Papia Raj, Aditya Raj
Waste management has been a chronic problem, especially in Patna, which was called “garbage city” of India by the High Court of Judicature at Patna in 2010. The situation has not improved much since then. Due to rapid unplanned urbanization and uncontrolled in-migration from different parts of Bihar, Patna has a very large population density. Due to lack of required behavioural practice by its populace, the city generates huge amount of wastes.
Our research since 2013 on assessing the health hazards of waste mis-management has indicated that in Patna most of the wastes that are generated can be categorized under Municipal Solid Wastes (MSW). MSW are defined as items which are utilised by humans and the remains of these used items that are thrown away (such as product packaging, grass clippings, furniture, clothing, bottles, food scraps, newspapers, appliances, paint, and batteries) more commonly called trash or garbage and is generated in municipal notified areas.
MSW is both commercial and residential waste as they originate from different sources like houses, schools, restaurants, markets, institutions, and businesses. Bio-medical wastes, generated through health care activities, are also part of MSW. Based on our previous studies carried out in Patna, we contend that the production of MSW has a strong association with the changing conspicuous consumption patterns with no regard for the environment. The Covid pandemic has further complicated the problem in Patna and is creating a parallel pandemic like situation.
In the recent past, the spread of Covid 19 has adversely affected all spheres of our lives. This un-precedented situation has set in a new normal challenging many conventional practices. We have learnt to inculcate certain behavioural changes, such as physical distancing, wearing mask and gloves, face shields, using sanitizers, and use PPE kits. The periodical lockdowns and restrictions on mobility has increased online shopping, including medical products especially among the middle class.
Also, there is panic buying including that of medicines and aided equipments. Though these behavioural changes are with a very noble intent, yet, they are not devoid of consequences that are environmentally not so viable. A point in case could is the increased consumption of medical and allied products which in turn has produced enormous amount of untreated bio-medical wastes. Our research suggests that in the first phase of the pandemic, generation of such wastes was confined mainly to medical institutions such as hospitals.
The media was prompt to highlight these issues because it was evident that our municipal systems were not equipped enough to deal with this un-fathomable amount of wastes. Situations in cities like Patna, where there is only one facility to treat bio-medical wastes plant at Indira Gandhi Institute of Medical Sciences (IGIMS), is alarming.
We know that there had been problems of transporting such wastes in Patna from various parts of the city even prior to the spread of Covid. When the administration was still struggling to strategize management of bio-medical wastes, the relaxed lockdown norms added more woes. Mobility of people increased and so increased vulnerability due to unattended Covid waste.
Covid appropriate behaviour is expected to be followed. But, in it there is no guidelines for how to dispose waste generated by practices in trying to protect from Covid virus For instance, airlines have followed protocols and made sure that the crew as well as the passengers were provided with necessary gears, such as face shield, masks, PPE kits, and so on.
But, in the whole plan there was no mention as to where to dispose these products after use. As a result people throw these like any other garbage in public dustbins which overflowed and hence the streets were strewn with used PPE kits, masks, and gloves. It was a shame to see the area near Patna airport dumped with these garbage items, which if not disposed safely would lead to spread of more infection.
People became happy that the Covid statistics were steadily decreasing but they never realised that through mis-management of wastes they have created a warehouse of breeding other pathogens which in the long run would adversely affect their health.
When people were almost getting back to their normal life, the second wave of Covid arrived like a tornado. It exposed the entire public health system, more so in Bihar. Lessons learnt and practices imbibed during the first wave were not enough to shield the community. The requirements and expectations of the mutated virus posed a great challenge to the administration as well as the community.
As a consequence we had multiple sites of bio-medical waste generation which emerged as a big public health threat. Due to non-availability of required hospital beds and oxygen cylinders, people with mild symptoms were advised to be isolated in their own home. This was an intervention to stop spreading of the virus and avoid over-crowding at the hospitals.
But, what this intervention did not anticipate was that many people who tested positive for the virus, did not disclose it in the community, mainly due to the social stigma of isolation being attached with Covid patients. The situation was worse in Patna where at multi-storeyed buildings there were several Covid patients in various apartments without the knowledge of the community so everybody who used the common facilities got exposed to the virus unknowingly.
Moreover, the wastes that were generated in households with Covid positive patients were mingled and collected with other household wastes which were not disposed as per required norms. Home delivery of food for Covid patients was a very supportive initiative offered by different catering services and restaurants in Patna. They delivered food in disposable containers to avoid reuse and stop spread of the virus.
Unfortunately, even these disposable containers were dumped with normal household garbage thus creating greater risk for the community. Therefore, in the second wave the bio-medical wastes were not only generated at hospitals and their surroundings rather in every neighbourhood and housing societies of Patna. Even the kitchen waste has been mixed with bio-medical waste at the source.
The onset of monsoon is aggravating the situation. Water logging and stagnated pools of water is a common problem that every one in Patna has to deal with in each monsoon season. All open drains and by-lanes in Patna have now become sites of waste disposal, where these days along with plastic bags and wrappers, a common site noticed is floating of used masks and syringes and we have got used to these without being concerned about their repercussions.
Recent research in Maharashtra has stated that one of the main reasons for the high rate of Covid positive cases in the state can be attributed to improper management of wastes generated during the pandemic. This is an indication for us to be extra careful as in Patna we are challenged with management of MSW. A report published in The Hindu lists the top ten states in India with maximum amount of bio-medical waste generation in the recent past.
Interestingly Bihar does not figure in the list. To most it might seem a happy scenario, but in reality it is a great concern. It clearly shows that there is under-reporting of the amount of bio-medical wastes generated in Bihar. This might be due to the fact that since most of these wastes are not separated from other wastes and do not undergo proper treatment they are not reported. Also, these wastes are strewn everywhere in the city and are not confined to specific geographical locales. As a result we need to be very cautious and take more precautions to combat the situation.
In most of the states in India generally waste management has been problematic in low-income areas, which are generally crowded, have open drains, lack proper sanitation, and also there is low awareness among people about proper waste management. But Patna presents a unique case, where field visits suggest that there is a positive correlation between lack of waste management and economic affluence of the neighbourhood.
An ironic example could be of Patlipurta colony, which is supposed to be one of the most plush neighbourhood in the city, housing head offices of various international and national non-government organizations (INGOs and NGOs) working on various developmental issues. There are heaps of un-attended garbage on the roadside of this area and during the monsoon, or even if there is seasonal rainfall, this neighbourhood is almost flooded with floating garbage everywhere.
This year it is no exception with added amount of bio-medical wastes. It is a pity that the so-called privileged in the society are unconcerned about it as they focus on development of Bihar! They do not realize that the air they breathe does not differentiate between people of different strata and are equally toxic for one and all.
Studies have established that Corona virus affects the respiratory system and weakens it. Moreover, people with co-morbidities including respiratory issues are more vulnerable to the adverse impacts of the virus. Our research in Patna has indicated that due to improper waste management the population in Patna is very prone to both chronic and acute respiratory diseases across age groups. This creates a more critical condition during the Covid pandemic.
Vaccination drives are rigorously carried out to protect people from this deadly virus. Nevertheless, the wastes that have been generated and created repositories for air and water pollution cannot be protected with the Covid vaccine. To curb this the need of the hour is to educate people about proper disposal of wastes and encourage segregation of waste at source. Health education is difficult to disseminate since it is different from formal education.
Of the main reasons, why health education has not been a success story in India is the fact that the medium chosen to create awareness and provide useful information had not been appropriate. For example, there had been over-reliance on printed materials and pamphlets, posters, etc. For a population with high illiteracy rate such venues to provide health education will not reach to one and all. Therefore, if appropriate medium, like advertisements in electronic and digital media, or mobile phones, that are accessible irrespective of educational status, are chosen to disseminate useful health education it will bring about desired changes.
Our campaigns against fighting Covid has reiterated the importance of health education and to a large extent we were able to combat the adversities. Covid pandemic has taught us that behavioural changes can be very instrumental to avoid any epidemic. Such behavioural changes should just not be restricted to use of specific items rather it should give more emphasis on how to dispose such items after use.
Otherwise, we are sitting on a time bomb. These wastes if not managed properly will create long term respiratory health hazards, especially for the young population who are most exposed to the outside world. On world plastic bag free day (July3, 2021), the Patna Municipal Corporation had adopted a good initiative to encourage people to abandon plastic bags and use handmade bags informing them about the environmental hazards of plastic bags. Similar initiatives could be launched educating people about the health hazards of improper management of MSW and encouraging them to segregate bio-medical wastes.
In this context, we would like to remind ourselves that we are getting ready to battle off the third wave of Covid pandemic, which is predicted to be more deadly, with every possible preparedness by arranging all curative measures, including availability of hospital beds, specials wards for children, enough supply of oxygen, to name a few. On the preventive front the vaccination drive has received new momentum and the numbers of vaccinated individuals are on the rise, even trials of vaccination for children are proceeding at a good pace.
It would be myopic in our vision if we do not consider the role of health education to bring about health promotion that leads to sustainable good health. It is important to set short term goals to overcome the looming pandemic. Similarly, it is equally important, if not more, to ensure that the conditions we generate in coping with the situation should not result in creating a parallel pandemic. People need to be made aware that the onus is on every individual to tackle the problem of waste disposal and waste management since all of us are responsible for waste generation.
Though it is the responsibility of the municipality to collect the wastes, but at the household level we should segregate waste and mark them. If we are not willing to make the required behavioural changes in our attitude, then we might create a parallel pandemic through improper management of increasing wastes. This pandemic would be more long lasting and lethal than the Covid as it will have serious latent health effects- every day through air and water pollution it will find way to the human immune system and make our respiratory system hollow from within like a termite.
The vaccines would protect us from the different variants of Corona virus, but lack of waste management will expose us to an ongoing pandemic which we consider to be part of our every day life. As soon as we unmask, these will strike us hard on the face. The improper management of waste is the most important public health challenge that we have to acknowledge, especially at a time when we are generating huge amount of bio-medical wastes. If we are reluctant to realise the seriousness about the problem of waste management, and focus only on dealing with the current pandemic at hand we would win the battle but lose the war.
First Published in Mainstream Weekly Towards Creating A Parallel Pandemic Due To Mis-Management of Wastes In Patna on July 23, 2021.
About the Author
Dr. Papia Raj, Professor Indian Institute of Technology, Patna
Dr. Aditya Raj, Professor Indian Institute of Technology, Patna