A Survey of Hospital Waste Management in Bir Hospital, Patan Hospital and Tribhuvan University Teaching Hospital

Abstract

Background: Most of the health care sector in Nepal practice improper waste management. Spread of infectious organisms through various means from medical waste pollute the environment and increase the risk of silent epidemics of infectious diseases like viral hepatitis, typhoid, pneumonia, AIDS etc. This study therefore was carried out with the objective of finding out the current practice of hospital waste management in three major hospitals of Kathmandu. Methods: The study was carried out in Bir Hospital, Patan Hospital and Tribhuwan University Teaching Hospital. Specific wards were chosen from three hospitals to characterize medical waste for a month. In this study, survey method was applied as a technique of investigation and information were collected through direct observation, questionnaires and interviews. Data was collected during the period of February-September 2003. The study adopted a model to make a comparative analysis of waste management in three hospitals. Review and analysis of available literature/documents pertaining to the study from former research projects and sample survey especially with reference to medical waste management were also carried out. Results: The two of the three hospitals namely Patan Hospital and Tribhuwan University Teaching Hospital have integrated approach of waste management while Bir hospital has poor hospital waste management. There is no central authority to watch and to monitor the management practices of hospital waste, so hospital authorities are treating waste carelessly. The waste generated from orthopedic ward of Bir hospital contained general waste 82.3%, hazardous waste 15.8% and sharps 1.9% by weight. The laboratory of Patan hospital had high recording of hazardous and sharp waste as compared to other departments. Both hazardous and general wastes were collected in same bucket in Bir hospital. Among the three hospitals only Patan hospital had auditing and recording system of generated waste done by the house-keeping department. Investigation showed that a high proportion of waste handlers were exposed to the risks associated with medical waste handling. Significant number of staffs from Bir hospital didn't wear protective clothing and equipment in the process of waste management. Staffs involved in waste management are highly unaware of the risk associated with health care waste. Patan and Tribhuwan University Teaching Hospital have working infection control committee. It was seen that among the three hospitals, Patan hospital has the best waste management practices and Bir hospital has the worst. Conclusions: Public awareness through mass media, proper hygiene education to scavengers, compulsory staff training for waste management and legislation to regulate hospital waste management system will change the problems encountered with current practices of hospital waste management. Keywords: general wastes; hazardous waste; hospital waste management; medical waste; practices; sharps.