Medical waste, sewage mix in open trench at Brac landfill

Faulty medical incinerator falls into months of disrepair

A Brac resident took this picture of the landfill medical waste pit on 29 Aug. - Photo: Submitted

An open pit of untreated medical waste and septic tank sewage at the Cayman Brac landfill is creating potentially “inhumane” conditions for staff.

The problem began around late April when the site’s medical waste incinerator malfunctioned due to a scorched burner, explained Patience Eke, the Department of Environmental Health’s officer for the Sister Islands.

Since then, workers have been forced to resort to a familiar backup method: dumping the bags of medical waste collected from Faith Hospital and Kirkconnell Community Care Centre into an open pit layered with soil.

This time, however, the biohazard has been exacerbated by the addition of septic tank sewage left by contractors in the same trench, Eke said.

The addition of sewage means workers will not be able to return to the trench to dig out and properly burn the medical waste once the site’s incinerator has been repaired. To do so, Eke said, would be unfair to her team.

“That would be very inhumane,” she told the Cayman Compass.

“It’s a very challenging situation.”

The Cayman Brac medical waste incinerator is pictured in 2018, when it was out of service for four months. – Photo: Ken Silva

The Brac’s medical-waste incinerator has broken many times before and government has been aware for years of the trenching of untreated medical waste at the landfill.

In 2015, the Brac’s medical-waste pit was described in the draft National Solid Waste Management Strategy, prepared for government by Amec Foster Wheeler and KPMG.

“Biomedical waste collected on Cayman Brac is currently landfilled in a discrete hazardous waste pit excavated into the landfill on Cayman Brac, although this was previously burnt in a now disused incineration unit,” the report said.

By 2018, the incinerator was back in operation. A malfunctioning burner, however, left it out of service for around four months that year.

News of trenched medical waste sent up red flags at the time about possible violations of public health law.

Section 6(5) of the Public Health (Infectious Waste) Regulations states, “Infectious waste may be disposed of in a sanitary landfill after it has been treated. Incineration and steam sterilisation are the primary treatment methods…”

Internal DEH emails from 2018, obtained through a freedom of information request, showed the department struggling to find a solution for the Brac’s growing biohazard.

This untreated medical waste was found by the Cayman Compass at the Cayman Brac landfill in May 2018. – Photo: Ken Silva

Jennifer Ahearn, then chief officer for the Ministry of Health, emailed officials, telling them to “get a proposed plan together asap” to communicate to the public.

A suggestion to transport the waste to George Town never proceeded. Eke pointed out that to move the waste to Grand Cayman, it would have to be transported in a special container and pretreated. So, the open trench remains the backup option when the incinerator malfunctions.

Eke told the Compass the machine is “aged” and has been recommended for replacement over the years, due to the expense and inconvenience of frequent repairs.

This time around, a burner was scorched during lockdown, complicating and stalling the repair process.

When a technician finally installed the replacement part in August, Eke said, they discovered the issue was larger than one burner. The roof and housing around the incinerator had rusted, allowing in moisture and short-circuiting the machine, she added.

“[Public Works] realised the rust is so much, it’s not something that can be fixed. The whole top needs to be removed,” Eke told the Compass.

Repairs are expected to begin over the weekend, with Public Works and a contractor dividing the responsibilities.

While the incinerator is used primarily for disposing of medical waste, Eke said it has also been used for burning police and customs documents, as well as expired medications. In the meantime, those items can be handled through controlled burns, she said, but medical waste requires the incinerator.

She added that eight large PVC containers have also been repurposed for medical-waste storage in the Brac. Those containers are entirely full.

Typically, medical waste would be stored in purpose-built, biohazard containers. While such containers have been provided to medical facilities, Eke said the landfill is relying on repurposed containers.

“We make sure they are covered so at least we can control fly infestation,” she said, adding that workers have also been spraying disinfectant.

She estimated the Brac landfill would need about 200 to 300 of the standard biohazard storage containers to address its need.

Once the incinerator is repaired, she said the waste in the eight repurposed containers would be the first to be processed.

Due to frequent break-ins at the dump site, typically carried out by individuals in search of car parts, Eke added that the trench has been placed in a remote section. The landfill does not have security to guard the area at night.

Like all of Cayman’s landfill sites, the Brac dump is unlined and was created without input from solid-waste engineers. It has been in operation since at least 1978 and is located 230 feet from Cayman Brac’s public beach on the south side of the island.

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  1. In addition to medical hazards, the Brac dump also has encroached on the Red Shrimp Hole, ruining a rare and valuable natural site where shrimp followed underground fissures and entered a pond from the sea. Proportionately, the Brac dump may cover and area larger than Mount Trashmore. The back “wall” of the dump is the actual face of Cayman Brac’s iconic bluff.