Against the backdrop of National Green Tribunal seeking a status report from the Tamil Nadu government on the management and disposal of biomedical waste recently, a glance at the Government Hospitals in the State reveals non-adherence to the Biomedical Waste Management Rules.
The Biomedical Waste Management Rules (BMWMR), 2016, mandates a safe, ventilated and secure location within the premises of a healthcare facility for storage of segregated biomedical waste in coloured bags or containers, to ensure that there is no secondary handling, pilferage of recyclables or inadvertent scattering or spillage by animals.
Despite the rules, government facilities lack the infrastructure to treat the waste before transporting it for disposal. “We ensure source segregation of biomedical waste and then directly transport it to treatment plants through the contractors concerned,” a nodal officer, biomedical waste management unit at Rajiv Gandhi Government General Hospital (RGGGH), said.
Before sending the waste to the treatment facility for final disposal, according to the regulations, hospitals should pre-treat laboratory waste, microbiological waste, blood samples and blood bags through disinfection or sterilisation on-site, as prescribed by the World Health Organisation (WHO) or National AIDs Control Organisation (NACO) guidelines. However, health officers at Stanley Medical College and Hospital and Kilpauk Medical College denied having any treatment plants for biomedical waste at their facilities. “Only ‘definite proven infected’ biomedical waste is treated, while there is no other treatment given to other forms of waste. We do not have any treatment plant currently for liquid biomedical waste or other forms of biomedical waste. The new hospitals or healthcare units might have such infrastructure, but we lack it,” said Dr P Vasanthamani, Dean of KMC.
Even for treating liquid waste the facilities are no better, “Liquid biomedical waste can easily get diffused in water bodies and cause major outbreaks. The biomedical waste is usually treated by sodium hypochlorite. However, it is ineffective for the treatment of liquid waste,” said Jawaharlal Shanmugam, a social activist. Hospitals are trusted with a range of procedures, to ensure segregation of liquid chemical waste at the source, pre-treatment or neutralisation prior to the liquid biomedical waste mixing with other effluents generated at health care facilities and treatment and disposal of liquid waste. On the contrary, many government facilities in the State do not even have a liquid waste treatment plant.
The norms also require Government Hospitals to provide training to all its health care workers and others who are involved in the handling of biomedical waste at least once a year. However, healthcare staff at Government Hospital are unaware of any such training. “We are only given instructions by our supervisors when we join the service and they just monitor our work. There has not been any yearly training for us,” said S Kamla, a conservancy staff at RGGGH for three years now.
The norms mandate that Government Hospitals should maintain a day to day biomedical waste management register and display the monthly record of waste generated in terms of category and colour coding on its website. But the websites of the Government Hospitals in Tamil Nadu reveals that they do not maintain any such registry.