Firms must be responsible in handling packaging waste

By Agnes Winarti 

Published in Bali Daily/The Jakarta Post, Tuesday, June 25 2013

Despite the 2008 waste management law, hardly any companies committed to packaging waste management, acknowledged an Environment Ministry official.

Extended producer responsibility (EPR), is one of the crucial waste management paradigm shifts stipulated in Law No. 18/2008 that also requires individuals and communities to take responsibility through reusing, recycling and recovering waste.

After being ratified in November last year, the law’s implementing regulation, PP No. 81/2012, came into effect this year.

Deputy environment minister for environmental communication and community empowerment, Ilyas Asaad, urged companies to move beyond corporate social responsibility (CSR) programs.

“We’ve seen more companies implementing CSR programs for environmental preservation. That’s a good thing. But companies must move beyond CSR. EPR is a responsibility that they must take. They need to see the difference,” Ilyas told Bali Daily recently on the sidelines of Bali’s Big Eco Weekend organized by Coca-Cola Amatil Indonesia, Quiksilver and Garuda Indonesia on Kuta Beach.

“Companies in Indonesia have been asking for time, around 5 to 10 years, as a transition stage to realize EPR because it requires more funding. The government understands that. But we want to see that these companies are making some progress from year to year,” he said.

Ilyas acknowledged that a change in the waste handling paradigm, which previously was seen as an act of collecting and dumping waste at the landfill, required time. This was why awareness programs needed to be performed continuously.

Coca-Cola Amatil Indonesia business services director Bruce Waterfield pointed out that over the years, the company’s main efforts in handling its waste were through ensuring that responsible waste disposal information was being communicated properly on product packaging.

“As we design the packaging, we include information on the side of the packaging because at the end of the day they have the bottle in their hands. The producer’s main responsibility is to communicate to the consumers, ‘What should you do once you consume the products?’”

When asked whether the company allocated special funding for the retrieval and recycling of its packaging waste, Waterfield only stated: “Our packaging department has a special budget to make sure that information on the packaging is taken care of correctly.”

“But internally, we also continuously look for innovative ways to reduce the amount of waste that we produce. Things like the weight of our bottles. In the last few years, we have been able to reduce the weight of our bottles, which actually means less waste,” he said.

Separately, bottled water company Danone Aqua has been implementing a CSR program providing social and welfare empowerment to around 5,000 scavengers in South Tangerang, Bandung and Bali since 2010.

“The key is providing price stability for plastic bottles they collect because they cooperate with a plastic reprocessing factory that is supported by Aqua,” said Danone Aqua’s PT Tirta Investama sustainable development director Sonny S Sukada.

“These approaches are made as our efforts to prepare for the implementation of the 2008 law. The government does not even have a roadmap but we already have. I believe we are one step forward,” said Sonny, while adding that the company also established a coalition for sustainable packaging with other brands, including Nestle, Unilever, Coca-Cola, Tetra Pak and Indofood.

Slowly but surely, Sonny said, the scavenger networks built by Aqua had been able to recycle 5 percent of the plastic bottles produced by the company. The company has set an initial target of engaging in the recycling process of around 10 percent of the plastic packaging it produces annually. Nevertheless, Danone Aqua was unable to disclose any figure on the volume of plastic used in the production of their bottles each year.

Creating added value from coconut shells

By Agnes Winarti 

Published in Bali Daily/The Jakarta Post, Monday, June 17 2013

Discarded coconut shells are plentiful around Tanah Lot. Previously a headache for the destination management, now they generate additional income for local waste collectors.

Recently, Ni Wayan Nomer, 48, was trained to collect and process shredded coconut shells and sawdust, making the mixture into briquettes that can be sold as stove fuel.

Nomer expressed her hopes that the briquettes would bring extra income to keep the stove in her own home burning as well.

“We have been promised a share when the briquettes are sold to the public,” said Nomer, who has worked for 30 years as a trash picker at Tanah Lot in Beraban village, Tabanan regency. For extra income, she also collects and sells plastic trash and dried frangipani flowers picked up from around the 3.6-hectare area.

Tanah Lot, with its iconic temple perched atop a gigantic chunk of rock in the open sea, has long been a magnet for domestic and foreign tourists. Up to 8,000 visitors come on regular days, while in peak season over 10,000 visitors can throng around the destination.

However, waste is also a constant visitor, amounting to around 100 kilograms of plastic and other inorganic materials, as well as over 1,000 coconut shells; young coconut juice is a favorite beverage for visitors watching the sun set over Tanah Lot temple.

“We were overwhelmed with discarded coconut shells. Our waste collectors can only pick up a small number of them; they sell them to roof tile producers. By processing them into fuel briquettes, we hope to be able to create added value,” said Tanah Lot tourism destination manager, I Ketut Toya Adnyana. He estimated that a kilogram of briquettes could be worth Rp 4,000-5,000 (40-50 US cents), slightly higher than the usual wood charcoal.

“The Bali Hotels Association, under the Tri Hita Karana Foundation, has shown interest in purchasing the briquettes,” he said. He stated that 90 percent of the income would serve as revenue and business capital for the Gemaripah group, an acronym standing for Gerakan Masyarakat Mandiri Peduli Sampah (Independent Community Waste Movement). The group currently has 45 members mostly comprising the Tanah Lot management’s sanitation staff. Toya said that in future, the hundreds of snack and beverage vendors based at Tanah Lot, as well as the villagers of the 15 hamlets in Beraban village, would be expected to take part in the group’s activities.

The remaining 10 percent of the income is to be shared with Yayasan Kesejahteraan Korpri Bali and lecturers from Warmadewa University that have encouraged coconut shell briquette processing since 2011.

The processing was planned and financed by the corporate social responsibility program, Aqua Lestari, of bottled mineral water company, Aqua. In addition to establishing the Gemaripah group, the program also includes tree planting, training and workshops, purchasing coconut shredding machinery, equipment, dump trucks, and trash bins and trash carts.

Let the trash battle begin

By Agnes Winarti 

Published in Bali Daily/The Jakarta Post Monday, March 11 2013

While the Balinese Hindu faithful perform a series of religious rites to welcome their sacred Day of Silence, or Nyepi, which is fast approaching, the capital city Denpasar will again silently fight its largest battle of the year — against trash. 

“Indeed it’s true. We fight our largest war against garbage every year during the Nyepi holidays,” head of trash collection services at the Denpasar Sanitation Agency Nyoman Astawa told Bali Daily on Saturday.

He acknowledged that the trash accumulated through the days of Nyepi’s series of various rituals, including Melasti (the purification), Pengerupukan (the battle against evil) and Ngembak Geni (family gathering) amounted to the largest quantity compared to that produced during other Balinese Hindu religious days, like Kuningan and Galungan.

On regular days, Denpasar produces around 2,500 cubic meters (cbm) of garbage. Astawa estimated the accumulation of trash throughout the Nyepi holidays could reach up to 6,000 cbm per day, mostly in the form of religious offerings, the remains of the ogoh-ogoh effigies burnt during the night of Pengerupukan, and household waste, both organic and inorganic.

About 4 to 5 cubic meters of trash equals 1 ton.

Manager of Cemara waste depot in Sanur Kaja village in Denpasar, Made Sunarta, recently said: “I’m having a headache with the growing amount of trash. This upcoming Nyepi, the accumulation of trash will be at its worst, as my staff will all be off for the holidays.”

During religious days, the depot usually takes at least twice the daily volume of 8 cbm of trash, equivalent to the capacity of four garbage trucks.

As Melasti already started on Friday, the volume of trash, especially along the beaches of Denpasar —Sanur, Padanggalak and Mertasari, was up to 120 cbm, triple the norm.

Nevertheless, Astawa gave his assurances that the Denpasar Sanitation and Parks Agency was ready to battle the trash. “We will deploy our emergency squads to handle the trash produced during Pengerupukan night. They will work all out until dawn on Nyepi and work again from early morning the day after Nyepi to ensure the streets are clear of rubbish,” said Astawa.

Squads of 600 sweepers and a battalion of 1,000 garbage collectors will be cleaning up the trash on 113 streets around Denpasar. The garbage collection battalion is equipped with a total of 19 garbage trucks with a capacity of up to 12 cbm each. These vehicles are deployed by both the sanitation and parks divisions at the agency.

“This is truly a war. That’s why we call our guys the emergency troops and battalion,” Astawa said.

When asked whether the local communities themselves would engage in the cleanup after the rituals, Astawa said: “Well, we cooperate with a few traditional villages, such as Sanur and Kesiman, to clean up the beaches. On a daily basis, we have also urged the residents to initiate community-based waste management and to reduce plastic use when performing their rituals.”

“But we have to understand that this is how the religious rites have always been performed in Bali. We can’t demand much from the residents. Instead, the administration is adapting to the way the Balinese perform these traditions,” said Astawan, who is also a senior pemangku (temple priest) in his village in Canggu, which is in the neighboring regency, Badung.

Last year, reportedly, a troop of 1,500 street sweepers and trash collectors were sent out. Yet, piles of trash equivalent to some four garbage trucks were left unpicked and scattered in the Sesetan area, as well as suburban streets like Jl. Gunung Agung, Jl. Supratman Timur and Jl. A. Yani.

Anyone care to join this year’s trash battle, then?

Who cares about Denpasar’s trash?

By Agnes Winarti 

Published in Bali Daily/The Jakarta Post Saturday, March 09 2013

In 2002, the Cemara waste depot in Sanur Kaja village in Denpasar was initiated by a group of some 10 housewives out of concern about their neighborhood waste. Today, some 11 years afterwards, although still operating, the initiative has not yet infected the rest of the community.

“Today, out of 30 residents, there can be only two or three who are willing to sort their waste before collection. The rest continue to leave their trash unsorted,” Wayan Winata, who drives the depot’s trash truck, as well as collects and sorts the trash, said on Friday at the Cemara depot located on Jalan Tukad Nyali No. 1 Sanur.

“Ever since this depot started, the residents have been encouraged to sort their own waste. Today, that remains as a mere discourse,” said Wayan.

Years ago, 12 people did the chores that Wayan does, but today, only five personnel are left operating the depot, while the mountain of trash continues to grow.

Cemara waste depot coordinator, who is also a founder of the local NGO Wiguna Bali, Made Sunarta, acknowledged the overwhelming situation. The Sanur Kaja village has a total of eight hamlets with 5,121 families — only 40 percent of which are willing to use Cemara waste management service.

“Most prefers to dump their trash on the streets pavements or elsewhere as the administration still provides free waste collection services. They are also still unwilling to pay any waste collection fee,” said Sunarta, whose depot charges a Rp 5,000 (51 US cents) to Rp 30,000 monthly fee depending on the volume of trash being collected.

The depot collects a total of 8-16 cubic meters of daily waste, which equals to four trucks of waste. Sunarta claims the depot is able to sort 80 percent of the organic and inorganic waste, and process the organic as compost fertilizers, while the inorganic garbage with economic value is sold to collectors of used papers, plastics and cardboard.

For years, Sunarta said that Cemara depot along with the village caretakers has conducted training for residents to independently process their organic waste into compost and to sort out their waste. “But such training never really brings much behavioral change,” he said.

“As long as the administration continues to provide free trash collection, people opt for the easy way out, which is to simply dump their trash,” he said, urging the administration to take braver action and discontinue the free service.

This year, he said that he had proposed Rp 80 million worth of budget allocation for the operation of so-called environmental monitoring personnel (Jumaling-Juru Pemantau Lingkungan) personnel, who are expected to teach residents to change their behavior in handling waste.

Separately, at the 1,000 square meter depot, Wayan and his colleague Agus, continue the impossible daily race to sift the organic and the inorganic waste before transporting the residue to the Suwung landfill.

“In the old days, we could complete sorting out the day’s trash by the end of the day. Nowadays, more and more carts of trash can not be handled properly. We are just overwhelmed. This depot is overloaded,” Wayan said. In January, the depot was overloaded by piles of untreated trash equal to the volume of 10 trash trucks, Sunarta recalled.

According to Sunarta, operation of Cemara depot since 2007, has been fully-funded by revenue obtained from the sales of compost fertilizers, the sales of plastics and cardboard garbage, and the collection fee from residents. He said that the cost of operation remains allocated at Rp 100 million per year, thus forcing the depot to cut down the numbers of its personnel from 12 to 5 people.

Cemara is not the only trash depot in the capital city. Others include the Palasari depot in Sanur Kauh village and the Cempaka depot in Ubung Kaja village, the Ubung Lestari depot in Ubung district, as well as others in Tegal Kerta, Panjer and Serangan villages.

“There are many more waste depots in Denpasar. Most of them have become inactive,” said Sunarta.

Based on last year’s Denpasar Sanitation Agency data, the city saw a total of 1,175,161 cubic meters of garbage. The agency claimed that it had successfully transported around 71 percent of the city’s garbage to the Suwung landfill. The remaining garbage was processed by the city’s garbage banks (11.2 percent), private companies (7 percent), self-management entities (3.5 percent) and PD Pasar traditional market management (2.3 percent).

Every day, around 700 tons of garbage is sent to Suwung landfill. About 45 percent of the load comes from Denpasar municipality.

Denpasar urges residents to sort waste

By Agnes Winarti 

Published in Bali Daily/The Jakarta Post Wednesday, February 27 2013

Overwhelmed by the growing garbage piles on every corner of the city, Denpasar Sanitation Agency is attempting to implement its latest, and arguably most innovative, breakthrough in waste management, involving its residents in sorting their waste prior to collection.

“By March 1, during trash collection every Friday, I have instructed my collectors to only collect garbage that has already been sorted by the owners. We aim to engage the residents to reduce the volume of garbage right from its source,” Denpasar Sanitation Agency official I Ketut Wisada told Bali Daily on Tuesday, while stating that in major cities, every person produced at least 4 cubic meters of waste on a daily basis.

Wisada said that organic waste would be brought to the agency’s five organic waste depots around the city, while the inorganic waste with economic value would be brought to the 15 trash banks that jointly work with the agency. “This is a learning process for the residents. That’s why we would only apply this measure on
Friday collections. After a three-month trial, we may apply such collection methods on other days,” he said.

Wisada said that in mid-February, the agency had begun campaigning about the program to the heads of villages, sub-districts and districts, schools at all levels, as well as via Republic of Indonesia Radio (RRI). “Even last year, we also held meetings with the heads of villages and hamlets, so that they would agree to include the residents obligation to sort their own waste in the awig-awig adat [traditional regulations],” said Wisada. He claimed about 40 percent of the 390 hamlets in the 43 villages throughout Bali’s capital city had already included the measure in their awig-awig.

Nonetheless, as of Tuesday, or three days prior to the start of the new waste collection policy, many residents remained clueless about it.

Former head of Tegal Asah hamlet, Ida Bagus Rai Sujana, who is now an active member of the Community Empowerment Board in Sanur Kaja village, which is home to eight hamlets, said, “We have not heard about it. Usually information from our village head will be passed on to us, because we are sort of the legislative house in our village.”

“But we have paid Rp 25,000 [US$2.57] every month for the waste collection service,” cried Intan Indasari, a resident of Kertalangu Kesiman hamlet.

While the idea to involve its residents may sound like a ground-breaking solution, real implementation is yet to be seen.

Based on last year’s Denpasar Sanitation Agency data, the city saw a total of 1,175,161 cubic meters of garbage. The agency claimed that it had successfully transported around 71 percent of the city’s garbage to the Suwung landfill. The remaining garbage was processed by the city’s garbage banks (11.2 percent), private companies (7 percent), self-management entities (3.5 percent) and PD Pasar traditional market management (2.3 percent). “Only 5 percent, or 59,388 cubic meters was not handled properly. That is the trash illegally dumped on empty land and in streets,” said Wisada.

A 2011 official report by the Denpasar Sanitation Agency, as quoted on its website http://dkp.denpasarkota.go.id/, revealed that within the five years 2005-2011, the agency had seen a steady decline in the volume of city waste transported to the final dumping ground in Suwung. In 2005, the agency transported about 73 percent of the year’s total 839,434 cubic meters of garbage to Suwung landfill, but 2011 saw the agency only transport some 60 percent of the year’s total 1,151,341 cubic meters of garbage.

The report further stated that the agency and other private entities overall had only been able to transport 71 percent of the city’s total volume of waste to the final dumping ground. In 2005, the report cited 92 percent of Denpasar waste went to Suwung landfill.

Despite the presence of his signature on the 2011 report, Wisada insisted, “The report was erroneous. We only tolerate 5 percent of unhandled garbage.”

The Denpasar Sanitation Agency is currently gearing up for the national annual Adipura competition, which awards cities nationwide for their excellence in environmental conditions. Denpasar has failed to win the award in the past three years because of — among other factors — the ubiquitous garbage on the city’s street corners and empty land.

Sarbagita Forum delays action as trash escalates

By Agnes Winarti

Published in Bali Daily/The Jakarta Post Monday, February 25 2013

While the mountain of garbage accumulates in the Suwung landfill, the Sarbagita Forum continued to delay taking any firm action to correct the improper waste management at Bali’s largest landfill by providing more time for the private operator to comply with requirements in the nine-year-old agreement.

“If by the end of the year, it [the private operator] still fails to fulfill its contractual obligation to build gasification infrastructure, the Sarbagita administrations will terminate all activities,” Sarbagita Forum chairman I Ketut Sudikerta told Bali Daily over the weekend.

Sudikerta is currently also Badung deputy regent and is running for deputy governor alongside incumbent Governor Made Mangku Pastika in the ongoing gubernatorial election.

The Sarbagita Forum itself consists of the deputy mayor and deputy regents of the four administrations Denpasar, Badung, Gianyar and Tabanan. The forum has known of the performance failure of the operator since 2010, however, no action has been taken to penalize the breaches of contract.

Currently, under a 20-year contract signed in 2004, the 38-hectare Suwung landfill in Denpasar is operated by private company PT Navigat Organic Energy Indonesia (NOEI). In the contract, PT NOEI has agreed to apply a waste-to-energy technology called GALFAD, which consists of gasification, landfill gas extraction and anaerobic digestion, commonly known as composting. The company had boasted that it would be able to produce 9.6 megawatts (MW) of electricity per day, 5.6 MW of which would be produced from the gasification technology.

However, the company has been generating a mere average 500 kilowatts to 1 MW of electricity daily since December 2008 and has never fully implemented all the promised technology, leaving the gasification machinery out of their operations.

During a recent interview with Bali Daily, the president director of PT NOEI, Agus N. Santoso acknowledged that his company had never installed the gasification machinery at Suwung.

“We have not imported the machine yet,” Agus said.

“Importing the machine would be a fatal investment decision for us, after we learned that the waste moisture level and the waste characteristics in Bali are problematic,” added Agus. He argued that he had only learnt about the unsorted waste collection in Indonesia after taking on the project, having previously assumed that Bali had a proper waste sorting system just like in European countries. Out of the some Rp 160 billion (US$16.4 million) investment that PT NOEI claimed to have made in Suwung, Agus said some had been spent on erecting a waste sorting facility, which as of today remains idle.

Agus stated that PT NOEI had proposed contract revisions to the Sarbagita Forum since 2010. “Without any contribution from the administrations, it would be difficult for us to perform,” he said, citing the implementation of a dumping fee for private operators was the norm for successful waste management in various countries worldwide. During the project bidding process from 2001 to 2004, PT NOEI, which was newly established in 2003, was the only company that submitted a waste management project proposal without a dumping fee required from the administrations.

Nonetheless, Sudikerta said that the forum remained firm on declining the payment of any dumping fees. “That’s impossible. Badung regency is not willing to do so, nor are the other administrations,” said Sudikerta.

Every day, around 700 tons of garbage is sent to Suwung landfill. About 45 percent of the load is transported from Denpasar municipality, 10 percent from Badung regency, and around 3 percent from Tabanan regency.

A source inside the Denpasar mayor’s office said: “Obviously, PT NOEI has breached its contract. We prefer contract termination because we see that the company is unlikely to make any improvements, while it’s burdening Denpasar administration. We want a new operator that is more competent in terms of management and technology.”

Denpasar deputy mayor IGN Jaya Negara, who is a member of the decision making authority Forum Sarbagita, was unreachable for comments.

Firm action urged on Suwung landfill

By Agnes Winarti 

Published in Bali Daily/The Jakarta Post Wednesday, February 20 2013

Despite the performance failures of the private landfill management company PT NOEI and the alarming mountain of garbage in Suwung landfill, the four administrations whose trash is managed there are still reluctant to make a move, either to revise or terminate the contract, and seek a more competent operator.

In 2004, the company signed an agreement with the administrations of Denpasar, Badung, Gianyar and Tabanan, locally known by the acronym Sarbagita, to jointly manage and process waste at Suwung landfill.

However, nine years later, PT NOEI is considered to have failed to properly manage the waste and comply with the agreement.

“Since 2010, BPKS Sarbagita Sanitation Agency has reported to the four administrations about the breaches, including the absence of gasification machinery. But the decision must be taken by the administrations. Apparently, they still doubt whether they will be able to continue operating the landfill without a dumping fee,” said head of BPKS, I Made Sudarma.

“The Sarbagita administrations, during a meeting in Jakarta on Jan. 21, announced they were ready to contribute. However, they have not agreed on the fees,” said Sudarma.

While acknowledging insufficient knowledge of waste management back in 2004, PT Navigat Organic Energy Indonesia (NOEI), today still expects a revision of its 20-year waste management contract.

“Back in 2004, waste characteristic was not a consideration. We assumed that the waste here was similar to Europe, which is already sorted into organic and inorganic waste. Waste management techniques were not understood well by us and other people in Indonesia back then,” PT NOEI’s president director Agus N. Santoso told Bali Daily on Tuesday, despite the fact that the company has never operated in any European country.

When the 20-year contract to manage Bali’s largest landfill in Suwung was signed in 2004, PT NOEI was a newly established company, having been founded in 2003.

The unsorted waste, high-level of dampness and seawater penetration due to the proximity of the 38-hectare landfill to the ocean, were among the factors Agus claimed to be causing the company’s failure to comply with its 2004 contract.

In the contract, PT NOEI had declared that it would be able to produce 9.6 megawatts (MW) of electricity daily by managing the waste dumped in Suwung landfill through three types of technology, referred to as GALVAD, or gasification, landfill gas and anaerobic digestion.

The 9.6 MW of electricity was to comprise 4 MW from methane gas extraction and anaerobic digestion, also known as composting, and 5.6 MW from a high-tech gasification technique that requires heavy machinery.

It took the company around four years from the signing of the contract before it began producing electricity. Nonetheless, the production volume of only 1 MW daily has never reflected the target boasted of in the contract. As of today, PT NOEI has only been able to produce a mere 500-kilowatts per day from composting.

Agus admitted there had been a decline in electricity production since October as a result of a one-week fire that had occurred in the landfill.

Since October, the so-called integrated waste management facility has also been operating without the direct supervision of an operational manager because the in-charge manager has been assigned to work at PT NOEI’s other massive project, the Bantar Gebang waste management facility in Bekasi, West Java.

Agus acknowledged that today, nine years after the contract, the gasification machinery from the UK had never been installed in Suwung.

“We have not imported the machine yet,” said Agus, citing that the company had spent Rp 160 billion (US$16.4 million) to fill the Suwung peat land, pay salaries to some 100 staff, build a bridge and roads in the compound, and to build an office building.

The company has also installed an electricity network and generator, as well as a waste sorting facility, which remains idle to date due to the absence of the gasification equipment.

“Currently, there are many scavengers on the landfill. They are the ones who sort the waste,” said Agus.

In response to questions on the long queue of garbage trucks at the landfill, mentioned by the Denpasar Mayor Ida Bagus Rai Dharmawijaya Mantra in a recent public hearing, Agus also had his reason. “The long queue was caused by the damaged road to the landfill. But it is not PT NOEI’s responsibility to fix that road, there is 28 hectares of landfill not under our authority. It is still under the authority of the public works office,” he said, arguing that PT NOEI’s jurisdiction covered only 10 hectares of the Suwung landfill compound.

PT NOEI has requested revisions to its contract since 2010. Among the revisions demanded was for the 38 hectares of land to be under the company’s authority. After previously saying he forgot the details of the proposed revisions, Agus admitted that a dumping fee, or fee charged to the administrations to manage their waste at the landfill, was one of them. Reportedly, PT NOEI has proposed a fee of Rp 250,000 per ton of waste.

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.