Mrs.Andrea Christ, Honourable Deputy Consul, Consulate General of the Federal Republic of Germany, addressing the delegates
Workshop on "Bio-Medical Waste Management and Infection Control
12th September, 2014 at Hotel Ashok, Hassan, Karnataka
Hassan district has seen an increase in Health Care Establishments (HCE) in the past five years, with an addition of almost 350 HCEs in number. Out of the 707 health care establishments in Hassan, only 276 avail the services of the common bio-medical waste treatment and disposal facility. The rest of the 431 health care establishments do not have a proper Bio-Medical Waste Management (BMWM). Hence, the Karnataka State Pollution Control Board (KSPCB) and the other authorities felt a need for a district wise situational analysis to generate evidence for gaps in BMWM and identify appropriate measures to tackle this problem.
An assessment of biomedical waste management and infection control was taken up by the GIZ study group for the hospitals which cater to in-patients in Hassan District. The study findings and possible solutions to tackle these problems were discussed in the workshop with 70 representatives from hospitals. The workshop was attended by decision makers of these hospitals mainly Doctors and Nursing Superintendents (Annex-1 list of delegates who attended the workshop).
Fears about the Ebola virus crisis, which is the largest outbreak ever recorded, being transported to India is impending among the concerned authorities here. A WHO document of August 2014 on ‘Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola’ gives nine key messages to the medical fraternity. Out of these nine messages, five messages are related to Bio-Medical waste management. This clearly indicates the importance of BMWM in today’s health care provision.
India has already experienced health crisis due to lack of waste management like the Plague, In 1994, wherein a total of 693 suspected bubonic or pneumonic plague cases were reported to WHO by Government of India. The state of Karnataka was also affected during this period. The recent episode was the hepatitis outbreak in Modassa, Gujarat, 2009, which pointed towards the core issue of poor biomedical waste management in the country.
The Ministry of Environment and Forests notified the “Bio-medical Waste Management and Handling Rules”, in July 1998 (later amended in 2003 and 2011) under the Environment Protection Act, 1986. Today, lack of resources to implement Bio-Medical waste and for infection control is not so much an issue. On the contrary, the same resources, like the disposables have led to an unprecedented burden of health care related waste.Although the disposables are considered a boon for infection control, this itself becomes a ‘Frankenstein's monster’ for infection control if not managed properly.
Since the last three decades, unregulated handling of biomedical waste is emerging as a serious threat to human health and safety, and many researchers have documented this as a priority area. Hence, this workshop in Hassan was the need of the hour.
The Bio-Medical Waste Management & Infection Control Workshop was inaugurated by Ms.Andrea Christ, Honourable Deputy Consul, Consulate General of the Federal Republic of Germany. In her inaugural speech, she stressed the need for implementing BMWM to avoid spread of infections in the society. She sighted the EU and German ‘systems’ which have been effective in infection control. Ms.Christ pointed out the challenges faced by India in terms of health budget constraint and also the BMWM treatment cost. However, she felt that devising standards, benchmarks and procedures can go a long way in tackling this issue and she is very confident that GIZ which is a competent body can provide this for Hassan. She mentioned that under the proficient advice of GIZ, Karnataka will be able to tackle this issue.
The inaugural session was graced by Dr.Shankar, District Surgeon, Government of Karnataka and Dr.Rangalakshmi, President of Nursing Homes Association and Vice President of IMA. The session was presided by Mr.Laxman, Zonal Senior Environmental Officer, KSPCB. Mr.Shivakumar, Regional Officer, KSPCB proposed the welcome address.
A view of the delegates attending the workshop
The workshop was also addressed by Dr.Ramakrishna Bhatt, President of IMA and Dr.Suresh Lankeshwar, past president of IMA. Concluding remarks was proposed by Dr.Shyamala Devi, the District Health Officer (DHO), Government of Karnataka.
Ms.P.Bineesha, Senior Advisor, GIZ-IGEP presenting the findings of the study
Dr.Shyamala Devi, District Health Officer, Govt. of Karnataka, addressing the delegates during the Panel Discussion Session
Presentation of the study findings
The study undertaken by GIZ in Hassan district was presented to the delegates by Ms.Bineesha, Senior Advisor, GIZ. She revealed that although the awareness among the hospital staff, in the basic principles of Bio-Medical waste management like segregation of waste, the existence of a legislative framework and broad framework of need for BMWM, was average, the gap in knowledge and implementation was very pronounced. It was realized that for the effective implementation of the BMWM, certain policy interventions are necessary. Ms.Bineesha, shared the guidelines, standard operating procedures and formats developed by GIZ with the delegates. These documents were then discussed in length with the delegates and opinions obtained.
Recommondation by the delegates
KSPCB to request Health department to make separate budgetary provision for all government health care institutions for Bio- medical Waste Management which includes payment for services to participate in the Common Bio- Medical Waste Management and also to take care of the in house requirementsKSPCB to send a circular to all the HCE’s regarding formats, guidelines developed by GIZGovernment and KSPCB to facilitate in organizing more training programs in district
Follow-up and deliverables of the workshop:
DHO to issue to circular to all the KPME registered hospitals and all Govt HCEs to follow the formats and guidelines and test the effectiveness of the implementationGIZ to conduct follow-up studies to check the effectiveness and finalize the formats and guidelinesKSPCB to issue an amendment to the consent given to all the Health Care Establishments which will now include the formats and guidelines developed by GIZGIZ to develop a manual for implementation of the BMWMDHO, KSPCB and GIZ to develop a detailed plan of action for training the Healthcare personnel.