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MANAGEMENT IN
BANGLADESH:
A SUSTAINABLE GUIDELINE
Mohammad Ali and Dr.Md.
Jahir Bin Alam
Undergraduate Student,
Assistant Professor
Department of Civil & Environmental
Engineering
Shah Jalal University of Science & Technology, Sylhet,
INTRODUCTION
What is Health Care Waste or Clinical Waste?
Health-care waste is defined as the total waste stream (solid and liquid) from health-
care establishments, research facilities and laboratories.
According to World Health Organization (WHO) approximately
85% non-hazardous
10% are infectious
around 5% are non-infectious but hazardous
✞In most government hospitals, private laboratories, and clinics waste was
disposed in municipal bins without proper regard to the harmful effects they
may pose to human health and environment.
✞City Corporation and Municipalities do not have a separate system for medical
waste or infectious waste collection.
✞Varieties methods were used by the medical facilities for medical waste
disposal. Which include
↔incineration ↔open burning ↔burial selling
↔dumping ↔reuse ↔removal by municipal trucks
↔Syringes, vials, empty packets, bottles and saline bags, used X-ray film-
developing chemicals were some of the items collected un-safely and re-
sold.
✞There are few initiatives taken by NGOs for medical waste collection, disposal
and training of hospital staff in a pilot scale.
✞The Ministry of Health and Family Welfare and DOE is working separately on
this issue.
LAWS, POLICY AND TECHNICAL GUIDELINES IN HEALTH
CARE SECTOR IN DEVELOPED COUNTRIES
National law should consist of Clear definitions, Defined
responsibilities, Duty of Care of waste producer, Tracking systems
and record keeping, Defined penalties, Regulatory and enforcement
systems.
For Clear definition some laws should be stablish. The laws are
Framework Law on Environmental Protection, including
environmental permitting, Law on Air, Law on Water Protection, Law
on Nature Protection, Law on Waste Management.
The policy document should be contained
(i) Description of health and safety risks
(ii) Reasons for safe and sustainable health-care waste management
(iii) Description of approved methods of waste minimization, handling
and disposal
(iv) Record keeping and documentation
(v) Training
(vi) Health and safety protection rules etc.
HEALTH CARE WASTE LAW IN BANGLADESH
According to the Bangladesh Environment Protection Act 1995, there is
no law for HCWM and specific legislation pertaining directly to the
handling, transportation or disposal of medical waste.
HEALTH-CARE WASTE MANAGEMENT
PLANNING
The need for planning
International recommendations for waste management
• Prevent and minimize waste production.
• Reuse or recycle the waste to the extent possible.
• Treat waste by safe and environmentally sound methods.
• Dispose of the final residues by landfill in confined and carefully
designed sites.
Train personnel & Ensure safe Ensure worker’s Improve stock management of
waste workers storage safety chemicals & pharmaceuticals
Treatment
Incineration, on-s ite or off-s ite-open-air burning, Chem ical dis infection, Autoclaving of highly infectious
was te, Encapsulation Dis infection of stools from cholera patients & of oth er infectious Bodily fluids
Final Disposal
Municipal landfill, Burying or Premises
Discharge into sewer
GUIDANCE FOR MUNICIPAL HEALTH CARE
WASTE MANAGEMENT
> Use of disinfectants before disposal of infectious waste to the bin is a good
practice.
> Once a waste management plan is made and is implemented in a hospitals, it
should be a sustainable one.
> A program for improving education, training and raising awareness about the
adverse effect of improper disposal of medical waste for all stakeholders.
> Initiation of programs at different hospitals to ensure that proper handling and
separation of medical waste takes place before disposal. This should include
training of all waste handlers.
> Inclusion of medical waste management in the curriculum of medical and
nursing colleges.
> Efficient separation and labeling of hazardous waste; this reduces the total
volume of hazardous waste and hence reduces the subsequent specialized
disposal.
> Create a dedicated budget line for waste management.
> Autoclave Infectious Waste and dispose as normal waste. It might be cheaper,
easier to operate, less operation and maintenance cost, no pollution.
Thank You All