BTFEC’s Grant for Waste Management

It is heart warming to read a report in the Kuensel of 22nd October, 2020 about the award of a grant of Nu.85.00 million by the Bhutan Trust Fund for Environmental Conservation (BTFEC) - for waste management programs in the country. A homegrown grant making institution being able to provide such substantial funding should be a matter of pride for all Bhutanese. I have myself been a recipient of a grant from the BTFEC, for a conservation related work.

I offer my congratulations to the BTFEC management - for their very meaningful contribution to the nation and the people of Bhutan - particularly during these difficult times. I pray that they grow from strength to strength.

The Kuensel report should have elaborated on the projects that the funding will support, so that Bhutanese people are better informed of the monumental benefit this grant will accrue to the people of Bhutan.

From what I hear, the regulatory authority – National Environment Commission (NEC) – is the implementing agency that will implement the waste management projects. Of the diverse projects that are planned and due to be implemented by the NEC, their “National Management Plan for Bio-medical and Hazardous Wastes” is of interest and relevance to me in my capacity as the Club Secretary of the Rotary Club of Thimphu. This is because we are also involved in donating bio-medical waste incinerators to the Ministry of Health. As of now, we have committed to donate 2 units of medical waste incinerators of 30 KGs per cycle capacity. Funding for another 100KGs per cycle capacity incinerator has also been assured – including the possibility of 2 more – one each from South Korea and Honolulu. But we need to proceed with caution – complete one and then go on to the next. We are unwilling to venture into multiple projects at multiple sites, while the ongoing one is still in a state of limbo.

According to Ms. Pem Zam of Ministry of Health, in one of our meetings with the Ministry of Health, she confirmed that the UNDP is donating 3 units of incinerators to the Ministry of Health – of 300 KGs per cycle capacity. From all these it is clear that Bhutan will be pretty well equipment – as far as bio-medical incinerators are concerned.

So, what are being planned to be procured under the BTFEC funding? What is the present generation of waste by the hospitals across the country, and how are the incinerators planned to be distributed and of what capacities? The following are the numbers.

WASTE GENERATION

In Bhutan, wastes are identified and categorized under two broad waste types: (1) General Waste; and (2) Infectious Waste. These two waste types are further segregated into different types – 2 types under the general wastes and 7 types under the infectious wastes.  The waste types under the General Waste are:

1.  General Waste; and

2.  Food Waste

The waste types under the infectious wastes are categorized as follows:

1.  Pathological Waste

2.  Infectious/Hazardous Waste

3.  Pharmaceutical Waste

4.  Sharps

5.  Chemicals

6. Pressurized Waste; and

7.  Radioactive Waste

It is comforting to know that the Ministry of Health and the NEC has up-to-date data on the total number of health care centers around the country. The numbers recorded are as follows:

1. Referral Hospital                  1 No.

2. Regional/Central Hospitals 3 Nos.

3. Full fledged Hospitals        49 Nos.

4. Public Health Centers      186 Nos.

For the total health facilities indicated above, the following bio-medical incinerators, autoclaves and bio-medical vehicles are planned to be procured under the BTFEC and other available funding:

1. National incineration plant 1 No. 300 KGs per cycle capacity

2. Regional incineration plant 3 Nos. 200 KGs per cycle capacity

3. Hospital incineration plants 49 Nos. 10 KGs per cycle capacity

4. Public Health Centers 186 Nos. 5 KGs per cycle capacity

5. Autoclaves 186 Nos. 20 Ltrs. per hour capacity

6. Bio-medical vehicles 10 Nos. -

With the above incinerators and autoclaves, the following medical wastes will be safely incinerated. The waste generation records are as of end 2019 (since we are concerned with medical waste, we will limit the records to infectious waste categories):

It seems like planning has been rigorous but I do see a small mismatch. Given that each cycle of incineration would not be more than 2-3 hours per cycle, it appears that the capacities of incinerators planned seem like - overkill. Well, it could be that they are planning for the next 50 years or so. Still that may be overdoing things - the problem with technology is that it has a tendency to go obsolete within few years of its introduction. Thus, we need to be careful that we do not plan too far off into the future – we need to provide for newer and more efficient technologies that are sure to be introduced – in manufacturing as well as in the way wastes are processed. At some point in time soon, we Bhutanese people need to learn to bring synergy between what standards we set – and what our capabilities are in achieving those high standards that we invariably set. It is best to be realistic and be aware of our inherent shortcomings and set achievable standards and goals, and achieve them.

Regardless, some serious thinking seems to have gone into the Waste Management Plan that has been engineered by the NEC and the Health Ministry, and perhaps Thromdes.

If one were to look at the current level of waste generation at the hospitals, one notices that the largest waste generator is the JDWNRH – generating on an average 110.82 KGs per day. This means that even a 40 KGs incinerator working at 3 hours per cycle shifts can incinerate all the waste generated by our largest hospital.