Medical waste is a hazardous waste produced and discharged from hospitals, clinics, pharmacies, dispensaries, blood banks, pathology, laboratories, veterinary institutions, and research centers.
World Health Organization (WHO) has estimated that among the total amount of Health Care Waste (HCW) generated, 15% is pathological and infectious waste, which are very harmful to human health. Therefore one must be very careful while handling this waste. Health care workers and waste handlers are always at the maximum risk of injury or infection because of close contact with infected healthcare wastes. However, the general public can also be affected due to accidental exposure.
As per the Ministry of Health and Population, Nepal (2012) only 38.7% of hospitals have adopted the correct process for the segregation of healthcare wastes. Private health facilities practicing the disinfection and recycling methods are rarely found. Many institutions are dumping waste on the backyard, rivers, open field, corners of hospital buildings, or anywhere around the premises or disposed of at Okharpauwa dumping site without any pre-treatment.
Even though Bir Hospital is the tertiary level government hospital that admits about 8,500 in-patients, deals with over 300,000 out-patients, and treats over 60,000 accident and emergency cases every year it has managed to set the standard in the proper management of biomedical waste in Nepal.
In 2010, Bir Hospital decided to make environmental health and safety its priority and reduce its climate footprint. Now, it is one of the first mercury-free hospitals in Nepal, along with the National Kidney Center. Infectious waste is disinfected using steam-based autoclave technology and they are recycled or decomposed. It is now recycling 53% of all the waste it produces and earns nearly about NRs. 524000 per year from recyclable waste.
Bir Hospital has used vermicomposting technology for the reduction of waste. It has also built the nation’s first bio-digestion plant for biodegradable waste which reduces 30% of the total hospital waste. The hospital is also continuously lobbying to get a separate budget for health care waste management from the government.
Proper management of biomedical wastes involves active cooperation between governmental and non-governmental bodies, medical institutions, and healthcare personnel. It would be better if every hospital constitutes a hospital waste management committee having a waste management officer, who develops clear plans and policies for the proper management and disposal of wastes.
While managing biomedical waste, it is also necessary to consider the health of patients. Within the hospital, waste routes must be planned to avoid the passage of waste through patient care areas. Alternate time should be embarked for transportation of biomedical waste to reduce the chances of mixing with general waste. The common waste treatment facility is another way to ease the problems where hospitals can bring their wastes for disposal and pay for treating the wastes
Furthermore, universities providing medical and paramedical education should include biomedical waste management in their curriculum. Different types of insurance facilities should be given to the health care workers and waste handlers to make them more secure about their jobs and life.
Unlike to Polluter Pay Principle (PPP), Manage Your Waste on Your Own can be one way for all health institutes to convert waste to energy which will surely help to sustain a green, clean, and safe environment.