From managing medical waste to measures to mitigate impact of climate change, Napapan shows the way

Meet Ms Napapan Nantapong, Director of the Bureau of Environmental Health, Department of Health (DOH), Ministry of Public health (MOPH), and a true champion of health and environment. Managing medical waste from the COVID-19 surge to protecting people from air pollution and the health impact of climate change, her contribution to health and the environment is inimitable.

COVID-19 has caused an enormous surge in medical waste. This includes used vaccine vials and syringes, personal protective equipment (PPE), used Antigen Test Kits (ATKs) and masks, much of which is made of plastic. According to WHO's report, massive medical waste from the pandemic exacerbates environmental impacts from solid waste and becomes a threat to human and environmental health.

Infectious medical waste became a pressing problem in Thailand in August 2021 during the peak of its 3rd COVID-19 wave. The country was producing 432.5 tons of medical waste per day, but the capacity of local incinerators was only 305 tons per day. As the Director of the Bureau of Environmental Health, DOH, MOPH, handling medical waste fell under Ms Napapan Nantapong's responsibilities. She worked with different stakeholders to modify the country's regulations and to contract industrial waste processing factories to dispose of the waste. As a result, the country rapidly upscaled its capacity of medical waste disposal to 1,491 tons per day.

Ms Napapan said apart from increasing the waste disposal capacity, the bureau also educates the general public on how to handle medical waste at home. Under her leadership, the Bureau of Environmental Health produced various educational materials and trained Village Health Volunteers to educate people in communities on how to dispose of the used ATKs and waste from COVID-19 patients under home isolation. If this waste is not handled correctly, it can spread the virus and pollute the environment, said Napapan. 

Through Village Health Volunteers and local radio stations, people are educated about handling medical waste. The volunteers will then give feedback to MOPH about concerns and additional support needed from the Ministry.

Up to 1.04 million Village Health Volunteers across the country have been a key part of primary health care in Thailand in the past four decades. They undertake health surveys, collect data, maintain family health records, and do disease prevention campaigns to support the public health authorities. Ms Napapan said 80 per cent of the village health volunteers are women. This is women's power in building good health from the grassroots level, she added.

Apart from managing medical waste, Ms Napapan also works in the area of the climate's effects on health, especially from extreme weather events. For example, air pollution has become a severe environmental and health issue in recent years, with the highest levels of pollution seen between November and March each year. Also, last year, Thailand experienced very high temperatures in April. As a result, many people suffered from heatstroke and heat cramps. 

In 2020, When Ms Napapan was the Head of the Health Impact Assessment Division, under DOH, she visited villagers in the North affected by air pollution. She initiated a 'clean air shelter' project for villagers who could not afford an air purifier for home use. As of 2022, the project has established 2,760 clean air shelters in eight provinces in northern Thailand and Bangkok. These rooms, equipped with air purifiers, serve as temporary shelters when air quality becomes unhealthy for people susceptible to respiratory diseases. In addition, the Department supported many villages in the Northeast, which often experience extreme weather events, to become model communities for climate mitigation and adaptation.

"Climate has an enormous impact on the people's health in Thailand. So our strategy is to work with communities to prepare them for disaster and support them after the disaster. For example, we educate people on how to take care of themselves during flooding. But after the flood, we work to ensure, for example, that the flooded markets are cleansed," said Ms Napapan.  

Ms Napapan believes in a bottom-up approach in building good health. She believes that good health begins with healthy behaviours, from sorting waste to managing sanitation at home. 

"It is crucial to educate people to have health literacy to have healthy behaviours and not become sick easily. When the population has good health and well-being, this healthy population can help develop our country sustainably," said Ms Napapan.

This piece was originally published on WHO.