Essential Action

Stop Construction of Medical
Waste Incinerators in India

"We fear that the disposal of medical waste
through on-site incinerators will be a cure which is
far worse than the disease itself."

-- Ravi Agarwal and Bharati Chaturvedi,
Indian Campaign Against Medical Waste Incineration

The World Bank plans to "cure" India's problem of medical waste disposal with the construction of hospital waste incinerators throughout a three-state area. But the incinerators will belch out deadly toxins, dioxins, mercury, arsenic, lead, cadmium and toxic ash. Better, even cheaper, waste disposal technologies are readily available. Indian advocates for the environment and public health ask Global Response members to persuade the Bank to stop funding incinerators and to install safe waste disposal technologies instead.

Medical waste is a serious problem in India, where "ragpickers" sift through contaminated hospital garbage to recover the glass, paper, plastic and metal that they can sell for recycling. To protect them and others who might easily find and reuse contaminated needles and other medical supplies, a safe system of disposing of medical waste is urgently needed.

But the incinerators that the World Bank plan to construct will create MORE toxic pollution. "The World Bank should not promote the transfer of the worst Western technologies to India and the rest of the world," says Gary Cohen, a coordinator of Health Care Without Harm (HCWH), a coalition of over 100 North American organizations working to reform the environmental practices of the health care industry.

Noting that hospital waste incinerators are among the top sources of dioxins released into the environment, HCWH says it is "unacceptable for hospitals to be contributing to cancer on the outside while treating it on the inside."

Instead of incinerating their waste, hospitals should: 1) phase out the use of PVC plastics and mercury products; safer products are available at competitive prices; 2) reduce, segregate, reuse and recycle as much waste as possible; 3) shred contaminated waste for volume reduction and to avoid reuse, and then sterilize the material using high-temperature steam or microwaving before disposal in landfills.

In India, a coalition of environmentalists and public health advocates, the Indian Campaign Against Medical Waste Incineration, is demanding that the World Bank implement these safe technologies instead of building harmful incinerators. They are supported by the World Bank's own South Asia office, which recommended that hospitals in India segregate and decontaminate medical waste at source rather than use "imported high-technology incinerators that are expensive to purchase and difficult to maintain."

Tawhid Nawaz, task manager for the Bank's project, agreed to look into their criticisms of incineration and the advantages of alternative technologies. In the mean time, the incinerator project is approved and some funds have already been dispersed -- so immediate corrective action by the World Bank is needed.

All About Dioxins:

What harm do dioxins do? Dioxins are potent cancer-causing agents. A September 1994 report by the United States Environmental Protection Agency documents the connection between dioxin exposure and cancer, birth defects, endometriosis, reduced sperm count and decreased testes size. Dioxin exposure also damages the immune system, leading to increased susceptibility to infectious disease. It can disrupt the proper function of hormones -- chemical messengers that the body uses for growth, development and regulation. Dioxins, furans and phthalates are endocrine-disrupting chemicals.

What harm do endocrine-disrupting chemicals do? According to a November 1995 statement released by an international panel of experts, endocrine-disrupting chemicals can undermine neurological, behavioral and reproductive development and subsequent potential of individuals exposed in the womb, or (in fish, amphibians, reptiles and birds) the egg. This loss of potential in humans and wildlife is expressed in both behavioral and physical abnormalities. Widespread loss of this potential in nature can change the character of human societies or destabilize wildlife populations.

How do dioxins get into humans? According to the EPA, 90 percent of human exposure to dioxin is through eating dioxin-contaminated food. How does our food become contaminated? The incineration of waste that contains chlorine (PVC plastics, for example) produces dioxins. The dioxins that are released into the air by incinerators settle onto soil, water and plant surfaces.

When dioxin-laden plants or feed are eaten, the dioxins end up in the animal's fatty tissues. When people eat meat, fish or dairy products, dioxins move up the food chain and into the human body. Because humans are at the top of the food chain, the dioxin content of human breast milk is higher than any other food. In their first months of life, human babies get very large doses of dioxins.

Requested Action:

Write a polite letter to Andrew Steer, Director of the Environment Department at the World Bank.

  • Commend the World Bank for addressing the critical need for safe medical waste disposal in India.
  • Point out that incineration is unsafe and creates new pollution problems; the World Bank's own South Asia office has recommended against incineration of medical waste in India.
  • Ask the World Bank to replace medical waste incinerators with cleaner, safer, less expensive technologies in the Indian State Health Systems Development Project and all other World Bank projects, both present and future.

Please send a polite letter, fax or e-mail to:

Andrew Steer, Director
Environment Department
The World Bank
1818 H. Street NW
Washington DC 20433
Fax: 202/477-0565
[email protected]

Send a copy of your letter to:

James Wolfensohn, President
The World Bank
1818 H Street NW
Washington DC 20433 Fax: 202/522-3031

This Global Response Action was issued in support of and with information provided by the Indian Campaign Against Medical Waste Incineration, Health Care Without Harm, and the Multinationals Resource Center.

For more information about the dangers of medical waste incineration, and how you can protect your own community, please contact Charlotte Brody, Coordinator, Health Care Without Harm, c/o CCHW, PO Box 6806, Falls Church VA 22040. Tel. 703/237-2249. E-mail: [email protected] A national campaign to educate the US public about medical waste incineration is just getting off the ground. Find out how your hospital disposes of its waste!

GLOBAL RESPONSE is an international letter-writing network of environmental activists. In partnership with indigenous, environmentalist and peace and justice organizations around the world, GLOBAL RESPONSE develops Actions that describe specific, urgent threats to the environment; each Action asks members to write personal letters to individuals in the corporations, governments or international organizations that have the power and responsibility to take corrective action. GR also issues Young Environmentalists' Actions and Eco-Club Actions designed to educate and motivate elementary and high school students to practice earth stewardship.

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