Buy an infection at Shahdara’s scrap market

• Illegal trade in used hospital equipment booming, exposing citizens to serious health hazards

Hospital waste and used medical equipment is being used by scrap traders to earn profits at the cost of spreading dangerous diseases amongst the unwitting public, Pakistan Today has learnt.

Shahdara houses a bustling used medical equipment market. Most of this equipment is brought in from local hospitals and medicinal factories abroad, from countries such as Japan and Germany, and carries germs, drugs and leftover material from the medicine manufacturing process, sources told Pakistan Today.

The local hospitals also contribute to this trade. Every day, countless used syringes, empty glucose tubes, injection vials and plastic tubes are collected from various hospitals illegally and brought to Shahdara for reselling.

The used glucose bottles available at the Shahdara market often contain germs and are refilled and resold, with each bottle costing a mere Rs 100 to Rs 150. According to doctors gastrointestinal infections, respiratory infections including measles virus, eye infections, skin infections, anthrax, meningitis, aids, haemorrhagic fever, viral hepatitis A, B and C, and avian influenza are among the diseases being spread in this way.

Unfortunately, the authorities are completely ignoring the situation.

One scrap trader in Shahdara on condition of anonymity informed that all those involved in the used medical equipment business had contacts with customs officials. He revealed that containers are brought into Lahore for sale, from where the local traders purchase the equipment dirt cheap and then sell it on the Shahdara scrap market.

In Lahore, only Children’s Hospital and ShalamarHospital have plants for safely disposing of used equipment, and even these are not fully functional.

 PRODUCING FROM WASTE:

According to sources, some of the used medical instruments are also used by the recycling industry. Cheap recycled plastic production is booming, with around 400 such points operating in Punjab alone.

The hygiene and safety of products produced with this plastic is highly questionable. Sources revealed that many factories manufacturing plastic medicine containers and tubes use plastic from shoes, used water bottles and broken utensils, which often carry infections.

The Small and Medium Enterprise Development Authority found that this poor quality plastic was being used to bottle medicines for hepatitis C, AIDS and tuberculosis, and drastically decreases their potency.

The same plastic is often used for manufacturing cutlery and plates used in many fast food chains, where it poses infection risks for consumers.

 ‘WE NEED TO EARN A LIVING’:

The situation presents dire consequences for public health; however, the scrap traders are adamant to continue with their business.

“We cannot discontinue our business. Even if I stop, there are countless others who engage in selling this imported equipment, many of whom are bigger traders and have far more powerful contacts than I do. Even the authorities cannot touch them. If they are still there, what difference will it make if I stop? Why should I deprive my children of food and shelter?” said a scrap trader from Shahdara.

“If this used equipment is spreading disease then the government should take abrupt action, and catch the big fish in the sea first and foremost. In my opinion, Pakistanis are continuously exposed to disease due to our unhealthy diet: all grain, vegetables and meat that we consume is adulterated with artificial chemicals and adulterated with hormones and dangerous fertilizers. The government should take action against that as well,” he added.

 EDO HEALTH AGAINST HOSPITAL WASTE:

While talking to Pakistan Today Health EDO Dr Zulfiqar said that Children Hospital’s incinerator was out of order, and would be fixed in a few days. He also informed that hospitals that lacked incinerators were instructed to burn the hospital scrap and then bury it.

Dr. Zulfiqar also thanked Pakistan Today for bringing the illegal sale of used hospital equipment to his notice. He has ordered an enquiry and crackdown on this dangerous trade.

AN EFFICIENT PLAN COULD DO THE JOB!

International Committee of the Red Cross in their publication “Medical Waste Management” has enunciated a list of responsibilities which could be adopted by the local health authorities in the city in order to take care of the hospital waste.

To keep a check hospital waste, the publication highlights the importance of establishing a waste management working group and also underlines the responsibilities of the personnel who have to deal with the hospital waste.

A waste management working group must thus be setup by the hospital manager. That team must include the following members: the hospital project manager, the water and habitat engineer, the local waste manager, and members of the hospital staff, such as the hospital administrator, the head nurse, the head of radiology, the chief pharmacist and the head of laboratory.

DUTIES OF THE HOSPITAL PROJECT MANAGER:

The hospital project manager has the overall responsibility of ensuring that the hospital wastes are managed in compliance with national legislation and international conventions. He is also responsible for setting up a working group in charge of drafting the waste management plan; appointing the local waste manager, who will supervise and coordinate the waste management plan on a daily basis; assigning duties; drawing up job descriptions; allocating financial and human resources; implementing the waste disposal plan; conducting audits and continuously updating and improving the waste management system.

DUTIES OF THE WATER AND HABITAT ENGINEER:

The water and habitat engineer is responsible for carrying out an initial assessment of the waste situation; proposing a waste management plan to the working group (including the choice of treatment/disposal methods) that is in line with any existing national waste management plan; planning the construction and maintenance of waste storage and disposal facilities; assessing the environmental impact of waste management (monitoring contamination, conducting hydrogeological assessments, etc.); regularly analyzing risks for the personnel; supervising the local waste manager and staff training.

DUTIES OF THE LOCAL WASTE MANAGER:

The local waste manager is the person in charge of administering the waste management plan on a daily basis. He is the guarantor of the long-term sustainability of the system and must thus be in direct contact with all the members of the working group and all hospital employees. His duties include: monitoring the collection, storage and transport of wastes on a daily basis; monitoring the stocks of receptacles and containers, bags and personal protective equipment as well as the maintenance of the means of transport used; forwarding orders to the hospital administrator; supervising the persons in charge of collecting and transporting wastes; monitoring the measures to be taken in the event of an accident (posting notices, informing the staff); monitoring protective measures; investigating incidents/accidents involving wastes; drawing up reports (quantities of waste produced, incidents); ensuring the maintenance of storage and treatment facilities.

DUTIES OF THE HOSPITAL ADMINISTRATOR:

The hospital administrator is responsible for: ensuring that stocks of consumables (bags, receptacles and containers, personal protective equipment, etc.) are permanently available; examining and evaluating costs; drawing up contracts with third parties (carriers, sub-contractors); giving advice on purchasing policies with a view to minimize/substitute certain items (mercury-free equipment, PVC-free equipment, etc.); monitoring proper implementation of protective measures; supervising in the absence of the water and habitat engineer.

DUTIES OF THE HEAD NURSE:

The head nurse is responsible for: training care staff in waste management (paying special attention to new staff members); monitoring sorting, collection, storage and transport procedures in the various wards; monitoring protective measures; supervising the hospital hygiene and taking measures to control infection.

DUTIES OF THE CHIEF PHARMACIST:

The chief pharmacist is responsible for: maintaining medicine stocks and minimizing expired stock and managing waste containing mercury. In the absence of the pharmacist, the hospital administrator takes over these responsibilities.

DUTIES OF THE HEAD OF LABORATORY:

The head of laboratory is responsible for: maintaining the stock of chemicals and minimizing chemical wastes; managing chemical wastes.

Reporting by Rana Haider, translation, editing and research by Moosa Abbas.