RICH TRASH PICKINGS
A flourishing repackaging industry brings disposed medical waste back into the nation’s
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.
SYRINGES IN PATNA