Towards a sustainable and integrated waste disposal approach: an assessment of waste-to-energy feasibility in Msunduzi Municipality, South Africa.

Masters Degree. University of KwaZulu-Natal, Durban.Industrialisation and business activities have seen increased economic growth in major cities and townships. Urbanisation is on the rise largely through rapid human migration from rural or outlying areas to urban areas in both global North and global South countries. Humans create solid waste. The complexity of general solid waste tends to degrade the environment. Global organisations such as the United Nations and its Sustainable Development Goals along with various national and sub-national frameworks seek ways of solid waste management. The insufficient management of solid waste is a palpable cause of stress to the environment, budget processes, community participation challenges, institutional arrangements, finance issues and unsustainable waste disposal. Therefore, this desktop study interrogates the research problem of handling solid waste management at municipal governance level in an urban setting. Some municipalities in different parts of the world implement waste-to-energy technologies to address solid waste issues. The municipal context studied in this minidissertation is Msunduzi Municipality, which is the capital of KwaZulu-Natal Province, South Africa. Msunduzi Municipality has an integrated solid waste management plan. However, it is yet to embark upon implementation of waste-to-energy technologies. Drawing upon secondary data, the objectives of this study were to determine whether or not waste-to-energy approaches can assist with providing sustainable solutions to waste disposal and energy challenges at the municipal governance level. The study further ascertained outcomes of waste-to-energy technologies employed by cities in different countries and to draw lessons from these jurisdictions that could benefit Msunduzi Municipality in developing waste-to-energy technologies. This descriptive exploratory non-empirical qualitative study is underpinned by the critical constructivist philosophical paradigm. Whilst Msunduzi Municipality provides the case context, the case is municipal solid waste and the unit of analysis is energy; approaches to deriving energy from solid waste. The study employed a non-probability sampling strategy and a purposive sampling technique. Secondary data were collected by using relevant words and phrases to source literature from various search engines and by examining global, national and sub-national policy frameworks. Findings, conclusions and recommendations provide lessons for Msunduzi and other similarly situated municipalities. The results inform policy and praxis for municipal governance on the feasibility of adopting sustainable integrated waste management approaches and waste-to- energy technologie

Evaluating the clinical management of severely malnourished children- a study of two rural district hospitals

Background. Severe malnutrition is an important cause of preventable mortality in most South African hospitals. Work recently done in two rural Eastern Cape hospitals supports the literature which shows that many deaths occur as a result of outdated clinical practices and that improving these practices reduces case fatality rates. Rapid assessment of clinical management in paediatric wards is necessary to highlight areas for improvement.Objective. To assess the management of severely malnourished children in two rural district hospitals and to recommend improvements for their care.Methods. Based on draft World Health Organisation (WHO) guidelines for inpatient care of children with severe malnutrition, data collection instruments were developed in conjunction with the district nutrition team to assess the quality of care given to malnourished children in two Mount Frere hospitals, Eastern Cape. Data were collected through retrospective review of case records, with detailed studies of selected cases, structured observations of the paediatric wards, and interviews with ward sisters and doctors.Results. The combined case fatality rate for severe malnutrition was 32%. Inadequate feeding, poor management of rehydration and infection, lack of resources, and a lack of  knowledge and motivation among staff were identified as areas that need attention.Conclusion. The clinical management of severely malnourished children can be rapidly assessed to highlight areas for improvement. Involving staff in the assessment process has led to their active involvement in improving the management of malnourished children in their hospitals