**3.5 Destruction of the waste**

Incineration is the commonest way of destroying most healthcare waste. If it available especially in formal healthcare settings is the most commonly used method of getting rid of the healthcare waste. Incineration involves a high temperature (850–1100 degrees Celsius) dry heating process that reduces organic and combustible waste to inorganic incombustible matter. It highly efficient in reducing weight of the waste. However it produces toxic emissions if the equipment is not well functioning. Dioxins and furans are generated by the combustion process which contains chlorine. They are highly toxic and bio accumulative. They can cause reproductive developmental problems, damage to the immune system, interference with hormones, and also can be mutagenic [6].

It is costly to have the High temperature incinerators. Incinerators use high heat to destroy waste. The De Montfort Incinerators can be rapidly deployed to emergency settings as they are small. In some cases single-chamber drum and brick incinerators can be designed to meet the healthcare emergency needs where resources are limiting. Transition to more sophisticated incinerators can be planned depending on the length of the healthcare emergency. Depending on setting, mobile incinerators can also be availed to add to the waste management strategies in the developed world in response to healthcare emergencies.

More sophisticated types can be deployed with time as they offer the option of polluting the environment less. The sophisticated ones include the dual chamber incinerators, and the co-incinerators. Dual Chamber incinerators burn waste at temperatures as high as 850 degrees Celsius in the primary chamber. The temperatures are maintained by multiple gas and oil burners with the vapors from the primary chamber being directed to the secondary chamber with one or more burners that raises the temperatures to 1100 degrees Celsius. Flue gas treatment is recommended to reduce air pollution. Other incinerators can also allow for multiple types of waste to be dealt with at the same time [6].

The incinerators must be ideally located approximately 61 meters away from habitable buildings, 46 meters from water sources and 300 meters from agricultural site. The waste management site should always be enclosed. In urban settings these waste management centers should be offsite. The ash from the incinerators should be removed safely from the site and appropriately disposed in a pit.

In most healthcare emergencies it might not be possible to have the incinerators in all possible places where healthcare waste is being produced. In addition, the available incinerators are easily overwhelmed due to the increased volumes of waste produced during emergency settings.
