Karachi hospitals face gaps in medical waste disposal systems

Karachi: Government-run district and taluka hospitals in Karachi and other parts of Sindh do not have adequate incinerator facilities for the scientific disposal of medical waste, resulting in hazardous material being handed over largely to private contractors with limited oversight over its final handling.

Among the city’s major public hospitals, Jinnah Hospital has two incinerators, but only one is currently working. Civil Hospital Karachi has two functioning incinerators. The National Institute of Child Health has an incinerator, but it has remained out of order for months because of gas shortages. The National Institute of Cardiovascular Diseases does not have an incinerator and disposes of waste through an arrangement with the Karachi Metropolitan Corporation. Lyari General Hospital has one operational incinerator.

Most district-level hospitals, however, do not have such facilities and rely entirely on private companies. Hospitals identified as lacking incinerators include Sindh Government New Karachi Hospital, Liaquatabad Hospital, Saudabad Hospital, Korangi Hospital, Ibrahim Hyderi Hospital, Qatar Hospital, Children’s Hospital North Karachi, Institute of Skin Diseases at Regal, Urban Health Center North Karachi, Lal Market New Karachi, Sobhraj Hospital, Karachi Institute of Heart Diseases and Gazdarabad Hospital, among others.

Medical specialists have warned that unsafe disposal of hospital waste creates serious health hazards. The waste includes used syringes, drip sets, cannulas, blood bags, urine bags and bandages, many of which may carry infectious material. Standard disposal methods such as incinerators, autoclaves and microwave systems are used to burn waste at around 1000°C so that it can be reduced safely to ash.

According to the World Health Organization, around 10 per cent of hospital waste generated per bed is highly hazardous and capable of spreading infection, while 90 per cent is classified as general waste. However, if infectious material is not managed properly, it can contaminate the rest of the waste stream and make all of it dangerous.

An estimated two to three kilograms of medical waste is produced per hospital bed each day. Government hospitals in Karachi have around 8,000 beds, of which about 6,500 are occupied, or 80 per cent, generating nearly 16,250 kilograms of waste daily. District hospitals alone produce about 1,600 kilograms a day despite lacking proper disposal arrangements.

Experts alleged that private contractors collecting this waste often recycle and resell it. The waste is reportedly moved at night to undisclosed sites where it is sorted and sold, raising public health concerns. There is no clear mechanism to monitor where the waste ultimately goes or how it is disposed of.

Although the Sindh government introduced Hospital Waste Management Rules in 2005 under environmental protection laws, implementation remains weak. Hospitals are legally bound to ensure safe disposal of hazardous waste, but the prescribed procedures are often not followed. In many facilities, even basic steps such as waste segregation and the use of syringe cutters are absent. In some instances, private hospitals have also been reported to dump waste into drains.

Dr Khalid Bukhari, Medical Superintendent of Civil Hospital Karachi, said the hospital’s two incinerators were operational and were being used for proper disposal. Dr Atiq Qureshi, former medical superintendent of Liaquatabad Hospital, said the 200-bed hospital had hired an NGO to collect waste, but its final disposal remained unclear. Dr Muhammad Suleman, Joint Executive Director of Jinnah Hospital, confirmed that one of the hospital’s two incinerators was not functional but said it would be repaired.

Public health expert Dr Pir Ghulam Nabi Shah Jillani said medical waste can carry dangerous pathogens, including influenza virus, tuberculosis bacteria, hepatitis B and C, and HIV, all of which can spread if waste is not handled correctly. He said institutions such as Aga Khan Hospital follow international standards through the use of colour-coded bins and proper disposal systems, and stressed the need for dedicated monitoring and greater awareness among healthcare workers and the public.

Even after decades, the Sindh Health Department lacks a proper mechanism or focal person to collect data on medical waste, contributing to the worsening public health risks in Karachi,