Cleanliness is an important factor of human life. About 80 percent of diseases such as diarrhea, cholera, typhoid and hepatitis are produce due to inadequate sanitation and poor hygienic conditions. Just like home, hospitals and healthcare units should be clean and sterilized simply because it is matter of life and death.
Uncontaminated hospital environment prevents health care associated infections and controls spread of diseases among patients and healthcare staff. Studies have confirmed that hospital environment contaminated with microorganisms. It recommends by healthcare authorities that environmental services personnel "pay close attention to cleaning and disinfection of high?touch surfaces in patient?care areas, hospitals must ensure compliance by housekeeping staff with cleaning and disinfecting procedures."
The World Health Organisation (WHO) has classified medical waste into six main categories. These are as follows, Infectious: These are material-containing pathogens such as waste from surgery and autopsies on patients with infectious diseases.
Sharps: This category includes disposable needles, syringes, saws, blades, broken glasses, nails or any other item that could cause injury. Pathological: tissues, organs, body parts, flesh, fetuses, blood, and body fluid. Pharmaceuticals: drugs and chemicals that returned from wards, spilled, outdated, contaminated, or are no longer required. Radioactive: solids, liquids and gaseous waste contaminated with radioactive substances used in diagnosis and treatment of diseases like toxic goiter.
Others: waste from the offices, kitchens, rooms, including bed linen, utensils, paper, etc, if remain unresolved. Despite the fact that around 250,000 tons of medical waste annually produced from health care units, most hospitals in Pakistan lack foolproof waste management system. Hospital waste can cause greater hazard than the original diseases themselves. Contagious waste can cause diseases like Hepatitis A & B, AIDS, Typhoid, Boils, etc. Infected equipments are threat for both patients and health care staffs.
According to estimation, in Karachi, out of 8000 tons of refuse generated every day, 0.5 percent is health care waste, generated by well over 400 hospitals, clinics and laboratories. According to the Environment Protection Agency (EPA) study on hospital waste, 20% of health care waste generated every day in the city is infectious waste.
JPMA( Journal Of Pakistan Medical Association) warns that unsafe collection and throwing health care medical waste at community waste sites is a threat to the healthcare workers, community and the environment. Any person exposed to this kind of waste, can acquire infections. Regretfully, sweepers, and garbage collectors of medical centers sell used equipments such as syringes, infusion and blood bags of hospitals to junk dealers. Even before this, dogs, cats and birds come in search of their food at community waste sites and further spread the infectious materials in the locality.
Since needles come into direct contact with an individual's blood, reuse of syringes can cause dangerous and contagious deadly diseases. The practice of reusing syringes is common in Pakistan. People lift up used syringes from the hospital waste and sell them. When an individual who does not have a certain disease accidentally pricked with the same needle used on an individual who does have it, he or she may be infected with the disease. It is responsibility of hospital authorities to make sure safe disposal of used syringes by means of strict rules. It is important to cut the needles of the syringes with the help of a cutter to avoid its reuse.
Patient care should be a top priority of every hospital. Conversely, to this, Patients admitted in government hospitals make complains of dirty bed sheets, unhygienic food, bed bugs, tainted washrooms, and dirty waiting rooms, etc. A patient adds that our government hospitals are places where people come for treatment but introduced to new set of diseases.
Government hospitals usually serve patients from deprived and poor areas. These hospitals are overcrowded, short staffed and lack funds to provide for medicines and health supplies. Unfortunately, unhealthy environment of government hospitals have made patients vulnerable to hospital-acquired infections. Both patients and healthcare staff complain that wards, corridors and doctors' rooms, receptions and toilets in government hospitals are in a ramshackle condition.
Rats, cats, cockroaches and even dogs have invaded many hospitals and health care centers because of poor sanitation and unhygienic environment. Existence of markets, restaurants and cafes in and around hospital vicinity also provide suitable atmosphere to rodents. According to a news report, the administrations of three teaching hospitals in Punjab Province have started relying on the stray cats to eliminate the rats from their premises after an incident in which a rat mauled a newborn baby in Holy Family Hospital (HFH) Labour Room 1 a few weeks ago. In this regard, the administration of HFH set free some stray cats at Gynae Wards and rooms of doctors.
Provision of clean and disinfected environment, adequate, accessible, appropriate and affordable health care are rights of every patient. A senior doctor of a government hospital regretfully states that cats are freely roaming in and out of OPD, wards, operation theaters, in labour rooms, on the lawns and corridors of hospitals. These big sized cats reside under the bed of patients. They often mess up the food items lying on the side tables of the patients' bed. Few days ago, staff found kitten inside the drawers of doctor's room table.
There should be an effective and regular inspection of hospitals by the concerned authorities. Cleaning staff should have complete training of exceptional levels of hygiene to ensure that hospital is spotless. A health care expert suggest to keep operating room doors closed except for the passage of equipment, patients, and to limit entry to essential personnel. When anaesthetising a patient with confirmed or suspected TB, place a bacterial filter between the anaesthesia circuit and patient's airway to prevent contamination of anaesthesia equipment or discharge of tubercle bacilli into the ambient air.
In order to prevent the spread of pathogens, doctors emphasise healthcare staff to practice hand hygiene and use of gloves before examining patients. A senior administration of a hospital requests the visitors of patients that please, do not come to the hospital if you are unwell for example, do not visit if you are suffering from diarrhea, vomiting, flu or chicken pox. If you have any doubts then please check with the ward staff before visiting.
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