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首页> 外文期刊>Journal of Solid Waste Technology and Management >A NATIONAL APPROACH TO CLINICAL WASTE MANAGEMENT
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A NATIONAL APPROACH TO CLINICAL WASTE MANAGEMENT

机译：临床废物管理的国家方法

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Before 1990 clinical waste in Malaysia was handled in a similar manner as any other solid waste within the hospital. This practice together with the lack of adequate disposal sites resulted in various unfortunate incidents, such as abuse of needles by drug addicts and scavenging of body parts by stray dogs. Such incidents and increasing concerns about HIV spurred the Malaysian Ministry of Health and Department of Environment to have clinical waste regulated under the Environmental Quality (Scheduled Wastes) Regulations 1989. The Ministry of Health also developed Guidelines on the Management of Clinical Waste and Other Related Wastes.rnHowever, lack of resources and infrastructure were identified as impediments for full compliance with Malaysia's Environmental Quality (Scheduled Wastes) Regulations and international standards on good management practices for clinical waste. Hence a decision was taken in 1993 to privatise this service for the Ministry's 127 hospitals and institutions throughout the country. This unprecedented move, while providing a solution to the problem of managing clinical waste, presented a whole new set of challenges. These include among others project viability and sustainability as well as maintaining quality of service in the face of commercial pressures.rnSome of the measures taken included awarding the contract to three Contractors, thus ensuring that there would be no monopoly and services could be taken over by either of the two Contractors in the event that one fails to deliver services. The approach taken in privatising the services took into account private sector's need for profitability, thus encouraging private sector participation and at the same time ensuring project viability and sustainabiiity. However to ensure a balance between profitability and public good service, the Concession Agreement (CA) with the three Contractors incorporated technical requirements, performance indicators, procedures and various other requirements to which the Contractors had to comply. Mechanisms such as a Deduction Formula and the right of the Government to engage third parties to provide services in case of poor performance by the Contractors were also incorporated into the CA.rnWith privatisation, the country has one of the best managed clinical waste management services in the region with dedicated vehicles and treatment facilities in place. The services have also been extended to all private hospitals and other government hospitals in Malaysia. With the experience gained in providing services in Malaysia, the Contractors are also selling their services and expertise abroad.
机译：在1990年之前，马来西亚的临床废物的处理方式与医院内的其他固体废物类似。这种做法加上缺乏适当的处置场所，导致了各种不幸的事件，例如吸毒者滥用针头和流浪狗清除了身体部位。此类事件和对艾滋病毒的日益关注促使马来西亚卫生部和环境部对临床废物进行了《 1989年环境质量（计划废物）条例》的管制。卫生部还制定了《临床废物及其他相关废物管理指南》。 .rn但是，缺乏资源和基础设施被确定为完全遵守马来西亚的《环境质量（计划废物）条例》和有关临床废物良好管理规范的国际标准的障碍。因此，1993年决定将该部在全国的127家医院和机构的服务私有化。这项史无前例的举措为解决医疗废物管理问题提供了解决方案，但同时也带来了一系列全新的挑战。这些措施包括项目可行性和可持续性，以及在面临商业压力时保持服务质量。rn采取的一些措施包括将合同授予三个承包商，从而确保不存在垄断，并且服务可以由如果一个承包商无法提供服务，则是两个承包商中的任何一个。服务私有化所采取的方法考虑了私营部门对盈利能力的需求，从而鼓励了私营部门的参与，同时确保了项目的可行性和可持续性。但是，为了确保盈利能力和公共服务之间的平衡，与三个承包商的特许权协议（CA）包含了承包商必须遵守的技术要求，性能指标，程序和各种其他要求。 CA还纳入了诸如扣除公式和政府有权在承包商表现不佳的情况下聘请第三方提供服务的机制。随着私有化，该国成为了管理得最好的临床废物管理服务之一。该地区拥有专用车辆和治疗设施。服务也已扩展到马来西亚的所有私立医院和其他政府医院。凭借在马来西亚提供服务的经验，承包商还向国外出售其服务和专业知识。

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