Safe disposal of infectious medical waste remains elusive in Karachi — I

Hospitals, agencies struggle to ensure safe disposal amid weak oversight and overlapping jurisdictions

By Mukhtar Alam

KARACHI: Safe disposal of infectious medical waste in Karachi remains a distant dream despite the presence of multiple regulatory and implementing bodies for years — a situation raising serious health and environmental concerns, this has emerged lately.

The Sindh capital — home to hundreds of public and private hospitals that generate medical and infectious waste daily — continues to await an integrated, foolproof system for its safe and scientific collection and disposal.

Sources in health and environmental circles blame municipalities and other government watchdogs for the looming crisis threatening public health, the environment, and the city’s aesthetics.

Environmental experts estimate that Karachi generates over 500 tonnes of healthcare waste every day, a sizeable portion of which is highly infectious — particularly from operating theatres, isolation wards, and diagnostic laboratories — yet often mishandled or improperly disposed of.

Observers note that medical-waste collection and disposal have increasingly fallen into the hands of private contractors driven by profit motives, aided by the lax attitude of healthcare facilities and the weak enforcement of health and environmental regulations.

Another observer remarked that regulators themselves have at times acted unevenly, allowing approved waste contractors to operate without sufficient oversight, thereby compromising timely and scientific disposal practices.

Inconsistent practices across hospitals

A review of hospitals and regulatory sources by this reporter reveals serious inconsistencies in how infectious waste is handled across Karachi.

Senior officials at the Jinnah Postgraduate Medical Centre and the Civil Hospital Karachi said their facilities use standard incinerators but could not share specific data, while the head of a major child health institute declined to comment.

Two major private hospitals along Stadium Road, however, provided detailed figures that help estimate citywide waste volumes. Together, the Aga Khan University Hospital (AKUH) and Liaquat National Hospital (LNH) — with a combined 1,600 beds — incinerate nearly five tonnes of medical waste daily, or about three kilogrammes per bed per day, compared with the World Health Organisation’s estimate of two kilogrammes per patient.

An AKUH spokesman said the hospital operates a 350-kg-per-hour incinerator at its Education City campus, disposing of around 90,000 kilogrammes of waste each month from the main site and its satellite units. “The plant is exclusively for AKUH waste, and monthly reports are regularly submitted to Sindh Environmental Protection Agency (SEPA),” he added.

At LNH, Syed Bashir Ali Shah, head of Clinical Housekeeping, said the hospital produces 1.8–2 tonnes of medical waste daily from its 700 beds. “We’ve been operating our SEPA-approved incineration plant for five years,” he said. “All waste is segregated at source, transported safely to the plant. We don’t accept outside waste, and all data are shared with SEPA.”

According to researchers, roughly 85 per cent of healthcare waste is general, non-hazardous material, while 15 per cent is hazardous — including used syringes, sharps, swabs, and contaminated devices and drugs.

A senior environmental expert explained that the Karachi Metropolitan Corporation (KMC) and district municipal bodies initially managed medical waste collection and disposal. “The system lost focus after SEPA introduced its 2014 rules and the creation of the Sindh Solid Waste Management Board (SSWMB),” he said.

He added that this regulatory overlap opened the field to private contractors, some lacking proper facilities, who often collected and resold discarded materials. “Many exploited loopholes, undermining KMC’s work despite its two-unit incineration facility at Mewashah,” said a KMC officer. “When we approach hospitals, they decline, saying they’re already tied to private contractors.”

An environmental consultant noted that SSWMB’s weak capacity has compounded the crisis. “Hospitals are legally bound to ensure safe disposal, but enforcement remains lax,” he said.

A senior SEPA official, requesting anonymity, confirmed that the agency had recently reduced its list of authorised contractors, allowing only those with operational incinerators to function — though he could not provide updated details despite repeated requests.

Meanwhile, A Amir Habib Siddiqui of KMC’s Medical Waste Management Department said the Mewashah incinerators remain functional, processing four to five tonnes daily from about 120 clients. “We continue to perform our role,” he maintained.

Originally published in Social Track, Karachi