Hazardous Health: Jaffna’s Growing Waste Crisis

R Ram

February 16, 2023


As the northern peninsula of the country, Jaffna District is renowned for its natural beauty and historical significance. But in recent years the area has been facing a new crisis that has caused a real stench. Our investigation can exclusively reveal the ever-growing improper disposal of harmful medical waste and the dangerous consequences it has for residents across the district.

Mrs. Dushiyanthan, a 34-year old mother of one, lives close to a disused limestone quarry in Keerimali, Nallinakkapuram. The site is vast, surrounded by small villages and a lush green landscape. Under the jurisdiction of Valigamamn North Pradeshiya Sabah, the area was known as an industrial pioneer when the country’s first cement production factory was established here in 1950. Long since abandoned, the backdrop of its now dilapidated steel structure is a constant reminder of a bygone era. But for Dushiyanthan, the present use of the site is far more pressing. The quarry has over time become a dumping ground for medical waste that’s mixed surreptitiously with household garbage, leading to a personal health crisis that has taken its toll on the Dushiyanthan family.

Dushiyanthan and her son stand outside their home, close to the Keerimali quarry where medical waste is dumped.

“My five-year-old son suffers from a variety of diseases one after the other. These days, he has increased wheezing and a severe cough. Last week we had him admitted to hospital, where he remained for several days”, her emotions seep through as she recollects her struggles since relocating to the area. 

“It has been five years now since we moved to this house.  For the last three or four years, they dump garbage in the quarry close to our house. Since that day our life has become a neverending shuttle from the house to the hospital and back home.”

Dushiyanthan lives in a ‘Reconciliation Model village,’ established as part of the resettlement process for families that had been housed in welfare centres across Jaffna. The homes were handed over in 2014; but in 2019, life changed for this fledgling community. 

The Valikamam North Pradeshiya Sabha created an ambitious land filling plan for the nearby quarry, collecting household garbage from all of its 17 local government councils and disposing of it on the site. As part of the plan, rubbish would be first graded and only harmless waste would be allowed to be dumped on the land. The villagers weren’t consulted about the plan and what subsequently transpired has had a suffocating effect on their lives.

Dushiyanthan isn’t alone in feeling trapped in a situation not of her making. Her neighbour, 63 year-old Rasaiyah Pushparanai, has no idea what kind of waste is dumped on her doorstep, yet the effects have tainted her golden years.

“Garbage tractors, vehicles and gully carriers dump all types of garbage and waste materials into the quarry. Unable to bear the foul smell, me and my grandchildren spend most of our time away from our village, only returning home in the evening. This has become routine for us now” says Pushparani with an air of resignation.

Unbeknownst to her – hospitals, the very institutions that have been charged with protecting the health of these villagers, could be contributing to their misery.

Jaffna District has five hospitals that discharge infectious medical and surgical waste that can cause serious health risks: Jaffna Teaching Hospital, Thellipalai Base Hospital, Point Pedro Base Hospital, Chavakachcheri Base Hospital and Oorkavatthurai Base Hospital.

Through a Right to Information request (October 2022) we have obtained data that reveals the three biggest producers of medical waste have a combined monthly total of over 23,000 kilos.

  1. Jaffna Teaching Hospital: More than 18,000kg
  2. Thellippalai Base Hospital: More than 3,500 kg
  3. Point Pedro Base Hospital: Up to 2000kg
Medical infectious waste from the Jaffna Teaching Hospital being transported into the premises of Thellippalai Hospital

Hospital waste is categorised into eight types: Infectious, disease-related, sharp, chemical, medicinal, microbial poisonous, radioactive and harmless waste. The Jaffna Municipal Council only accepts harmless waste, the rest should be incinerated in keeping with the regulatory guidelines set out by the World Health regulations and recommended by the Environmental Protection Authority of Sri Lanka.  This potentially hazardous waste must be burned at 1000-1200 Degrees Celsius and sharp waste (including used syringes), must be crushed and neutralized using a machine called a Metamizer.

However, after visiting these hospitals, we can reveal that these guidelines are not being systematically followed in the processing of Jaffna’s burgeoning medical waste as the capacity of existing infrastructure creaks under the weight of expectation.

Jaffna District’s only operational large scale incinerator working overtime at the Thellipalaya Hospital Complex

The mathematical equation is simple. For the whole of Jaffna District, there is currently only one operational incinerator, capable of processing 50 kgs of waste per hour. Other operational incinerators have either been decommissioned due to environmental concerns or remain in a state of disrepair.

Under the current strain this one incinerator, which is located on the Thellippalai Hospital site, needs to process waste for at least 20 hours a day just to cope with Jaffna Teaching Hospital’s current levels of waste. Yet it can only remain functional for 10-12 hours per day, due to the need for intermittent cooling, leaving a shortfall of thousands of kilos of hazardous waste that is literally left to rot with nowhere to go. 

Backlog: Hospitals have turned to storing medical waste due to the lack of processing facilities.

To compound matters, Thellipalai hospital’s Metamizer, which is used to break down and sanitize sharp waste, is decommissioned at present. With no alternative methods available, staff are now turning to incinerating these ‘sharps’ with other materials.

This ‘temporary’ solution not only breaks set guidelines, it also affects the recommended incineration temperatures., resulting in operational temperatures falling over 200 degrees Celsius. Jaffna’s only incinerator has now lost its capacity for effectively incinerating waste.  During our visit to the site, we observed a lot of partially-burned waste being discharged, including sharps.

Partially burnt waste discharged due to lower incineration temperatures

We approached, the public health department of the Jaffna Teaching Hospital to ask where this partially burned waste was being taken after discharge. They claimed that vacant land earmarked for their eye treatment unit in the Ariyala area, 19 km away outside Jaffna city, was being used to dump all partially burned waste.

However, after visiting this location we found no traces of waste. Wanting answers, we requested clarification from Jaffna Teaching Hospital’s management to their initial claim. Information Officer, Dr. S. Yamunanandal, retracted the first statement claiming he was now “not sure about it”.

But Jaffna Teaching Hospital isn’t alone in facing accusations of improper disposal of their waste. During our investigation we were informed that open burning of medical waste was allegedly  taking place on the grounds of Chavakachcheri Base Hospital in the dead of night.

Residents who live in close proximity to the hospital complained about finding it difficult to breathe due to the foul smell emanating from the hospital grounds. They also claimed that they have witnessed medical waste being burned. However, the director of the hospital denied the allegations when approached.

Returning to the Keerimali quarry, we find the villagers’ concerns have found support from Sanmugalingam Sujeevan, member of Valikamam North Pradeshiya Sabha.  He insists medical waste is being dumped surreptitiously into the quarry close to Nallinakkapuram without any grading – as promised in the initial land filling plan. Sujeevan seems to have taken on the role of spearhead in voicing residents’ complaints about the dumping of medical waste.

Keen to prove his claims, he enthusiastically directed us to the mountain of garbage that has engulfed the quarry, pointing out where remnants of medical waste are dumped. We can verify his claims, having witnessed surgical waste submerged within the decomposing vegetation including syringes, used tubes and glass vials.