Hospital Waste Management in Kathmandu Valley

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A Term Paper for the partial fulfillment of M. Sc. second year in Environmental Science

Submitted by:
Ganesh Karki

Executive summary:


Total wastes generated by hospitals and healthcare establishments are generally termed as hospital wastes. In other word, Hospital waste means all wastes coming out of hospitals, it may be biological or non-biological that is discarded, and is not intended for further use in a hospital. Mainly there are two types of wastes generated from hospital. They are classified as Risk Waste and Non-risk waste. The Non-risk waste covers 75-90% of total waste generation whereas risk waste covers only 10-25% of total hospital waste. (Visvanathan C. 2006) The Risk waste consists of chemical waste such as Lab reagents, Disinfectants, Solvents, Pathological waste such as Body parts, Blood & other fluids, Pressurized containers such as Gas cylinders, Cartridges & Aerosol cans, Infectious waste such as Lab Cultures, waste from isolation wards, tissues, Pharmaceutical Waste such as Expired or no longer needed pharmaceuticals, Used or damaged medicinal material such as heavy metal content Batteries, broken thermometers, Blood pressure gauges, Needles, infusions sets, Scalpels, knives, blades etc. (WHO, 1999).

The hospital wastes have high potential for hazards. So, hospital waste can cause pollution and disease if it is not handled properly. Infectious waste, especially sharps, poses a risk to anyone who comes into contact with it. The WHO estimates that 40% of hepatitis cases and 12% of HIV cases worldwide are caused by occupational exposure. Chemical, pharmaceutical and radioactive waste generated from hospital, which need specialist handling. Added to this, there will be large amounts of more ordinary trash including packaging, paper and food which can make up around 80% of the waste stream. A large hospital can produce tons of waste every single day.

Hospital waste in Kathmandu valley:

Hospital and health care waste management poses a serious challenge in Nepal, especially in the Kathmandu Valley. Hospital wastes, both hazardous and non-hazardous, are scattered around the health facilities in the valley. Such improper management not only poses a great risk to the service providers and patients, but also has an adverse impact on the environment.

Some 80 percent of the total waste generated from health care activities is general waste and is comparable to domestic waste. The remaining 20 percent is considered hazardous materials that may be infectious, toxic or radioactive in nature. In the context of Nepal, all wastes are turning hazardous because of improper management. Hence, the management of health care waste is an integral part of the national health care system (Baral B., 2008). Hospitals and nursing homes in the Kathmandu valley alone produce over 250 kg of hazardous medical wastes each day (The Rising Nepal, 2005).

A number of surveys have been conducted in the Kathmandu Valley to establish an overview of the health care waste management. Two of them include surveys of the quantities of health care waste (HCW) and health care risk waste (HCRW).

The first survey was conducted in 1997 (ref. VII) and included measurements of the quantities of waste generated at 11 hospitals in the Kathmandu Valley.

The average quantity of waste estimated for all 11 HCFs appear from table 2.3 below (ENPHO 2001).

|Category of waste |Average amount of waste for all 11 | | |health care facilities | |Health care waste (HCW) |0.54 kg/patient/day (rounded figure) | |Health care risk waste (HCRW) |0.16 kg/patient/day (rounded figure) |

Treatment of Hospital Waste in...
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