Disposal of medical wastes

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Shaila Azad
Medical waste, due to its content of hazardous substances, poses serious threats to environmental health in Bangladesh. The hazardous substances include pathological and infectious material and chemical wastes such as rejected bandages, cut-off tissues from operations, used syringes and needles, etc. In hospitals, different kinds of therapeutic procedures i.e. cobalt therapy, chemotherapy, dialysis, surgery, delivery, autopsy, biopsy, para clinical test, injections etc., are carried out without safe practices on the part of those who operate the devices for such medical operations. Medical wastes may carry germs of diseases such as hepatitis B and AIDS.
In Bangladesh, medical waste has not received much attention and it is disposed of together with domestic waste in many cases. Improper medical waste management is alarming in Bangladesh and it poses a serious threat to public health.
Medical waste contains highly toxic metals, toxic chemicals, pathogenic viruses and bacteria, which can lead to health problems for humans from exposure to the same. Such waste presents a high risk to doctors, nurses, technicians, sweepers, hospital visitors and patients due to arbitrary management. It is a common observation in Dhaka City that poor scavengers, women and children collect some of the medical wastes (e.g. syringe-needles, saline bags, blood bags etc.) for reselling despite the deadly health risks. It has long been known that the re-use of syringes can cause the spread of infections such as AIDS and hepatitis. The collection of disposable medical items (particularly syringes), its re-sale and potential re-use without sterilization create a serious disease burden.
The safe disposal and subsequent destruction of medical waste is a key step in the reduction of illness or injury through contact with this potentially hazardous material, and in the prevention of environmental contamination. The transmission of blood-borne viruses and respiratory, enteric and soft tissue infections through improper medical waste disposal is well known. The management of medical waste therefore, has been of major concern due to potentially high risks to human health and the environment .
The growing number of hospitals, clinics, and diagnostic laboratories in Dhaka City exerts a tremendous adverse impact on public health and environment. All of the hospitals, clinics, and diagnostic laboratories are considered here as health care centres (HCC). Some 600 HCCs in Dhaka city generate a huge amount of wastes a day. Like ordinary household wastes, medical wastes are generally dumped into Dhaka city Corporation (DCC) bins. It is reported that even body parts are dumped on the streets by the HCCs. The liquid and solid wastes containing hazardous materials are simply dumped into the nearest drain or garbage heap respectively.
Proper management of medical waste is crucial to minimise health risks. The improvement of present waste management practices for HCCs in Bangladesh will have a significant long-term impact on minimising the spread of infectious diseases. Medical wastes require specialized treatment and management from its source to final disposal. Simply disposing of it into dustbins, drains, and canals or finally dumping it to the outskirts of the City poses a serious public health hazard. Thus, there is a need to initiate a concentrated effort to improve the medical waste management to reduce the negative impact of waste on environment; public health; and safety at health care facilities.