MOBILE HOSPITAL WASTE MANAGEMENT SYSTEM
SUITABLE FOR NURSING HOMES, LABORATORIES,
BLOOD BANKS, CLINICS ETC
INTRODUCTION
The bio-medical rules (in India) were issued on 20 Jul 1998. The deadline was extended noticing that the health care institutions were nowhere near achieving it. The Rules have been further amended to include alternate technologies, and Common Biomedical Waste Treatment Facility (CBWTF). In essence the CBWTF system provides for periodic collection of waste from different health care facility, transportation of the waste to the designated area far from the city limits, disinfection, and disposal. Large as well as small hospitals have joined the system, and more are likely to opt for it. As per the Rules waste should not be kept in storage for more than 48 hrs. The turnaround time for the pick up transports would be at least 12 to 30 hrs, if not more.
As per CAG report, removal of the waste from the health care facilities in Delhi varied between 3 to 58 days. There are no air conditioned vans, nor can be expected without escalating the cost of waste treatment.
Bacterial flora multiplies in the waste, and normal cycle is 20 to 40 minutes, depending on the species and the climate. Therefore proliferation, spread of infection in the ambient air would already have taken place before the waste is lifted. Thus the very purpose of investing in waste management gets defeated.
The large hospitals should be encouraged to have their own disinfection system, but by and large all go for the easier alternative that is the CBWTF. To think that smaller health care facilities will bring their waste to the facility at a larger place/hospital is too utopian to succeed in Indian scenario, given the callous attitude of the health care providers, the work culture, level of awareness, and loose controls. Moreover in case of litigation it would be impossible to trace the source of the particular waste (could be an amputated limb or a fetus) unless a well defined and thorough tracking system is put in place.
A very large number of nursing homes, dispensaries, laboratories, dental clinics etc (registered and unregistered) in any urban locality is yet to establish waste management system. Unless all these are ensnared into the waste management system there will hardly be any success. Spread of infection is not governed by geographical boundaries and therefore a holistic control mechanism will have to be put in place to achieve successful implementation.
Each small hospital or nursing home cannot be expected to have their own system. That would jack up the hospitalization cost to unacceptable level. If the aim of treating the biomedical waste at the earliest opportunity is to be achieved the answer is a mobile system. The concept of mobile system is already available. Requirement is to test it in the field conditions. It is possible to have an Eco-friendly system, or a combination mounted on a vehicle with captive power, or power drawn from predetermined outlets.
The vehicle can be customized as per the requirement. Considering different ingredients in hospital waste, a multi-option approach will have to be adopted, and the equipments mounted on the vehicle accordingly. There are two main groups of waste generated by health care facility. These are bio-degradable, and bio-non-degradable. Both carry infection and have to be disinfected closest to the point of generation.
For the bio-non-degradable waste a microwave system should be used, and for the bio-degradable waste, a waste sterilization unit. Both these equipments can work by captive electrical supply, or supply at predetermined points. The system would be able to treat waste of all categories generated by a health care facility (HCF).
One mobile system would be able to treat waste from a number of HCF, and therefore cost-effective. It can be started as a pilot project, and the efficacy tested in the field conditions. The advantage will be eliminating transport network, and treatment of the waste nearest to the point of generation. The system will be less labor oriented, and thus eliminate ‘human factor and failure’. There will be no requirement of secured landfill since the treated waste can be put in a dumping pit without causing any environmental pollution or posing any danger to the human health The treated waste does not attract flies, scavengers, birds etc, and since it is disinfected it does not pose any danger of spread of infection. The treated bio-degradable waste (including the food waste) can also be used as manure, or fuel-source since the system does not destroy the stored chemical energy. The non-degradable (treated and shredded) waste can be sold to vendors for recycling. With this system there will not be any requirement for each health care facility to have individual system, thus will help the environment from destabilizing. It would be much cheaper in the immediate and long run since it will take care of the waste generated by many health care institutions, simultaneously.
The Rules have not been successfully implemented. That is the fact, whatever may be the reason. A number of large hospitals have not even bothered to apply for permission to operate, and obtain license. Nursing homes and labs etc still lack a proper waste management system. Most of the private hospitals have contracted vendors to take care of their wastes. They are not concerned as to what happens to the waste after it is lifted from their premises (though as per Rules the Occupier is responsible to ensure safe disposal). In the meantime the population is exposed to many hazards of improper bio-medical waste disposal. Are we not ignoring a very important societal responsibility?
When known and seemingly easy solutions are not effective it is necessary to look for doing things differently to achieve success.
New Delhi
Jan 04, 2003 (LK Verma)
Monday, March 8, 2010
Healthcare in India: The Road Ahead
During the past decade there has been tremendous advancement in the health care scenario in India. Mainly spurred by economic growth private health care facilities have sprouted in all urban localities. The public sector spending still remains a dismal .9 % of GDP. With insurance scheme recently on the anvil it may go up marginally by introducing 1% cess on Income Tax for health care which primarily will be used for health insurance. How far will this succeed in removing health inequality in the country will remain debatable. Because health inequality is not only governed by economic consideration but many other factors, such as low level of awareness, poor connectivity, economic and gender bias etc. 15 % of Indian population do not have access to health care due to various reasons. Rural health care facilities are almost non-existent.
As per World Bank, India has a vast network of rural health care infrastructure but acutely deficient of trained manpower, and other facilities which would make such infrastructure capable. In other words there is a wide gap in capacity & capability. India has about 137,000 Sub-centres, 23,000 Primary Health Centres (PHCs), about 3,000 Community Health Centres (CHCs), and about 12,000 secondary and tertiary hospitals. Public Sector manpower includes about 29,000 doctors, 18,000 nurse midwives, 134,000 auxiliary nurse midwifes (ANMs), and about 60,000 paramedical staff (Min of Health & Family Welfare 2000). Thus availability of doctors is just about 1 per thousand, that of nurses is still lower at 0.9 per thousand, and for midwives the figure is just 0.2 per thousand. Total beds in India are about 0.7 per thousand (a total of about 8 Lakhs beds) whereas as per the WHO standards it is supposed to be at least 5 per thousand (about 40 Lakhs beds).
So, in the future substantial addition is likely to take place in hospital beds. Assuming that hospital beds in a decade would be 4 per thousand that would amount to more than four fold increase in the bed strength in the country. Only on account of hospital beds it would amount to an investment opportunity of more than INR 24,000 Crores (assuming each bed would cost about INR 10 Lakhs which would include other technical & non-technical infrastructure and equipment; and work services) in a decade. In fact this estimate is going to go up with awareness regarding waste management having taken roots in the health care sector by about additional INR 10, 000 per bed. Apart from this if the rural health care infrastructure is to be improved it would require heavy investment to improve infrastructure in the villages, such as basic amenities and connectivity. Most importantly the public health care is on the decline. Void is being filled up in the urban areas but there is no agency to fill the gap in the rural areas. Private health care facilities are not likely to invest in villages since these are profit oriented. Insurance scheme is being thought about but whether it will help the situation is debatable. Such schemes are likely to fail since it does not take two things in account. One is that insurance by itself is not going to cure a patient. He/she will have to be brought to a tertiary care hospital which does not exist at many places near a rural area. And even if there is one, connectivity being poor time taken would be more than acceptable. Moreover ethos and practices in the India are such that one patient is usually accompanied by one or two relatives. Insurance will not cover their expenditure. Taking all these in consideration it is doubtful whether insurance will be helpful to the rural population. Thus benefit of insurance would be limited to urban population, by and large. And one should not forget that more that 70 % of population live in villages in India. Need is to improve infrastructure at the villages- improve technical capability of the PHCs, improve awareness amongst the village population, institute better hygienic practices, improve availability of potable water, improve connectivity (in time frame), and create facilities which would at least not distract medical professionals from getting posted to rural areas. No doubt, these measures would require heavy investment; but an investment which is likely to give cost-effective and durable results.
Indian economy is on the move. Spending power amongst middle class has been growing continuously. We have had 7 % growth successively for the fourth fiscal year. With economic growth there is changed aspiration and expectation. Healths being primary to healthy growth of a society, hospitals are bound to mushroom. Already we are having many chains of hospitals in the country. These are all in the private sector and in urban areas, but with passage of time such chains and state of the art hospitals are likely to come up even in the rural areas. With growth in the health sector there will be demands for manufacture & supply of equipment, construction of hospitals, training of medical staff, and continued awareness programmes all through the year.
As per the National Health Policy 2002 aggregate annual health expenditure is about INR 80, 000 Crores. R & D in health sector is just about 1150 Crores. Goals set to be achieved by year 2010 is to increase the allocation in health sector (centre) to 2 % of GDP, and to increase state sector spending from present 5.5 % to 7 %. Thus we have to look at investment opportunity to the extent of at least INR 80,000 to 100, 000 Crores every year up to year 2010. If the proportion of doctors, nurses, and paramedics is to be improved (which will have to be improved to cater for increasing hospital beds) then many more educational institutions will have to be created and run. One can very well imagine what it would mean. It will mean tremendous addition in the infrastructure which would require all sorts of consumables & durables required to establish and run a training establishment. All these will be a challenge and opportunity for Indian Companies to come forward and deliver.
For example if only the future requirement of equipment for health care waste management is taken into consideration the scenario would be some what as follows: -
• Assuming there will be a four fold increase in hospital beds
• Assuming that waste management plans are as per the rules
At the rate of about INR 10, 000 per bed estimate it would be about INR 800 to 1000 Crores as per present projections & requirements; and about INR 3200 to 4000 Crores in the next 5 years. Therefore there is no doubt that health care sector is going to have a major change and allocation of resources from the public as well as private sector is going to go up many times.
Much of medical and dental equipment are imported at present. Thus investment cannot be said to be cost-effective as much as it could be. Therefore there is an acute need for indigenization of manufacture of equipment and medicines in the country, which has tremendous scope. Of course, research & development in manufacture of equipment & also in medicines will have to go hand in hand only then one can expect a substantial change in the present scenario. Present scene of research is rather dismal in terms of allocation of financial resources, trained manpower, and unfortunately the mind set where every researcher tries to emulate the WEST. No doubt scientific advancement which has taken place in the developed countries must be taken advantage of but application must be tuned to conditions, infrastructure, and practices & beliefs as per local conditions. This is truer in areas of applied research. In certain cases research & development will have to be in areas which can be directed as per need. More research will have to be undertaken in areas, such as environmental health, system application research for hospitals and medical institutions, applied research for rural health care etc, where capacity will have to be translated to capability. Only then advancement will be beneficial to public at large without discrimination and division of resources. If India has to gain advantage (in health care sector) of present economic boom applied research will have to be dominant area of research. All these would not only be a challenge but tremendous opportunity to the business sector in the country.
Health tourism is a recent development in India. Patients from other countries are attracted due to good quality of medical care and low cost in comparison to developed countries. Long waiting period in countries like the UK is another reason. It is easily an industry of about 1000 Crores per year. As per statistics published in Asia Times Jul 19, 2003 “hospital services, health care equipment, managed care and pharmaceuticals are poised to grow by 13 percent annually for the next six years. India's health care industry could grow exponentially, as have software and pharmaceuticals over the past decade. The government believes that only 10 percent of the market potential has been tapped. With global revenues an estimated $2.8 trillion, health care is the world's largest industry”
All in all it would be apparent that health care sector has large potential for growth and offers challenges & opportunities together.
To the question should Indian industries aspire to take a lead in the health care sector the answer is an emphatic ‘YES’. It is technically, administratively as well as financially feasible and is capable.
Lalji K Verma
New Delhi November 29, 2005
During the past decade there has been tremendous advancement in the health care scenario in India. Mainly spurred by economic growth private health care facilities have sprouted in all urban localities. The public sector spending still remains a dismal .9 % of GDP. With insurance scheme recently on the anvil it may go up marginally by introducing 1% cess on Income Tax for health care which primarily will be used for health insurance. How far will this succeed in removing health inequality in the country will remain debatable. Because health inequality is not only governed by economic consideration but many other factors, such as low level of awareness, poor connectivity, economic and gender bias etc. 15 % of Indian population do not have access to health care due to various reasons. Rural health care facilities are almost non-existent.
As per World Bank, India has a vast network of rural health care infrastructure but acutely deficient of trained manpower, and other facilities which would make such infrastructure capable. In other words there is a wide gap in capacity & capability. India has about 137,000 Sub-centres, 23,000 Primary Health Centres (PHCs), about 3,000 Community Health Centres (CHCs), and about 12,000 secondary and tertiary hospitals. Public Sector manpower includes about 29,000 doctors, 18,000 nurse midwives, 134,000 auxiliary nurse midwifes (ANMs), and about 60,000 paramedical staff (Min of Health & Family Welfare 2000). Thus availability of doctors is just about 1 per thousand, that of nurses is still lower at 0.9 per thousand, and for midwives the figure is just 0.2 per thousand. Total beds in India are about 0.7 per thousand (a total of about 8 Lakhs beds) whereas as per the WHO standards it is supposed to be at least 5 per thousand (about 40 Lakhs beds).
So, in the future substantial addition is likely to take place in hospital beds. Assuming that hospital beds in a decade would be 4 per thousand that would amount to more than four fold increase in the bed strength in the country. Only on account of hospital beds it would amount to an investment opportunity of more than INR 24,000 Crores (assuming each bed would cost about INR 10 Lakhs which would include other technical & non-technical infrastructure and equipment; and work services) in a decade. In fact this estimate is going to go up with awareness regarding waste management having taken roots in the health care sector by about additional INR 10, 000 per bed. Apart from this if the rural health care infrastructure is to be improved it would require heavy investment to improve infrastructure in the villages, such as basic amenities and connectivity. Most importantly the public health care is on the decline. Void is being filled up in the urban areas but there is no agency to fill the gap in the rural areas. Private health care facilities are not likely to invest in villages since these are profit oriented. Insurance scheme is being thought about but whether it will help the situation is debatable. Such schemes are likely to fail since it does not take two things in account. One is that insurance by itself is not going to cure a patient. He/she will have to be brought to a tertiary care hospital which does not exist at many places near a rural area. And even if there is one, connectivity being poor time taken would be more than acceptable. Moreover ethos and practices in the India are such that one patient is usually accompanied by one or two relatives. Insurance will not cover their expenditure. Taking all these in consideration it is doubtful whether insurance will be helpful to the rural population. Thus benefit of insurance would be limited to urban population, by and large. And one should not forget that more that 70 % of population live in villages in India. Need is to improve infrastructure at the villages- improve technical capability of the PHCs, improve awareness amongst the village population, institute better hygienic practices, improve availability of potable water, improve connectivity (in time frame), and create facilities which would at least not distract medical professionals from getting posted to rural areas. No doubt, these measures would require heavy investment; but an investment which is likely to give cost-effective and durable results.
Indian economy is on the move. Spending power amongst middle class has been growing continuously. We have had 7 % growth successively for the fourth fiscal year. With economic growth there is changed aspiration and expectation. Healths being primary to healthy growth of a society, hospitals are bound to mushroom. Already we are having many chains of hospitals in the country. These are all in the private sector and in urban areas, but with passage of time such chains and state of the art hospitals are likely to come up even in the rural areas. With growth in the health sector there will be demands for manufacture & supply of equipment, construction of hospitals, training of medical staff, and continued awareness programmes all through the year.
As per the National Health Policy 2002 aggregate annual health expenditure is about INR 80, 000 Crores. R & D in health sector is just about 1150 Crores. Goals set to be achieved by year 2010 is to increase the allocation in health sector (centre) to 2 % of GDP, and to increase state sector spending from present 5.5 % to 7 %. Thus we have to look at investment opportunity to the extent of at least INR 80,000 to 100, 000 Crores every year up to year 2010. If the proportion of doctors, nurses, and paramedics is to be improved (which will have to be improved to cater for increasing hospital beds) then many more educational institutions will have to be created and run. One can very well imagine what it would mean. It will mean tremendous addition in the infrastructure which would require all sorts of consumables & durables required to establish and run a training establishment. All these will be a challenge and opportunity for Indian Companies to come forward and deliver.
For example if only the future requirement of equipment for health care waste management is taken into consideration the scenario would be some what as follows: -
• Assuming there will be a four fold increase in hospital beds
• Assuming that waste management plans are as per the rules
At the rate of about INR 10, 000 per bed estimate it would be about INR 800 to 1000 Crores as per present projections & requirements; and about INR 3200 to 4000 Crores in the next 5 years. Therefore there is no doubt that health care sector is going to have a major change and allocation of resources from the public as well as private sector is going to go up many times.
Much of medical and dental equipment are imported at present. Thus investment cannot be said to be cost-effective as much as it could be. Therefore there is an acute need for indigenization of manufacture of equipment and medicines in the country, which has tremendous scope. Of course, research & development in manufacture of equipment & also in medicines will have to go hand in hand only then one can expect a substantial change in the present scenario. Present scene of research is rather dismal in terms of allocation of financial resources, trained manpower, and unfortunately the mind set where every researcher tries to emulate the WEST. No doubt scientific advancement which has taken place in the developed countries must be taken advantage of but application must be tuned to conditions, infrastructure, and practices & beliefs as per local conditions. This is truer in areas of applied research. In certain cases research & development will have to be in areas which can be directed as per need. More research will have to be undertaken in areas, such as environmental health, system application research for hospitals and medical institutions, applied research for rural health care etc, where capacity will have to be translated to capability. Only then advancement will be beneficial to public at large without discrimination and division of resources. If India has to gain advantage (in health care sector) of present economic boom applied research will have to be dominant area of research. All these would not only be a challenge but tremendous opportunity to the business sector in the country.
Health tourism is a recent development in India. Patients from other countries are attracted due to good quality of medical care and low cost in comparison to developed countries. Long waiting period in countries like the UK is another reason. It is easily an industry of about 1000 Crores per year. As per statistics published in Asia Times Jul 19, 2003 “hospital services, health care equipment, managed care and pharmaceuticals are poised to grow by 13 percent annually for the next six years. India's health care industry could grow exponentially, as have software and pharmaceuticals over the past decade. The government believes that only 10 percent of the market potential has been tapped. With global revenues an estimated $2.8 trillion, health care is the world's largest industry”
All in all it would be apparent that health care sector has large potential for growth and offers challenges & opportunities together.
To the question should Indian industries aspire to take a lead in the health care sector the answer is an emphatic ‘YES’. It is technically, administratively as well as financially feasible and is capable.
Lalji K Verma
New Delhi November 29, 2005
EGOCENTRIC TO ECO-CENTRIC
“The learned is happy, nature to explore
The fool is happy that he knows no more”
- Alexander pope.
‘Gaia’ or the ecosystem of the earth is a vast collection of mass of matter which is self regulating. It is amazing that such awesome manifestation of being always remains in perfect balance. In nature everything is in a cyclic existence even in mega-timeframe.
Ecosystem of the earth consists of all the earth, atmosphere, marine world, forests, vegetations, and all living species including the human beings who are most important ingredient of the whole system.
Man is important on two counts. Firstly, because it is a thinking species, and secondly, because the human activity has grave and long lasting effect on the ecosystem. Compared to other living species humans are the only species who are always trying to find another ‘niche’ for themselves in the whole earth’s ecosystem. All living species exist in complete harmony with nature. It is only the humans who consider themselves as master of universe and are always making efforts to twist or bend the rules of nature to suit material comfort and development. Humans are only one of about 1.6 million living species but have acquired the mantle to rule over all. We are the last to arrive on the history sheet of the earth but have mastered the art of destruction in the shortest time.
Life appeared on the earth about 3.6 billion years ago. And if the calendar of life on earth is compressed into 24 hrs dial the Homo sapiens arrived on the scene only one second before midnight, and industrial revolution, which has accelerated maximum changes took place only 0.0001429 second before the midnight (GT Miller 1994).
First let us consider ecological balance. It is apparent that ecology is maintained in a critical balance. Balance of such a complex arrangement is also very complex but at the same time very simple. Life is a form of energy and the body i.e. manifestation is a complex house of chemicals which render the living being apparent, and which at the end of living cycle returns to nature.
On a more tangible plane the air we breathe is also maintained by balancing the gases. Whenever we breathe out we cause aberration in this balance, which fortunately is only temporary. The composition of air (Oxygen and Nitrogen etc) changes momentarily. However the flora uptakes the excess C02 emissions and use these to bind sun’s energy to provide food (energy so essential for life). But it must be understood that the ability of the ecosystem to purify the air is also limited. At the same time due to human activity the forest cover is reducing day by day. Normally 33% forest cover is required to maintain adequate eco-balance, which in India has now dwindled to only about 13% or so (official figures may be about 18 %). This has resulted in other adverse impact a well. Like the soil erosion from the mountains, silt in the rivers, rising level of rivers during rainy season, floods, lack of proper monsoon etc.
Some other activity of human beings leading to eco imbalance are increasing green house gases’, air, water and soil pollution, erosion of top soil (which is essential for crops), ozone layer depletion etc. Desire to live like superhuman has led to concomitant industrial activity and resultant degradation. Malthus was a scientist of 19th century who had predicted that the exponential growth of human population will overtake growth of crop production and thus predicted that population will stabilize.
He had not contended with crafty mind of humans. His theory is being disproved everyday. Population continues to grow exponentially and the mother earth continues to provide life support. But for how long?
The ability of ‘Gaia’ to support life on earth is limited. The ability of the ecosystem to clear aberration caused by activities of living species, specifically the human being is limited. The mother earth is reaching its ‘break point’. In this context it would not be out of place to mention what Mahatma Gandhi had to say ‘The earth provides enough for every man’s need but not for everyman’s greed.” (Mahatma Gandhi an Apostle of applied ecology - TN Khoshoo).
The greenhouse gases are causing Global warming. It has been estimated that in the next few decades the Polar ice caps may partially melt to raise the ocean’s water level by 6-7 Mtrs, thus submerging large number of islands and a large part of littoral land.
The beautiful balance maintained between the glaciers and the rivers and oceans is something to realise. The glaciers collect more and more ice during cooler months and give away water to rivers during summer/rainy season. But latest studies have shown that Himalayan glaciers are receding @ 30 Mtrs per year and are developing crevices which are sure sign of recession (Down to Earth, Apr 30, 1999). If glaciers cannot hold ice when high level of water is not required then one can imagine what can happen. If would be like a mother who had milk before birth of a child but dried up immediately thereafter.
Generation of waste is in direct proportion to the population growth. Whereas the population of other species has remained static, or dwindled; the human population has been increasing by leaps and bounds. Waste generated also has gone up accordingly and now the scene is that in all localities at least in the developing world, heaps of waste lie all over posing serious health hazard. With limited ability to purify and reestablish the eco-balance it must be a very difficlt task for the nature.
While living cannot stop, progress towards reaping the benefit of scientific and material advancement cannot be rolled back, but for survival through next millennium proper strategy will have to be adopted. In tact the key word today is ‘Sustainable development’. Meaning thereby, enjoy life of today but leave the world livable for the future generations.
What needs greatest attention therefore is:
(a) To control the population
(b) To develop the awareness and concern for the future generations.
(c) To understand overload created on the ecosystem and urgent steps to minimize it.
(d) To treat the whole ecosystem as one, and not divided by geographical boundaries, because eco degradation at one place my have impact at another place.
(e) All must unite to preserve the beautiful earth and its ecosystem.
Action taken today will determine the viability of future generations. Unfortunately human beings’ life span is so limited that one cannot appreciate the gradual degradation, taking place. It is however hoped that today’s generation will realise and make sincere effort to leave livable world to its progenies. Egocentric humans must change to being ecocentric (earlier the better) in thought and action.
“Hope is the last bastion”.
“When mind stops to perceive,
or to acknowledge new ideas
one attains intellectual death”.
- Laljee K Verma
“The learned is happy, nature to explore
The fool is happy that he knows no more”
- Alexander pope.
‘Gaia’ or the ecosystem of the earth is a vast collection of mass of matter which is self regulating. It is amazing that such awesome manifestation of being always remains in perfect balance. In nature everything is in a cyclic existence even in mega-timeframe.
Ecosystem of the earth consists of all the earth, atmosphere, marine world, forests, vegetations, and all living species including the human beings who are most important ingredient of the whole system.
Man is important on two counts. Firstly, because it is a thinking species, and secondly, because the human activity has grave and long lasting effect on the ecosystem. Compared to other living species humans are the only species who are always trying to find another ‘niche’ for themselves in the whole earth’s ecosystem. All living species exist in complete harmony with nature. It is only the humans who consider themselves as master of universe and are always making efforts to twist or bend the rules of nature to suit material comfort and development. Humans are only one of about 1.6 million living species but have acquired the mantle to rule over all. We are the last to arrive on the history sheet of the earth but have mastered the art of destruction in the shortest time.
Life appeared on the earth about 3.6 billion years ago. And if the calendar of life on earth is compressed into 24 hrs dial the Homo sapiens arrived on the scene only one second before midnight, and industrial revolution, which has accelerated maximum changes took place only 0.0001429 second before the midnight (GT Miller 1994).
First let us consider ecological balance. It is apparent that ecology is maintained in a critical balance. Balance of such a complex arrangement is also very complex but at the same time very simple. Life is a form of energy and the body i.e. manifestation is a complex house of chemicals which render the living being apparent, and which at the end of living cycle returns to nature.
On a more tangible plane the air we breathe is also maintained by balancing the gases. Whenever we breathe out we cause aberration in this balance, which fortunately is only temporary. The composition of air (Oxygen and Nitrogen etc) changes momentarily. However the flora uptakes the excess C02 emissions and use these to bind sun’s energy to provide food (energy so essential for life). But it must be understood that the ability of the ecosystem to purify the air is also limited. At the same time due to human activity the forest cover is reducing day by day. Normally 33% forest cover is required to maintain adequate eco-balance, which in India has now dwindled to only about 13% or so (official figures may be about 18 %). This has resulted in other adverse impact a well. Like the soil erosion from the mountains, silt in the rivers, rising level of rivers during rainy season, floods, lack of proper monsoon etc.
Some other activity of human beings leading to eco imbalance are increasing green house gases’, air, water and soil pollution, erosion of top soil (which is essential for crops), ozone layer depletion etc. Desire to live like superhuman has led to concomitant industrial activity and resultant degradation. Malthus was a scientist of 19th century who had predicted that the exponential growth of human population will overtake growth of crop production and thus predicted that population will stabilize.
He had not contended with crafty mind of humans. His theory is being disproved everyday. Population continues to grow exponentially and the mother earth continues to provide life support. But for how long?
The ability of ‘Gaia’ to support life on earth is limited. The ability of the ecosystem to clear aberration caused by activities of living species, specifically the human being is limited. The mother earth is reaching its ‘break point’. In this context it would not be out of place to mention what Mahatma Gandhi had to say ‘The earth provides enough for every man’s need but not for everyman’s greed.” (Mahatma Gandhi an Apostle of applied ecology - TN Khoshoo).
The greenhouse gases are causing Global warming. It has been estimated that in the next few decades the Polar ice caps may partially melt to raise the ocean’s water level by 6-7 Mtrs, thus submerging large number of islands and a large part of littoral land.
The beautiful balance maintained between the glaciers and the rivers and oceans is something to realise. The glaciers collect more and more ice during cooler months and give away water to rivers during summer/rainy season. But latest studies have shown that Himalayan glaciers are receding @ 30 Mtrs per year and are developing crevices which are sure sign of recession (Down to Earth, Apr 30, 1999). If glaciers cannot hold ice when high level of water is not required then one can imagine what can happen. If would be like a mother who had milk before birth of a child but dried up immediately thereafter.
Generation of waste is in direct proportion to the population growth. Whereas the population of other species has remained static, or dwindled; the human population has been increasing by leaps and bounds. Waste generated also has gone up accordingly and now the scene is that in all localities at least in the developing world, heaps of waste lie all over posing serious health hazard. With limited ability to purify and reestablish the eco-balance it must be a very difficlt task for the nature.
While living cannot stop, progress towards reaping the benefit of scientific and material advancement cannot be rolled back, but for survival through next millennium proper strategy will have to be adopted. In tact the key word today is ‘Sustainable development’. Meaning thereby, enjoy life of today but leave the world livable for the future generations.
What needs greatest attention therefore is:
(a) To control the population
(b) To develop the awareness and concern for the future generations.
(c) To understand overload created on the ecosystem and urgent steps to minimize it.
(d) To treat the whole ecosystem as one, and not divided by geographical boundaries, because eco degradation at one place my have impact at another place.
(e) All must unite to preserve the beautiful earth and its ecosystem.
Action taken today will determine the viability of future generations. Unfortunately human beings’ life span is so limited that one cannot appreciate the gradual degradation, taking place. It is however hoped that today’s generation will realise and make sincere effort to leave livable world to its progenies. Egocentric humans must change to being ecocentric (earlier the better) in thought and action.
“Hope is the last bastion”.
“When mind stops to perceive,
or to acknowledge new ideas
one attains intellectual death”.
- Laljee K Verma
DDA NEEDS TO WAKE UP
SOLID WASTE MANAGEMENT:
DWARKA
Solid waste includes domestic waste, food & kitchen waste, and bio-medical waste. The news is that a large number of hospitals are being planned in Dwarka, apart from a large number of dispensaries and laboratories already functioning. The infected waste generating from these health care premises is presently being thrown wherever convenient. Thus the small quantity of infected waste will infect a huge quantity of municipal solid waste and pose a serious threat to the society at large. Those engaged in collecting and removing the waste without disinfection are at the risk of contracting infectious diseases as they will not be using any protective clothing, or gear.
Proper disposal of the waste generated by the citizens is a societal responsibility. This is clearly stated in the relevant rules. The solid waste handling and disposal is governed by the SOLID WASTE MANAGEMENT AND HANDLING RULES promulgated by an extraordinary gazette of the Min of Env & Forest, Govt of India-2000, and the bio-medical waste under the BIO-MEDICAL (MANAGEMENT AND HANDLING) RULES, 1998.
For the bio-medical waste it has been stated in the Rules that " It shall be the duty of every occupier of an institution generating bio-medical waste which includes a hospital, nursing home, clinic, dispensary, veterinary institution, animal home, pathological laboratory, blood bank by whatever name called to take all steps to ensure that such waste is handled without any adverse effect to human health and the environment." It is the duty of the prescribed authority to satisfy that the laid down conditions for safe disposal after disinfection are met before granting license to operate any health care outlet. Under no circumstances the bio-medical waste is to be mixed with other waste. The municipal authorities will continue to be responsible for collection, transportation and disposal of other waste (including treated bio-medical waste) from the health care premises. For Delhi, the Prescribed Authority is the Delhi Pollution Control Committee (DPCC). Either the DPCC helps in rendering advice to those who do not know how to lay down a proper hospital waste management system, or create an advisory body, as provided for in the Rules.
Management and handling of municipal solid waste is primarily the responsibility of the civic body, like the Municipal Corporation/ Council/ Nagar Panchayat. This is clearly provided in the Municipal Waste Handling Rules. Some of the relevant provisions are: -
1. Prohibit littering on the roads
2. Organize house to house waste collection and notify the public about the schedule and the methodology of collection
3. Conduct awareness programs……..and hold regular meetings with the resident welfare groups and the NGOs
4. Devise ways to collect the waste from difficult areas, such as slums, hotels etc and the commercial areas.
5. Build adequate storage facility
6. Color code waste bins so as to promote segregation of waste at the source.
7. Transport the waste only in closed vans to avoid spilling of waste
8. Disposal of collected waste as per prescribed method.
The responsibility of the citizen is also defined in these Rules. These are only two as follows:-
1. Avoid littering and ensure delivery of the waste as per the notified system by the local body
2. Segregation of waste at source
Presently there is no planned methodology either for bio-medical waste or for the municipal solid waste. It has been learnt that the DDA is trying to wash off its hands saying that it is only responsible for the construction activity, and not for the disposal of waste. That would be the responsibility of the civic bodies. The NDMC on the other hand feels that since the township has not been handed over to them they have no role to play. The population in the meantime is increasing and so is the quantity of waste and filth, which is against the spirit of the duties prescribed in these two rules. The waste and the filth continue to adversely affect the human health and the environment.
The Solid Waste Rules also provides for a citizen's right to complain. Under section 19, any citizen can lodge a complaint in the court stating the intent to file a complaint to the court and proceed further. There are other constitutional provisions (since improper disposal tends to adversely affect the health, and thus infringe on the fundamental right to life) under which legal interventions can be requested.
There are two things, which must be done immediately. Firstly the DDA must be made to appreciate that they cannot, and should not wash off their hands from such important societal responsibility. And the second that the DPCC and the health department must authorize, including renewal, the hospitals, dispensaries, laboratories etc, only after fully satisfying that proper disposal of bio-medical waste has been ensured by the applicant. Many eating places have come up. If there is a complaint on hygienic condition (lack of it) of one of the eating joints then where does one complaint? In the present scenario, the DDA does not have a medical officer, and the sub-city has not been handed over to the NDMC. So where does a citizen go?
Changes are difficult to come by. Let us live in hope that things will brighten for Dwarka residents, since it is professed to be a modern and clean township.
Lalji K Verma
SOLID WASTE MANAGEMENT:
DWARKA
Solid waste includes domestic waste, food & kitchen waste, and bio-medical waste. The news is that a large number of hospitals are being planned in Dwarka, apart from a large number of dispensaries and laboratories already functioning. The infected waste generating from these health care premises is presently being thrown wherever convenient. Thus the small quantity of infected waste will infect a huge quantity of municipal solid waste and pose a serious threat to the society at large. Those engaged in collecting and removing the waste without disinfection are at the risk of contracting infectious diseases as they will not be using any protective clothing, or gear.
Proper disposal of the waste generated by the citizens is a societal responsibility. This is clearly stated in the relevant rules. The solid waste handling and disposal is governed by the SOLID WASTE MANAGEMENT AND HANDLING RULES promulgated by an extraordinary gazette of the Min of Env & Forest, Govt of India-2000, and the bio-medical waste under the BIO-MEDICAL (MANAGEMENT AND HANDLING) RULES, 1998.
For the bio-medical waste it has been stated in the Rules that " It shall be the duty of every occupier of an institution generating bio-medical waste which includes a hospital, nursing home, clinic, dispensary, veterinary institution, animal home, pathological laboratory, blood bank by whatever name called to take all steps to ensure that such waste is handled without any adverse effect to human health and the environment." It is the duty of the prescribed authority to satisfy that the laid down conditions for safe disposal after disinfection are met before granting license to operate any health care outlet. Under no circumstances the bio-medical waste is to be mixed with other waste. The municipal authorities will continue to be responsible for collection, transportation and disposal of other waste (including treated bio-medical waste) from the health care premises. For Delhi, the Prescribed Authority is the Delhi Pollution Control Committee (DPCC). Either the DPCC helps in rendering advice to those who do not know how to lay down a proper hospital waste management system, or create an advisory body, as provided for in the Rules.
Management and handling of municipal solid waste is primarily the responsibility of the civic body, like the Municipal Corporation/ Council/ Nagar Panchayat. This is clearly provided in the Municipal Waste Handling Rules. Some of the relevant provisions are: -
1. Prohibit littering on the roads
2. Organize house to house waste collection and notify the public about the schedule and the methodology of collection
3. Conduct awareness programs……..and hold regular meetings with the resident welfare groups and the NGOs
4. Devise ways to collect the waste from difficult areas, such as slums, hotels etc and the commercial areas.
5. Build adequate storage facility
6. Color code waste bins so as to promote segregation of waste at the source.
7. Transport the waste only in closed vans to avoid spilling of waste
8. Disposal of collected waste as per prescribed method.
The responsibility of the citizen is also defined in these Rules. These are only two as follows:-
1. Avoid littering and ensure delivery of the waste as per the notified system by the local body
2. Segregation of waste at source
Presently there is no planned methodology either for bio-medical waste or for the municipal solid waste. It has been learnt that the DDA is trying to wash off its hands saying that it is only responsible for the construction activity, and not for the disposal of waste. That would be the responsibility of the civic bodies. The NDMC on the other hand feels that since the township has not been handed over to them they have no role to play. The population in the meantime is increasing and so is the quantity of waste and filth, which is against the spirit of the duties prescribed in these two rules. The waste and the filth continue to adversely affect the human health and the environment.
The Solid Waste Rules also provides for a citizen's right to complain. Under section 19, any citizen can lodge a complaint in the court stating the intent to file a complaint to the court and proceed further. There are other constitutional provisions (since improper disposal tends to adversely affect the health, and thus infringe on the fundamental right to life) under which legal interventions can be requested.
There are two things, which must be done immediately. Firstly the DDA must be made to appreciate that they cannot, and should not wash off their hands from such important societal responsibility. And the second that the DPCC and the health department must authorize, including renewal, the hospitals, dispensaries, laboratories etc, only after fully satisfying that proper disposal of bio-medical waste has been ensured by the applicant. Many eating places have come up. If there is a complaint on hygienic condition (lack of it) of one of the eating joints then where does one complaint? In the present scenario, the DDA does not have a medical officer, and the sub-city has not been handed over to the NDMC. So where does a citizen go?
Changes are difficult to come by. Let us live in hope that things will brighten for Dwarka residents, since it is professed to be a modern and clean township.
Lalji K Verma
Hospital Waste Causing Havoc with Human Health
Hospital waste has become a very important source of spreading infection in the society. It is not that it was not so earlier but the population explosion has reduced the natural barrier and made the spread of infection that much easier. Moreover the generation of waste – per-capita has grown exponentially. Hospitals of today, which were always considered a seat of healing, have become seat of infection
Apart from the above consideration, infection contracted in a hospital settting is more difficult to treat because of mutated varients of microbes. Mutation in a hospital takes place in two ways. One in vivo and another in vitro. In other words infected waste strewn allover would undergo a process of mutation, which will be in proportion to the time the waste was left unattended before disinfection (limited up to desiccation). There have been doubts whether mutation in vitro is a known phenomenon. Many literatures have been consulted and it is now well established that mutation is very much possible in vitro as well.
Regeneration is a basic instict of any living species. So when the bacterial flora has to grow against an impinging atmosphere of antibiotic presence, where it cannot grow in its nascent form it has to acquire certain new features or property. That is precisely what must be happening. That would lead to mutated variety of microbial which would then dissipate as aerosol.
If the abovementioned hypothesis is accepted then it would be explainable as to why the hospital acquired infections are more difficult to treat.
It is a well-established fact that mutated varieties of microbial flora have been found in the underground water where Terramycin has been used as a food supplement of the chicks. Most glaring possible example of mutation in the
The AIDS virus has probably developed as a result of serialization of the otherwise non-viulent siman immunodeficiency virus (SIDS). It has been brought out by a researcher and published in the Lancet of Dc 8, 2001. During 1950s mass scale inoculation was given in Uganda and Somalia to fight against yaws. As an accepted practice, the syringes were not disinfected (considering the poverty of the countries), and many individuals were vaccinated with using the same syringe.
How and why this so far neglected topic has caught the attention of everyone in India suddenly? And if so it is certainly not too late. With the population explosion the natural barrier, which existed due to sparse population, has reduced. Spread of infection would therefore be that much easier and that much faster. At the same time the waste generation has become voluminous as per the increasing population, since generation of waste is directly proportionate to the population. Rural to urban migration has further caused havoc to the old civic amenities, which were laid out decades ago. So the population overload is one of the very important reasons for the condition of today. Most of the urban sewage systems are at the breakdown point, and are on the verge of collapse. The society does not have budget for replacing the age-old systems. One thing leads to another and the result is that the situation is becoming bad to worse, by the day.
A large portion of resources in terms of money or trained manpower is devoted to treating diseases, and for clinical preventable measures but hardly any concerted efforts are in the offing to improve the conditions where occurrence of these preventable disease itself, becomes a remote possibility. Hospitals are supposed to be seat of healing but with the present trend it has become a seat of infection. Spread of diseases by nosocomial infection is the order of the day. At the same time hospital acquired infections are more tenacious and difficult to deal with since the infection is by a more virulent strain, which is the result of mutation. There are a number of macro-observations indicating mutation in vitro.
Similar is the case with other infections. The society spends a very large portion of its resources on the treatment of patients who have been afflicted by disease process but not much is being done to root out the cause of spread of nosocomial infection. Cross infection in a hospital and hospital acquired infection have remained an area of great concern. Much deliberations take place the year around but no one pay much heed to the root cause. Hospital waste strewn allover the hospital compound is a major source of the spread of infection but still no focused concept has been developed yet. Rag pickers still are as active as ever. Studies done in a major hospital has brought out clearly that heaps of plastic syringes are carted away to a slum area and washed, repacked and brought to their collaborators in the city. These are then stocked as new ones and sold to the unsuspecting buyers. In certain cases the nexus between the rag pickers, the medicine shop owners and some of the nursing homes as well as hospitals are well-established .
On an average about 30% to 50 % one time use plastic syringes come back into the circulation. In fact the plastic syringes were encouraged and introduced so that nosocomial infections reduce. However that has not happened, at least in not in the developing countries, including India. As per the WHO “whereas introduction of the plastic syringes had the desired result in reducing the nosocomial infection in the developed countries it did not have any effect amongst the developing or the underdeveloped countries". It has been attributed to the wrong practices in the lower income group countries. It is estimated that in and around Delhi itself the total trade value of the recycled plastic ware (used in the medical management) is about Rs fifty million per year.
In the US, about one billion waste syringes are generated by patients of Diabetes taking domiciliary treatment. Each plastic syringe cost about $ 1 to 1.5. So that is a lucrative trade of about one to one and half a billion $. However the better part is that in the US the regulatory authorities, general awareness of the public is such that reuse of used plastic syringes is limited to group of drug abusers or drug peddlers. Unfortunately no such statistics is available in India, but it must be matching (of course in rupees). This being the monetary attraction effective measures will be required to deal with this menace.
In an urban area in India not all the nursing homes are rgistered, besides the umpteen numbers of quacks practicing and flourishing at every nook and corner of the cities, semi urban, and rural areas. In Delhi alone there are about 2500 nursing homes and hospitals registered. But there would be an equal number unregistered. Apart from the nursing homes there would easily be about 10,000 quacks in Delhi. Also there are domiciliary patients to cater to. Thus taking a comprehensive care of the biomedical waste in an urban area like Delhi would be a nightmare. The task may appear insurmountable. But with elaborate planning this can be planned and executed.
The WHO reports : -
1. Each person in the developing world receives 1.5 injections per year on the average. Hosp patients receive 10 to 100 times more injections.
2. At least 50% of all injections are unsafe
3. There was convincing link between unsafe injections and transmission of Hep B&C, Lassa virus and Malaria.
4. 20-80% of all new Hep B infections were due to unsafe injections.
5. In the world it is estimated that 16 billion syringes are sold every year, out of which 1 billion injections are given in the course of childhood vaccination program. Total manufacture capacity of plastic syringes reains at about 12 billion. Shortfall is obviously made up by reuse of plastic syringes, mostly in the developing world.
6. In Britain, an outbreak of Malaria took place in 1917 among soldiers who were given injections for Syphilis.
7. Introduction of disposable syringes largely reduced the problem in the developed world but not in the developing countries.
8. In India, 96% of injections were for antibiotic, vitamins and analgesics (in 1987).
9. 20% of 67 million new Hep B infections, each year in the developing world are due to unsafe injection.
10. Annual estimate of infection due to unsafe injection, worldwide is
( (i) Hep B --------------8-16 million
(ii) Hep C ------------- 2.3 – 4.7 million
(iii) HIV ---------------80,000-160,000
% Isolates with Methicillin resistant staph aureus has increased over a period of time from less than .1% in 1960 to 4% in 1969, 10% in 1984, 75 % in 1999, in a study carried out in the UK.
Of all hospital acquired infection the largest group is of upper respiratory tract infection-49.01% in the study carried out at an ICU at BHU, Varanasi.
The above mentioned research findings are indicative of mutation taking place in the infected discards of the hosp waste. More work is required to be undertaken to find out and establish on scientific platform the damage the untreated or uncared for hospital waste is causing to the society.
Though it can never be tangible the advantage the society will gain out of proper hosp waste management are tremendous. Perhaps the prevention of communicable diseases in number and quantity can never be specified, perhaps not even the number of cases thus prevented but the fact would remain that managing the hosp waste in a proper and scientific manner could bring about a very substantial change. This not only may save the resources of the society but also bring up the gradation of health. Could the chemicals in waste also contribute to the changed behavior and the mental outlook? It would be an interesting study if such a study can be undertaken.
Lalji K Verma
New Delhi
Apr 15, 2005
Hospital waste has become a very important source of spreading infection in the society. It is not that it was not so earlier but the population explosion has reduced the natural barrier and made the spread of infection that much easier. Moreover the generation of waste – per-capita has grown exponentially. Hospitals of today, which were always considered a seat of healing, have become seat of infection
Apart from the above consideration, infection contracted in a hospital settting is more difficult to treat because of mutated varients of microbes. Mutation in a hospital takes place in two ways. One in vivo and another in vitro. In other words infected waste strewn allover would undergo a process of mutation, which will be in proportion to the time the waste was left unattended before disinfection (limited up to desiccation). There have been doubts whether mutation in vitro is a known phenomenon. Many literatures have been consulted and it is now well established that mutation is very much possible in vitro as well.
Regeneration is a basic instict of any living species. So when the bacterial flora has to grow against an impinging atmosphere of antibiotic presence, where it cannot grow in its nascent form it has to acquire certain new features or property. That is precisely what must be happening. That would lead to mutated variety of microbial which would then dissipate as aerosol.
If the abovementioned hypothesis is accepted then it would be explainable as to why the hospital acquired infections are more difficult to treat.
It is a well-established fact that mutated varieties of microbial flora have been found in the underground water where Terramycin has been used as a food supplement of the chicks. Most glaring possible example of mutation in the
The AIDS virus has probably developed as a result of serialization of the otherwise non-viulent siman immunodeficiency virus (SIDS). It has been brought out by a researcher and published in the Lancet of Dc 8, 2001. During 1950s mass scale inoculation was given in Uganda and Somalia to fight against yaws. As an accepted practice, the syringes were not disinfected (considering the poverty of the countries), and many individuals were vaccinated with using the same syringe.
How and why this so far neglected topic has caught the attention of everyone in India suddenly? And if so it is certainly not too late. With the population explosion the natural barrier, which existed due to sparse population, has reduced. Spread of infection would therefore be that much easier and that much faster. At the same time the waste generation has become voluminous as per the increasing population, since generation of waste is directly proportionate to the population. Rural to urban migration has further caused havoc to the old civic amenities, which were laid out decades ago. So the population overload is one of the very important reasons for the condition of today. Most of the urban sewage systems are at the breakdown point, and are on the verge of collapse. The society does not have budget for replacing the age-old systems. One thing leads to another and the result is that the situation is becoming bad to worse, by the day.
A large portion of resources in terms of money or trained manpower is devoted to treating diseases, and for clinical preventable measures but hardly any concerted efforts are in the offing to improve the conditions where occurrence of these preventable disease itself, becomes a remote possibility. Hospitals are supposed to be seat of healing but with the present trend it has become a seat of infection. Spread of diseases by nosocomial infection is the order of the day. At the same time hospital acquired infections are more tenacious and difficult to deal with since the infection is by a more virulent strain, which is the result of mutation. There are a number of macro-observations indicating mutation in vitro.
Similar is the case with other infections. The society spends a very large portion of its resources on the treatment of patients who have been afflicted by disease process but not much is being done to root out the cause of spread of nosocomial infection. Cross infection in a hospital and hospital acquired infection have remained an area of great concern. Much deliberations take place the year around but no one pay much heed to the root cause. Hospital waste strewn allover the hospital compound is a major source of the spread of infection but still no focused concept has been developed yet. Rag pickers still are as active as ever. Studies done in a major hospital has brought out clearly that heaps of plastic syringes are carted away to a slum area and washed, repacked and brought to their collaborators in the city. These are then stocked as new ones and sold to the unsuspecting buyers. In certain cases the nexus between the rag pickers, the medicine shop owners and some of the nursing homes as well as hospitals are well-established .
On an average about 30% to 50 % one time use plastic syringes come back into the circulation. In fact the plastic syringes were encouraged and introduced so that nosocomial infections reduce. However that has not happened, at least in not in the developing countries, including India. As per the WHO “whereas introduction of the plastic syringes had the desired result in reducing the nosocomial infection in the developed countries it did not have any effect amongst the developing or the underdeveloped countries". It has been attributed to the wrong practices in the lower income group countries. It is estimated that in and around Delhi itself the total trade value of the recycled plastic ware (used in the medical management) is about Rs fifty million per year.
In the US, about one billion waste syringes are generated by patients of Diabetes taking domiciliary treatment. Each plastic syringe cost about $ 1 to 1.5. So that is a lucrative trade of about one to one and half a billion $. However the better part is that in the US the regulatory authorities, general awareness of the public is such that reuse of used plastic syringes is limited to group of drug abusers or drug peddlers. Unfortunately no such statistics is available in India, but it must be matching (of course in rupees). This being the monetary attraction effective measures will be required to deal with this menace.
In an urban area in India not all the nursing homes are rgistered, besides the umpteen numbers of quacks practicing and flourishing at every nook and corner of the cities, semi urban, and rural areas. In Delhi alone there are about 2500 nursing homes and hospitals registered. But there would be an equal number unregistered. Apart from the nursing homes there would easily be about 10,000 quacks in Delhi. Also there are domiciliary patients to cater to. Thus taking a comprehensive care of the biomedical waste in an urban area like Delhi would be a nightmare. The task may appear insurmountable. But with elaborate planning this can be planned and executed.
The WHO reports : -
1. Each person in the developing world receives 1.5 injections per year on the average. Hosp patients receive 10 to 100 times more injections.
2. At least 50% of all injections are unsafe
3. There was convincing link between unsafe injections and transmission of Hep B&C, Lassa virus and Malaria.
4. 20-80% of all new Hep B infections were due to unsafe injections.
5. In the world it is estimated that 16 billion syringes are sold every year, out of which 1 billion injections are given in the course of childhood vaccination program. Total manufacture capacity of plastic syringes reains at about 12 billion. Shortfall is obviously made up by reuse of plastic syringes, mostly in the developing world.
6. In Britain, an outbreak of Malaria took place in 1917 among soldiers who were given injections for Syphilis.
7. Introduction of disposable syringes largely reduced the problem in the developed world but not in the developing countries.
8. In India, 96% of injections were for antibiotic, vitamins and analgesics (in 1987).
9. 20% of 67 million new Hep B infections, each year in the developing world are due to unsafe injection.
10. Annual estimate of infection due to unsafe injection, worldwide is
( (i) Hep B --------------8-16 million
(ii) Hep C ------------- 2.3 – 4.7 million
(iii) HIV ---------------80,000-160,000
% Isolates with Methicillin resistant staph aureus has increased over a period of time from less than .1% in 1960 to 4% in 1969, 10% in 1984, 75 % in 1999, in a study carried out in the UK.
Of all hospital acquired infection the largest group is of upper respiratory tract infection-49.01% in the study carried out at an ICU at BHU, Varanasi.
The above mentioned research findings are indicative of mutation taking place in the infected discards of the hosp waste. More work is required to be undertaken to find out and establish on scientific platform the damage the untreated or uncared for hospital waste is causing to the society.
Though it can never be tangible the advantage the society will gain out of proper hosp waste management are tremendous. Perhaps the prevention of communicable diseases in number and quantity can never be specified, perhaps not even the number of cases thus prevented but the fact would remain that managing the hosp waste in a proper and scientific manner could bring about a very substantial change. This not only may save the resources of the society but also bring up the gradation of health. Could the chemicals in waste also contribute to the changed behavior and the mental outlook? It would be an interesting study if such a study can be undertaken.
Lalji K Verma
New Delhi
Apr 15, 2005
RELEVENCE OF ENVIRONMENTAL EDUCATION
IN THE 21ST CENTURY
Quest of man for better living explains the environmental exploitation. Every other living species know how to live in complete harmony with nature except the human beings. Resources of the nature are being used, and not replenished in every field and industrial activity. In fact industrial activity of the 18th century can be said to be the watershed in the development of exploitive societies. With the industrial revolution one can easily see the connection of population explosion which again is an indirect cause of environmental degradation. Environmental resources are limited whereas the human population is not. With increase in human population there is demand for more houses, more clothes, more buildings, more hospitals, vehicles, aircrafts, and everything else; and greater generation of waste. Human activities put a strain on the resources of the nature and exploitation leads to ecological imbalance. When we see the population growth in the last few centuries it is clear that every 100 years the population has been more than doubling:
Year Population
1750 791 million
1850 1262 million
1950 2526 million
2000 Over 6000 million
-And the population is growing exponentially in geometric progression. Malthusian theory that it will limit itself due to limit on availability of food stands falsified due to ingenuity of human mind. How long this ingenuity will let the growing human population sustain is yet to be seen.
Effects of growing population can be depicted in a pictorial form as below: -
Density
Migration
Urbanization
Industrialization
Construction Activities
Hospitals & Health Facilities
Morbidity
Waste generation including bio- medical
Individual & Societal stresses
Stress related to diseases
Consumerism
POPULATION EXPLOISION
Environmental Quality
Environmental Health
Quality of Food
Quality of Air
Quality of Water
Quality of soil
Physical & mental tolerance
Lower Health Status
Environment is something which surrounds, and environment & ecosystems are interdependent. It is the environment which sustains life on the planet. Basic fact is that the building blocks of life start from the capture of solar energy. If there were no plants or green life there would be no chlorophyll action and no life even if there was enough sun’s energy. Pollutants of human activity threaten human existence, and it is no more a question of ‘sustainable development’ but simply a question of ‘sustainable existence’. Pollutants cause environmental degradation of every conceivable dimension. It would be uncared for pollutants which will threaten the human existence and may not be shortage of food or water in the coming centuries. Progress and environmental sustainability appear adversarial but both can co-exist provided we take care of waste products in a manner that the waste of one can be used as input of resources of the nature for other activities. Today, there are initiatives focused towards ‘Zero Waste’ concept. Therefore one should aspire for achieving sustainable existence through application of principles of Zero Waste Concept.
That would only be possible when one knows about the environmental pollutants due to human activities. Environmental pollutants can be grouped in four categories as follows: -
1. Physical Pollutants
2. Chemical pollutants
3. Radiological pollutants
4. Biological pollutants
Noise pollution, pollution caused by floods, hurricanes, heat & GHG, particulate emission, global warming are all a result of physical pollution. Chemical pollutants are by far the biggest in the group. It means pollution caused by any of the chemical pollutants such as the Green House Gases, Dioxins & Furans, volatile gases, arsenic, mercury etc. Radiological pollutants would mean any waste or procedure which carry radiological waste along with such as the radiological means of treatment & diagnosis, x-rays, radiotherapy etc. But the chemical pollutants are by far the biggest scourge. Chemical pollutants are by–product of industrial activities, as well as of patient care activities. Chemical pollutants are also of the group commonly known as ‘dirty dozen’.
POPs are a group of toxic chemical pollutants harmful to human and wild life health (in fact all animals, birds, plants, and the human beings)
12 POPs also known as “dirty dozens” are listed by UNEP:-
-Aldin
- Chlordane
- Dieldrion
- DDT
- Dioxin
- Furan
- Hexachlor benzene
- Heptachlor
- Mirex
- Polychlorinated biphenyles
- Toxaphene
- Endrin
Other chemical pollutants are pesticides, herbicides, insecticides, chemicals used during war such as ‘agent orange’ etc, chemical fertilizers, chemicals in health care waste & in municipal waste etc.
Microorganisms cause diseases in humans. There is a relationship between host, environment, and the agent. All these act on each other and amongst each other to cause a disease. This is to say that biological pollutants would cause disease only when interaction between host, environment, and the agent has a positive derivation. Due to the fact that a lot many microbial floras in untreated medical waste keep on proliferating there is always a chance of bacterial mutation. SARS & Avian Flue is results of mutation and the microbes are becoming more deadly by the day.
Pollutants are known to cause many adverse effects on the health of an individual. Most of these chemical pollutants are neurotoxic and nephrotoxic. In fact most of these chemicals are known to cross the placental and blood brain barrier. Thus a child is exposed to the ill effects of all these pollutants from the womb itself. Dioxins have a predilection for depositing in the fatty tissues ad therefore there is greater prevalence of breast cancer etc amongst population living near to incinerators. All these pollutants enter food chain, bio-magnify through trophic levels and are cumulative. Thus effects of these chemicals are result of accumulated dosage. Wastes generated from industrial activities get accumulated in the aquifer by leaching, such as mercury waste, which also undergo the process of bio-magnification in the food chain. Thus one would find higher concentration of mercury in the tuna fish which is at the top of marine life in the context of trophic level. Children are more vulnerable to the ill effects of the pollutants as they consume more food, water, and air proportionately due to higher metabolic rate. Most of these chemicals get absorbed through skin, and thus a child is exposed to the chemical pollutants during early part of childhood more than adults while they play in the grass and come in contact with the foliage.
Therefore there are many reasons why one should know about the environment. But most important one is for the survival of the generations to come, for sustainability, and for existence with healthy surroundings and healthy environment. Education to a child starts from birth. Child learns to cry to demand food (milk). Thus there is acquired knowledge through self realization. The other would be imparted knowledge which comes through teaching and learning by examples. It is the later type of gathering knowledge where the role of elders is relevant. It is the bounden duty and responsibility of each citizen to impart knowledge to the children through teaching, examples and actions etc. Education on environment must not only come from the teachers and school but also from parents and elders in the family and society.
Environmental education today is inescapable and must be included in teaching schedule at all levels. Many tools may be employed for this, but the most important tool would be demonstrative teaching and training which will have greater impact on the mind of a child. Interactive group discussions, debates etc should be included in the teaching curriculum of schools and colleges. Demonstrated evidences of environmental degradation such as fly and mosquito breeding, putrefaction of waste, river pollution, water pollution etc could be some of the areas. Simple hygiene practices should be demonstrated and practiced in schools. Principles of healthy food intake, use of chemicals &fertilizers in agriculture & in food preservation, and its ill effects etc should be taught. Advantage of organic farming should be taught in schools. In fact it is rather surprising that there is hardly any emphasis on farming and agriculture in schools in a country like India where 80 % of population is agro-based.
Waste management such as segregation & collection of household waste in proper containers could be one of the important teaching schedules. Composting and other methods of waste disposal should form a part of syllabus. Children should be exposed to health care waste, its infectivity and danger it poses to the society at large. Facts that health care waste may be responsible for higher incidence of communicable diseases, higher hospital admission, compromised health status, and aberration in the personality of an individual etc should be included in the syllabus.
Astronomer Sir Martin Rees give 50-50 chance of making it to the 22nd century. The way we are exploiting the resources of the nature and the way wanton destruction is taking place almost everyday due to violence and terror his prediction may not be totally out of place. It is high time humanity wakes up to the challenges it has built upon itself to survive and thrive in the 21st & 22nd century.
Lalji K Verma
New Delhi
September 7, 2004
IN THE 21ST CENTURY
Quest of man for better living explains the environmental exploitation. Every other living species know how to live in complete harmony with nature except the human beings. Resources of the nature are being used, and not replenished in every field and industrial activity. In fact industrial activity of the 18th century can be said to be the watershed in the development of exploitive societies. With the industrial revolution one can easily see the connection of population explosion which again is an indirect cause of environmental degradation. Environmental resources are limited whereas the human population is not. With increase in human population there is demand for more houses, more clothes, more buildings, more hospitals, vehicles, aircrafts, and everything else; and greater generation of waste. Human activities put a strain on the resources of the nature and exploitation leads to ecological imbalance. When we see the population growth in the last few centuries it is clear that every 100 years the population has been more than doubling:
Year Population
1750 791 million
1850 1262 million
1950 2526 million
2000 Over 6000 million
-And the population is growing exponentially in geometric progression. Malthusian theory that it will limit itself due to limit on availability of food stands falsified due to ingenuity of human mind. How long this ingenuity will let the growing human population sustain is yet to be seen.
Effects of growing population can be depicted in a pictorial form as below: -
Density
Migration
Urbanization
Industrialization
Construction Activities
Hospitals & Health Facilities
Morbidity
Waste generation including bio- medical
Individual & Societal stresses
Stress related to diseases
Consumerism
POPULATION EXPLOISION
Environmental Quality
Environmental Health
Quality of Food
Quality of Air
Quality of Water
Quality of soil
Physical & mental tolerance
Lower Health Status
Environment is something which surrounds, and environment & ecosystems are interdependent. It is the environment which sustains life on the planet. Basic fact is that the building blocks of life start from the capture of solar energy. If there were no plants or green life there would be no chlorophyll action and no life even if there was enough sun’s energy. Pollutants of human activity threaten human existence, and it is no more a question of ‘sustainable development’ but simply a question of ‘sustainable existence’. Pollutants cause environmental degradation of every conceivable dimension. It would be uncared for pollutants which will threaten the human existence and may not be shortage of food or water in the coming centuries. Progress and environmental sustainability appear adversarial but both can co-exist provided we take care of waste products in a manner that the waste of one can be used as input of resources of the nature for other activities. Today, there are initiatives focused towards ‘Zero Waste’ concept. Therefore one should aspire for achieving sustainable existence through application of principles of Zero Waste Concept.
That would only be possible when one knows about the environmental pollutants due to human activities. Environmental pollutants can be grouped in four categories as follows: -
1. Physical Pollutants
2. Chemical pollutants
3. Radiological pollutants
4. Biological pollutants
Noise pollution, pollution caused by floods, hurricanes, heat & GHG, particulate emission, global warming are all a result of physical pollution. Chemical pollutants are by far the biggest in the group. It means pollution caused by any of the chemical pollutants such as the Green House Gases, Dioxins & Furans, volatile gases, arsenic, mercury etc. Radiological pollutants would mean any waste or procedure which carry radiological waste along with such as the radiological means of treatment & diagnosis, x-rays, radiotherapy etc. But the chemical pollutants are by far the biggest scourge. Chemical pollutants are by–product of industrial activities, as well as of patient care activities. Chemical pollutants are also of the group commonly known as ‘dirty dozen’.
POPs are a group of toxic chemical pollutants harmful to human and wild life health (in fact all animals, birds, plants, and the human beings)
12 POPs also known as “dirty dozens” are listed by UNEP:-
-Aldin
- Chlordane
- Dieldrion
- DDT
- Dioxin
- Furan
- Hexachlor benzene
- Heptachlor
- Mirex
- Polychlorinated biphenyles
- Toxaphene
- Endrin
Other chemical pollutants are pesticides, herbicides, insecticides, chemicals used during war such as ‘agent orange’ etc, chemical fertilizers, chemicals in health care waste & in municipal waste etc.
Microorganisms cause diseases in humans. There is a relationship between host, environment, and the agent. All these act on each other and amongst each other to cause a disease. This is to say that biological pollutants would cause disease only when interaction between host, environment, and the agent has a positive derivation. Due to the fact that a lot many microbial floras in untreated medical waste keep on proliferating there is always a chance of bacterial mutation. SARS & Avian Flue is results of mutation and the microbes are becoming more deadly by the day.
Pollutants are known to cause many adverse effects on the health of an individual. Most of these chemical pollutants are neurotoxic and nephrotoxic. In fact most of these chemicals are known to cross the placental and blood brain barrier. Thus a child is exposed to the ill effects of all these pollutants from the womb itself. Dioxins have a predilection for depositing in the fatty tissues ad therefore there is greater prevalence of breast cancer etc amongst population living near to incinerators. All these pollutants enter food chain, bio-magnify through trophic levels and are cumulative. Thus effects of these chemicals are result of accumulated dosage. Wastes generated from industrial activities get accumulated in the aquifer by leaching, such as mercury waste, which also undergo the process of bio-magnification in the food chain. Thus one would find higher concentration of mercury in the tuna fish which is at the top of marine life in the context of trophic level. Children are more vulnerable to the ill effects of the pollutants as they consume more food, water, and air proportionately due to higher metabolic rate. Most of these chemicals get absorbed through skin, and thus a child is exposed to the chemical pollutants during early part of childhood more than adults while they play in the grass and come in contact with the foliage.
Therefore there are many reasons why one should know about the environment. But most important one is for the survival of the generations to come, for sustainability, and for existence with healthy surroundings and healthy environment. Education to a child starts from birth. Child learns to cry to demand food (milk). Thus there is acquired knowledge through self realization. The other would be imparted knowledge which comes through teaching and learning by examples. It is the later type of gathering knowledge where the role of elders is relevant. It is the bounden duty and responsibility of each citizen to impart knowledge to the children through teaching, examples and actions etc. Education on environment must not only come from the teachers and school but also from parents and elders in the family and society.
Environmental education today is inescapable and must be included in teaching schedule at all levels. Many tools may be employed for this, but the most important tool would be demonstrative teaching and training which will have greater impact on the mind of a child. Interactive group discussions, debates etc should be included in the teaching curriculum of schools and colleges. Demonstrated evidences of environmental degradation such as fly and mosquito breeding, putrefaction of waste, river pollution, water pollution etc could be some of the areas. Simple hygiene practices should be demonstrated and practiced in schools. Principles of healthy food intake, use of chemicals &fertilizers in agriculture & in food preservation, and its ill effects etc should be taught. Advantage of organic farming should be taught in schools. In fact it is rather surprising that there is hardly any emphasis on farming and agriculture in schools in a country like India where 80 % of population is agro-based.
Waste management such as segregation & collection of household waste in proper containers could be one of the important teaching schedules. Composting and other methods of waste disposal should form a part of syllabus. Children should be exposed to health care waste, its infectivity and danger it poses to the society at large. Facts that health care waste may be responsible for higher incidence of communicable diseases, higher hospital admission, compromised health status, and aberration in the personality of an individual etc should be included in the syllabus.
Astronomer Sir Martin Rees give 50-50 chance of making it to the 22nd century. The way we are exploiting the resources of the nature and the way wanton destruction is taking place almost everyday due to violence and terror his prediction may not be totally out of place. It is high time humanity wakes up to the challenges it has built upon itself to survive and thrive in the 21st & 22nd century.
Lalji K Verma
New Delhi
September 7, 2004
A PRPOSAL FOR
SOLID WASTE MANAGEMENT
AT DWARKA
Preamble
Dwarka sub-city is a well planned modern township in the making. The township has been planned for approximately one million population. Over the last few years people have started settling down in this sub-city. The inhabitants, by and large are the retired people. About 40% of the dwelling units are already occupied, and with the flyover under construction more and more people are settling here by the day. The town planning is of modern concept.It needs to be maintained as such. There are a lot of green areas in form of parks etc, which is very pleasant. The residents generally are retired people from the Govt Service or the private sector. By and large the citizens are educated and aware lot where it will be easier to apply apt interventions for proper solid waste disposal.
Wherever there will be population there will be generation of waste. Waste is defined as something which has no further use. Human and animal activities in many forms generate waste. The natural course of waste treatment by the nature is limited in scope and quantity, since the environment is finite and so are its instruments of cleansing. The ecological balance is cyclic and aberration caused by activities of the living species gets automatically corrected. That is how the life thrives on the planet. But with the population explosion ecological balance is likely to trip. Just imagine what may happen if the plants cannot absorb carbon dioxide or fix energy by chlorophyll action of the primary producers. Overload on the environment and on the ecological balance, caused mainly by the population overload, rapid urbanization, and heightened activity of the humans tend to lead to such a situation.
Solid Waste
Solid wastes are the household (HH) or domestic waste, street and market waste and the industrial waste. Green waste may be referred to the waste generated out of the parks, gardens, cultivation etc. At Dwarka, there being no industry there is no industrial waste except some construction waste (which is temporary). Though all these waste has no further need it is not totally useless. Any organic waste has stored chemical energy which can be brought to further use. Burning reduces the waste to gaseous form, and to get back the lost energy again, the long chain of fixation of energy by chlorophyll action will be required. Hence burning of any waste should not be the choice at all.
Methods of Solid Waste Disposal
There are many methods of disposal of municipal solid waste (MSW). Age-old methods, of course are the composting by landfill, apart from burning. Then there are many other methods developed in the recent past decades based on ‘waste to energy’ or ‘waste to wealth’ concept such as production of gas for domestic purposes, or production of electricity. Composting is aimed at retaining the stored chemical energy for further use. Production of gas or electricity from waste, requires elaborate costly mechanical systems, and is labor oriented hence likely to suffer from ‘human failure’.
Disposal Area
The choice is limited to composting or any other modern system of MSW disposal. Dwarka does not have any earmarked dumping ground, or any laid down collection and disposal system of MSW. This is something which tends to make Dwarka a dirty township in the coming days if care is not taken now. The advantage that the population consists of retired and educated and enlightened people should not be lost sight of. The other advantage is that people have not got used to wrong practices, and therefore it will be easier to inculcate correct habits amongst the population. It is far easier to introduce good or correct habit than to correct entrenched wrong practices. The composting system of disposal requires an elaborate transportation network, labor force, and large land area for secured landfill. If the waste is not properly disposed off in the landfill then it would be a pernicious source of atmospheric pollution, besides being a source of disease and infection amongst the population.
Disposal
The waste being generated is mainly domestic waste and market waste. Common interventions can be easily applied which can take care of the domestic as well as the market waste. While it may not be possible at this point of time to predict or roughly estimate the market waste, it is possible to estimate the domestic waste. Quantum of solid waste generated differs widely depending upon the economic standard and the living habits. People in the higher economic bracket tend to use more of disposables thus increasing the quantity of waste. In higher income group such as the population at Dwarka, a figure of about 2 Kg per household (HH) can be taken as estimate. Out of this about 60% is the biodegradable part and the rest is non-degradable. Thus considering the present population at 4 Lakhs, the total domestic waste will be about 800 MT per day. Out of this about 480 MT would be bio-degradable component, and the rest plastic waste metal waste etc, which can be recycled.
Currently the waste is thrown and can be seen strewn allover the place- by the side of roads, parks, low lying areas etc. Bushes are the natural toilet for the migrant population. Thus the whole area remains unplanned dumping ground, and at places stinks.
The method employed by the NDMC is collection, transportation and disposal in few designated dumping grounds. As per the latest news all these dumping grounds are full and overflowing, forming a collective source of environmental pollution. Performance is also far from satisfactory. The waste is not collected regularly on the appointed day or time, carried in open trucks (whereas as per rules it should be carried in closed vans), and dumped in non-secured dumping grounds (it should be in a secured landfill and covered with a layer of soil or mud, which is never done). Therefore the system poses health hazard to the population at large. The dumped waste is scattered allover by scavengers, birds and wind.
The sub-city presently is under control and responsibility of the DDA. The DDA does not have any MSW disposal system with it as one of its designated responsibility or task. The NDMC displays its inability since the township has not been handed over to it as yet. The waste in the meantime continues to putrefy, and the population continues to suffer. In Bangalore, the BDA in similar situation has gone in for separate contracts to ensure solid waste is taken care of. Thus it is possible to undertake MSW management by the DDA, pending handing over to the NDMC.
The landfill system eventually aims to produce manure. But given the awareness and commitment of the waste handlers this system never works satisfactorily, success is totally dependant on the waste handlers who are non-skilled work force, and chance of ‘human failure’ is very high. Similarly the efforts to produce methane gas from the landfill fails when there are unskilled and not so committed work force. In any case methane adds to the green house gases (GHG), and is not recommended considering the issue of Global Warming. Other methods such as producing slurry etc and then electricity suffer from the same fear of failure because of complexity of the equipment, lack of skilled labor, and the day to day supervision.
The principle of the waste handling is that it does not pose a health hazard for the handlers or for the public at large, the environment, and at the same time can be brought to use. The intention should be to use this stored energy. Burning may also cause atmospheric pollution.
Therefore there is requirement of thinking and applying some other modern method of waste disposal which is not labor oriented, is not polluting to the environment, does not pose health hazard, and is easy to run and maintain. It has been seen on experimentation that once the waste is treated with regulated and controlled heat energy, it loses attraction for the flies, rodents, cats, dogs, birds, or any other scavenger while retaining its stored chemical energy. Moreover the system not being so heavily dependant on the skill of a large work force, nor requiring land- mass for composting, and produces manure in a matter of about an hour, is bound to succeed. This is not a hypothesis, but a proven fact based on scientific study which was undertaken during a WHO project for hospital waste management at Bangalore. The treated solid waste (including food waste) has been tested for protein, carbohydrate, and fat content, and hardly any change was noticed after the treatment. When the treated waste was left in different corners in the hospital in the open, it was found that flies, cats dogs, birds etc were not attracted towards it for a few days (till fungus growth started). The treated waste has been used as manure with satisfactory result.
Such programs would only succeed with community participation (which is true for any disposal method). Therefore a committed awareness program for the HH, the shop owners, and others generating waste will have to be undertaken. The unauthorized vendors of food items will have to brought within the purview of the municipal rules so as to discourage open vending of food items, and so that they collect their waste in the scientific manner, and become part of the system.
The mainstay of the system is a machine known as Bioclave, Hydroclave, and Vapoclave etc. All these names mean the same except that these are produced by different companies. The capacity of the machine or the number of units can be customized as per the quantity of waste it is intended to treat, and the cluster of houses or market waste to be taken care of. Each cycle lasts for about an hour. The end product can be used as manure or as a source of energy to cook food etc, in a bricket form by adding a compacting and a bricketting machine. The bricks or the manure can be sold to offset the running cost.
The system can be installed in an area of 20 ft x 20 ft. It runs on electricity. A water inlet is required. The area needs to be covered to make it safe from rain etc. The engineering details of the system is placed at appendix. Only one person is required to handle it, and he may be just semi-skilled. The system is rugged and can be operated 18 to 20 hours in a day without failure. There are fail safe attributes in the system, which takes care of the worker’s safety.
PROPOSAL
(a) A demonstration unit can be installed, with commitment of 2000 Kg of waste, at least. The system can be planned on turnkey basis, or otherwise. On turnkey the HH will be provided with two colored bags – one for bio-degradable, and the other for non-bio-degradable waste. The cost in such a case would be about Rs 2 to 2.50 per KG of waste.
(b) The equipment can be bought and installed. For running, training can be imparted. The project can be run as a pilot project. The cost would be less in this case, about Rs 1.50 per Kg.
(c) The total project be authorized on a turnkey basis, with capital investment to cover the cost of installation. Running can be the responsibility of the vendor at a mutually accepted terms and conditions.
(d) Training cost will have to be separate, in case so desired.
CONCLUSION
The feeling that landfill system is cheaper to run is a misplaced notion. It can be cheaper only when it is not run with due scientific consideration. That is when the transportation is by open rickety trucks dropping the waste on its way, when the lifting of the waste is not as per the laid down schedule, when door to door collection is not insisted, when the storage bins are the assembly point of the vagabond cattle to rummage in, when the cost of the land is not taken in reckoning, and the designated area is used as a dumping ground, and not as a secured landfill. The waste so dumped gets scattered allover by scavengers, birds and wind; and becomes source of spread of infection and pollutants. There is always the danger of polluting the underground water (aquifer) by leaching. Land is not available, or even if available it may become a problem in the future in a crowded country like India. Therefore alternates must be considered. What has been suggested above is one of the alternatives-well tried and tested.
It must be remembered that nothing comes free except misery, disease, pestilence, and infirmity. Therefore the societies must be prepared to spend money to clean the pollution brought about by its inhabitants, and thus help the environment to maintain its balance on which our survival depends.
Success comes by doing things differently rather than by doing different things
Lalji K Verma
New Delhi
Dec 20, 2002
SOLID WASTE MANAGEMENT
AT DWARKA
Preamble
Dwarka sub-city is a well planned modern township in the making. The township has been planned for approximately one million population. Over the last few years people have started settling down in this sub-city. The inhabitants, by and large are the retired people. About 40% of the dwelling units are already occupied, and with the flyover under construction more and more people are settling here by the day. The town planning is of modern concept.It needs to be maintained as such. There are a lot of green areas in form of parks etc, which is very pleasant. The residents generally are retired people from the Govt Service or the private sector. By and large the citizens are educated and aware lot where it will be easier to apply apt interventions for proper solid waste disposal.
Wherever there will be population there will be generation of waste. Waste is defined as something which has no further use. Human and animal activities in many forms generate waste. The natural course of waste treatment by the nature is limited in scope and quantity, since the environment is finite and so are its instruments of cleansing. The ecological balance is cyclic and aberration caused by activities of the living species gets automatically corrected. That is how the life thrives on the planet. But with the population explosion ecological balance is likely to trip. Just imagine what may happen if the plants cannot absorb carbon dioxide or fix energy by chlorophyll action of the primary producers. Overload on the environment and on the ecological balance, caused mainly by the population overload, rapid urbanization, and heightened activity of the humans tend to lead to such a situation.
Solid Waste
Solid wastes are the household (HH) or domestic waste, street and market waste and the industrial waste. Green waste may be referred to the waste generated out of the parks, gardens, cultivation etc. At Dwarka, there being no industry there is no industrial waste except some construction waste (which is temporary). Though all these waste has no further need it is not totally useless. Any organic waste has stored chemical energy which can be brought to further use. Burning reduces the waste to gaseous form, and to get back the lost energy again, the long chain of fixation of energy by chlorophyll action will be required. Hence burning of any waste should not be the choice at all.
Methods of Solid Waste Disposal
There are many methods of disposal of municipal solid waste (MSW). Age-old methods, of course are the composting by landfill, apart from burning. Then there are many other methods developed in the recent past decades based on ‘waste to energy’ or ‘waste to wealth’ concept such as production of gas for domestic purposes, or production of electricity. Composting is aimed at retaining the stored chemical energy for further use. Production of gas or electricity from waste, requires elaborate costly mechanical systems, and is labor oriented hence likely to suffer from ‘human failure’.
Disposal Area
The choice is limited to composting or any other modern system of MSW disposal. Dwarka does not have any earmarked dumping ground, or any laid down collection and disposal system of MSW. This is something which tends to make Dwarka a dirty township in the coming days if care is not taken now. The advantage that the population consists of retired and educated and enlightened people should not be lost sight of. The other advantage is that people have not got used to wrong practices, and therefore it will be easier to inculcate correct habits amongst the population. It is far easier to introduce good or correct habit than to correct entrenched wrong practices. The composting system of disposal requires an elaborate transportation network, labor force, and large land area for secured landfill. If the waste is not properly disposed off in the landfill then it would be a pernicious source of atmospheric pollution, besides being a source of disease and infection amongst the population.
Disposal
The waste being generated is mainly domestic waste and market waste. Common interventions can be easily applied which can take care of the domestic as well as the market waste. While it may not be possible at this point of time to predict or roughly estimate the market waste, it is possible to estimate the domestic waste. Quantum of solid waste generated differs widely depending upon the economic standard and the living habits. People in the higher economic bracket tend to use more of disposables thus increasing the quantity of waste. In higher income group such as the population at Dwarka, a figure of about 2 Kg per household (HH) can be taken as estimate. Out of this about 60% is the biodegradable part and the rest is non-degradable. Thus considering the present population at 4 Lakhs, the total domestic waste will be about 800 MT per day. Out of this about 480 MT would be bio-degradable component, and the rest plastic waste metal waste etc, which can be recycled.
Currently the waste is thrown and can be seen strewn allover the place- by the side of roads, parks, low lying areas etc. Bushes are the natural toilet for the migrant population. Thus the whole area remains unplanned dumping ground, and at places stinks.
The method employed by the NDMC is collection, transportation and disposal in few designated dumping grounds. As per the latest news all these dumping grounds are full and overflowing, forming a collective source of environmental pollution. Performance is also far from satisfactory. The waste is not collected regularly on the appointed day or time, carried in open trucks (whereas as per rules it should be carried in closed vans), and dumped in non-secured dumping grounds (it should be in a secured landfill and covered with a layer of soil or mud, which is never done). Therefore the system poses health hazard to the population at large. The dumped waste is scattered allover by scavengers, birds and wind.
The sub-city presently is under control and responsibility of the DDA. The DDA does not have any MSW disposal system with it as one of its designated responsibility or task. The NDMC displays its inability since the township has not been handed over to it as yet. The waste in the meantime continues to putrefy, and the population continues to suffer. In Bangalore, the BDA in similar situation has gone in for separate contracts to ensure solid waste is taken care of. Thus it is possible to undertake MSW management by the DDA, pending handing over to the NDMC.
The landfill system eventually aims to produce manure. But given the awareness and commitment of the waste handlers this system never works satisfactorily, success is totally dependant on the waste handlers who are non-skilled work force, and chance of ‘human failure’ is very high. Similarly the efforts to produce methane gas from the landfill fails when there are unskilled and not so committed work force. In any case methane adds to the green house gases (GHG), and is not recommended considering the issue of Global Warming. Other methods such as producing slurry etc and then electricity suffer from the same fear of failure because of complexity of the equipment, lack of skilled labor, and the day to day supervision.
The principle of the waste handling is that it does not pose a health hazard for the handlers or for the public at large, the environment, and at the same time can be brought to use. The intention should be to use this stored energy. Burning may also cause atmospheric pollution.
Therefore there is requirement of thinking and applying some other modern method of waste disposal which is not labor oriented, is not polluting to the environment, does not pose health hazard, and is easy to run and maintain. It has been seen on experimentation that once the waste is treated with regulated and controlled heat energy, it loses attraction for the flies, rodents, cats, dogs, birds, or any other scavenger while retaining its stored chemical energy. Moreover the system not being so heavily dependant on the skill of a large work force, nor requiring land- mass for composting, and produces manure in a matter of about an hour, is bound to succeed. This is not a hypothesis, but a proven fact based on scientific study which was undertaken during a WHO project for hospital waste management at Bangalore. The treated solid waste (including food waste) has been tested for protein, carbohydrate, and fat content, and hardly any change was noticed after the treatment. When the treated waste was left in different corners in the hospital in the open, it was found that flies, cats dogs, birds etc were not attracted towards it for a few days (till fungus growth started). The treated waste has been used as manure with satisfactory result.
Such programs would only succeed with community participation (which is true for any disposal method). Therefore a committed awareness program for the HH, the shop owners, and others generating waste will have to be undertaken. The unauthorized vendors of food items will have to brought within the purview of the municipal rules so as to discourage open vending of food items, and so that they collect their waste in the scientific manner, and become part of the system.
The mainstay of the system is a machine known as Bioclave, Hydroclave, and Vapoclave etc. All these names mean the same except that these are produced by different companies. The capacity of the machine or the number of units can be customized as per the quantity of waste it is intended to treat, and the cluster of houses or market waste to be taken care of. Each cycle lasts for about an hour. The end product can be used as manure or as a source of energy to cook food etc, in a bricket form by adding a compacting and a bricketting machine. The bricks or the manure can be sold to offset the running cost.
The system can be installed in an area of 20 ft x 20 ft. It runs on electricity. A water inlet is required. The area needs to be covered to make it safe from rain etc. The engineering details of the system is placed at appendix. Only one person is required to handle it, and he may be just semi-skilled. The system is rugged and can be operated 18 to 20 hours in a day without failure. There are fail safe attributes in the system, which takes care of the worker’s safety.
PROPOSAL
(a) A demonstration unit can be installed, with commitment of 2000 Kg of waste, at least. The system can be planned on turnkey basis, or otherwise. On turnkey the HH will be provided with two colored bags – one for bio-degradable, and the other for non-bio-degradable waste. The cost in such a case would be about Rs 2 to 2.50 per KG of waste.
(b) The equipment can be bought and installed. For running, training can be imparted. The project can be run as a pilot project. The cost would be less in this case, about Rs 1.50 per Kg.
(c) The total project be authorized on a turnkey basis, with capital investment to cover the cost of installation. Running can be the responsibility of the vendor at a mutually accepted terms and conditions.
(d) Training cost will have to be separate, in case so desired.
CONCLUSION
The feeling that landfill system is cheaper to run is a misplaced notion. It can be cheaper only when it is not run with due scientific consideration. That is when the transportation is by open rickety trucks dropping the waste on its way, when the lifting of the waste is not as per the laid down schedule, when door to door collection is not insisted, when the storage bins are the assembly point of the vagabond cattle to rummage in, when the cost of the land is not taken in reckoning, and the designated area is used as a dumping ground, and not as a secured landfill. The waste so dumped gets scattered allover by scavengers, birds and wind; and becomes source of spread of infection and pollutants. There is always the danger of polluting the underground water (aquifer) by leaching. Land is not available, or even if available it may become a problem in the future in a crowded country like India. Therefore alternates must be considered. What has been suggested above is one of the alternatives-well tried and tested.
It must be remembered that nothing comes free except misery, disease, pestilence, and infirmity. Therefore the societies must be prepared to spend money to clean the pollution brought about by its inhabitants, and thus help the environment to maintain its balance on which our survival depends.
Success comes by doing things differently rather than by doing different things
Lalji K Verma
New Delhi
Dec 20, 2002
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