space Press Releases, News Stories

by Catherine Lazaroff, ENS

Medical waste incinerators produce significant amounts of dioxin, a carcinogen, and mercury, a heavy metal which causes central nervous system, brain, kidney and lung damage.

Incineration is being phased out in industrialized countries because cleaner alternative treatment technologies are available. In the U.S., there were over 4,500 incinerators in operation in 1990. Today there are fewer than 2,500, most of which are being closed because they can not meet environmental standards.

"While the United States is turning away from this technology, the World Bank is promoting it," said Ann Leonard, director of the Multinationals Resource Center (MRC), a Washington, D.C. based member of Health Care Without Harm, founded by consumer advocate Ralph Nader.

"It is incredibly ironic that the World Bank, an institution allegedly committed to environmental protection, is facilitating the spread of this dangerous technology to Third World countries, says Leonard. It is a clear case of environmental racism - incinerators and dioxin are too dangerous for us in the rich countries but are acceptable for people in the Third World."

Environmental and health organizations in India, Japan, Lebanon, Mexico, Senegal, South Africa, and Turkey also released the report and called for an end to medical waste incineration in their countries.

Babcar Ndaw of the Senegalese anti-incinerator network, Réseau Sénégalais d'Information sur les Déchets, says "we want funds to treat us and not to poison us" from the World Bank.

The World Bank’s principal environmental specialist David Hanrahan says incinerators are sometimes used in developing countries because other methods can be too costly for small, underfunded medical facilities.

Disposal of contaminated syringes, scalpels and other dangerous medical waste can form a large percentage of a medical facility’s budget.

"Where hospital budgets are extremely small, we all have a problem of how to insure there’s an adequate approach to the medical waste problem," says Hanrahan. The risks associated with incineration should be put in the larger context of the problem of medical waste disposal, he told ENS.

Multinationals Resource Center first learned of World Bank funding for medical waste incineration while interviewing an official of the West Bengal Ministry of Health and Family Welfare in Calcutta, India in April 1996. The official reported that the World Bank had recommended incinerators at hundreds of hospitals throughout the State and that the Bank had not provided any information regarding problems with incinerators or availability of alternatives. The World Bank has had discussions with HCWH members over the past six months, and is working with various groups to address medical waste issues. "We would agree with them that uncontrolled burning is unacceptable. We both recognize this is a major problem. We have taken that as a starting point to try to address the whole issue" of medical waste disposal, Hanrahan says.

Opponents of incineration claim risks from dioxin can outweigh other risks from medical waste. Earlier this month, traces of dioxin in animal feed in Belgium caused the most expensive international food contamination scandal in history, and toppled the Belgian government in elections on June 13.

"At a time when Europeans are frightened about dioxin in their food supply and American babies are being born with dioxin already in their bodies, it is outrageous that the World Bank is actually financing projects which will increase the dioxin load in countries around the world," said Gary Cohen, co-coordinator of HCWH.

Medical waste in India (Photo courtesy Indian NGOs) "We believe that properly designed and controlled incineration should be an option, given that it is a totally accepted solution in all the regulatory agencies," says Hanrahan. The World Bank is making an effort to ensure that medical waste disposal is handled in the best possible manner, particularly where concerns have been raised over individual sites.

"In India, we have reviewed exactly what has been happening to make sure that whatever the Bank does support meets environmental and health requirements," says Hanrahan.

Some Indian citizens say that is not enough. Nityanand Jayaraman, an anti-incinerator expert in India, says, "Citizen groups and communities in India must be warned about the World Bank's complicity to poison us by financing incinerator proposals. It's a pity that the Bank hasn't learnt from its past mistakes and continues to dump dirty western technologies and practices onto unsuspecting southern countries."

The World Bank is working with the health sector to provide information on options for medical waste disposal. The Bank is now circulating a guidance note to help medical professionals "understand when they have a medical waste problem and how severe it might be," Hanrahan says. The Bank intends to solicit comments from HCWH and other concerned groups on the note, which is based on guidelines from the World Health Organization.

"We keep coming back to the problem that good waste management is a costly business," Hanrahan says. "What are the priorities of the health sector and how do we help them to meet those priorities?"

The HCWH report, "The World Bank's Dangerous Medicine: Promoting Medical Waste Incinerators in Third World Countries" is available online at:

www.essentialaction.org/waste/worldbank.