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Waste Management in Health Care Sector

Waste Management in Health Care Sector

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Published by Dr.Mazhar-Ul-Khaliq

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Published by: Dr.Mazhar-Ul-Khaliq on Mar 01, 2012
Copyright:Attribution Non-commercial

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11/07/2013

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 Page 1 of 2241
 
 Page 2 of 2242
FOREWORD
 Way back in 2004, in the capacity of District Surgeon, I, suggested then MedicalSuperintendent, DHQ Hospital Jhang that the hospital should buy an incinerator for wastedisposal. To my surprise Late Dr. Ajmal Ahmdani came up with a big no. He said “Never think of buying an incinerator, it is more a harm than help. You should go forAutoclave”. A totally unexpected answer I was never ready to accept. “Look at theperson. He seems totally ignorant”. But I did not have enough knowledge to prove mypoint. I decided to study the literature to find arguments for proving my point. I searchedbooks, internet and all available resources. I lost and Dr. Ahmdani won the debate. Now Ihad already developed interest in the subject. Literature consistently advocated Autoclavefor the predisposal management of Hospital waste. Then I visited World Wild Life Fundoffice in Lahore, where, I was told about presentation of a doctor named Sudheer Josephfrom St. Stephens Hospital, Delhi. I contacted the doctor; planned the trip and visited thehospital in Nov. 2006. In New Delhi I had the opportunity to visit the central wastedisposal facility managed by the private company Synergy. The facility was catering for1500 hospitals and was located outside Delhi 3Km away from all the residential areas. Alocal NGO with the name of Toxic Links helped me a lot. After that visit I read theliterature again and things became clear in my mind. I realized that very few people inPakistan have the idea about waste management. On my return I sought appointment withDr. Shagufta ShahJahan, now Director General Environment and discussed the idea of NO BURNING WASTE with her. She listened to me patiently and finally agreed withmy point. With her help my name was included in WHO collaborated project being rununder Dr. Shakeela Zaman, then Director Health Services Academy Islamabad. In Oneand half year after surveys and workshops a national plan was prepared for wastemanagement in Pakistan. Meanwhile National Programme for Hepititis Control sent ateam to Jhang. This comprised Dr. Rustam and Dr. Mumtaz. I discussed the syringedisposal programme (Indian model) with them and they liked it very much.Now the Healthcare waste management became my passion and I founded a societycalled “Waste Watch &Works” in Jhang. 15 clinics participated in our syringe disposalprogramme.When you started discussion some hear, out of them few listen and very few act. It isamazing that Dr. Mazhar ul Khaliq caught the point and started studying about thesubject. He went forward and decided to write a book. Not an easy decision but finallythe product has come in our hands.At this point of time when Pakistan is seriously considering Healthcare WasteManagement, the problem needs an exhaustive theoretical workup before launching acomprehensive plan for the country. In order to understand the depth of subject weshould try to take a multidimensional view of current state of affairs in the World withparticular reference to its application in Pakistan.1.
 
Paradigm Shift: In the last decade there has been global concern aboutincineration hazards due to toxic emissions like DIOXIN & FURANS
 
and highCapitol and recurring costs for minimizing the pollution problems in this systemof Healthcare Waste Management. Therefore developed countries startedadopting alternative methods e.g. Autoclaving, Microwaving and ChemicalDisinfection.
 
 Page 3 of 2243
2.
 
Difference in Circumstances: Third World Countries have limited Resources andother operational constraints along with peculiar circumstances making itimpossible to replicate the exact models of HCWM of developed nations.3.
 
Questionable Compliance: New patterns of HCWM e.g. reduction andsegregation of hazardous waste necessitate change in the attitude of the people,which is a big undertaking in a society of relatively low literacy rate withlongstanding ignorant practices.Thus,In PAKISTAN we need to:-1.
 
Benefit from the research and experiences of developed countries withcustomization of methods to fit in our environment.2.
 
Study HCWM practices in developing countries. In this respect the closestcountry with similar environment is India.In INDIA:-
 
The country is updating the system of HCWM.
 
They have started alternative techniques like CHEMICAL DISINFECTIONand AUTOCLAVING.
 
PVC and other plastics are not incinerated and only body parts are incinerated.
 
Central Facilities have been developed in many cities. These cater for manyhospitals and are located outside the cities. These have INCINERATOR,AUTOCLAVES, SHREDDERS and EFFLUENT TREATMENT PLANTS.
 
SEGREGATION with color coding is being adhered to. They are using fourcolors for incinerator, autoclave, recyclable and common waste respectivelywith separate system for sharps. *Pictures of St. Stephens Hospital Delhi.
 
They are considering MERCURY free environment.
 
The hospitals are establishing EFFLUENT TREATMENT PLANTS.This Book is going to fill the gap of reference material locally written on the subject andwill be useful to individuals (doctors & Allied personnel) as well as institutions.

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