Time to bring in the ‘fourth’ bin for home medical waste

Sujoy Dey works in multiple high-rise complexes in Kolkata, picking up garbage every morning. The 45-year-old seldom wears a mask or gloves. Nor has he been trained to segregate medical waste coming from housing societies, as more people quarantine themselves at home to break the spread of the novel coronavirus (Covid-19).

The situation is not too different in other parts of the country, where biomedical waste disposal guidelines falter in their implementation.

As dry and wet waste and home-generated medical waste end up in the same bin, the risk of getting infected increases for cleaners and garbage pickers as well. With three bins dedicated to home-generated waste, experts call for the “fourth” bin to pick up medical waste.

Tamil Nadu was among the earliest to issue guidelines on the collection, transportation and disposal of Covid biomedical waste. It identified 11 agencies to set up common biomedical waste treatment (CBWT) facilities across the State to handle such waste safely.

The TN Pollution Control Board (PCB) guidelines outlined procedures for healthcare establishments and home quarantine, including colour-coded bins, bags, containers, etc.

R Keerthivasan, an employee working with a private firm, and wife K Sridevi were home-quarantined on testing Covid-positive. They had a volunteer assigned to pick up the medical waste they generated in a yellow bag, and replaced, every single day.

Dr B Vijayalakshmi, Senior Consultant, Infectious Diseases, Kauvery Hospital, Chennai, explains that direct disposal of Covid waste is harmful. There is a separate spot allocated for Covid waste disposal. Laundry from Covid wards is soaked in hypochlorite and sent for washing in double covers in a yellow bin. The waste is disposed through the process of incineration or is filled in deep pits of land.

Foot-operated lids

Central PCB guidelines (issued June 10) for the handling, treatment and disposal of Covid-19 waste mention separate colour-coded bins (with foot-operated lids), separate records be maintained of waste generated, etc. These guidelines have been adopted by the Delhi Government.

Ruby Makhija, Secretary, Resident Welfare Association, Navjeevan Vihar, points to measures taken by them. “Our objective was to reduce the usage of disposable masks, gloves. We distributed paper bags, washable masks to the residents to reduce the wastage. Instead of using gloves, we told them to wash their hands frequently. We have been doing wet and dry waste segregation since last year and also started segregating domestic hazard waste now.”

But waste management expert Swati Singh Sambyal says there is a lack of awareness on waste segregation and this is evident during the pandemic. It means more than dry and wet waste segregation, There is domestic hazard waste, such as disposing of discarded cans of pesticides, broken mercury thermometers, etc, in a separate bin, she adds. In Telangana, garbage disposal from hospitals and other healthcare institutions is handled by organised players under contractual agreements. But home quarantine faces a problem.

Sources say the Swachh Auto Tipper drivers, tasked with the door-to-door collection of garbage, are worried about collection of garbage from homes quarantined. They expect home-owners to dump the waste into the vehicles themselves as they do not want to touch waste.

Kerala has not encountered major incidents of disposable medical waste piling up in the public space or dumped along with municipal solid waste. But they anticipate challenges during monsoon, says P Kesavan Nair, Managing Director, Clean Kerala Company (CKC).

BBMP in Bengaluru and the Directorate of Municipal Administration have taken measures to tackle the rising medical waste and have roped in expert private parties to handle it.

They have also outlined guidelines for waste management of houses where residents have been quarantined.

The authorities have insisted that waste be picked up from such homes in a separate vehicle, “Pourakarmikas” (civic workers) and vehicle drivers be provided with the necessary safety gear, such as gloves, goggles and gowns. Once the waste has been transported to the designated waste management facility, the vehicle be washed with hypochlorite solution daily.

Gujarat administrators say that home quarantine cases have a separate waste collection mechanism as per the ICMR guidelines. It is collected by local authorities through their sanitation workers and disposed using incineration, deep burial or disinfection, and the people handling such waste are trained.

The State has adequate number of medical waste treatment facilities and incinerators, says Anil Shah, Member Secretary, Gujarat PCB.

With the third largest number of Covid cases in the world and the rising tide of medical waste that comes with it, States need to put a tighter lid on home-generated medical waste to ensure efficient disposal. Even the best containments efforts will fail if the bottom is leaky.

(With inputs from V Rishi Kumar, Anil Urs, Vinson Kurian, Garima Singh and Rutam Vora)

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