Oblivious of the health hazard the hospital waste poses, the twelve-year-old Sameer Khan collects empty infusion bags and syringes, from the Holy Family Hospital’s (HFH) refuse, to sell them in the market.

He has been involved in this business since the last few years, along with his brother. This is the only source of livelihood for his five-member family.

He was not ready to buy the argument that the waste could land him in serious trouble.

He, however, said that he had no option but to do this job. He said that he had been in this business since long, but it did not harm him. “We are immune to such health hazards,” he added.

“My father died, and my mother is too ill to earn livelihood for us,” he said, adding that he had an option to collect waste papers, but that would not fetch good price.

“The plastic infusion bags of the medicines sell at Rs40 per kilogram and the waste papers at Rs10 per kg. By selling empty infusion bags, I manage to get Rs150 daily,” he said.

According to him, he works from dawn till dusk, seven days a week.

Fourteen-year-old Mohammad Zubair said that his father was suffering from hepatitis and the doctors advised him to rest in bed. “My father was a labourer but due to his illness, he is unable to do more work,” he said.

He said that his two brothers are also doing the same job. “We collect infusion bags, and the thermocol waste outside the food outlets in commercial markets. We earn money to feed our family in Waziristan,” he said.

He was also not aware of the health problems accompanied by the hospital waste, although his elder brother, involved in the same business, has become ill.

These children are among many, in the garrison city, who collect the waste material from hospitals and endanger their lives. However, the city administrators and the Punjab government have turned a blind eye to this grave issue.

Government hospitals, private hospitals and clinics have all failed to dump their waste properly, exposing the scavengers to serious health issues.

“I received three hepatitis-C cases in the past two months. My housemaid brought two of her relatives from Rawalpindi locality of Leh Nullah to Pims. Their case history shows that they used to collect material from the clinical waste,” said Mohammad Haroon, a doctor at Pakistan Institute of Medical Sciences (Pims), while talking to Dawn.

“Collection of recyclable items from hospital waste is a very dangerous exercise for the scavengers. When they come into direct contact with an infected bandage it definitely spreads the disease.

“Mostly scavengers sift through the garbage with bare hands and the infectious bandages and syringes transmit germs to them,” he said.

According to Punjab Environmental Protection Act 1997 (amended 2012), the hospital waste should not be mixed with solid waste and it should be disposed off properly.

The Punjab Hospital Waste Management Rule 2005 also made it clear that all the infectious material, generated in the hospitals, should either be sent to an incinerator for auto flaming or dumped in landfill sites.

Under the law, district health department is responsible to monitor the dumping of clinical waste in its designated areas. However, in the garrison city, the law is not being enforced.

The garrison city has an incinerator at the Holy Family Hospital (HFH) to accommodate the waste of the public and private sector clinics and hospitals, but it is not utilized to its capacity.

The HFH provides the incinerator service to the government hospitals free of cost, but charges Rs20 per kg of waste from private hospitals and clinics. In case they also use the transport of the incineration centre, the fee is increased to Rs25 per kg.

During the visit to the HFH, Benazir Bhutto Hospital (BBH) and the district headquarter (DHQ) hospital, this reporter found that heaps of garbage and clinical waste were either dumped near the outpatients department or adjacent to the main gate.

Due to improper dumping of clinical waste, the business of recycling of plastic items is booming. “We face the foul smell, emitting from these plants. It is illegal and the administration has not taken any steps to stop them,” said Muhammad Shabbir, a resident of Dhobi Ghaat area, between Asghar Mall and Satellite Town, where the waste is recycled.

Suhail Ahmed, a resident of Dhoke Dalal, said that a small industrial unit has been set up in the area to make plastic footwear.

“A large number of scavengers can be seen here, in the evening, trying to sell the empty infusion bags to the footwear makers,” he said.

When contacted, Dr Tariq Niazi, additional medical superintendent of HFH, said that the hospital’s incinerator was being utilized to its full capacity. “There is no open dumping of clinical waste in the hospital,” he claimed.

BHH Medical Superintendent Dr Asif Qadir Mir also claimed that the hospital sent all of the infectious material to HFH for incineration.

“We generate very less amount of infectious clinical waste, while the other waste is handed over to Rawalpindi Solid Waste Management Company,” he said.

However, the official in Rawalpindi Medical College (RMC) said that the hospital waste was not properly managed in three government run hospitals and the district health department did not have any record of the private clinics and hospitals to check them.

When contacted, District Officer for Environment Mian Mohammad Nawaz said that the Punjab Environment Protection Agency (Punjab-EPA) had issued notices to more than 30 private clinics and government hospitals for not disposing off the clinical waste properly.

He admitted that the disposal of clinical waste along with solid waste poses serious threat to public health. Due to improper disposal, the recycling business of syringes and other material has also flourished, he said.

“It is the responsibility of the health department to implement the law in all public and private clinics and hospitals but it is not doing its job,” he said.

He asked the Rawal Town Municipal Administration (RTMA) to take notice of these illegal small industrial units in the residential areas.