Big hospitals in city have an efficient waste disposal system in place. However, many small medical facilities have not fallen in line, citing difficulties

On April 10, the Delhi Pollution Control Committee (DPCC) issued an ultimatum to non-bedded healthcare facilities to comply by April 25 with Bio-medical Waste Management Rules, which require all hospitals to get authorisation from the local pollution control body.

According to the Union Environment Ministry, the deadline for following the new rules for handling biowaste was extended to March 27, 2019 but some government hospitals and clinics of the Capital are behind schedule.

Bio-medical waste has been a problem for a long time now. Despite a well-drafted law in place to curb unscientific disposal, it continues to threaten public health, with many smaller medical institutions openly flouting the rules.

Bio-medical waste is worse than household waste as it is potentially infectious. According to the Central Pollution Control Board (CPCB) annual report of 2016, the total quantity of bio-medical waste generation in the country is approximately 517 tonnes per day.

As per a joint report by the Associated Chambers of Commerce and Industry of India in 2018, the total quantity of medical waste generated in India is 550 tonne per day, and these figures are likely to increase close to 775.5 tonne per day by 2022. To deal with this menace of the increasing quantity of bio-medical waste and unscrupulous dumping, 199 common bio-medical waste treatment facilities (CBWTFs) are in operation and 23 are under construction (CPCB, 2017).

There was continued illegal dumping of bio-medical waste in Barapullah Nullah, for which the DPCC recently imposed Rs 5 lakh as environmental compensation charge on SDMC, PWD and district-level monitoring committee (South East).

Roadblocks in disposal

According to the new guidelines, hospitals and clinics that operate on a small scale and do not necessarily create waste are also required to register. But some of the doctors have complained that the service that is provided is so slow that the waste collection in some areas is allegedly done once in 10 days.

“The problem is that a general physician or a not so well-established doctor who just prescribes medicines and does not generate waste per se also has to register. And the doctors who have registered, complain that in some places, the waste is collected once a week or after every 10 days,” says Dr Girish Tyagi, President of Delhi Medical Association.

Several big hospitals are systematically segregating and dumping their bio-medical waste, but many smaller nursing homes and clinics are flouting the rules. The smaller medical clinics also haven’t switched over to the non-chlorinated bags. Most of the big hospitals have started using non-chlorinated bags. But mixed bags result in increasing the emission level.

“The problem in Delhi is that there are just two common biomedical waste treatment facilities and their areas are demarcated, so that they have a monopoly in their respective areas. The government has not been able to carry out a competitive bidding process because we need more than one bidder,” says a senior official from Delhi government’s health department, on condition of anonymity.

It is being said that the bidding for the process has not been carried out as the government does not have the required number of bidders. One of the bidders has joined hands with a company to source the software and barcodes. Only 10 hospitals in the Capital are in the process of registering themselves. Under the process, which is being managed by the CBCP, the state governments have been asked to share the login ID and password to track their biomedical waste. The CPCB have informed all the state governments about the login ID and password. Some of the states have reverted to this, some are yet to reply.

Setting an example

Six hospitals that fall under the North Delhi Municipal Corporation have already complied with the new guidelines. The disposal bags sent by these hospitals are now barcoded and can be tracked. Some of these hospitals are adhering to the rules, but the Central government-run Safdarjung Hospital has devised a method that many others can implement too, for its efficacy.

Safdarjung Hospital was the first to follow these newly-formulated rules. It also created a method of its own because the vendors did not have a barcoding system in the beginning. The superintendent of the hospital, Dr KT Bhowmik, said that their system is commendable as it is dynamic and the data that is stored can be integrated with any other network.

A worrying factor

It is not just bio-medical waste from hospitals for humans, but there are other aspects to this problem that loom over us. Bio-medical waste from the National Zoological Park in Delhi is also reaching municipal landfills, along with other garbage, posing serious health hazards and putting our lives in grave danger.

“If an animal is detected with a contagious disease, then the biomedical waste is not dumped with the other waste, but it is destroyed in an incinerator, which is located behind the zoo hospital. But normally, most of the medical waste — such as bandages, saline pipes and cotton — are dumped along with the general waste,” says Abhijit Bhawal, a veterinarian at the zoo. According to medical experts, this waste can also be a potential source of zoonotic diseases like Anthrax, Nipah and avian influenza, which can be transferred from animals to humans.

This bio-medical waste that goes into the landfills is also in complete violation of the Biomedical Waste Management Rules, 2016. In fact, there are very few veterinary hospitals or clinics in Delhi that have obtained any kind of authorisation from the concerned body.

Stringent orders

Recently, the National Green Tribunal (NGT) also directed all the states and Union Territories to present reports pertaining to the management of bio-medical waste to the CPCB by April 30. Noting that non-compliance of bio-medical waste management rules is “widespread,” a bench headed by NGT chairperson Justice Adarsh Kumar Goel warned of heavy fines on authorities, if they fail to furnish reports.

“We direct all States and Union Territories to ensure that reports [in terms of relevant rules] are furnished to the CPCB within one month or on or before April 30, for the period the reports are due as per rules. The CPCB may furnish a status report of compliance of BMW rules after proper analysis to NGT within one month,” the bench said. It added, “It is made clear that any failure will result in the defaulting States being required to pay compensation to be deposited with the CPCB at the rate of Rs 1 crore per month after May 1.”

It is high time that we realise the gravity of the situation. All medical facilities should comply with the rule, following the example of big hospitals that have a well-managed waste disposal system. It is crucial that the entire medical community understands the need for proper waste management and does not become a contributor to the mess that puts our lives at stake.