Bike to school, not for the faint-hearted

By Agnes Winarti 

Published in Bali Daily/The Jakarta Post 

 | 

Saturday, June 16, 2012

  

With the almost non-existent public infrastructure for bicycles, the growing number of vehicles on the roads and motorists’ low level of tolerance, to name just a few hurdles, the implementation of the Bike to School program is a hard sell indeed.

“The bike to school program is only realistic for junior high school students who live just a stone’s throw from their schools,” junior high school (SMP) PGRI 2 Denpasar headmaster I Gede Wenten Ariyasudha told Bali Daily on Thursday.

“Other than that, I believe parents’ priority will be their children’s safety. Letting the children bike through the bustling main roads for long distances would not be an option,” said Ariyasudha. The school has about 1,600 students, 200 of whom cycle to school daily, while most others are picked up by their parents from homes as far away as the Batubulan area in neighboring Gianyar regency.

The Bike to School program, an effort to reduce traffic jams and create a less-polluted environment, was initially launched in 2010 by the Denpasar-based bicycling community SAMAS, and was supported by the Denpasar municipal administration. Last year, SMP PGRI 2 welcomed SAMAS’ Bike to School campaign. This year, SAMAS secretary Endra Datta said that the community had also been campaigning at junior high schools, including SMP Dwijendra, SMP 1 Ubud, SMP 8, and senior high school SMA 1 Ubud.

Since 2009, Denpasar has only provided 20 kilometers of special cycling lanes, which cover Jl. Sudirman, Jl. Raya Puputan, Jl. Tjok Agung Tresna to Jl. Hang Tuah and Jl. Danau Tamblingan in Sanur. However, the lanes cover only a miniscule part of the route required for the 58 junior high schools and 45 senior high schools around the capital. Also, the lanes can’t be properly used, as they are often full of parked cars, not to mention that cyclists have to compete for space against motorcyclists who dominate the main streets of Denpasar.

Last year’s data from the Denpasar Transportation Agency’s traffic division showed that the streets of the capital city were packed with 575,111 motorcycles, the number of which has grown rapidly throughout the years. In 2010, there were 492,285 motorcycles on the streets of Denpasar, while in 2009, there were only 457,772.

Even the prestigious state senior high school, SMA Negeri 3 Denpasar, that had a compulsory policy for 30 years obliging all its students to bike to school, has now surrendered this policy and has allowed students to ride motorcycles since 2006.

The school might have won the 2012 Adiwiyata Nasional award from the Environment Ministry for its numerous environmental efforts, such as waste sorting, composting, making biopore holes and building greenhouses for plants, as well as academic writings and films on the environment, but it currently has to rent a 2,500 square meter plot of land to continue expanding its parking lot for its students’ motorcycles.

“The consideration to terminate our compulsory policy for students to cycle to school initially surfaced in 1992. We were overwhelmed performing daily raids on the students, who secretly rode motorbikes to school,” said teacher Anak Agung Ayu Sri Adi, who is also the school’s environment coordinator.

The bike to school policy was terminated in 2006, with the claim that it would ease the journey for students coming from homes more than 10 kilometers away in Kuta, Jimbaran, Sukowati, Peguyangan, as well as Singapadu. “We are still urging those living nearby to bike to school, but now almost all of them drive motorbikes,” Sri Adi said.

Only about 10 students at SMA 3 still routinely cycle to school every day, while the other 851 students in the 10th grade to 12th grade ride their own motorbikes, despite the fact that it is illegal to have a driving license below the age of 17.

And what do the students have to say about Bike to School?

“Studying at class covered in sweat won’t be convenient. Besides, when it’s time for us to return home, at noon, it’s hot and the streets are too crowded with motorcycles. So it’s better we ride our own,” said 11th grader Putu Sri Adnyasari, 17, who has been driving her own motorbike since 10th grade and lives just about 1.5 kilometers from school.

Another student, Diah Gayatri, 16, who drives without license, said, “I have too many activities after school. Riding a motorcycle saves my time and energy, I couldn’t bike all the way.”

Most students also said that having no driving license was not a problem, as long as they knew how to avoid streets where traffic police were on watch. Some parents even slip Rp 20,000 notes in their children’s motorbike STNK (vehicle registration card), so that the child can use the money to bribe the police, just in case they are caught.

“It happens,” regretted teacher Sri Adi, highlighting just another attitude that will block the realization of the Bike to School program.

Mercury phase-out at hospitals faces uphill battle

By Agnes Winarti

Published in Bali Daily/The Jakarta Post Wednesday, June 13 2012

The phasing-out of mercury-based equipment is proving to be an uphill struggle as it faces resistance from hospitals in Denpasar. This is despite the United Nations Environment Programme (UNEP) planning a global legally binding treaty on mercury.

In 2013, the UNEP expects to launch a global legally binding treaty on mercury to gradually terminate the use of mercury worldwide. The World Health Organization (WHO) and Health Care Without Harm have also targeted a 70 percent reduction in the usage of thermometers and sphygmomanometers at worldwide medical facilities by 2017.

“Resistance comes from some hospitals, as they argue that digital thermometers and sphygmomanometers are lacking in accuracy. Speaking subjectivity, the mercury-based blood pressure measurement tools are actually more subjective and less accurate due to mercury leakages inside the measurement tube that are often left unnoticed,” Bali-based environmental NGO Balifokus founder Yuyun Ismawati told Bali Daily recently.

For the past five years, Prima Medika private hospital in Denpasar has been promoting the use of digital thermometers to service patients. The hospital’s general affairs manager, Dr Dian Ekawati, said that currently some 80 percent of the thermometers used in the hospital were digital, while the remaining 20 percent were mercury-based.

“Digital thermometers are easier to use. When measuring patients’ temperatures with the mercury-based thermometers, we sometimes need to wait longer for the Hg movement,” said Dr. Dian.

“However, to monitor blood pressure we prefer using the mercury-based equipment, because when we are reading the blood pressure we also feel and listen
to the systolic and diastolic pressure [of the heart muscles when relaxing and contracting]. If we use a digital monitor we have to fully rely on the equipment, so the result is less convincing and sometimes erratic,” Dian added.

Sanitation coordinator at Bali’s top referral hospital, Sanglah, Ketut Gede Surata, acknowledged that the process of gradually ending the use of mercury equipment was a matter of changing the medical staffs’ behavior and mindset, which he said, “is not as easy as turning the palm of your hand”.

Money matters also speak volumes in hampering hospitals to terminate the use of mercury-based equipment.

“The purchase of the non-mercury equipment would cause a bulging allocation from the hospital budget. A mercury sphygmomanometer only costs between Rp 700,000 [US$74.2] to Rp 1 million, while the digital or aneroid ones are Rp 3 million to Rp 5 million,” said Surata, adding that Sanglah currently planned to reduce the use of mercury fluorescent lamps and was working on setting its own Standard Operational Procedure (SOP) to cope with the chance of mercury spills in the hospital’s compound.

Balifokus staffer specializing in toxic waste, Luh Putu Kusuma Ririen, said that all 20 hospitals in Denpasar had yet to have a special storage for their mercury waste due to budget constraints.

Yuyun highlighted that the mercury phase-out efforts were seen as disrupting the long-standing business cooperation between hospitals and vendors of mercury-based equipment.

“We hope the vendors are willing to share responsibility with the hospitals to recycle the waste from their products. Equipment vendors are only concerned with selling their products, but they have no idea what to do with their products’ waste,” said Surata, citing that Sanglah also faced confusion in dealing with its silver bromide liquid waste, which was the end-product of developing x-ray films.

Every month, Sanglah’s x-ray lab uses 60 liters of liquid and at the end of the month there is about 1.5 liters of silver bromide chemical waste. “There are currently about four cans, or 20 liters, of silver bromide chemical stored in our warehouse. We still don’t know what to do with it,” said Surata.

Medical waste from 45 Bali hospitals: Where does it go?

By Agnes Winarti 

Photo by Anggara Mahendra

Published in Bali Daily/ The Jakarta Post Saturday, June 09 2012

Alone: 
BD/Anggara Mahendra
A technician pushes a cart filled with medical waste in an alley at Sanglah Hospital, which operates the only industrial-grade incinerator on the island.
Due to urgent calls to lower the operational capacity of its eightyear- old incinerator, Sanglah Hospital has, since March, ceased receiving medical waste from 45 private and public hospitals and clinics around Bali.

“We are trying to prevent our incinerator from breaking down. Previously, it could burn up to 700 kilograms of medical waste daily, but now we are limiting the total to 500 kilograms per day,” head of household and supplies at Sanglah Hospital Dr. I Wayan Aryana Yudiasa told the Bali Daily recently.

Since the initial operation of the incinerator eight years ago, Sanglah waste facility has served as the disposal point for medical waste from 93 hospitals and clinics throughout Denpasar, Gianyar, Klungkung, Tabanan and Bangli. Most of these are private institutions, 87 of which actively renew their yearly contract with Sanglah.

Between March and April, 45 hospitals and clinics had their yearly contracts ended. Sanglah is mulling whether to continue the heavy workload that has been taking a toll on the one-and-only incinerator for the whole island.

Among those with yet-to-be renewed contracts is BIMC Hospital, near Simpang Siur intersection. BIMC’s monthly medical waste amounts to 300 kilograms and is among the largest amount arriving at Sanglah. As Sanglah itself generates up to 350 kilograms of daily medical waste, a staggering 8,000 kilograms monthly, the incinerator can only accept an additional 150 kilograms daily from other hospitals, forcing Sanglah to halt the over-100- kilograms senders.

BIMC Hospital housekeeping manager Ari Prana Indra acknowledged to the Bali Daily on Friday that its contract with Sanglah had ended on April 1. However, when asked what measures had been taken for the past two months to handle their medical waste, he was reluctant to reply. Asked the whereabouts of BIMC’s medical waste since the contract ended, Ari said: “It is not here [at the hospital’s disposal area] anymore. It’s been transported for disposal, but it’s not a public disposal site. I’ve no further comment.”

Other hospitals that have been served by Sanglah’s incinerator also include private hospitals Prima Medika and Surya Husadha, just a stone’s throw away from Sanglah.

Surya Husadha’s household manager, overseeing sanitation and waste management, Desak Mahayani, declined to comment and suggested the Bali Daily contact a member of the hospital’s marketing team instead.

Surya Husadha’s daily medical waste, claimed to weigh up to 29 kilograms, is disposed of at a temporary disposal site and picked by trucks predawn. When asked where the trucks transported the waste, head of night-shift security, I Dewa Ketut Edi Adnyana, replied, “Please direct the question to the hospital’s public relations.”

Prima Medika’s general affairs manager, Dr. Dian Ekawati, said the hospital’s 15 kilograms daily medical waste was still transported to Sanglah as usual. “We’ve been cooperating with Sanglah since 2002,” said Dian, citing the contract had been renewed earlier this year.

“We’ve not thought about selfmanaging our own medical waste due to limited space. Building a waste management installation is difficult with regard to permits, not to mention a costly investment,” she said.

Among the 20 hospitals in Denpasar, only four are governmentowned, the rest are private hospitals. Sanglah’s incinerator was purchased with a grant from Australia in 2004. Every year, the incinerator requires up to Rp 80 million for maintenance, with a total allocation of Rp 150 million (US$8560) for operational expenses for both solid and liquid waste. Sanitation coordinator at Sanglah Hospital Ketut Gede Surata said, ideally, the annual allocation for the waste management system would be about Rp 600 million.

“This year, we requested a new incinerator with the same specification from the Health Ministry. But we are not sure whether the unit will arrive this year,” said Surata, who suggested that the hospital waste management system should have been divided into four zones, east, west, north and south Bali, to ease the burden of Sanglah as the island’s sole medical waste facility as it is today.