Appropriate Solid Waste Management (SWM) is critical for public health. This is particularly true in emergencies and situations of humanitarian crisis as existing services, such as collection, treatment or disposal, may be disrupted. Additionally, extra waste caused by the crisis may have a public health impact. On one hand disasters and conflicts can result in large amounts of waste, in particular debris and remains from building and other wreckage. On the other hand, displacement of people and new temporary settlements (camps) will require new arrangements. Unmanaged solid waste attracts insects and animals that can act as disease transmitting vectors, such as flies, rats, or other animals scavenging the garbage. Solid waste littered into drainage channels will cause blockages, flooding or stagnant ponds. This can propagate the breeding of mosquitoes that transmit malaria, dengue and yellow fever. Large piles of unmanaged solid waste are often set on fire and smoke can be a health hazard if the burning waste contains items such as plastics or chemicals. Exposure to unmanaged hazardous waste, such as excreta (from the lack of sanitation facilities), infectious medical waste, sharp items (needles, glass) or toxic chemicals may be a further direct threat to people’s health. Soil and water, in contact with waste, become rapidly contaminated threatening soil quality, food safety, as well as surface and groundwater resource quality. Finally, yet importantly, indiscriminately dumped solid waste in a settlement area is unappealing and lowers the pride of communities.

The Solid Waste Management “System”

Solid waste can be broadly defined as any unwanted solid product or material generated by people or industrial processes that has no value for the one who discards it. Other terms for solid waste are “garbage”, “trash”, “refuse” and “rubbish”. With denser settlement patterns, solid waste challenges become more acute. Municipal solid waste refers to solid wastes deriving from settlements (houses, shops, offices, lying on streets and in public places) and is usually the responsibility of local government. Although other solid waste generated inside municipal areas, for instance excreta from lacking sanitation facilities, or waste from industrial processes or construction are typically not identified as "municipal waste", they nevertheless need to be considered as they also end up in the municipal solid waste stream. Integrated sustainable waste management (see figure 6) incorporates considerations of all physical elements of the waste management system, starting from waste generation through storage, collection, transport, recycling, treatment and final disposal. It furthermore includes governance and strategic considerations including economic and financial sustainability, political/legal and institutional aspects, and the involvement of all stakeholders (various waste generators and service users, informal and formal waste service providers and waste users, international agencies, local, regional and national governments, civil society and nongovernmental organisations, etc.).

Planning and Implementing Solid Waste Management Services

For an appropriate and sustainable SWM service, the following tasks should be considered:

Planning/implementation in coordination and inclusion of all relevant stakeholders: SWM services must be planned and implemented in coordination with service users, relevant agencies and authorities, and potential or existing service providers. This should happen before a solid waste problem becomes a major health risk to the affected population.

Consideration of links to other sanitation branches: Solid waste can create a range of challenges in other branches of sanitation. Litter can clog stormwater channels, creating standing water and overflows leading to flooding of streets and houses. Solid waste thrown into pit latrines can make it very difficult to empty these latrines and to further treat, process and reuse/dispose of the faecal sludge collected in the pits. These links should be considered, especially for awareness raising campaigns.

Assessment and understanding of waste generation and current waste practices: The basis of all planning and implementation is to measure how much (kg) and know what type (organic, plastic etc.) of waste is generated. Besides household waste, waste streams with high-risk potential (e.g. healthcare waste) must be carefully evaluated.

Consideration of menstrual hygiene products: Menstrual hygiene products which are not disposed of correctly can create challenges, e.g. by clogging toilets or due to their infectious nature. Menstrual hygiene product waste is usually produced within toilet cubicles. Therefore, solid waste bins with a lid and lining should be provided and operated and managed within all public toilets and people should be educated on the correct and safe disposal of menstrual hygiene products.

Fostering an environment that avoids and reduces waste: Not using materials that are not essential, are hazardous or difficult to handle (e.g. disposable plastic water sachets, multicomponent materials, solvents or aerosol cans) is one way to structurally avoid waste. Furthermore, measures at the service-user level can incentivise behavior change to lessen waste generation.

Enhancing recovery, recycling and ensuring treatment: Waste should be seen as a resource. Enhancing recycling on-site (at household level) or off-site (neighbourhood or central level) not only reduces need (and costs) for residual waste management, but can also provide employment opportunities to the local population and reduce dependency on external resources. To boost recycling, implementing waste segregation (as early as possible) is a key activity. This augments the value of different waste fractions and eases further processing. Typical examples are the processing of organic waste by composting for fertiliser, or anaerobic digestion for energy, recycling of waste paper for briquettes and fuel, or recycling of other waste streams (rubber, plastic, metal) to produce secondary low-cost products. Nevertheless, the technologies and approaches selected and implemented should consider market demand for waste derived end products, and not aggravate health risk and environmental pollution. Mixed waste incineration is usually not a favourable option as such waste typically has a high moisture content and the technology requires high capital expenditure, highly skilled and costly operation and management, and results in severe respiratory health hazards and environmental contamination.

Provision of a collection and transport system: Removing waste from residential areas avoids its accumulation in the neighbourhood. Regular collection avoids contact and exposure of residents to waste and eliminates attraction and proliferation of disease transmitting animal vectors. It also decreases the risk of waste burning, a measure often used to eliminate waste, which results in severe respiratory health hazards. The potential for small scale business development should be considered. Often an informal sector is active and can be professionalised.

Ensuring safe disposal: It comprises selection of a location that avoids contamination of surface and groundwater with waste leachate. Disposal sites should be fenced off to prevent access by people and animals. Furthermore, drainage around the site should avoid water flowing into the waste. The waste tipping face at the site should be covered daily or at least weekly with a thin layer of earth to prevent attracting vectors such as flies and rodents. .

Planning of clean-up campaigns: In consultation with the population and responsible local authorities it will be necessary to organise periodic cleaning of public spaces to ensure a hygienic environment but also remind and reactivate the necessity of public participation in neighbourhood cleanliness as a civil duty and citizen responsibility.

Ensuring safe waste management from healthcare facilities: Healthcare waste may expose the population, healthcare workers and waste handlers to the risk of infections, toxic effects and injuries. In a disaster situation, the most hazardous types of waste are likely to be chemicals or infectious wastes (wound dressings, blood-stained cloths, syringes and other sharps, etc.). Such waste should be separated at source from non-infectious waste (paper, plastic wrappings, food waste, etc.) for special treatment (incineration or controlled containment).

Safeguarding staff welfare: All staff involved in waste management must be provided with protective clothing and equipment to safeguard against exposure to the hazards in waste. When necessary, immunisation against tetanus and hepatitis B should be provided.

Development of an appropriate operation and maintenance structure: A plan for sustainable operation of waste management services must consider social acceptance, financial sustainability, workers’ skills and capacities as well as a suitable legal and institutional setup. Some key questions that need to be resolved are: What participation is required from the service users and how can this be ensured? Who provides what kind of service? How is the service monitored and evaluated? How are the costs of this service covered in long term?

Rapid Emergency Response

Immediately after an emergency/disaster, hygiene and waste disposal are usually poor, so vermin and other pests, including rodents, can spread and breed rapidly. The Sphere minimum standard for SWM states that the environment should be free from littering by solid waste, including medical waste and that there should be means of safely disposing domestic waste. All households should have access to refuse containers and these should be within 100 m from communal refuse pits and be emptied twice a week. Refuse containers should be a minimum of 100 L in size for every 10 households. Medical waste has to be isolated and disposed of separately and safely. Another high priority is debris clearance and respective waste clean-up. This is necessary to provide access to emergency response services, rescue survivors, retrieve dead bodies and address urgent public health and environmental issues. Management of disaster waste will depend on the types of waste and debris generated. During the rapid response phase, any hazardous waste and human or animal remains should be separated from other waste streams wherever possible. Temporary, and if possible, final disposal sites need to be rapidly identified and prepared. Restoring services must consider long term feasibility.

From Emergency Towards Development

Routines should be rapidly developed and implemented for waste storage, collection and disposal. This is particularly important in high-density sites such as refugee camps. In urban and out-of-camp settings, national systems should be used and strengthened. Such plans should also integrate a long-term development vision that enhances recycling and recovery options, technical skills and capacity, financial self-sufficiency and various other elements of a sustainable SWM system. A camp can be treated like an urban area, however here SWM is a joint responsibility of camp coordination and camp management that ensures coordination and collaboration with the WASH and health sectors.