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Bir Hospital Sets Example in Medical Waste Management

July 18, 2011, Kathmandu Post
By Nirjana Sharma
Excerpt from the article:

If you are wondering where have gone the heaps of garbage, a usual sight on Bir Hospital premises earlier, don’t rack your brains. The country’s oldest hospital has properly managed their disposal.

The start of waste management is spreading a positive message and helping maintain cleanliness and hygiene of the hospital at the same time.

In a bid to set an example 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.

According Sarita Shrestha, housekeeping in-charge of hospital, all 26 indoor wards, where patients are shifted for advance medical treatment and observation, have separate buckets for the segregation of waste. “We have been noticing fast recovery of the ailing patients after the new practice. Menace of cockroaches and rats has also declined,” she said.

Three separate bins are placed to segregate biodegradable, degradable and nondegradable waste. Additional buckets have been put up in the special wards such as ICU and chemotherapy. A needle disposing machine has been placed in the wards to destroy syringe right after the use.

“At first, developing the habit of disposing waste in separate buckets took time. But now the nurses, visitors and patients, too, are careful,” said Kishori Bhandari, in-charge of Bir’s male surgical cabin. She said that to see the government hospital following norms was laudable.

Another staff Tulsi Malla, in-charge of medical surgical ward, said the patients, who used to suffocate in wards in the past, are happy to see the hospital tidy.

Waste collected from the wards is transported to the Waste Treatment and Storage Area in every 24 hours and segregated by separating the non-risk waste and disposed accordingly. The hospital has two machines to dispose the waste—one equipped to destroy 15 kg of waste in 30 minutes at 121 degrees Celsius, according to officials. “We have started selling the normalised waste which can be recycled in India,” said housekeeper Shrestha. “Now, we are sending treated gall cotton only to municipal dumping sites.”

For the management of indoor wastes, the hospital is paying Rs 24,000 to the private sector that takes away the hospital waste to the nearest municipal container. Earlier, the hospital was paying Rs 36,000 for the same.

A study shows that 332 kg waste is generated by Bir Hospital everyday when there is 65 percent occupancy, while the waste volume reached over 500 kg during the full occupancy. Of the total waste, 75 percent is highly infectious.

Apart from this, the hospital is also a mercury free zone now. As per the report issued in the fiscal year 2009/10, the mercury level in the hospital was in the air.

“Some 1200 thermometer was used and destroyed in the year which was mixed in the air. One gram mercury can contaminate a pond occupying 20 acres land. Now we can imagine how hazardous it is if spread carelessly,” said Mahesh Nakarmi, programme director of HECAF-Nepal.

The mercury-based thermometer and blood-pressure measurement sets have been displaced by digital technology nowadays.

Nat’l Kidney Centre first

The National Kidney Centre is the first health centre in the country to introduce proper disposal of medical wastes in 2000. After the successful practice in the kidney centre, a similar process is being applied by Bir Hospital. When it comes to management of medical wastes, even the sophisticated hospitals dump rubbish products directly without any treatment. “Dissected organs, tumours, foetus and a large quantity of infected syringes are found on the roadside when the garbage collection remains halted in the capital,” said Nakarmi.

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