable of treating both types
of waste in order to meet this requirement.

...Many other cities have pointed out the need for incineration
facilities to dispose of industrial hazardous waste.  Recently, a
company in Dong Nai province Sonadezi has taken the lead in planning
to establish an industrial waste disposal center to help businesses
located in Industrial Parks of Dong Nai Province dispose of their
waste. The planned zone is 100 hectares in Giang Dien district of Dong
Nai Province. The center is expected to be equipped with recycling
facilities, temporary storages, landfill cells, and incinerators.
However, Sonadezi has planned to divide the project into many phases.
The first phase is just a pilot project with small capacity facilities
in a two-hectare area.


Again, let me know if you need any additional information.


search strategy -- Google searches on:

"medical waste" OR "medical wastes" site:vn

"medical waste" OR "medical wastes" vietnam
nobleresearcher-ga rated this answer:5 out of 5 stars
Thanks for your great job

Subject: Re: plz tell me about the state and impact of Vietnam Medical Waste
From: neilzero-ga on 14 Oct 2004 02:47 PDT
If you are asking about medical waste, produced during the Vietnam
war, my guess is only one part per million is still seriously
hazzardous. If you are asking about medical waste produced today in
Vietnam, they are likely less careful than in the USA and perhaps
1/10th percent is seriously dangerous, resulting in perhaps one
unnecessary death per month. If you clarify, you may get better than
my wild guesses.   Neil
Subject: Re: plz tell me about the state and impact of Vietnam Medical Waste
From: pafalafa-ga on 15 Oct 2004 06:47 PDT
You're quite welcome.  And thank you for the kind comments and generous rating.


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