The Tamilnadu Government is planning to implement a comprehensive Health Care Waste Management Plan for all the hospitals in the state, by setting up Common Treatment Facilities (CTF) s in 29 districts in the state, except Chennai, at an investment of over Rs 32.59 crore.

To be implemented with the active participation of NGOs, private health care providers and Indian Medical Association (IMA), the Health Care Waste Management System is meant for all the private and public sector hospitals in the state.

It is likely to be implemented integrating with the proposed Tamilnadu Health Systems Project (TNHSP) with World Bank assistance to create healthcare infrastructure in the state. A major component of the programme involves creating awareness among hospital professionals and public on hospital waste management and professional training for NGOs and hospital staff in management of biomedical wastes.

According to government sources, as per the plan, autoclaving and deep burial method would be followed instead of incinerators and the respective district collectors will provide land for establishing the CTFs. Each hospital will collect their waste from various collection spots or departments according to the categorization and will store them in the storage rooms in their premises. Vehicles arranged for collection of the waste will collect the wastes from the hospital to the CTF once in two days. Numbers of vehicles will be allotted according to the number of beds in each district, both in the private and public sector.

At the state level, the secretary, Health will chair a State Project Monitoring committee, responsible for the monitoring and supervision of the HCWM Plan at the state level. Each of the districts will have a District Monitoring Society, headed by a top official of the health department, and the society will meet once in a month. Besides, a Hospital Monitoring Committee, headed by a Medical Officer, will be formed to assess the biomedical waste management at the hospital level, and the committee will meet every 15 days. Health Care Waste Reports from CTFs will be sent weekly to the Environment Health Officer (EHO) and to the district programme officer, who will report to the Project Director of HSP once in a month.

Charges at an agreed rate per bed per day will be collected from the member hospitals by the IMA/NGO/private partner for the operating cost and maintenance of CTF. Thirty percent of the money collected would be deposited in a bank account of the society as corpus fund for maintaining the CTF and the rest will be utilized periodically for operational expenses and training.

The sources said Tamilnadu has 14 medical colleges having bed strength of 21,538 and generates waste to the tune of 1 to 1.5 kgs approximately per bed per day. The 26 district headquarters hospitals in the state have bed strength of 8221 and generate approximately 8000 kgs to 12000 kgs of biomedical waste per day. Similarly, the state has 244 sub district hospitals with total bed strength of 12401, and they generate waste of about 12,000 to 18,000 kgs per day. The 1413 Primary Health Centres with bed strength of 8976 generates waste to the tune of about 8000 kgs of biomedical waste per day. The state also runs TB hospitals/sanatoria, ESI hospitals, dispensaries and Women and Children hospitals with estimated bed strength of 2,532, generating waste to the tune of 2,500 kgs to 4,000 kgs per day. In the private sector, the state is estimated to have about 25,000 to 30,000 hospitals generating 25,000 to 45, 000 kgs of biomedical waste everyday.

It may be noted that the Tamilnadu Government is yet to establish comprehensive waste management plan for the government hospitals in and around Chennai, though there are proposals in the final stages to implement CTFs for Chennai, Kancheepuram and Thiruvallur districts. At present two CTFs in the private sector are available to cater to the private hospitals in these districts. The facility in Thenmelpakkam covers about 6000 beds in the private sector where as the CTF in Chennakuppam covers about 3000 beds in private sector.