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 Table of Contents  
PRACTICE STORY/OPINION
Year : 2017  |  Volume : 15  |  Issue : 3  |  Page : 252-256

Recycling: Wealth from waste


Continuing Medical Education Unit, Christian Medical College, Vellore, Tamil Nadu, India

Date of Web Publication7-Aug-2017

Correspondence Address:
Tony Abraham Thomas
Continuing Medical Education Unit, Christian Medical College, Vellore - 632 002, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_59_17

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  Abstract 


Recycling of waste produced by a hospital is an essential component of hospital management. The volume of nonmedical waste, in the form of organic and non-organic materials, is often much greater than the volume of medical waste generated by a large hospital. Recycling this nonmedical waste is a much more efficient, environmentally friendly and economical alternative to disposal by dumping or other methods. The recycling project of Christian Medical College and hospital, Vellore, has been managing the large amounts of nonmedical waste from the hospital for over a decade and this can be emulated in hospital settings of a similar or smaller size.

Keywords: Biogas, medical waste, non medical waste, recycling, vermicompost


How to cite this article:
Thomas TA. Recycling: Wealth from waste. Curr Med Issues 2017;15:252-6

How to cite this URL:
Thomas TA. Recycling: Wealth from waste. Curr Med Issues [serial online] 2017 [cited 2019 May 26];15:252-6. Available from: http://www.cmijournal.org/text.asp?2017/15/3/252/212377




  Introduction Top


Management of waste generated by a hospital is an important responsibility that has social, environmental, financial, and legal implications for the institution. Recycling of nonmedical waste serves the purpose of managing waste in an environmentally responsible manner while also generating some income. The recycling project of Christian Medical College(CMC) has been functional for the past 12years, safely disposing waste and generating income through sales of the recycled materials, vermicompost, and biogas generated from the waste. Along the way, the project has been quietly transforming the lives of the workers involved in the process as well.


  the Problem Top


The recycling project started in response to a problem. Alarge medical institution like CMC has to deal with a massive waste management issue–around 11,000 kg/day of nonmedical waste(paper, plastic, leftover food, etc.). The volume of nonmedical waste generated is larger than that of medical waste(which is dealt with by an agency authorized by the Pollution Control Board). Until 2005, the nonmedical waste had been managed by burying in large pits and landfills in a corner of the campus. However, this was associated with some significant problems-(1) Cost and space–a large area of valuable land was used up which could be used in a more productive manner,(2) environmental hazard–toxic materials in the waste buried in pits tend to leach into the ground, contaminating groundwater to a radius of 10 km, especially during rainy season, and(3) smell–decaying food matter results in a bad odor that is not appropriate in residential areas. As the hospital grew in size, the problem increased alongside, and the administration was faced with the challenge of managing all the three problems associated with waste disposal in a manner that was safe and environmentally responsible.


  the Solution Top


In the search for a solution, the possibility of recycling the nonmedical waste appeared to be a solution that could potentially tackle the problem of disposal of waste, while also generating some income from the material that was recycled.


  the Recycling Process Top


The recycling center in CMC Vellore is situated in one end of the campus and has a separate area for each function. Recycling involves collection of waste, segregation of the materials into various classes(paper, plastic, etc.), and washing, drying, and grading according to quality. Once separated and graded, the material is baled(compacted) for transport and sale.

Collection

The nonmedical waste from the hospital and college campus is collected by workers who travel in tricycles. This involves collection of the plastic covers(made of biodegradable plastic) of different colors by women from the self-help groups who go around in a tricycle. The collected bags are then transported by trucks to the recycling center [Figure1].
Figure1: Collection of waste.

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Recycling waste from a hospital is most effective when there is segregation of waste at the source. Medical waste (needles, syringes, tissues, blood/fluid-stained materials, etc.) has to be first separated from nonmedical waste. The different types of nonmedical waste should also ideally be segregated at source. In CMC, different colored plastic bags are provided for different types of waste and staffs are educated to throw waste of different types only in the appropriate colored bin (green for food waste, brown for recyclable waste). This segregation at source is fairly effective if reinforced periodically and is useful in making the process of waste recycling more efficient.

Segregation

At the recycling center, the collected waste material is then segregated into organic(food waste) and inorganic waste[Figure2] and [Figure 3]. Once this is done, the inorganic waste is further segregated according to the type and grade of material(paper, plastic, etc.) and sent for baling. In the segregation yard at the recycling center, there are two kinds of segregation–dry site and wet site segregation.
Figure2: Segregation.

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Figure3: Segregation of waste.

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Wet site segregation

Here, plastic, polythene, and aluminum foil covers are separated from the food through a process of washing and drying. The washed materials are then dried in a large solar drier[Figure4] before being graded further along with the dry items. Among the food items, uncooked material such as vegetable peels and bones are removed and sold as animal feed. The leftover cooked food is then used to produce methane in the biogas plant.
Figure4: (a) Washing at wet site segregation.(b) Solar drier.

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Dry site segregation and grading

The dry materials are segregated into plastics, papers, metals, and glass bottles and then graded according to quality. For example, plastic covers are graded low-density polyethylene and high-density polyethylene, road waste(polystyrene food packing), and polypropylene packing. And, plastic containers are graded into first grade or virgin plastics, second-grade plastics, and broken plastic pieces[Figure5]. Metal, paper, cardboard, and wood scraps are similarly segregated and prepared for baling. The process of segregation and grading may appear to be work intensive, but is worthwhile because this ensures that the center receives the right price according to the quality of the item, thus increasing the income generated.
Figure5: Plastic segregation.

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Baling

Once segregated and graded, the items are sent for baling. Baling is the process of compacting the plastic, paper, and other items using an electric baling machine[Figure6]. Compact volumes reduce the space needed for storage and ensure that a greater quantity of material can be loaded into a truck for transport, thus reducing transport costs.
Figure6: Baling machine.

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Biogas

Biogas is generated from the leftover cooked food materials collected and is used for cooking in the nearby men students' hostel, providing up to 50% of the cooking gas used. This enables a saving of Rs. 10,000/week in cooking gas expenses. About 1000–2000 kg of food waste is processed in this manner every day. The biogas plant comprises an open feed tank, a slurry chamber, and a closed digesting chamber. The process involves mixing the collected food material with slurry (which contains the micro-organisms that digest the food). This mixture is then fed into the digesting chamber where the process of fermentation results in the release of methane gas[Figure7]. Cow dung was initially used for this process, but over time, engineers experimented and innovated with different percentages of cooked food. Today, methane gas is generated from the leftover food alone, without adding any cow dung, which is the traditional source of biogas. Gobar gas (derived from cow dung) yields a higher percentage of methane(42%), compared to food materials alone(32%–34%). However, this method of using food materials alone serves the purpose of recycling our food waste efficiently.
Figure7: Components of biogas plant.

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Vermicompost

The women employed in the recycling center are also involved in generating a high-quality, nutrient-rich vermicompost from cow dung and food waste with the help of earthworms [Figure8] and [Figure 9]. This is then sold for gardening purposes and provides a part of the income.
Figure8:Generating vermicompost.

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Figure9: Earthworms used in vermicomposting.

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  Interview With Dr.anna Pulimood, Principal Of Christian Medical College Vellore Top


How did the recycling project start?

The recycling project was started in response to a problem the institution faced in the disposal of nonmedical waste generated by the hospital and residential areas. The project was thus initiated in 2005, in partnership with a nongovernmental organization called EXNORA. The project grew over the years and proved to be very effective, providing benefits in areas that we had not initially envisioned.

EXNORA had been involved in greening of the hills around Vellore, and to provide green cover to a hill within the college campus, compost was required. We realized that we could generate compost from the food waste from the hospital and thus the recycling project started.

A portion of the institution's land was allotted for a recycling plant and we started employing women from the surrounding villages and trained them to collect, segregate, and process the materials. The motto of the recycling project was “wealth from waste.” We envisioned a project with 100 workers handling a certain amount of waste, but within a few weeks, realized that we would have to scale up the project considerably. We had to ensure that the waste that was collected in the morning was processed by evening to avoid the problem of bad odor in the residential areas. Despite several initial teething troubles, the project took off.

The women workers are initially given 15days of training, where they are made to work in different sections of the recycling center to learn how to segregate and grade the waste materials. After the period of training, they are taken in as employees. We have about 200 women employed at present. Each worker has a bank account and certain amount is set apart as savings. The institution provides financial support to the women employed in the recycling venture.

Is the program economically self-sustaining?

The income generated varies and covers between 25% and 50% of the total expenditure, depending on various factors such as the price of the materials and government regulations that determine the sale of certain types of materials(like virgin plastic from intravenous fluid bottles). However, the project has solved the thorny issue of disposing off the waste generated in an environmentally friendly manner. This more than compensates for the fact that it is not fully self-sustaining.

What is the impact on Christian Medical College and the community?

The project has solved the problem of managing our nonmedical waste. The recycling process generates income from the sale of the material. The use of biogas has reduced cooking expenses considerably in the student hostel. The CMC community is involved as the residents understand the various aspects of the project, interact with the workers, are involved in waste segregation, and buy vermicompost for gardening, which has contributed to the greening of the campus.

However, the most important impact has been the transformation among the workers. The project has provided a regular source of income to several women and transformed their way of life. Many of the women come from broken families, with a background of poverty, domestic abuse, and difficulties in bringing up children without a steady source of income. Many of them are the only breadwinners of the family. Working in the project ensures that they receive a steady income with paid leave. Moreover, they have the guarantee that they are employed throughout the year, which is rare in rural households, especially for women involved in nonformal work with daily wages. Even government schemes like MNREGA only provide work for 100days of a year.

The system works because of a sense of comradeship among the workers who often come from similar backgrounds. The women enjoy their work and there is a sisterhood with a sharing of each other's lives, working together, eating together, electing their own leaders, and carrying each other's burdens. They have a sense of dignity because they manage the project on their own, elect their own leaders, and provide for their families. Ihave enjoyed overseeing this project and I would say this was one of the most useful things I have done in my life.

Do you think this model can be emulated in smaller hospitals?

Definitely, recycling of nonmedical waste is feasible and can be done in a smaller hospital. In fact, it should be encouraged as it solves several problems. Initially, there may be a significant cost involved, but over the years, the income generated will cover much of the investment. The savings in the value of land that is wasted as landfill, if we are not recycling waste, is something that cannot be easily measured but is significant.

Online resource: View a short documentary on the recycling project of CMC Vellore–Available from: https://www.youtube.com/watch?v=uzmSjknGXkY.


  Interview with Women Workers Top


In the office of the recycling center, a group of four women workers agreed to talk about their work they do. The conversation is candid, and the smiles that punctuate the free-flowing conversation point to a contented group of women, happy with what they are involved in[Figure10]. Gauri* is a middle-aged woman who has been working since 2006, starting as a trainee and working up the ranks. She is now a supervisor in one of the sections. Hailing from a nearby village, she joined the project to have a steady source of income. Income from making papads, which was what she used to do, was irregular and insufficient. The steady income has ensured that she can fulfill the needs of her two children despite the twin shocks of losing her brother and husband to alcohol. “My girl is training as a nurse and my son works in a software company in the city,” she says with a calm sense of assurance.
Figure10: Women workers at the recycling center.

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Gomathy*, another middle-aged woman with a bright “pottu” on her forehead, added to this by saying, “I get a regular salary which is a big boon. Iused to struggle to pay the house rent on time and pay the school fees regularly, which is not an issue now. Also, I can take loans for a very small rate of interest, which has been useful in meeting some major expenses in my family–like paying for my children's education, funeral expenses for my husband, and others. My husband had a drinking problem, was abusive, and did not work. Now I can manage my family even if there is no financial input from a male member. There are many like me in this center.” The others nod in agreement.

When questioned about the training that they underwent and the work, Sasikala* replied that all of them underwent training in the various aspects of recycling and had to undergo an examination by professionals from a nearby engineering university and were given a certificate. She found work to be a little difficult at first, but that was a passing phase. Over the years, she was promoted to a higher position and is now in a supervisory role in one of the sections in the center. The sense of dignity and confidence that the work gave her was something she valued dearly.

Sunitha*, who hails from a nearby village and has been working for 12years, took up this job after her husband died and faced an uncertain future. “Today, I have the courage that there will be food in my house, without having to depend on anyone else. When my husband died, I went into deep depression and was on medication, but this work has helped me come out of my despair. However, the best part of working here is the happiness I get in working with other women with whom I can share my difficulties, laugh and cry, and eat together. If I do not have anything to eat, others share their food; if I have a problem at home, my friends pitch in to help.” Two others chime in with similar statements, affirming that the sense of being together and working together is what makes them most happy and enables them to continue working in this place.

The women come from the villages nearby or from far away, some all the way from neighboring states. The common thread that runs through all their stories is a desperate need for income to sustain their families and the oft-repeated reality of loss of income from the male members of their family due to alcohol or ill-health. The job has provided them with not only the comfort of steady income, but more importantly, dignity and a sense of belonging and camaraderie among themselves.

(*names changed).

Financial support and sponsorship

Nil.

Conflicts of interets

There are no conflicts of interest.




    Figures

  [Figure1], [Figure2], [Figure 3], [Figure4], [Figure5], [Figure6], [Figure7], [Figure8], [Figure 9], [Figure10]



 

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Abstract
Introduction
the Problem
the Solution
the Recycling Pr...
Interview With D...
Interview with W...
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