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

Hospital Waste ManagementA hospital’s infection control programme must include proper hospital waste managementtraining and an action plan as elements of its strategy. With regard to hepatitis B and HIV,biomedical waste is a dangerous source of infection. Compared with other areas of the world,hepatitis B is growing the fastest in India. HIV infection is another major hazard. It is said thatMumbai is the AIDS capital of India, because roughly 5% of the population there is sufferingfrom AIDS or is HIV-positive. In the state of Rajasthan, hepatitis B positivity has been found in4% of the population and is increasing constantly. In fact, infectious diseases remain a leadingcause of death in many parts of the world. Many infectious diseases once thought conquered areincreasing, such as tuberculosis, polio, and jaundice, and continue to be a serious public healththreat. Over the last decade, the health care industry has shifted from a mainly reusable productsupply system (all glass syringes, hospital laundry) to a primarily disposable product supplysystem (disposable syringes and needles, use-and-throw hospital linen). The unscrupulousrecycling of these disposables contributes largely to the spread of infections like hepatitis B andC and HIV.The recent legislation for biomedical waste deals with the following matters.1. Biomedical waste management should aim to prevent occupational, public health, andenvironmental hazards, and should also take into account aesthetic aspects.2. The recovery and recycling of materials must be done with caution, taking into accountsafety, health, and environmental risks.3. Hazardous health care waste should be dealt with as part of an overall hazardous wastemanagement system, with appropriate control procedures.4. It is mandatory that waste contaminated with pathogens of diseases, notifiable underepidemic control regulations, such as cholera, gastroenteritis, and plague, should not leavethe premises unless suitably disinfected.Hospital waste management requires commitment from persons at all levels of the health carefacility. According to the World Health Organization, “The human element is more importantthan the technology. Almost any system of treatment and disposal that is operated by welltrainedand well-motivated staff can provide more protection for staff, patients, and thecommunity than an expensive or sophisticated system that is managed by staff, who do notunderstand the risks and the importance of their contribution.”Management of Hospital WasteIdentification of Various Components of the Waste GeneratedThe 1998 Biomedical Waste (Management and Handling) Rules say that such waste shall besegregated into containers/bags at the point of generation, in accordance with Schedule II of therules, prior to its storage, transportation, treatment, and disposal. All containers bearinghazardous material must be labelled with the ‘biohazard’ or ‘cytotoxic’ symbol as the case maybe, according to Schedule III of the rules. At the same time, the containers should bear the nameof the department/laboratory from which the waste has been generated and the name of theconcerned person so that, in case of a problem or an accident, the nature of the waste can betraced back quickly and correctly and the responsible person can be traced.206