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Medical waste sold, not destroyed; No ‘authority’ formed in 14 years: TIB study finds

A section of the hospital staff sells reusable waste (glass bottles, syringes, saline bags, knives, scissors, blood bags, rubber/plastic tubes, etc.) to recyclable waste collectors instead of destroying them. A syndicate then cleans and packages the reusable waste without proper sterilisation and sells it to drug stores, hospitals, and clinics, finds TIB’s research.

As per the Medical Waste (Management and Treatment) Rules 2008, there are guidelines to prick or cut rubber/plastic tubes and various bags into pieces to prevent the re-use of medical waste, but it is not followed. The research says that 31 percent of hospitals do not cut off rubber/plastic tubes, and 49 percent do not have needle destroyers.

During a virtual press conference, TIB revealed the “Governance Challenges in Medical Waste Management and Way Out” study. A total of 93 medical waste workers and 231 institutions (181 hospitals, 38 city corporations/municipal authorities and 12 contractor companies) of 45 districts participated in the survey of the qualitative and quantitative research conducted between June 2021 & November 2022.

As per The Medical Waste (Management and Processing) Rules 2008, an ‘Authority’ was supposed to be constituted within three months of publishing the gazette; however, it has not been formed even in the last 14 years. Besides, the study says that city corporations/municipalities and hospitals are conducting medical waste management activities by appointing certain contractors, who are not licensed, on a contractual basis.

Besides, the rules do not specify any organisation responsible for generating a central database related to medical waste. As a result, hospitals, city corporations, and municipalities do not store information on medical waste, and no central database has been developed in this regard.

There are also anomalies in the recruitment process of waste management workers. Around 1-2 lakh taka is exchanged in the govt. hospitals for recruitment, the study points out. The study also shows a lack of coordination between concerned ministries and entities, including the DGHS, DoE, and Office of the Divisional Commissioner, to form the ‘Authority’ on medical waste management. Due to a lack of coordination, the National Advisory Committee, including the Appellate Authority and Waste Management Committees at city corporations/ municipalities, district and upazila levels, are ineffective.

At the press conference, TIB Executive Director Dr. Iftekharuzzaman said, “Although the legal and regulatory framework for medical waste management is on paper, there is no effective implementation or accountability. In terms of all seven indicators of good governance on which the study was conducted have alarming deficiencies. Fourteen years have passed since the waste management rules were enacted in 2008, but the “authority”, as per the rules, has not yet been formed. There is also no accountability in this regard. There is total anarchy with neglect of duty, lack of coordination, and corruption-irregularity. Lack of good governance and corruption in this important area of health care has led to greater risks of disease transmission and environmental degradation at every stage.”

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