Mismanagement of medical waste

The rapid growth of the medical facilities around Dhaka and the rapid move towards the use of disposable medical products has contributed to the massive amount of medical waste produced by such facilities like hospitals, clinics, pathology and diagnostic centres. This can be a threat for communicable diseases to the people exposed to those waste. It is not only a hazard to the individuals directly exposed to medical waste, but also to the surrounding community and to the wider environment. Many countries maintain stringent management systems for management and safe disposal of medical waste to minimise the risk. However, for rapidly growing megacity Dhaka, it has become a cause for concern that needs to be seen as an emergent threat.
Our research in collaboration with Teesside University UK and Stanford University USA revealed that there may be a layered arrangement of hidden networks. These networks may operate at every level and influence the bottom layers of the arrangement, comprising scavengers and unofficial recycling operatives. Interaction between the networks does not appear to be constructive, with evidence of corruption, subservience. It appears that the layered network structure is stabilised by aspects of poverty, caste and fatalism.
Many people rely on the present unregulated and informally managed system for their livelihoods, including waste workers, waste scavengers, truck drivers, waste dealers and union leader. Healthcare establishment operatives and officials are engaged to sell high sensitive drug such as Morphine and Pethidine injection, painkillers, including sleeping pills to the waste scavenger. They are involved with this illegal activity to earn their daily cash money and use date expired medicine as a drug. Drug dealers have developed a strong network with the scavengers.
Barriers to adoption often appear to include a lack of resource and a lack of commitment at the national level, but there is also evidence for cultural and organisational barriers. Thus, to minimise the potential risks associated with medical waste, it is necessary not only to identify the structured network, but also identify how the network is structured to a plan for socio-cultural and organisational acceptance from top to bottom. Therefore, we need to identify the behavioural and socio-cultural aspects towards structured network that may influence psychological attitudes on proper medical waste management.

The writer is Head, Department of Geography and Environmental Science, Begum Rokeya University Rangpur.
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