Hordes of broken needles, soiled cotton and bandages, laboratory-tested samples, leftover coats, abandoned organs and used utensil, instruments and containers are the inevitable hazards of any hospital. The diseases such waste can lead to include AIDS, hepatitis, gastroenteric, respiratory, ocular and skin infections, septicemia and haemorrhagic fevers.Thus, the waste produced in the course of health-care activities carries a higher potential for infection and injury than any other type of waste.

Recognising the hazards associated with the biomedical wastes generated by hospitals, Armed Forces Medical College (AFMC), Pune in association with the Indian Society of Hospital Waste Management hosted ISHWM Con-2003 at Bhardwaj Auditorium, AFMC, Pune. The theme of the two-day conference was "Biomedical Waste Mangement-Introspection and Implementation".

Inaugurating the conference, Surgn Vice Admiral SP Malhotra said that hospitals in small cities and towns should pool their resources and manage the medical waste on a cost-sharing basis as management of the waste is very expensive. He also observed that paramedicos should also be aware of the method of managing the biomedical waste as it can lead to any number of diseases.

In his key-note address, Air Marshal SK Dham observed that despite a direction by the Supreme Court and subsequent gazette notifications by the Government of India, the health-care institutions in India do not follow a proper hospital waste management system. He urged the medical practitioners, media and NGOs to form their own code of conduct rather than depending on legislation. "The evidence of social commitment is visible but presumably a far greater thrust is required in this regard. The entry of NGOs in this field has helped in channelising and motivating public", opined the Air Marshal who is also the President of the Society.

Quantification and segregation of waste is the crux of the problem. On an average, a patient generates a waste of 2.5 to 3.5 kg per day. Thus, a hundred-bed hospital produces waste between 250 and 350 kg out of which hardly 10 per cent is infectious waste. If it is possible to handle this 10 per cent, the task is half done. The remaining waste such as cotton-related and biodegradable waste can be disposed of by conventional means like vermiculture, chemical treatment, incineration or deep burial.

However, this is not as simple as it appears to be. For example, take the case of most of the public hospitals. They admit patients more than their capacity. Besides the patients, the visitors also add to the garbage bin. Lack of civic sense on the part of the staff of the hospital compounds the problem. The conference suggested uniform disposal facilities. It also stressed the need for a standard colour coding for handling of wastes as has been done in all military hospitals.

The delegates appreciated the management of kitchen waste at the Artificial Limb Centre, Pune using
E-M technology. An exhibition of biomedical waste treatment technologies was inaugurated by Lt Gen JR Bharadwaj, Director General, Health Services, Air Force. On the occasion, a handbook on hospital management technologies was released by Lt Gen AK Lahiri, Director General, Medical Services (Army). During the two-day conference, more than 200 delegates participated.