Over the years, solid waste management system in Lahore has evolved from being archaic to a modern and mechanised one.

For decades, solid waste was collected manually and disposed off in an unsafe manner. People resorted to burning it in open plots or even on roadsides. Scavengers also had a major role in this context as they would sift through the deposits of solid waste in different areas and pick objects of their choice.

A major change came after the formation of the Lahore Waste Management Company (LWMC) and awarding solid waste collection and disposal contracts to Turkish companies. There might be a disagreement among critics on the processes involved and terms of the contracts but there is a consensus on the fact that the level of cleanliness in the city has increased. Barring days when workers go on strike for any reason or there is suspension of work due to financial issues, things at LWMC are fine.

While there is a system in place to handle municipal solid waste, there is an area which has remained largely ignored even at the cost of people’s lives and health. The reference here is about the lack of a foolproof system to dispose of hospital waste, especially the infectious one, generated at health facilities including public and private hospitals, dispensaries, clinics, pathological laboratories etc.

This waste is very harmful but still reaches some manufacturers who recycle it to make cheap plastic products of daily use, says Ali Rasikh who deals in medicines and medical products. "People who come in contact with such products or consume liquids or food items stored thus are at high risk of contracting serious ailments," he says.

"Recycling hospital waste is totally illegal but mafias benefitting from this trade break law with impunity. Where there is money there’s a way."

Different reports and investigations suggest that recycled hospital waste is used to make items such as feeding bottles for babies, disposable plastic spoons, plates, glasses, pots, utensils, toys for children etc. The hospital waste products recycled for this purpose can be anything like blood bags, urine bags, syringes having traces of blood, samples and containers used in pathological tests.

Ayaz Saleem, an importer of plastic granule, says that the plastic used in medical products is virgin plastic which is a high-value product. Due to this, even the products formed after recycling may appear to be of high quality but they aren’t safe due to the presence of infectious material in them. "Some people think the infectious hospital waste can be purified by washing, heating, and melting, but this is not possible."

Saleem says that businessmen like him suffer because the raw material they import is many times more expensive than what is supplied by the recyclers of infectious hospital waste. He suggests the consumers must also be watchful and avoid buying plastic products that are amazingly cheap because the health risks are far bigger than the savings they make. "Would you buy mutton if it is on sale for Rs300 per kg or milk for Rs30 per kg?"

The infectious hospital waste is harmful even if it is buried at landfill sites because it may contaminate the soil and the air surrounding the place as well as infect the municipal solid waste deposited there. So the best option is to incinerate the hospital waste and then bury the residue at landfill site. For that, there should be enough incinerators in the city to burn this stuff but unfortunately this is not the case.

The situation on ground is that out of the 17,400 kg hospital waste generated in Lahore every day, only 3,000 kg is reaching the Children’s Hospital for incineration through a strong monitoring system installed by the LWMC. The said hospital houses two incinerators that burn waste generated at four public-sector hospitals -- namely, Children’s Hospital, Ganga Ram, Lady Aitchison and Jinnah. The remaining is lifted and disposed of by a private party in a manner where chances of pilferage are high.

One wonders if recycling of such harmful substances is going on in the city, what are the government departments doing to stop it?

Naseemur Rehman, Director at Environment Protection Department (EPD), Punjab, says the department raids the places they doubt hospital waste is being recycled or kept for recycling at. He reveals that last year the department raided a place on Bund Road, Lahore, and found 60 tonnes of hazardous waste lying there. "It’s a big challenge," he says, "even to dispose of this stock."

Rehman further says that there are rules formed in 2005 and amended in 2014 that define procedures to dispose of hospital waste, and the government departments are trying their best to follow them. A problem in this respect, he says, has been the shortage of incinerators in the province but the good thing is that the number is increasing gradually.

He says the monitoring of hospital waste management is mainly the responsibility of the health department, and the other departments only provide support to it. "The health department has asked the Punjab Healthcare Commission (PHC) to stay vigilant and introduced systems at hospitals on how to collect hospital waste category wise and ensure their pilferage-free transport to landfill site."

As for solutions, Rehan Paracha, Project Director, Hospital Waste Management, at LWMC, says the company has developed a foolproof mechanism under which hospital waste is collected in bags that are properly sealed and carry barcodes. These bags are weighed and loaded in vehicles for transportation to Children’s Hospital for incineration. "The whole movement of vehicles is tracked and there is no possibility of pilferage."

Paracha says that at the moment they are treating 3,000 kg waste of four teaching hospitals per day but will be able to cover the whole 17,000 kg waste once the three approved autoclaves are installed in Lahore. Each of these autoclaves will have the capacity to treat 5,000 kg waste per day. (For the uninitiated, autoclaves are used as heat treatment processing units to destroy micro-organisms of hospital waste before disposal at a traditional landfill.)

As per the government plan, the three autoclaves are to be installed by a consortium of Pakistani and Chinese companies that will also be responsible for operating these for 10 years. The government has earmarked Rs400 million for the purpose but the project has not kicked off yet. It is suggested that the required equipment is installed without any further delay to save the citizens from hazardous impacts associated with the use of recycled hospital waste.