“It is unbearable to breathe here”: air quality, open incineration, and misinformation in Blantyre, Malawi

Frontiers in Public Health

Public Health

Hope Chilunga¹  Jonathan Kwangulero¹  Saloni Vijay²  Lars Schöbitz²  Elizabeth Tilley²  Marc Kalina³  Heiko Heilgendorff⁴ 

[1] Department of Environmental Health, Malawi University of Business and Applied Sciences, Blantyre, Malawi;ETH Zurich, Department of Mechanical and Process Engineering, Global Health Engineering, Zurich, Switzerland;ETH Zurich, Department of Mechanical and Process Engineering, Global Health Engineering, Zurich, Switzerland;School of Engineering, University of KwaZulu-Natal, Durban, South Africa;School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa;

关键词: waste management;    healthcare waste;    trash burning;    air quality;    Malawi;    urbanisation;   

DOI  :  10.3389/fpubh.2023.1242726

 received in 2023-06-19, accepted in 2023-09-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

Blantyre, Malawi’s Queen Elizabeth Central Hospital (QECH), or Queen’s, as it’s known locally, is the country’s largest public hospital. However, Queen’s is not served by regular municipal waste collection. Rather, most hospital waste (infectious and non-infectious) is gathered by grounds staff and openly burned, in several constantly smouldering piles, sending up clouds of smoke. Speaking directly to an identified knowledge gap on air quality impacts linked to trash burning and the paucity of African urban dwellers’ voices on air quality issues, this study employed a mixed-methods approach to both quantitatively measure the air quality around QECH, and to qualitatively investigate the perceived impacts amongst staff and caregivers. Low-cost sensors measuring particulate matter (PM) with particle sizes less than 10 μm (PM10) and less than 2.5 μm (PM2.5), expressed as the mass of PM per volume of air (μg PMx/m3 air) were recorded every 5 min at 8 locations across the QECH for 2 months. Qualitative data collection consisted of 56 interviews with patients, caregivers and hospital staff (including janitorial and maintenance staff, nurses, doctors, and administrators). Our results show that safe air quality thresholds are consistently exceeded across space and time and that the most problematic air quality surrounds the shelter for caregivers and those receiving treatment for HIV/AIDS. Moreover, staff and visitors are severely impacted by the poor air quality within the space, but feel powerless to make changes or address complaints. Waste management interventions are desperately needed lest the patients who arrive at Queen’s leave with more health issues than the ones with which they arrived.

【 授权许可】

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Copyright © 2023 Tilley, Chilunga, Kwangulero, Schöbitz, Vijay, Heilgendorff and Kalina.