Medical waste generated in healthcare facilities poses serious health risks as many hospitals keep discharging untreated waste water into open water bodies and dumping solid wastes in nearby dustbins.
Public health experts said that medical waste is more hazardous than other types of waste as it contains infectious materials, harmful microorganisms, and toxic substances that pose risks to both human health and the environment.
Blood, serum and stools from infected patients are particularly dangerous, they added.
According to the Department of Environment, 195 healthcare facilities in Dhaka, including hospitals and clinics, are required to have Effluent Treatment Plants. Of them, 163 are privately run and 32 are public hospitals.
However, none of the public hospitals have an ETP, and 44 per cent of private hospitals also lack the facility.
As per DoE regulations, hospitals and clinics with over 20 beds must have an ETP.
Due to the absence of these treatment plants, untreated liquid waste is being discharged into water bodies through drainage systems.
Waste Concern co-founder and executive director Abu Hasnat Md Maqsood Sinha said that medical waste contains infectious, hazardous, and sometimes radioactive materials, which pose severe health risks if not managed properly.
鈥楿nlike general wastes, improper disposal of medical waste can spread diseases, contaminate water sources, and expose waste handlers, the public, and the environment to harmful pathogens and toxic chemicals,鈥� he said.
According to the standard, a hospital bed generates 1.62kg of waste on average per day. With Bangladesh having 1,27,360 hospital beds, the country produces an estimated 75,308 tonnes of medical waste per year.
A Waste Concern study found that Dhaka generated about 68 tonnes of medical waste per day in 2019. This is projected to increase to 106 tonnes per day in 2041 and 142 tonnes per day in 2053.
Chief adviser鈥檚 special assistant Professor Md Sayedur Rahman acknowledged the poor state of hospital waste management but said that immediate improvements were difficult.
鈥榃e have taken steps to ensure safe waste management. By August this year, you will see some visible progress,鈥� he said.
Solid medical waste in Dhaka and some other cities is partially managed by third-party vendors. However, there is no scope for third-party involvement in liquid waste management.
Doctors for Health and Environment vice-president and Bangladesh University of Health Sciences occupational and environmental health professor MH Faruquee said that untreated wastewater from hospitals could spread communicable diseases like cholera, diarrhea, typhoid, and hepatitis.
He said that infections such as hepatitis B, hepatitis C, and HIV could also be transmitted through medical waste.
Bangladesh Private Hospital Owners鈥� Association vice-president Jahangir Alam said that the high cost of installing and operating ETPs discouraged hospitals from complying with the regulations.
In July 2020, the High Court, responding to a writ petition filed by Supreme Court lawyer Mohammad Humayun Pallab on behalf of the human rights organisation Law and Life Foundation, asked the government to report on the implementation of the Medical Waste Management and Processing Rules 2008.
Humayun said that the DoE鈥檚 report to the court had highlighted the poor condition of hospital waste management.
鈥榃e will bring the issue to the High Court again soon,鈥� he said.
According to the Directorate General of Health Services, Bangladesh has 610 government hospitals, 4,596 private hospitals and clinics, and 9,741 diagnostic centres.
The Medical Waste Management and Training Manual issued by the DGHS mandates hospitals to segregate medical waste into different categories 鈥� general/non-hazardous waste (black), infectious, pathological and anatomical waste (yellow), sharps (red), radioactive waste (silver), recyclable waste (green), and liquid waste (blue).
However, most hospitals continue to dump their waste in municipal dustbins or burn it openly.
Despite the presence of the Medical Waste (Management and Processing) Rules 2008 and the National Guideline for Medical Waste Management (Revised 2016), these regulations are largely ignored.
DoE director Farid Ahmed said that several notices had been served to non-compliant hospitals, clinics, and diagnostic centres, and many were fined.
鈥楢s per the law, DoE has the authority to shut down hospitals that pollute the environment due to the lack of waste management facilities,鈥� he said and added that stricter actions would be taken soon.
Dhaka South City Corporation officials said they lacked the capacity to manage medical waste, though DSCC generated 3,573.24kg of medical waste per day in 2019.
That year, the per day amount of infectious waste, sharps, and recyclable waste in the area were 2,626.8kg, 560.12kg, and 386.32kg, respectively.
Local government agencies such as city corporations and municipalities are responsible for urban waste management.
Since they lack medical waste management facilities, third parties are authorised to handle solid wastes. However, liquid waste continues to be discharged into city drainage systems untreated.
