Typical problems in the operation of wastewater systems include:
• lack of awareness among senior staff at health-care facilities on wastewater problems;
• insufficient or non-functioning pretreatment and primary treatment systems, or no hazardous wastewatermanagement
system;
• little or no programme of preventive maintenance;
• non-availability of basic tools to carry out maintenance;
• use of systems that are too complex to be operated by unskilled workers, or operational costs that are unbudgeted
or too high to be affordable.