Incinerators, a bitter pill for most hospitals

KOLLAM Nov. 24. Even as the deadline set by the State Pollution Control Board (PCB) for hospitals to install incinerators expires on December 31, only a few of them have cared to take the authorisation of the PCB and engage in the process. PCB authorities said that even some of the major Government and private hospitals in the State are yet to comply with the directive.

According to a directive given by the PCB under the Biomedical Waste (Management and Handling) Rules 1998, following a gazette notification from the Union Ministry for Environment and Forest, ``it is the duty of all health care institutions like hospitals, nursing homes, clinics, dispensaries, pathological laboratories and blood banks which generate biomedical waste to ensure that such waste is handled, treated and disposed of without any adverse effect to human health and environment''.

These institutions are required to set up biomedical waste treatment facilities either individually or commonly.

Wastes generated from these institutions are classified into ten categories, out of which four require mandatory treatment and disposal through the incinerator.

These include hospital-generated waste like human anatomical waste, microbiology and biotechnology waste, discarded medicines and cytotoxic drugs and solid waste.

The rules specify the type of containers to be used to hold each category of waste. For instance, only yellow coloured plastic bags should be used as container for wastes categorised to be disposed through the incinerator.

Talking to The Hindu, the PCB environment engineer, A.B. Pradeep Kumar, said the board had been issuing directives to hospitals for erection of incinerators right from 1998.

However, many hospitals have taken these directives lightly.

The Union Ministry is now very serious about the issue and reluctance to comply with the directive would invite stern action.

One of the prime reasons for incinerators and proper biomedical waste disposal facilities is the fact that seven out of ten persons going to a hospital for the treatment of a particular disease become a victim of nosocomial infection, which in other words mean an infection contracted from the hospital.

A peculiar aspect in Kerala is that while the State accounts for just 3 per cent of the nation's population the hospital bed strength is 27 per cent.

While a majority of the hospitals in other States have complied with the directive, in Kerala, most hospitals are still reluctant because of the ``commercialised approach that investment for waste disposal is a waste, for it brings no returns''.

As the deadline nears, the PCB is organising an awareness campaign by calling district-level meetings with representatives of all hospitals and branches of the Indian Medical Association (IMA).

IMA proposal

The IMA State branch, under a project christened `Image' (IMA Goes Eco Friendly), has proposed a suggestion to the PCB to construct incinerators that could be used as a common facility by several hospitals.

Under the proposal, which is understood to be in an embryonic stage, a fee would be levied from each hospital for the purpose.

The tentative fee proposed is reportedly Rs.1,000 as initial deposit and a daily fee at the rate of Rs. 3 per bed.

Even if this project works out it would be the duty of each hospital to take up the responsibility of constructing facilities for waste segregation.

The operators of the common facility would be responsible only for the transportation and disposal of the waste.

It is understood that the IMA has identified a site in Kollam district for the purpose and if the project works out it would cater to the biomedical disposal requirements of health care institutions in Kollam, Alappuzha, Pathanamthitta and Thiruvananthapuram districts.