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ashish k. Gupta

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Bio-Medical Waste Management: A Much Neglected Area
India is a vast country with fast evolving healthcare infrastructure. New healthcare facilities are coming up every day in both curative and preventive-promotive areas.
Indian parliament passed ‘Biomedical Waste handling and Management Rules’ in the year 1998 and it became a regulatory requirement for the healthcare industry in India. Pollution control boards in India have the power to close down such facilities and even arrest the owners of such facilities that flout these rules. Fifteen years have passed. Still this is the most flouted law by the healthcare facilities in India right from the primary care to the tertiary care and both in public and private sector healthcare facilities.
The problem is at all steps:
• The healthcare facilities lack proper color coded bins
• If bins are there then they are either improper i.e. uncovered/ have flapping covers that need to be touched to open/ mal-functioning foot operated lids; Or are of disproportionate size and not as per the calculated waste requirements; Or are wrongly located i.e. at the end of the ward away from the working area, forcing the healthcare operator/ worker to mix the waste at source of generation and segregation is done later (A wrong method).
• Waste segregation at source is lacking at almost all healthcare facilities, in actual practice.
• Proper disinfection facilities of infected BMW are hardly available at the source of waste generation.
• Even if 1% Sodium Hypochlorite is available then this is mostly found in an uncovered container, leading to vaporization of Chlorine and making the solution ineffective for the purpose
• Even if such covered containers are available the disinfectant is not re-constituted every eight hourly as recommended.
• The holding period of the waste in the solution also is not sufficient many a times.
• The waste transportation to central waste storage facility, which itself lacks in most of the healthcare facilities, is also not as per the law. These are either transported in open many purpose trolleys/ bins and different category waste is not carried in different designated trolleys, but in the same one, again a flouting of law.
• Central storage facilities, when present are not kept locked or out of bounds for reg pickers, birds and animals.
• There is pollution of the ground water table through seepage of openly lying biomedical waste.
• Waste is not picked up in the defined time period by the waste handling agencies and one can think of what all happens to a biological waste in tropical country like India.
• Healthcare organizers, healthcare providers and healthcare managers are equally responsible for this mess so are the civic agencies and Govt. bodies that are custodian of this law.
When will we wake up to the urgent requirement of saving our environment and its inhabitants…who are no different than our very own children….. 
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