Management of Hospital waste in BPKIHS

B.P. Koirala Institute of Health Sciences (BPKIHS) is a tertiary health care center and referral center in eastern development region. Thousands of patients come here every day seeking outpatient medical care. It also has got a 700-bedded inpatient ward and the largest (in terms of manpower) emergency unit in the nation. There is also a separate College of Dental Surgery(CODS) for dental facilities which consist of nine different departments. So, a large amount of general waste and biomedical waste is produced from the hospital every day.  General waste includes paper and plastic packages of medicine, wrappers of junk foods, kitchen waste from hospital kitchen, etc. and biomedical waste includes used gloves, cotton dressings and gauges, used syringes and medicine bottles, excised body parts, etc. These waste materials must be suitably disposed of immediately lest they putrefy, emit foul smells, act as a source of infection and disease, and become a public health hazard. It is the responsibility of the healthcare institute producing those wastes for the proper management of health care waste, not the government or local governing unit.

In BPKIHS too, there is a provision of proper waste disposal, which, however, is not the best protocol to follow. Juniormost staffs are responsible for the collection and disposal of the waste. For the workers’ health and safety, Health welfare scheme/Treatment facility is provided by the institution. The workers are vaccinated and Personal protective equipment (PPE) viz. Long boots, gloves, face mask, Cap and plastic apron are also provided for the employees. The materials used for the collection of the wastes are:
-Plastic bags (Black)
-Cartons (Red/Orange/Green colored)
- Plastic buckets
-Wheel big plastic bins (Red/Orange/Green)

The wastes are segregated by using different color coded containers for different types of wastes.
The Nepal Health Research Council (NHRC) guidelines are followed as listed below:
Green Box (Non- Infectious): Non-infected stuffs/General waste
Orange box / Red box (Infectious): Infected Stuffs – Gauze/ bandage/cannula/urobag/blood/bodyfluid contaminated stuffs
Sharp Box: Needle/syringe/surgical blade/infected sharp materials

The collection and transportation of infectious wastes from wards to the incinerator is done in two shifts per day. And the residual sterile waste is disposed of to the dumping site. This is done by the attendants posted at the incinerator.

Similarly, the non-infectious waste is collected in two shifts from the wards to the bay/Collection container by ward attendants. Then, it is transported to the dumping site by sanitary workers in three shifts. 

Though the waste segregation system has been applied, it’s not properly followed due to unawareness. Also, The spread of infection from the open dumping site and direct contact transmission of disease to those poverty struck rag-pickers from the dumping site is always a risk which may cause a serious health hazard. Besides, A clean hospital and good housekeeping have a direct effect on the health, comfort and morale of patients, visitors and hospital personnel alike. Cleanliness radiates cheer and a well-kept hospital would give the public a feeling of confidence. So, due care has to be given in proper management of wastes and adequate budget should be allocated for that purpose.