China's medical waste piles up

NANNING - Although China has regulations on disposal of medical waste, the danger of pollution from such waste remains very real, experts have warned.

In 2003, the central government regulated the administration of medical waste, requiring county level governments to build disposal centers where all biohazardous material is treated. The regulations led to collective treatment of medical waste and many disposal centers were established.

Despite regulations, problems continue to crop up. Dangers of pollution still loom, said Luo Jiefeng, deputy director of the health bureau's office of medical affairs in Guangxi Zhuang autonomous region. "While the law requires all medical scrap to be treated collectively, many hospitals and clinics are not abiding by law due to poor management and substandard facilities," Luo said.

Medical waste can carry transmittable disease and chemical risk for those who come into contact with it. Plastic in the waste can cause "white pollution", said Yang Li, deputy director of nursing at the First Affiliated Hospital of Guangxi Medical University.

In 2002, total production of medical waste stood at about 650,000 tons, averaging 1,780 tons per day. The figure has increased by 10 percent every year since, and now stands at roughly three times that amount, consisting of disposable items including sharps, human tissue and organs, bodies of animals used in experiments, dressings, patients'body fluids including blood, etc, said Huang Zhiyong, vice principal of Guangxi Academy of Social Sciences.

In 2011, the municipal government of Guangxi' s Qinzhou city, home to over 300 rural hospitals and clinics, invested more than 18 million yuan (about $3 million) in building a disposal center 13 kilometers from the city, but it is not living up to expectations.

"We send trucks all over to make collections every day, but many hospitals and clinics are far from arterial roads," said Pan Ling, deputy general manager of the center's operating company. The company can only make collections from 118 medical institutions, leaving more than 200 to basically clean up their own mess.

"The center can deal with about five tons a day, but we are only processing three," Pan said.

Way off the beaten track, the problematic material is simply burnt using diesel oil at appointed places without any decontamination, according to Xie Xiuchuang, from the health bureau of Lingshan County, Qinzhou. "This is bound to cause air and water pollution, and things like glass bottles are never completely destroyed," he said.

Another issue for local governments is poor management of disposal centers, mainly due to a lack of qualifications.

In August, residents in Chongkou Village, Guilin city started a blockade against a local disposal center they accused of irresponsiblity. The people of Chongkou have never been happy since a disposal center was established just 600 meters away from the village in 2003. The center was upgraded in 2010, becoming a disposal center for Guilin city, and suddenly about six tons of medical waste from more than 300 hospitals and clinics was arriving there every day. Earlier this year, local people discovered that waste was frequently lying in the open air for months without any treatment. Regulations state that the material should be disposed of within 24 hours. The furious villagers took it upon themselves to shut down the center.

The revolt of the local population created quite a panic among hospitals in Guilin, which cannot handle waste on site. Wang Changming, head of the Affiliated Hospital of Guilin Medical University, said that his hospital produces about one tonne of waste which is collected and sent to the center every day. "The center did not collect the garbage for days and the rubbish piled up in out temporary storage," Wang said.

Villagers soon found out that the center's operating company was not qualified to run it, and their equipment had not been tested.

Chongkou has now stopped their blockade, which lasted over a month, thanks to the intervention of the Guilin government, but the worries live on, said Qin Zengrong, a local villager. "I hope that the government can find safer and more efficient measures to deal with this problem," Qin said.

Further complicating the process are the high expenses, Pan Ling said.

Medical waste in Guangxi was handled by sanitation departments in the past, and hospitals and clinics only had to pay one yuan for each bed. Now, expenses have surged to at least 2.5 yuan per bed. Some institutions have refused to pay the increase, putting heat on the treatment centers. This will eventually lead to cessation of operations, and a huge amount of medical waste will go untreated, according to Pan, who added that similar problems have been reported in other areas.

Yang Li believes that waste processing should be a public service, and that governments, rather than hospitals, should pay for it.

"If the situation continues, hospitals will transfer the increased cost onto patients, which will only add to their burdens," Yang said.

Huang Zhiyong urged the government to allocate more funds, build more standard facilities, improve training for staff in the centers, to reduce the problem of secondary pollution.