Kerala’s problem of treating bio medical waste: Why sole plant in Palakkad is not enough
Kerala’s problem of treating bio medical waste: Why sole plant in Palakkad is not enough

Kerala’s problem of treating bio medical waste: Why sole plant in Palakkad is not enough

Incidents of illegally dumping bio-medical waste from Kerala in Tamil Nadu and Karnataka has increased significantly.

In January 2020, the Mysuru police arrested two men from Kerala for dumping two tonnes of general waste and bio medical waste in an empty plot in Nanjangud in Karnataka. TNM had reported how the incidents of dumping has increased significantly over the past few years prompting the Mysuru City Corporation to demand a police checkpoint back in January 2019 itself.

While it is from Kodagu, Mysuru and Chikmagalur districts that incidents of lorries from Kerala dumping tonnes of waste have been reported in Karnataka, a handful of districts in Tamil Nadu too have not been spared either. 

In November 2018, 27 lorries carrying waste from various hospitals in Kerala were seized in an operation by the Tirunelveli police and Health Department. In October 2016, people living in Coimbatore, which borders Palakkad district in Kerala, had stopped 23 such lorries.

These are some of the bigger caches of waste seized, but almost on a monthly basis reports emerge of indiscriminate dumping by various players in Kerala in their neighbouring states.

Kerala, a state that tops most health indices in the country, has witnessed a spurt in hospitals in the past decade. However, the state has only one bio medical treatment plant, Indian Medical Association Goes Eco-friendly (IMAGE), which functions in Puthussery panchayat in Palakkad. Set up and managed by the IMA, the plant was commissioned on December 14, 2003.

Bio Medical Wate Dumped in Nanjangud

There were only 300 health institutions in the state when IMAGE was commissioned. But this number has burgeoned in the past few years. According to the state Economics and Statistics Department, government-run modern medical institutions in the state, including hospitals, community health centres, public health centres, etc., have a total of 38,000 beds.

The Kerala Private Hospitals’ Association has 1,362 members and estimates that there are around 700 small private institutions that are not affiliated with them.

IMAGE is a Common Biomedical Waste Treatment and Disposal Facility (CBWTF), and waste from across medical institutions in Kerala is brought here. According to the Indian Medical Association (IMA), as of June 2019, a total of 14,327 healthcare establishments were affiliated to IMAGE and the plant caters to waste from 1,01,494 beds.

Read: Ground Report: Why activists want IMA’s waste treatment plant in Palakkad to be shut down

According to the statistics available with the State Pollution Control Board, the number of healthcare institutions that have their own treatment and disposal facilities in the state are just 23 and the rest depend on IMAGE. However, many institutions – mainly smaller ones – are not affiliated with IMAGE.

Lacunae in the system

On record, both IMA and the Kerala Private Hospitals’ Association maintain that all hospitals that do not have their own treatment facilities do send their bio medical waste to IMAGE, and that the dumping of waste in other states is an exception.

But IMAGE’s website contradicts this version and tells another story. According to the website: “There are more than 1 Lakh patient beds available in Kerala, including Government & Private Sector. The waste generation rate in healthcare establishments ranges between 0.5 and 2.0 kg bed per day. The solid waste from the hospitals consists of bandages, linen and other infectious waste (30-35%), plastics (7- 10%), disposable syringes (0.3-0.5%), glass (3-5%) and other general wastes including food (40-45%). Thus the quantity of bio medical waste generated in whole Kerala is estimated to be around 50 – 60 tons per day. The IMAGE Plant (CBWTF) at Palakkad presently has the capacity to treat about 40 tons of bio medical waste per day”.

“The plant is saturated. Moreover, there is a possibility that hospitals that are not affiliated with IMAGE are finding other quicker and cheaper ways to deal with the waste,” a source in the Health Department said.

Dr MS Sharmad, Superintendent of the Government Medical College Thiruvananthapuram, also insists that instances of dumping waste in neighbouring states are isolated cases, though officials in both Karnataka and Tamil Nadu would disagree. Dr Sharmad, however, conceded that there is a lacunae in the system. “Some hospitals might be disposing of the waste to evade the fee to be paid to IMAGE for collecting and segregating waste,” he said.

IMAGE charges Rs 4.50 per bed for collecting waste from government hospitals while the rate is higher for private hospitals, at Rs 6.35 per bed.

Initially, Karnataka police officials had suspected that the bio medical waste was being sold to jaggery manufacturing units, which in turn was using the waste as fuel.

“Earlier the information we had received from the truck drivers is that the Kerala garbage contractors were being paid by private jaggery manufacturers in Karnataka to bring in the bio medical waste so they could use it as fuel. However, our investigation has revealed that this is not true,” Deputy Superintendent of Police (DySP) of Nanjangud subdivision, Prabhakar Shinde, told TNM.

The police now believe that this was being used as an excuse by contractors to dupe lorry owners and drivers who may otherwise be reluctant to dump waste, that too in a different state.

Investigators now believe that healthcare institutions, municipalities and corporations in Kerala hire contractors to treat waste, and an unscrupulous lot simply try to dump it illegally rather than pay the costs for treatment.

A senior environmental officer of the Karnataka State Pollution Control Board’s Mysuru subdivision says that jaggery manufacturing units use materials like bags, thermoplastic items, used slippers and clothes dumped in the garbage as fuel. He says that the trucks going to Kerala to transport perishable goods like fruits and vegetables once a week come back to the state with truckloads of garbage.

Concerns of having a single plant for the state

According to the Bio-Medical Waste Management Rules 2016, bio medical waste comprises human and animal anatomical waste, and treatment apparatus like needles, syringes and other materials used in healthcare facilities in the process of treatment and research. This waste is generated during diagnosis, treatment or immunisation in hospitals, nursing homes, pathological laboratories, blood banks, etc.

The rules, which were amended in 2016, say that untreated human anatomical waste, animal anatomical waste, soiled waste and biotechnology waste shall not be stored beyond a period of 48 hours.

In this scenario, a single plant, which is located in a district far from the southern and northern parts, raises concerns over how quickly the state’s bio medical waste is treated.

“As per norms, bio medical waste shouldn’t be transported for more than 75 km owing to the serious environmental issues it can cause. But in Kerala we don’t have any alternative, considering the non-availability of isolated areas to set up a plant and the associated huge costs. Now what we do is pack the waste properly without any spillover,” a source working in a government hospital told TNM.

India allowed bio waste disposal facilities from 1998 and therefore medical institutions to transport waste for treatment to a common plant. However, Bio-Medical Waste Management Rules 2016 say that healthcare facilities should “ensure treatment and disposal of generated bio medical waste through a CBWTF, located within a distance of 75 km”.

Currently, waste from all the districts in Kerala is taken to Palakkad and most of the lorries used to transport the waste have to traverse many kilometres to reach IMAGE. Capital city Thiruvananthapuram is more than 300 km from Palakkad, while Kasaragod on the northern tip of the state also lies more than 300 km away.

Dr Sulfi M Noohu, the Kerala chapter secretary of the Indian Medical Association (IMA), said, “Basically, IMAGE is not sufficient to treat the waste generated in the state, but as of now there is no backlog as we treat the waste generated every day within 24 hours. As per the requirement, the bio medical plant should be within a 75-km radius of the hospital and therefore the state needs one plant for two districts.”

Why plans for additional plant are stalled

What Kerala needs desperately now is a second treatment facility. But finding a vacant space in a densely populated state like Kerala has been an almost impossible job for authorities.

The IMA’s move to open a second plant at Peringamala at Palode in Thiruvananthapuram has witnessed protests from locals citing the environmental damage the plant would cause. Though the 7-acre land was bought in 2011, the residents have been protesting as the area was declared ecologically sensitive by the Kasturirangan Committee report.

“This is the same story in almost every district of Kerala when it comes to treatment plants. From bio medical waste to slaughterhouse waste, no one wants treatment facilities to come up near their homes. Other than the environmental concerns, people also fear that land prices may go down,” a bureaucrat told TNM.

Why a Kerala panchayat is protesting against IMA’s bio medical waste plant

Recently the government sanctioned two acres of land to set up a plant at Brahmapuram in Kochi. However, the area has its own bunch of issues, including a large landfill that has caught fire two years in a row.

The government has not set aside any funds for this plant. “The government needs to find land. IMA has done what it can, but it is time for the government to step in,” says Advocate Hussain Koya Thangal, President of the Kerala Private Hospitals’ Association.

Inputs- Dhanya Rajendran.

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