Despite strict enforcement of laws on dumping of bio medical waste, cases of illegal dumping of medical waste mixed with municipal solid waste has become rampant in city based hospitals across the country. Dr Suleman Merchant, Dean, LTMG Hospital, Mumbai, shared his perspective with Clean India Journal based on certain official reports.
In a recent incident, a light green polythene bio bag containing one kilogramme of medical waste was found outside a city hospital in Coimbatore. As per official reports, workers handling bio medical waste in hospitals in Indore have become prone to hospital associated infections. Kerala is also facing the problem of safe disposal of waste generated from medical institutions. These are a few of the reports that highlight the need for an effective hospital waste disposal mechanism throughout our country.
Proper hospital waste management bears more significance as the total quantity of hospital waste generated in Bangalore is about 40 tonnes per day and Delhi based hospitals boast of 1.5kg/day/bed of bio medical waste for an estimated 40,000 beds. Data provided by Madhya Pradesh Pollution Control Board has also revealed that some of the city hospitals have not been segregating waste as per the standards set by the Government under the Bio- Medical Waste (management and handling) Rules 1998. Lack of proper segregation of hospital waste has further compounded the problem of hospital associated infections and growing trend in resistance to a wide variety of antibiotics
Garbage disposal has been a major challenge area for Mumbai’s LTMG Hospital which is surrounded by major slums – Dharavi, Pratikshanagar, Koliwada, Labour Camp Matunga and Rawadi camp.
Talking about the lack of an effective hospital waste management model, Dr Suleman Merchant told that the situation became grave when rodents started creating havoc recently due to piling up of garbage in the hospital premises. As a part of the solution, additional garbage bins were installed in the hospital premises and it was ensured that garbage collection by the civic body was done thrice a day. Smaller bins will be replaced with bigger ones to control the spillage.
“We are also integrating our efforts with the SWM department of Brihanmumbai Municipal Corporation (BMC) for effective disposal of garbage. A women’s organisation that was roped in recently for filtering the garbage and collecting recyclable material, has been cautioned about spillage on account of ‘sorting’. I have ensured proper garbage management by using a ‘rear’ entrance to my office located right next to the garbage bins; keeping the garbage clearance workers on their toes. This has ensured cleanliness of a hitherto unused area which is now used as an additional parking area for the hospital and medical college,” he informed.
Challenge and the Solution
He emphasized that challenge lies in segregating bio- medical waste at the grassroots level that is at the ward level. Our staff collects, segregates and dumps at a specified place from where it is taken away by the BMC authorised agency SMS Envoclean Private Ltd for further disposal. A separate agency, Yashraj Biotech, has also been appointed to collect tissue fluids and pleural effusion.
The specified area or compartments for the disposal of biomedical waste inside the hospital is very small. In order to address the problem, the hospital has started the job of constructing a much larger room for the same. “Setting up of an incineration plant onsite is mulled over by the hospital management owing to the space crunch,” Dr Merchant said.
Public Education and Waste Management
Keeping patient care in mind, LTMG Hospital, popularly known as Sion Hospital, has adopted a zero tolerance policy towards piling up garbage. “We have made a marked change in improving the scenario but the attitude of people towards garbage needs to be dealt with in a much pragmatic way. Contractors are generally assigned a rough schedule of cleaning by the BMC but need is to clear the garbage consistently five to eight times a day. The need is also to enforce the rules strictly so that they are complied with by the public as well. The amount of garbage created is huge. For that sorting, segregation and awareness is required and hazardous waste has to be disposed off separately.”
Waste as a resource
All biodegradable waste is not recyclable. The currently recyclable biodegradable waste which comes after segregation majorly being plants and leaves, is burnt and the ashes are preserved to be used as fertilizer.
The hospital conducted a cleanliness drive with the help of hospital staff and over 100 students recently. Environmentalists Afzal Khatri and Nusrat Khatri personally guided the students in their cause and helped clean huge decrepit area. About 12 dumper truckload of debris was removed during the drive. “The area cleaned was actually a playground, but was being used as a dumping ground for years. Now, not only can we have cricket pitch there, but also a basketball court with a garden. This will go a long way in boosting our students’ and resident doctors’ health,” Dr Merchant added.