How liquid waste causes health risk

A 250-bed hospital in Dhanmondi produces about 4,000 litres of liquid waste a day. The liquid is treated to ensure that it doesn’t spread infection when disposed of.

This, however, is a rare scenario among government and private healthcare facilities in the capital.

It is rare because no government healthcare facility has any mechanism in place to treat liquid waste, while only five to six percent of private hospitals are taking care of the waste through a formal set-up, according to the Department of Environment.

The Bangladesh Environment Conservation Act, 2010 imposes restriction on dumping of waste that may have a harmful impact on the environment. Under this law, the DoE issues clearance to hospitals only after they install an effluent treatment plant (ETP).

The DoE served a letter to Labaid Cardiac Hospitals and Labaid Specialised Hospital three years ago. And that was when the Labaid authorities began thinking about how to ensure safe disposal of liquid waste, said Farid Hossain who oversees the operations of ETP at the facilities.

It took almost a year to draw up lines to carry liquid waste from different units to the ETP, he said.

Like Labaid, some other upscale healthcare facilities, including Apollo Hospitals Dhaka, Square Hospitals Ltd, Ibn Sina Hospital have set up ETP to treat liquid waste and the total number is not even close to 50 of more than 1,000 healthcare facilities in Dhaka, said Sohrab Ali, of Dhaka metropolitan office of the DoE.

While the DoE is trying to compel private entities to address the concern over liquid waste management, the scenario at public hospitals is bleak and there is no sign of getting things right in the near or distant future.

Last year, the DoE issued a letter for the second time to Dhaka Medical College Hospital, which treats nearly 3,500 in-patients on a daily basis, bringing its attention to the matter of liquid waste disposal. The letter went unheeded, Sohrab said.

The previous letter was served three years earlier. The hospital followed it up by communicating the matter to the health ministry, but met a dead end there.

While recent developments regarding discharge of liquid waste from hospitals fail to evoke any sense of optimism, findings of a 2017 research present a horrifying picture of how it can become a source of public health hazard.

Scientists from Iccddr,b, Erasmus University Medical Center of the Netherlands and Stanford University of the USA had tested about a hundred wastewater samples from areas adjacent to hospitals and communities and found that 96 percent of those contained bacteria resistant to the most powerful class of antibiotics.

“In view of existing practice of discharging untreated liquid wastes into the environment,” the study report says, hospitals in Dhaka city contribute to the spread of such bacteria.

The Medical Waste Rules 2008 require diluting liquid waste with water and then releasing it into the sewer system. Liquid waste can also be treated with 1 percent sodium hypochlorite before it is discharged into the sewer, according to the rules.

Administration of many public and private hospitals seem to lack awareness about the issue or are downright negligent.

When asked where the liquid waste goes, Sazzad Hossain, ward master of Sir Salimullah Medical College Mitford Hospital, located on the bank of the Buriganga river, on October 16, said it was dumped along with the infectious waste that PRISM Bangladesh Foundation carries every day to its Matuail treatment plant.

Prism is an NGO tasked with collecting and disposing of medical waste.

But Prism says it collects only solid waste from hospitals across the capital for safe disposal in Matuail.

About the necessity of an ETP, Mazibur Rahman, superintendent at Ibrahim Cardiac Hospital and Research Institute, said, “The hospital doesn’t have one since it doesn’t need one. Liquid waste is harmless.... Besides the amount of such waste [generated in that hospital] is negligible.”