waste management - model

1. CMC
Vellore
SUMMARY - MODEL WASTE
MANAGEMENT FACILITY AT CMC
VELLORE
Mr. JOEL SABASTIN
Engineer
ENVIRONMENTAL ENGINEERING
Christian Medical College Vellore
Serving the nation since 1900

2. CMC
Vellore
Summary on the Model Waste Management Centre at
CMC Vellore
Christian Medical College & Hospital, Vellore is a complex multidisciplinary system, which consumes
thousands of items for delivery of medical care and is part of the physical environment. All products
consumed in hospitals leave some unusable leftovers. These wastes are generated as a result general and
clinical activity.
There was a need for a complete rethinking of "waste" handling & disposal - to analyze if waste is indeed
waste.
Arethinking that calls for - “WASTE to become WEALTH,
REFUSE to become RESOURCE,
TRASH to become CASH

3. CMC
Vellore
Christian Medical College & hospital not only excels in providing excellent patient care &
in academics, but also excels in complying with the legal & statutory requirements
prescribed by the State & Central level competent authorities.
Christian Medical College, Vellore & its peripheral campuses are handling about 11- 12
MT of General waste and 6.2 MT of Bio medical waste every day and All campuses
follow the same Methodology to Properly handle and dispose the waste as per the Solid
waste management rules & Bio Medical waste management rules respectively.
CMC Vellore as a Waste Management Model Centre

4. CMC
Vellore
S.NO Location Bed Capacity
1 Christian Medical College Hospital- Scudder Road-
Vellore
2565
2 Christian Medical College Hospital- Ranipet Campus
1200
3 Ophthalmology Department and Low Cost Effective
Care Unit
140
4 Community Health and Development Department
(CHAD).
135
5 REHAB Unit.
83
6 MHC & Nambikkai Nilayam Centres
98
7 RUHSA Hospital-
70
8 Christian Medical College Hospital- Chittoor Campus
130
CMC & its PERIPHERAL CAMPUSES

5. CMC
Vellore
Baseline Audit At Nodal Centre CMC Vellore
27
 On July 17th, a meeting was conducted by CAHO and
WHO nominee Mr Manjeet Saluja with the Christian
Medical College Vellore, one of the Model waste
management centres.
 As CMC Vellore has multiple campuses, a briefing
meeting was held on 17.07.2023. Dr Vikram
Mathews, Director of CMC Vellore welcome Mr.
Manjeet Saluja and had an opening remarks
meeting along with Dr Lallu Joseph.
 The opening meeting was attended by BMW
Committee members of CMC Vellore, the CAHO
project team and the WHO nominee.

6. CMC
Vellore
Baseline Audit At Nodal Centre CMC Vellore
28
During the visit, multiple parameters as laid out in
the questionnaire and audit checklist was observed.
As a part of the visit, the common treatment facility
centre at Kandipedu Vellore (Ken biolinks) was
visited the audit team.

7. CMC
Vellore
Model Ward and ICU for the Model Waste Management
Site Christian Medical College, Vellore
2
9
At CMC the model wards identified were as follows:
S. No Campus Ward/ICU
1 Ranipet C201 & MICU
2 Town B Ward & MICU
3 MVRC PMR One male ward Cubicle Bed No 15-18, Female Ward 19-22
4 SCHELL Male, Female, Camp Ward and Operation Theatre
5 MHC Low-Cost Private Ward & Emergency Department
6 RUHSA Labor Ward & Operation Theatre
7 CHAD Antenatal Ward & ICU
8 Chittoor Medical Ward & HDU

8. CMC
Vellore
Bio-medical waste generated from the health care facility into four categories based on the segregation pathway and colour code.
This quantity of such waste is around 10 % to 15 % of total waste generated from the facility.
Steps involved in Bio-medical Waste Management rules 2016 & 2018.
• Segregation – Source segregation based on four colour coded categories and packing & labelling of the waste bags/covers.
• Collection – Dedicated timings for collection of waste
• Pre-treatment – The microbial, blood bags & laboratory wastes are autoclaved at Site and disposed as per the BMW 2016
Rules.
• Intramural Transportation – Dedicated closed trolleys & dedicated route for transportation of waste.
• Storage – Dedicated Temporary storage area with scheduled cleaning protocols & clearance of waste before 48 hours
• Maintaining the records of bar coding of the waste bags at Site prior disposal.
• Submission of Bio Medical waste Annual report through OCMMS portal
• Treatment and Disposal of biomedical waste through CBWTF or Captive facility authorized by the state pollution control
board.
• Drug / expired medicine Disposal – by the TNPCB Authorized Treatment facility/ handlers
Bio medical waste

9. CMC
Vellore
Bio Medical Waste Handling at CMC Vellore :

10. CMC
Vellore
Final Disposal at CBMWTF – (Ms. Ken Bio Links)

11. CMC
Vellore
LIQUID WASTE MANAGMENT
Liquid Waste :
The waste from the above sources are collected in a separate collection tank.
1% Sodium hypochlorite solution is added into the collection tank with a retention of 20 minutes to
neutralize the microorganism in the effluent.
The Neutralized liquid waste is treated using the Effluent Treatment plant

12. CMC
Vellore
Sewage & effluent are treated by designing a sewage treatment plant (STP) & Effluent
treatment plant, which involves three stages: primary/preliminary, secondary and tertiary.
The Facility operates Different capacities of sewage Treatment plant ranging from 2000 KLD,
300 KLD, 250 KLD, 100 KLD , 450 KLD X 2 and DEWAT plant in their respective campuses
with different concept of Treatment mechanisms like Membrane bio reactor, Fluidized media
reactor and FluidizedAerobic Bioreactor (FAB).
The waste water from the health care facility is treated using a biological system and the
effluent discharged or reused should satisfy the Standards prescribed by Central Pollution
control board.
The application of the treated water is Flushing, Gardening, and Laundry & HVAC.
The STP’s & ETP’s operational at CMC Vellore adhere to the standards prescribed by the Legal
authorizes and fulfil the legal compliances.
LIQUID WASTE

13. Waste water treatment Plant

14. CMC
Vellore
The effluent generated or treated from the premises of occupier or operator of a common bio medical
waste treatment and disposal facility, before discharge into the sewer should conform to the following
PARAMETERS
(1) pH -
(2) Suspended solids -
(3) Oil and grease -
(4) BOD -
(5) COD -
PERMISSIBLE LIMITS
6.5-9.0
100 mg/l
10 mg/l
30 mg/l
250 mg/l
(6) Bio-assay test 90% survival of fish after 96 hours in 100% effluent.
STANDARDS FOR DISCHARGE OF LIQUID WASTE

15. CMC
Vellore
This quantity of such waste is around 85 % to 90 % of total waste generated from the facility.
• Segregation – Source segregation based on two colour coded categories & labelling of the waste bags/covers.
• Collection – Dedicated timings for collection of waste
• Intramural Transportation – Dedicated open trolleys & dedicated route for transportation of waste
•Storage – Dedicated Temporary storage area with scheduled cleaning protocols & clearance of waste on daily basis.
Transportation of waste to the central facility for further segregation into Wet & Dry categories
The Dry Waste are segregated into various categories as follows
(i) News paper, paper and card boxes (dry waste)
(ii) Plastic water bottles, plastic covers/liners & Packaging materials (dry waste)
(iii) Aluminum cans & metal containers (dry waste)
(iv) Food Containers after emptying residual food (dry waste)
(v) Organic / Bio-degradable waste - mostly food waste (wet waste)
(vi) E – waste / Battery waste.
The Dry waste are segregated into various categories by the work force and disposed through the TNPCB authorized vendors.
The E –waste are collected segregated separately by the Asset recycling office and disposed through the TNPCB Authorized vendor.
Hazardous waste – Spent oil generated from the facility are collected a stored in a Dedicated location and these spent oils are handed over to
TNPCB Authorized handlers/recyclers.
General waste /Solid waste

16. CMC
Vellore
SEGREGATION OF GENERAL WASTE

19. CMC
Vellore
WET WASTE
The Wet waste are segregated based on the following categories
• Food waste
• Vegetable waste/kitchen waste
• Mixed waste (Wet plastic & Paper)
• Food waste & Vegetable waste will be fed into the Bio Gas Plant for production of methane gas
for cooling application.
• The mixed waste will be dried using solar dryer and then segregated into respective category for
proper disposal.

20. CMC
Vellore
As per the Solid waste management rules, the food waste generated from the facility should be either be treated using Organic
waste Convertor / Bio Gas plant.
The Food waste which is generated from the facility is segregated by the work force and fed into the Bio gas plant /Bio
methanation plant for production of Methane for Cooking & electricity applications.
CMC Vellore handles & operated two different types of Bio Methanation plant/Bio Gas plant
 Fixed dome Bio Gas Plant:
This type of Bio Gas/ Bio Methanation plant is operational at CMC Bagayam campus to handle 3.0 TPD (3000 Kgs of food
waste per day).
The generated Bio Gas is utilized for cooking application
 Floating Dome Bio gas plant:
This type of Bio Gas/ Bio Methanation plant is under construction at CMC Ranipet campus to handle 3.4 TPD (3400 Kgs of food
waste per day).
It has been planned to utilize the bio gas generated for cooking & electricity production application.
Thus CMC Vellore complies with the regulatory requirements of the competent authorities.
Bio methanation plant / Bio Gas Plant

21. CMC
Vellore
Feeding of Bio gas Plant – CMC Bagayam campus

22. CMC
Vellore
Construction of Bio Gas Plant – CMC Ranipet campus

23. CMC
Vellore
Training of Trainers at CMC Vellore
(ToT training)
15.09.2023
41

24. CMC
Vellore
Christian Medical College and Hospital
• On 15th of September 2023, a pivotal Training of Trainers (ToT) programme was
executed at both the CMC T
own Campus and Ranipet Campus, marking a significant
stride in the comprehensive WHO Waste Management project. The faculty of this
training initiative were esteemed faculty members, Dr.Arcy Billoria and Ms.. Vidhya
Mani.
• The curriculum of the training was meticulously designed, encompassing six one-
hour sessions dedicated to the critical subject of "General and Biomedical Waste
Management." The intended audience included a broad spectrum of professionals,
ranging from doctors to nursing staff and other support service personnel.
• A total of 267 staff members (trainers) actively engaged in these enriching sessions,
showcasing a commendable level of enthusiasm and commitment.

25. CMC
Vellore
Evidences
43

26. CMC
Vellore
Conclusion
• This project helped us to assess the gaps in our hospital and improved the compliance to
segregation and legal compliance.
• Few major gaps were blue cardboard boxes were used for glass containers, bag in bags,
Barcoding is not widely implemented across all campuses, and patients wheel
wheelchairs was used in a few peripheral campus for transportation.
• Training of trainers – 267 staff
• ToT staff trained the entire hospital in batches
• Gap closures using the WHO funds
• Project goals will be used as continuous quality improvement project in our hospital and
annual audit will be done across all campuses by the trained staff
Acknowledgements: WHO, CAHO & CMC Vellore Administration

27. CMC
Vellore