Mismanagement of medical waste may present an environmental health hazard. Causes of mismanagement include a lack of appropriate legislation, effective control, financial constraints and lack of education, training and awareness. This is specially a concern in developing countries like Bangladesh where a large number of people are involved in the formal and informal process of medical waste management. In this paper the management of the medical waste in Dhaka, the capital city of Bangladesh, was analyzed with an aim to propose an integrated medical waste management system in the city. Data was collected from Healthcare Establishments (HCEs) such as hospitals, clinics and diagnostic centers, waste disposal operatives, official and unofficial recycling operations and scavengers. Both quantitative and qualitative data gathering techniques were used, including observation and formal structured interview through questionnaire survey and informal dialogue. The study focused on the character of HCE, its in-house and municipal management (collection, temporary storage, transportation, treatment and final disposal options of medical waste) practice in the study area. The results indicated that the management of medical waste had not been conducted properly. Deficiencies, inconsistencies and improper processes were revealed. Malpractice was observed, among individuals involved in handling medical waste, in mid-level management, and also in the senior management level. The study revealed the need for training, capacity building programs of all employees involved in medical waste management, to promote awareness and focus on environmental and health risks of medical waste. The results obtained may be generalised to most economically developing countries where there are similar environmental problems and strict budgets.
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