The First Medical Waste Training After 33 Years

At 60, Bilkis Begum has spent more than three decades cleaning hospital waste at Rangamati Langadu Upazila Health Complex, a small healthcare facility in the remote Chittagong Hill Tracts of Bangladesh. Every day, Bilkis cleaned patient wards, carried infectious waste, and handled used syringes, blood-stained bandages, and broken glass. Yet, despite doing one of the hospital’s most dangerous jobs for 33 years, she had never received any formal training on how to manage medical waste safely.

For years, Bilkis carried out the work with almost no protection. She wore ordinary sandals instead of boots and handled all kinds of waste mixed together in the same bins. Needles, blood-soaked gauze, broken glass, saline bags, and food waste were often dumped without separation. Injuries became a regular part of her life. One day, while throwing waste into an open dumping pit behind the hospital, she slipped and broke her leg. But the incident she remembers most clearly was when a used needle pierced her finger while she was collecting waste. “It started bleeding immediately. I was terrified thinking, what if I had been infected with a deadly disease?” she recalled. The fear stayed with her long after the wound healed. At times, the smell of the waste made her nauseous and unable to eat after returning home from work. More than anything, she worried that the risks she faced every day might also endanger her family.

Hospital cleaners like Bilkis are often the unseen frontline workers of healthcare systems, especially in remote areas. While doctors and nurses treat patients, cleaners handle the dangerous aftermath, infectious waste, contaminated materials, and overflowing disposal pits, usually with little recognition and limited protection. In the Chittagong Hill Tracts, where healthcare facilities face logistical and resource challenges, unsafe waste disposal also created risks for surrounding communities and the environment. Medical waste was frequently burned in open spaces or dumped carelessly, exposing workers and residents to harmful pollution and possible infections.

In 2023, that reality began to change. With support from the Government of Japan, the United Nations Development Programme (UNDP), together with the Government of Bangladesh, launched a healthcare infectious waste management initiative across 26 hospitals in the Chittagong Hill Tracts. The project introduced safer systems for collecting, transporting, and treating infectious waste while also focusing on the people handling it every day. Hundreds of healthcare workers, waste handlers, and local authorities received hands-on training on safe waste management and workplace safety.

For Bilkis, the changes felt immediate. She now wears gloves, masks, boots, and protective clothing while working. Waste is separated into different colored bins, making collection safer and easier. “Now I understand which waste goes where,” she said proudly. “I feel much safer while working.” Today, she also helps guide patients and supports two other cleaners at the facility, passing on the knowledge she never had for most of her life.

The initiative also introduced modern waste treatment technology in Rangamati. In May. 2026, an Infectious Waste Treatment Plant was inaugurated at Rangamati General Hospital, creating a safer and more environmentally friendly system for managing medical waste across the region. Instead of open dumping and burning, hospitals can now safely treat infectious waste using modern sterilization technology.

For Bilkis, however, the biggest change is deeply personal. After spending more than three decades working in fear, she finally feels protected and valued. As she nears retirement, she hopes future cleaners will never have to face the same risks she did.

“No one should work without training,” she said. “This training can save lives.”

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