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Medical waste: A pollution crisis no-one talks about

Hazardous medical waste that needs to be carefully disposed of by incineration. Items include clinical waste such as used syringes and needles, used swabs, plasters and bandages. Used drug blister packs and ampules. Biomedical waste is potentially infectious.Because of pollution, 350 hospitals and clinics in Goa face closure. This is not because of air pollution, however.  It is because of a different pollutant entirely: medical waste.

The Goa State Pollution Control Board (GSPCB) has issued show cause notices to the facilities in question because of their failure to “[apply] for authorisation and consent to operate under the water act and the air act for disposal of biomedical waste”, according to chairman Ganesh Shetgaonkar. If they continue to fail to do so, the Board will be forced to close the facilities pursuant to Section V of the Environmental Protection Act.

Facilities are compelled to deliver returns to the GSPCB about the volume of medical waste they generate. There are different provisions for the disposal of medical waste: facilities can either dispose of the waste on-site or have it collected by service providers for management elsewhere.

The collection of medical waste, of course, is not an issue limited to Goa. India generated 550.9 tonnes of medical waste daily, it was reported in March last year. By 2020, this figure is likely to leapfrog to 775.5 tonnes. The country’s output of medical waste is anticipated to grow by seven percent annually.

“In the 2002-04 period, it was found that 82 percent of primary healthcare facilities, 62 percent of secondary healthcare facilities, and 54 percent of tertiary healthcare facilities lacked a “credible” system of biomedical waste management. In the years since the situation has improved. However, in 2016, 37 tonnes per day of medical waste continued to go untreated.”

The considerable growth in the volume of medical waste being generated in India necessitates appropriate waste management procedures. As per the Bio-Medical Waste (Management and Handling) Rules first instituted in 1998 (and repeatedly modified in the years since), common biomedical waste treatment facilities ought to be established at a rate of one for every 150 kilometres throughout the country. However, a number of incidents over recent years suggest improper disposal of medical waste is a regular occurrence.

In the 2002-04 period, it was found that 82 percent of primary healthcare facilities, 62 percent of secondary healthcare facilities, and 54 percent of tertiary healthcare facilities lacked a “credible” system of biomedical waste management. In the years since the situation has improved. However, in 2016, 37 tonnes per day of medical waste continued to go untreated.

Numerous instances have seen facilities mired in controversy over the mishandling of medical waste.

By SONUKURIAN (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
The BRD Medical College in Gorakhpur, Uttar Pradesh, which was fined Rs 5 crore for improperly handling medical waste. Image credit: By SONUKURIAN (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
Earlier this year, the BRD Medical College in Gorakhpur, Uttar Pradesh was fined Rs 5 crore by the National Green Tribunal for improper practises in the disposal of medical waste. In Gujarat in 2009, improperly disposed-of syringes were reused and led to almost 140 people being infected with hepatitis B, leading to more than seventy deaths. Multiple doctors were arrested in the aftermath.

Meanwhile, in Andhra Pradesh in 2011, it was reported that “a large number of dental clinics run by private parties, primary health centres and community health centres [were] reportedly disposing of waste in open drains and garbage bins maintained by sanitation workers of the municipal corporation in urban areas.” This left the sanitation workers in question vulnerable to “a grave threat to their health as they come into contact with blood soaked cotton pieces, used syringes and remnants of flesh generated at the time of surgery and other bio-medical waste.”

Health Issues India has reported before on the issues surrounding waste management in India – be it plastic or e-waste or general solid waste. Proper processing is a must for all types of waste. Medical waste is no exception.

Medical waste, because of the circumstances in which it is generated, necessarily must be handled and disposed of properly. The risk to public health is too great for this not to be the case. While India has initiated policies to govern the disposal of such waste, the need is to ensure compliance from all quarters of the health sector and avert a biomedical pollution crisis.

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