This hospital in Kirkuk, a major city in Iraq, clearly has a serious problem. In hospitals batch incinerators are most often used. The idea is you put together a batch of medical waste to be burned up to the capacity of the incinerator. It might be a 1 ton, 2 ton and sometimes 10 ton batch that needs a certain time limit to be completely burned.
https://kirkuknow.com/en/news/71409
This batch also has a menu. You combine medical waste in predetermined percentages with wood and other combustible materials to get the cleanest burn. Too many moist materials and you get a ton of smoke and the batch takes forever to burn. I am not 100% sure what's happening with this incinerator but I am confident the batch is not comprised in the manner the unit was designed for.
In some cases hospitals are not even allowed to build incinerators such as in the following case in the city of Giurgiu, Romania. Ruse city council perhaps are influenced by mishaps like that in the hospital in Kirkuk. But of course where will Giurgiw's medical waste end up going? I cant imagine being comfortable with it being buried accumulating for all eternity in some local landfill.
https://www.bta.bg/en/news/balkans/1016710-ruse-municipal-council-adopts-declaration-against-construction-of-hospital-waste
This is particularly unfortunate. Not only because a hospital of all places ends up polluting the air but the heavy particulate entrapped in this smokes falls all around the neighbourhood and it has the potential to make a lot of people very sick.
The problem of waste composition also plays a part in this story about a foreign built waste to energy pant is Addis Ababa, Ethiopia. In this case it's a continuously fed incinerator far larger than the batch style unit in Kirkuk. The problem is the waste in Ethiopia is mostly wet and in order to feed the incinerator it has to be mixed with dry construction waste so it will burn properly.
https://www.packaginginsights.com/news/reppie-waste-energy-failure.html
Yet another story from the Barbados Hospital details how "afterburners" were added in an attempt to control smoke emissions. This makes me think the secondary burners were never included in the original incinerator purchase contract. To get complete combustion an incinerator needs secondary burners to fully combust all the gas emitted from the burning of medical waste batches.
As well there has to be a prescribed burn menu to make sure the incinerator is not full of purely wet waste. Too much wet medical waste and you will get smoke.
https://barbadostoday.bb/2025/11/25/qeh-chief-declares-incinerator-era-over-as-new-waste-system-comes-online/
Putting the correct menu of waste feeds together has resulted in this incinerator operating at half the capacity it was intended for. No mention of how much smoke is being produced but we have to assume the operators are doing a good job of holding the menu composition so that complete combustion is attained.
It is also important to bear in mind that the hospital incinerator gets rid of medical waste that would be otherwise disposed of in local landfills. Medical waste seepage can cause cause disease and infection on a widespread scale if the waste is not contained properly and indefinitely. This hospital in Nigeria is trying to avoid exactly that kind of scenario by having Japan build them a hospital waste incinerator that gets rid of the waste once and forever.
https://championnews.com.ng/2025/12/05/japan-ssdo-partner-to-expand-healthcare-support-in-enugu-with-medical-waste-incinerator-project/
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