Solving the problem of medical waste?

Nghe An currently has 27 hospitals, including 10 provincial hospitals, 17 district general hospitals, 2 provincial centers with beds, the Provincial Reproductive Health Care Center and the Eye Center, a district medical center with beds in preparation for operation, Nghia Dan Medical Center, 8 private hospitals with a total of 5,419 beds in the province.

Due to the lack of proper investment in waste treatment systems, waste from many medical facilities has had a significant impact on the environment in recent times. On average, district-level general hospitals alone discharge 30-50 kg of waste per day.

Through the survey, it can be seen that, up to now, most district hospitals have solid waste incinerators, some units do not have incinerators but have collected them at designated locations.

Hoval Incinerator of the NA Friendship Hospital is now the place to treat solid waste.
for many hospitals in the area

What is worrying is that currently, most hospitals do not have a liquid waste treatment system. Some hospitals have approved investment projects to build liquid waste treatment systems but they are currently suspended due to inflation. Some private hospitals have wastewater treatment systems but they are not complete.

Recently, the inspection team for waste treatment in hospitals conducted inspections at 4 facilities, including 3 medical facilities that were listed as causing serious environmental pollution according to Decision 64/2003/CP-TTg dated April 22, 2003 of the Prime Minister, namely the Provincial General Hospital of Friendship, the Tuberculosis and Lung Disease Hospital, the Vinh City General Hospital, and a private medical facility, the Thai An General Hospital.

For domestic waste, all four facilities have contracts with the City Urban Environment Company for daily treatment. For solid and hazardous waste, the Provincial General Hospital and Thai An Hospital use the Austrian Hoval incinerator, which was put into use in 2001 and is located at the Provincial General Hospital. The capacity of this incinerator is 400-500 kg/day, treating waste for many other medical facilities in the city.

Due to being used for over 10 years, sometimes being overloaded, the incinerator has degraded. The hospital has repaired it and it is still working today.

Vinh City General Hospital previously used this incinerator, but since April, the hospital has invested in an incinerator using government bond funds with a capacity of 20kg/h, which has been inspected by the Department of Natural Resources and Environment to measure the amount of smoke and dust and determined to meet the required standards.

As for the Tuberculosis and Lung Disease Hospital, the incinerator was installed in 2008 and has been inspected for technical standards with a capacity of 20kg/h and burned twice a week, but is now showing signs of a lot of smoke. The hospital is proposing to the incinerator installation facility to re-check the technical standards and invite an environmental monitoring agency to inspect.

As for liquid waste, all four hospitals have invested in treatment systems, but their operations have encountered many difficulties in the past. Vinh General Hospital has a liquid waste treatment system using microbiological technology from the Ho Chi Minh City Institute of Environmental Science and Technology, which has been in use since 2005 with a capacity of 100m3/day and night.

In 2008, due to improper operation, the system stopped operating. Up to now, it has been repaired, put into operation and recognized by the Department of Natural Resources and Environment as meeting discharge standards. The Tuberculosis and Lung Hospital has a liquid waste treatment system using high-frequency activated sludge technology of the Ho Chi Minh City Institute of Science and Technology, with a capacity of 100m3/day and night, in use since 2008 but has not been granted a discharge license because it has not met the permitted standards. The Department of Health has requested the hospital to urgently invite technical experts to inspect and repair this system.

At the Provincial General Hospital, liquid waste is treated using anaerobic-aerobic technology combined with chlorine disinfection by the Ministry of Science and Technology with a total cost of 7.7 billion VND, construction and installation started in October 2007 and has been completed. However, the contractor has not yet handed over the project to the hospital, so the system has not yet been licensed for discharge while the results of environmental monitoring inspection last February concluded that the indicators are within the permitted standards.

At Thai An Private Hospital, a liquid waste treatment system was previously invested in, but at the end of 2009, during the upgrading and renovation process, this system no longer operated according to the process and discharged directly into the pond behind the hospital. Currently, the hospital has designed and contracted to install a liquid waste treatment system with Ho Chi Minh City Environmental Company and committed to completing this new system in 2 months after being recognized by a professional agency as meeting standards.

Thus, it can be seen that the reality is that investment in waste treatment systems in hospitals, especially "key" hospitals in Decision 64, is not lacking, but more importantly, the use and preservation are not taken seriously.

Besides, the procedures for handing over projects and submitting them to competent authorities for approval to exit Decision 64 of some hospitals have not been carried out quickly.

The Health sector has also proposed that non-public medical facilities should proactively invest in building new, upgrading, and renovating waste treatment systems in accordance with regulations; have a regime for operating, using, maintaining, and servicing waste treatment systems to ensure good operation.

Propose to the Province to prioritize investment funding to build wastewater treatment systems for public hospitals; invest in the Provincial General Hospital to build cold storage for waste; invest in replacing old, degraded incinerators with new ones; in the future, propose to invest in building centralized incinerators for medical facilities in the region.

Thuy Vinh