KSPCB's 'shock treatment' to hospitals

BANGALORE, AUG. 30. The issue of notices to three Government hospitals in the City for unscientific management and disposal of biomedical waste by the Karnataka State Pollution Control Board (KSPCB) last week is without precedent in the country.

It has also come as a ``shock treatment'' for the various stakeholders who are still grappling with a ``chicken-and-egg'' syndrome. Most hospitals currently segregate the waste they generate, and some of them also incinerate it. However, the badly needed, and now mandatory, integrated incineration, autoclaving and landfill facility is yet to be put in place in the City, which makes segregation under the present circumstances, seem pointless.

The Biomedical Waste (Management and Handling) Rules were made in 1998, and July 2000 was the deadline given to the State governments and the hospital sector to put their systems in place.

In Bangalore, of the 5,000-odd healthcare centres (Government hospitals, private and corporate super-speciality facilities, nursing homes, clinics, private practitioners) around 500 facilities come under the purview of the KSPCB. The board has issued the notices under Rule 5 of the Biomedical Waste Rules, which prescribes standards for treatment and disposal.

Schedule-I of the Rules lists the categories of waste and the treatment options for each of them. Incineration or deep burial is suggested for human and animal anatomical waste. Local autoclaving, microwaving, incineration are the options for waste from laboratory cultures, cultures toxins, dishes and devices, waste sharps (needles, syringes, scalpels, glass, etc) are to be disinfected chemically, or by autoclaving and microwave, and shredding.

This is where the chicken-and-egg syndrome comes in. Autoclave (this works like a pressure cooker, where the waste is treated to high pressure and temperature to completely kill the pathogens) and even incinerator, for that matter, is an expensive proposition even for large hospitals such as Vani Vilas and Victoria.

Besides, as Ms. P.Bineesha, Research Associate, Centre for Renewable Energy and Environment Studies, Tata Energy Research Institute (TERI), says Bangalore does not have a facility for treatment and disposal. ``In fact, Government hospitals are segregating the waste and occasionally use colour coding. But there is no common, final destination for the waste, as yet,'' she said.

Ms. Bineesha, who is involved in a project of TERI to develop an interactive website on managing biomedical waste, points out that Government hospitals generate far less biomedical waste than corporate facilities. In Government hospitals, such as Victoria, it is around 0.5 to 0.8 kg. per bed per day, whereas in corporate hospitals, it is 1 to 1.5 kg.

Clearly, unless Bangalore comes up with a common landfill, and integrated site for treatment and disposal, efficient management will not become a reality.

Currently, Bangalore generates 25 tonnes of biomedical waste daily. The waste meant for the incinerator is a mere 2 per cent, while the infectious waste meant for autoclaving is about 15 per cent. General garbage makes up for over 75 per cent of the waste.

After the waste is disposed of suitably, ash can be disposed of at landfills, while the autoclaved waste clear of the pathogens can head for landfills, or be recycled to some extent for use in some other sector. Garbage can be reclaimed for composting or biogas plants.

Meanwhile, sources in the Health Department concede that the KSPCB's move of throwing the rule book at the hospitals has proved to be a shot in the arm for the authorities to hasten the process of setting up a facility.