Toxic waste, callous treatment

Deadly, hazardous and toxic, untreated bio-medical waste could trap us in all in a twister of nightmarish infections. Isn't this reason enough to bring every healthcare setup in the city under a stringent regulatory system with the utmost urgency? Not so, if a damning report based by the Comptroller and Auditor General (CAG) is any indication.

First, what do the rules say: The Bio-Medical Waste Management Rules, 2016 (BMW Rules) mandate every Health Care Establishment (HCE) generating BMW to take all steps to ensure that such waste is handled without any adverse effect on the human health and environment.

Glaring lacuna
The infectious wastes are required to be collected, transported, treated and disposed of strictly in accordance with the BMW rules. The CAG report found a glaring lacuna in the enforcement of this rule by the Karnataka State Pollution Control Board (KSPCB): "KSPCB does not have details of the mode of treatment and disposal of BMW of 3,473 HCEs in the state. Disposal of a significant portion of the BMW using unscientific methods cannot be ruled out."

The implication is clear: A disturbing number of hospitals, clinics, diagnostic centres are clearly guilty of not segregating the hazardous waste. Used syringes, contaminated swabs, expired drugs and even body parts are being mixed with municipal waste. Contamination of soil and water bodies is a real danger, a readymade recipe for an outbreak of deadly diseases.

Common facilities
The bio-medical waste collected is treated at the city's Common Bio-Medical Waste Treatment Facilities (CBMWTF). But the Pollution Board has been charged with not doing enough to monitor them. Studies have indicated that the efficiency of these facilities are low since they use outdated technologies. Their incineration facilities and emission control levels have also come under question.

An estimated 25 tons of BMW are generated by the healthcare units in Bengaluru every day. But how much of this ends up at the city's two CBMWTFs? This is not clear. Top KSPCB officials have themselves found during random checks that a majority of hospitals do not fully comply with the mandated BMW segregation.

But the Board has been found to be lax in cracking down on the violating hospitals. Waste management experts, environmentalists and concerned citizen activists are asking why the pollution watchdog is not closing down such facilities.

Deliberate mixing
Healthcare establishments have been repeatedly found mixing medical and general waste. Preferring anonymity, pourakarmikas confirm that they do find the hospital waste in huge quantities at the landfills and solid waste treatment centres.

Segregation of BMW is a continuous process, and this can be done efficiently only when there is continuous training. This has been found lacking even in big hospitals, notes Wilma Rodrigues from Saahas Zero Waste, a social enterprise. "This reiteration of training has to be taken right down to the cleaning person. Lab assistants too need to be vigilant about BMW," she notes.

Guilty clinics
Wilma also draws attention to the smaller clinics that hardly follow the BMW rules. "A lot of them don't even know that such rules exist. There is no segregation. Nor do they hand over biomedical waste to the right agencies. This violation is even worse with dental clinics where a lot of BMW is generated. Has KSPCB randomly visited such clinics?" she wonders.

At a prominent private hospital in Indiranagar, proper segregation of BMW and transportation to a common treatment facility is currently on. A visit to the hospital confirmed this. But the entire process was streamlined only a year ago.

An insider, who did not want to be named, reveals that before a newly trained officer took charge, the entire medical waste generated in the hospital was mixed with municipal waste and carted away to the landfills. Awareness was low and inspections too were rare.

No segregation
In Dasarahalli, at the BBMP Maternity Hospital, syringes, swabs and other waste were found dumped in a huge dustbin. However, there was no sign of any segregation. A hospital staffer explained the segregation would happen outside the health facility at a nearby BBMP garbage facility. But rules mandate that this process should be completed within the hospital by trained staff.

Segregated or not, once the biomedical waste leaves a health facility, does the entire load reach the CBMWTF? Narendra Babu, a solid waste management specialist and equipment supplier, notes that the BMW finds its way to the municipal waste dump yards enroute. This, he alleges, is in collusion with the Palike and the garbage mafia.

Environmental hazard
From an environmental perspective, the unregulated dumping of BMW with municipal waste can be disastrous. "We find tons of biomedical waste in a lot a quarries where garbage is dumped. This is particularly common in Anjanapura, Kengeri, Bommasandra and other areas. Besides being extraordinarily hazardous, BMW is highly pathogenic too. Infected body parts are coming out of hospitals. Infections can spread very fast since awareness on public health is so low," notes Leo Saldanha from the Environment Support Group (ESG).

The high rate of morbidity among the BBMP pourakarmikas, who are in direct contact with BMW -mixed garbage, is a clear indication of the hazards. "They are the most exposed," as Saldanha puts it. Conversations with pourakarmikas in early morning pickup vans in HAL area confirms that they do get hospital waste bags filled with used syringes, swabs and more.

Landfills to water sources
A recent study by ESG is another proof of how the hazardous waste finds their way to landfills. Finding fault with the treatment plant at Mavallipura, the study reveals that heavy metals are being released by the landfills into the water sources. Notes the report: "This is quite uncharacteristic of municipal garbage, indicating thereby the strong possibility that these landfills have been receiving hazardous wastes as well." This observation says it all.

(With inputs from Darshan Devaiah B P & Madhuri Rao)