Biomedical Waste Management
Bio medical waste management is one of the key components identified for health facilities. All health facilities have the primary responsibility of ensuring that ‘No Harm’ is done to its patients. Health facilities are a significant source of infections which may pass from one patient to another or from staff members to patients or from within its environment or from its neighboring environment and facilities to users. The waste generated in health facilities is often contaminated by biological and chemical waste that results from its care and treatment interventions. In healthcare facilities, toxic wastes are generated because of improper management, which has a direct impact on the health of the healthcare workers, the society, and the environment.
Biomedical waste is defined as “any solid, fluid and liquid or liquid waste, including its container and any intermediate product, which is generated during the diagnosis, treatment or immunization of human being or animals, in research pertaining thereto, or in the production or testing of biological and the animal waste from slaughter houses or any other similar establishment”.
The hospital wastes when mixed with general wastes, makes the whole course of wastes a hazardous stream. Waste segregation in an improper manner results in an unscientific method of waste disposal increasing the contamination of other municipal waste. Unprofessional management of Bio-medical waste causes unpleasant smell, environmental pollution, and growth and multiplication of vectors. It increases the transmission of diseases like hepatitis, typhoid, cholera and AIDS through injuries from syringes
For proper disposal of Bio-medical waste every health care worker is sensitized about segregation of bio-medical waste as per the rules at the point of generation. Coloured coded bins as per Bio-medical waste management rules has been procured and distributed to all the health facility.The procurement of non-chlorinated bags is in process and distribution of the same to all the health facility will be completed at the earliest.
For the pre-treatment and disinfection of bio-medical waste before final disposal in District Hospital, microwave sterilizer has been installed and functioning in all the 11 District hospital. Disinfection of bio-medical waste in the subsidiary health facility is to be done by autoclave. Procurement of autoclave equipment is completed and distributed to all the functionalhealth facilities.
For the liquid waste disinfection, Effluent treatment Plant (ETP) is already installed in all 9 District Hospital except Peren DH and NHAK. Disinfection of liquid waste in subsidiary health facility is done by stagnation process where the untreated liquid waste is kept in a container filled with sodium hypochlorite solution for twenty four hours and then discharged to drainage.
Incinerator installed at Dimapur district hospital and Phek district hospital has been serviced and functioning for disposal of biomedical waste.
As Nagaland state is without any Common bio-medical waste treatment facility (CBMWTF) at present, after taking prior approval from State Pollution Control Board, yellow category waste are disposed off by deep burial pits and the sharps are disposed off in sharps pit. A total of 517 deep burial pit and sharp pit is constructed across the state. The recyclable items like plastics and glassware after disinfection and mutilation and kept separately for recycling as per the rules.
Information, Education and Communication (IEC) materials for Bio-medical waste management has been developed. Training manuals for bio-medical waste management has been prepared as per the current following Bio-medical waste management rules and manuals has been distributed to all the health facilities across Nagaland. Posters of all the categories of Bio-medical waste have been prepared as per the current Bio-medical waste management rules. Mass media (animated video) as a medium to create awareness for Bio-medical waste management is created and is shared to all health workers.
Training of about 2800 health facility workers has been completed in all the health facility across the state of Nagaland. Infection control review week for management of waste at the health facilities is also organised in all the District Hospitals and Health facilities to review and educate the health facility workers under Bio-medical waste management.
Every health care worker is be ensured for occupational safety by providing appropriate and adequate personal protective equipment. Personal protective equipment which includes gloves, apron/ gown, boot, goggles, masks has been procured and distributed to all the health facility workers.
A total of approximately 6000 health workers were immunized involved in handling bio-medical waste with Hepatitis B. The immunization of health care workers with Tetanus is in process regularly.
Till November 2020, Authorization of 255 Government health facilities have applied/received authorization from State Pollution Control Board the remaining health facility is under process for obtaining authorization.
In compliance to the provisions of the Bio-medical waste management rules, the State Government have constituted the Advisory Committee and District Level Monitoring committee to monitor the compliance of the provisions of the rules in the health care facilities and in the state as a whole.
In compliance with the rules Bio-medical waste management rules annual report has been submitted to the prescribed authority regularly.