MINISTER OF State for Environment and Forests Jayanthi Natarajan could land in a soup in the Lok Sabha for breach of privilege, for no fault of hers. On 29 August, in a written reply on the status of bio-medical waste in India, she submitted incorrect data — statistical evidence supplied by the Central Pollution Control Board (CPCB) for the past three years. Collating data from all the states, it claims that India treats more than 70 percent of the bio-medical waste it generates. If only it were true. Take Kerala for instance. The state pollution control board (SPCB) reported more than 1.65 lakh kg of waste generated per day in 2007. However, in response to TEHELKA’s queries, the board replied that the state generated less than half of that — 55,148 kg per day. There is also an inexplicable fall in the generation quantity to 32,884 kg per day in 2009. The board says this “may be due to the improvement of proper segregation of bio-medical waste”. But it really hasn’t bothered to check. Similarly, Rajasthan’s official daily generation reads 31,399 kg in 2007, 32,779 kg in 2008 and 19,591 in 2009. However, the SPCB said that it produced only 15,872 kg per day in 2007 and 9,782 kg in 2009. A typing error in the records for Madhya Pradesh states that they generated 65,213 kg waste per day in 2009, an impossible jump from 4,073 kg in 2008. But this discrepancy was not noticed by the CPCB. These cases illustrate the apathy of the monitoring authorities. The problem was even highlighted in the audit conducted by the Comptroller and Auditor General (CAG) in 2008, which said, “…since all the SPCBs did not submit annual reports every year, data was not comprehensive and may not be comparable year-wise”. So where is the untreated waste? In our backyards, along with household garbage. An estimated 250-300 gm of infectious bio-medical waste is generated per hospital bed per day. If left untreated, it can lead to meningitis, hepatitis or even AIDS. To prevent this, the government came out with the Biomedical Waste (Management and Disposal) Act, 1998. To oversee its implementation, SPCBs were roped in instead of health departments. The rule, which should have ensured the authorisation of hospitals, nursing homes and clinics catering to more than 1,000 patients per month, latest by 2002, is still waiting to be implemented at the ground level. This, as mentioned by the CAG report, is due to “lax monitoring” by most SPCBs. Because it is expensive for each hospital to create separate infrastructure for treating waste, the CPCB has actively promoted disposal at privately owned Common Biomedical Waste Treatment Facilities. The charge is Rs 2.5- 20 per bed or Rs 13- 25 per kg. Small clinics are charged a flat fee per month fixed by the SPCBs. To avoid this cost, some hospitals dump their toxic waste with general waste. It is then picked up by municipal workers and ragpickers, exposing them to hazardous elements and infectious microbes. The reduced waste is what gets reflected in the data submitted to SPCBs. The environment ministry plans to fix liability for damage caused by improper disposal of waste Andhra Pradesh has more than 1.2 lakh hospital beds. But according to 2009 statistics, it generated only 14,500 kg of biomedical waste per day. The actual data should be somewhere close to or higher than 30,000 kg per day if the average estimate of 250 g per bed is taken into account. Same is the case with Tamil Nadu, Gujarat, Jharkhand, and Bihar. A retired senior CPCB official, who doesn’t wish to be named, says, “SPCBs don’t manipulate data. If the quantity of bio-medical waste in the states is decreasing in spite of the number of hospital beds increasing, there’s something wrong.” Another problem is of compliance. Infectious waste is supposed to be incinerated and the less-harmful wastes should be first disinfected. Anu Agarwal, a consultant with an NGO Toxics Link, says, “Most facilities operate like open ovens, burning the bio-medical waste at a temperature of around 400 degrees Celsius when it should be above 1,000 degrees Celsius.” At lower temperatures, she explains, there is more chance of formation of harmful gases. According to the WHO, emissions from the partially burnt waste can be 40,000 times higher than the emissions limit set in the Stockholm Convention. Dr Ragini Kumari, a senior programme officer, Toxics Link, says, “Chemicals containing chlorine, chlorinated plastics and blood-bags contribute to these emissions. But chlorinefree plastics are not easily available.” Air Pollution Control Devices (APCD), which are mandatory in incinerators, were absent in 297 out of 547 facilities across the country in 2009. The number hasn’t changed considerably in spite of CPCB ordering the closure of the defaulters within three months in May 2010. Agarwal says, “CPCB guidelines say that a common treatment facility may cater to over 10,000 beds in a radius of 150 km. This ensures their economic viability.” But most of them dispose of far less than that. They sell plastic from bio-medical waste to make extra money and dump the rest. Dr S Vira, Senior Medical Administrative Officer at Sri Ganga Ram Hospital, New Delhi, concurs: “There are incinerators everywhere. We don’t need that many.” The statistics presented by the environment minister show that the number of defaulting facilities have come down from 19,090 in 2007 to 13,037 in 2009. The retired senior CPCB official says, “This points to an even bigger malaise. The figures don’t mean that compliance with rules has increased, but that the number of inspections carried out by SPCBs has declined.” And why would the SPCBs carry out inspections when there is no penalty it can lay down? The CAG blamed the Ministry of Environment and Forests (MoEF) for the problems as the ministry “did not clear the confusion regarding responsibility for implementation of the waste rules” at both the Central and state levels. To address these issues, the MoEF, on 24 August, came up with a new draft of the Bio-medical Waste (Management and Handling) Rules, 2011. It proposes roping in people from health, environment and urban development departments, along with local bodies, in the advisory committees to be formed at state and district levels. “This is being done to make sure that these organisations own up to their responsibility of disposing of bio-medical waste and become active participants,” says J Chandra Babu, environment engineer at CPCB. The draft also aims to fix the liability for the damage caused to the environment. Provisions have been made to make sure that common treatment facility operators keep separate records of waste incinerated, disinfected and buried. Although the solutions proposed look good on paper, Dr Archana Thakur, professor of microbiology at GB Pant Hospital, New Delhi, disagrees. She says, “There are practical problems in disposing syringes. It is easy to make laws, but what’s the point when they’re not implemented.” But the CPCB was ill-equipped to begin with. B Vinod Babu, in charge of Hazardous Waste Management division in CPCB, says, “Under Environment (Protection) Act, 1986, CPCB can issue notice to any facility found to be violating rules. Under the Water Act, we can give directions to SPCBs or even take over their functions.” However, to do that, CPCB has no manpower. An evaluation conducted in 2010 by Indian Institute of Management, Lucknow, shows that CPCB is in need of 550 more people, 308 of them immediately. Considering it would take approximately 2-3 years for a hospital to train its staff in proper segregation of bio-medical waste, efforts are required from all stakeholders. But, in a country of 1.2 billion people, only one educational institute — Indira Gandhi National Open University — runs a course in healthcare waste management. Without radical reform, the basic rights — right to life, health, and safe and healthy working conditions — would continue to be violated. Will there have to be an epidemic before the authorities concerned sit up and take notice? Prakhar Jain is a Trainee Correspondent with Tehelka.