Uttar Pradesh, India’s most populous state and one of its poorest, hasn’t had the best track record in terms of medical facilities. Most infamously, 30 children died in the main government hospital in the district of Gorakhpur in 2017 due to a lack of oxygen cylinders. In January, the same hospital, Baba Raghav Das Medical College, was fined Rs 5 crore ($720,000) by the National Green Tribunal for improper disposal and burning of biomedical waste this January.
The problem of biomedical waste disposal isn’t new to Gorakhpur, nor limited to it. In 2016, Gaurav Srivastava filed a Right to Information, or RTI, request to find out how many biomedical waste treatment facilities existed in Gorakhpur and three nearby districts. 34-year-old Srivastava, who formerly worked on climate change issues and as an environmental auditor in the state, received a damning response—zero.
Little has changed since. Uttar Pradesh, as on 25 July 2018, had 525 violations of the Biomedical Waste Management Rules by healthcare facilities and treatment facilities. And while it may be one of the worst offenders, biomedical waste disposal is a nationwide issue.
India has a problem—it generates more biomedical waste than it can process. According to 2017 data from the Central Pollution Control Board (CPCB), India generates 559 tonnes of biomedical waste a day. The CPCB says that 92.84% of this waste is processed properly, either incinerated or sterilised and buried by independent treatment facilities or by hospitals.
The remaining 7% or so, however, goes untreated—that’s 41 tonnes of waste a day, or nearly 15,000 tonnes a year. Without proper treatment, and with reports aplenty of biomedical waste being mixed in with municipal garbage, India is staring at a potential biohazard crisis.
Among the types of infections caused by biomedical waste are gastrointestinal transmitted by faeces or vomit, respiratory infections caused by saliva and mucous, and eye infections caused by infected eye secretions. Inadequate waste management, apart from causing environmental pollution may lead to transmission of diseases like typhoid, cholera, hepatitis and AIDS through needles contaminated with infected blood.
Poor management of medical waste risks polluting water, air and soil.

The environment ministry in February this year updated the 2016 biomedical waste regulations. The idea was to improve compliance and strengthen implementation as healthcare facilities are not segregating medical waste diligently and handing it over to facilities.
But there are no punishments, not even heavy fines, under the current regulations. Only a show-cause notice or suspension of licence by the district magistrate. The lack of stringent punishments is one of the reasons why these rules have been criticised as ineffective.