BIOMEDICAL LIQUID WASTE: A SERIOUS UNNOTICED THREAT TO PUBLIC HEALTH RIVERS STATE OF NIGERIA

Biomedical waste in solid form is usually and always noticed by everybody. But hospitals, clinics, health centers and mortuaries also generate liquid biomedical waste daily in huge quantity too in most cases. For instance, an average hospital generates about 15/20 thousand liters, or more,  of liquid biomedical waste monthly, from departments of the hospital.. Also, mortuaries cannot do without enough water and other liquids for cleansing and maintance of the corpses and the facility environment. 

Water is very important in hospitals, clinics, health centers, mortuaries and indeed other healthcare facilities, to achieve acceptable standards of Environmental health/hygiene. Hospitals use a lot of water in surgical theaters cleaning, washing/cleaning of wards etc. 

Used liquids are most times mixed with the spent water and disposed of in drains, Rivers, streams and burrow-pits without treatment/laboratory analysis to ensure it doesnt pose problem to the environment, animals/birds and indeed public health. Also, documentation of the weight, volume, and sources too is not recorded by the hospitals, clinics and mortuaries, thereby making statistical reference and planning problematic. 

These hospital liquid waste water is usually a mixed solution of all potentially toxic substances and spent (contaminated) water discharged by various departments, including the residential areas of the hospital, Nurses quarters, canteen, wards, operating theaters, mortuaries, clinics etc... Sadly this category of waste (liquid biomedical waste) is usually allowed by the hospitals administrators to be discharged into drains such that the said liquid biomedical waste flow down into the hospital's drainages through to the public main drain of the city.

Most hospitals, as we know, are with open drains with very minimum gradient resulting in the effluent flowing down slowly or stagnating at some points and becoming the bathing point and drinking water sources of scavenging animals/birds like the Crow and Sparrow. After taking bath in that water, most birds will sit in the open to make themselves dry. The processes of drying and grooming self by these birds/animals leads to the shaking off of microbes into the air or leaving it behind on clothes drying lines, window panels, hand rails, etc for humans to pick up and get infected or fall ill.

The entire process mostly goes unnoticed to most of the staff of hospital and the Environmental Health Authority, including the government.  The Administrators of the hospitals, clinics and mortuaries seem not to care about the health hazards these could cause  and of course have also forgotten that the have a duty to ensure proper management of the liquid waste thereby protecting Public Health. 

The hospital administrators should engage Environmental Health professionals to manage the situation professionally as they (the Environmental Health professionals) would have to study and determine requisite flow rate  so as to increase the flow rate of the drain by engaging competent civil contractor to that effect and to ensure the proper covering of the drains sanitarily.

Also, the Environmental Health professional would know when to maintain the bed of the drain sanitarily by removing silt and garbages in the drain regularly; install appropriate bar/mesh screen (to arrest any solid that may come with the flow) and from time to time checking up with the sweepers so as to avoid sweeping into the drain. 

So all hospitals generating liquid biomedical waste in the course of the health care services they provide, must mandatorily ensure proper treatment of the said liquid biomedical waste before they are finally discharged to the main drain (or appropriate final disposal sites) for the sake of public health and to prevent any possible disease outbreaks. The Environmental Health professionals engaged by the hospitals should be given free hand/ unfettered practice and adequate funding in the management of the liquid biomedical waste as they would be saddled with that serious responsibility and more...

It must be pointed out that failure of hospitals, clinics and health centers to properly document, contain and treat the aforesaid effluent before final discharge, would amount to gross contamination of the environment and the Rivers/streams through the drains. 

Ultimate destination of waste water in the main drain is the Rivers/streams. From Rivers/streams such effluent would finally find its way farther into the open sea/oceans. Bio indicators have given clear signals that we cannot survive with these contant contamination/pollution of our water bodies. Today, water flora faces extinction and the same can be said about the fishes too. The toxic level has gone up to such extent that marine flora and fauna are at risk and facing extinction.  

In turns the same water is coming back to our food chain through fish and vegetables growing and with some effect on drinking water too.  Most wastes of our society including health care and industrial wastes are disposed of in water bodies without any hesitation/care. Today the time has come for us to see for ourselves the ill effect of merciless act of humans against themselves.

This unnoticed pollution is constantly (till now) causing various health hazards cycle and also causing infectious organisms to spread to other areas that are hitherto considered safe, thereby making disease control difficult.

To this end, it must be emphazised that it is very sad and disturbing that medical practitioners who are the administrators of our hospitals/clinics, especially in Nigeria, give very little or no priority to how the liquid biomedical waste / effluents are properly documented, sanitarily contained, treated/analyzed in laboratory and finally disposed of as recommended by the Environmental Health Legislation.

Also, that there is no known standard /reliable tracking mechanism being employed or followed by the management of our hospital and clinics in Nigeria and Rivers State especially, is very worrisome and its the reason why statistic of biomedical liquid waste (effluents) generated by their facilities in the states and Nigeria as a whole are hard to find, and not documented.

The government, via the Environmental Health Authority and the Environmental Health Officers Association Of Nigeria (EHOAN) must wake up and activate specific professional handling /disposal of this somewhat catastrophic Liquid waste that is potent enough to be called WEAPON OF MASS DESTRUCTION (WMD).

The management, handling and final disposal of liquid biomedical waste must be professionally done by qualified/licensed Environmental Health professionals and NEVER BE POLITICISED OR BE GIVEN TO POLITICIANS TO MANAGE, IF THE GOVERNMENT TRULY VALUE THE HEALTH AND WELL BEING OF THE PEOPLE GOVERNED.

NOTE: THE NIGERIA MEDICAL  ASSOCIATION AND INDEED THE MEDICAL DOCTORS/PRACTITIONERS MUST DISENGAGE THEMSELVES FROM WASTE MANAGEMENT AS THEY ARE NOT PROFESSIONALS IN WASTE MANAGEMENT. THEIR CONTINUED UNPROFESSIONAL INTERFERENCE IN WASTE MANAGEMENT IS CREATING SERIOUS NUISANCES TO THE UNSUSPECTING PUBLIC ALSO CREATING MORE PROBLEMS FOR ENVIRONMENTAL HEALTH PROFESSIONALS/AUTHORITIES.
THEY MUST ENGAGE OR PARTNER WITH LICENSED ENVIRONMENTAL HEALTH PROFESSIONALS TO EFFICIENTLY AND PROFESSIONALLY MANAGE HOSPITALS LIQUID BIOMEDICAL WASTE.Hospitals / Clinics and health sector administrators in Port Harcourt, Rivers State, and Nigeria in general, must install at least  one standard effluent treatment plants (ETPs) which has got very low effect and installed at the worst possible places of the hospitals  i.e. close to Canteen, theatre, mortuary, Accidents and Emergency..etc

Plant should be installed close to final ditcher’s line of waste water but  not too close to canteens or the main gate of the hospital. That may compromise the canteen environment/ hygiene and and also hospital visitors using the main gate as entrance/exit, including the entire hospital environment as a whole. Selection of place should be done under the care of waste management committee members headed by a registers/licensed Environmental Health professional in the management cadre of the administration. 

Pre and post installation analysis of waste water must be done, by the Environmental Health Officer in charge and engaged by the hospital to be sure that plant is functioning properly. Also, the Environmental Health professional must know all the discharge points of liquid biomedical wastes from each unit, to departments and the entire facility too, knowing and recording the weight, volume, toxicity level before and after the laboratory analysis (ie Raw and Treated LBW quality analysis).

If the present status quo is not changed any time soon, then any catastrophe may happen.