Medical waste from 45 Bali hospitals: Where does it go?
Due to urgent calls to lower the operational capacity of its eightyear- old incinerator, Sanglah Hospital has, since March, ceased receiving medical waste from 45 private and public hospitals and clinics around Bali.
“We are trying to prevent our incinerator from breaking down. Previously, it could burn up to 700 kilograms of medical waste daily, but now we are limiting the total to 500 kilograms per day,” head of household and supplies at Sanglah Hospital Dr. I Wayan Aryana Yudiasa told the Bali Daily recently.
Since the initial operation of the incinerator eight years ago, Sanglah waste facility has served as the disposal point for medical waste from 93 hospitals and clinics throughout Denpasar, Gianyar, Klungkung, Tabanan and Bangli. Most of these are private institutions, 87 of which actively renew their yearly contract with Sanglah.
Between March and April, 45 hospitals and clinics had their yearly contracts ended. Sanglah is mulling whether to continue the heavy workload that has been taking a toll on the one-and-only incinerator for the whole island.
Among those with yet-to-be renewed contracts is BIMC Hospital, near Simpang Siur intersection. BIMC’s monthly medical waste amounts to 300 kilograms and is among the largest amount arriving at Sanglah. As Sanglah itself generates up to 350 kilograms of daily medical waste, a staggering 8,000 kilograms monthly, the incinerator can only accept an additional 150 kilograms daily from other hospitals, forcing Sanglah to halt the over-100- kilograms senders.
BIMC Hospital housekeeping manager Ari Prana Indra acknowledged to the Bali Daily on Friday that its contract with Sanglah had ended on April 1. However, when asked what measures had been taken for the past two months to handle their medical waste, he was reluctant to reply. Asked the whereabouts of BIMC’s medical waste since the contract ended, Ari said: “It is not here [at the hospital’s disposal area] anymore. It’s been transported for disposal, but it’s not a public disposal site. I’ve no further comment.”
Other hospitals that have been served by Sanglah’s incinerator also include private hospitals Prima Medika and Surya Husadha, just a stone’s throw away from Sanglah.
Surya Husadha’s household manager, overseeing sanitation and waste management, Desak Mahayani, declined to comment and suggested the Bali Daily contact a member of the hospital’s marketing team instead.
Surya Husadha’s daily medical waste, claimed to weigh up to 29 kilograms, is disposed of at a temporary disposal site and picked by trucks predawn. When asked where the trucks transported the waste, head of night-shift security, I Dewa Ketut Edi Adnyana, replied, “Please direct the question to the hospital’s public relations.”
Prima Medika’s general affairs manager, Dr. Dian Ekawati, said the hospital’s 15 kilograms daily medical waste was still transported to Sanglah as usual. “We’ve been cooperating with Sanglah since 2002,” said Dian, citing the contract had been renewed earlier this year.
“We’ve not thought about selfmanaging our own medical waste due to limited space. Building a waste management installation is difficult with regard to permits, not to mention a costly investment,” she said.
Among the 20 hospitals in Denpasar, only four are governmentowned, the rest are private hospitals. Sanglah’s incinerator was purchased with a grant from Australia in 2004. Every year, the incinerator requires up to Rp 80 million for maintenance, with a total allocation of Rp 150 million (US$8560) for operational expenses for both solid and liquid waste. Sanitation coordinator at Sanglah Hospital Ketut Gede Surata said, ideally, the annual allocation for the waste management system would be about Rp 600 million.
“This year, we requested a new incinerator with the same specification from the Health Ministry. But we are not sure whether the unit will arrive this year,” said Surata, who suggested that the hospital waste management system should have been divided into four zones, east, west, north and south Bali, to ease the burden of Sanglah as the island’s sole medical waste facility as it is today.