Hospital waste sickening public and environment

* Three tonnes of waste produced daily, 75 percent of it from govt hospitals
* WWF warns that incinerators dangerous too, proper process more important

By Shoaib Ahmed

LAHORE: The major public and private hospitals and laboratories in the city produce three tonnes of waste every day. Most of this, 75 percent, comes from government hospitals and is dumped into city government containers, putting citizens at risk of diseases such as diarrhoea, dysentery, cholera, typhoid, hepatitis, malaria, the plague, skin diseases and HIV (AIDS), according to a city government report on hospital waste management.

“There are no proper measures taken for the safe disposal of hospital waste. It is just dumped into district government containers,” sources in the city government said.

According to the report, made available to Daily Times, of the 115 hospitals and laboratories surveyed, only 30 hospitals and seven laboratories get their waste incinerated, through Shalimar Hospital. The rest do not have access to an incinerator and dump their hospital waste in solid waste management (SWM) containers.

The sources said none of the government hospital has proper collection, storage or disposable facilities. There is also concern that costly apparatus meant to be used once is sometimes reused.

“Orthopaedic implants and dental implants sometimes get picked up by unscrupulous doctors and are subsequently sold to people looking for a bargain,” the sources said.

Another problem is that much of the waste is plastic, such as tubes and syringes, that are picked up by rubbish scavengers from SWM dumping sites and sold on. According to the report, the dumping site at Shahdara, Farukhabad is the main site for the sale of hospital waste, with each container fetching Rs 1,000 to Rs 2,000.

The report names one Gulzar, alias Kalu Changar, as the main buyer and says that drivers and sanitary staff are involved in the selling. Kalu Changar allegedly segregates the waste and sells it on to various parties for various purposes. The buyers send the waste for reuse, repacking and recycling. The main plastic recycling site is at Bara Sari Road, Shahdara.

Drug addicts often buy or sometimes steal used syringes Scavenger birds, animals and insects can transfer infections from waste to human beings. Waste is also dumped into the Ravi, leading to contaminated river water that causes diseases in humans and animals.

According to the report, there are other places where hospital waste is dumped with municipal waste, which is damaging to the environment and public health. These places include Nishter Town, Ravi Town, Allama Iqabl Town, Gowala Colony, the Mahmood Booti dumping site, Data Gunj Baksh Town, Shalimar Town, Aziz Bhatti Town and Padri village, Barki.

According to a study done by a Shalimar Hospital official later submitted to the city government, an average Pakistani uses five disposable syringes per year, making a demand of about 750 million syringes. The study says Pakistan imports 250 million syringes and 500 million syringes are produced locally in “suspect condition”. “Most of these 500 million disposable syringes are of dubious origin and used in rural areas,” a source said quoting the report.

The city government is soon to submit proposals on better hospital waste management to the chief minister. The recommendations will include that hospital waste should be documented and weighed and its disposal must be supervised by hospital committees of three or more people. The disposal of hospital waste in SWM containers should be banned. The Ministry of Health should order hospitals, labs and clinics to incinerate their waste.

However, the World Wide Fund for Nature (WWF) opposes the use of incinerators. According to a WWF report sent to the environment secretary, Pakistan in December 2001 signed the Stockholm Convention on Persistent Organic Pollutants.

The convention seeks to eradicate twelve of the most virulent pollutants on earth, including four that are key contaminants in incinerator emissions. The convention has branded incinerators as a primary source of dioxins, the most toxic human-made substance known to science with no known safe level of exposure. Studies have shown that dioxin causes cancer, decreased fertility, birth defects, disrupted sexual development and leads to IQ deficits. It can also create behavioural disorders and damage the immune system.

The WWF says the most important component of waste disposal is segregation. Imposing segregated practices within hospitals to separate biological and chemical hazardous waste will result in a clean solid waste stream, which can be recycled easily. If proper segregation is achieved through training, clear standards and through enforcement, then resources can be turned to the management of the small portion of the waste stream needing special treatment. “We need to focus on process, not on technology,” says a WWF report. It says that only 10-15 percent of hospital waste needs special treatment.

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