The International Committee of the Red Cross provides aid to those in need all across the world. This means operating in distant lands, with sometimes minimal resources delivered by road, rail or air. The challenge of freight shipment of incoming supplies is critical – the weight and size of shipments incurs delay and raise costs so correct selection of goods and supplies is critical. There is often little room for flexibility since every item must be carefully considered with bulky or heavy items substituted for those creating fewer shipment problems.

On the obverse, aid operations should not create waste disposal problems that cannot be resolved by local treatments or outward shipment. Again, this carries a cost that must be minimised as the ICRC and other aid agencies seek to maximise their efforts to the immediate delivery of care.

Some compromises are therefore necessary. Burial and burn pits may be used for tissue and other wastes. Impromptu waste containers may suffice, with waste treatments being be far less rigorous that we might expect elsewhere. However, safety is important and it is to the great credit of ICRC, and others, that they have created a carefully crafted medical (clinical) waste management plan that is now freely available to all.

A bound copy is available directly from ICRC in Geneva, but the guide can be downloaded free of charge from http://www.icrc.org/eng/assets/files/publications/icrc-002-4032.pdf.

The guide comprises clear advice, concisely and with carefully detailed illustrations to explain the practicalities required. It covers the general framework for waste management, safety requirements, and has separate short data sheets for each waste fraction. In some respects, it is everything that HTM 07-01 should have been!

As always, ICRC have done an excellent job in this medical waste management guide as they do in all aspects of their work. It is important not to take guidance from the ICRC guide for application outside areas requiring emergency aid delivery where waste-related resources and infrastructure are compromised or non-existent. However, the guide will be of great value in all under-resourced areas and in developing nations where an effective waste infrastructure is lacking.

The guide contains much compromise in approaches to waste management. It is entirely clear that those compromises are the end result of considerable experience and expertise, are well thought out and balance carefully safety and environmental concerns with practicality and need.

Congratulations to ICRC.