How's Bali manage its infectious medical waste during Covid-19 pandemic?

During the Covid-19 pandemic across the world, for more than three months we stayed at home, working, studying, and all the activities we did from home. Many changes have occurred, not only in the fields of education, economics, but also in the field of the environment, especially the problem of solid waste.

Since the co-19 pandemics, waste production has decreased by 40-50%, this is due to the reduced activity of the community, companies, as well as tourism objects or closed public places (NS, 2020). Then what about Covid-19 waste? How to handle it?

Let's see, what is included from this covid-19 garbage. According to the Ministry of Health of the Republic of Indonesia and the Healthy Living Community Movement (Germas) in the Guidelines for managing hospital waste in referral hospitals, emergency hospitals and community health centers, which are included in Covid-19 waste, are goods or materials that are left over from activities that are potentially not reused and potentially contaminated by substances that are infectious or in contact with patients and / or officers in health care facilities that handle Covid-19 patients. These include: used masks, used gloves, used bandages, used tissue, used food and beverage plastic, used food and beverage paper, used syringes, used infusion sets, used personal protective equipment, patient food scraps etc. from service activities in the ER, isolation room, ICU room, treatment room, and other service rooms. We can see that Covid-19 waste is included in the category of solid medical hazardous and toxic waste (B3).

Of course this Covid-19 Waste has its own rules in its management. In the Circular of the Minister of Environment SE No.2/MenLHK/PSLB3/PLB.3/3/2020 concerning Management of Infectious Waste (B3 Waste) and Household Waste From Handling of Corona Virus Disease (Covid-19) dated March 24, 2020, it is mentioned that there are three models of steps for handling Covid-19 waste, namely infectious waste originating from health service facilities, infectious waste originating from people in monitoring (ODP) originating from households, and managing household waste and similar household waste in this pandemic period.

In general, infectious waste originating from the health facility must be handled quickly, it can be stored in a closed package no later than two days after it is produced. Then it can be transported and destroyed in the processing of B3 waste either with an incinerator at a minimum temperature of 800⁰C or with an autoclave equipped with a shredder. The results of the destruction are then packaged and given a poison symbol and a label for B3 waste and then handed over to the B3 waste management.

Infectious waste from ODP in households, collect all infectious waste in the form of PPE waste such as masks, gloves and personal protective clothing, separate in a closed container, transported and destroyed in the B3 waste processing.

Whereas the arrangement for household rubbish all cleaners must be equipped with PPE such as masks, gloves and safety shoes. Communities should wear reuse masks, if healthy people use disposable masks, they must tear, cut, and neatly pack the trash before throwing it in the trash to avoid misuse. The government is required to prepare special bins for masks in public spaces.

Well, what about Covid-19 rubbish in Bali, especially those produced by hospitals in Bali. For example, hundreds of PPE waste sets are produced by Klungkung District Hospital in one day. All of this rubbish is PPE rubbish used by medical personnel to serve patients during the Covid-19 pandemic. This rubbish adds to the volume of the previously generated medical waste. The medical waste management from the Klungkung Regional Hospital in collaboration with third parties, who previously transported waste twice a week, now has taken three times a week since the pandemic (Eka, 2020). Meanwhile, RSPTN Unud as one of the Covid-19 patient referral hospitals, in a month the medical waste generated could reach 2 tons. Medical waste is also managed by a third party. Likewise, with Covid-19 waste in Tabanan Regency, in its management, they collect all medical waste in one of the hospitals to be transported by PT. Triata Mulia Indonesia as a third party. Based on data from the Bali Health Service, it is estimated that the total production of medical waste generated from 60 hospitals, 200 clinics and 120 puskesmas in Bali is 3 tons per day or 90 tons per month (Feri, 2020).

References:

ADB, 2020, Managing Infectious Medical Waste during the COVID-19 Pandemic,  https://www.adb.org/sites/default/files/publication/578771/managing-medical-waste-covid19.pdf diakses tgl 28 Juni 2020

Eka Mita Suputra, 2020, Dalam Sehari RSUD Klungkung Buang Ratusan Sampah APD, Produksi Limbah Medis Meningkat Selama Pandemi

https://bali.tribunnews.com/2020/06/05/dalam-sehari-rsud-klungkung-buang-ratusan-sampah-apd-produksi-limbah-medis-meningkat-selama-pandemi?page=2, diakses tanggal 29 Juni 2020

Feri Kristianto, 2020, Bali Butuh Investor Pengolahan Sampah Medis, https://bali.bisnis.com/read/20180507/537/792231/bali-butuh-investor-pengolahan-sampah-medis, diakses tanggal 29 Juni 2020

Kementerian Kesehatan RI dan Germas, 2020, Pedoman Pengelolaan Limbah Rumah Sakit Rujukan, Rumah Sakit Darurat dan Puskesmas Yang Menangani Pasien Covid-19, Pengelolaan Limbah padat Domestik, dan Pengelolaan Limbah B3 Medis Padat, Direktorat Jenderal Kesehatan Masyarakat Direktorat Kesehatan Lingkungan

Nengah Budiarta, 2020, Selama Pandemi Covid-19, Volume Sampah di Bali Turun 40 Persen, https://www.balipuspanews.com/selama-pandemi-covid-19-volume-sampah-di-bali-turun-40-persen.html diakses tgl 28 Juni 2020

NS, 2020, Pandemi Covid-19, Produksi Sampah di Badung Turun

https://www.nusabali.com/berita/74983/pandemi-covid-19-produksi-sampah-di-badung-turun, diakses tanggal 29 Juni 2020