|Volume 6 | Issue 08 | August 2012 ||
Most of the private hospitals and clinics in the country, especially in the capital city, dispose of toxic medical waste rampantly violating environmental rules and laws, reveals MUSHFIQUE WADUD.
Just a few months ago, three amputated human legs were recovered from Kalyanpur Lake in the city's Darussalam area. According to newspaper reports, among the legs two were covered by bandages and all three were amputated from below the knees. The legs were sent to Dhaka Medical Collage Hospital (DMCH) morgue for autopsy and then it was learned that they were dumped in the lake after surgery at a hospital or a clinic.
Dumping parts of the body after surgery in a dustbin or a lake by the hospitals and clinics is nothing new. Very often, body parts are found in canals, lakes and dustbins in different parts of the city. This is a clear manifestation that hospitals, clinics and diagnostic centres in the country are neglecting scientific management of the medical waste. With hospitals, clinics and diagnostic centres growing in all parts of the city, medical waste has become a serious concern for human health and the environment.
According to Health Bulleting 2011, there are 583 government hospitals and 2,501 registered non-government hospitals in the country. There are also many unregistered private hospitals in the country. According to different estimates, 36,000 tons of medical waste are generated every year in Bangladesh, out of this approximately 7,200 tons are hazardous.
Last year, Calin Georgescu, the UN Special Rapporteur on human rights and toxic waste, issued a report in which he warned that the world is not paying enough attention to the problems caused by medical waste. According to his report, some 20 to 25 per cent of the total waste generated by health-care establishments is regarded as hazardous and may create a variety of health and environmental risks if not managed and disposed of in an appropriate manner.
A study titled 'Medical Waste Management (MWM) in Dhaka, Bangladesh: It's a Review' states that waste management and practices were found to be quite unsafe. It said that poor people collect the waste and sell it for recycling. Almost 85.0% of sharp injuries are caused between their usage and subsequent disposal. It also said that more than 20.0% of those who handle them encounter “stick” injuries. Another study showed that people use an average of 3.4 injections per year, in which 39.3% were administered with reused equipment for low level of management.
One does not have to be an expert to understand that the medical waste can be fatal if they are disposed like normal waste here and there but the concerned authorities and the hospital management are not heeding to the alarm. Consequently, city dwellers are under threat to several deadly diseases. Only a few numbers of the medical providers in the country have scientific waste management system while most dispose the waste into the nearby dustbins, canals or lakes exposing us to infectious diseases.
It is not hard to find used syringe and other medical waste that are dangerous to human health in the adjacent dustbins of National institute of Traumatology and Orthopaedic Rehabilitation or Dhaka Medical College Hospital or any other hospitals. The dangerous thing is that many children were found in these dustbins to segregate the waste and collecting medical waste for reuse. These children are most likely to be infected to various deadly diseases.
One might say that when serious patients are not properly treated in the government hospitals and many a time even patients have to lie on the floor or do not get any doctor to see them, how can we expect proper management of medical waste? Indeed it is not an irrational question. Human health concern is not something our policy makers are worried about. Whether it is about food adulteration or the medical waste, no one seems to be concerned.
But the private hospitals, clinics and diagnostics centres which are always telling us that they do not compromise with health concerns, are least concerned about the public health when it comes to the question of medical waste management.
Though the private hospitals, clinics and diagnostic centres are charging high from patients in the name of safe medical facilities, most of them do not properly manage the medical waste. There is a medical waste rule on the handling, treatment and disposal of waste but because of the lack of treatment facilities and enforcement of existing guidelines, medical wastes are unabatedly dumped into the dustbins. The alarming thing is that the infectious wastes are often sold for recycling and they are repackaged for use which is seriously risking public health. The reuse of the medical waste can trigger the spread of various harmful diseases such as hepatitis, HIV, tuberculosis, gangrene and tetanus.
Under Health, Nutrition and Population Sector Program (HNPSP) 2003-2011 and Health, Population and Nutrition Sector Development Program (HPNSDP) 2011-2016, medical waste management has been included as one of the important components of health facility management. Under the programme, government will establish scientific medical waste management system at the upazila levels. The components of the program are: (i) construction of pits (for infectious, general and recyclable wastes, and sharps) in the upazila health complexes; (ii) procurement and regular supply of logistics for collection and transportation of wastes and safety materials for the waste-handlers; (iii) training and orientation of the health personnel on proper waste management; and (iv) community awareness of medical wastes, its management, and individual responsibility.
But, like all government programmes, they are going at a snail pace. Non-government organisation PRISM Bangladesh has a programme in association with Dhaka City Corporation to scientifically manage medical waste but a small number of hospitals participate in the programme. Many diseases can be transmitted by hospital wastes. The threats remain high as the waste is mixed with the normal waste and the whole waste is becomes hazardous.
According to experts, medical wastes could be the root cause of some deadly diseases. In case of any exposure to a decomposed part of a particular human body, people may be affected by the diseases that the person to whom the part belonged to may have had and this may well spread among the masses. Also, people can be exposed to some skin diseases through such wastes. If they are disposed of in any lake or pond, some waterborne diseases can be spread from them. If the pond or lake has any connection to the drinking water system, people can be afflicted by various diseases such as diarrhoea, cholera and jaundice among others.
The Environment Conservation Act 1995 states that 'no industrial unit or project shall be established or undertaken without obtaining, in the manner prescribed by rules, an Environmental Clearance Certificate from the Director General.' But many such hospitals and diagnostic centres are established without any proper arrangement of the medical waste management. The environment department or the Director General of Health Service hardly has any monitoring to look after the fact.
Unfortunately, people are not aware about the threats of the medical waste. The people who are also working with the waste management are not aware of the threat of the medical waste to the human health. Bringing about awareness about the dangers is an important task.
The government should be responsible for arranging a proper system for scientific management of waste of the government hospitals. The government should also strictly monitor the private hospitals, clinics and diagnostic centres that are charging high in the name of safe medical facilities so that they are forced to properly manage medical waste.
No one should be allowed to play with public health.
Mushfique Wadud is a reporter at the New Age.
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