Jaipur: Despite tall claims by the National Rural Health Mission (NRHM), Rajasthan on strategies to dispose of bio-medical waste, successive (3rd, 4th and 5th) Common Review Mission (CRM) reports have highlighted the state’s lackadaisical approach towards handling bio-medical waste. Even the largest state-run facility SMS Hospital that is located in the heart of the city, does not adhere to Bio-Medical Waste (Management & Handling) Rules. According to the 5th CRM report, “No system for bio-medical waste management, sterilization of equipment, infection control exists in Barmer. The facilities visited had poor arrangements for bio-medical waste disposal systems. Some facilities had been provided with color-coded bins but the staff was trained in the use of the bins. At primary health centre (PHC) of Bhagsoda these bins were kept adjacent to the casualty area. At PHC Ghosunda in Chittorgarh and PHC Dhanau in Barmer the waste was disposed of in the open bin just adjacent to the facility.” There are said to be approximately 14,000 government hospitals in the state which include hospitals attached to medical colleges, district and other hospitals, community health centers (CHCs), PHCs and sub-centers. However, as per the records available, only about 950 government hospitals are under authorization/consent mechanism by the state pollution control board under the Bio-Medical Waste (Management & Handling) Rules 1998, Water (Prevention & Control of Pollution) Act, 1974 & Air (Prevention & Control of Pollution) Act, 1981. While NRHM, Rajasthan clearly states that compliance with Bio-Medical Waste (Management & Handling) Rules 1998, the health care facilities are required to obtain authorization/renewal of authorization certificate from state pollution control board, there is little adherence to the rules. To add to the woes, the pollution control board is merely a paper tiger that so far has not prosecuted a single government facility for violating norms. Another report states that even large hospitals like Sawai Man Singh Hospital, Jaipur, MBS Hospital Kota, Jhalawar Hospital and Medical College, Jhalawar have failed to fully comply with the provisions of various acts/rules despite repeated letters and show-cause notices. It is evident that the majority of the government hospitals are in violation of the provisions of the various environmental regulations. Sources in the SMS Hospital have confirmed having received repeated reminders from the Rajasthan State Pollution Control Board. At the moment there are 11 Common Bio-Medical Waste Treatment and Disposal Facilities (CBMWTDFs) established in the state for collection, transportation and disposal of the bio-medical waste. Besides this, one facility located at Agra is allowed to collect, transport and dispose of bio-medical waste of Dholpur district. Yet bio-medical waste is disposed of without a care.