Managing waste is one of the most complicated and risky tasks among the many challenges of running a hospital in Pakistan. Few health facilities comply with the applicable waste disposal laws, which can jeopardize patient and practitioner health. But one government hospital is using eco-friendly methods to reduce its waste.
It is a complete mess. Waste is generally stored in buckets under the patient’s bed, and there are no procedures in place to safely dispose of infected materials, including syringes.
WHO http://www.who.int/water_sanitation_health/healthcare_waste/en/ defines healthcare waste as including needles, chemicals, pharmaceuticals, medical devices, radioactive materials blood and body parts. “Poor management of healthcare waste exposes healthcare workers, waste handlers and the community to infections, toxic effects and injuries,” warns the agency.
Waste disposal system can be improved by separating hazardous materials from non-hazardous garbage, and by introducing new disposal procedures, such as vermicomposting, in which waste is fed to various types of earthworms.
“It is generally accepted that 70 percent is about the maximum recyclable amount,” Ruth Stringer, international science and policy coordinator at Health Care Without Harm [ http://www.noharm.org/ ], an international organization advocating environmentally friendly healthcare systems.
The waste management campaign enhances safety. Pharmacies many a times sell fake syringes that have been made from used syringes. Electronic and manual needle-cutting devices in all inpatient wards must be used by all medical staff to destroy syringes properly, immediately after use. This way we can keep the plastic pieces, put them in the autoclave, then recycle the parts. An autoclave can use pressurized steam to sterilize medical items.
Autoclaving is essential for safety when it comes to hazardous materials, but it also means we’re not just burning waste and creating more air pollution. Burning plastic creates carcinogens. We’re a healthcare facility, how could we do that?
Other organic options can be looked int. Experiments with worms eating contaminated gauze that hasn’t been autoclaved can be done. It will take several rounds of testing to determine whether the worms’ digestive process sterilizes the material or not. A 2006 study in India [ http://www.noharm.org/lib/downloads/waste/Effects_of_Vermicomposting.pdf ] suggested that worm digestion could sterilize infectious waste, but no large-scale trials have been conducted.
Biogas system [ http://www.irinnews.org/report/75719/Pakistan-biogas-technology-beginning-to-make-its-mark ] to dispose of tumours and severed body parts for bio-degradation alongside food waste should be used. Biogas is a mixture of methane and carbon dioxide produced by fermenting organic matter like animal or human waste, biodegradable waste, and municipal solid waste.
Pakistan should have a law mandating each hospital to sterilize its hazardous waste before handing it over to the municipality, in line with the WHO “polluter pays” guidelines http://www.who.int/mediacentre/factsheets/fs253/en/index.html.