There are around 2,100 public and private hospitals nationwide with an approximate capacity of 96,000 beds, generating 28,000 kg. of health care wastes (HCW) per day at an average of 0.30 kg. per bed capacity per day. On the other hand, there are around 680 public hospitals with an approximate capacity of 44,000 beds generating 13,200 kg. of HCW per day. The NCR has the largest bed capacity (approximately 30,000 beds) which can generate 9,000 kg. of HCW per day. The volume does not include the amount of wastes from small clinics, stand-alone laboratories, research laboratories, municipal health centers and barangay health stations, which generate mostly general or domestic health care wastes.
The general distribution of health care wastes is as follows: general or domestic wastes (80%); pathological and infectious wastes (15%); chemical and pharmaceutical wastes (3% percent); sharps (1%); radioactive wastes, cystostatic wastes, pressurized containers, broken thermometers and used batteries (less than 1%).
As the lead government agency in the formulation of national guidelines for health care waste management, the DOH requires all health facilities to follow correct procedures in the five-stage process of health care waste management: (a) waste minimization and segregation; (b) waste handling and collection; (c) waste internal transport and temporary storage; (d) waste treatment; and (e) final disposal.
Complying with the five-stage process is a responsibility of HCW sources or generators themselves, consisting mostly of private and public hospitals. Private hospitals are responsible for their own investments in equipment operations and personnel for HCW management. Public hospitals, on the other hand, need to justify and apply for an annual budget for HCW.
Since the Clean Air Act (RA 8749) of 1999 and its IRRs were issued, the health sector has been limited to nonburn technologies for the treatment of HCW, such as wet thermal disinfection or autoclaving, microwave, chemical disinfection and the biological process. The first two technologies are largely imported and usually costly.
Hospitals must determine which technology best meets the needs of HCW management while minimizing the impact to the environment and enhancing the safety of the hospitals and the general public.
Public and private hospitals in the NCR contract out the treatment and final disposal of their HCW to private companies called Transport, Storage, Disposal (TSD) facility operators. At present, there are 10 accredited TSD facility operators serving public and private hospitals in the NCR and nearby regions. Elsewhere in the country, however, TSD facility operators are nonexistent and public and private hospitals must rely on inhouse options and technology for waste treatment and disposal.
Of the 72 hospitals managed by the DOH, 30 percent are located mostly in Metro Manila and contract out their waste treatment and disposal requirements. Most use chemical disinfection for waste treatment and have limited or no access to a sanitary landfill for the final disposal of treated wastes. Of these same 72 hospitals managed by the DOH, 90 percent have existing sewage treatment plants or are currently in the process of installing these facilities.