**4. Other alternatives in healthcare emergencies**

#### **4.1 Onsite burial of waste**

Onsite burial of waste can be considered in cases where the resources are limiting, and the amount of waste produced is also small and also if it is for a limited of time. The pit should be 1–2 meters wide and 2–5 meters deep. The bottom of the pits should be 2 meters above the ground water level to avoid contamination of ground water (**Figure 3**).

A fence should be constructed around the pit to stop wild animals and people from gaining access to the pit. Alternatively the waste can be burnt to reduce the volume of the waste.

**Figure 3.** *Waste disposal pit [7].*

In cases where pathological waste is also being produced placenta pits can also be used to dispose to dispose pathological waste. These placenta pits need to be located in specific places with the view of avoiding contamination of ground water. Natural degradation and draining of liquid into subsoil will greatly reduce volume of waste.

Sharps need to be disposed in concrete lined pits after decontamination (**Figure 4**).

### **4.2 Washing, cleaning and disinfection**

Existing cleaning and disinfection procedures for healthcare settings should be followed consistently. In most cases 705 ethyl alcohol and 0.1% sodium hypochlorite are sufficient to disinfect most surfaces.it is recommended that all individuals in charge of environmental cleaning laundry and dealing with soiled bedding, towels and clothes from patients should wear appropriate PPE. Soiled linen should be placed in appropriately labeled leak proof bags or containers after carefully removing any solid excreta.

It is recommended that utility gloves or heavy-duty reusable plastic aprons are cleaned with soap and water and decontaminated with 0.5% sodium hypochlorite each time they are used.
