Lahore’s medical waste not being properly disposed

The situation of medical waste disposal in the city is extremely dire. Internationally accepted guidelines on the proper management of waste are largely ignored, medics say.

The risks posed by improper waste management are three-fold, Dr. Rizwan, a medical practitioner from Johar Town, explained: “risks to the hospital staff, risks to the general public and risks to the environment.”

“If sharp equipment such as used syringes are not sealed and segregated appropriately, the hospital workers are prone to injuries which can lead to infections of hepatitis, HIV, etc.

When waste is dumped in open or uncontrolled sites, the general public is also likely to face consequences: contact with toxic chemicals can cause accidents while contact with ‘sharps’ can cause injuries and infections,” he elaborated.

“Most alarmingly, medical waste can also have adverse effects on the greater environment,” Dr Rizwan said.

“It has been proven that dumping waste in unlined pits can lead to water contamination. Moreover, incineration without emission control can cause air pollution and various diseases.”

So why do hospitals in Pakistan consistently disregard waste disposal guidelines?

According to an anonymous source at a public-sector hospital in Lahore, the answer is not simple because there are many factors at play.

First and foremost, there is the financial problem. Most hospitals in Pakistan, especially public-sector ones, run on tight budgets and are unable to splurge on proper waste management equipment such as incinerators, needle cutters, and storage containers.

Secondly, medical staff in Pakistan lacks the necessary training and knowledge that is required in order to dispose of waste responsibly.

Another big issue that hinders progress in this area is that janitorial staff often makes ends meet by selling used medical items on the black market.

A study conducted in Ayub Medical College, Abbottabad found that cleaners and janitors commonly earn from 20 to 50 rupees for every used syringe they sell.

Finally, and perhaps most importantly, Pakistani hospital workers simply do not understand the importance of proper waste disposal.

They consider proper management procedures to be an unnecessary hassle. The study conducted in Abbottabad discovered that even when medical staff was given extensive training workshops on how to handle medical waste, the majority still did not comply with the guidelines.

Many workers consider even wearing gloves as something that “only people in rich countries do”.

Clearly, there is an awareness problem. No solution can be achieved if the workers themselves are fundamentally reluctant to change their ways.

All hope is not yet lost.

Dr. Shahida Husain, an obstetrician, proposes a nation-wide fundraising campaign in order to raise money specifically for buying proper waste disposal equipment for public-sector hospitals.

She says that while this may have been difficult in the past, the Internet makes it possible to crowdsource anything nowadays.

With enough outreach to people all over Pakistan, sufficient money can be raised to get at least a few hospitals in every major city the necessary paraphernalia.

Moreover, she says that the hospital staff can be encouraged to cooperate using financial incentives.

The study in Abbottabad found that while staff was initially reluctant to adopt proper waste management techniques, giving them small financial incentives made them much more cooperative. The money for this can also come from fundraising.

Training workshops and lectures should be held in major hospitals so doctors and staff can be educated on the necessity of proper waste disposal as well as the latest techniques and safety measures.

Medical colleges and research centers should be encouraged to conduct such events.

There is consensus among environmentalists that legislation should be passed requiring hospitals to adhere to a strict set of rules and regulations regarding waste management.

If any hospital or clinic fails to comply with these rules, they should be fined. While this may seem harsh, in the long run this is beneficial for society as damage to the environment and to the public is minimised.

In order to make long-term improvements, we need a shift in the mindset of the general population.

Sustainability and conservation of the environment should be our top priorities. This can be done over time by integrating environmental sciences into school curricula, say experts.