Dr. Nat's Journal

Back when my parents were at primary school, a large emphasis was placed on the 3 R’s – reading, writing and arithmetic.

In more recent years, a second set of 3 R’s (which all actually start with the letter R this time) has been introduced. Reduce, reuse and recycle is the modern mantra taught to encourage social responsibility through waste management.

The 3 R’s are meant to be a hierarchy, in order of importance. Hence, we should start by reducing what we use, followed by reusing, then recycling.

When I lived in London, most people I knew participated in recycling – it isn’t hard to remember to put out tins, bottles and cardboard once a week to do your bit for the planet. However, the first two R’s tended to slip amidst the hustle and bustle of city life. General waste was collected twice a week in my borough, making it easy to throw away anything used or broken and to generate large amounts of waste.

In Zambia, I have a small bin in my kitchen. There is no recycling system, and no formal waste collection system. Any rubbish I generate, I have to carry to the communal bin in the hospital, and I haven’t yet probed about what happens to it from there.

As a result, I find myself generating much less rubbish and focusing more on reducing and reusing. Glass jars, plastic bottles and cardboard boxes all have useful functions that make them worth cleaning up and holding onto.

It isn’t just me reusing things. Locals reuse things again and again, both for the item’s original function and for completely new functions. I have been most impressed by the number of things you can do with a plastic bottle both in and outside the hospital.

When trying to treat someone with asthma, I discovered that we do not have any spacer devices for inhalers here. A spacer is a plastic cylinder that eases inhaler use by providing a chamber to hold the aerosolized drug before breathing it in. When I mentioned to a nurse that I wished we had a spacer, she quickly fashioned one from a plastic bottle, and the situation was resolved.

The plastic bottle water-sprinkler system used around the hospital grounds is another gem. It is so effective; I can’t understand why anyone would buy a real sprinkler!

There are many more uses for plastic bottles, including as a chest drain container for draining pleural fluid, as bird feeders, plant pots, drinking cups, water scoops for bathing, lanterns for outdoor candles, and the list goes on.

Beyond water bottles, you see other everyday items being used to repair things or create a new function. I am particularly fond of the makeshift wheelchairs using patio furniture.

I am not trying to say that the management of rubbish in Zambia is better than in London. The amount of litter strewn on the side of the road with food packaging and medication bottles stuck in bushes highlight how far from ideal things are here.

Financial reasons and lack of resources is driving the large amount of reuse that occurs in Zambia. As the country develops, wages and consumerism will rise. At that point, the current sprinklers will likely start to be replaced by shop-bought sprinklers, and more and more plastic bottles will litter the side of the road.

For now, I will continue to marvel at the numerous innovative uses for everyday items that could easily be thought of as waste, and feel grateful for my crash course on the first two R’s.