Health Policy Issues and Health Programmes in ... - Amazon S3

Hospital Waste Managementproperly managing the collection and disposal of waste from hospitals. The administration isstill not familiar with proper waste classification, segregation, handling, disposal of the wastegenerated in hospitals, and treatment technologies. In many instances, waste handling is left topoorly educated, low-level workers operating without adequate guidance and supervision. Arecent study demonstrated that hospital waste management throughout the country requiresimprovement in order to reduce health risks from improper handling and disposal ofbiomedical waste. It is a matter of concern that two-thirds of waste-controlling authorities,administrators, and managers of government and non-government health care facilities claimthat they are not aware of either the documents outlining the hospital waste management rulespublished in July 1998 or their directives. About 80%–90% of respondents indicated that theywere not aware of the existing rules.Biomedical waste management is like the ‘Christmas Tree Syndrome’—from one package, theamount of waste continues to grow downwards, and new branches generating more and morewaste arise. Biomedical waste management has assumed great importance the world overbecause of the serious hazards it poses to the environment in general and the public inparticular. Before we understand the basic principles of biomedical waste management, it isimperative to know exactly what constitutes biomedical waste.Perhaps one of the most important issues in biomedical waste management and its regulation is thedefinition of exactly what constitutes infectious waste. Unlike for chemical and radioactive waste, noobjective tests exist to identify or classify infectious waste from the hospital waste stream. Thus,infectious wastes are categorized primarily by subjective evaluation of the health hazard potential.Waste generated from different health facilities will have a different character in the compositionof biomedical waste. Therefore, the waste generated from maternity and obstetric wards willhave large amounts of placentas, abortus, and soiled sanitary napkins, while the wastegenerated from operation theatres (OTs) will consist mainly of swabs, bandages, viscera, tubes,catheters, and so forth. Similarly, the waste generated from pathological centres will have sharps,needles, vials, cotton, body fluids, urine, stool and blood.Infectious and non-infectious waste are generated simultaneously along with other hospitalwaste, and once generated, are difficult to separate because of health and safety concerns.Because of this problem, non-infectious (black bag) waste finds its way into the infectious (redbag) waste, and, unfortunately, this infectious waste may be deposited with the municipal wastethat goes directly to a landfill, polluting the total municipal waste into infectious waste.Improper segregation will lead to all hospital waste being considered as infectious waste,barring waste from kitchens and offices.Although the medical waste stream represents only a small fraction of the total municipal waste,it is most visible and critical in public opinion. In 1996, home health care waste, such as sanitarynapkins, baby diapers, and equipment used in home health care, (syringes, needles, cathetertubes, discarded cytotoxic drugs, etc.), was 16% of the total hospital waste generated. Since then,this figure has grown steadily in India as well as worldwide and needs attention.205