ISLAMABAD: Waste management is turning out to be a serious issue for countries across the globe and it becomes more serious in developing countries with poor waste collection and waste disposal mechanisms.
The situation turns even worse when it comes to improper handling of hospital waste which is hazardous to human beings as well as the environment.
Background information gathered from sources and interviews with the administrators of the tertiary care hospitals in twin cities of Rawalpindi and Islamabad revealed that none of the hospitals were fully adhering to the World Health Organization (WHO) protocols as most of them did not have fully trained sanitary workers to segregate the toxic waste from the municipal waste generated there.
In the process of the segregation of hospital waste, colour coding was introduced, but it was noticed that these codes were not fully adhering to the standards.
According to the WHO protocol the red-coloured containers are allocated for non-sharp infectious waste comprising soiled surgical dressings, pus, cotton swabs etc. Blue-coloured containers are allocated for all types of infectious and non-infectious waste including used syringes, needles, cannulas etc. The grey-coloured containers are allocated for municipal waste generated in hospitals.
Sources in the Rawalpindi General Hospital said that garbage segregation in the facility was not strictly followed as the matter was not on top of the hospital management’s agenda.
A deputy medical superintendent at Benazir Bhutto Teaching Hospital however insisted that they were completely adhering to the standard operating procedures (SOPs) that the hospital management had devised for waste disposal, and after segregating the toxic waste from the municipal waste it was dispatched to the Holy Family Teaching Hospital where the incinerator was installed. The toxic waste generated in all three hospitals in the city was eventually burnt there.
According to the statistics available in the recently held study at all the three teaching hospitals of Rawalpindi — the Benazir Bhutto Hospital, the Holy Family Hospital and the District Headquarters Hospital — the average waste generated in the aforementioned hospitals per patient per day was around 1.35kg, while the infectious waste per patient is one-fifth of the total generated waste.
Similarly, most of the infectious and toxic waste being generated in the hospitals came from the surgical wards and operation theatres while the second highest ratio of the infectious waste was produced by the pathology laboratories and labour rooms of the hospitals.
When contacted, the Pakistan Institute of Medical Sciences (PIMS) spokesman Dr Wasim Khawaja informed that on a daily basis the total garbage produced in the hospital is around 1,800kg out of which the infectious waste amounts to 260 to 300kg which is burnt in the incinerator of the hospital.
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But sources in the hospital said that although the incinerator of the hospital was operational, not all the waste was incinerated, and at least 30 to 35 per cent of hospital waste (both toxic and municipal waste) was dumped with the general garbage, ultimately ending up in the landfill sites in the outskirts of Rawalpindi and Islamabad. A portion of it went down the drains and nullahs passing through the city.
Condition at pvt hospitals, labs
The more horrific side of the story is the private hospitals, which are well over 150 in number in Rawalpindi and Islamabad; they do not have the incinerator facility or any other mechanism of dealing with infectious waste. Almost all the hospital waste was disposed of with the general municipal waste at filth depots established across the city.
Collectively the toxic waste generated in these hospitals was much higher in quantity as compared to the waste being generated in the government hospitals, environment activist Dr Aashar Azeem told Bol News.
Secondly, a large number of pathology laboratories operating in the twin cities also do not have any mechanism of disposing of the waste being generated in the form of needles, syringes and blood, urine and other samples taken from patients for conducting various tests.
Most of the leftover fluids taken as test samples made their way into drains and sewer lines and ultimately these fluids seep into the soil and get mixed up in subsoil water, becoming perilous.
Dr Tahir Khan, former additional superintendent of the Holy Family Hospital, said the hazardous waste being generated by the private hospitals and clinics was much higher than the waste generated by the government hospitals in the twin cities.
The officials of the Water and Sanitation Authority (Wasa) Rawalpindi have confirmed the presence of hospital waste that is generally collected from the various filth depots across the city for final disposal at the landfill site in the outskirts of the city.
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Sources in Wasa have informed that there was no proper landfill site, and the authorities dump the garbage in the open spaces and ravines naturally created in the area. So, the mixing up of toxic hospital waste with general garbage become perilous and results in the spread of infectious diseases that poses health hazards to the nearby localities.
Wasa has a maximum capacity of lifting and properly disposing of up to 60pc of the total garbage generated in the city per day while the remaining 40pc of the garbage was either dumped in the green areas, open plots in the residential areas and some part of it was being dumped in the main Nullah Leh passing through the city. As the leftover garbage also contained hospital waste that included toxic waste, its presence in the residential areas exposed people to various types of infectious diseases.
Recent research conducted in Rawalpindi on the sharp increase in the number of hepatitis cases attributed the rise to the washing away of the highly contagious material by the pathology laboratories in the city as the toxins seep down in the soil and mix up with the subsoil water. As the area is facing water scarcity, most local people depend on pumping out subsoil water with shallow drilling exposing them to the contaminated subsoil water.
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Environmentalists also question the use of incinerators for disposal of toxic hospital waste as burning of this waste also pollutes the environment from the toxic metals in the incinerated ash. A study in this connection conducted in the twin cities revealed that ash samples taken from five incinerators installed in the various hospitals of the cities showed presence of toxic heavy metals in it.
Although health has been devolved to the provinces after the passage of the 18th Constitutional Amendment, keeping in view the gravity of the situation the Ministry of National Health Services should step in and come up with some unified policy of dealing with hospital waste not only in the government hospitals but also rope in the private hospitals and big medical clinics in some statutory framework to save people from the deadly effects of infectious hospital waste being disposed of in an improper manner.
The government should also adopt new ways and means to deal with the infectious waste which are more environment friendly as the use of incinerators is decreasing worldwide.
