Medical Waste: A danger to public health

Published in The Daily Star
Star City
Wed. January 25, 2006

Syed Tashfin Chowdhury

Medical organisations like hospitals, clinics and diagnostic centres are constantly polluting the environment and endangering public health with a wide range of medical waste.

"These organisations dispose of medical waste on roads, dustbins, drains and any open space available in the absence of laws or policies governing such actions", said Tarit Kanti Biswas, project co-ordinator, Hospital Waste Management Project, Prism Bangladesh, an expert in waste management.

Biswas pointed out that over 200 tonnes of waste is produced daily from numerous hospitals, clinics and other medical service providing organisations.

"Officially around 600 such organisations operate in the city. Most of them use their own sweepers or staff. These ignorant staff members usually throw away the waste in bins or on the streets," he said.

The waste is then picked up by Dhaka City Corporation (DCC) vehicles and deposited at the dumping grounds. This waste then mixes with normal household garbage.

"The system is hazardous and poses a serious threat to the environment and city-dwellers. Hospital wastes are required to be treated separately," said Milon, a senior official of Prism Bangladesh.

Prism Bangladesh, an NGO, initiated 'the Hospital Waste Management Project' in February 2004, financially supported by the World Bank's Water and Sanitation Programme (WSP).

"We received a one acre plot in Matuail from DCC to initiate our waste management plant" Biswas said.

The Canadian International Development Agency (CIDA) provided vehicles and assistance for the plant construction.

According to Prism officials, medical wastes are broadly of seven types.

General waste consists of food items, infectious waste like tissues, amputated limbs. Surgical waste that result from operations and treatment of patients.

Sharp waste consisting of used syringe, glass, and needles, along with liquid waste that of blood, mucus and body fluids.

Then comes plastic or recyclable waste, followed by chemical and pharmaceutical waste, which consist of medicines or chemicals used in laboratories.

"Radioactive waste is not produced extensively in the city, but there is a certain percentage of it too", said Biswas.

Prism officials said they were concerned of the various ways by which such waste could affect the environment and health of city-dwellers.

"In the West, waste is classified and quarantined accordingly. Such is not the case in Bangladesh," said a Prism official.

The official said that 70 percent of medical waste dumped in the local dustbins is infectious.

"Waste like used syringes, gloves and others are picked by scavengers. These are later sold to unknowing patients or their family members at a price lower than the price of an average syringe or pair of gloves," said Biswas.

Infectious waste, at one time was dumped into garbage landfills of the city.

"Such waste decomposes with time and may seep into underground water supplies, cultivated lands contaminating soil and water," he said.

Gross incineration of this waste also causes pollution.

In their fight against this growing menace the organisation has, till now oriented around 680 employees from hospitals and medical service providing organisations of DCC Ward 49 and 57, about the 'Hazards of Medical waste'.

"As most clinics are located in these two areas, we decided to initiate our pilot project here," said a Prism official, adding that 40 hospitals and clinics have been trained since its launch.

"We first provided training free of cost, but most hospital authorities still ignored the training we provided", said Biswas.

"Most hospitals and clinics still hesitate to utilise our services as they have to spend more to implement our methods, but they agree that the methods are absolutely safe," he added.

He also said that most hospital authorities are consistently dumping medical waste consciously as a strict law concerning the issue is yet to be enacted.

Biswas also urged the need for an incinerator, which can reduce the volume of medical waste produced by these medical organisations.

"We have successfully reached our primarily goal of raising awareness and training a significant amount of hospitals about the hazards caused by medical waste in these two wards. With support from DCC and other organisations, we hope to initiate a bigger project soon, which will cover other parts of the city," he said.

When contacted, senior officials of the Department of Environment stated that though there is an existing law concerning waste and pollution, a definite law against medical waste is yet to be formulated.

"The law states that every organisation, government or non-government, should dispose of their waste properly. But we do not have a law solely focussed towards medical organisations and services," said Solaiman Haider, Assistant Director, Industrial Pollution, Department of Environment.

Although medical waste management is popular in developed nations as a part of the medical curriculum, Bangladeshi medical experts say such topics are yet to be added in the local medical curriculum.

"Most doctors, nurses, matrons and staff of hospitals and clinics are unaware of such waste management though it is very necessary," said a doctor of Sir Salimullah Medical College, under condition of anonymity.

"It is about time that concerned authorities propose, pass and enact a law and add courses to the existing medical curriculum to fight this increasingly dangerous menace to national environmental and health," said Biswas.