"We separate wastes based on whether they are hazardous or non hazardous but are compelled to dump them into the same container," said Deula, who has been serving at the hospital for the last 14 years. [break]
The hospital has buckets of different colors for segregated wastes but at the end of the day they are all dumped in the same garbage container.
He said that the hospital burns discarded syringes on the roof top. "Used syringes pose great risk to the public health, so we burn them on the roof top of the hospital," said an employee seeking anonymity. He said that due to lack of proper waste disposal facility, the hospital has been burning the used syringes.
As the only national referral center for tropical and infectious diseases, the hospital have been providing treatment to patients with HIV, tuberculosis, tetanus, swine flu, dengue, Malaria, hepatitis, rabies, among others.
Patients suffering from infectious diseases are sent to the hospital from across the country for treatment.
"It´s a harsh reality. We haven´t been able to purchase an autoclave machine to sterilize used syringes," conceded Dr Indra Prasad Prajapati, director at the hospital.
He also admitted that the hospital does not have a system to dispose medical wastes and has been mixing them with the general waste that is carried off by KMC.
Doctors at the hospital said that proper management of medical waste is a big challenge in view of the emergence of new types of infectious diseases.
Dr Prajapati said that the government and the World Health Organization (WHO) have urged the hospital to manage the hospital waste properly.
"But we are not in a position to set up a waste management facility on our own," he said, adding, "We have been requesting to the ministry to provide additional grant but to no avail."
He said that the hospital would welcome support from donor agencies and individuals willing to assist it in the waste management.
Director Prajapati also said that the waste produced from the hospital is 10 times riskier than the wastes produced from other hospitals because it mostly deals with infectious diseases. Over 2,000 HIV infected patients are undergoing treatment at the hospital. Employees at the hospital said that every morning garbage collectors scramble for plastic and other medical wastes in the waste container inside the hospital premises. The hospital authority even does not think it necessary to bar them from scavenging hazardous waste Fluids, body parts, chemicals, pharmaceuticals, medical devices and radioactive materials come under hazardous hospital waste.
STIDH, popularly known as Teku Hospital, is one among many hospitals in the country that lack proper waste disposal system of their own. "Most of the private hospitals, nursing homes, poly clinics and some government run hospital do not have waste management facility," said Dr Sumitra Shakya, executive director at Solid Waste Management and Technical Support Center (SWMTSC), which under Ministry of Urban Development (MoUD). The Prime Minister´s Office (PMO) had formed a committee to propose ways to regulate hospital waste. "We have found too much negligence on the part of hospitals," said Amatya. She said that the committee has drawn the attention of all hospitals to manage medical wastes generated by them properly. "They have been complaining about lack of budget, but the problem lies in the lack of strong will to manage the waste," she added.
The committee has also warned Teku Hospital not to burn used syringes on its roof. "Burning syringes in that manner pollutes the environment. We have asked them to halt the practice immediately," added Amatya. She said that the committee would take legal action against any hospital that is found not complying with the directives.
She said that private hospitals have more responsibility to manage the waste produced at their institutions as they are profit oriented.
The SWMTSC has also cautioned the Kathmandu Metropolitan City (KMC) against mixing up hospital waste with household garbage. KMC´s executive officer Kedar Bahadur Adhikari said that the office has decided not to collect hospital waste, which poses high risk to public health. The KMC has been providing container services to the hospitals and nursing homes and has an understanding to collect only non hazardous waste. He said that the office would take action against the hospitals which have been mixing up medical waste with those generated at homes. The move comes after the warning issued by the Prime Minister´s Office (PMO) not to mix up hospital waste with those generated by households.
"We will scrap the agreement with hospitals altogether if they are found mixing hospital waste with general ones," said Rabinman Shrestha, an official at KMC´s environment department. He said that the department will accelerate monitoring of hospital waste management in the future.
Krishna Hari Baskota, secretary at PMO, who has taken the initiation to regulate hospital waste, said that no one would be excused. He said that private hospitals have been adding beds and costly equipments every six months but showing indifference toward waste management. He said that the concerned government authorities would also be penalized if they failed to act against erring hospitals.
Krishna Hari Baskota,
Secretary at Prime Minister´s Office
How serious is the hospital waste management problem in our country?
Waste generated from hospitals pose high risk to public health. It should be managed properly. But most hospitals, nursing homes and private clinics operating in the capital do not have mechanisms to dispose hazardous waste properly. It is a serious problem. As per the law they have no right to run the business if they cannot manage such waste properly. We have given them an ultimatum to have a system in place to take care of the hospital waste.
Some government hospitals have cited budget crunch as the reason for their inability to manage hospital waste. What do you say?
Even the government run hospitals cannot be excused for failing to manage medical wastes properly. If they cannot manage the waste properly they should shutdown their institutions. Just as restaurants cannot operate without having toilets, hospitals also cannot run without having a proper system to manage wastes. Ministry of Health and Population (MoHP) should strictly monitor waste management system before providing license to hospitals. Officials who give nod to operate hospital would be liable if the institutions did not manage waste. Government hospitals should also be allocated sufficient funds for waste management.
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