12-10-2012, 01:48 PM
Hospital Waste Management Practice in Nepal
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Introduction
Hospital Waste refers to all waste, biological or non biological, that is discarded and not intended for further use.
According to a report World Health Organization (WHO) - 2004 around 85% of the hospital wastes are actually non hazardous, 10% are infective (hence, hazardous), and the remaining 5% are non-infections but hazardous (chemical), pharmaceutical and radioactive (WHO 2004)
Classification of Medical Waste
Infectious: Material containing pathogens in sufficient concentrations or qualities that, if exposed, can cause disease. This includes waste from surgery and autopsies on patients with infectious disease.
Sharps: Disposable needles syringe saws blades broken glasses nails or any other item that could cause a cut.
Pathological: Tissues organs body parts human flesh, fetuses, blood and body fluids.
Pharmaceuticals: Drugs and chemicals that are returned from wards spilled outdated contaminated or are no longer required.
Radioactive: Solids, liquids and gaseous waste contaminated with radioactive substances used in diagnosis and treatment of disease like toxic goiter.
Others: Waste from offices, kitchens rooms, including beds linen, utensils, paper etc.
Methodology
The term paper is based on secondary information
Different articles and journals along with different textbooks and websites, newspaper were reviewed several times to finalize this term paper.
Articles are access on October 18 to October 25,2011
Result and Discussion
According to annual health report published by Department of Health Services 2000/2001 there are 74 Hospitals, 172 Primary Health Care Units, 710 Health Posts and 3132 Sub-health Post in Nepal.
In total 4088 HCIs produce a large amount of HCW in across the country, and is invariably mixed with other non-infectious waste
The amount of hospital waste generated in Nepal is approximately 1.7kg/person/day,
Average incinarable waste generation rate is 396.77gm/day/bed,
Infectious waste generation rate 0.48kg/person/day
All together, these HCI have the capacity of 3905 hospital bed. These HCIs produce 1300kg of infectious waste per day in the Kathmandu valley.
Hospital Waste Management practice in health Care Institutions
More than 90% of healthcare institutions do not practice safe waste handling, storage and disposal methods and most healthcare institutions rely on municipal services for their ultimate disposal.
In Kathmandu Valley, Tribhuvan University Teaching Hospital and Patan Hospital have incinerators to treat their wastes.
According to the study conducted by Save the Environment Foundation (SEF), hospitals collect all medical wastes including pathological wastes, syringes, bandages and others in a normal bin and dump into the municipal containers. Personnel who handle those wastes do not use even gloves while dumping the material
Since 1996, the problem of biomedical waste has been considered as a cross cutting issue by the Government of Nepal, resulting in formulation of Medical Waste Management and Handling Rules.
There is no proper management system for disposal of biomedical waste in most of HCIs. The segregation of waste at source (wards, O.T, and lab) is far from satisfactory and it was also found that collection of non-infectious and hazardous waste done in open hand–driven trolley.
Some HCIs were using plastic buckets of assorted variety at ward and department level for waste collection, however most of them were in broken condition and replacement was not provided.
Bir Hospital Set an Example
Bir Hospital, country’s oldest hospital, recycles 80% of its total waste.
With the recycled waste, a garden has been constructed and the management makes NRS 30,000 a month by selling fertilizer.
It is now a mercury free zone.
The hospital produces more than 320 kg of infectious waste daily.
In Medical waste management by managing highly infected waste piled up inside hospital premises, the Bir administration in cooperation with Health Care Foundation-Nepal (HECAF) had launched the medical waste management programme on July 20, 2010.
The start of waste management is spreading a positive message and helping maintain cleanliness and hygiene of the hospital at the same time, say officials of the hospital.
In all 26 indoor wards, where patients are shifted for advance medical treatment and observation, have separate buckets for the segregation of waste.
This helps to reduce menace of cockroaches and rats.
Conclusion
Hospital waste management practice in Nepal wasn’t found satisfactory beside there are good hospital waste management practice.
Bir Hospital set an good example of hospital waste management practice.
The segregation, collection, transportation and disposal practice of the hospital waste practice was found unsatisfactory