Waste disposal problems and the resale of hospital waste by corrupt officials have become alarmingly common in the country. The recent reports show that hospitals' waste-dumps are routinely scavenged for material used in medical procedures, which is then recycled to be sold as brand new. Sources said these dumps are allegedly being contracted off on annual basis. There have been instances of hospital staff conducting open auctions of hospital waste including syringes, urine bags, blood bags, dextrose/saline bottles, bandages, canulas, IVs, catheters, glass slides and vials.
Hospital Waste Management (HWM) Project Director Fawad Hameed Rai said that an average Pakistani uses five disposable syringes per year, making a demand of about 750 million syringes of various sizes. Pakistan imports about 25 crore syringes and 50 crore syringes are produced locally in suspect conditions, Rai said, adding that most of these 50 crore disposable syringes of dubious origins were used in the rural areas of the country, where there is little emphasis on clean medical treatment.
According to Rai, there are 115 public and private hospitals in Lahore and approximately 10,000 beds in these hospitals. The daily production of waste from these hospitals is about 11 tonnes, which includes about 2.5 to 3 tonnes of infectious waste.
There are two modern incinerators installed and supervised by the HWM project in the city, which are at Shalimar Hospital and United Christian Hospital with 200-kilogram capacity per hour each. The third incinerator, which was in Shaukat Khanum Memorial Hospital, was used to dispose only the in-hospital waste with a capacity of 20 kilogram per hour. These incinerators dispose off about 15 to 20 percent (3.2 to 3.5 tonnes) of the most infectious waste on a daily basis. The remaining hazardous waste goes to city garbage dumping sites and roadsides. One modern incinerator costs Rs 1 crore including the cost of construction and land.
The HWM was founded in 1998 to educate health industry people on waste disposal and the problems it could cause if waste was not treated. There are 80 members of the project and 80 percent of them are in hospitals and 20 per cent in private clinics and laboratories. 60 percent of the members of HWM don't pay the waste disposal charges to the project while 10 per cent are defaulters. Daily Times learnt that the Babar Ali Foundation was able to persuade a major city hospital to join the project by picking up the tab for the first six months of waste disposal.
According to Rai, the total cost of waste transport and incineration for hospitals was Rs 90 per bed per annum. However, he said many hospitals avoid paying their dues, which hinders the proper treatment of hazardous waste. On average, in a day each hospital bed generates 0.5 to 2 kg of medical waste and 0.1 to 0. 5 kilogram of this should be treated as hazardous and infectious material.
He said a lack of civic sense among medical practitioners, hospital waste buyers and sellers has caused about 20 to 25 per cent increase in the rate of infectious diseases in a short time and this practice has caused an increase in reported HIV (AIDS), typhoid, hepatitis, diarrhea, respiratory illnesses, skin disorders and meningitis cases. According to Rai, these potentially life-threatening diseases could spread like wildfire if proper measures were not taken in time.
He said the disappearance of waste from operation theatres dealing with cardiology, kidney, liver transplant and dialysis institutions was alarming as the material might be reused in fresh packing by unwary patients. The paraphernalia used during a cardiac surgery or liver, kidney transplant costs between Rs 40,000 and Rs 60,000. Orthopedic implants and dental implants sometimes get picked up by unscrupulous doctors and are subsequently sold to people looking for a bargain in the high-cost medical treatment world.
The Punjab Health Minister Dr Tahir Ali Javed on March 4, 2003 stressed the need for hospitals to dispose waste and make sterilized gloves and good quality syringes available. He said about seven hepatitis patients were being reported in Lahore hospitals daily. Solid Waste Management Department (SWMD) Lahore Managing Director Mohammed Rafiq Jatoi said that 10,000 sanitation employees and15,000 garbage scavengers were at risk from hospital waste.
Earlier, the SWMD raided the Gulab Devi Hospital on July 20, 2001 and arrested Medical Superintendent (MS) Dr Moham-med Akram for publicly auctioning the hospital waste. The Pakistan Environmental Protection Act 1997 clearly defines selling hazardous waste as a punishable crime.
- (Daily Times)