KABUL

Solid waste produced by the health-care system in Kabul and other major cities is not being properly managed and poses a serious public health risk, according to health experts.



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Medical waste - including used needles and syringes, soiled dressings, body parts, diagnostic samples, blood, chemicals, pharmaceuticals and medical devices - is lying in open rubbish dumps near hospitals in urban areas.



Tonnes of vaccination waste resulting from an exercise to immunise about 1.6 million children against polio on 21-23 September have been thrown away in the open, health workers said.



Kabul Municipality has said it has little experience of safe waste disposal and few tools with which to separate and dispose of medical waste.



"It is the responsibility of hospitals and the Ministry of Public Health to safely dispose of medical waste," Nisar Ahmad Habibi Ghori, director of Kabul Municipality's waste management department, told IRIN.



Kabul is reeling under increasing mountains of rubbish with waste management apparently slipping out of control.



Lack of regulation



Afghanistan does not have bylaws on the safe management of medical waste, and over 60 public and private hospitals in Kabul do not have incinerators or other equipment to deal with the problem.



"We have instructed government hospitals to burn medical waste… but we have problems with private hospitals," said Ahmad Shah Shokohmand, director of the health services department at the Ministry of Public Health (MoPH).



At least two government hospitals in Kabul have dumped medical waste into open dustbins where poor children often scavenge for food and reusable items.



"We burn nothing. We throw all sorts of waste into the rubbish bin or outside," said an official at Jamhuryat hospital on condition of anonymity.



Cleaners at the Indira Gandhi Child Hospital also said they put medical waste into ordinary rubbish bins.







Photo: Khaled Nahiz/IRIN Children scavenging in waste bins for food and reusable items in Kabul

Infection risk



Some medical waste is classified as infectious or biohazardous and could potentially lead to the spread of infectious diseases, according to the UN World Health Organization (WHO).



Epidemiological studies conducted by WHO showed that a person who experiences one needle stick injury - from a needle used on an infected patient - entails risks of 30 percent, 1.8 percent, and 0.3 percent of becoming infected with hepatitis B and C viruses and HIV/AIDS respectively.



At least seven children involved in scavenging in Herat Province, western Afghanistan, have been infected by hepatitis B, syphilis and suspected cases of HIV, the Children Protection Action Network (C-PAN) reported.



"These children were scavenging among hospital waste for food and usable items," Mohammad Siddiq Mir, an official at C-PAN in Herat, told IRIN, adding that the children had collected contaminated needles, serum bags and bandages.



Officials at Kabul Municipality also reported at least two suspected cases of hepatitis B among city cleaners in September.



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