By James Jimenez
In 2003, the Department of Environment and Natural Resources – Environmental Management Bureau (DENR-EMB) released a report on the state of medical waste management in the Philippines. That report found that medical institutions and healthcare related entities in Metro Manila alone generated approximately 47 tons of medical waste per day, with 27 tons – or more than half of that total – being classified as infectious waste. And as if that weren’t worrying enough, the report also found that only about 18.5% of the infectious waste was being disposed off properly, with 81.5% or approximately 22 tons per day, being discarded through the municipal waste collection service.
A burgeoning concern
While it is true that hospitals are likely the largest producers of hazardous and infectious waste – one government hospital alone has been reported to generate a monthly average of 10,000 kilograms of infectious medical waste, comprised of used personal protective equipment (PPEs), dressings, swabs, blood bags, urine bags, sputum cups, syringes, test tubes, and histopatholgical waste – they are not the only ones. Dental clinics, aesthetic clinics, funeral parlors, medical schools and laboratories, pharmaceutical companies, and health research institutions all contribute to the problem. And with the widespread use of some form of personal protective equipment still being recommended in light of the persistent threat of a resurgent COVID virus, private companies, hotels, seaports and airports – and even private households – are now also emerging as significant sources of hazardous waste.
Consider this: A facemask weighs around three grams; a pair of single use surgical gloves weighs about fifteen. At that rate, if every person in the National Capital Region were to use one facemask and a pair of gloves per day, we would be dealing with upwards of 94,000 tons of medical waste generated from ordinary households – on a daily basis. Where does all of that go?
A question of waste responsibility
Given the devolution of responsibility on solid waste management, mandated by Republic Act 9003 (Ecological Solid Waste Management Act of 2000), the issue of disposal gets laid squarely at the feet of local government units which are required find fiscal and operational measures to solve the growing waste problem.
There is much that local governments can do. They can be more rigorous in waste segregation, for instance, and more closely monitor the collection and disposal of conventional waste. Awareness programs are very helpful too, where households are instructed to reduce, reuse, and recycle whenever possible.
But with medical, electronic, and chemical wastes – hazardous and infectious detritus – proper disposal methods are far beyond the capabilities of local government units to provide. As a result, responsibility for these wastes gets swept, as it were, under the rug.
The intricacies of hazardous waste treatment and disposal
By law, the proper treatment and disposal should be handled by DENR-accredited treatment, storage, and disposal (TSD) companies, of which there are currently only a handful in Luzon and even fewer in the Visayas and Mindanao. TSD companies are entrusted by the Philippine government to conduct safe transportation and treatment of hazardous wastes.
From the hauling of wastes, storage prior to treatment, proper decontamination, and treatment, down to final disposal, TSD companies are closely monitored and subject to rigorous oversight, not just as to the physical handling of the wastes, but also as to its actual disposal. Treatment varies depending on the type of waste. Some undergo neutralization, sterilization, destruction, filtration, stabilization, and encapsulation. Which specific processes are used varies depending on the need and the approved technologies available in the industry – for instance, we don’t really have incinerators anymore owing to the Clean Air Act. But whatever method is ultimately adopted, tests after treatment should be conducted to ensure proper the waste has been properly disposed of.
Bottomline, hazardous wastes should be monitored at every step from collection down to disposal.
In a more perfect world, this regulatory framework assures us that all TSD companies adhere to our environmental laws. But we don’t live in that world. Instead, in our world, these regulations are routinely sidestepped by illegitimate operators who play fast and loose with the laws, abetted by compromised law enforcers and – most heartbreakingly – aided by the broader public that doesn’t know any better.
Tip of the iceberg
The available data mostly focuses on the National Capital Region, but other metropolitan centers such as Cebu, Davao, and Iloilo are equally massive sources of infectious and potentially hazardous wastes. And despite the end (sort of) of the pandemic, the quantity of hazardous waste being produced on a daily basis remains worryingly high. Realistically speaking, the numbers we do have right now only show us the tip of the iceberg. Much remains unseen and unaddressed just below the surface.
Thus far, the DENR has been managing to stay on top of the challenges, but government can’t do this alone. More than just strong enforcement of existing policy, there needs to be a broader and more meaningful understanding of the importance of safe and environmentally sound disposal.
The failure of the public to comprehend the necessity for the safe disposal of hazardous wastes leads to low compliance with even the most basic precautions, such as proper segregation. Worse, if the public does not fully appreciate the risk posed by the improper disposal of hazardous waste, then it becomes easy prey for predatory entities that capitalize on that ignorance by cutting corners and engaging in unsafe practices.
