Leakages Linked to Cost Reduction Schemes

The leakages of medical waste to scavengers and recycling centers can occur at healthcare facilities, during the transportation and in waste management companies.

KOMPAS/PRADIPTA PANDU MUSTIKA

An employee of PT Tenang Jaya Sejahtera in Karawang, West Java, Friday (12/13/2019) prepares to put medical waste into an incinerator. Medical waste is a hazardous and toxic material (B3) so employees are equipped with adequate personal protective equipment.

CIREBON, KOMPAS – The leakages of medical waste to scavengers and recycling centers are believed to be linked to schemes to reduce waste management costs. Leakages can occur at healthcare facilities, during the transportation and in waste management companies.

As of 2018, Indonesia had only six licensed medical waste management companies with a total processing capacity of 120.48 tons per day. Meanwhile, data from the Environment and Forestry Ministry shows that, as of 2018, Indonesia produced 300 to 340 tons of medical waste per day.

To resolve this, the ministry boosted its issuance of medical waste management licenses in 2019. The number of medical waste management companies had grown to 12 with a total processing capacity of 201.7 tons per day. This is still lower than the daily medical waste production of 340 tons.

Furthermore, the medical waste management companies are not equitably distributed nationwide and not every island in Indonesia has one. Eight of the companies are located on Java. The four remaining companies are spread in Kalimantan, Batam and Makassar.

At the time, about 450 tons of medical waste was found.

Allegations of medical waste leakage and its link to cost reduction schemes first emerged after the discovery of medical waste piled up at Panguragan Kulon village, Panguragan district, Cirebon regency, West Java, in 2017. At the time, about 450 tons of medical waste was found.

Some 250 tons of the waste were transported by the Environment and Forestry Ministry in December 2017. About 200 tons remained buried in the backyard of the house of a local identified as Agus Sari.

A Kompas investigation in late December 2019 found that the waste in Agus’ yard was between one and two meters high and covered an area of almost 100 square m. It was estimated that the volume of the waste was about 200 cubic m and weighed about 200 tons. The medical waste might pollute the environment and cause diseases.

KOMPAS/PRADIPTA PANDU MUSTIKA

An employee of PT Tenang Jaya Sejahtera in Karawang, West Java, Friday (12/13/2019) prepares to put medical waste into an incinerator. Medical waste is a hazardous and toxic material (B3) so employees are equipped with adequate personal protective equipment.

Court ruling

In a court ruling against illegal medical waste managers in Cirebon in 2017, a panel of judges clearly cited them as the source of the waste in Panguragan Kulon village. In the ruling, the judges said the waste was taken from the premises of legal medical waste management company PT Tenang Jaya Sejahtera (TJS) in Karawang, West Java.

BL, 35, a former worker at the illegal medical waste management site in Pangurangan Kulon village, said that he routinely transported medical waste from PT TJS’ premises to Panguragan Kulon throughout 2017. In a week, he could make four trips to transport medical waste. He transported four tons of waste in one trip.

“The waste contained various items, including needles, metallic bowls, syringes, body parts and used IV tubes,” BL said.

Upon confirmation, PT TJS spokesperson Oland PH Sibarani said investigators never requested statements from his company related to the medical waste management at Panguragan Kulon village.

The waste contained various items, including needles, metallic bowls, syringes, body parts and used IV tubes.

PT TJS production head Bambang said that the illegal medical waste management in Panguragan Kulon village was not connected to PT TJS. Thus far, he said, whenever there were problems related to work, his company always held meetings attended by all units.

“We discuss all problems we have at PT Tenang Jaya Sejahtera. Everyone involved in the job would have been summoned,” he said.

A statement from a legal medical waste management company said that the cost for medical waste management was between Rp 8,000 (58 US cents) and Rp 9,000 per kilogram. If the medical waste is disposed by sending it to an illegal disposal site like the one in Panguragan Kulon village, it can be done at almost no cost.

KOMPAS/PRADIPTA PANDU MUSTIKA

Piles of medical waste is seen in Panguragan, Cirebon, West Java, on Saturday (23/11/2019). The medical waste was dumped in 2017 in a case that has not been solved by the Environment and Forestry Ministry or local residents.

Many spots

Environment and Forestry Ministry environmental pollution investigation subdirectorate head Anton Sardjanto said there were many locations for potential leaks in the process of transporting medical waste from a healthcare facility to a waste management site. For instance, independent clinics have much medical waste leaking to trash scavengers and recycling centers.

Anton said that corporations, medical waste management companies in this case, might be involved in the huge medical waste piles, such as the one found in Cirebon.

He said that in the inventories of the medical waste management company alleged to have disposed of medical waste in Cirebon, it was found that the amount it received was not the same as the amount it destroyed. Therefore, the ministry has demanded the company show its waste processing manifest.

Anton said that, if a company received 10 kilograms of medical waste but only processed nine kilograms of it, then it should be determined where the remaining one kilogram was destroyed. Usually, companies will hand over the remaining waste to PT Prasadha Pamunah Limbah Industri, which is licensed for waste collection.

“Based on our findings, there are imbalances. [The investigation] is still ongoing and I have requested [one of the medical waste management companies] to find out where the remaining waste goes,” he said.