ISLAMABAD: Despite the passage of over three weeks and even after Prime Minister Shehbaz Sharif took notice of the matter, an inquiry into the sale of infectious waste by the Pakistan Institute of Medical Sciences (Pims) could not be finalised and made public.

However, the Ministry of National Health Services (NHS) has claimed that a criminal investigation into the incident was going on and it will be ensured that those involved would be penalised.

On the other hand, managements of other hospitals have been on their toes ensuring that hospital waste was incinerated as per the standard operating procedures (SOPs) of the Pakistan Environment Protection Authority (Pak-EPA).

On Feb 27, a vendor hired by the Pims administration to incinerate medical waste on the hospital premises was found involved in the sale of infectious material such as discarded syringes and blood bags along with some hospital employees.

PM had taken notice of issue, sought report about three weeks ago

Subsequently, Pims Executive Director Dr Naeem Malik formed a three-member committee, headed by Prof of General Surgery Dr S.H. Waqar with directions to submit a report in 48 hours and also wrote a letter to the Islamabad inspector general of police (IGP) asking him to register a first information report (FIR) of the case.

On March 1, the prime minister took notice of the matter and issued directions for an independent inquiry to be conducted instead of an internal inquiry.

Later, the National Assembly’s Standing Committee on National Health Services also took notice of the sale of infectious waste by Pims employees and the vendor.

A senior officer of the ministry of NHS, wishing not to be quoted, said that in the inquiry all responsibility for this was placed on a sanitation worker due to which the hospital was directed to hold the inquiry again and send a report nominating all the responsible persons so that action would be suggested against them.

“However, it seems that there is a silent compromise between the hospital and top management of the ministry due to which the report could not be made public even after the passage of almost a month,” he said.

An official of Pims said during the investigation it was revealed that there were a number of discrepancies in the award of the contract and conditions were made in favour of the company which had to collect infectious waste and incinerate it.

A spokesperson for the ministry of NHS Sajid Shah said it was not correct that the ministry had put the issue on the back burner.

“On the directions of the ministry, criminal investigation is going on and it will be ensured that responsible officers would be punished. However, we do not want to take any decision in haste because it can put the future and career of officers at stake. I can assure that strict action would be taken against the responsible officers of Pims so that no hospital would do this in the future,” he said.

Hospital waste can become the reason for infections as they contain blood, human parts and sharp surgical instruments among other dangerous materials. Across the globe, incinerators are used to burn such waste. Ideally, an incinerator should have primary and secondary chambers to dispose of hospital waste and also process the smoke produced as a result.

In 2018, Pims received an incinerator that could burn 100 kilogrammes of waste in one hour. This incinerator has a dual chamber due to which in the first step it burns the waste and then it converts it into ash. The ash is considered infection-free and can be dumped in a pit or can also be given as municipal waste.

The Pims management had hired a company that gets around Rs1.4 million per month to collect hospital waste and incinerate it on the premises. However, the sale of the waste to private parties came to the fore after an official of the hospital followed the vehicle laden with infectious waste to G-11 where hospital waste was sold to a local depot.

A spokesperson for Polyclinic Abdul Jabbar Bhutto said that the hospital had its own incinerator.

“The hospital produces over 160kg infectious and around 1,100kg non-infectious waste daily. We have a comprehensive system to segregate the waste initially on the basis of infectious and non-infectious waste.

“The incident at Pims has put all hospital managements on their toes and they have been ensuring that the hospital waste would not go outside hospitals. We have an incinerator within the premises of the hospital and there is a doctor called infectious control officer and a sanitation inspector responsible for burning the waste in the incinerator,” he said.

Dr Bhutto said representatives of Pak-EPA also visit the incinerator and in the past appreciated the arrangements of Polyclinic.

Published in Dawn, March 20th, 2023