This analysis focuses on the issue of the connection between waste management and health, bringing along the case study of Lebanon, where since 2015 a waste crisis has been taking place, leading to serious repercussions on people’s wellbeing. It will investigate in how the crisis started and developed, analyzing the effects on the population’s health. Subsequently, it will also explain the reasons why no effective solution has been found yet. Finally, it will conclude by suggesting policy recommendations to address the issue.Waste management, environment and health
As put out by the World Health Organisation (WHO), health is a comprehensive state, for which mental, physical and social aspects play a critical role. Environmental conservation, and in particular waste management, is therefore pivotal for people’s health. The inability of taking care of waste causes its deterioration, worsened also by weather conditions, and results in toxins release, water contamination, and bursting of infective diseases. In Lebanon, the most used practices to deal with waste are landfilling, incineration and dumping. In the country, only 17% of the whole waste produced is recovered through composting and recycling.
Studies proved that landfilling is linked to an increase in the risk of cancer cases (especially for pancreas and skin) and asthma and in the rates of hospitalization for asthma and other respiratory complications. Moreover, incineration is found to be associated with congenital abnormalities–urinary tract defects, respiratory difficulties and spina bifida. In addition, waste mismanagement plays a role in negatively affecting the environment by boosting climate change: indeed, incineration and landfilling are a threat to environment as they prevent oxygen diffusion into the soil, hampering revegetation. These practices also produce carbon dioxide – one of the greenhouse gases responsible for global warming. In addition, the toxins produced decrease plants growth and agricultural yields. Fishes mortality has increased because of the toxic dioxide. Herbivores health is affected as the plants they consume contain metals traces. Combining the population growth, the decreasing land areas and the waste management issue, Lebanon is today the country with the highest cancer prevalence rate in the Eastern Mediterranean Region.
Lebanese waste management crisis
In 1997, after having identified Solid Waste Management (SWM) as a priority area of intervention, the government agreed on opening the Naameh landfill, which was supposed to receive 3M tons of waste from Beirut and Mount Lebanon for the following 10 years. Despite these provisions, the landfill reached its full capacity in 2001, as it had received 600.000 tons per year since its opening. This was due to several reasons: first, another landfill, called Bsalim, should have shared the amount of waste with Naameh, but never opened, as it was found that in that location groundwater would have been at risk of contamination. Secondly, the composting capacity of Naameh was not enlarged–as supposed–therefore, more organic material piled up. Finally, recyclable plans designed for two centers–Karantina and Aamrousieh–did not develop, and the recyclable waste filled in Naameh.
With no better solution, the Naameh landfill was further expanded and was scheduled to close in January 2015; however, the government extended the time for closing, due to the lack of alternatives. Eventually, in July 2015, the residents of the nearby area forced its closure; at the same time, the garbage trucks company (Sukleen) was required by the government to continue street cleaning, although its contract was expired. Given the lack of a place where to dispose waste, the company stopped its activities and uncontrolled waste handling started.
In the aftermath of the Naameh’s closure, dumping and burning became the most adopted solutions for individuals to handle waste: the government had no other plan ready; therefore, people just started piling up the trash in the streets. In addition to this, it became common to burn waste in unauthorized places, which jeopardized the health of residents.
Given the state of emergency, the authorities started suggesting many solutions: eventually, the re-opening of the Naameh landfill was one of the measures approved. In addition, the decision of opening two new centers–in the Southern (Costa Brava) and Northern (Bourj Hammoud) regions of Beirut–was harshly criticized by the population, since in the light of the first failure people did not trust the government’s ability of dealing with waste issues. Moreover, the proximity of these sites to residents’ houses, and the lack of an impact assessment, gave further reasons for protesting against the measure. Manifestations took place in the end of August 2015, and led, at the beginning, 10,000 people to gather to protest against the lack of a long-term plan for waste management. Clashes between civilians and the police ended with the latter using water cannons and teargas against the protesters: on Sunday 23rd, the Lebanese Red Cross claimed to have treated 402 injured people, while around 40 have been taken to the hospital.
The protests continued, starting from the specific resentment for the waste mismanagement, to a wider indignation for the government’s corruption: by 29th August, 100,000 people went on the streets of Beirut to protest against the institution, accusing them of corruption, theft and having failed in running the country.
Despite the oppositions, the two landfills have been opened, with negative effects: in Bourj Hammoud, the trucks were found to dump the waste directly in the sea, causing damages to the fishermen working in the area. Furthermore, Costa Brava is located in the proximity of the airport; the waste collected there attracts birds, which are dangerous for planes and, therefore, represent a threat to public safety.
All the solutions suggested suffered of either mismanagement, causing further problems, or lack of sustainability, as they were tackling the problem with a short-term perspective, whilst not preventing another waste-crisis to occur again.
What could be done?
Many scholars suggested that to face the waste management crisis, Lebanese authorities should adopt the Integrated Sustainable Waste Management System (ISWM): this approach was elaborated in the mid-1980s and further developed in the mid-1990s. This strategy is considered to be sustainable as it has a long-term view and highlights areas to prioritize. In this perspective, it sets out a top-down/hierarchical approach, which means to: 1) prevent pollution; 2) conserve resources; 3) recover energy and material; 4) reduce waste before disposal; 5) dispose waste through incineration and landfills. One should be aware that such an approach cannot be top-down without raising awareness amongst people. Indeed, the first and the fourth points are those interfering the most with individuals’ daily life. In addition, the practice of dumping and burning waste, although in response to a lack of alternatives, seems to be embedded; thus people need to be educated on good practices about waste management, to make the ISWM work.
Indeed, another solution pointed out by researchers is multi-sectoral collaboration: they call for cooperation among the government, municipalities, citizens and the health system. The government should be in charge of raising the issue of public health, and make a priority out of it. On the other hand, municipalities should both raise awareness among the population and define where the landfills should be, make sure that these do not jeopardize the water provision and avoid waste piling up on the streets. As a result of an increased awareness, citizens should be careful about their waste production, be able to differentiate and recycle, and sensitized towards environmental issues. It is also true that the citizens have not sit back watching garbage piling; there are indeed examples of coordination amongst individuals for cleaning the streets, inspired by recycling companies such as Recycle Beirut. Besides organizing waste collection and training on recycling practices, the company also undertook raising awareness campaigns, which, combined with other initiatives, eventually led to protests against the government–such as the grassroots movement “You Stink!,” which played a pivotal role in the protests of August 2015.
In the light of the link between waste management, environmental conservation and the impact on health, the government should engage in finding sustainable solutions to these issues. Moreover, the work carried out by NGOs and recycling companies is admirable, as they intervene where the state fails; however, such institutions should not be replaced: they should be in charge and feel the ownership of addressing such topics, such as waste management. The Lebanese government should refer to what other Upper-Middle Income Countries (UMIC) are doing in terms of environmental conservation and waste management: organizing collection (which in UMIC covers between 50% and 80% of the waste produced), increasing recycling rates and starting finding alternatives to landfilling and dumping. However, the chronical lack of engagement from the government represents a challenge. Following the dismissal of the Prime Minister Saad Hariri, last 4th November, it will be inevitable to wait for a new government to be formed and hope that it will make of waste management and health a top priority.
Master’s degree in International Development (Sciences Po – Paris Institute of Political Studies)
Notes and references
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 Kulhánová, I., Bray, F., Fadhil, I., Al-Zahrani, A. S., El-Basmy, A., Anwar, W. A., Al-Omari, A., Shamseddine, A., Znaor, A., & Soerjomataram, I. (2017, April 2017). Profile of cancer in the Eastern Mediterranean region: The Need for Action. National Centre for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28268206
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 Kohn, A. (2016, December 27). Trash Crisis Forces Lebanon’s Environmental Awakening. Deutsche Welle. Retrieved from http://www.dw.com/en/trash-crisis-forces-lebanons-environmental-awakening/a-36765579