With the SARS outbreak fresh in their minds, environmentalists are pressing for improved sanitation conditions and waste disposal methods.

In a recent but little reported development, the State Environmental Protection Administration (SEPA) has submitted a plan to the State Council for setting up centres across the country to dispose of what it terms as "dangerous wastes".

"Medical wastes are classified in our plan as 'dangerous'," Wang Shancheng, a SEPA official, says. "We believe that medical wastes are no less dangerous to human health than the radioactive wastes and toxic particles discharged by some industries."

Details of the plan have yet to be published, pending approval by the State Council. Wang, however, discloses that the plan calls for establishing two to three hundred medical waste disposal centres nationwide over the next two or three years.

Sources with the Beijing municipal government say that the Chinese capital is to build two new medical waste disposal centres between now and the end of 2004, which are expected to handle 60 tons of waste per day.

Beijing was among the world's hardest hit regions during the SARS epidemic earlier this year, reporting 193 deaths in total. Before the epidemic struck, hospitals in the city were producing, on average, 41 tons of medical waste per day. But with only two incinerators to burn the waste, even at full capacity, the city was only able to dispose of about 10 tons per day, according to an official with the Beijing Municipal Administration Committee.

The amount of SARS garbage, a major source of infection, continued to grow as the situation worsened, from about 50 tons on April 30 to 70 tons on May 7. From time to time, as many as 150 tons per day were being produced when the SARS epidemic peaked in late May. The city was completely unprepared for the onslaught. "We had no specially designed vehicles to transport infectious medical waste," says Lu Jianguo with the Beijing No 2 General Sanitation Engineering Co. "We had to order such vehicles from elsewhere. After the first shipment arrived on April 24, we had to put some of the trucks to work even before they had licence plates." The company, which operates under the Beijing Municipal Administration Committee, is responsible for the city's general sanitation.

The panic-stricken municipal authorities also placed emergency orders for incinerators wherever they were available, in China or abroad. Altogether, 42 incinerators were purchased, along with 90 airtight trucks for transporting waste and garbage from hospitals handling SARS cases, along with which 17 incineration stations were set up. In mid-May, the first two new incinerators were put into use in the Daxing and Haidian districts, respectively. "The temperature inside the combustion chamber (of an incinerator) is as high as 850 degrees centigrade, enough to melt iron let alone the kind of coronavirus scientists have identified as the culprit of SARS," Lu says.

Altogether, 500 sanitation workers were organized into special teams to transport and burn SARS garbage. "They worked day in and day out to help fight the epidemic, and it was not until August 1 that they were able to remove their protective suits and masks," Lu recalls.

Officials and experts with the Ministry of Health and Beijing municipal government admit that the SARS epidemic taught China an "important lesson". They agree that on no account must China slacken its vigilance against SARS, as there is still so little known about it.

As Wang Shancheng puts it, however, the SEPA plan is meant not only to cope with a possible return of SARS but also to address the country's environmental concerns.

Centralized disposal

A survey conducted by Nie Yongfeng, a professor at the Department of Environmental Science and Engineering of Tsinghua University, indicates that about 90 per cent of medical waste produced in China is buried like household garbage. "This practice has caused a myriad of environmental problems and could be a long-term threat to soil and water sources," the professor notes.

Of the medical waste produced across the country, the professor continues, only 10 per cent is burned in incinerators. Hospitals in nearly all large and medium-sized cities in the country have no up-to-standard incineration facilities. According to Professor Nie, the disposal process of substandard incinerators is too rudimentary to eliminate harmful and poisonous substances found in medical waste. In fact, they actually produce particles that pollute the air. "I think that a centralized incineration of medical waste should be set up on the spot or in the neighbourhood," Professor Nie says.

He adds: "Centralized disposal of medical waste must be done with technologically advanced and reliable facilities, and medical waste disposed of in this way should be buried deep, preferably 50 metres underground, in order to be safe."

Incineration is costly compared to other methods of disposal. But Nie and other experts stress that after incineration, the amount of solid wastes can be reduced by 80 to 90 per cent, thus requiring far less burial space. "Besides," Nie adds, "the heat produced during the combustion process can be used to generate electricity.

"While the situation in China is complicated," Nie continues, "'we still have the ways and means to determine the output of medical waste and find out where such waste ends up. We can, if we try, ensure thoroughly effective control of medical waste disposal."

He suggests that hospitals classify waste, as required, before sending it to disposal centres. They should take drastic measures to guarantee that the waste they produce is handled under strict supervision and through permitted channels. He insists that all hospitals be fitted with facilities for proper disposal of their waste.

"The government should emphasize practical results and set a higher standard for medical waste disposal," Nie says. "It's worthwhile for both public health and environmental protection."

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