Ebola in Liberia: Keeping communities safe from contaminated waste

February 2015

Every day, every bed in an Ebola treatment unit creates approximately 300 litres of liquid waste. Managing this waste has been a challenge in the Ebola outbreak in Liberia. WHO is working with partners to ensure this waste is effectively decontaminated and no longer poses a threat to health.

Managing the contaminated liquid waste from the Ebola Treatment Unit, Liberia
Managing the contaminated liquid waste from the Ebola Treatment Unit, Liberia
WHO/R. Sorensen

Rosy Petors lives with her two daughters, Mary and Comfort, just next door to the Island Clinic, outside the capital Monrovia. In September last year, the former clinic was transformed into one of the largest Ebola treatment units (ETU) in Liberia, housing as many as 200 patients and 3 times as many staff.

During the rainy season, water started to seep through the brick wall that surrounds the Island Clinic compound. People in the neighbourhood were very anxious about what this water might contain, even though it came from the section of the ETU which housed no patients.

"You can’t stop the water, it will always find a way," says Hassan Srour from WHO. Together with his team from the water, sanitation and hygiene sector, Srour quickly engaged the neighbours in a cash-for-work programme to construct a channel to lead the water out of the neighbourhood.

Moses Williams and his grandchildren live next to the Island Clinic on Ebola, Liberia
WHO/R. Sorensen

"We are not afraid of living next door to Island Clinic anymore,” says Mary. “We appreciate what WHO has done very much."

"My main concern was that the Ebola virus would leak out," says Moses Williams, who also lives by the clinic. "Now my grandchildren can play around here safely and the situation has improved because of the work of WHO."

300 litres of waste per treatment bed

Another major challenge for the WHO team is managing the contaminated liquid waste from the patient side of the ETU. One Ebola treatment bed creates approximately 300 litres of liquid waste per day. In addition to sewage, contaminated liquid waste includes the 0,5 chlorine solution used to disinfect the health workers’ equipment and the 0,05 chlorine solution used for showers and hand washing.

All the liquid waste from the ETU goes into septic tanks. When these filled up, the WHO team worked to find a way to decontaminate and store this waste. WHO partnered with the Liberia Water and Sewer Corporation which provided their Fiamah sewerage plant in Monrovia for storage of the liquid waste.

Not in my backyard

Once the site for the waste was identified, new problems arose. People in the community around the Fiamah sewerage plant were anxious about having liquid waste from the ETUs stored near their homes.

Sign outside waste management facility: Keep away. Treated Ebola waste safely stored here, Liberia
WHO/R. Sorensen

Lawrence E Flumo, from the Fiamah municipality, says his community had serious concerns about having the Ebola waste dumped there. "We have worked with UNICEF on sensitizing the community since November," he says. "Now that we have a secure fence around the waste management plant, the community have accepted the presence of the liquid waste depot."

In late January all the necessary elements were in place. WHO advised on infection prevention and control, while the International Committee of the Red Cross (ICRC) provided trucks to desludge the septic tanks and UNICEF helped construct the fence and other facilities. At the end of January the depot was opened.

Related stories on the Ebola response