By By Amer Malik
SCIENTIFIC management of hospital waste seems a far cry as the Punjab Health Department has failed to install 11 out of 19 incinerators sponsored by the federal government even after a delay of two years.
The mafia involved in recycling hospital waste has become active because authorities had failed to implement Hospital Waste Management Rules, 2005 in letter and spirit.
The Health Department could not install incinerators in 11 districts including District Head Quarter (DHQ) Hospital, Mandi Bahauddin, Okara, Sheikhupura, Mianwali, Khushab, Muzaffargarh, Liyyah, Dera Ghazi Khan, Khanewal, Chakwal and Jhelum despite availability of these incinerators in respective hospitals for around two years ago. Incinerators were installed in eight districts i.e. Shaikh Zayed Hospital, Rahim Yar Khan, DHQ Hospital, Attock, Lodhran, Bahawalnagar, Toba Tek Singh, Jhang, Narowal and Hafizabad. Out of these, incinerators in three districts are still not functioning. The Punjab government had not allocated funds for installation and running expenses of incinerators in 19 districts across the province, they said. Medical experts said that Hepatitis-B prevalence had reached an alarming level of up to 10 to 12 per cent in Pakistan because 98 per cent of hospital waste was not being disposed of properly. They observed that a mafia was supplying hospital waste to market.
Medical professionals point to irregularities in purchase of incinerators, saying the federal government had purchased “substandard and outmoded incinerators” that could not dispose of hospital waste properly. “There are massive anomalies in purchase of incinerators, which better be called furnaces,” observed Prof Dr Javed Akram, the principal of Allama Iqbal Medical College/Jinnah Hospital, Lahore. Modern incinerators had dual chambers with scrubbers, which helped stop the omission of poisonous gases, he added.
Dr Javed had attended a meeting on “Hospital Waste Management Rules, 2005” held at the Environment Protection Department held under the chairmanship of the EPD secretary.
Sources said while the need to implement Hospital Waste Management Rules, 2005 in letter and spirit was stressed at the meeting but no one displayed instructions, manual/charts and staff working in hospitals, clinics and pathological laboratories was also not trained.
According to minutes of the meeting available with The News, it was also learnt that the Punjab Health Department had failed to convene even a single meeting of Hospital Waste Management Advisory Committee after its constitution through a notification in 2007.
Moreover, although implementation of these rules rests with the district health officer but the Punjab Environment Protection Agency had been taking action on cases of violation of these rules. Sources privy to the meeting said the Health Department was shunning its responsibility to inspect hospitals and initiate legal action against cases of violations of rules. They said the Environment Department was discharging this duty.
Officials told The News that the Environment Department could only refer cases of violation to the Environment Protection Tribunal which delayed decisions for years. They said the Health Department, in case it fulfilled its responsibility, referred these cases to magistrates of Class-I having powers of environment magistrates for quick disposal of cases.
It was recommended during the meeting that the Health Department must ensure installation of incinerators in remaining 11 districts within 15 days in addition to holding meeting of the committee constituted under the chairmanship of the health secretary to review the progress of implementation of Hospital Waste Management Rules, 2005. EDOs (Health) were directed to ensure compliance of rules in their respective districts under the supervision of health and environment departments.
It was also decided that training of lower staff would be conducted and instruction manuals/charts would be displayed in hospitals, clinics and pathological laboratories.
Health Secretary Anwaar Ahmad Khan was not available for comments. When contacted, Additional Secretary (Technical) Dr Mushtaq Ahmad Sulehria told The News that the federal government dispatched 19 incinerators to districts two years ago but these could not be installed in 11 districts due to “inefficiency and slackness” on part of the Health Department and officials in hospitals of respective districts. He said the Health Department recently issued a directive to expedite the installation of incinerators in hospitals and complete this process by the end of November.
He claimed the Health Department was discharging its responsibilities with regard to inspections of hospitals and checking/taking action against violations of Hospital Waste Management Rules, 2005.