Nurses peel off bandages on patients and throw them in a red bag which is to be burnt. A blue bag meant for paper and medicine covers is also overflowing with dirty bandages. A nurse throws a used syringe into it, though he is supposed to put it in a basin filled with bleach solution. The blue bag goes to the municipal dump that day. Most government hospitals in Delhi have a colour coding system to segregate infectious and non-infectious wastes, but in most places the infectious wastes find its way into the municipal dump.Nurses in Safdarjung Hospital blame it on work pressure.

In LRS TB Hospital, Mehrauli, a study by environmentalist Iqbal Malik shows, much of the waste is dumped in the community bin as the incinerator works intermittently. ``Of the 250 kg of wastes there, 25 per cent comprises leftover food, which is infectious,'' she says. In Rajan Babu TB Hospital and in the Infectious Diseases Hospital, she says, wastes are still buried and infectious uro bags used by TB patients can be seen all over the hospital. Dr T.K.Joshi, who is in charge of waste management in LNJP hospital, has been organising workshops for nurses to teach them how to segregate and treat medical waste. Health Secretary Ramesh Chandra says such workshops were planned in other government hospitals also.

As the December 1999 deadline for Delhi hospitals to stick to waste management rules is approaching, most hospitals have bought incinerators, but there is no guarantee that all infectious wastes get burnt.

But none of the incinerators installed in the hospitals operate at the temperature required by law and considered necessary to detoxify wastes. As per rules, they must have two chambers, one at 800 degrees and the other at 1050 degrees. GB Pant Hospital has only a single-chambered incinerator, and it achieves a highest temperature of 600 degrees.

In Bara Hindu Rao hospital also, the incinerator does not reach the minimum required temperature of 800 degrees. Hence the incinerators release viruses and unburnt toxins, heavy metals like lead, mercury, cadmium and soot produced by burnt body parts into the city air. And as most government hospitals except, LNJP, AIIMS and RML burn their plastics against the rules, carcinogens toxins are released. The incinerators are not being used properly as the operators are not trained, says Agarwal.

Private hospitals have not adopted either of these options citing costs. (Small microwaves and autoclaves, suited for up to 100 beds, cost between Rs 9 lakh and 20 lakh while the bigger ones cost about Rs 55 lakh).

Seven autoclaves have been ordered by the Delhi government according to Ramesh Chandra, while Sanjay Gandhi Memorial Hospital already has the only autoclave in Delhi. But hospitals which charge patients 200 times more are either dumping wastes in the Yamuna and landfill sites or burning them.