A flour­ish­ing repack­ag­ing in­dus­try brings dis­posed med­i­cal waste back into the na­tion’s

India Today - - NATION - By Amitabh Sri­vas­tava with Nir­mala Ravin­dran

Arvind Ku­mar, 45, rum­mages through a cart­load of de­bris just off­loaded near two longdead in­cin­er­a­tors be­long­ing to Patna Med­i­cal Col­lege and Hos­pi­tal ( PMCH). If the sy­ringes, pills vials, hy­po­der­mic nee­dles and plas­tic drips that he picks up are good enough for re­sale to pri­vate med­i­cal clin­ics, Ku­mar will earn Rs 350. A good in­vest­ment, given he paid Rs 70 to a ward cleaner for this pile.

Ku­mar is just a mi­nor cog in Patna’s sky­rock­et­ing repack­ag­ing in­dus­try where many play­ers—from clean­ers in state-run hos­pi­tals to re­cy­clers—in­ject back used med­i­cal de­bris into the health­care sys­tem.

PMCH is not the only hos­pi­tal erring on biomed­i­cal waste dis­posal. The Min­istry of Environment and Forests ( MOEF) on Au­gust 29 re­leased a list of 13,037 health­care fa­cil­i­ties in the coun­try that have been found to be in vi­o­la­tion of biomed­i­cal waste gen­er­a­tion and dis­posal rules. The num­ber of er­rant health­care units in 2007-08 was 19,090.

Ac­cord­ing to MOEF fig­ures, 4,05,702 kg of biomed­i­cal waste is gen­er­ated ev­ery day in the coun­try, of which only 2,91,983 kg is dis­posed. The fig­ure con­firms that ev­ery day, 1,13,719 kg of waste is left unat­tended which more of­ten than not re-en­ters the sys­tem. The fig­ures show that the high­est num­ber of vi­o­lat­ing med­i­cal fa­cil­i­ties is in Ma­ha­rash­tra (4,667), Bi­har (1,221) and Ker­ala (1,547).

In terms of vol­ume, the states that gen­er­ate the high­est quan­tity of biomed­i­cal waste are Kar­nataka (62,241 kg), Ut­tar Pradesh (44,392 kg), Ma­ha­rash­tra (40,197 kg) and Ker­ala (32,884 kg). Kar­nataka is the worst of­fender as it fails to dis­pose of 18,270 kg of med­i­cal waste a day. Ma­ha­rash­tra claims to have dis­posed of all the biomed­i­cal waste it gen­er­ated, de­spite also ac­count­ing for the high­est num­ber of er­rant fa­cil­i­ties (see box).

The Bio-med­i­cal Waste (Man­age- ment & Han­dling) Rules, 1998, makes it in­cum­bent upon the health­care fa­cil­i­ties gen­er­at­ing biomed­i­cal waste to en­sure that the waste is han­dled with­out any ad­verse ef­fect on hu­man health and environment. But this sel­dom hap­pens. In Fe­bru­ary 2009, more than 50 deaths of vi­ral hep­ati­tis were re­ported from Gu­jarat’s Mo­dasa town. A health depart­ment in­ves­ti­ga­tion had re­vealed that im­proper dis­posal of biomed­i­cal waste led to the spread of the deadly virus that killed many.

The ab­sence of de­ter­rent is also a big rea­son why biomed­i­cal waste guide­lines are of­ten vi­o­lated. A se­nior po­lice of­fi­cer con­cedes that the IPC has pro­vi­sions for stern ac­tion against

those who dump such waste. “But we usu­ally ig­nore such vi­o­la­tions largely be­cause govern­ment hos­pi­tals have been the big­gest vi­o­la­tors,” he said.

Bi­har gen­er­ates only 3,572 kg of biomed­i­cal waste ev­ery day—the least among big­ger states—yet has the third high­est num­ber of health­care units that have been found to have flouted dis­posal rules. This means a higher pro­por­tion of health­care units in Bi­har dis­re­gard rules.

The state Health Depart­ment ad­mits that gaps ex­ist in dis­posal. “This is a se­ri­ous is­sue. The state has ini­ti­ated sev­eral steps like bond­ing with pri­vate play­ers while seek­ing to out­source the biomed­i­cal waste man­age­ment sys­tem in all govern­ment hos­pi­tals. The im­ple­men­ta­tion process is at var­i­ous stages in dif­fer­ent hos­pi­tals,” Health Sec­re­tary San­jay Ku­mar told IN­DIA TO­DAY.

If the waste is not in­cin­er­ated at the pre­scribed tem­per­a­ture of 1,150° Cel­sius, it gen­er­ates per­sis­tent or­ganic pol­lu­tants ( POP) like diox­ins and fu­rans that can lead to can­cer. “In western coun­tries, dis­posal of biomed­i­cal waste is a com­mer­cial ac­tiv­ity. Here in In­dia, we need to rope in the pri­vate sec­tor,” says Dr S.P. Dua, re­gional co­or­di­na­tor of a project launched by the United Na­tions In­dus­trial De­vel­op­ment Or­gan­i­sa­tion on re­duc­ing POPS.



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