01 July 2004	Thursday	12 Jamadi-ul-Awwal 1425

KARACHI, June 30: Speakers at a seminar on Wednesday stressed the need for promoting safe health care waste management practices in the province, particularly in Karachi.

They observed that a major quantity of hazardous waste generated at hundreds of health care units across the city were either handled along with municipal solid waste or recycled and reused for financial benefits, which were hazardous to society.

The seminar on "Hospital Waste Management" was organized by the Sindh Environmental Protection Agency (SEPA) in collaboration with UNDP's NEAP-SP. The two sessions of the seminar were presided over by secretary, Sindh Environment Department Shujaat A Qarni and DCO Karachi Mir Hussain Ali respectively.

In his introductory speech, Director General, SEPA Muhammad Younus Dagha said the seminar was aimed at agitating for the issue of hospital waste, raising awareness in the quarters concerned, and motivating them to play their respective roles with dedication.

He underlined the role of hospital managements and doctors in safe disposal of hospital waste, and urged them to ensure promotion of sound Hospital Waste Management (HWM) practices, which would help in improving the health of citizens.

He informed that SEPA had already issued an environmental protection order and guidelines for safe disposal of hospital waste. Irfan Saeed Alrai of the federal ministry of environment, said most of the liquid hospital waste was directly being disposed of into the municipal sewerage system, which could prove as sources of epidemics.

He said that under the Pakistan Environmental Protection Act 1997, hospital waste fell within the category of hazardous waste, and as such institutions spreading the waste or not attending to safe disposal practices were liable to legal action.

He said all individuals exposed to hospital waste were potentially at health risk. Therefore, among other protective measures, minimum generation, proper recovery of materials and segregation of toxic hospital waste could be ensured at the source.

Dr Arshad Altaf of the Aga Khan University said doctors and nurses were at the highest risk of getting pricked by sharp objects by accident, including needles, contaminated by patient's blood, while working in a health care setting.

He also gave details of an observational study of infection control practices of 44 clinical laboratories in the city, including 18 in the public sector, and maintained that about 59 per cent of them had waste sites, while about 16 per cent were using an incinerator facility.

According to his survey conducted in 2001, 88pc of sweepers and 96 per cent of scavengers interviewed were selling used syringes to various dealers, who further sold them to plasticware industries and crushers. He said that health care workers and others in the recycling business were at risk of acquiring bloodborne pathogens.

Khalid Javed of CDGK's solid waste management department said the city government had two plants, each with a capacity of incinerating 1000 kg per hour; while they collected, transported and incinerated hazardous hospital waste of only 127 hospitals, and as such were operating at under 15 per cent of their capacity.

While complaining about the poor response from hospitals and clinics, which are believed to number around 3,000, Mr Khalid said that SEPA and CDGK had got the authority, under various rules, to take action against any person or institution contaminating municipal waste with any hazardous waste.

However, he viewed that health care units could develop their own hospital waste disposal system, which should be approved by the authority concerned. Shahid Lutfi of SEPA informed the participants about the laws that dealt with mismanagement of hospital waste.

He said that SEPA was heading towards implementation of Section 14 of the PEPA 1997, by involving all stake holders, including the city government, doctors, and hospital management.

An official of the city government's health department, Dr Muhammad Suleman Otho, stressed the need for sustainable and collaborative approaches towards development of a safe handling of health care waste.

The president of Pakistan Medical Association, Dr Haseeb Alam, viewed that CDGK should provide incineration services to health care units, which were already overburdened by various taxes and charges collected by different government agencies.

Director of SEPA Iqbal Nafees Khan, said that actions involved in implementing effective hospital waste management programmes required a multi-sector co-operation and interaction at all levels of the government and society.

He said that SEPA would be holding similar seminars at other places in the province to ensure community participation in streamlining the hospital waste management system and other environment related issues.

DCO Karachi, Mir Hussain Ali, said there was a need to change attitudes of people and institutions towards issues. He observed that government machinery had not been able to address the environment related issues properly, but it was high time that various sections of society, including doctors, joined hands with the government to ensure a true enforcement of related laws.

In his concluding remarks, the secretary environment, said the government was making efforts to address the HWM issue, but individuals, including doctors, were required to come forward with a missionary zeal to achieve a healthy and safe environment for people.