A peer-reviewed study published in the Journal of Applied Bioanalysis has laid bare what many healthcare administrators may have preferred to keep quiet: government-run health centres across Kashmir are engaged in systematic, widespread violations of India’s Biomedical Waste Management Rules, 2016. This is not a matter of paperwork irregularities or procedural lapses.

These are dangerous, life-threatening breaches of law that place ordinary citizens, healthcare workers, sanitation staff, ragpickers, and stray animals directly affected. The findings demand not merely attention but urgent, decisive action from the highest authorities.

The study, which assessed 104 Ayushman Arogya Mandirs-including 28 Primary Health Centres and 76 Sub Centres across 10 districts of Kashmir-found that not a single facility possessed a centralised biomedical waste management room.

In facilities that handle syringes contaminated with blood, used dressings soaked in infectious material, discarded needles, and pharmaceutical waste, there is no dedicated space to safely segregate, store, or process what is, by any definition, hazardous material. Researchers rightly called this a “critical infrastructure gap”. It is, in truth, a critical failure to comply with established norms.

What makes the situation graver still is the manner in which this waste is being disposed of. Nearly a third of Sub Centres dump biomedical refuse in the open, while over a quarter resort to open burning. The toxic plumes from burning medical waste carry dioxins and heavy metals into the air that local communities breathe.

Open dumping contaminated soil and, critically, during Kashmir’s heavy rainfall season, seeps into water bodies and underground aquifers that supply drinking water to thousands of households. When medical garbage is mixed indiscriminately with municipal waste, it is not long before stray dogs tear through it and ragpickers – among the most economically vulnerable people in any community – rummage through it with bare hands, wholly unaware that they are handling material that could transmit Hepatitis B, Hepatitis C, or HIV.

Perhaps the most alarming dimension of this crisis involves discarded syringes and needles. Sharps pits – designed specifically to prevent the re-entry of used needles into circulation – were available in only 32 per cent of Primary Health Centres and a mere 11 per cent of Subcentres.

This is not a trivial statistic. Used syringes, carelessly discarded, can be collected by unscrupulous individuals, repackaged, and sold back into the medical supply chain. An accidental needle-stick injury to a passerby or a child playing near a dumping site can result in a lifelong chronic illness. These are not hypothetical risks; they are documented public health realities.

What compounds the outrage here is the question of accountability. All healthcare facilities operating in India are legally required to maintain records of biomedical waste disposal and submit compliance reports to the relevant authorities.

The Biomedical Waste Management Rules, 2016, are explicit and enforceable. Inspection teams – the same teams that regularly audit private clinics and nursing homes, often levying fines for minor infractions – are apparently not subjecting government-run facilities to the same rigour. It is, to put it plainly, a double standard that has allowed systemic non-compliance to flourish unchecked for years.

It is worth emphasising that the infrastructure to do this correctly already exists. Common Biomedical Waste Treatment Facilities operate across the districts of Jammu & Kashmir. Fee structures are in place. Circulars have been issued. Private healthcare providers, under the watchful eye of regulators, largely comply. Only 13 percent of Sub Centres were found to be sending waste to these authorised facilities. The excuse that treatment infrastructure is unavailable simply does not hold.

The path forward must be non-negotiable. Every AAM in Kashmir must be brought into full compliance with the Biomedical Waste Management Rules, 2016 – immediately and without exception. Trained permanent sanitation staff must be deployed, not part-time workers with no understanding of hazardous material protocols.

Colour-coded bins, needle destroyers, and sharps disposal systems must be made universally available. Most critically, every facility must submit a mandatory weekly compliance report on waste disposal to the district health officer, with consequences for non-submission. Discipline is not optional in matters of public health. It is the very foundation of prevention. The institutions that set rules are running these centres and, as such, cannot claim ignorance or other excuses.