Waste Clinics: A practical approach to identify challenges and solutions for solid waste management

This article was originally published in Waste Management World Magazine.

Local governments face enormous challenges in managing the ever-growing waste streams as they are responsible for their collection, treatment, and disposal. To help local governments, Waste Clinics were conceived as a tool for identifying their most pressing challenges and finding potential solutions.

1. Introduction

Population and economic growth contribute to increasing solid waste generation around the world. Local governments face enormous challenges in managing this waste as they are responsible for its collection, treatment, and disposal. To help local governments, Waste Clinics were conceived¹ as a tool for identifying their most pressing challenges and finding potential solutions. A Waste Clinic brings together local government representatives, considered as “patients”, and waste management experts, who are facilitators and represent the “doctors”. During a Waste Clinic, local government representatives share their perspectives, knowledge, and experiences and develop a path forward based on best practices shared by their peers and experts.

Waste Clinics have been used by several organisations, including the Climate and Clean Air Coalition, the U.S. Environmental Protection Agency, Clean Air Task Force (CATF), C40, and RMI. The process of preparing and conducting a Waste Clinic varies and can be adapted depending on the specific needs of both the facilitating institution and the participants. Some basic steps for planning and conducting the Waste Clinic are described here based on CATF’s experience.

2. Planning a Waste Clinic

The smooth running of the Waste Clinic requires that the logistics are well planned and executed, and challenges faced by cities and potential solutions posed by experts are discussed efficiently. At Clean Air Task Force, we have developed and refined a flexible process to design and conduct Waste Clinics focused on solutions to mitigate methane pollution from the solid waste sector. Planning includes the activities leading to conducting the Waste Clinic, as discussed below:

2.1. Identifying the solid waste management representatives who will participate in the Waste Clinic

It is necessary to identify appropriate cities and the type of representatives from those cities who will be invited to participate in the waste clinic. While cities of different sizes and different waste management practices can learn from each other, the Waste Clinic is often most effective if participating cities are from the same country with similar policies and regulatory systems in place. Cities often have multiple people involved in waste management: political decision-makers (e.g., mayors) who may be elected, administrative decision-makers (e.g. commissioners), managers (e.g., chief engineer, chief sanitation officers), zone-level managers responsible for implementation (e.g., assistant engineer, sanitation officer), and on the ground staff (e.g., waste collectors, recyclers, facility operation staff). The appropriate levels of participants are political or administrative decision-makers who can effect change, accompanied by managers who can inform decision-makers about the situation on the ground. The ideal number of cities at a waste clinic should be based on the number of experts available; there should be no more than 3-4 cities for each expert at any given time.

2.2. Identifying challenges faced by participating cities

Preliminary work is necessary to ensure that the clinic is tailored for the audience. This involves desktop research and discussions with experts familiar with the policies and waste management systems in place. For instance, if most cities are currently disposing their waste in landfills, the clinic may need to focus on improving waste disposal practices, capturing methane from landfills, and diverting organic waste. The challenges can be categorized under several topics, including data collection and maintenance, waste collection, organic waste management, recycling, disposal site operations and management, and financing. Depending on the challenges faced and the Waste Clinic’s objective, any of these topics may be expanded to include more detail. For example, collection could be further subdivided into collection coverage, collection route optimization, collection infrastructure, source segregated collection, etc. The clinic should focus on no more than three or four topics to allow participants to explore challenges without being fatigued by the process or overwhelmed with information on numerous topics.

2.3. Identifying the experts

Based on the selected topics to be discussed at the clinic, the next step is to identify the experts who will act as facilitators. The experts need to have more than subject matter expertise, they need to understand it in the context of the participants’ experiences and be empathetic to their situation. For example, an expert from a developed country with a poor understanding of the situations faced by the global south may be tone-deaf to the situation on the ground and offer impractical solutions. It would be ideal to identify in-country or regional experts or experts with experience in similar contexts. Language may be a barrier, so it is important to identify enough experts who can communicate in the language of the participants.

2.4. Select an appropriate venue

The venue for the waste clinic needs to be large enough to accommodate the number of discussion groups and their participants. Discussion groups can become animated and noisy, and it is important to ensure sufficient space between the groups. The following logistics should be considered in the venue:

• Audiovisual requirements: This includes laptops with presentations pre-loaded, projection screens, microphones, and podiums, if necessary.
• Room layout: The screen, podium for speakers, and chairs for participants should be laid out in such a manner that the speakers and the screen are visible to all participants. Participants should be seated at tables so they can take notes easily. The tables may either be laid out in rows as in a lecture or classroom style with the audience facing the screen. These tables would have to be rearranged for a discussion setting for small groups to gather around for the later discussion sessions. Alternatively, round tables could be used with half the side being occupied during presentations with the audience facing the screen and occupying all seats during the later discussion sessions.
• Supplies: While some participants may prefer to use their laptops to take notes, pens and notepads should be provided and laid out at each seat. Flip charts and markers should be used for discussion sessions to capture key topics. This allows for a transparent process where all participants can ensure that topics of importance to them are captured.
• Allocation of tables: The number of tables set up for group discussions should equal the number of topics addressed, which are chosen in advance.

3. Conducting the Waste Clinic

The following section describes the five sessions of a Waste Clinic. The content of these sessions is inherently flexible, as numerous adaptations are required depending on the country’s needs.

3.1. Opening session

This session is geared towards providing context for the waste clinic and may include presentations by officials who discuss national policies and their implications on local actions and the introduction of experts and participants. This is followed by the organizers discussing the Waste Clinic’s objectives to incentivize city representatives to participate more actively in the later sessions by sharing their challenges, questions, and practical solutions that may have worked in their cities.

3.2. Expert presentations

Following the introductory session, experts present information on waste management of relevance to the country and audience at the waste clinic. These presentations would ideally highlight best practices to increase awareness of potential solutions to the challenges faced by the cities in attendance. For instance, if the focus were organic waste management, it would be useful to have presentations on best practices (ideally with examples in that country or similar countries) for efficient collection of segregated waste, organic waste treatment processes, and financing mechanisms for developing the infrastructure to collect and treat organic waste.

3.3. Discussion on challenges

This session is fundamental, as it is when participants specify the challenges they face, and their peers share solutions that have worked for them. Facilitating this session should be done considering the following:

• Grouping of participants: The groups will consist of representatives from 3-4 cities, one or more experts on the topic, and one notetaker.
• Process: The city representatives will spend 30 to 40 minutes at each table, allowing time for discussion and questions. Some participants may dominate the discussion, and it is the expert’s responsibility to diplomatically move it along to ensure that all representatives speak about their challenges. The note taker should capture all key challenges and identify shared challenges. After the allotted time, the city representatives should move to the next table and repeat the process on a different topic. After all city representatives have participated at all tables, the expert(s) at each table should summarize the challenges faced by the cities, including identifying common and unique challenges.

3.4. Expert-led discussion of solutions

In this session, experts help the participants identify potential solutions to their challenges and guide them in developing an action plan to implement them. The experts should encourage city representatives to consider various solutions and identify problems associated with their implementation. At the end of the session, every city representative should ideally be able to identify some solutions to address the challenges for each topic. City representatives may then develop a work plan that can be the basis for improving waste management. Worksheets should be provided for all participants to facilitate the discussions.

An alternative model to having the cities discuss solutions to their problems is to provide a case scenario. Information on a hypothetical city that is struggling with multiple challenges is presented along with an expert-facilitated discussion on potential solutions, allowing cities to discuss solutions without being constrained by their own situations. Participants should be encouraged to suggest solutions and activities for the hypothetical city based on their experience and the best practices presented by the experts and their peers. Here, experts can facilitate the discussion and provide more detailed information on solutions, as needed. An example of the worksheet for this activity is presented in Annex I.

3.5. Closing session

The closing session summarizes the key outcomes of the waste clinic and final remarks from the sessions. Any final announcements on making presentations available and providing contact information for experts may also be included. If having follow-up conversations with participants is possible, this can also be mentioned here. All participants should be thanked for attending and provided with a participation certificate. Finally, a survey should be used to capture participant feedback to inform future waste clinics.

4. The CATF Experience

CATF has conducted Waste Clinics in several countries, including Colombia, Mexico, and Ecuador, and intends to continue this practice in the future. A collection of valuable insights from CATF’s experience are provided below:

• A two-day workshop is ideal with the first day devoted to expert presentations and panel discussions on key topics, and the second day devoted to conducting the Waste Clinic. The first day’s proceedings help the audience get familiar with the waste sector landscape at the local, national, and international levels. This helps the city representatives better understand, share, and productively participate in the Waste Clinic.
• Having the “right” city representatives and experts is crucial to the success of Waste Clinics. City representatives should include both decision-makers and staff who have a practical understanding of the waste management practices in the city. Experts need to have appropriate experience assisting with waste management solutions in the global south. It is also important for experts to be good facilitators and good listeners.
• As participants move from table to table, it is important to consider the various permutations of participants in the groups. Assigning them to different groups ahead of time ensures smooth transitions between groups and allows for city representatives to hear a variety of experiences rather than moving with the same participants throughout the session.
• Identifying challenges through the Waste Clinic helps CATF develop policy recommendations for the national government. They also help CATF in identifying cities to assist and the types of targeted technical assistance that they can offer these cities as a follow-up to the Waste Clinic.
• After piloting a session focused on solutions to the cities’ own challenges, CATF altered the format to focus on a hypothetical city with challenges similar to what most participants face. This scenario was more productive as city representatives felt less constrained by their own situations and more open to seeking solutions, discussing potential hurdles to their solutions, and overcoming those hurdles in a cooperative group discussion.
• Translation services are important and crucial as some international experts bringing in expertise from countries with similar experiences may not speak the local language. It is important to brief the translators on the topic and vocabulary, so communication is most effective.
• CATF has worked with national governments and local experts to ensure diversity in the cities participating. It does not focus just on the largest cities but ensures variety in size, region, and issues faced.
• Cities have uniformly found this exercise invigorating, unique, and useful in helping them understand the potential for improvements in waste management.

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¹ The concept of a Waste Clinic was originally conceived by a group of experts from the Clean Air Coalition (CCAC) and the U.S. Environmental Protection Agency between 2014 and 2016.