National 5 (Spotlight Weekly)

Stranded In Trivial Matters

Despite adequate infrastructure and a guideline for proper segregation and disposal, hospital waste is still disposed along with other solid wastes

By THAKUR AMGAI

Hospital wast management : Raising awareness

Given the increased awareness among health professionals, infrastructures and guideline, it has been seen that hospital wastes can be managed properly for now, if some trivial problems are addressed properly. The infrastructure for proper Hospital Waste Management (HWM) that can cater to the present needs are already in place. Special vehicles have been brought to ferry the hospital wastes and an incinerator, considered vital tool for the destruction of infectious wastes, has been installed. Moreover, a guideline for HWM has been published and is being distributed.

The Kathmandu Metropolitan City (KMC) and the National Dental Hospital (NDH), with the help of Environment and Public Health Organization (ENPHO), released the Medical Waste Directory for use by doctors, nurses, lab technicians and support staff of the hospitals. Trainings will be conducted in a few months to hospital workers about the procedure for proper hospital waste management.

The awareness for proper hospital waste management has grown over the years among the medical professionals and hospital managements. While hospital managements used to avoid any issues about hospital waste management in the past taking it as worthless, now, they are more concerned. “Now the doctors and hospital managements are more positive towards hospital waste managements than they used to be few years back,” says Dr. Sushil Koirala, of the Hospital Management Waste Training Center.

The guidelines, however, have not yet been followed. The practice of disposing hospital waste along with general solid waste has not stopped. This practice is posing great threat to the public health. Although the volume of hospital waste is no more than one metric ton, it is contaminating the whole 300 metric ton of solid waste as they are put together. A study conducted in 2001 had revealed that hospitals in Kathmandu produce about 1200 kg of wastes everyday.

According to the World Health Organization (WHO), hospital wastes are the most infectious of the wastes. Hospital wastes can cause serious injuries, and can spread diseases. It contains sharp materials such as needles, blades and it contains infectious and mentally unpleasant materials such as bodily fluids like puss, blood and human tissues.

Experts in the field of Hospital Waste Management claim that 80 per cent of the problem of HWM can be solved by efficient categorization. Disposal of well-categorized waste is not very difficult. Less than one-fifth of the hospital waste is infectious. The rest can be dumped along with the solid waste or can be recycled and reused. But in our case, the infectious waste is about one part in four, informs Dr. Koirala, because of inefficiency in categorization.

At present, three hospitals, National Dental Hospitals, Gangalal National Heart Center and National Kidney Center have been developed as role-models for HWM. Others are expected to follow the suit.

In private nursing homes and clinics, the chief reason for not segregating the waste could be the cost factor. According to Dr. Sushil Koirala who is also involved with the Hospital Waste Management Training Center, 2 to 3 per cent of the total hospital income will suffice for proper segregation. However, the hospitals have to suffer larger losses indirectly if the wastes are not managed properly.

In the government hospitals, the sense of irresponsibility is the chief reason for the current situation. The attendants of the patients are made to throw the waste. The attendants, who could be people who are very less educated if not totally illiterate, have no idea of the categorization.

For its disposal, KMC has brought two special vehicles and an incinerator, with a capacity to incinerate 450 kg wastes at a temperature of 850 degree celsius. But both the facilities are gathering dust at the KMC premises thanks to the public opposition to operating the incinerator.

The locals of Teku area argue that the burning of incinerator would produce poisonous gases detrimental to public health. Doctors and environmentalists claim that if operated properly, the incinerator does not produce harmful gases. “If operated properly at high temperatures, the incinerator does not produce much harmful gas,” said environmentalist Bhusan Tuladhar. “Moreover, the harm that is being caused to public health because of disposing the hospital wastes in public is far more dangerous than gases produced from the incinerator.” The incinerator may produce poisonous gases like bi-oxin if burnt at low temperature.