How do we tackle the issue of biomedical waste during the pandemic?
The Covid-19 pandemic, which seems to have completely transformed our notions of normalcy, has caused a considerable amount of damage to society and the economy. However, given its highly contagious and deadly reputation, most people seem to have overlooked another problem that has sprouted as a by-product of the pandemic -- biomedical waste management.
If not managed properly, biomedical waste poses a very serious threat to global public health, particularly in low-income or less economically developed countries such as Bangladesh.
In a densely populated city like Dhaka, the spread of a highly contagious novel virus like this is the worst nightmare for public health organizations and the government -- improper biomedical waste management is only proving to exacerbate its spread.
Hospitals and other health facilities generate around 1·63-1·99kg of waste per bed per day in Dhaka, and an estimated 15% of all waste can be infectious, hazardous, or radioactive. Biomedical wastes possess the aforementioned qualities because they host potential virus particles that can be hidden beneath human tissue; items contaminated with blood bags, needles, syringes, body fluids, plaster casts, cotton swabs; beddings contaminated with blood or body fluid, etc.
Antibiotic-resistant germs and viruses such as the coronavirus can easily spread through these types of waste. Sharp objects such as needles, knives, surgical blades, broken glass infusion sets, etc can find their way into landfills and dumps, posing injury risks to people scavenging in waste disposal sites -- a practice commonly seen in Dhaka.
A pressing issue is the clear attribution of responsibility of appropriate handling and disposal of waste. According to the “polluter pays” principle, this responsibility lies with the waste producer -- usually the health-care provider, although the government is also responsible for policy implementation and monitoring.
Who actually steps up to tackle the problem?
Despite the introduction of the Medical Waste Management and Processing Rules in 2008, no adequate system has been developed as of yet to properly manage medical waste. Healthcare waste management falls under the auspices of the local municipal bodies or third party organizations which are responsible for the collection, removal, and disposal of wastes from public places.
City Corporations are generally in charge of collecting this waste but due to insufficient capacity, the collection of waste is often irregular, stemming from a lack of resources in most cases.
Even when third-party organizations and NGOs are thrown into the mix, the capacity does not scratch the surface of what is required in a safe and environment-friendly waste disposal system. Private hospitals and clinics either have little to no policies or guidelines regarding safe and ethical waste management or do not provide their staff with adequate training.
It is also important to keep in mind that in a country like Bangladesh where the waste handlers are illiterate, the hospital or clinical waste procedures should be very simple and easy to understand.
Informal sanitation workers generally coming from low-income backgrounds and settlements are at a higher risk of contracting Covid, given their lack of knowledge regarding safe waste disposal and access to insurance and healthcare services. Approximately 40,000 informal workers are under high risk of contracting the virus due to inadequate protection, with these individuals ultimately becoming the main carriers of the virus as they usually do not have the privilege of working from home or getting tested whenever they experience symptoms.
While India’s neighbours may breathe sighs of relief knowing they’r their infection rates are far lower, it is important to remember that anything can change at any time. Bangladesh was already struggling in terms of proper waste management and seems to have been hit even harder by the sudden surge in biomedical waste produced as a result of the Covid-19 pandemic.
Government complacency in waste management could very well be the initiation of another nationwide public health crisis. Ultimately, a policy-level paradigm shift into an efficacious and strategic waste management system is required in order to ensure health and environmental safety for everyone, not just those who have the privilege of quarantining in their homes.
After all, the pandemic has just served as a reminder that nobody is safe until everybody is.
Armeen Ahmed is a freelance contributor.