WHO-EM/CEHA/68-E

REGIONAL TRAINING COURSE ON

SOLID WASTE MANAGEMENT

Amman, Jordan, 25 March to 6 April 1995

WORLD HEALTH ORGANIZATION

REGIONAL OFFICE FOR THE EASTERN MEDITERRANEAN
REGIONAL CENTRE FOR ENVIRONMENTAL HEALTH ACTIVITIES (CEHA)

Amman, Jordan

July, 1996
 CONTENTS

1. INTRODUCTION........................................................................................................1

2. TECHNICAL PRESENTATIONS...............................................................................2

2.1 A global and regional (EMR) overview of solid.................................................2

waste management

2.2 Environmental pollution and health implications.................................................2

of solid waste

2.3 Solid waste surveys: quantities, sources and composition...................................2

2.4 Planning and management of storage systems.....................................................3

2.5 Waste collection vehicles and systems................................................................3

2.6 Clinical waste management................................................................................3

2.7 Computer aided design of solid waste storage,...................................................4

collection and transportation systems

2.8 Solid waste minimization, separation and recycling............................................4

approaches and options

2.9 Role of community participation in solid waste management..............................4

2.10 Information management for municipal solid waste............................................4

management services

2.11 Waste collection vehicle scheduling and management........................................5

2.12 Siting, design and evaluation of sanitary landfills...............................................5

2.13 Development and use of checklists/methods for................................................6

evaluating disposal sites

2.14 Selection and use of appropriate waste disposal................................................6

manpower and equipment

2.15 Feasibility, planning and management of composting in....................................6

Eastern Mediterranean Region

2.16 Composting in Kuwait : A case study..............................................................7

2.17 Incineration as a waste disposal option in .......................................................7

Eastern Mediterranean Region
 2.18 Evaluation of course.......................................................................................7

3. SITE VISITS.............................................................................................................8

4. COUNTRY PRESENTATIONS................................................................................8

4.1 Egypt..............................................................................................................8
4.2 Islamic Republic of Iran...................................................................................9
4.3 Iraq.................................................................................................................9
4.4 Jordan.............................................................................................................9
4.5 Morocco.......................................................................................................10
4.6 Oman............................................................................................................10
4.7 Pakistan.........................................................................................................11
4.8 Sudan............................................................................................................11
4.9 Tunisia..........................................................................................................11
4.10 Republic of Yemen.......................................................................................12

5. CONCLUSIONS AND RECOMMENDATIONS....................................................12

5.1 Conclusions..................................................................................................12

5.2 Recommendations........................................................................................13

6. PLAN OF ACTION................................................................................................16

7. CLOSING SESSION..............................................................................................17

ANNEXES

1. Agenda...................................................................................................................18
2. Programme.............................................................................................................19
3. List of Participants..................................................................................................22
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1. INTRODUCTION

A Regional Training Course on Solid Waste Management was organized by the WHO
Regional Office for the Eastern Mediterranean (EMRO) with its Regional Centre for
Environmental Health Activities (CEHA), Amman, Jordan, from 25 March to 6 April 1995.
Dr Saad Al Kharabsheh, inaugurated the Training Course on behalf of H.E. the Minister of
Health, Jordan. Eighteen participants and one observer from 11 countries of the Eastern
Mediterranean Region of WHO took part in the workshop. In addition, experts from the
University of Newcastle upon-tyne, the Centre for Environment and Development for the Arab
Region and Europe (CEDARE), University of Jordan, Greater Municipality of Amman, and
WHO/CEHA Staff Members participated.

The main objectives of the workshop were to:

– "train the trainers" in procedures and practices of solid waste collection,

transportation and disposal, various solid waste management technologies available;

– review and acquaint them with the appropriate and available legislation, standards
and guidelines (national and international) related to solid waste management, landfill
design, operation and maintenance;

– provide opportunity for discussions, site visits, exchange of experiences and success
stories, of participants in their respective countries;

– train and acquaint the concerned technical staff with health hazards and implications
of solid wastes and promote the establishment of national or local occupation and safety
health requirements and programmes.

A message from Dr Hussein A. Gezairy, Regional Director for the Eastern Mediterranean
Region of WHO, was read by Dr M.Z. Ali Khan, CEHA Coordinator. Dr Gezairy pointed out
that every year more waste is produced in the urbanized and industrialized countries of the
Region. Inadequate storage, collection and disposal of such wastes continues to endanger public
health, as well as result in increased environmental hazards. Training of personnel, use of
appropriate technologies and modernizing equipment can reduce and even solve the ever-
increasing waste problems in their countries. He hoped that this course would train the trainers
on how solid waste can be managed by adopting safe, hygienic, “environmentally sound and
friendly” practices. Finally, he hoped for a successful and fruitful course with practical
recommendations for further follow-up.

Dr Saad Al Kharabsheh, on behalf of H.E. the Minister of Health, formally opened the
Training Course and welcomed the guests to Jordan. He stated that he appreciated CEHA’s role
in holding such training courses and further emphasized that the problem of solid waste
management, especially medical waste, hazardous waste and abandoned tyres, had a high priority
in the country’s environmental strategy as well as action plan. He wished all guests a very
pleasant stay in Amman.
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After the introduction of participants and adoption of the agenda and programme (Annexes
1 and 2, respectively), Dr Abdel Kaher El Zaemey (Yemen) was elected as Chairman of the
Training Course, Mr El Sayed Al Araby Sarhan (Egypt) as Vice-Chairman and Mr Zafar Iqbal
Beg (Pakistan) as Rapporteur.

A list of participants is given in Annex 3.

2. TECHNICAL PRESENTATIONS

2.1 A global and regional overview of solid waste management

Dr Khan, Coordinator, CEHA, utilizing the global and regional literature resources,
presented the solid waste management situation globally and then reviewed the regional situation.
He presented information indicating that in the Eastern Mediterranean Region (EMR), solid
waste has 2-3 times higher organic content, moisture content and density and less paper, glass
and metal content than anywhere else in the world. Generation rates are 1/2 to 1/3 of the global
rates. In EMR only about 20% of solid waste is collected and 80% of that is disposed off by
open dumping. The percentage disposed of by dumping and uncontrolled land filling, recycling,
composting and other means are 80%, 0.5%, 0.5% and 19% respectively. He concluded that the
problem of solid waste is growing every year, requiring urgent attention by governments,
institutions, United Nations agencies and international organizations.

2.2 Environmental pollution and health implications of solid waste

Dr Anderson, WHO Temporary Adviser, in his presentation stated that solid waste contains
human pathogens from a wide range of sources. In addition, inadequate storage and collection
and poor treatment and disposal practices serve as ideal breeding sites for rats and flies, etc.,
which can act as passive vectors in transmitting diseases. He outlined the various population
groups which are exposed to the risk of disease, as well as the various routes by which the
diseases are transmitted to the groups referred to.

The solid waste practices which can be used in the management system to minimize or
eliminate health and safety risks were also discussed, including measures which should be taken
in the home, office and factory, during transport and transfer and finally at the waste treatment
(incinerator and composting) plants and the ultimate disposal location points, the sanitary
landfill. Emphasis was also placed upon the need to replace dumps with sanitary landfills and to
control scavenging in an unlicensed manner. In addition to health and safety problems, the issue
of environmental degradation was considered, including air pollution from incinerators and the
leachate and gases emanating from sanitary landfills.

2.3 Solid waste surveys: quantities, sources and composition

Mr Elliott, WHO Temporary Adviser, highlighted that planning an appropriate waste

collection and disposal system is dependent upon an accurate assessment of the waste
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composition. Comparisons were made of waste characteristics in different countries and over
time. The classifications of waste categories were outlined, together with detailed methodologies
for sampling wastes for physical and chemical classification.

2.4 Planning and management of storage systems

Dr Anderson pointed out that the handling, storage and processing of solid waste at source
is critical to the overall management process since it may have a significant effect on public
health, subsequent operations and the public's attitude concerning the operation of the overall
management system.

The presentation considered the relationship between the volume of the storage containers
with collection frequency and climate. It then went on to outline the factors which determine the
design of storage containers for home, office and industry, paying particular attention to odours,
aesthetics and disease prevention. Consideration was also given to the use of the storage system
to enhance or improve source separation to enable recycling and solid waste utilization to take
place conveniently and economically.

2.5 Waste collection vehicles and systems

Mr Elliott in his paper discussed the factors affecting the choice of vehicles used in waste
collection systems. He stressed the need for sustainability and interrelationship between local
storage vehicle type, road conditions, and haul distance. Comparisons were made on collection
vehicle efficiency with respect to waste density and loading rates.

2.6 Clinical waste management

Dr Anderson described clinical wastes as being among the most important of the wastes
produced in all societies and also which have a significant potential impact on the health of health
care workers, scavengers and the public. He outlined the main categories of waste produced in
the health care sectors, after defining exactly what this sector includes. Details were given of the
recommended methods for the safe storage of each category, and the on-site and off-site transport
to their treatment and disposal.

It was emphasized throughout that the key to safety is isolating the most infectious wastes
from workers and the public and that consideration should be given to the ideal situation, that all
wastes generated in hospitals should be considered as "clinical" and disposed of accordingly,
even if this imposes an additional cost burden upon the hospital, the municipality or the
community. Finally, the various methods of pre-treatment and disposal were outlined although it
was stressed that when feasible, all clinical wastes should be incinerated in an incinerator
designed specifically for such a task. The only acceptable alternate is a sanitary landfill where all
appropriate measures are taken to dispose of the waste in a safe and aesthetic way.
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2.7 Computer aided design of solid waste storage, collection and transportation systems

Mr Elliott presented a detailed description of the Waste Generation System (WAGS)

computer program written for Habitat by Mennus Coffey Associates. The program was
described with the aid of a case study on Chania, Crete. Estimates had been made for vehicle and
labour requirements with their associated financial and economic costing.

2.8 Solid waste minimization, separation and recycling approaches and options

Mrs Akrouk, CEDARE, stated that the solid waste management problem had become one
of the pressing global issues. More and more waste was being generated and disposing of it
posed a global dilemma.

However, attitudes towards solid waste are changing worldwide. It is being recognized that
many valuable materials could be recovered from the solid waste stream by adopting the concepts
of waste minimization, recovery and recycling. In the process the amounts of waste that will
need ultimate disposal could be reduced, thus preserving landfill capacities and reducing risk to
human health and the environment. It is also being recognized that, through recycling, energy
and natural resources could be conserved and business and employment opportunities could be
created.

She gave an overview, along with some examples of solid waste recovery and recycling
that are taking place in the industrialized as well as developing countries. Solid waste recovery
and retrieval systems were also discussed and some points of recycling constraints were given.
Finally, the pilot project of "Paper-making at home" from indigenous plants, carried out by the
Zabbaleen in Mokattam, Cairo, and was assisted and documented in Arabic by CEDARE, was
presented.

2.9 Role of community participation in solid waste management

Dr Anderson in his presentation highlighted the fact that any successful system of solid
waste management is totally dependent on the willingness of the community to fully support the
approach taken. Different levels of participation were discussed associated with type of
collection and storage system specified. The issues associated with the interaction between
participation, public education and legal enforcement were also addressed.

2.10 Information management for municipal solid waste management services

Mr Malkawi, CEHA, and Dr Khan made the presentation in two parts. Part one dealt with
environmental health information resources available at CEHA. The subjects covered were:
CEHANET history and future plans; CEHA's documentation unit; information exchange
programme and services; data bases available at CEHA, and how to make use of these resources
in serving professionals and institutions working in solid waste management, and in
strengthening the national information exchange capabilities of existing information systems.
Special attention was given to the use of CD/ROMs in provision of recent literature on solid
waste management (two bibliographies of literature published in 1993/1994 on solid waste had
been compiled and are
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available upon request from CEHA). Part two introduced CEHA's reprinted document
Information Management for Municipal Solid Management Services as a good guide on
designing of information management systems. The following points were highlighted in this
part: role of information in solid waste management systems; types and categories of needed
information; detailed description of information that should be included in the information
management system; and some important issues that should be taken into consideration while
designing information management systems.

2.11 Waste collection vehicle scheduling and management

Mr Al-Hishan, WHO National Temporary Adviser, in his presentation pointed out that
solid wastes have become one of the most difficult problems that threaten environment in over
populated cities. As the developing countries cannot transfer, successfully, the methods used in
the industrialized countries to treat solid wastes, they must use their available potential. They
must exploit the cheap labour available, and provide the trained technical staff members who are
qualified to perform treatment of solid wastes. Moreover, the importance of health education
among people must be taken into account. People must be fully aware of the risks of
environmental pollution risks. He said that this can be done through schools and universities.
The relevant concept must be incorporated in the academic curricula. Then, it should be possible
for the municipalities to reduce their expenditure costs and improve the environmental status in
the area.

He emphasized that if it is possible to produce the required tools and machinery locally, it
will surely help reduce the financial burden that has to be shouldered by the municipalities.
Since local machinery will be cheaper it will help municipalities save the hard currency that
should be used in importing the required inputs of the development plans.

2.12 Siting, design and evaluation of sanitary landfills

Dr Anderson and Mr Elliott in their joint presentation said that sanitary landfill is a
method of disposing of most types of solid wastes, including domestic, industrial, commercial
and, if required, hazardous and clinical.

Sanitary landfill is defined as depositing the uncompacted waste in as small an area as

possible, compacting it in order to optimize the use of the volume available and covering each
day with an inert material of 150-200 mm depth. Once the final level has been reached the site
should be covered with 1 m of perforated impervious material (such as clay) and covered with
topsoil in order to prepare the area for final restoration.

They described the three basic types of landfill in use, namely the area, trench and cell
methods as well as described briefly the methods of lining such sites, the collection and
utilization of the gas produced and the methods of controlling and treating any leachate which
may be generated.
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2.13 Development and use of checklists/methods for evaluating disposal sites

Dr Anderson, utilizing the English version of a paper given by Mr Bani Hani in 1993,
identified a series of headings which were used to characterize the suitability of a site for landfill
purposes. A weighting system had been developed to allocate a point score to each heading.
Decisions on site selection may be made by comparing total point scores for each site.

2.14 Selection and use of appropriate waste disposal manpower and equipment

Mr Al-Hishan reviewed various categories of equipment currently being used by the

Greater Amman Municipality and the manpower requirements, based on existing landfill sites
around Amman, Mafraq, Irbid and Zarqa cities. He emphasized that the equipment and
manpower must be based on the type of waste, topography, local constraints and conditions.

2.15 Feasibility, planning and management of composting in the Eastern Mediterranean

Region

Dr Natour, WHO National Temporary Adviser, reviewed composting as a biological

process involving the microbial degradation of organic materials. He added that it is simply a
means of converting raw waste organic matter, (a potential source of foul odour and public health
problems), into an innocuous humus. Thus, composting is generally viewed as a solution to
waste management problems and as a means for improving soil quality.

In order to prevent the production of foul odours, breeding of flies, preservation of

nitrogen in the composted material and killing pathogenic agents, composting is carried out under
aerobic conditions, using various processes. Composting processes vary from very simple, low
technology methods to high technology and continuous processes. Due to the high costs of the
highly mechanized composting processes, composting plants which depend on such high
technology had been closed and replaced by the simpler processes which are based on batch
composting in wind rows.

Moreover, composting is affected by various parameters, i.e temperature, aeration,

moisture, pH and particle size, as well as types and amounts of impurities in the material to be
composted. For proper and successful composting, pretreatment of compost materials, to rid it
from noncombustible materials, i.e. glass, plastic, rubber, steel and metals or rubbish, is of prime
importance. Also, maximizing the materials surface by minimizing the particle size (milling or
shredding) constitutes a vital factor in good composting.

Owing to high cost and improper composting, most composting plants in the Region had
been closed. However, Egypt had established three 160 tonne capacity per day, composting
plants in 1984, using the wind row process. So far, composting in Egypt had proved to be
successful and the Government plans to establish more, similar plants.

2.16 Composting in Kuwait : a case study

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Dr Natour presented the case study based on a project during 1980/1981 which had
proved that municipal refuse in Kuwait was ideal for composting. Over 75% of such refuse is
compostable and contains food waste at a rate over 53%, most of which consists of cooked food,
fibrous shells, peelings and bread. Such nutritively rich refuse may have other important
utilizations, besides composting, depending on the method of handling.

As for composting, household refuse was found to contain a carbon:nitrogen ratio of 19-
40:1, depending on the percentage of paper and carton present in the refuse. Such
carbon:nitrogen ratios indicated the refuse to be of high quality for composting. In fact, addition
of nitrogen sources to compost material did not improve composting. Compost trials of such
refuse produced a high quality compost within relatively very short periods of time for each of
the composting methods used. So far, composting in artificially aerated bins and in naturally
aerated bins gave the best results.

Compost microflora was found to be highly adequate for good composting. The various
microflora populations isolated during various stages of composting, revealed bacteria as the
most dominant, followed by actinomycetes and fungi respectively.

Municipal composing conditions were often found to be inadequate. Thus, in spite of

composting for four to seven weeks, the municipal factory produced low quality compost. Such
compost, when compared with trial compost was found to contain a much higher percentage of
particles larger than 5 mm, have much lower water holding capacity, higher ash content, a high
rate of non-degradable impurities, higher levels of heavy metals and lower levels of plant
nutrients. Due to the fact that the factory became very old and it was not possible to make the
necessary corrections for better composting, the factory had closed within four years of this
study.

2.17 Incineration as a waste disposal option in the Eastern Mediterranean Region

Dr Anderson indicated that incineration is an option which must be at least considered for
the disposal of solid waste in any large city. The shortage of low-cost land adjacent to cities, and
the ever increasing costs of transport to, and operation of, sanitary landfills may make
incineration a cost-effective option. The type of incinerators available and their various
advantages and disadvantages were outlined, together with the role which incineration may play
in the overall management of municipal solid wastes. He also discussed the management and
controls which must be considered for all emissions from an incinerator, not only the stack gases
but also the liquid and solid discharges.

2.18 Evaluation of course

Dr Anderson compiled and presented the evaluation which showed that the overwhelming
opinion of the participants on the course was that they had found it very useful and that they
appreciated both the technical content of the lectures and the quality of the presentation. Of
maximum significance perhaps, was the fact that everyone found that the course was in some
way relevant to their current waste problems. All believed that they had benefited from the
course and
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that sufficient time had been made available for discussions although they were divided on the
usefulness of the site visits.

Generally the subject matter was considered to be theoretical rather than practical and
there was sufficient (or too much) handout material. Nobody found the course too difficult and
everyone benefited from exchanges of experience with both the lecturers and other participants.

There was universal agreement that some level of usefulness would be gained by all
countries represented and that the course would provide those attending with an opportunity to
pass on the knowledge gained to other with whom they work. They would now be able to take
appropriate decisions and apply new methods since they are better able to understand the various
options available to them in solid waste management. Overall the course was highly rated.

3. SITE VISITS

The course participants and advisers made a full day visit to the Al-Akaider and Rusaifa
sanitary landfills. Using the checklists, they noted various positive and negative factors dealing
with design, operation and maintenance aspects of both sites. These observations were then
jointly discussed in a group session and resulted in individual and useful improvement strategies
and approaches in view of each country’s situations.

4. COUNTRY PRESENTATIONS

4.1 Egypt

Historical concern about solid waste management and governmental concerns were
covered by various laws such as 38/1967, 39/1976 and 129/1982 including penalties and
punishments related to general cleaning and waste management. Recently a separate law, 4/1994
concerning all environmental affairs, was approved by the Government.

The main public health concerns and problems are:

– air pollution resulting from accidental combustion, emissions of particulate matters, oxides of
sulfur and nitrogen.;

– water pollution resulting from leachate from landfills and composting plants that reach
roundwater with heavy concentrations of organics and heavy metals;

– public health hazards resulting from biological, physical and chemical agents exposure to
explosives, broken glass, nails, pins, wires, bones, smoke, animal and insect bites, virus,
bacteria, fungi, parasites and protozoa;

– respiratory diseases, eye diseases, skin diseases, parasitic infections, accidental wounds and
dog
bites among people working in collection and transport;
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– hazards from dangerous wastes like laboratory and hospital wastes.

4.2 Islamic Republic of Iran

Collection and disposal of urban solid wastes is primarily undertaken by municipalities

(Ministry of Interior), while monitoring and surveillance of the health aspects of refuse disposal
is the responsibility of the Environmental Health Department affiliated to the Ministry of Health
and Medical Education, and the Environmental Protection Organization.

The local strategy for refuse collection and disposal includes a high technology compost
plant installed in Isfahan since 1989 with a capacity of 500 000 kg per day. The plant has
provision for recycling of plastic wastes for the time being, but more advanced equipment will be
installed for recycling of metals, glasses, paper and cardboard, in the future.

Regarding hospital and clinical refuse disposal, some hospitals are equipped with refuse
incinerators but this method does not function in big cities, because of air pollution problems,
therefore hospital and medical laboratory refuse is collected utilizing special procedures and is
subsequently buried in a sanitary landfill.

4.3 Iraq

The municipalities deal with the solid waste management because they are governmental
bodies which have all responsibilities for collection, transportation and disposal of the solid
waste. The legislation, restrictions and requirements of landfilling for ordinary and toxic
hazardous solid waste are issued by the Deputy Prime-minister’s office in Iraq.

The number of landfills in Iraq is around 108 in the 15 governorates and the average
amount of solid waste produced by one person per day is 0.7 kg.

The amounts of solid waste produced in Baghdad city and 14 governorates during the first
half of 1994 were 1 650 000 and 8 601 745 tonnes per day respectively out of which only 439
000 tonnes was collected. The equipment available to deal with solid waste management consists
of 1204 pieces. The actual requirement is for 1885 pieces indicating a shortage of 681 thus
resulting in accumulation of solid waste in large amounts, increase in harmful insects and
rodents, bad smells and consequent effects on health and environment.

4.4 Jordan

Solid wastes will continue to be a source of environmental pollution unless scientific and
sound bases are considered in their management. These wastes constitute a large burden that has
to be shouldered by the municipalities' budgets and the costs of collection, transport and disposal
are very high. Prices for machinery required are also very high. Sound management and optimal
organization are just two factors that will assist in reducing the high costs incurred in solid waste
management. Last but not least, the education of people regarding pollution and ecological risks
is another main factor in a successful treatment and processing of solid wastes.

4.5 Morocco
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The management of solid waste is largely assured by the local governments with the
logistics of the Ministry of Environment. In the city of Rabat, population 880 000 inhabitants,
the management of solid wastes is assured by the cleaning services of the community and urban
communes. They collect 950 tonnes a day of solid waste of which 90% is of household origin
and therefore disposal is 25% composting and 75% burying. About 16 tonnes a day of recyclable
products, of which 83.6% is cardboard, are collected through the acquisition of 1400 dustbins,
compressing dampers and a new rubbish dump (80 ha). Unfortunately negative repercussions on
the environment are noted due to bad conditions. Consequently the action plan which will
include three deadlines, short, medium and long-term should have as its principal orientations:

– sensitization of the population for better conditioning and sorting from the beginning;

– improvement of work and salary conditions of the waste collector; and

– adequate reduction/elimination options.

4.6 Oman

Disposal of the various kinds of solid waste is a problem as there are many factors
affecting both environmental and human health. There are laws of environmental conservation
and the State makes great efforts to implement the best methods of solid waste disposal. Disposal
is done in three phases: collection, transportation and final disposal

With regard to collection, the municipal authorities are trying to provide the largest
possible number of small waste steel barrels of 200-litre capacity and large mechanical containers
of 1.1 m3. The municipalities use various vehicles for transportation of solid wastes. The
automatic vehicles which are used in towns crush and press the waste. The big trucks and small
vehicles are suitable for the remote areas. For off shore locations, such as islands, large boats are
used for transportation of waste. The process of final disposal is still being developed, so the
municipalities are using traditional methods in final disposal of waste at present, such as open
burning, burying or both. Waste that cannot be burnt, like solid hardware, old vehicles and
construction refuse are thrown in open specified areas.

Solid waste in the regional municipalities comes from domestic sources, slaughterhouses,
workshops, garages, old furniture and wood. They are disposed of at locations far away from
inhabited areas as specified by the municipality, where they are burnt in the open or buried or
both. The waste from livestock and poultry farms is transported by the farm owners and by the
municipalities, while tree cuttings and leaves are collected and burnt outside the farms in
uninhabited areas. Waste from hospitals and clinics, although hazardous, is disposed of in the
municipality waste bins and then transported by municipality vehicles to the final dumping area.
Only large hospitals use closed burning areas for disposal of their solid waste. Construction
refuse is transported to specific locations by the contractors. Old vehicles are collected and
transported to a specific location near the dumping areas. Currently, some private firms demand
these steel structures for reuse. Industrial waste is managed by the Ministry of Commerce and
Industry and oil waste is treated by Ministry of Petroleum and Minerals.

4.7 Pakistan
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In accordance with Federal Government policy on local government affairs, provincial

local governments frame rules for local urban and rural councils. The local councils are
autonomous bodies and are responsible for solid waste management. The municipalities levy
taxes for economic development and solid waste management. There is a system of refuse
storage, collection and disposal. The efficiency and effectiveness of each municipality and its
organization up varies from city to city.

4.8 Sudan

Fifteen percent of the population of 25 million are living in urban areas, and the other
85% live in rural localities. Refuse collection and disposal has been organized governmental
work since the beginning of this century, when the British colonizers first adopted that system in
big towns in the country by using animal carts. Since 1951 local councils have held the
responsibility for improvement of sanitation and so refuse collection and disposal is a local
council responsibility. The methods of collection and disposal vary from one locality to another,
but any system adopted should ensure efficiency and safety of means selected. Community
participation has an important role in environmental activities in Sudan, and it helps in disease
control and removal of accumulations of refuse.

4.9 Tunisia

The Tunisian strategy on solid waste management is aimed at three targets: preventive
measures, reinforcement of curative interventions and improvement of environmental control.
The Solid Waste Management National Programme (PRONAGDES) is one of the curative
measures chosen by the government to manage solid wastes, protect natural resources, provide
various cities with an efficient system for solid waste management, encourage private sector
investment in this field, and issue new legislation for the solid waste sector. Ministries, agencies
and institutions involved in the management of solid wastes are: Ministry of Interior, Ministry of
Environment and Land Use Planning, Ministry of Public Health, Sanitation Office (l'ONAS),
Environment Protection National Agency (ANPE) and the municipalities.

The production of municipal solid waste is about 880 000 tonnes/year for 4.8 million city
dwellers, with an average production of 500g/day and a growth rate of 1.3% per year. Study has
shown that the techniques of composting and aerobic decomposition before dumping are the best
methods to treat municipal solid waste in Tunisia. The National Strategy Plan on Solid Waste
Management foresees that 50% of municipal solid waste should be eliminated by the year 2005,
and 100 % by the year 2025. The success of the National Strategy Plan for Solid Waste
Management depends on providing financial resources combined with private sector investment
in this field.

4.10 Repulic of Yemen

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The cleaning Department of the Ministry of Construction, Housing and Urban Planning
has responsibility for solid waste management programmes in the municipalities. Under the
present system, environmental problems have been low on the list of national priorities, due to
inadequate financing to cover the total cost of the operations. Solid waste is generated at an
average of 0.5 to 0.7 kg per person per day, with a density of 0.02 to 0.35 kg per litre. The
composition of solid waste in the city of Sana'a is: vegetable 49.3%, plastic 8.6%, metals 2.3%,
bones 1.2%, textiles 3.6%, glass 1.2%, paper 8% and miscellaneous 8.1%.

5. CONCLUSIONS AND RECOMMENDATIONS

5.1 Conclusions

Solid waste management is one of the most pressing environmental health problems
requiring immediate and urgent attention in the coming decades by all Member States and
sustainable solid waste management options need to be identified for adoption. Sanitary landfill
still offers an acceptable and practical solution to the disposal of municipal solid waste. Solid
waste management in rural communities is not given a sufficiently high priority while more than
50% of the population in the Region live in such areas.

However, while waste minimization at source, recycling, recovery and reuse options can
offer practical solutions to solid waste problems, there are often no incentives available to the
waste generators and to industry. Basic guidelines, information and data on solid waste
management problems, health risks, appropriate local technologies and environmental health
needs are not available for Member States in the Eastern Mediterranean Region. This could be
rectified by the production of an appropriate book or manual by WHO. Likewise, adequate laws
and regulations, policies, strategies and plans of action for the management of solid waste do not
exist in most of the Member States. Finally, there is a great shortage of trained personnel in the
field of solid waste management and adequate protection against "occupational hazards and
health risks" are not available.

Successful operation of any solid waste management system depends mainly on the
involvement and participation of the public. The level of cooperation, participation and
improvement in collection services, especially neighborhood cleanliness, can be increased by
strengthening of environmental health awareness through the mass media and specifically
designed community education programmes. The following actions, at national level were
recommended:

Some legislation exists, in most countries of the Region, for waste management, however,
it was felt by the participants that the existing legislation in all countries needs to be reviewed
and updated to reflect current waste management issues, particularly to regulate industrial and
hazardous wastes. The enforcement of waste management legislation needs to be considerably
strengthened with sufficient human and financial resources. In some countries this has already
been addressed by the establishment of environmental protection agencies whose responsibilities

include waste management, but they have not yet been in operation long enough to assess their
effectiveness and impact.
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5.2 Recommendations

Community involvement, participation, education and awareness

1. Member States should promote, and seek the assistance of EMRO/CEHA in, setting up and
planning public participation and awareness programmes and facilities.

2. Central governments should develop well-researched and forceful public education

programmes, in close cooperation and consultation with local municipalities or executing
agencies.

3. Governments and local authorities should hold education and public awareness programmes in
rural areas.

4. Mass media (television, radio, press, etc.) should be used to emphasize the need for and role of
public participation in the efforts related to solid waste collection, storage and its implications
for health and economics.

5. Simple teaching materials, in national languages, should be prepared for schools. School
children should be encouraged to participate in environmental health improvement projects.

6. Academic institutions, environmental health institutions and agencies, and non governmental
organizations or groups should be encouraged to sponsor the preparation of promotional and
demonstration material as well as promote pilot projects to increase community participation
and develop new approaches.

7. Consideration should be given to the involvement of the private sector in solid waste
management. The role and increased participation of non governmental organizations and
local social committees and groups, in raising environmental health awareness, and in
educating the public concerning health hazards associated with solid waste should be
recognized by the local municipalities.

Education and training of environmental health personnel in solid waste management

8. Training efforts should be undertaken by Member States, at three levels of education and
training in:

1. Waste management planning for engineers and managers.

2. Operation, maintenance and overall management for engineers and technicians.
3. Health and safety requirements and good working practices for supervisors and operators.

They may also seek support and cooperation from EMRO/CEHA in the preparation of
relevant teaching and learning materials at various levels and their translation into local
languages.
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Appropriate solid waste management technologies and options

9. The participants agreed that sanitary landfill is the best option for disposal of solid wastes in
the Region. Municipalities, environmental engineering schools and United Nations agencies
should provide support for the preparation of appropriate guidelines and training courses for
the design and operation of sanitary landfill sites. Crude dumps and open burning sites should
be replaced by proper sanitary landfill or landfill sites.

10. Recycling and resource recovery should be promoted with proper consideration for
environment and health. Separation of municipal solid waste components at source and reuse
and recycling of materials by industry should be encouraged, by providing practical and
appropriate incentives.

11. The success of some composting plants in the Region, and the need for soil conditioning using
organic materials, such as compost, were noted. It was recommended that more plants be built
in places where there is a market for compost, and waste segregation is available, and that
information on operating and managing compost plants be shared freely or through
CEHANET in the Region.

12. For economic health and environmental reasons, it was agreed that clinical and medical wastes
be disposed of using small specialized incinerators or by properly designed and secure sanitary
landfilling.

13. It was recommended that storage containers and collection vehicles should, where possible, be
of types that are suitable for standardization and capable of being manufactured locally, and
preference should be given to local manufacturers to overcome problems of obtaining spare
parts from overseas.

14. The selection and specification of collection vehicles should be based on local data and
conditions. More attention should be focused on measuring work rates and estimating running
costs so that economical systems are selected.

15. Proper schemes should be developed for the handling of hazardous wastes at source.

Legislation and institutional set up

16. EMRO/CEHA should support Member States in identifying, through solid waste management
research and surveys, strengthening institutional and personnel needs.

17. All Member States should have national policies regarding equipment and fleets for solid
waste collection and disposal with a back-up policy for replacing and upgrading such fleets.

18. Appropriate funding should be made available by Member States for solid waste management
schemes in each city and rural community (if possible) to provide equal services to all the
sectors, regardless of income or socio economic levels.

19. National environmental health regulations should call for monitoring the safety and health of
all workers involved in solid waste management, through health insurance and other schemes.
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20. EMRO/CEHA should support Member States in developing national environmental health
policies, legislation and regulations related to the management of solid waste in an
"environmentally sound and health-friendly" manner. Support is also needed by Member
States in developing regional environmental health intervention levels related to solid waste
management.

21. Member States should review their policies concerning the control of solid waste treatment
and disposal, so that it is not necessarily carried out by the ministry of health but by an
independent agency such as a regional or national organization, (e.g. ministry of environment,
regional waste disposal authority).

National goals and plans of action

22. It is highly recommended that each Member State sets up time-bound national targets for each
municipality or district for the preparation and implementation of solid waste management
plans.

National plans must include an assessment of current and future environmental health
personnel, equipment and financial needs. Exchange of solid waste management information (on
a regional basis) through CEHANET should be encouraged. The action plans may include the
following:

One)Identification of priority needs;

Two)Arranging annual "Environmental Health" and "Cleanliness" days for communities, with
financial incentives and appreciation/acknowledgment systems;

Three)Provision for community participation and environmental health awareness in

highlighting the health risks associated with solid waste management and development
schemes;

Four)Training of human resources at all levels;

Five)Development of systems and technologies that are affordable, robust and appropriate to
local conditions for storage, collection, resource recovery and disposal of solid waste;

Six)Introduction of specific management procedures for toxic and hazardous, including

clinical, wastes;

Seven)Evaluation of quantities and characteristics and the management of industrial wastes of

all types;

Eight)Provision for the exchange of information, knowledge and experiences on national,

regional and inter regional levels.

Nine)Development of research on the operation and design of sanitary landfill sites, with
emphasis on odour control, gas collection and venting, leachate control and other problems,
based on national and regional experiences.
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6. PLAN OF ACTION

All the participants, after review and discussion of the conclusions and recommendations,
agreed to the following general points for further follow-up to this Solid Waste Management
training course in their personal or official capacity.

1. To translate in to local languages, disseminate, share and spread the information (through
local newsletters, news items, etc.) gathered and knowledge gained, and to act as "trainers"
in implementing activities related to the technical area of solid waste management in their
respective countries.

2. To promote and assist their governments in follow-up, through the authorities concerned, of
the implementation of the recommendations.

3. To assist with, and promote, the process of collaboration and cooperation between
government, industry and the public.

4. To obtain appropriate literature, information and support, from WHO and other United
Nations agencies for education and training.

5. To print, adapt or translate the appropriate available documents concerning solid waste
management and prepare special materials (teaching learning materials) in the country.

6. To recommend to appropriate authorities, as well as to participate in and promote the holding

of "follow-up" workshops or seminars, at local and national levels.

7. To arrange to send any success stories and progress in such programmes in the country to
EMRO and CEHA, in due course, for inclusion in its newsletter.

8. To maintain links with EMRO and CEHA and other participants about the tasks being
undertaken or needed, for the purposes of activity networking in the Region and sharing
technical know-how.

9. To assist in the formation of twinning inter-municipality programmes.

10. To assist in promoting greater understanding of solid waste problems among the people and
in changing peoples attitudes towards it.

11. To assist the government in the assessment and evaluation of the solid waste disposal options
and their environmental health impact assessments.

12. To initiate and promote processes of recycling and composting as pilot studies and also the
handling of special wastes, such as clinical waste.

13. To sensitize their respective agency staff and the public through celebration of "World
Environment Day".
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7. CLOSING SESSION

Dr Khan thanked the participants for their cooperation and active participation during the
training course as well as in the formulation of recommendations for future follow-up. He
emphasized that the participants, after their return to their countries, should disseminate
information and knowledge gained from the course, might wish to keep a close link with
WHO/CEHA and feel free to request additional information from CEHA.
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Annex 1

AGENDA

1. Opening Ceremony

2. Global and Regional Overview of Solid Waste Management

3. Environmental Pollution and Health Implications of Solid Waste

4. Solid Waste Surveys, Storage, Collection and Disposal Facilities

5. Use of Computers in Designing Solid Waste Management Systems

6. Solid Waste Minimization, Recycling and Composting

7. Solid Waste Disposal Options

8. Country Reports

9. Site Visits
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Annex 2

PROGRAMME

Saturday 25 March 1995

08:30 - 09:30 Registration

09:30 - 10:00 Opening Ceremony

- Message from Dr Hussain A. Gezairy,
Regional Director, Eastern Mediterranean Office
- Welcome address by H. E. The Minister of Health, Jordan

10:30 - 10:45 Introduction of participants

10:45 - 11:00 - Election of course officers (Chairman, Vice Chairman, Rapporteur)

- Announcements
- Agenda adoption
- Scheduling of Country Papers

11:00 - 11:30 Scope and purpose of course (Dr Khan, TRA/CEHA)

11:30 - 12:00 A global and Regional (EMR) overview of solid waste management (Dr Khan)

12:30 - 13:30 Environmental Pollution and Health Implication of Solid Waste

(Dr G. K. Anderson)

13:30 - 14:30 Discussions

14:30 - 15:30 Solid waste surveys: Quantities, sources and composition (Mr D. J. Elliott)

Sunday 26 March 1995

08:30 - 10:00 Planning and management of storage systems, (Dr G. K. Anderson)

10:30 - 11:30 Discussions

11:30 - 13:00 Waste collection vehicles and systems, (Mr D. J. Elliott)

13:30 - 15:00 Discussions/Case study

Monday 27 March 1995

08:30 - 13:00 Site visit to solid waste storage and collection facilities in and around Amman

13:30 - 15:00 Discussions/Case study

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Tuesday 28 March 1995

08:30 - 10:30 Country papers and discussions

11:00 - 13:00 Continue country papers and discussions

13:30 - 14:30 Clinical waste management, (Dr G. K. Anderson)

14:30 - 15:30 Discussions

Wednesday 29 March 1995

08:30 - 13:00 Computer aided design of solid waste storage, collection and
transportation systems, (Mr D. J. Elliott)

13:30 - 15:00 Solid waste minimization, separation and recycling approaches and options,
(CEDARE) Eng. M. Akrouk.

Thursday 30 March 1995

08:30 - 09:30 Role of community participation in solid waste management

09:30 - 10:30 Discussions

11:00 - 12:00 Information management for municipal solid waste management services
(Eng. Malkawi, Dr Khan)

12:00 - 13:00 Discussions

13;30 - 15:00 Country papers and Discussions

Saturday 01 April 1995

08:30 - 13:30 Visit to maintenance workshop for waste management equipment

13:30 - 14:30 Discussions

14:30 - 15:30 Waste collection vehicle scheduling and management (Mr El-Hishan)

Sunday 02 April 1995

08:30 - 10:30 Siting, design and evaluation of sanitary landfills,

(Dr G. K. Anderson/Mr D. J. Elliott)

11:00 - 12:00 Discussions/Case study

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12:00 - 13:00 Development and use of check lists/methods for evaluating disposal sites,
(Dr G. K. Anderson/Mr D. J. Elliott)

13:30 - 15:00 Selection and use of appropriate waste disposal manpower and equipment
(Mr El-Hishan)

Monday 03 April 1995

08:30 - 15:00 Site visit and evaluation of existing landfills (Al-Akaider and Rusaifa) and
their environmental health impacts

Tuesday 04 April 1995

08:30 - 10:30 Feasibility, planning and management of composting in EMR (Dr Natour)

11:00 - 12:00 Discussions

12:00 - 13:00 Composting case study (Dr Natour)

13:30 - 14:30 Incineration as a waste disposal option in EMR (Dr G. K. Anderson)

14:30 - 15:30 Discussions

Wednesday 05 April 1995

08:30 - 15:00 Full day site visit and evaluation of landfill sites of Madaba, Mafraq
and Humra, as well to a functional hospital waste incinerator

Thursday 06 April 1995

08:30 - 10:30 Evaluation of course and recommendations (Dr G. K. Anderson)

11:00 - 12:00 Closing

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Annex 3

LIST OF PARTICIPANTS

EGYPT

Mr Youssef Shafik Youssef

Director General
Environmental Health
Ministry of Health
Cairo

Mr El Sayed Al Araby Sarhan

Director
Potable Water Control
Environmental Health
Ministry of Health
Cairo

ISLAMIC REPUBLIC OF IRAN

Mr Sayed Mohammad Hossein Kazemi

Expert of Environmental Health
Ministry of Health
Boushehr Province

Mr Hassan Ali Jafari

Senior Expert of Environmental Health
University of Medical Sciences and Health Services
Isfahan

IRAQ

Eng. Rasoul Sahib Ghazi

Director of Environmental Protection Unit
Al Najaf Governorate

Eng. Mohamed Ali Abdel Ameer

Chief Engineer
Environmental Protection Centre
Baghdad

JORDAN
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Eng. Mohammad Khalik Dabbas

Ministry of Health
Amman

Eng. William Salty Haddad

Greater Amman Municipality
Amman

MOROCCO

Dr Boukli
Director
Bureau Municipal d’Hygiene
Rabat

OMAN

Mr Mattar Mahkoom Shabail Al Riyami

Head of Toxic and Hazardous Substances
Department of Environmental Health and
Malaria Eradication
Ministry of Health
Muscat

PAKISTAN

Mr Nayyer Mahmood
Administrator
Rawalpindi Municipal Corporation
Rawalpindi

Mr Zafar Iqbal Beg

Environmental Engineer
Lahore Metropolitan Corporation
Lahore

SUDAN

Mr Kamal Abdel Azim Ibrahim

Director Environmental Health
White Nile State

Mr Mohamed El Gak Humrani

c/o WR/Sudan
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TUNISIA

Mr Raki Zghondi
Ingenieur Principal
Office National de l’Assainissement
Tunis

Mr Lotfi Helaoui
Sanitary Engineer
Environmental Health Division
Ministry of Public Health
Tunis

YEMEN

Dr Abdel Kaher El Zaemey

Head, Environmental Health Division
Civil Engineering Department
Faculty of Engineering
Sana’a University
Sana’a

Mr Mohamed Abdul Wasih Al Iryani

Head of Cleaning Division
Environmental Health Department
Ministry of Housing and Urban Planning
Sana’a

OBSERVERS

United Nations Relief and Works Agency for the Palestinian People in the Near East
(UNRWA)

Mr Hassan Salem
Field Sanitary Engineer
Jordan

Mr Ibrahim Al Abdallah
Senior Sanitarian
Lebanon

Mr Zohdi Salah
Field Sanitary Engineer
Gaza
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WHO SECRETARIAT

Dr M. Z. Ali Khan
Coordinator
WHO Regional Centre for Environmental Health Activities (CEHA)
Amman

Dr G. K. Anderson
WHO Temporary Adviser
University of Newcastle-upon-Tyne
United Kingdom

Mr D. J. Elliott
WHO Temporary Adviser
University of Newcastle-upon-Tyne
United Kingdom

Dr R. Natour
WHO National Temporary Adviser
University of Jordan
Amman

Eng. S. Al Hishan
WHO National Temporary Adviser
Greater Amman Municipality
Amman

Eng. Mazen Malkawi

Technical Assistant
CEHA

UNITED NATIONS/INTERNATIONAL ORGANIZATIONS

Engineer Maha Akrouk

Research Assistant
Urbanization and Human Settlements Programme
Centre for Environment and Development for the
Arab Region and Europe (CEDARE)
Cairo
Egypt