Malady of household biomedical waste New awakening beckons?
Source: Toxics Link, Date: September , 2013
As per the Indian
Demographic Profile (2013) there are 0.9 beds available per 1000 of the
countryâ€™s population. That leaves me to wonder that besides those individuals
who end up as inpatients in acute medical cases, there must be a substantial
number that takes medicines at home for recovery; a huge lot that gets into
accidents but is not admitted and perhaps an increasingly growing figure of
those who do not suffer from illnesses that require hospitalization but need to
be administered medicines at home. What happens to the biomedical material once
used, in these cases? More importantly, what â€˜shouldâ€™ happen to this material
once used? Since medical waste generated at home is not regulated as per the
gazette definition of biomedical waste (Biomedical Waste Management and
Handling Rules, 1998), this problem becomes severely acute.
The harmful effects of
needle stick injuries leading to diseases like AIDS and Hepatitis, occupational
hazards to waste haulers, children, recycling workers or animals and
contamination of natural resources due to the infectious nature of biomedical
waste, is all well documented now and has been for over a decade. However,
unlike some of the developed nations where established collection routes
(either through local pharmacist, hospitals and in some cases mail back
services) exist, India still lags behind in formulating rules of domestic
biomedical waste management. So what is the need of the hour in this
context? Perhaps, beginning with a
definition? For instance, would you classify the carcass of a dead pet as
biomedical waste just the same as a needle used for administering insulin; what
is a the urine soiled bed sheet of a sick family member; what are expired
medicines that cannot be used anymore or X- Ray films that are old; is a used
condom, razor blade or pregnancy and sugar test strips biomedical waste; and
what happens to sanitary pads contaminated with human blood; what is mercury
from a broken sphygmomanometer or thermometer? Where does this waste go and
again where should it go? Surprisingly, there is nothing that any of our
gazette rules on biomedical waste say about this.
Domestic medical waste not only
causes serious health hazards but when added to the 800-1100 grams of
unregulated infectious medical waste that is generated in hospitals per bed per
day in India and coupled with lack of adequate segregation practices at home,
it assumes the character of a grim administrative malady. It is well established that urban India is on a
massive waste disposal crisis. With migration and change within urban populace
in terms consumption and lifestyle, a need for community engagement is rapidly
developing for driving the point of waste segregation at source, home. In
December 2012, an initiation in this regard was observed in Bangalore, however,
no follow up studies are available to ascertain implementation levels.
lack of any rules pertaining to household biomedical waste management in the
country have been brought to light by the state of apathetic waste disposal in
cities across Uttar Pradesh. This again points out to the crucial significance
of increasing efforts right now to bring about policy shifts in regard to
management of biomedical waste generated at domestic levels.
The problem of
domestic biomedical waste management is not just urban in nature as is
exemplified by the fact that diabetes affects more of rural India than urban
cities! Also per the Indian Diabetes Federation, there is an increase of 2
million diabetics per year in India. Studies have shown that prevalence of
Hepatitis C in India amongst individuals who inject drugs ranges from 33 per
cent to 95 per cent, both in populous and remote areas. As per the Indian
Council of Medical research, there are 2.4 million individuals in India
infected with HIV. What do these established facts scream? India is projected
to become worldâ€™s most populous country by 2030 and faces important challenges
and opportunities in the sphere of public health. One
such challenge facing the country is management of household biomedical waste.
Therefore, it becomes imperative to step back and assess the scope and
magnitude of this problem to nip I tin the bud.
May be it is
time now to at least begin with conceptualizing that domestic biomedical waste
is an ignored malady in India, a potential cause of spreading infections,
co-infections and full blown diseases to lead on to a blanket guideline to
inform care takers at home about how to handle and dispose biomedical waste.
But would that lead to successful accomplishment of safe management in absence
of any collection routes for this kind of waste and how can such systems be
fully functional in lack of integrated step by step layout for segregation,
treatment and disposal on part of each and every stakeholder? Perhaps it is
time to shout out to policy makers for a safer home environment rid of diseases
â€“ perhaps it is time take a first step ourselves, now.