"A few months after we constructed the waste area for the hospital, I'm still preoccupied with medical waste."

A few months after we constructed the waste area for the hospital, I'm still preoccupied with medical waste. It's a large part of my job (as a logistician, I'm in charge of all of the practical details that allow the medical teams to do their jobs), and one aspect where I can help in the medical nature of our work.

Over the last few months, my team has constructed smaller waste areas in nine rural health centers, with two more under construction at the moment. I see receipts and invoices pass across my desk for bricks, cement, metallic components to volume-reducers, fencing, and contracts for the manual labor to put it all together. Then it's the training for the Health Center Managers (gloves do NOT go in the same pit as placentas, thank you), and on to the next center. We're on track to finish 18 of the 21 rural health centers this year. Two centers are in provisional sites, so we won't invest in a waste area this year, but I'm pushing to find time in our schedule for that 3rd and final site.

Our sister project in Gore (see JJ's blog; we're neighbors!) is finished with their vaccination campaign, but the plans for the destruction of their waste fell through. We're in negotiations now to transport all of their waste (sharps boxes, gauze, glass vials) here to our nifty new waste area and dispose of it. My inbox fills with the exchange of who notifies whom, which car will take what waste when, and a detailed list of medical waste. I never knew I'd be so into trash.

Today marked another chapter of medical waste management, as I worked with a mason all morning to start the construction of a Montfort type medical waste incinerator. That's right, folks, I'm building a technical treatment device for sterilizing and destroying medical waste. In the heart of Africa. It's a highly technical build, since the magic of the incinerator is all about proportions (something about air flow between the two combustion chambers will allow temperatures to mount above 870 degrees Celsius--which is pretty hot, according to touch tests).  We're building it out of heat-resistant bricks, which have been imported from France (you can tell because they're square and a different color from the ground you're walking on), and refractory cement, which will withstand the blistering temperatures inside the device (most incinerators fail from heat cracking or improper curing).

I've spent the last month (on and off) going over the drawings and the construction guide, assembling the materials, and negotiating the contract with the most skilled mason in the district. Finally, the day arrives. We thoroughly follow the instructions, weighing, measuring, mixing, timing. The first batch of cement is ready. The bricks are laid out and a final position is fixed. The level is standing by.

And the cement won't hold. It's like apple crumble. I don't think I can build a high-tech waste-annihilator with apple crumble.

The mason and I kind of look at each other, each hoping the other will magically solve the problem.

After a few beats, we just start winging it. We add more water, we stop treating the refractory cement like gold, and we build the first layer. After an hour of precision brick-laying, it's done. We laugh about the apple crumble, but stop at the first layer. Because the nutella paste we ended up with, while equally tasty-sounding, does not give us much confidence. Will the cement hold?

We leave it to dry over the weekend, and resolve to come back on Monday. If it holds, we continue. If only the nutella holds, we redo the apple crumble. If nothing holds, we call Bordeaux.

Update 25th September: The cement held!