Used PPEs, gloves, masks pile up in Delhi crematoriums; lack of public awareness leaves city facing biomedical waste crisis
In Delhi, there has been no awareness building around COVID-generated biomedical waste and how to safely deal with it.
Pre-COVID, Delhi’s crematoriums used to be littered with heaps of withered marigold, broken bits of earthen pots, tetra pak containers of ghee and mineral water bottles.
Today, even as COVID has made cremation of bodies a challenge and sharply restricted attendance at funerals, the garbage dumped at these sites — consisting mainly of biomedical waste as people carelessly strew their PPEs, masks, gloves, shoe covers worn to funerals — is becoming a health hazard.
Such are the proportions of the problem that on 22 June, the South Delhi Municipal Corporation slapped a Rs 50,000 penalty on the Arya Samaj, which manages the Lodhi Road crematorium in south Delhi, one of the five designated COVID crematoriums in the city.
The penalty itself was only a token move, considering that the SDMC had on that day pressed into service 12 trucks and staff who had to work till late into the night to clear the crematorium and its parking area of discarded PPE kits.
The Central Pollution Control Board (CPCB) estimates that Delhi generates at least 11 tons of COVID-related biomedical waste daily, with every possibility of this number increasing over the next few weeks.
From the street children at traffic signals to VVIPs, everyone in the city — as indeed in the country — knows the importance of wearing a mask, saying “namaste” instead of shaking hands, and maintaining “do gaz ki doori”. But few have seen yellow dustbins, let alone know why they are necessary, along with the blue and green ones at home or in public places.
The CPCB, in colour coding different types of garbage, has chosen yellow bags and yellow bins for the collection and trashing of biomedical waste.
While most big hospitals and labs have yellow bins, they are nowhere to be seen in public.
Dangers from mixed waste
There has been no awareness building around COVID-generated biomedical waste and how to safely deal with it. Households have an idea about the need to separate their wet waste from dry waste, with electronic waste forming a third category.
But municipal corporations have not informed the public of the need have a third bin to dispose of used masks, PPEs, shoe covers, and gloves.
At the best of times, managing the capital’s mounting mounds of garbage has been a nightmare. Now, when the city is listed as a COVID hotspot, no one know hows much of the biomedical waste generated daily has ended up in landfills, though municipal corporation officials admit it has.
Their explanation is poor and tardy segregation of waste at source.
One statistic that points to the fact that contaminated COVID biowaste has been mixed with general waste is that over 45 sanitation workers have tested positive with 37 in hospital, and according to the Delhi Safai Karamchari Association, 15 have died. The association president Sanjay Gahlot said he has no doubt that these workers contracted the virus from handling contaminated waste.
Though there is basic awareness that containing the virus depends greatly on proper sanitation and hygiene, that the virus spread is also related to scientific waste management has not gained public attention.
“Waste management comes at number one,” said independent waste management expert Swati Sambyal. In her view, leaving aside the New Delhi Municipal Corporation area, that is Lutyens’ Delhi from where the Government of India governs the country, the rest of Delhi does not segregate its garbage.
With increasing instances of asymptomatic people testing positive, this kind of mixed waste can create havoc, say experts. Especially since many sanitation workers who collect household waste are not always wearing masks, or are wearing masks discarded by others or which they have picked up from the garbage. And hardly any of them wear gloves, let alone any PPEs.
“Ideally they should be given a new mask every day,” said Sambyal. “They are directly exposed as they are dealing with mixed waste and sorting it. There are protocols in disposing such PPEs.”
For instance, a mask should be ripped up, wrapped and given to the collector separately to ensure nobody uses them again.
Creating awareness on the dangers involved in handling such waste and how to correctly dispose of PPEs is the challenge.
A resident of West Delhi’s Punjabi Bagh who did not wish to be named said residents and their Resident Welfare Associations have not been informed of any new or different way of handing over household waste to the sanitation worker.
“Earlier we used to segregate wet and dry waste,” she said. “Now the collector has told us not to bother, because he will bring the bag for wet waste one day, and one for the dry waste the next day. And they are in a great hurry to collect and leave.”
Incidentally, they have not heard of a yellow bin, or the need to segregate masks and gloves from other waste. Nor are they aware that biomedical waste generated by COVID-related health protocols cannot be treated like other biomedical waste.
“There are senior citizens using diapers, there are sanitary pads, cotton swabs and babies’ diapers,” said Malini Sivaram a member of the subcommittee on waste segregation at the Azad Apartments adjoining the Delhi IIT campus.
Azad Apartments is one of seven societies chosen for focused segregation of waste. “We don’t know who is asymptomatic, who has mild symptoms and who is self-quarantining,” Sivaram added.
Given the difficulties in getting tests done and finding hospital beds, Malini said many are trying to deal with flu symptoms on their own.
For her part, she has asked residents to discard the masks they have used separately and urged RWAs to get in touch with the SDMC for detailed information of waste segregation in the light of COVID. “The guidelines we received last week were no different from what we had been following for over a year,” she said.
As the government now clearly wants patients with mild or no symptoms to remain in home isolation, it is particularly urgent that a fresh set of guidelines to the public and sanitation workers on collection, segregation and disposal of biomedical waste be issued.
What municipal corporations say
The five local bodies — the municipal corporations of North Delhi, South Delhi, East Delhi, and New Delhi Municipal and the Delhi Cantonment Board — said they have devised systems to manage this issue.
North Delhi Municipal Corporation deputy commissioner Ira Singhal said every time they receive information of a new positive case or a case of COVID care centre advised-home isolation, the address is conveyed to the garbage collection team.
“A team of three in PPE kits collect the garbage in double-layered yellow bags as prescribed by the CPCB,” said Ira Singhal. “These bags are first disinfected with sodium hypochloride and then deposited in the processing facility. We have collected and disposed of almost 20 tons of biomedical waste.”
The other municipal corporations said they too have similar arrangements, and collectors reaching different addresses said they follow the guidelines conveyed to them.
Though he has not collected biomedical waste so far, Shyam Sunder, who collects garbage from Parpatganj in East Delhi is aware of the yellow, double-layered bags in which garbage is collected from containment zones. “But we don’t have the time to tell people to segregate and cannot threaten them that we will leave their garbage, so we pick it up in whatever state it is in,” said Sunder.
In containment zones, sanitation workers and garbage collectors enter wearing PPE kits. “We collect and treat all waste as contaminated bio medical waste,” said a door-to-door garbage collector at Shahdara in east Delhi.
The CPCB under the environment ministry first issued “Guidelines for Handling, Treatment and Disposal of Waste Generated during Treatment/Diagnosis/ Quarantine of COVID-19 patients,” on 18 March and revised it thrice since.
From a four-page document in March, the guidelines now run into 10 pages. But it is only in the latest revision of 10 June that the CPCB for the first time listed among the duties of Urban Local Bodies (ULBs), a clause involving citizens.
“Create awareness among citizens regarding segregation of municipal solid waste and biomedical waste (as part of Domestic Hazardous Waste) generated from homes/quarantine homes/home care facilities”. A line that has so far remained on paper.
Needed, a decentralised waste disposal system
“Delhi’s waste management is handled by a private company which has signed an agreement with the municipality to collect and dispose the waste,” said Swati Sambyal.
An agreement with the common biomedical waste treatment company typically details the services sought and bought by the government which includes collection, transportation, treatment and disposal of the waste, bar coding, advanced tracking of the biomedical garbage from the point of generation to the final disposal, and integrated waste collection services including waste storage, manpower and PPEs.
The Delhi government has signed up with Biotic Waste Solutions Pvt Ltd which has six biomedical waste management facilities in north India.
It handles everything from collection to final disposal of the waste.
Delhi has two biomedical waste management facilities of Biotic, one each at Okhla and Neelothi, with an installed capacity of 13 and 19 tons a day respectively. Their work is overseen by the Delhi Biomedical Waste Management Cell formed under the Delhi government’s Directorate General of Health Services. Ahead of the pandemic, the Delhi Pollution control Committee said 13,641.22 kg of biomedical waste was generated daily.
“Cities that have decentralised collection, like in Bengaluru, have more active citizen and volunteers groups, NGOs, all involved in creating awareness,” said Swati. “In a centralised system, Delhi’s residents have nothing to do with their waste… just hand it over to someone else, with little awareness of the changed circumstance. In cities where civic groups, NGOs and volunteer groups are active, they have more effective action to prevent contamination from the COVID-related waste.”
While biomedical waste from hospitals and COVID care centres and quarantine facilities are collected and treated separately from the other biomedical waste, in Delhi’s residential areas, from the upmarket South Delhi to the very poor near the Gazipur landfill, no such segregation is occurring.
According to Swati, “Neither the people nor the collectors seem to be aware of the need for a third bin — for hazardous household waste. According to the Central Pollution Control Board guidelines, used masks and gloves from households should be kept in a paper bag for at least 72 hours before being disposed of as general waste.”
Few residents comply with this, even discarding used PPEs they buy to visit a hospital or attend a funeral in their home dustbins.
Incidentally, biomedical waste management is an important segment in the training being imparted to “COVID Warriors” — from doctors to nodal officers of the government, associations, nurses, dentists, pharmacists, ayush personnel and ASHA workers, everyone involved in the effort to track, trace and treat COVID patients.
In fact, four years ago, the administration came out with a 253-page “SOP For Infection Prevention & Control in Healthcare Settings,” which pretty much covers everything that the government is trying to do in its fight against COVID. From the use of PPEs and masks and gloves by people dealing with biomedical waste to their safe disposal, everything is already listed.
Except for creating awareness among people on this, especially now.
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