UNABATED medical waste dumping on roads, bins, drains, water bodies and open spaces in the capital and elsewhere has raised serious public health and environmental concern. The hazardous substances in medical waste include pathological and infectious materials, such as sharp needles and toxic chemicals. In hospitals, various therapeutic procedures, such as cobalt therapy, chemotherapy, dialysis, surgery, delivery, resection of gangrenous organs, post-mortem examinations, biopsy, para-clinical tests and injections, are carried out, which result in the production of infectious and radioactive wastes. Medical waste also carries germs of infectious diseases such as Hepatitis B and diarrhoea. Poor scavengers, women and children, are often found collecting medical waste, such as syringe needles, saline bags, blood bags, etc, for resale despite the deadly health risks. It is estimated that a hospital bed generates 1.62 kilograms of waste on an average a day, which means Bangladesh, with 127,360 hospital beds, produces an estimated 75,308 tonnes of medical waste a year. Yet, indiscriminate dumping of medical waste remains the rule of the day.
There are regulations, laws and High Court directives regarding better management of medical waste, but they remain unimplemented. The Medical Waste (Management and Processing) Rules 2008 and the National Guideline for Medical Waste Management (Revised 2016) have largely failed to make any impact. The environmental regulations stipulate that hospitals and clinics with more than 20 beds should have an effluent treatment plant, but no public hospitals and 44 per cent of private hospitals operate in Dhaka without such a plant. The Medical Waste Management and Training Manual mandates hospitals to segregate medical waste into different categories that include non-hazardous, infectious and anatomical, radioactive and liquid waste. As the monitoring mechanism is ineffective, the manual has not been followed. In 2018, the High Court asked the government to set up a medical waste management authority. Later, in 2020, it also directed the Department of Environment to implement medical waste management rules and regulations. While waste management remains in a sorry state, no visible steps have so far been taken to improve the situation. Hospitals, meanwhile, keep discharging untreated waste water into open water bodies and dumping solid waste in nearby bins.
The safe disposal of medical waste is key to minimisation of illness and to prevention of environmental contamination. The manner in which the hospitals dispose of the waste is anything but scientific. The government needs to ensure that related rules and regulations are enforced and take immediate steps to set up effluent treatment plants at public and private health facilities. The chronic negligence in the management of medical waste may, otherwise, prove costly in terms of health, environment and economy.
