The School of Environmental Studies (SES) at Cochin University has introduced a new eco-friendly, cost effective system for the bio-medical waste management in the hospitals. SES has developed this system as per the directions of Qualified Private Medical Practitioners Association (QPMPA).

QPMPA had asked SES to take up the study in view of the Union Health Ministry's directive for effective waste management system in hospitals to be implemented before December 31, according to its president Dr. AK Sabhapathy.

Dr. Sabhapathy said that the new system will be helpful to all the private hospitals in India. " Incineration is the traditional method for treating the bio-medical waste from the hospitals. But it is not possible for a state like Kerala considering its high population density, high rainfall and humidity, the awareness and sensitivity to the issue, the very active and radical environmental groups etc. More over incineration of medical waste create more problems than apparent solutions. It is definitely an outdated option. So we prefer the no-burn technology suggested by SES," he said.

He said that this technology is more suitable for Kerala than incineration. "This system can be adopted by any hospital with an investment of less than Rs one lakh where as incineration needs a huge investment. This is the method of treating the waste in the hospital premises itself through autoclave, deep burial, disinfection, auto digestion, anaerobic digestion and recycling. Liquid and solid waste has to be treated separately. After the treatment and analysis, liquid effluents are let out to open drain or central sewage," he said.

Solid waste has to collected in separate containers with different colours. General waste collected together (food, paper etc) should be handed over to the civic authorities. Glass, syringes etc should be disinfect and then given for autoclaving. It can be reused after the treatment. Ampoules and vials can be recycled or given for deep vault burial. Needles and sharp objects are to be disfigured using needle burner. Plastic syringes IV sets etc can be disfigured by manual cutting or shredder disinfect using bleaching solution. SES has designed a PAB reactor for treating placenta. This reactor is a 200 litre tank to contain 4 to 6 placentas per day can be kept within the labour room or adjacent place.

Dr. Sabhapathy said that this method is very cost effective and echo-friendly. " All treatment for hospital up to 500 beds can be carried out within the hospital premises. Deep burial, auto claving disinfection, auto digestion, anaerobic digestion are all prescribed methods on the Act. This is the most eco-friendly technology available. Incineration causes more problems as the biological infectious problems are converted into chemical poisons which are equally or more harmful to humans. Pollution Control Authorities failed miserably to control pollution caused due to incineration of bio-medical waste. Public opposition to incineration is also great, but no-urn technologies do not attract opposition from the public," he said.

QPMPA has asked the Ministry of Environment to extant the stipulated time limit for another six months for implementing bio medical management system in hospitals.
The hospitals in Kochi, failed miserably in the management of bio-medical waste, according to the survey of SES. As the waste materials are not segregated properly and mixed together in many hospitals the whole heap becomes infectious and requires management appropriated for hazardous waste says the study. The SES team, which visited the hospitals as part of the survey found out that appropriate and scientific biomedical waste management plan was lacking in almost all institutions.

"A strong mistaken belief has acquired strength among the authorities and others that incineration is the best option for disposal of biomedical solid wastes. Generally without proper segregation of the dangerous biomedical wastes all the wastes are mixed together making the entire waste voluminous and dangerous. The proposal recommended by the authorities for disposal of most categories of solid waste is incineration. But in Kerala the load of the waste per hospital is so low that each hospital cannot have the engineering/technological back ups to build and more importantly to operate and maintain system/plants of very complexity," observes the study.

In Kerala, there are more than 3,800 hospitals with 72,000 beds in private sector compared to 1,740 hospitals with 38000 beds in government sector. Kochi city alone has 43 private hospitals. For the city as a whole, the average quantities of infectious and non-infectious waste will be 0.101 and 0.956 kg per bed per day respectively and the liquid waste per day is only 3.27 liter a day. Incineration is an expensive method for these hospitals as the quantity of the waste generated is very low, according to the study.