One of the big contributors to air pollution in Kathmandu is the unhygienic management of waste by the Valley’s mushrooming healthcare institutions. According to a study, over 70 percent of waste generated by hospitals in Kathmandu is incinerated, to potentially disastrous consequences. The toxic materials released from incineration, a waste disposal technique involving combustion of organic substance, has been attributed to a drastic increase in the cases of pulmonary problems like asthma and Chronic Obstructive Pulmonary Disease (COPD). Of course, unhygienic practices at hospitals are by no means limited to improper waste disposal systems.
The lack of seriousness of hospitals towards the management of hospital-induced infections was brought home recently when the Thapathali-based Paropakar Maternity Hospital had to be shut down after women in labor and the newborn started contracting potentially life-threatening infections, which, it turned out, owed to the failure of hospital authorities to take necessary precautions against infections in one of its operation theaters. Likewise, while the whole population of Kathmandu is at an elevated risk of contracting respiratory illnesses, the patients who visit the hospitals that have adopted unhygienic waste disposal system are at even higher risk.
The problem is that new healthcare institutions don’t carry out the Environmental Impact Assessment (EIA) or Initial Environment Examination (IEE) which determine the adverse impact of hospital waste management on the environment. This is the case because there are no proper waste management policies in place, nor are the rules on hospital waste management being implemented in the absence of an effective monitoring mechanism. Given the grave risks associated with unregulated management of hospital waste, it is remarkable that the issue has been completely neglected.
Amazingly, it is Bir Hospital, which often comes into news for its shortage of vital equipments and gross mismanagement, which is showing the way for the rest of the healthcare facilities when it comes to management of hospital waste. Since last year, Bir Hospital has started to segregate its waste into organic and non-organic waste. While the organic waste is used to produce methane gas (used for cooking) in underground plants, non-organic waste is recycled to make handicrafts. Moreover, used cotton and gauge are turned into compost manure which the hospital sells for profit. Since the start of the program, the recovery time of surgical patients has been shortened as infections that resulted from unmanaged wastes have gone down drastically.
There are other safer alternatives too. For instance, if the incineration is carried out in very high temperature (above 800 degrees Celsius), the emission of organic pollutants and carcinogens could be significantly reduced. Even if incineration has to be carried out under lower temperatures—most incinerators brought into use by Kathmandu hospitals operate under much lower temperatures—a safe distance should be maintained between the incinerator and hospital wards housing patients.
But these safety measures are unlikely to be adopted as the hospitals have found it convenient to dispose of their waste as they see fit, without any concern about the enormous health costs such a process entails for other people. Unless urgent steps are taken to minimize pollution from hospital wastes, Kathmanduites will continue to breathe the noxious air, to a great detriment of their health