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The state of Biomedical Waste Management in India today

Between June 2020 and June 2021, India generated over 56,898 tonnes of Covid-related biomedical waste. This is in addition to such waste produced by non-Covid hospitals, beds and procedures. Could India cope with this sudden addition to its biomedical waste burden? Can it be treated by techniques other than incineration? Masood Mallick, Joint Managing Director, Ramky Enviro Engineers Limited (REEL) shares his views.

Is India managing its biomedical waste as well as it should? 

The biomedical waste generated by healthcare establishments is comprehensively covered under existing regulations and is being managed via authorised treatment facilities in most urban areas of the country. However, there are some other potentially biohazardous wastes (e.g. sanitary and biomedical wastes generated within households, that are currently being disposed of together with municipal garbage) that may have similar properties and similar risks like with biomedical waste. There is currently no uniform policy or infrastructure to enable appropriate segregation, collection and scientific treatment of such waste.

The pandemic has really tested the biomedical waste management capacity of the country. However, as waste volumes went up multifold, we were able to leverage our industrial hazardous waste processing capacity and scale up our operations for Covid waste management, within a very short timeframe.

Government agencies also recognized that industrial waste incinerators (with larger capacities of around 1.5 tonnes per hour, compared to biomedical incinerators which typically operate at around 100-250 kg/hour) can help augment the capacity gap and quickly permitted the use of industrial hazardous waste incinerators to treat Covid waste.

Whilst we also read some media reports on biomedical waste being disposed of together with municipal waste in some parts of the country, in our view, that would have been more of a localised issue, and not a nationwide or systemic problem. We are operating in 23 dedicated locations across the country, servicing over 400,000 beds associated with 40,000 healthcare establishments every day. We are confident that there is no capacity or infrastructure gap in the catchments that we are serving.

Compared to even five years ago, segregation at source of biomedical waste today is happening reasonably well. Why? Because it is largely being undertaken by trained hospital staff. However, if you look at domestic hazardous waste (that is not being classified as biomedical waste), its scientific management is not yet in place.

Is incineration the be-all and end-all of biomedical waste management?

High temperature incineration is the preferred route for Covid waste, as mandated by the Central Pollution Control Board (CPCB). However, we are also working with the government to mainstream alternate technologies for appropriate streams of biomedical waste.

In addition to common technologies such as steam autoclaving, technologies like microwave can provide effective disinfection of plastics based biomedical waste. Post sterilization/ disinfection and shredding, such waste can be recycled. For example, the colour coded bags that we supply for collection of biomedical waste are manufactured from recycled plastics!

We are continuously trying to learn from best practices and technologies in other countries and also innovating to make the process more environmentally sustainable and resource efficient.

Do biomedical waste generators follow up on the fate of their waste? How is it tracked?

Many of them do follow up. Some healthcare institutes have audit programs where they come and visit our treatment facilities.

The audit process is not a mandatory requirement for the generator. What is mandatory is to get a certificate of disposal, which we provide. However, we will always track waste on an end-to-end basis, whether or not it is mandatory or desired by the waste generator.

For every batch of biomedical waste, there is a chain of custody. We document what and how much was picked up from which location. The bags are barcoded and tagged at source, and scanned there. It is logged throughout the transport process. Every vehicle transporting such waste is GPS-enabled and is live-tracked.

Until the waste is certified as shredded and autoclaved, or incinerated at the point of disposal, the chain is not closed. We take this responsibility very seriously. All our facilities are electronically enabled and have live CCTV coverage. Our 24X7 command-and-control centre enables us to monitor operations remotely. We can live-track vehicles and quantities in real time.

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