Personal protective equipment (PPE) or the “white suits” come on as the Amang Rodriguez Memorial Medical Center housekeeping team begins to handle its most important package of the day.
The daily routine to gather and dispose hospital waste happens at least twice a day, depending on the load of patients who come through the doors of the hospital in Marikina City.
They prepare a black bin for biodegradable waste and a yellow bin reserved only for biohazard waste, meaning waste with microorganisms that can infect and harm humans or the environment.
Walking down the long hallways of the hospital to the containment facility takes just a few minutes, but for the housekeeping team, where the few minutes are the most critical part of their day, it seems eternal.
They load healthcare waste such as face masks and face shields as well as other potentially infectious hospital waste into the containment facility at the back of the hospital, carefully following the protocols step by step.
In a report published by the Asian Development Bank (ADB) based on the experience in Wuhan, China, the epicenter of the pandemic, it is estimated that Metro Manila’s 14 million population can generate as much as 280 metric tons of medical waste in a single day.
The National Capital Region, with about 55% of the nation’s total number of COVID-19 cases, used to produce an estimated 47 metric tons of medical waste daily before the pandemic.
As COVID-19 cases in the country continue to rise, medical facilities are getting the brunt, and with the increase in patients come the surge in the volume of infectious medical waste.
The housekeeping team themselves at the Amang Rodriguez hospital could use up to three complete PPE sets during their shift.
A complete PPE set includes the coverall suit, an N95 mask, surgical mask, gloves, goggles, face shield, shoe covers, and a surgical gown.
Despite the protective gear, hospital workers are most at risk to getting exposed to infectious medical waste specially if not managed properly.
But hospitals are not the only place that need to handle healthcare trash responsibly. The communities being serviced by the same hospitals need to know proper waste disposal if they are to fight the pandemic as well.
Masks in public
The coronavirus pandemic has changed the way we live. Everything, from commuting, to buying groceries, to doing ordinary chores in public must include the wearing of face shields and face masks.
What used to be a routine trip to the hospital is now a cause for worry as people have to don protective gear used to be reserved for medical workers.
The task of fighting the pandemic has come down to an individual’s knowledge and practice of safety precautions before going out in public. Part of that is the use of protective equipment and what to do with it after use.
Because of the change in lifestyle, residential communities also contribute to the surge in medical waste in the country.
Infectious wastes in the households
In Banaba, San Mateo, Rizal, the community is trying to keep the fight against the accumulation of pandemic trash contained before it leaves the doors of households.
The community’s garbage collectors adopted a similar scheme to the hospitals where medical waste, like surgical masks and face shields, should be put in a separate garbage bag.
They took this initiative upon themselves being front liners who have to service the needs of the community.
Jenny Sobrejuanite and her fellow volunteers said the idea is to make sure the medical waste is separated before they collect the garbage door to door. But come collection time, she said few households are able to follow the regulation. They end up segregating the waste themselves when it gets to the barangay materials recovery facility (MRF), a mandated facility that every barangay should have to recover recyclable wastes.
“’Pagka may nakita kaming mga face mask o kaya face shields na kasama sa inilabas nilang basura, hindi na namin ginagalaw, diretso na yun sa truck.” Sobrejuanite said.
The task is tedious, and the garbage collectors now wear an extra layer of protection in handling these kinds of trash. When the municipal or city garbage truck comes in the afternoon, they just need to pick up the segregated trash from the MRF and take them to their designated garbage dumps.
“Buti nga po hindi pa kami tinatamaan dito ng COVID,” Sobrejuanite sighed in relief.
“Tumaba pa nga po ako dito,” she joked, “Patpat na patpat ako dati nung 5-years na nakalipas.”
But she said it’s no laughing matter when it comes to following the proper precautions.
“Dati ang mask namin washable pero nung nagkaroon ng COVID disposable na ang gamit namin,” Sobrejuanite explained to emphasize how they too had to change their behavior from before.
While the ADB report emphasized that the proper procedure in handling medical wastes from the household, to transportation, up to its proper treatment before disposal to the dumpsite should have limited manual intervention as possible, it acknowledged certain gaps in the informal sector that sometimes result in the handling of the wastes multiple times thereby upping the risk for informal sector workers.
Medical waste and the vulnerable sector
Being under several scales of quarantine for more than six months, people have slowly adapted in their habits and behaviors. The lockdowns have changed the course of people’s lives, albeit slowly, as they adapt to the change.
In the informal sector community at Manila’s port area, Jesus de Luna has observed even the poor are now regularly using face masks, and occasionally face shields.
As a pedicab driver, de Luna ferries people to and from their houses and the importance of keeping protective gear on is not lost on him because of the increased interaction with different people.
“May handa kami lagi na face shields at face mask, ‘pag umiikot dito yung mga barangay officials, takbuhan na ang mga taong walang suot na face mask,” de Luna narrated.
The people, de Luna lamented, may already be aware of face mask use, but it’s disposal after use is another matter.
De Luna recalled the countless times he has run over with his pedicab garbage bags strewn on the streets. In communities such as these, healthcare waste is mixed with common trash, making it harder for residents to avoid coming into contact with potential infectious material.
He also noted the irregular collection of wastes by the city’s garbage trucks, a situation where they are sometimes left with uncollected garbage for weeks.
“Pag walang nagko-koleksyon, kanya kanya na lang kami ng walis sa paligid namin.”
Despite all the precautions he is taking, he realized danger is just lurking in the corner.
“Paano ‘ka ko yung health protocol, hindi yata naniniwala ang mga tao dito sa pagi-ingat,” de Luna observed about the improper waste disposal. “’Pag nilipad ng hangin at tumapon, hindi na dadamputin.”
With a nervous laughter he implied that just like the garbage they are throwing in the air, the virus in the air could just come back at them without them knowing.