UPDATE

The management and disposal of wastes in India largely in cities leaves a great deal to be considered. There is an absence of any appropriate mechanism for disposing the Bio-medical wastes generated in the health institutions so far. It is largely done through indiscriminate burning, causing serious health and environmental implications.

Problem attains a mammoth status when this small quantity of infectious and hazardous waste is mixed with the innocuous bulk of general waste. The fact that the country lacks appropriate procedures for handling, transport, treatment, and disposal of biomedical waste, presents a grim situation. Also, High mercury (a neurotoxin) usage in health care industry marks a dangerous trend. Toxics Link in its endeavor to bring forth toxics related issues and information in the public realm and foster state level capacity building and awareness generation on the issues organized various regional workshops. The organization in collaboration with state pollution control boards organized regional workshops in Imphal (13th September 2011), Guwahati (18th October 2011), Shillong (15th September 20011), Ludhiana (19th December 2011) Amritsar (21 December 2011) and Bhubhuneswar (17th Nov. 2011-19.Nov. 2011).

Imphal, Manipur
Toxics link in collaboration with the Manipur Pollution Control Board (MPCB), Institute of Social Research and Development (ISRD) supported by Swedish International Development Agency (SIDA), organized a workshop in Manipur. Mr. Satish Sinha (Associate Director, Toxics Link) inaugurated the session and gave a brief insight into the challenges faced by the country on the issue and the regulations on Biomedical Waste Management (BMWM). Mr. Minaketan Singh, (Senior Environmental Engineer, MPCB) in his keynote address, shared that some NGOs are working together with MPCB and 80% of the bio-medical waste management has been achieved. However, there is a need for collaborative and coordinated efforts of Municipal Corporation, financial institutes and MPCB.

 While Mr. N. Raghumani Singh, (Chairman Imphal Municipal) briefed that collection, burying and proper disposal of syringes and needles, blades and expired medicines need appropriate management to prevent unwanted infections. He further emphasized on the need of an effective legislation, which would ensure appropriate disposal of bio-medical waste.

There was a presentation by Mr. Minaketan Singh and Dr. Sudhukar Vira, (Senior Medical Officer of Sir Ganga Ram Hospital, Delhi) where the speakers briefed on the Status of Bio-medical Waste Management in the region and the Lessons Learnt in Bio-medical Waste Management at a Tertiary Care Hospital. While Dr. Ragini Kumari, (Senior Program Officer, Toxics Link) deliberated on the national scenario of waste management in hospitals and the major concerns. She also talked on Mercury Phase Out from HealthCare Sector in great detail.

There were more than 50 participants including various stakeholders, the State Health Department/NRHM, Environment and Ecology Departments, private hospitals, Manipur Pollution Control Board, civil society and the media.

Guwahati, Assam
Mr. H. K. Karforma (Additional Director, Central Pollution Control Board, Shillong), inaugurated the workshop in Guwahati, on the initiatives towards making health care toxics free. The workshop was organized by Toxics Link in association with WHO, India, where Mr. Karforma pointed that the ultimate solution for BMWM must be the non burn technology and also stressed on the ban on mercury usage in hospitals. Briefing on the rule on Bio Medical Waste Management (BMWM), Mr. Satish Sinha, (Associate Director, Toxics Link), pointed that despite the existing rules on BMWM which came into being in 1998, there is no proper implementation. He also expressed concerns over the use of incinerators which adversely affects human health and environment by releasing harmful and toxic gases.
Jury Sharma Bordoloi pointed that the city generates about 500 metric tons of solid waste per year however; the management is able to compost only 50 metric tons waste annually. Dr. Ragini Kumari (Toxics Link) presented on, “Implementing Waste Management System in Hospital�, where she talked on the importance of managing biomedical waste. Mr. H.K. Karforma, concluding the session shared the ways of managing the waste.

Shillong, Meghalaya workshop:
In his inaugural address, Mr. Satish Sinha, briefed on the fragile eco-system of Meghalaya and pointed the need for proper implementation of Bio Medical Waste Rule. He also explained the lurking dangers of mercury based healthcare equipment like thermometers and BP instrument (sphygmomanometer).

 Mr. B. Blah War, (Asstt. Environmental Engineer,MSPCB) briefed on the status of biomedical waste management in Meghalaya.He informed that there were 662 healthcare units in Meghalaya that required authorization from the Board. While Mr. E.Thma (NEEDS-NGO), threw light on the status of implementation of the Rules in selected hospitals in Shillong

Dr. Ragini informed that a global movement for phasing out mercury from the healthcare sector by 2017 is being initiated jointly by the World Health Organization and the United Nations Environmental Programme, while a Global Mercury Treaty will be in place by 2013.

Ludhiana and Amritsar, Punjab
The Punjab Pollution Control Board in association with the Indian Medical Association and Toxics Link, New Delhi, organized a workshop on the hazards of mercury at Government Medical College, Amritsar. The workshop was attended by doctors and paramedical staff from government as well as private hospitals. It focused on the need for replacing mercury equipped instruments like thermometers and sphygmomanometer with aneroid-based instrument.

During the workshop, Dr. Ragini Kumari pointed the adverse impact of mercury inhalation due to spillage from instruments that could damage the lungs, kidney and the central nervous system. Mr. K.S. Pannu (Chairman, Punjab Pollution Control Board), who presided over the workshop in Ludhiana, emphasized that it was high time for a progressive state like Punjab to make its healthcare facilities mercury-free in the coming year. He lauded the hospitals that had volunteered to become mercury-free. While Mr. Kulwant Singh (President, IMA), assured that all healthcare sectors in the city would be made mercury-free.

Bhubhuneswar, Odisha
Toxics Link, in collaboration with PARIBARTA, Odisha initiated a three day state level Training-cum-Workshop on Bio-Medical Waste Management and Mercury Phase-out from Health sector in Odisha. First 2 days were devoted for generation of awareness among the health care providers on BMWM followed by a ToT

Dr. Sitakanta Mohapatra (Jt. Director (DMET) inaugurated the session where he highlighted the pros and cons of Bio- Medical Waste Management. Dr. Ragini Kumari, gave a brief insight into the types of medical waste; procedures for treatment; handling and disposal of medical waste; legal provisions related to Bio-Medical Waste Management and Specific guidelines for handling wastes.While Dr. S.P. Samantaray, (Sr. Scientist, SPCB, Odisha) threw light on the role of State Pollution Control Board in the Management of Bio-Medical Waste; the authorization system and the standards for treatment, handling and disposal of different category of Bio-Medical Wastes.

 Ms. Kankana Das (Sr. Programme Officer, Toxics Link) presented on Bio- Medical Waste Management Rule-1998. Mr. Pravat Ranjan Dash, (Advocate High court, Odisha) spoke about the standard operating and the laws related to handing & management of Medical waste. Also a group work was under taken with the objective to assess the ASK (Attitude, Skill, Knowledge) of the participants and evoke their opinion about a Model Facility on BMWM. The training facilitators empowered the participants with technical inputs on the types of medical waste; the ways for handling them and the appropriate measures required.

The last day of the training programme was devoted for training of the trainers. Ms. Kankana, briefed on handling needle destroyer. The regional workshops saw an overwhelming response. The audience actively participated in the deliberations and significant ideas and key proposals were made for the future course of action for proper management of bio-medical waste and phasing out of mercury from the healthcare sector evolved. Also, some valuable recommendations on bio medical waste management were flagged in the workshops that included adoption of decentralized funding partner for waste management; Fixing responsibility and accountability; strict monitoring and supervision mechanism.