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During a regular morning stroll along the beach, Karachi resident Shaneira Akram saw heaps of medical waste, including used syringes, drips, cannulas, blood and urine bags and used swabs and bandages, along the shoreline.
After Akram took to her Twitter account and requested the authorities to cordon off the area, prompt action was taken by the police and the municipal authorities to start a cleanliness drive.
This was, however, not a one-off incident of negligence as the disposal and treatment of medical waste has been a long-standing problem in Pakistan - one that poses a high risk of jeopardising the health of staffers, patients, disposal workers and anyone else coming into contact with the often hazardous materials discarded by hospitals and other healthcare facilities.
Medical waste littered outside Dow Dental College in Karachi
Bio-hazard
Medical waste can include a wide range of hazardous materials, such as infectious waste, anatomical and pathological waste, obsolete or expired chemical products and pharmaceuticals, radioactive materials and so-called "sharps" - medical instruments or devices that are no longer used.
To top it all off, there is no readily-available data of disposable waste being generated by each patient's bed in public hospitals to assess the overall quantity of the waste and how it could potentially cause danger if not treated or disposed of in the required manner.
"Throwing untreated medical waste into the sea or out in the open may give rise to diseases and, sadly, there is no institute in Pakistan through which statistics and figures of medical waste can be gathered to assess the gravity of the situation," Dr Asim F Belgaumi, Chief Medical Officer at the Aga Khan University Hospital (AKUH), told The Express Tribune.
According to sources, the hospitals that come under the provincial department of health and the Karachi Metropolitan Corporation (KMC) do not even have a record of the amount of waste being produced by them per day, while according to health experts, a single bed in a hospital produces approximately two to three kilograms of disposable waste on a daily basis.
Of all the public hospitals in Sindh, only five teaching hospitals have standard operating procedures to dispose of waste using scientific methods, including sterilisation and incineration. These hospitals include the Jinnah Postgraduate and Medical Centre, Dr Ruth Pfau Civil Hospital and Lyari Hospital in Karachi, and Liaquat Hospital and Benazir Bhutto University Hospital in Larkana.
On the other hand, 37 hospitals that come under the administration of the KMC and the Sindh health department still use 'traditional' methods to dispose of medical waste.
While in some hospitals, medical waste is 'recycled' by an organised group through sanitary workers, other hospitals have no standard procedures to treat the waste. In fact, how and where the waste is dumped is not even known.
These hospitals include the Sindh Government Hospital New Karachi, Sindh Government Urban Health Centre North Karachi, Sindh Government Liaqatabad Hospital, Sindh Government Saudabad Hospital, Sindh Government Ibrahim Hyderi Hospital, Sindh Government Children Hospital North Karachi, Sindh Government Qatar Hospital, the Institute of Skin Diseases Regal Karachi, the Institute of Heart Diseases, and Sobraj Maternity Hospital, among others.
According to the International Institute of Health, 90 per cent of medical waste generated by hospitals is deemed harmless but the remaining 10 per cent is regarded as dangerous which can cause various infections. If not disposed of scientifically, all medical waste can be hazardous.
Shaniera Akram raises alarm after biohazardous waste washes ashore on Seaview beach
The law
In 2005, the Sindh government crafted rules regarding the scientific disposal of medical waste, while in 2012, the rules were amended under the Environmental Protection Act of 1997. According to the rules, medical waste must be dumped in secure places according to scientific techniques. Despite the existence of the law, however, most hospitals do not follow the rules.
Dr Belgaumi, who is also a professor at the Hematology and Oncology department in AKUH, said that following the international laws, the AKUH has installed various dustbins within the facility where infected waste is dumped.
"The needle of used syringes is first clipped using a clipper and then put in a separate box, while other types of waste generated by the hospital is dumped in other dustbins," he explained. "Hazardous waste is treated into an insulator before being dumped."
He stressed that the disposal of medical waste is a serious issue and there is a dire need to raise awareness among hospital staff and the public about it.
"Disposing of medical waste in a non-scientific manner can transfer viruses and bacteria from one place to another. Besides spreading awareness, the provincial department of health should also form an institute that could maintain data regarding medical waste," Dr Belgaumi concluded.
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