The problem of disposal

As the number of COVID-19 cases continues to rise, the country is faced with another urgent pandemic-related problem: the lack of facilities to properly dispose of medical waste and to cremate those who have died from the disease. Just as hospitals’ COVID-19 wards have been filling to capacity, TSD (treatment, storage, and disposal) facilities and crematoriums have also been overwhelmed.

In Cagayan de Oro, for example, the city’s two crematoriums—Divine Shepherd Memorial Gardens and Cosmopolitan Funeral Homes—have been swamped with bodies, some of them coming from other places in Northern Mindanao that have no such facility. Divine Shepherd recently stopped accepting more bodies for cremation to avoid a pile-up, while Cosmopolitan suspended operations last Sept. 5 after its machine bogged down; it had to send nine bodies to the other crematorium because it couldn’t handle the volume.

Each crematorium has a capacity of eight bodies a day but, due to the pandemic, an average of 10 bodies is being processed daily. Two weekends ago, Cosmopolitan received 15 bodies in a single day. Its machine had to be repaired last August and again this month. Divine Shepherd, meanwhile, cremated 328 bodies last month, more than its monthly capacity of 240.

Included in the burning were the personal belongings of the diseased—a practice that has sparked serious concern among environmentalists and public health advocates. The Cagayan de Oro city government announced a probe after it received complaints over Divine Shepherd’s frequent emission of thick black smoke, which turned out to be due to personal effects being burned along with the bodies during the cremation process. Armen Cuenca, the city government’s environment chief, said PVC materials, cellphones, and laptops were among those included in the cremation because hospital workers had placed them inside the cadaver bags, and the Department of Health (DOH) prohibits opening these bags once sealed to avoid contamination.

The practice, however, violates Republic Act No. 9003 (the Ecological Solid Waste Management Act) and RA 8749 (the Clean Air Act), which prohibit the burning of waste that would cause the emission of toxic and poisonous fumes. Cagayan de Oro’s COVID-19 interagency task force has already appealed to the DOH to issue a directive prohibiting hospitals from putting the personal effects of patients who died from COVID-19 inside the cadaver bags.

The problem of disposal is as worse and problematic for medical waste, given the country’s limited number of TSD facilities. Per the Environmental Management Bureau (EMB), there were 135 registered TSD facilities nationwide as of January 2020; of these, at least 45 were qualified to process medical waste. As of June, there were more than 634,000 metric tons of health care waste, including personal protective equipment and COVID-19 test kits, that had been generated, according to EMB assistant director Vizminda Osorio. This is about 11.30 percent of the total capacity of existing TSD facilities.

Waste management, said Philippine Hospital Association president Dr. Jaime Almora last month, was becoming more difficult and costly for hospitals. The bulk of the hazardous waste generated by hospitals is made up of used intravenous plastic bottles, but the treatment, storage, and disposal of these have additional cost. The government has also mandated hospitals to segregate regular hospital waste from COVID-19 waste and hazardous waste, but Almora suspects such rule is probably not being followed considering the overwhelming number of COVID-19 cases.

Aside from hospitals’ COVID-19 waste, households have also been generating infectious waste, mainly face masks—on top of regular waste such as single-use plastic, which has spiked due to people preferring online shopping and food deliveries at this time. The Philippines is not alone in this; an article published on ecowarriorprincess.net, a platform focusing on green topics, noted that the waste crisis in different parts of Asia—driven by poor implementation of laws and the lack of infrastructure and limited waste management systems—has been “further aggravated by the COVID-19 pandemic.”

The Department of Environment and Natural Resources announced early this month a $4.65-million health care waste management project funded by the Global Environment Facility. It aims to manage, treat, and dispose of nonpathological infectious health care waste generated by COVID-19.

It cannot be overemphasized that the proper segregation and disposal of waste, as practiced by more developed countries like Japan down to the household level, has become even more imperative now. The sooner this is sorted out, with clear directives and vigorous implementation by concerned national agencies, the better for a country in danger of facing yet another full-on health crisis.