Disposal Initiative Allows Bangladesh Hospital to Reclaim Space, Reduce Health Risks

Every piece of medical equipment has a life cycle, and at the end of that cycle, it becomes unusable. Large numbers of unusable items have been stored for years in the Sher-E-Bangla Medical College (SHEBACHIM) Hospital and many other public health care facilities in Bangladesh. The Ministry of Health and Family Welfare (MoHFW) issued several orders for the disposal of these unusable items, but due to a lack of clarity on the overall disposal process and limited initiative from hospital authorities, regular disposal of these items did not take place. As a result, a significant amount of space was being wasted, and there was a substantial public health hazard associated with exposure to infectious agents.

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With technical assistance from the US Agency for International Development-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, implemented by Management Sciences for Health, the MoHFW has recently been focusing on this problem. The Ministry’s Procurement and Logistics Management Cell (PLMC) assessed the status of medical equipment that was no longer usable and explored the logistics in health facilities across the country to accelerate the disposal process. The PLMC and SIAPS conducted seven divisional workshops on condemnation of medical and non-medical items for all district- and sub-district-level health managers under the MoHFW to share the assessment findings, the disposal process, and how that process could be improved for effective logistics management as part of a hospital management system.

Hospital staff overseeing the disposal process. Photo courtesy of MD. Razzaqul Alam, SIAPS Bangladesh

As part of the initiative, SIAPS worked with SHEBACHIM Hospital staff to carry out the government orders to dispose of unusable items. First, SIAPS facilitated a meeting that was chaired by SHEBACHIM Hospital’s director and included all departmental heads, the principal of the medical college, and relevant hospital officials. Unusable and obsolete items were identified, and all unusable linen and medical and surgical requisite items were burned in April 2016. Fire service staff were present during the procedure to ensure safety. SHEBACHIM Hospital authorities have initiated the process to auction other unusable items, and approval to dispose of heavy medical equipment is pending.

Hospital staff at all levels are very happy with the outcome of the process and committed to continuing the effort.

Senior Staff Nurse Rasida Begum, who participated in the disposal drive, recalled that in the hospital’s 48 years of operation, disposal of unusable equipment has occurred only twice. She said, “Taking care of and periodical counting of old unusable bed sheets, mattress, pillows, and curtains made our daily duties boring and painful; only wasted our valuable working hours.”

This exercise recovered approximately 14,000 cubic feet of space in the hospital. After disposal was completed, SHEBACHIM Hospital Director Dr. S. M. Sirajul Islam said, “These old, unclean, and dirty materials made our hospital environment unhygienic and unhealthy. Now it’s clean. We have planned to use these spaces for patient beds or any other functional purpose.”

SIAPS is currently working with the MoHFW to develop a comprehensive condemnation guideline to ensure optimum use of hospital space and to keep hospitals cleaner and safer for all.