The dismal state of medical waste management in the country is no secret, but it has become a serious public health concern of late. According to a new study of the Transparency International Bangladesh (TIB), conducted over a period of 18 months, around 60 percent of hospitals do not have bins to store medical waste, let alone segregate them, while 83 percent of the hospitals have no waste treatment system in place. The study has also found irregularities and corruption in every step of waste management, including collection, storage, transportation, and treatment. One of the scariest revelations is that a group of unscrupulous contractors, with the help of a section of medical staffers, are selling unrefined and harmful medical waste as "fresh" medical equipment.

Such neglect and exploitation of dangerous clinical waste is really unfortunate, especially in a country that is one of largest generators of such waste in the region. This is despite having disposal guidelines in the form of Medical Waste Management and Processing Rules 2008, which, it goes without saying, remains mostly unenforced. According to these rules, there should be seven divisional authorities in seven divisions of the country as well as a separate dumping zone in each division. Medical waste should be kept separate from other kinds of waste at all stages of their management: collection, wrapping, storing and transportation. Sadly, over a decade has passed since these rules were formulated, but proper enforcement still remains elusive.

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Hospital infections must be kept in check

Reportedly, a majority of the hospitals still dispose of their waste along with non-medical waste without even sterilising them. Even though third-party organisations are employed by some of the hospitals and clinics to dispose of their waste in the right way, their capacity is still very low compared to the amount of waste generated.

Moreover, the rules do not clarify the responsibilities and accountability of city corporations and municipalities concerning the management of such waste. Therefore, they have no developed action plan in this regard. The absence of a coordinated system has led to growing concerns over the build-up of medical waste at the landfills. And since these landfills are situated near rivers and other water bodies, the hazardous waste is polluting our vital sources of water as well as contaminating the soil, which is a serious cause for concern.

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A hospital without hygiene is the opposite of healthcare

The question is, how long will this issue be neglected? The TIB has made a number of recommendations involving coordination, monitoring, and supervision of institutions related to waste management. These deserve to be considered seriously. In addition, we need to make necessary amendments to the relevant laws to make them more effective and to close all possible loopholes. The need for coordination among all stakeholders – including the Department of Environment, Directorate General of Health Services, hospitals, city corporations and municipalities – cannot be stressed enough. We will be able to address the issue only if all stakeholders and responsible authorities work together in light of existing rules, and if violations of such rules are properly addressed.