What are the medical waste?
Medical waste includes the following:
Sharps materials e.g. glass wares, syringes, needles, blades, plastic material like disposable gloves etc.

Biologically cultured stocks and plates like culture plates, media, human blood, different body fluids like sputum, CSF, stool, urine, pus, different scrapping like skin scrapping for fungus and tissues.

All clothing -- bed sheets, cotton, bandage, dressing material used by the patient.

The usual practice of medical waste disposal in our country now is to dump these material in some places, throw it in the dustbins or pour the blood and other body fluids into the basin, sewerage. Some large labs, hospitals have incinerators for waste disposal but most of these are outdated, not maintained and used properly and not working now. All of these process are unscientific and can cause hazards and spread of infectious disease.

Prevention of the menace
First of all the present law of waste collection which is followed now was effective from 1983 by an ordinance but it has no special provision for medical waste. This law should be changed and new law for medical waste disposal with provisions for jail, fine and cancellation of labs or hospital or clinics should be enacted. Foreign constancy and visit to different countries abroad to see observe the system may be advocated, if needed.

Secondly it should made mandatory for all labs, hospitals, clinics to buy and install incinerator for proper medical waste disposal. The lab, hospital, clinic authority must employ qualified people to supervise this and oversee that this is followed strictly, properly. Violation of the rule should be punished, even registration may be cancelled.

Thirdly the Ministry of Health and Family Welfare can appoint some authority or body to collect these medical waste from different hospitals, labs, clinics for proper disposal. They will supply all labs, hospitals, clinics proper bags/container with different colors, marked with bio-hazard safety and other signs. The concerned lab, hospital, clinic will instruct their employees to put the medical waste in specific container designed and when it is full they wills end it to a central place or store from where they will collect these medical waste and take it away to specified place for disposal under their supervision. The labs, hospitals, clinics will pay for this service. This will prevent these menace. The Municipal Corporation authority may be approached for this. They will follow the same criteria described above for the medial waste disposal.

Creating Public awareness is a must to present this condition. Radio, television, different media, local dailies and public relation department should create different live programme, documentaries, write on different aspect of medical waste, its hazard as environmental and spreading of diseases and how to present it.

What are the hazards if medical waste is not disposed off properly?
Environment pollution-decomposition of plastic material will pollute the environment.

Water and sewerage system may be contaminated with infectious agents of hepatitis A, hepatitis E, typhoid and paratyphoid, cholera, diarrhoea, food poisoning, worm infection leading to anaemia and malnutrition. Infection with hepatitis virus will cause jaundice, inflammation of liver leading to the complications of chronic liver diseases.

The used disposable plastic syringes, needless if not incinerated or burnt -- these items will be collected by the tokais (Street Urchins), homeless, jobless people and these items will be sold to drug users, other clinics, labs, hospitals or plastic industry for re-use. These items are important source of spreading HIV (AIDS), hepatitis B (HBV), hepatitis C (HCV) infections which are responsible for chronic liver disease leading to cirrhosis, liver cancer and liver failure.

So it is evident that the spread of these dreadful diseases are due to improper medical waste disposal and cause serious public health problem and involve huge money in terms of treatment, diagnosis and loss of working hours, family and social burden, which are not at all accepted in a developing country like ours.

Proper disposal
The labs, hospitals, clinic authorities must have some empathy for their patients.

It can be said that medical waste disposal is a serious environmental issue and immediate measures should be taken by the government, NGOs, donors to address the problem, formulate new laws with provision for fine, jail. It can ensure better health for us. The sooner we do this the better is for the peoples health.

The writer is a Professor and Head of Pathology of Ibrahim Medical College, Segun Bagicha, Dhaka.