Piling up medical waste discarded thoughtlessly at landfills in city corporation areas pose serious threat to public health. Divisional cities, excluding the capital, have around 1,380 healthcare establishments -- public and private -- that produce over 20 tonnes of medical waste every day. To draw attention to this alarming issue, The Daily Star is highlighting medical waste management in major cities across the country. In this instalment, we look at medical waste management in Mymensingh city.

Majority of healthcare facilities in Mymensingh city are not following proper medical waste disposal system, due to authorities’ failure to check the malpractice and lack of necessary government arrangement to dispose of those.

The city has a total of 221 healthcare facilities -- 131 hospitals and clinics and 90 diagnostic centres, according to the civil surgeon’s office.

According to Medical Waste (Management and Processing) Rules 2008, all healthcare centres must have mechanisms to incinerate or sterilise medical waste.

But no hospital, clinic or diagnostic centre in the city has any such arrangement. Medical waste -- in many cases mixed with general ones -- are dumped in public dustbins and open spaces -- particularly at Moilakanda in Char Kalibari.

farmer Abdul Malek stands next to his cropland which has been ruined due to unabated garbage dumping. Photo: Md Aminul Islam

Amid the situation, Nobo Waste Management Service Ltd in collaboration with Mymensingh City Corporation (MCC) set up a medical waste disposal unit at Akua in September last year.

Abul Hasnat Epu, managing director of Nobo Waste, said necessary infrastructures -- incinerators, two pits and a recycling unit -- has been set up on 18 decimal of land given by the city corporation. The project cost is Tk 40 lakh, which they spent from their own fund.

But even after setting up the system to dispose of waste properly, only 18.63 percent of the healthcare facilities avail the service through them in exchange for monthly fees, he added.

“We charge hospitals and clinics Tk 2,000-3,000 per month. Till now, only 41 hospitals are taking the service.”

Mymensingh Medical College Hospital (MMCH), the lone government and major hospital in the city, does not incinerate or sterilise its waste.

MMCH Deputy Director Dr Laxmi Narayan Majumder said they are unable to install the equipment. “We have a shed where we dump all sorts of waste. Later, garbage trucks of the city corporation carry those to Moilakanda in the evening.”

Amputated body parts and other materials produced from the operation theatre are buried near the dumping spot, he said.

As MCC carries all sorts of garbage in their trucks, it is not productive to keep those in separate containers, said Dr Narayan.

“In a recent meeting, officials of public health engineering department and MCC assured us of establishing a modern waste disposal plant on the hospital premises,” the doctor added.

When asked about taking service from Nobo Waste, he said, “We pay tax to the city corporation. So, the responsibility is theirs.”

During a recent visit, this correspondent saw general and medical waste (used syringes, needles, broken glass tubes and bandages) dumped together on the hospital premises.

Dr HA Golandaj Tara, secretary of Bangladesh Private Clinic and Diagnostic Centre Owners Association, said many private hospitals do not want to pay additional fee to another company as they are already paying the city corporation a monthly fee to remove all sorts of waste.

He, however, said, “We are encouraging clinic owners to dispose of medical waste through the private company. We held a meeting with the city corporation officials and Nobo Waste to settle the matter.” He hoped the crisis would be resolved by this month.

When asked why they do not have their own arrangement, he said no healthcare facility in the city could afford such disposal plant.

Mehdi Hasan, executive officer of Nexus Hospital, said a discussion is ongoing with Nobo Waste to dispose of waste.

Prof Dr Motiur Rahman Bhuiyan, one of the owners of Liberty Hospital, echoed the same.

When asked what actions are being taken against errant healthcare facilities, Mymensingh Civil Surgeon Dr ABM Moshiul Alam said they repeatedly issue notices to them, but to no avail.

The activity of Department of Environment also seemed to be limited to issuing notices as well, which became evident while speaking to Farid Ahmed, director of Department of Environment in Mymensingh division.

City Mayor Ekramul Haque Titu said it is becoming a huge challenge to manage three tonnes of medical waste produced from hospitals and clinics daily. Every healthcare centre is individually responsible for properly disposing of its medical waste, he said.

“The MCC has no expertise on how to manage toxic medical waste,” said the mayor.

Admitting that they are managing such waste in a “traditional system”, the mayor also said it is urgent to go for modern treatment plant.

This correspondent also visited several private hospitals at Charpara where he found unsorted medical waste dumped in one or two bins inside the hospitals.

A worker dumps all sorts of garbage on MMCH premises. Photo: Md Aminul Islam

Golam Maula, managing director of Vision Clinic and Diagnostic Centre, said they keep medical waste in two drums and their sweepers store those near MMCH for city corporation trucks to collect.

Mujibur Rahman, manager director of Islam Hospital, said they put medical waste in three drums and their cleaners collect those daily. He, however, could not say where the waste go.

Expressing concern over the issues, Shibbir Ahmed Liton, a local green activist, said until the healthcare facilities can afford waste treatment plant, they must go through the garbage management company’s process. “They should be able to afford Tk 2,000-3,000 per month.”

COMPANY’S CONCERNS

Nobo Waste Managing Director Abul Hasnat Epu said, “So far, only 41 private hospitals and clinics are taking this service from us. Even though this initiative is a must to save the environment, we are also running a business. We have to think about profit as well.”

“We already incurred a loss of Tk 10 lakh. If such a situation persists, we will have to think about something else,” said Epu.

The company official said they have already assured the hospital and clinic owners of collecting all sorts of waste and urged them to discuss the issue of “reasonable” service charge with them.

SITUATION AT MOILAKANDA

Garbage from almost all healthcare centres -- including MMCH -- are being piled up on the dumping ground, creating health and environmental hazards. The area is home to hundreds of people.

Locals said waste is also spilling out of the unenclosed area, affecting the adjacent cropland.

Noor Mohammad, a farmer from Char Kalibari, said, “I am facing a serious setback in production due to land infertility.”

“The saplings of my boro seed bed on 10-decimal land became unusable this year,” said the 70-year-old.

Similarly, Shafiqul Islam said he has been incurring loss in mustard cultivation for last two years. Another mustard farmer Abdul Malek echoed the same.

Besides, putrid stench is turning the area uninhabitable. Mukta Akter and Suborna Akter, two sixth-graders at a local school, said often times they lose appetite amid malodour.

Dr Ranjan Kumar Majumder, a retired medicine specialist fromMMCH, said people living in the area are at risk of being affected with diseases like asthma, diarrhoea, allergies and eye irritation.

During monsoon, rainwater mixed with waste float towards the Old Brahmaputra river that is in close proximity to the dumping ground, said Shibbir Ahmed Liton, secretary of Mymensingh Poribesh Rokhha o Unnayan Andolon.

This malpractice has to be stopped to protect the waterbody from pollution, he said. “The authorities must take initiative to dispose of medical waste properly. They also need to take strict measures against healthcare facilities for not following the rules,” Liton stressed.