In Kampala, private clinics and medical centers are lifelines for communities in densely populated areas like Kyebando and Bwaise. Yet, behind their mission to heal, many of these facilities are perpetrating a grave environmental crime: the illegal disposal of hazardous medical waste.
This reckless practice is polluting water sources, poisoning the air, and threatening both public health and fragile ecosystems, violating Uganda’s environmental laws and endangering the very communities these clinics serve. Investigations by our reporter reveal a disturbing pattern.
Used syringes, blood-stained gloves, placenta bags, expired drugs, and even aborted fetuses are being dumped into open drains, garbage skips, and wetlands, with some facilities burning waste in the open air.
Sadam Zakaria Bisase, a leader of a community group tasked with cleaning the Lubigi channel in Bwaise, Kawempe Division, painted a stark picture of the environmental crisis unfolding in one of Kampala’s largest drainage systems, which feeds into the vital Lubigi wetland and water network.
Zakaria and his team regularly encounter medical waste, some of which he described as “disturbing items.” He noted that private clinics, mirroring the behavior of some residents, often exploit the cover of night or heavy rainfall to dump their waste directly into the channel, exacerbating pollution and endangering both the ecosystem and the health of those who rely on these water systems.
Peter Okech, a Kampala Capital City Authority (KCCA) cleaner, shared similar concerns. “We find placentas and aborted fetuses in the waste. It’s terrifying. This isn’t just scary; it’s dangerous for everyone,” he said. The environmental toll is profound. This untreated medical waste releases toxic substances that contaminate soil and water, threatening wetlands critical to Kampala’s ecosystem.
At some facilities, nurses were observed burning medical waste in the open, a practice that releases toxic pollutants into the air. Ashes and residues wash into nearby channels and wetlands during rains, further polluting the environment. This violates Uganda’s National Environment Act, the Waste Management Regulations (2020), Sections 49 to 64, and the Public Health Act, which mandate safe incineration or transport to licensed disposal facilities.
Joy Taffe, a staff member at JB Medical Clinic in Bwaise, explained that their facility attempts to comply with regulations by sorting waste: sharps in safety boxes, blood-soiled materials in red bins for highly infectious waste, and non-infectious items like paper in black bins.
However, she admitted that some clinics cut corners. “Many hand over infectious waste to regular waste collectors, who mix it with household refuse and dump it at sites like Kiteezi,” she said. The Kiteezi landfill, recently temporarily closed, continues to receive illegal waste, with residents reporting hazardous materials like syringes, gloves, and drug packaging spilling into nearby homes.
Dr. John Kayanja of Maxwell Clinic emphasized the challenges. “We use a licensed waste management company, but private incinerators are costly to acquire and maintain,” he said. While condemning open dumping as unprofessional, he acknowledged that many facilities engage in it due to financial pressures.
Brain Baluku, a laboratory technician at St. Kizito Health Centre III in Bwaise, shifted the blame to government agencies, saying several ministries and regulatory bodies have neglected their responsibilities. Baluku added that no health unit can be granted a license without presenting a proper waste management plan and proof of a company to handle its medical waste. But, to him, this requirement exists only on paper, and many clinics continue to dispose of their waste openly into the environment.
According to Ministry of Health data, 26% of medical waste in Uganda is hazardous—20% infectious, 3% pharmaceutical, 1% sharps, and 1% cytotoxic or radioactive. The scale of the problem is staggering, yet enforcement remains weak. Dr. Joseph Nkodyo, National Coordinator of the Biosafety Programme at the Ministry of Health, emphasized that improper disposal of medical waste from health units is hazardous to both human health and the environment, and if not managed correctly, can have serious consequences.
“Environmental and health risks are mounting. Contaminated water sources threaten communities, while air pollution from open burning harms ecosystems and public health. Wetlands, vital for flood control and biodiversity, are under siege,” he noted.
Dr. Nkodyo explained that the Ministry of Health recognizes the problem and is actively working with various professional councils, including the Uganda Medical and Dental Practitioners Council, the Uganda Nurses and Midwives Council, and the Allied Health Professionals Council, to find better solutions and ensure compliance.
Available information shows that the problem extends to public facilities, exacerbated by a funding shortfall. Months ago, the U.S. government paused USAID funding for healthcare waste management as part of a foreign policy review. Although some funds were restored, the Shs 22.2 billion previously allocated for medical waste management was lost.
Dr. Nkodyo acknowledged the issue, explaining that USAID previously managed medical waste disposal nationwide. “With the closure of the USAID program, funding stopped, and some facilities have resorted to open burning and other unsafe disposal methods, putting both the environment and public health at risk,” he said.
He added that the Ministry has instructed public facilities to use regional incinerators, such as those at Mulago and Kiruddu in Kampala. Private facilities are required to engage registered medical waste companies or coordinate with these regional incinerators, rather than burn waste openly or dump it into drainage channels.
Meanwhile, with weak oversight, Mark Musaazi, a local conservationist, warns that the illegal disposal of medical waste remains a pressing environmental crime that requires urgent government action.
“Without stronger enforcement, affordable waste management solutions, and renewed funding, the health benefits provided by these clinics and other health facilities will continue to come at a severe cost to both the environment and public health,” he said.
Several reports by UNEP and the Ministry of Water and Environment note that wetlands like Lubigi act as natural filters, detoxifying pollutants such as nitrates, phosphates, heavy metals, and hydrocarbons.
However, the dumping of hazardous waste, including medical waste, overwhelms this capacity. This feature was sourced with some support from The Resilience Fund and Transparency Advocacy.
