Clinical waste: A major threat to Sri Lanka: Not disposed but stored

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By Zeeniya Musadique

Clinical waste is a huge problem in our country with no proper disposal method. A shocking revelation has been made where clinical waste from the main hospitals in the country has been stored instead of being disposed, posing a major health hazard to the environment and to the handlers, putting the lives of many at risk. 

If the authorities do not effectively handle this issue, it would lead to untold damage to the environment and hardship to the handlers of the waste.


Meanwhile, according to the Sri Lankan Waste Management Report, clinical waste should be disposed of within 48 hours, but that is not the case. It is far from it! The company entrusted to handle clinical waste disposal does it at its own time and mind you, the waste is disposed a good three months after. 

Sisili Hanaro Encare Pvt Ltd has been entrusted with the job and as mentioned earlier it is a cool three months before the waste is disposed.

Cleaning staff

This is what the cleaning staff at the National Hospital Kandy had to say, “We don’t mind  our hands being constantly injured by sharp objects such as injection needles, scalpels and knives’. 

These poor workers are only earning a wage and were unaware of the deep damage they are faced with and the repercussions it entails. “The black bags had normal waste while the yellow bags had clinical waste and, we store the waste in a proper repository”, they said.

According to research carried out to evaluate the current situation of Bangladesh’s Hospital Waste Management, it has been found that  “Due to the incorrect management of Clinical waste, many health problems occur. 

For example, needles, scalpels and blades injure the hands when clinical waste is discarded. Increasing physical health disorders, spread of pathogens, HIV/AIDS 0.1%, Hepatitis B 30%, Hepatitis C 1.8%  such types of diseases may mix in the blood and could be found in the used lint. In addition, many have suffered from infectious diseases including skin infections, diarrhoea, tuberculosis, and malaria”.

Danger

Because of the lack of awareness of the danger, clinical waste could cause and only one company being entrusted  with  the disposal of clinical waste from major hospitals, there is a potential threat to the local health sector.

A single company has been allotted the task of collecting clinical waste from the five main hospitals in Sri Lanka. However, the National Hospital Kandy has been excluded.

A startling revelation was made when an investigation carried out by the National Hospital in Kandy from September to December of last year, found that staff do not use any security equipment when disposing clinical waste. It had also been found that nurses at the Neurosurgery Centre dispose clinical waste without even wearing a pair of gloves.

Not only that, it was observed that used lint with blood, bandage used for injuries, used needles and saline were disposed as these were just normal domestic waste and went into black waste bags used in homes for domestic waste disposal. 

By the way, what the authorities might not be aware that, there is a law with regard to the disposal of clinical waste. It is the well-known yellow-coloured bags that have to be used to dispose clinical waste but lo and behold this hospital was not even aware of that such a thing is existed.

Cleaners unaware

Another astounding revelation was that  cleaners were unaware with regard to how clinical waste should be handled and disposed. Poor they! They just handled it as if it were handling  the usual domestic waste, not knowing that they were putting their lives on the line when handling this type of waste. These poor workers sans any protective clothing took sharp equipment and used gloves boxes away!

Meanwhile, the Kandy National Hospital stores a staggering 10 kg of clinical waste on a daily basis.

The Public Health Inspector who introduced himself as Thushara said “We have to store clinical waste because it is not taken away by Sisili Hanaro Encare Pvt Ltd.”

Implications

Knowing the implications of such an endeavour, he said  patients in hospital and everyone in that environment were at risk of being infected with pathogens by clinical waste collected over several days., so much so that, sodium hydrochloride (salt) was sprinkled to prevent 75% of pathogens.

This statement however was disclaimed by Director Dr. R.M.S.K.Rathnayake, National Hospital Kandy . He however said, the clinical waste that accumulates was a too a huge bulk and  sodium hydrochloride could not be used. He further said ” we don’t use chemical substances on this bulk”.

He was quick to point out that clinical waste had been stored at the hospital because the licence of Sisili Hanaro Encare Pvt Ltd’s incinerator station had been temporarily cancelled. But said the company was now operating and the waste was being disposed.

When asked about the harm caused to humans and the environment, he said,” This waste have a major impact on environmental pollution while at the same time humans are at high risk of infection. Because these clinical wastes have blood test specimens of patients with Infectious Diseases such as HIV/AIDS Dengue, Malaria.

Such clinical waste is hard to protect in the rainy season. Patients and people in that environment are at risk of being easily infected by pathogens. Human organs removed during surgery also among the clinical waste. Meanwhile, dogs, bats and crows could be seen hovering in the area and sometimes these animals  pull out human organs and could be seen scattered around the area emanating an unbearable stench.

Collected

Sisili Hanaro Encare Pvt Ltd collected clinical waste from the Kandy National Hospital, Colombo National Hospital,Lady Ridgeway Hospital, Castle Street Hospital for Women and Karapitiya Teaching Hospital. However, last September the Wattala Pradeshiya Sabha cancelled the licence of the Company. 

Meanwhile, the company’s  incinerator in Wattala was temporarily stopped as a result.

When the Chairman of the Wattala Pradeshiya Sabha,  R.A. Thyagaratna Alwis was asked, he said  Sisili Hanaro Encare Pvt Company’s documents were not in order and that was the reason for the cancellation. 

He further said Opposition members of the PS objected to the handing over of clinical waste to Sisili Hanaro Encare Pvt Ltd without prior approval of PS members. Therefore, the licence was cancelled.

Chairman, Udaya Abeysekera claims that  its Muthurajawela incinerator currently burns eight metric tons of clinical waste on a daily basis, where the temperature is kept  between 1000-1200 degrees celsius. 

However, he said, “Although we had all the documents, the Wattala Divisional Secretariat cancelled our temporary licence due to internal disputes between political parties, but the licence has now been renewed.”

Sisili Hanaro Encare commenced collecting clinical waste from health facilities in the Northern, Southern and Central Provinces after a tripartite agreement with the Ministry of Health and Environment in 2014.

However, due to the licence being cancelled, a staggering amout of clinical waste is being stored at various facilities. Here is a breakdown of how much is being stored in these hospitals– the Institute of Infectious Diseases (IDH) 1,57236 kg, Karapitiya Teaching Hospital 52,025 kg, Kalutara General Hospital 13,695 kg, Teaching Hospital Peradeniya 29,808 kg of clinical waste are kept in storage with no proper disposal mechanism in sight!.

[This report was produced under the CIR Investigative Journalism Fellowship Program 2019/2020]

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