Safe disposal of infectious medical waste remains elusive in Karachi — II
By Mukhtar Alam
KARACHI: As concerns deepen over inconsistent and unsafe
medical-waste handling across the city, professional bodies and regulatory
officials have stepped forward to outline the challenges and responsibilities
they believe must be addressed to prevent further risks to public health and
the environment.
PMA calls for urgent reform
“The management of medical and infectious waste across Karachi’s healthcare
facilities — including hospitals, laboratories, and maternity homes — remains
largely inadequate,” said Dr Abdul Ghafoor, Secretary General of the Pakistan
Medical Association (PMA).
He noted that studies have repeatedly shown poor segregation practices, with
hazardous waste often mixed with municipal garbage. “Collection, transportation,
and final disposal remain deficient,” he said, adding that many facilities
still dump waste in open areas or municipal landfills instead of using standard
incineration.
According to Dr Ghafoor, these lapses pose a grave risk to public health and
to those directly handling such waste. “Improper disposal can spread infections
such as HIV and Hepatitis B and C through contaminated needles and syringes,”
he warned. “Waste handlers and scavengers are at particular risk, while open
burning releases toxic pollutants that contaminate air, soil, and water.”
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| Dr Abdul Ghafoor |
While estimates vary, older studies suggest Karachi’s hospitals generate
roughly 1.3 kilogrammes of waste per bed per day, amounting to over 1,000
tonnes daily, of which 10–25 per cent is hazardous.
Dr Ghafoor proposed a set of urgent actions: strict enforcement of segregation
at source across all healthcare facilities; establishment of geographically
distributed, WHO-compliant incineration or autoclaving units; regular training
for clinical and sanitation staff; and stronger SSWMB accountability to ensure
dedicated waste transport and prevent mixed disposal.
SHCC clarifies role
Dr Ahson Qavi Siddiqi, Chief Executive Officer of the Sindh Healthcare
Commission (SHCC), said the safe disposal of medical waste is primarily the
responsibility of the healthcare facility that generates it, while
municipalities are tasked with the collection and final disposal of treated or
stored waste within their jurisdictions.
He explained that SHCC’s quality standards for healthcare establishments
include comprehensive guidelines for managing medical waste under the Infection
Prevention and Control (IPC) framework — covering generation, segregation,
collection, treatment, storage, and disposal. “These standards are reinforced
through regular training sessions and verified during licensing inspections,”
he said.
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| Dr Ahson Qavi Siddiqi |
He added that smaller health facilities remain dependent on municipal
systems, which are largely non-functional in most parts of Sindh. “As a result,
even when facilities segregate, disinfect, and store waste properly, they often
have no choice but to dispose of it along with household waste in the absence
of any alternative service,” he observed.
SEPA stresses vigilance
Responding to written questions, SEPA Director General Waqar Hussain
Phulpoto said the agency maintains “vigilant oversight” of all licensed
entities involved in the collection, transportation, and incineration of
medical and infectious waste from hospitals, clinics, diagnostic labs, and
pharmaceutical units.
He said SEPA’s actions are guided by the Sindh Environmental Protection Act,
2014, and related waste management rules. “Our records are regularly updated to
reflect active authorisations, and we remain committed to transparency,” he
stated.
On estimates of Karachi’s daily medical waste generation and compliance
levels, Mr Phulpoto said quantifying such volumes involves data from multiple
healthcare sources, monitored through coordination with health authorities and
other stakeholders. “Preliminary surveys show substantial generation consistent
with the city’s healthcare scale, but compliance levels are being closely
reviewed,” he said. “We are expanding our data collection to better align
disposal practices with environmental standards.”
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| Waqar Hussain Phulpoto |
Experts urge technology-driven
reform
According to M Jibran Khalid Kidwai, an environment and sustainability
specialist, Karachi can transform its medical waste management through modern,
technology-driven solutions.
“Centralised biomedical waste treatment facilities equipped with autoclaves,
shredders, and plasma-based incinerators can sterilise and neutralise
infectious waste without releasing harmful emissions,” he said.
He recommended integrating such facilities with digital waste-tracking
systems so hospitals can label and monitor waste from generation to disposal,
ensuring accountability. “AI-based monitoring and GIS mapping can also help
identify illegal dumping sites and optimise collection routes,” he added.
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| M Jibran Khalid Kidwai |
To make these innovations work, Mr Kidwai suggested training and
certification programmes for hospital waste managers and digital integration
among SEPA, the Health Department, and private operators. “With such measures,
Karachi can move towards a cleaner, safer, and more sustainable biomedical
waste system,” he said.
When asked whether the absence of an integrated policy was the core issue —
and if KMC should lead operational collection while SEPA and SHCC focus on
regulation — he agreed: “An integrated policy and action plan is essential. All
stakeholders need to come onto the same page.”
This is Part 2 (last) of our series on Medical Waste Management in Karachi, originally published in the weekly Social Track, Karachi.
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