Most of the nearly 15,000 medical institutions in Bangladesh mix biomedical waste – including gloves, masks, swabs and other items used for COVID-19 – in with ordinary garbage, potentially endangering more than 1 million sanitation workers who lack training for managing infectious waste, according to labor leaders and experts.
In a report last week, The Lancet medical journal warned that improper handling of biomedical waste could aggravate the spread of the coronavirus disease in the South Asian country.
“Bangladesh was already struggling with poor medical waste management before the COVID-19 pandemic and has now been hit hard by a sudden increase in the volume of medical waste,” the British-based journal said in its report published Aug. 13.
Nirmal Chandra Das, the secretary general of Harijan Oikya Parishad, a group that represents trash sweepers across Bangladesh, said workers had not been trained to deal with medical waste even as they face hazardous conditions amid the viral outbreak.
“About 1.5 million people are involved in collecting waste. Initially, many did not get any protective equipment despite the coronavirus pandemic,” he told BenarNews. “Later, some gloves and masks were supplied after we staged protests.”
According to the PRISM Bangladesh Foundation, an NGO that works with hospitals across the country to manage their trash, more than 90 percent of private and public hospitals and clinics nationwide lack their own facilities to dispose of biomedical waste.
“We are working only in six cities or towns out of 330 municipalities and 12 city corporations across Bangladesh. Medical waste is not treated separately in all those towns or cities except our six,” Mazharul Islam, the coordinator for PRISM’s medical waste management program, told BenarNews, adding that medical and ordinary waste were mixed together in most communities.
Md Mostafizur Rahman, one of the authors of the report in The Lancet and an environmental science instructor at Jahangirnagar University, called on government agencies to work together to address the issue.
“It is urgent that the departments of environment, health and local government undertake collective initiatives to change the situation, but it is necessary they conduct extensive research before finalizing any decision,” he told BenarNews.
The amount of medical waste in Bangladesh multiplies each day, according to the report in The Lancet.
“In April 2020, at least 15,980 tons of waste from health care was generated across the country because of COVID-19, which has undoubtedly increased due to the increasing infection rate. Also, on average, 227 tons of medical waste are produced because of COVID-19 per day in Dhaka alone,” it said.
The waste is a major concern, said one Bangladesh government official.
“We have many schemes to address the issue,” Md Jahirul Islam, additional secretary of the Local Government Division, told BenarNews but without elaborating.
The Lancet, meanwhile, reported that as many as 5.2 million people worldwide, including 4 million children, die each year from diseases related to “unmanaged medical waste.”
“There might be a serious risk of spreading SARS-CoV-2 [COVID-19] if used masks, gloves and other personal protective equipment are not managed and disposed of properly. Additionally, household waste (tissues, masks, gloves) puts waste management workers at increased health risk,” the report said.
As of Thursday, Bangladesh had confirmed almost 288,000 cases of the coronavirus disease and 3,822 deaths from it, according to the latest data from experts at U.S.-based Johns Hopkins University.
No safe system
The report in The Lancet noted that despite the introduction of Medical Waste Management and Processing Rules in 2008, Bangladesh does not have a safe system for disposing of biomedical garbage.
Mazharul Islam of the PRISM Bangladesh Foundation agreed with the report in the British journal that the nation lacks a proper system.
He said the government had established municipalities and city corporations without developing proper waste management systems despite the 2008 rules.
“It is supposed to be a precondition to set up waste management for any city, but there is no such facility in major cities including Gazipur, Narayanganj and Savar in Dhaka’s outskirts,” he said.
Rahman, the co-author of the report, said solid waste from COVID-19 treatments and tests should not be the government’s only concern.
“While the situation has been created due to negligence of the government, we are thinking only about solid waste,” he said. “Nobody looks into waste water released by hospitals being channeled to normal drains which is very dangerous.”