Waste disposal in households is often done in a haphazard manner. Characteristics of daily general waste disposal in Ugandan households more often than not consist of people dumping their trash onto the streets, in pit latrines, open burning and worse, discarding it into water ways.
Within that waste, cosmetic products and pharmaceutical items are usually included.
On average, each family may keep a minimum of one kind of medication within its household for emergency use for common conditions such as flu and colds.
Lately, there has been an increase in the demand for medication that people believe is critical in the treatment of Covid-19 symptoms. People hoard and keep such drugs in their homes. This has contributed to an increase in the amount of pharmaceutical waste in households.
Most often these drugs end up being unused, partially used, damaged, or kept until they expire or are no longer wanted by the family. These drug items are then disposed of into the normal domestic waste, pit latrines and flushed down toilets or sinks.
Inappropriate disposal of pharmaceutical waste in Uganda is a serious but often overlooked threat to not only our environment but also our health. Some wastewater treatment plants may be unable to completely remove pharmaceuticals and their related compounds from wastewater. Unacceptably discarded pharmaceutical items can also leach their contents and ingredients into our soil. Eventually, such pharmaceuticals make their way into the water reservoirs and, in the end, into the very water we consume.
A study, “Pharmaceutical pollution of water resources in Nakivubo wetlands and Lake Victoria, Kampala, Uganda,” published in 2020 indicates the presence of common prescription and non-prescription pharmaceutically-active substances in wastewater, with antibiotics being among the dominant in the water system in Kampala. This could lead to the development and spread of antimicrobial resistance and all its related implications.
Factors contributing to improper disposal practices include lack of information, lack of resources for proper garbage pickup and disposal and sometimes a lack of personal concern and accountability for one’s environment.
Majority Ugandans lack knowledge of proper disposal practices of pharmaceutical waste, and the consequences of erroneously discarding such waste. Besides, many households do not have access to proper waste disposal methods.
However, different methods can be employed to reduce pharmaceutical waste in our environment. Healthcare professionals should emphasise safe, ethical and responsible disposal of the drugs that are dispensed to patients during the provision of medical information.
Guidance and enhanced consumer education on the proper understanding and identification of pharmaceutical waste and the consequences of its improper disposal on people’s health and on the environment should be stressed at the facilities where the drug items are dispensed.
Public and private healthcare facilities have policies and procedures in place for correct management and disposal of medical waste. Such health facilities should be encouraged, and supported by the government, to have “medication take-back programs”. This will allow people to return their pharmaceuticals to health facilities for proper disposal.
Efforts to mitigate pollution from pharmaceutical waste should be a joint initiative between the public, the distributors, the regulators, the government.
The author, Claire Marunga Banura is a pharmacist