A Deeper Look into the Inner Factors Associated to Healthcare Waste Management in Chittagong – The Commercial Capital of Bangladesh

Proceedings Sardinia 2013, Fourteenth International Waste Management and Landfill Symposium, S. Margherita di Pula, Cagliari, Italy; 30 September – 4 October 2013

17 Pages Posted: 15 Mar 2016

See all articles by Mosharraf Hossain

Mosharraf Hossain

University of Chittagong

Ohidul Alam

East China University of Science and Technology

Date Written: March 11, 2016

Abstract

Urbanization is rising with increasing population and migration which makes municipal solid waste management (MSWM) a daunting task for urban authorities. MSWM is a very severe problem for municipalities in third world countries like Bangladesh where lack in popular awareness along with inadequate budget and technological inputs make MSW a public health issue and an environmental concern. Among different categories of MSW, wastes generated from healthcare facilities, popularly known as healthcare wastes (HCW) contributes about 1% by weight of MSW. But HCWs are of special characteristics requiring special attention in their management i.e., collection, storage, transportation, treatment and disposal. If not properly managed HCWs may convert the whole mass of MSW into hazardous waste. Chittagong is the second largest city and the commercial capital of Bangladesh – the abode for more than 6 million people with sprawling unplanned healthcare entities (HCEs) of different categories and standards which are generating diverse classes of HCW in ever increasing quantities. Only recently, the city authority – the Chittagong city corporation (CCC) which has solely been managing all the HCW in the city – has partnered with a private HCWM entity to enhance the efficiency of HCWM. However, in absence of an integrated HCWM plan based on objective data these management initiatives are addressing the HCW issue in a fragmented and inefficient manner. However, there is not much data to establish a baseline for further study on HCW. In order to assist the policy makers with focused baseline data on different aspects of HCWM we have conducted this detailed investigation into different aspects of current HCW management process in CCC area from June to December, 2012 by using semi structured questionnaire surveys from different stakeholders along with actual quantification of different sub-categories of HCW collected from different HCEs. We have found a rapid rise in the number of HCEs between 1991-2000 which intensified almost two folds between 2001 and 2010. However, most of these new HCEs are smaller ones and the old public sector big hospitals are still the major HCW generator in the city. The positive thing is that majority of HCEs established between 1991 and 2010 have environmental clearance certificates compared to older HCEs. However, when we look at the adoption of waste segregation at source by using color coding system, we observed that older HCEs established prior to 1980 follow color coding system while in newer entities color coding was not adopted properly. Also, color coding system was seen to be followed only by general hospitals among all categories of HCEs studied. While big general hospitals dispose most of their HCWs to CCC managed dustbins, eye hospitals and diagnostic centers preferred throwing most their HCWs to private drums and the other HCEs adopt the unhygienic practice of throwing HCWs to open places. The generated HCW quantity is increasing with increasing number of HCEs without any changes in HCWM. Similar scenario has also been reported for other big cities of Bangladesh and we hope our findings will assist the CCC and other city authorities in upgrading their SWM system by putting special emphasis on HCW. In CCC area, the contributors of HCW are the general purpose hospitals, dental clinics, diabetic hospitals, general purpose clinics, maternities and eye hospitals, respectively with mean HCW quantities of 440, 115, 90, 75.75, 56.86 and 53.75 kg/day. Since hospitals are larger in size and handles more patients, we compared the entities to see the waste generation per day per patient to get a better HCE generation picture and we found that maternities are generating significantly higher quantity of HCW than other HCEs per patient handled (6.63 kg/day) followed by almost similar contributors – eye hospital (4.48 kg/day) and general clinics (4.47 kg/day). Large general purpose hospitals were better in controlling the waste per patient to as low as 2.12 kg/patient/day. If we consider polluters pay principle in case of HCWM system at CCC, we can propose charging differential rates for HCWM to different categories of HCEs based on the aforementioned findings. In HCWM training of stakeholders i.e., the physicians, the nurses and the workers are important. Most of the HCEs provided training to physicians and workers, however, in case of nurses – who generate most of the wastes, maternities, clinics and diagnostic centers provided training in 60-70% cases which is worrisome. We are in the process of investigating the issues further and we are hopeful that these findings will contribute towards a better HCWM system at CCC.

Keywords: CCC, MSW, HCE, HCW, Management, Factors

Suggested Citation

Hossain, Mohammad and Alam, Ohidul, A Deeper Look into the Inner Factors Associated to Healthcare Waste Management in Chittagong – The Commercial Capital of Bangladesh (March 11, 2016). Proceedings Sardinia 2013, Fourteenth International Waste Management and Landfill Symposium, S. Margherita di Pula, Cagliari, Italy; 30 September – 4 October 2013, Available at SSRN: https://ssrn.com/abstract=2746598

Mohammad Hossain

University of Chittagong ( email )

Chittagong, 4331
Bangladesh
+8801729094397 (Phone)
+880-31-726310 (Fax)

Ohidul Alam (Contact Author)

East China University of Science and Technology ( email )

Shanghai
China

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