Implementation of Biomedical Waste (Management and Handling) Rules, 1998, framed by the Union Ministry of Environment and Forests, for hospitals and nursing homes are yet to take off in Mumbai after several extension of the deadlines. The last deadline set by Brihanmumbai Muncipal Corporation was January 1, 2003.

First of all, Corporation could not register all the nursing homes in the city so far. Out of 1400 hospitals and nursing homes operating in the city, only 930 were so far registered with the Corporation. Even from these registered nursing homes and hospitals, collection of the biomedical waste by the Corporation appointed Bhavani Travels, is extremely irregular.

Some of the nursing homes are complaining that Bhavani Travels, the sole waste collection agent for the entire Corporation area, comes to their premises once in a week or once in a fortnight. As per the standard agreement signed between the nursing homes and the Corporation, the collecting agent is expected to collect the waste every day in specific plastic bags.

As the waste collection is highly irregular and uncertain, nursing homes in most parts of the city continue to throw the biomedical waste, generated everyday, at the roadside dumps. It would be highly dangerous to keep decaying human tissues and other waste in the premises of hospitals and nursing homes for days, a leading nursing home owner said.

The nursing home owners also feel that they are being overcharged for various services claimed by the Corporation and Maharashtra Pollution Control Board. MPCB charges a flat fee of Rs.2500 per year on every nursing home irrespective of the size of establishment for permission to generate waste.

When asked about the frequent complaints and inconsistent waste collection patterns, R.R.Markhandeya, Chief Engineer, Solid Waste Management of BMC, said, "the Corporation has only 5 garbage vans to collect waste from all over the city. Each van makes two trips per day and can cover maximum 40-50 hospitals per day. Preference is first given to big hospitals and then the small nursing homes. It becomes almost impossible for us to cover all nursing homes in the city in a single day," he pointed out.

He further said, "We regularly stay in touch with them and inquire about the waste generated per day. When there is enough waste generated (about 2-5 kgs) we go and collect it from them. The time limit to dispose the waste is 48 hours, which we implement strictly," he asserted.

Bombay Nursing Homes Association (BNHA), the only organization representing the nursing homes in the city, is now taking up the matter with both the authorities as the grievances from its members are pouring in on the issue of highly disorganized waste collection and disposal system at an unbearable cost to the small nursing homes.

Dr Parvez Sheikh, secretary, BNHA said that while the registration and waste disposal charges may be justified in the case of medium and large size hospitals, it is unreasonably high for small nursing homes. "The criterion for the Corporation to collect the amount is based on the general bed-occupancy, which is arbitrarily fixed at 80 per cent. While in case of nursing homes where the average occupancy stands at a mere 30-40 per cent, charging approximately 15/- per 250-gms/per bed/per day seems too exorbitant," said Dr Sheikh.

To this, Markandeya sounded indifferent and said, "fixing of rates, registration charges and penalizing defaulters comes under the purview of MPCB. We are only responsible for the disposal and segregation of waste," he said.

BNHA had written to the MPCB about a year back requesting for a repeal of its charges. BNHA feels that MPCB should charge nothing for nursing homes with less than 5 beds, Rs. 500 per year for nursing homes with 5 to10 beds, Rs 750 for nursing homes with 11-15 beds, Rs 1000 for nursing homes with 16-25 beds and Rs 2500 for nursing homes having more than 25 beds. But this was not even considered by the MPCB and it fixed a flat waste generation fee of Rs 2500/- for all categories of nursing homes.