‘Health Without Harm’: Reducing Risk from Healthcare Waste in India

The Global Healthcare Waste Management project, implemented by UNDP in partnership with the Ministry of Environment and Forests and supported by WHO and Health Care Without Harm is helping promote best practices in healthcare waste management and mercury waste management at King George’s Medical University in Lucknow, India. The project is funded by the Global Environment Facility. As a result of a series of interventions, the hospital has been able to reduce the amount of infectious waste generated by 80 percent due to proper segregation, transportation and treatment of waste practices.

Highlights

  • The Global Healthcare Waste Management project is helping promote best practices in healthcare waste management in a hospital in the King George’s Medical University in Lucknow
  • The project, implemented by UNDP and funded by GEF, has helped reduce the amount of infectious waste in the hospital by 80 percent
  • Training in proper segregation, transportation and treatment of bio-medical waste has also helped in reducing health and environment risks through bio-medical waste
  • The hospital also earns INR 18,00,000 (US$ 32,700) annually through recycling the hospital waste

In the north Indian state of Uttar Pradesh (UP), the King George’s Medical University (KGMU) has added a new milestone to its 100-year legacy. One of the largest hospital complexes in north India, it has been transformed over the last few years from a hospital that did not have any healthcare waste management system in place to an institution which today embodies sound healthcare waste management practices, generating less than one-fifth of the infectious waste generated three years ago.

Efforts at KGMU are a result of the hospital’s participation in the Global Healthcare Waste Management project, an initiative underway in eight countries to demonstrate and promote best practices aimed at reducing the health and environmental risks of waste generated in hospitals. Implemented by UNDP with support from WHO and Health Care Without Harm, the project is funded by the Global Environment Facility. In March 2013, the Bio-Medical Waste Management Committee of the hospital received a Special Recognition Award from the global project team. 

Spread across 1.5 kms, KGMU has 49 buildings and a 3,000 bed hospital in Lucknow, the capital of UP. Five-hundred resident doctors cater to almost 2,000 outpatients every day. However, with a ratio of one nurse to every 60 patients and limited human and financial resources, implementing sound bio-medical waste management practices was a challenge.

Before project interventions began in 2010, 2,500 kgs of waste generated at the hospital every day was simply disposed of in the open with the risk that it would find its way into the rest of the city’s municipal waste. The health risk of such an approach is summarized by Dr. Kirti Srivastava, Member Secretary, Bio Medical Waste Management Committee, KGMU, who says, “Between 10-20 percent of waste generated by a hospital is infected waste but if you don’t segregate this infected waste from general waste, similar to say household waste, then you will actually need to treat 100 percent of the waste generated in your hospital.”

The hospital complex had no systematic bio-medical waste management programme in place to segregate bio-medical waste from ordinary waste. Handling infectious waste was considered the responsibility of sweepers and waste handlers who had no training on the infectious potential of the wastes nor given any protective gears. Bins of overflowing waste lying around were a common sight.  

After three years of intensive efforts at KGMU, the situation has been completely transformed. Infrastructure for treating waste has been built and specially designed waste segregation storage containers are used by hospital staff. Special trolleys for collection and transportation of waste have been made. The KGMU Bio-Medical Waste Management Committee recruited a doctor from each of forty-nine departments to monitor progress of each unit. In addition, training in proper waste management practices is regularly provided to all hospital staff.

Today, KGMU generates less than 500 kgs/day of infectious or hazardous waste. The hospital also earns INR 18,00,000 (US$ 32,700) annually through recycling this waste. Further, initiatives have been taken to handle general waste. A general waste collection area and a programme to compost organic waste are being initiated. In addition, KGMU is shifting to non- mercury thermometers, sphygmomanometers, and other medical instruments, and is developing programmes to collect and manage its e-waste and liquid waste.

While India has taken many steps over the past few decades to address pollution caused by healthcare waste, it is estimated that only just over 50 percent of the country’s 84,809 hospitals and healthcare facilities in India properly treat their waste and properly segregate infected waste from non-infected waste.

Improving healthcare delivery systems is a key priority for countries like India where, for example, there are only 45 doctors for every 100,000 people. The experience of KGMU holds important lessons for India’s healthcare system to realize the objective of ensuring ‘health without harm’.

Projects and Initiatives
Demonstrating and Promoting Best Techniques and Practices for Reducing Healthcare Waste to Avoid Environmental Releases of Dioxins and Mercury

In partnership with the Ministry of Environment and Forests, Government of India, the project aims to demonstrate best practices in healthcare waste management such as promoting the use of alternative waste treatment technologies, improved waste segregation practices, waste minimization and the use of appropriate alternatives to mercury-containing devices.

Click to Download Factsheet