| Deadly garbage Mushfique Wadud roams hospitals and pathological centres in the city to investigate the medical waste management procedures adopted in these institutions and talks to experts regarding the risk posed to public health by the haphazard disposal of medical wastes  An air of uncertainty, even bordering on panic, surrounded onlookers as they caught the rather grotesque sight of a human body-part, floating past them on the Dhanmondi Lake, on July 5. After an autopsy, the Dhanmondi Thana police declared that the body-part in question was a woman's and was highly infectious. Police later confirmed that as it was not in its normal shape, they had to assume that a doctor might have separated that part of the body for purely medical purposes. They also informed reporters that it was a part of the waste that one of several hospitals in the area might have disposed of. The aforementioned incident does not necessarily call for an overly uncommon or unusual labelling to it in Dhaka city. On many an occasion, parts of the human body have been seen to surface in different parts of the city following medical institutions' failure to properly dispose of their extras in the medical wastelands that primarily consist of roadside bins or lakes in and around the city. With the ever-growing number of hospitals and medical centres in the city, a good quantity of waste is obviously generated and this may yet prove to be a cause for concern for authorities and city-dwellers alike. According to the Directorate General (Health) office, there are some 2,286 private hospitals and 4,767 pathological and diagnostic centres in the country, most of which are mushrooming in Dhaka city. There are a good number of blood banks in the capital as well along with slightly less than a handful of unauthorised clinics. According to the Solid Waste Management Division of the Dhaka City Corporation, the amount of total solid waste generated in the city is around 3,500 tonnes each day of which, around 50 tonnes are medical wastes. However, most hospitals have failed to implement a safe waste management system, with there being a few exceptions to that notion. Director (Hospital) of DG Health Dr Akhter Hossain Bhuiyan informs Xtra that government hospitals adopt an in-house waste management policy, wherein, all the medical excesses are piled up in an area, waiting to be collected and disposed of by City Corporation vans. An Xtra investigation provides further evidence of the inadequacies and the general lack of competence or attention paid to the subject of safe waste disposal by the majority of hospital authorities in the city. However, there are exceptions to the unfortunate scenario, with a particular government hospital along with a few private ones, that have adopted a set of procedures to properly manage their excesses with the aid of Prism Bangladesh. While government hospital authorities claim that they dispose of the waste through an in-house management system, there is a distinct dearth of any actual set of procedures followed. Upon a visit to the Shishu Hospital, two City Corporation vans were seen waiting just outside the hospital's main gate as the hospital attendees stockpiled all the excesses into the vans. When completely filled, the vans drove off to the BNP slum area, a mere mile away from the hospital, where they were emptied into a waste depot, containing other household wastes. Wastes are disposed of in similar fashion at the National Orthopaedic Hospital as a City Corporation van rids all the excesses into an open field opposite to the hospital. In some cases, attendees are even seen throwing medical wastes into the drainage lines of the hospital, which explains why people in those localities often see medical waste floating around during water-loggings. Private hospital authorities too, despite the large sums of money they charge to ensure safe health and high quality service, are accountable for contributing towards the city's as well as its people's detriment when it comes to waste management. The authorities of such hospitals again claim that they deal with their wastes in a safe and sensible manner, within their own capacity but then refuse to provide any details of the process they use to do so. When a customer supervisor of the United Hospital was contacted, he informed Xtra that the hospital manages its wastes on its basement. 'We manage dangerous medical waste in our basement and the Dhaka City Corporation collects the wastes that are not dangerous to public health to have them disposed of,' says Asad. While he fails to inform Xtra the exact procedures followed to manage the waste, he suggests that the chief clinical support department of the hospital could shed more light into the matter. However, the chief clinical support of United Hospital could not be reached. When the Director of Clinical Development, Dr Abu Sayeed MM Rahman, was contacted by Xtra, he refused to comment on the matter. He said, 'as far as I am concerned, the hospital authorities manage waste with the help of an NGO.' He however vouches for the implementation of a safe medical waste disposal system. Director of house keeping and management of Apollo Hospital, Abdur Rahman, informs Xtra that the hospital has a hygiene control department and that department monitors the waste disposal system of the hospital. 'We isolate different wastes in our own capacity and then an NGO takes them away to dispose them of safely and in a scientific way,' he says. Prism Bangladesh is an NGO working with hospitals to manage their excesses. The NGO collects a fee from hospitals to aid them with services to deal with their medical wastes. Fees for hospitals have been set in accordance to the number of beds in each hospital. 'We have all modern equipments for safe disposal of medical waste and we dispose them in a scientific way,' says Torit Kanti Biswas, programme co-ordinator, Prism Bangladesh. Prism Bangladesh has acquired one acre of land in Dhaka's Matuail, where there are some modern equipment for safe disposal of medical waste, informs Torit. The medical wastes are first separated and stored in closed boxes by hospital authorities for Prism to collect and dispose in its Matuail plant. The list of equipment at the plant includes an incineration machine, with which, medical wastes are reduced to ashes. In case of wet medical wastes or any body-parts, Prism resorts to burying them. Hospitals and other medical institutions generate different types of waste. They include human tissues, blood, body fluids, organs, body parts, human foetuses, and other similar waste organs from surgeries. Biopsies and autopsies, dressing materials of infected or surgical wounds, disposable towels, gloves, and broken hospital equipment, needles, syringes, scalpel blades, as well razors, infusion sets along with broken glass and blood tubes, are all parts of the list. These wastes generated by the different hospitals and medical institutions are not to be cast aside lightly as medical experts affirm that they pose a serious threat to public health. Medical wastes contain the threat of passing viruses and infections and therefore, demand a systematic manner of disposal with various safety measures. 'Hepatitis B, Hepatitis C and different liver diseases can be contracted from the medical wastes if they are not disposed of in a safe way,' warns Professor Dr Anisur Rahman, head of Epidemiology of National Institute of Preventive and Social Medicine (NIPSOM) 'Also, people can be exposed to some skin diseases through such wastes,' he adds. '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.' An assistant professor of the same department Monira Akhter believes 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,' she says, '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.' She also informs Xtra that any plastic medical waste like syringes can be very dangerous since some unscrupulous factions of society can remodel and sell them in the market for reuse. This again can trigger the spread of various harmful diseases such as hepatitis, HIV, tuberculosis, gangrene and tetanus. 'All forms of wastes are dangerous for public health but more so with medical waste. We should remember that these wastes come from people who have been suffering from different diseases,' says Professor Mahmudur Rahman, director, Institute of Epidemiology, Disease Control and Research (IEDCR). He highlights the need to implement a systematic set of procedures to deal with such wastes citing the various health hazards it poses, including liver diseases. Dr Akhter Hossain says that the government is planning to implement a scientific medical waste management system to be followed by all government hospitals very soon. 'Mitford Hospital has already started a scientific medical management system with the help of a NGO and within very short time all the government hospitals will be under safe waste management system,' he concludes. |
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