Gujarat hospitals are not disposing of biomedical waste safely: CAG

Only 27 per cent of test-checked government hospitals, health centres are segregating waste; many flout rules by burning the hazardous waste

 
By Jyotsna Singh
Published: Monday 17 August 2015

The Comptroller and Auditor General (CAG) of India's report last week which said every third child in Gujarat is undernourished created stir in the political and media circles. The same report (released on October 4) also examines the status of biomedical waste disposal in the state. The figures obtained by CAG do not reveal much. However, field visits by CAG team to select government-run healthcare establishments showed frequent flouting of Bio-Medical Waste (Management and Handling) Rules of 1998. As no government department maintains record of registration of non-govermental healthcare establishments, CAG could not scrutinise their functioning.

CAG test-checked 80 health centres and hospitals. Records revealed that only 14 of them were categorising waste and putting them in separate containers. The rest 56 were not segregating waste as required by the rules. "This resulted in improper segregation and consequential improper treatment posing health hazards," reads the report.

Rules flouted
 
  • Number of hospitals, health centres checked by CAG: 80
  • Number of hospitals, health centres not segregating waste: 58
  • Number of hospitals, health centres found burning waste: 48
 
According to the rules, the waste is to be put in separate containers with colour codes yellow, red, blue or white, and black. Waste in yellow is to be incinerated or buried deep. Waste in red, blue and white has to be microwaved, autoclaved or chemically treated. Contents of white or blue can be disposed through shredding too, while those marked black have to be sent to secured landfill.

Without the initial segregation, medical waste risks getting mixed with municipal waste and less hazardous biomedical waste. Going by the rules, medical is to be kept separate from other wastes. The local bodies are to pick up the segregated as well as treated waste for disposal at the municipal dumpsite. However, out of 80 centres test-checked, medical waste was found mixed with municipal solid waste in 58 centres (73 per cent). The waste was also found to be disposed of in open landfill sites, which has the potential of spreading infectious diseases.

The state has 13 common biomedical waste treatment facilities. As per Central Pollution Control Board guidelines, each facility can cater to the need of up to 10,000 beds in health establishments within a radius of 150 km. It was found that because of shortage of treatment facilities, the existing facilities were catering covering areas beyond the 150 km of radius.

Hazardous disposal 

In many instances the biomedical waste was being burnt. The rules nowhere prescribe burning as a mode of disposal of such waste. On inspection it was found that 48 of the 80 health establishments were disposing biomedical waste by burning.

Mercury is used in a variety of medical devices. As it is a fatal neurotoxin, people need to be protected from exposure to it. Similarly, waste containing blood also requires proper handling. However, out of the test-checked health centres, only five had mercury and blood spillage management kits.

Data obtained from the government, however, presents a rosy picture. The Gujarat Pollution Control Board's annual reports show that in 2007-08, 56 per cent of biomedical waste went untreated; in 2008-09 this figure dropped to 42 per cent. The 2009 to 2012 annual reports show that no biomedical waste goes untreated. The data does not tally with the reality check carried out by CAG. What's more Gujarat Pollution Control Board's records show that it sent 2,700 show-cause notices to various health centres and hospitals for flouting biomedical waste disposal rules. Of these, 2,123 were sent in just one year—2011-12.


Report of the Comptroller and Auditor General of India on general and social sector: Government of Gujarat

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