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Failure to handle hospital waste

Archna Mishra, April 10, 2013

Poor segregation, disregard for public safety and lack of watchdog prove worrisome

segregated Hospital waste must be kept in colour-coded boxes else it poses health risks.

At a time when the Delhi government is grappling with the disposal of solid municipal waste, the Comptroller Auditor General (CAG) report on the disposal of hazardous biomedical waste, also known as hospital waste, has put the government on the mat.

The administration is being castigated for disregarding public health and safety.
There are Common BioMedical Waste Treatment Facilities (CBWTFs) in the City for the treatment and disposal of biomedical waste, but questions have been raised on the way contracts are awarded to the operators of these treatment plants and the lack of quality standards that they maintain.

The Delhi High Court has questioned the setting up of waste incineration plants in Sukhdev Vihar. It has directed the civic authorities to shift the incinerator at Okhla in south Delhi, following health concerns expressed by residents of Sukhdev Vihar, a residential locality bordering Okhla.

Need for regulatory body


“Problems raised by the people of Sukhdev Vihar form one aspect of the quality of treatment in these plants. No doubt the government has tried to regulate the disposal of biomedical waste but the problem lies in certifying the quality of treatment,” says Ravi Aggarwal, director of Toxic Link, an environmental NGO.


“We don’t have an external body that can keep an eye on the working of treatment plants. There should be a separate institution to work on the quality control,” he suggests. More worrisome is the lack of awareness regarding biomedical waste disposal among both hospital staff and safai karamcharis.

“There is no awareness on segregation of biomedical waste. Generally, hospital staff do not put the waste into colour-coded boxes. Hazardous waste is dumped in the open. Ragpickers sort it and they are the worst hit. They could get series infections such as Hepatitis C,” says Prof A K Agarwal, president of the Indian Society of Hospital Waste Management (ISHWM).

Apathy

According to the BioMedical Waste (Management and Handling) Rules,1998 different kinds of waste generated by hospitals must be kept in colour-coded boxes.

Hazardous waste such as bandages, gauze, cotton or any object that has body fluids, human body parts or placenta are to be stored for further disposal in yellow containers or bags; plastic waste such as catheters, injections and syringes in red bags; all types of glass and discarded/ expired medicines in blue bags; needles without syringes, blades, sharps and all metal articles in black bags.

Mercury in hospital waste poses another serious problem. “The poisonous metal is found in medical instruments such as thermometers, blood pressure instruments, gastrointestinal tubes, dilation and feeding tubes and dental amalgams. The disposal of mercury is a serious business. Many hospitals are trying to phase out its usage by using alternatives such as electronic thermometers. Even dentists are opting for alternative composites like ceramic to fill cavities,” explains Prof Agarwal.

Tapas Sahay, MD, Synergy Waste Management, faults the “lax approach” of hospital authorities in segregating waste. “It is the responsibility of the hospital to segregate its waste according to guidelines. An object that has to be autoclaved cannot be put in an incinerator. If hospital waste is not segregated, it is bound to create a problem when it comes to waste treatment,” he says. Synergy is one of the operators of Common BioMedical Waste Treatment Facilities (CBWTFs).

The Delhi Pollution Control Committee (DPCC) has authorised three operators for the collection, treatment and disposal of biomedical waste from as many as 3,000 health care units in the City. But there are plenty of small clinics that fall below the DPCC’s radar.

“Big government and private hospitals work with waste disposal operators but there’s no one to keep a check on small clinics. They usually dump their biomedical waste in open grounds,” says Prof Agarwal. A joint effort by clinics, hospitals and the government is the only way out of the crisis.

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