Questions/Answers

1. To overcome the problem of increasing medical waste generation. 2. Proper handling and treatment of medical waste. 3. To achieve the national/governmental goals of the government: Diverting 75% of the generated waste from landfills by 2021. 4. To achieve the sustainable objective of the UN: Good Health and Well-Being. 5. Achieving Employees, customers, and community happiness and satisfaction. 6. Achieving the highest level of public health and safety for the employees. 7. Promote the principle of sustainability in the treatment facility. 8. Promote the principles of "waste reuse" in the premises. 9. Promote the principles of innovation and creativity in ideas generation and implementation.

This initiative intended to develop and create comprehensive and integrated sustainable systems and programs in the medical waste treatment facility which is considered the only treatment plant of its kind all over the Emirate and managed by DM. The initiative ensures integrated approaches in the field of waste management and treatment. It contributes to achieve: the DM's vision in building a happy and sustainable city, the fifth strategic pillar of the municipality plan; City Environmental Sustainability, and Dubai Plan (2021): The place pillar; Environmental Elements are Clean, Health, and Sustainable. The initiative is a result of employees ideas and they use their own resources for its implementation (Changing the tradition thinking).

The initiative/project is in line with the UN sustainable objectives, specifically the third objective: "Good Health and Well-Being". The improper handling with the medical waste and increasing their quantities diverted to landfills adds more burdens on the environmental resources through polluting them chemically and micro-biologically. This will lead to impose a serious threat to humans, animals, and plants. Children are the most sensitive and vulnerable groups which are affected more than others by pollution. The initiative helps implicitly and indirectly everyone to live in a healthy life away from dangerous diseases due to the spread of pollutants from medical waste.

This initiative does not only have positive impact on the vulnerable groups of the population. But, it affects all the population categories directly and indirectly, explicitly and implicitly. More than 125 hospitals and medical centers in Dubai (this is except the medical laboratories and clinics) generate medical waste from all categories and groups (children, women, older persons, etc.) every day. These wastes are hazardous and if not properly managed and handled, they become a main source of soil, water, and air contamination. However, the vulnerable groups who have impaired immune systems (mainly, children and elderly people) are more susceptible to disease resulted from the improper way of handling the medical waste. Through the initiative, the DM staff was able to improve the operational and environmental performance and efficiency of the medical waste treatment facility. This enables it to receive approximately all the generated medical waste in the Emirate. This means treating all the medical waste received. And so, less medical waste is diverted to landfills.

The introduced system is considered different, unique, creative, and distinctive, since it has been developed from our own ideas, without any external help, and using our own human and financial resources without the need to utilize the complex and expensive engineering techniques. The creativity was not in the components themselves, but in the idea of integrating them into the current treatment plant and using the available resources (innovation in coming up with new ideas). In addition, most of the materials and equipment used were manufactured internally through our technical team (Innovation in tools). As per the future planning, we are going to deploy the principles of artificial intelligence to minimize the human intervention and guarantee good work quality.

The innovation is not in the introduced system, but it is in the way of implementation and in the idea itself in how it is integrated to improve the standards of the current treatment plant. It’s an integration of four different techniques and programs, but they form together one unit to achieve the initiative’s objectives. De-ashing system was created. Then, the collected ash which is resulted from the incineration processes of the medical waste is reused in battery stabilization unit, alternatively from cement as feedstock. Additionally, an automatic electroplating system was introduced for making chambers more efficient to burn higher quantities in the long run. So as a one unit, yes it’s considered original.

The initiative is a technical one and still new, many different private and governmental sectors conducted field visits to our site to share knowledge, experience, and transfer best practices in the field of medical waste management and treatment. Many university students organized site visits to the plant to attend short-term training programs. Also, because the implementation doesn’t require high financial and human capacity, it is easy to transfer it to similar facilities.

1. Our human resources (DM Staff) from all concerned fields (mechanical, chemical, electrical, environmental). 2. Using our allocated budget: during the planning phase, we were careful and aware to pay the costs from our allocated budget without having to ask for additional budget. 3. Most of the materials and equipment utilized in the integrated system were internally manufactured at the facility.

Of course, the initiative is considered sustainable. The integrated system enabled DM to provide its services to wider and larger health care sectors in the Emirate and for all private and public sectors without discrimination. The system is in continuous operation in parallel with the original treatment plant. The integration improved the technical, operational performance, socio-environmental conditions, economical aspects, and occupational safety and health.As part of the system program, employees are frequently trained to comply with safety and health procedures to maintain their health and safety and so, contributing to their happiness and satisfaction. Also, awareness programs, workshops, and forums were launched and organized for the local community and the interested parties in the field of integrated medical waste management. In addition, short-term training programs and sessions were developed for the university students. This is because we believe that the success of this integrated diversion program is the result of cooperation of all members of the society in all sectors. As a result, less waste are diverted to landfills, less environmental resources pollution, less human and material are used (less costs), and so improving the social aspects of the stakeholders and the local community.

Yes

After the idea is conceptualized, extensive brain-storming events were organized to set out the ABC’s of the initiative. The initiative’s key success was the proper organizing and planning. A multidisciplinary team from the department was formed for following up the ongoing works and the executed activities. Each project’s component was assessed separately, and after the whole system was integrated in October, 2017, it was evaluated by the specialized formed team. Accordingly, some improvements and corrective measures were conducted. The Final assessment report was prepared by the team in May, 2018. Success criteria were based on comparing results and performance before and after the implementation of the initiative.

1. The time needed for incineration before and after the initiative's implementation. 2. The quantities of medical waste incinerated per day. 3. Number of human resources needed to accomplish a specific task. 4. Time needed for maintenance (Periodical maintenance). 5. Quantities of materials used (cement, disinfectants). 6. Number of medical waste containers disinfected and used per hour. 7. Percentage of biological pollution. 8. Quantities of medical waste diverted to landfills (before & After). 9. Financial & recurring benefits before and after implementation. 10. Employees, customers, and community's happiness and satisfaction.

The evaluation results are incorporated in the assessment report. They are divided into tangible, financial, and intangible outcomes. The incinerated medical waste quantities are increased by 140% and so around 94% of the received medical waste was treated and diverted from landfills. Resources used are minimized such that: the quantity of cement needed for battery stabilization was reduced by 67% Because of reusing the collected ash in other treatment unit as per the integrated system. The time needed for maintenance was reduced from once per year to once per 5 years. Before the initiative's implementation, the biological pollution was measured as 39% where it is now ZERO. Reducing number of employees and invest them in other services.Increasing the number of disinfected containers by 300%. As a default result, the public has been benefited from the initiative through eliminating the hazardous emissions from the waste, odor, and polluting the groundwater. This increased the sustainability of the city's environment which means ensuring a good life quality for the current and future generations. Saving financial costs: (Man power): 16,700 $/year, maintenance costs: 65,200 $/year, and saving the cost of installing a new incinerator: $ 1,388,448.

Basically, the idea of the initiative was suggested as a result of the stakeholders needs. All the feedback and notes from the stakeholders were taken seriously by our staff in the field. After we got a clear conceptualization about what is required, we began designing and implementing the initiative. After finishing and before the final assessment was conducted, the Waste Management Department at Dubai Municipality organized a forum for the stakeholders in April, 2018. This forum was entitled: “Hazardous and Medical Waste Generators and Transporters”. The main goal of the forum was raising the awareness of the local community in the integrated waste management to achieve the department’s vision. Also, the forum was aiming to consolidate partnerships and effective communications with stakeholders and the local community especially in the field of hazardous waste management and treatment. Through this, the public are involved in our projects and initiatives which helped us a lot to achieve the objectives of this initiative. This feedback was received through electronic opinion surveys filled by the stakeholders, and will be used for future and continual improvements of the integrated system. The results of the survey were published by the Customers & Partners Relations Department (attached as a supporting document).

Innovation can only be achieved when it becomes a habit practiced during the work. Public engagement (Bottom-Up Approach) is the key success of any initiative. Do not ignore your stakeholders and make sure to consult them regardless of their scientific levels and positions; they are best able to express the core problem. Every institution should take/bear responsibility towards environment to achieve sustainability. Further improvements: the need to introduce/integrate the electronic dimension with the whole treatment process so that the customer is part of the operations. Example: using smart applications in the handling of medical waste will increase customers’ happiness and satisfaction.