It is an indisputable fact that the earth is not inherited; rather, it is merely to be held in trust for generations to come! Balancing the interests of the present with those of the future has indeed become a difficult task in itself due to the selfish and unmindful tendencies of human nature. This being so, there is a constant conflict of interests with matters relating to environmental protection. Healthcare is undoubtedly an inevitable facet of human existence. The very functioning of healthcare establishments generate waste, which in turn needs to be effectively managed. The focus of this article is the legal control of management of such waste in India with special reference to the State of Goa.
Over the years there have been tremendous advancements in the healthcare system. However, it is ironic that the healthcare settings which restore and maintain community health are also threatening their well-being. Poor waste management practices pose a huge risk to the health of the public, patients, professionals and contribute to environmental degradation.
Bio-medical waste means any waste fabricated during the diagnosis, testing, treatment, research or production of biological materials, by either animals or mankind. Such waste has the potential to be hazardous to human health if it is left unregulated. It originates from bio-medical waste facilities, such as hospitals, clinics, nursing homes, laboratories, funeral homes, dentist offices, veterinarian or physician complexes, medical transporters (e.g., ambulances) and storage and treatment facilities for biological entities since they all produce bio-medical waste. It contains human body parts, tissues and organs as well as animal body parts, carcasses, excreted bodily wastes, parts containing blood and wastes generated at veterinary hospitals.
Items that come into contact with biological-waste functions are also considered bio-medical waste originators. Needles, syringes, blades, scalpels, blood stained material or cotton balls and dirtied plasters are a few such examples. Discarded medicines, used tubing and catheters, chemicals used for disinfection purposes and any waste that is a consequence of laboratory upkeep are all instigators of bio-medical waste as well.
World Health Organization (WHO), in its classification of waste, classifies
bio-medical waste into the following categories: general waste, infectious waste, pathological waste, radiological waste, chemical waste, pharmaceutical waste, sharp and pressurized waste. This categorization is on the basis of weight, density and constituents of the waste. As per the available documentation in a given context of a modern hospital, the average waste ranges between 1.5 and 2.5 kg per day per bed.
It constitutes plastics, paper, glass, linen, metal, human flesh and organic tissues.
The percentage of wastes may vary from hospital to hospital, depending upon its practices.
The state of Goa has a rapidly growing healthcare delivery system both in terms of government involvement and in respect of private players who have been responsible for the mushrooming of new hospitals with super-specialties and state-of-the-art facilities. This is mainly due to the fact that the state is a domestic and global tourist destination that has converted it into a hot spot for medical tourism.4 Needless to say, such healthcare establishments are expected to generate a large quantum of hospital waste, especially where ‘foreign patients’ expect the ‘dispose after use’ rule for practically every durable used in the establishments. Healthcare is an inseparable part of human resource and therefore, such a situation coupled with the ever-rising migrant labor class presence due to the year-round real estate industry have increased the demand for additional healthcare facilities like pathology laboratories, dental clinics and dispensaries on a regular basis. All of these will but naturally, contribute to the rising quantum of bio-medical waste generated in the state. In view of these facts, the state of Goa will witness the amount of bio-medical waste generating for the next decade increasing to several metric tons/day.
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