The wastewater from HCMC’s Children Hospital No. 1 runs through a pipeline into the city’s drainage system.

Untreated wastewater from hospitals nationwide poses a huge health risk.

The An Binh Hospital in Ho Chi Minh City’s District 5 hasn’t had an effective waste treatment system for the past 15 years.

The hospital had invested in a 400 cubic meters a day treatment system, but it stopped working after a short time, according to doctor Nguyen Dinh Chanh.

With more than 500 beds, it discards some 500 cubic meters of wastewater underground or into the waterways every day.

An Binh Hospital is symptomatic of a larger malaise that infects many other hospitals in HCMC, posing a public health hazard that policy makers have paid scant attention to.

Cho Ray is ranked among the hospitals which have waste treatment systems but it uses one that has been in service since 1972.

It has a tank able to hold 500 cubic meters of wastewater while it spews out 3,200 cubic meters every day.

Thus there’s not enough time for the waste to be treated before it is discharged into the environment, with rocks and gravel providing insufficient filtering.

Saigon General Hospital, one of the city’s leading hospitals, has no choice but to release 300 cubic meters of untreated wastewater into the city drainage system every day.

“It has had no wastewater treatment system ever,” says Nguyen Van Xuyen, the hospital’s director.

Recent estimates by the HCMC Health Department have the city receiving more than 17,000 cubic meters of wastewater from 130 state hospitals and medical centers, of which 39 have no wastewater treatment facilities and 43 have substandard systems.

Some hospitals and medical centers are labeled substandard because the bar was raised in 2002 and their treatment systems have yet to be upgraded.

The above figures don’t include thousands of private medical centers whose wastewater treatment is out of the city authorities’ control.

A report in March by the Environment Protection Agency under the Ministry of Natural Resources and Environment found HCMC’s hospital wastewater “is a potential source of water-borne disease transmission.”

Wastewater is mainly discharged from surgeries, medical tests, treatments, and hygienic cleansing activities.

Over the past decade, new hospitals have sprung up and old ones have expanded at a fast pace, but the increase in patient intake has been inversely matched by their wastewater treatment capacity.

Cho Ray Hospital, for example, was first built to hold 800 beds. The number is 1,700 at present and will be 3,000 in the near future. Still the hospital’s wastewater treatment system has not been upgraded correspondingly.

Children Hospital No. 1 has been using a system that can treat 400 cubic meters a day since it started operating in 1992, according to the hospital’s director Tang Chi Thuong.

It would keep the wastewater in a tank for 15 minutes and then use air entrainment method and chemicals to treat the waste in another tank.

The hospital carries out this process four times a day, spending a total of VND30 million (US$1,800) a month, not including the cost of taking wastewater samples for testing every month.

But after its daily wastewater generation jumped to 800 cubic meters a day and its inpatient numbers reached 1,200-1,500, the hospital failed to treat it to meet safety standards. It was fined VND10 million ($604) by the Department of Natural Resources and Environment recently.

Thuong says last year the hospital set up a VND12 billion ($725,000) project which can treat 1,500 cubic meters of wastewater a day, but the project had to go through numerous administrative formalities and was yet to be implemented.

Chanh says the same thing happened with An Binh Hospital when it launched a wastewater treatment project in 2004.

The Health Department suggested to An Binh that it should seek financial support from a certain market association, but it had to wait without a response for so long that the project was switched back to the city budget. By this time, the construction cost had jumped from VND4 billion ($242,000) to VND5 billion ($302,000).

All the preparatory steps have just been completed and the hospital is rushing things so that construction can begin this year, says Chanh.

A shortage of funds seems to be a common problem for any hospital wishing to improve its wastewater treatment, including the Trung Vuong Emergency Hospital, says Nguyen Kim Thien, the hospital’s deputy director.

In January the hospital started work on its treatment system, expecting to spend VND11.6 billion ($700,700), but when the construction material prices surged later, the contractors abandoned the project after the hospital did not agree to pay them another VND178 million ($10,752).

According to Nguyen Van Chau, director of city’s Health Department, some decisions by the city administration have made the problem worse.

In late 2007, the city People’s Committee banned all hospitals and medical centers in the city center from starting new constructions.

The Health Department recently asked for wastewater treatment projects to be excluded from the ban because “it’s impossible to cut the amount of wastewater from the hospitals,” said Chau.

Meanwhile, the Saigon General Hospital has yet to build its treatment system because the city has informed it will be moved, without revealing when, says Xuyen.

At the city meeting in August 2006, the Department of Natural Resources and Environment asked all the city hospitals to build wastewater treatment systems by January 2007.

No north-south divide

Numerous hospitals with so much untreated wastewater is also old news in Hanoi.

Hanoi’s 32 large hospitals discharge more than 6,000 cubic meters of wastewater a day, half of which is untreated, says a report by the city’s Department of Natural Resources and Environment.

All wastewater from the Hanoi Obstetrics Hospital flows directly into the city’s drainage system.

In May this year, staff of the Central Hospital for Tuberculosis and Lung Diseases in the capital city were caught allegedly selling untreated medical waste to outsiders.

Similar operations at Hanoi’s Bach Mai, K and Viet Duc hospitals were uncovered by the police in 2007, and the Viet Duc Hospital was fined VND20 million ($1,208).

In June, the Environment Protection Agency proposed fining the Son La General Hospital in northern Son La Province VND47 million ($2,840) for dumping untreated medical waste and wastewater into its surroundings.

In central Da Nang City, the Health Department says hospitals discharge not less than 4,000 cubic meters of wastewater a day but 57 percent of the hospitals don’t have treatment systems.

Among those that do, half are not tested regularly.

The city also has 56 state and 700 private health centers which release wastewater directly into the public drainage system.

According to statistics issued last year by the Ministry of Health, only a third of the country’s 1,050 hospitals and over 10,000 health centers have installed waste treatment facilities.

Most of the country’s hospitals are old, building the treatment system underground and thus “it’s hard to check if they comply with safety standards,” says Ly Ngoc Kinh, head of the Health Ministry’s Treatment Department.

“To improve those old wastewater treatment systems costs a big sum of money. The authorities in large cities have not paid much attention to the matter of medical waste.

“If we are not determined to get rid of it, we’ll kill ourselves.”

Source: TT, TN