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Geographic Distribution of Healthcare Entities in RCC

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A Case Study on Geographic Distribution of Healthcare Entities & Effect of Improper Management of Healthcare Waste in Rajshahi City Corporation.
N. E. Jannath, A. A. Masum, M. O. Polak & M. R. N. Alam Department of Civil Engineering Rajshahi University of Engineering & Technology (RUET)

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Geographic Distribution of Healthcare Entities in RCC

  1. 1. A Case Study on Geographic Distribution of Healthcare Entities & Effect of Improper Management of Healthcare Waste in Rajshahi City Corporation N. E. Jannath, A. A. Masum, M. O. Polak & M. R. N. Alam Department of Civil Engineering Rajshahi University of Engineering & Technology (RUET) Department of Civil Engineering, RUET ICPACE 2017
  2. 2. Department of Civil Engineering, RUET ICPACE 2017 Abbreviations • HCE - Healthcare Entity • HCW - Healthcare Waste • RCC - Rajshahi City Corporation • GPS - Global Positioning System • RMCH - Rajshahi Medical College Hospital • IBMCH - Islami Bank Medical College Hospital
  3. 3. Department of Civil Engineering, RUET ICPACE 2017 Overview • Introduction. • Objectives. • Study Area. • Methodology. • Mapping • Geographical Accessibility & health. • Geographic Distribution • HCW Management • Effect of Improper HCW Management • Conclusion • Recommendation
  4. 4. Department of Civil Engineering, RUET ICPACE 2017 Introduction Healthcare is a multitude of services rendered to individuals, families and communities. The spatial analysis is the geographic approach to understand inequalities in distribution of healthcare centers. However, healthcare activities also generate waste. Improperly managed waste possess a risk to human health and the environment. Planning and implementing a comprehensive program for waste collection, transport, disposal and recycle can eliminate these problems.
  5. 5. Department of Civil Engineering, RUET ICPACE 2017 Objectives To study geographical distribution and ease of access to the health services. To analyze the situation of three major health care centers (RMCH, IBMCH and City Diagnostic Centre) through assessment of current waste management practices. To identify the potential impacts on both human health and the natural environment due to improper disposal and management of health care wastes.
  6. 6. Department of Civil Engineering, RUET ICPACE 2017 Study Area • Rajshahi City Corporation lies between 24⁰21′ and 24⁰26′ north latitudes and between 88⁰28′ and 88⁰37′ east longitudes. • The city is bounded on the east, north and west by ‘Paba’ and that on the south by the ‘Padma river’ and the shape of the city is like an invert T with an area of about 47.78 sq. km. Figure 1: Map of Rajshahi city corporation
  7. 7. Department of Civil Engineering, RUET ICPACE 2017 Flow Chart of Methodology Literature Reviews and existing data compilation Data collection Primary data collection Secondary data collection Practical field observation Field based data collection Data analysis Collected data was analyzed through MS Excel Mapping was done by GPS visualizer Identify the potential impacts due to improper disposal Published and unpublished source Internet
  8. 8. Department of Civil Engineering, RUET ICPACE 2017 Mapping First we compiled all of our collected GPS location points of HCEs and HCW discharging or dumping points into MS Excel Sheet. Then we put them into GPS visualize web utility (www.gpsvisualizer.com) and put desired instructions. Finally, we got Google Maps prepared by GPS visualizer according to our requirement for presenting research findings information through maps
  9. 9. Department of Civil Engineering, RUET ICPACE 2017 Figure.2: Geographical Distribution of HCEs in RCCFigure.3: Geographical Distribution of HCW Dumping Points
  10. 10. Department of Civil Engineering, RUET ICPACE 2017 Geographic Accessibility & Health • Governments try to improve the geographical coverage of a service because they believe all sections of the population will benefit from the service if people are closer to it. • In this paper, current coverage is evaluated. It is not enough to argue that utilization rates will increase if either more clinics are built or their quality improved. • By evaluating the potential to improve geographical coverage using the same quantity of resources deployed in different locations, we believe it is possible to realize substantially increased health services utilization in RCC.
  11. 11. Department of Civil Engineering, RUET ICPACE 2017 Total Number of HCEs and HCW generation Type of Healthcare Entities Total No. of HCEs Waste Generation Rate (kg/day) Hospital 19 180.26 Clinic 16 93.75 Maternity 4 62.5 Eye clinic 6 88.33 Dental Clinic 12 8.33 Diagnostic Centre 27 63.7 Physiotherapy 5 5 Pathology Centre 6 87.5 Medical Centre 2 3 Homeo Centre 17 1.17 Pharmacy 103 0.8 Fig. 3. Graphical Representation of Waste Generation Rate (kg/day)
  12. 12. Department of Civil Engineering, RUET ICPACE 2017 Average Composition of HCW in RCC 58%23% 10% 9% General Waste Non-Bio degradable waste Infectious Hazardous Waste Sharp Waste
  13. 13. Department of Civil Engineering, RUET ICPACE 2017 Collection System of HCW INFECTIOUS WASTE SHARP WASTE HAZARDOUS WASTE NON- INFECTIOUS
  14. 14. Department of Civil Engineering, RUET ICPACE 2017 Flow Diagram of HCW management in RCC Healthcare Waste Solid Waste HCWs Bin RCC RMCH Incinerator Incinerator Ash RCC Burial Place Liquid Waste HCWs Bin Sewerage Line
  15. 15. Department of Civil Engineering, RUET ICPACE 2017 Recent HCW Management Practice Of RCC Figure 4: Incinerator in RMCH PremisesFigure 6: RMCH Dumping BinFigure 7: HCW Stored inside IBMCHFigure 5: Burning in Incinerator in RMCH Premises
  16. 16. Department of Civil Engineering, RUET ICPACE 2017 Improper Management of Healthcare Wastes • Health Effect • Effect on Aquatic Life • Effect on Climate Change • Effect on Receiving Stream
  17. 17. Department of Civil Engineering, RUET ICPACE 2017 Health effect Laboratory safety and hygienic disposal are common practices in developed countries, but unfortunately it is not being practiced in ours. HCW is a great public health threat to Rajshahi City dwellers. Diseases shown in following table are spreading day by day due to improper management of healthcare wastes in RCC. Effect on Climate Change. Type of Infection Infective Agent Transmission Agent Gastrointestinal infections Enterobacteria (Salmonella, Vibrio cholerae, Shigella, etc.) Faeces, vomit Respiratory infections Mycobacterium tuberculosis, Streptococcus pneumoniae, SARS virus (Severe Acute Respiratory Syndrome), measles virus Inhaled secretions, saliva Eye infections & Eye secretions Herpes virus Eye secretions Skin infections Streptococcus Pus Meningitis Neisseria meningitidis Cerebro-spinal fluid AIDS Human Immunodeficiency Virus (HIV) Blood, sexual secretions, other body fluids Haemorrhagic fever Lassa, Ebola, Marburg, and Junin viruses Blood and secretions Viral hepatitis A Hepatitis A virus Faeces Viral hepatitis B and C Hepatitis B and C viruses Blood and other biological fluids
  18. 18. Department of Civil Engineering, RUET ICPACE 2017 Effect On Surrounding • The liquid HCW leached, which may pollute soil and ground water Figure 8: Waste Disposed on Land Surface (a) IBMCH (b) Nawdapara bhagar (a) (b)
  19. 19. Department of Civil Engineering, RUET ICPACE 2017 Effect on Receiving Stream At Rajshahi, HCW is one of the major pollutant that causes water pollution. HCWs ultimately discharged into the river Padma, thus polluting the river water. Figure 9: HCW Disposed Nearby Sewerage Line in Bypass
  20. 20. Department of Civil Engineering, RUET ICPACE 2017 Effect on Aquatic Life • When a HCW storage bin or disposal site is located near pond or river, the wastes get mixed with the water body through the flow of rain water. • Many micro-organisms are produced in the disposal of HCW, which are harmful to human as well as the aquatic life. Figure 10: HCW Dumping Near Pond in Nawdapara
  21. 21. Department of Civil Engineering, RUET ICPACE 2017 Conclusions From the study it is observed that the prime HCEs cluster in Rajshahi city is Laxmipur area. This zone covers approximately two third of the city’s HCEs and they account about 75% of HCW per day. The next HCEs density zone are station road and Shaheb bazar road. The major three HCEs do not segregate hazardous waste from non- hazardous waste but only separate wet infectious waste. Recent HCW management practice is not environment friendly. It has a adverse effect on health, aquatic life, receiving stream, surrounding and climate.
  22. 22. Department of Civil Engineering, RUET ICPACE 2017 Recommendation HCEs in RCC City Corporation should be equally distributed. To avoid the risk of Health effect from the wastes, it needs to formulate proper policy regarding this issue. To reduce environmental pollution, healthcare wastes are needed to be segregated. Ensure availability of waste collection van at RCC & supplying of bin through a central system. Ensure final collection, treatment and disposal facilities by RCC authority to protect the environment, public health and aquatic life from HCWs adverse effect.

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