Failure on the part of the government as well as private hospitals, nursing homes and clinics to dispose off bio-medical waste in a safe manner is posing a major health hazard to the residents of Goa for a long time now. This, despite the Union Ministry of Environment and Forests (MoEF) issuing specific guidelines to all the States and Union Territories for mandatorily installing appropriate facilities to ensure treatment and disposal of bio-medical waste in a scientific manner under the Bio-Medical Waste (Management and Handling) Rules, 1998.
Public demand is that an effective policy is urgently needed from the State government to tackle the problem of medical waste disposal, as these wastes are a shade more dangerous than normal waste matter, in that they contain disease causing micro-organisms and have the potential for spreading dangerous ailments like cholera, typhoid, gastroenteritis, tuberculosis, diphtheria and even AIDS.
Discussions on the issue revealed that the government is struggling to obtain 10,000 square metres of land in industrial estates for setting up a common bio-medical waste treatment and disposal (CBWTD) facility, a Goa State Pollution Control Board (GSPCB) proposal under Bio-Medical Waste (Management and Handling) Rules, 1998.
The proposed project is highly essential to the State for scientific management and handling of bio-medical waste – the currently adopted measures are inadequate for proper treatment and disposal of waste from hospitals, but the non-availability of required land in any one of the several industrial estates has delayed implementation of this important project for over one year. According to official statistics, on an average, 180 tonnes of bio-medical waste is being generated each month by both, government as well as private health-care establishments spread all over the State.
Hospital waste includes glass slides with bloodstains, used needles and syringes, biopsy tissues, placenta, dressings, etc. Nearly 25 per cent of these wastes are infectious and the hospitals are supposed to segregate the wastes and dispose them off separately and in a safe manner. However, most of the hospitals and clinics dump untreated waste on municipal grounds or on the roadsides in front of their buildings. It is alarming to note that these materials are disposed off in a manner of other waste, leading to their reuse after they are carted away by ragpickers, who are themselves at a great risk while handling these waste materials without adequate protection.
The key to handle medical waste, according to environmentalists, is to segregate it in order to facilitate the reduction of wastes that require special treatment. Plastic used for medical purposes, for instance, is not suitable for reuse as their uneven surfaces tend to harbour pathogens.
The wastes generated by various medical institutions are increasing, with more disposable items being used. While it is not so much the liquid waste that is causing the problem; sold wastes are finding their way to municipal dumps along with other regular types of wastes including household garbage, putting the public at grave health risk. In fact, if untreated infectious waste is mixed with the general waste including garbage, the entire quantum of waste gets infected. With the annual outbreaks of a host of communicable diseases, civic dumps are becoming breeding grounds, not only for viruses, but also for vector hosts like mosquitoes, flies and rats. The most hazardous wastes are the sharps – mainly needles, syringes, blades and broken glass, which are the main source of infection transmission. Another category of infectious waste is contaminated gauze and bandages. The third is contaminated body tissues.
Unfortunately, neither the authorities in charge of the State’s public health services nor voluntary organizations have initiated any serious debate on the steps to be taken for improving hospital waste management, despite the Supreme Court’s directives to all the hospitals with more than 50 beds to adopt an effective waste treatment and disposal system. The Medical Association also seems confused or rather unconcerned.
Recycled used syringes and needles from hospitals make their way to drug stores, making ragpickers and even hospital staff themselves open to risk of serious infections, including AIDS.
The Goa Medical College (GMC) Hospital at Bambolim, the premier public health care establishment in the State, itself is struggling with the problem of bio-medical waste management, even as it has made some improvement in its existing facilities, following warning of strict action by the Goa State Pollution Control Board (GSPCB). Board officials who inspected the hospital had found the incinerator unit was not in operation and the concerned authorities were disposing off the waste generated by the health care establishment in an unhygienic and unscientific manner.
According to GSPCB Officials, GMC hospital had blatantly defied directives specified for handling and treatment of bio-medical waste by dumping broken vials, bottles, plastic on its premises in a hazardous manner. However, during inspection, none of the hospital officials concerned were able to give proper information to the GSPCB officials about the facilities available for treating and disposing off bio-medical waste on their premises.
The GSPCB had also conducted inspection on bio-medical waste disposal facilities available with various hospitals, health centres, nursing homes as well as pathological laboratories, and had issued notices to a large number of the health care establishments which were not adhering to the provisions of the Bio-Medical Waste (Management and Handling) Rules, nor following the guidelines under the Municipal Solid Waste management Rules of 2000.
Medical waste disposal has become a major problem even in developed countries, and as a result, many have now re-introduced glass syringes and bottles as well as the earlier practice of sterilization. But standards of hygiene need to be much greater before we can contemplate such a move here. It is high time that the government and other stakeholders in the health care sector gave more importance to the issue and suggested a time-bound action plan for safe disposal of bio-medical waste in the interest of maintaining public health as well as ecological balance of the State.
(The writer is a freelance journalist)
