The 252-bed district hospital at Kohima generates an average of 206 kg waste in a day out of which 8.11 kg are medical waste

Kohima: With no bio-medical waste treatment facility in the state, Kohima, the capital of Nagaland, under the Kohima Smart Mission, is striving for a waste management plant that will specifically treat toxic medical wastes.

Speaking with EastMojo, administrator of the Kohima Municipal Council (KMC), Kovi Meyase, said that it has taken up the matter to built a bio-medical waste treatment plant with the state government and a Detailed Project Report (DPR) for Kohima district, as per requirements, was submitted to the government in December last year, under the Smart City initiative.

Kohima became the first district in the state to launch the waste management facility on May 1, 2011, and while it has achieved in managing other wastes, there is still no treatment for bio-medical waste that are produced from all healthcare units. Eight health care institutions, including the Naga Hospital Authority Kohima (NHAK)—the only government district hospital– outsources the bio medical waste to the KMC for disposal.

On the delay of the initiation for the treating medical waste, Meyase said “Probably, we woke late to the nuances of waste management, particularly Bio-medical waste, but I think, we woke up at the right time. I see that the progress and concern seen from the government is on the right track.”

He then said that bio-medical waste trucks used to collect medical wastes from the healthcare institutions ensuring it is properly enclosed. Queried about the method of disposing it, he said “Although unscientific, the only available method for us to dispose the bio medical waste is deep burial which is done 15-16kms away from the main town in the dumping site, very far away from human habitation”. While the Bio-Medical Waste (BMW) law requires for certain medical wastes to be disinfected before being treated, in the absence of facilities, such legal procedures are not being followed by many health care institutions.

Expressing the seriousness of diseases caused by the toxic wastes, Meyase suggested that competent experts from the health department must look into the matter. In regard to the proposed treatment Plant, Meyase said that if the municipality is to perform better, proper support and knowledge about managing it must be ensured to rightfully implement it. “Not just the infrastructure, it must also be managed in its most efficient and professional way and that it is self sustaining. Otherwise just brining the project and making it a failed method will create bigger mess because by then a lot of waste will be collected”.

The old building of the Naga Hospital Authority Kohima (NHAK)

Meanwhile, a visit to Naga Hospital Authority Kohima, the only government district hospital in the State’s capital reveals the ill side of bio-medical waste management. Officials of the hospital informed EastMojo that waste segregation is followed from the point of waste generation, however, safety measure of waste collection by its waste handlers, as per the Law, is not followed due to lack of safety equipment.

An official pointed that, guidelines for the transportation of medical waste from the point of generation to the garbage storage point, are not followed adding that the Personal Protective Equipment (PPE) guidelines, prescribed by the Centre, are not implemented due to the high price and the unavailability of supply from the government. The 252-bed hospital generates an average of 206 kg waste in a day out of which 8.11 kg are medical waste.

When asked if the process of disinfecting medical waste are maintained, the official said that only wastes generated from the microbiology laboratory of the district hospital are treated. The official added that treating medical waste such as shredding sharp objects before disposing is also not implemented, although waste handlers are immunized.

Mentioning that ¾ medical wastes lying in the dustbins are to be disposed off within two days, the official highlighted that the Municipal waste collectors fails to collect the waste in time. When cross-checked with the municipality, Meyase said that such complaints were never highlighted to the office. He said such a situation would have happened only due to mechanical breakdown of the Waste truck and further added that a new vehicle is now assigned to collect medical wastes.

Under the Kalyakalp assessment which assesses various criteria of a health care functioning, Naga hospital secured 54% and failed the required mark of 70-75%, the core reason being the poor infrastructure of the hospital. In regard to the bio medical waste management, the official recommended for a competent expert to be in-charge of overseeing the implementation of the BMW law.

The official also pointed that an incinerator was constructed within the hospital premise years ago but was left unused due the in-feasibility of the location. The incinerator was later dismantled due to the construction works of the proposed Cancer Project. It may also be noted that the garbage storage point of the hospital is located just few steps away from the female surgical ward of the hospital.

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