A Changed Face

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Photo story
WASH in health center
WaterAid/Ronny Sen

When Ritik Chavariya, 19, wears his uniform, laces it up with work shoes, apron, gloves and mask, and then manoeuvres his trolley around the health centre, he considers himself no less important than the medical officer. Ritik is in charge of the Bio-Medical Waste (BMW) collection at the Community Health Centre (CHC) in the Ichhawar block of Sehor District in Madhya Pradesh. 

medical center

The trolley Ritik carries contains three bins – red, green and yellow in which he collects different types of waste. Every day, he makes at least two rounds of Operation Theatre (OT), labour room, men and women wards, and pathology lab to collect the waste. During the day, the staff deployed at these places keeps collecting waste in different coloured plastic bags allocated for particular waste. Ritik collects these bags and then carefully deposits them at the BMW collection centre from where it is picked up by the garbage collecting van.  

Watching Ritik doing his duty is a treat to the eyes because the whole process is well synchronised and systematic, and very unlikely for a CHC in a rural setup. This regular practice is just one reason, though quite important, why the CHC has been winning the Kayakalp award consecutively for two years.  

As one enters the facility there is a welcoming platform with a shade where patients’ wards wait. The platform is overlooking a beautifully manicured garden with seasonal flowers. There are proper signs everywhere along with a warning sign informing the visitors of a fine if they litter the campus.  

Incidentally, the CHC was not always like this. 

“Earlier there was no system, the waste was collected but not segregated, and was thrown at a certain place behind the boundary wall of the CHC – we were practically zero in BMW management,” the honest admission comes from the Block Medical Officer and the CHC In-charge Dr BB Sharma. “Now, anyone can walk in anytime and will find BMW properly segregated, collected, and disposed. 

waste segregation

Dr Sharma says even Ritik was only for routine cleaning of wards and corridors when he joined 16 months ago, as the waste collection was not a dedicated job. 

However, during the Kayakalp orientation workshops, convened by Samarthan with the support of WaterAid, ideas emerged and Ritik was made in charge of BMW collection. A system was put in place for other activities as well.  

For example, in the past, the sweepers came to the hospital and cleaned the areas allotted to them, and then relaxed for the whole day with no more work. Dr Sharma changed their timetable and called them in three shifts, which ensured that the CHC was cleaned at least three times a day.  


Dr Sharma was already inclined to improving the conditions of the facility for he was keen to reduce the cases of maternal morbidity (women dying after delivery due to septicaemia). Besides, he believed that patients would come to a facility which is clean and welcoming. His inclination was pushed with the Kayakalp training and orientation programme, and a system was put in place. 

Now, the CHC is having regular training programmes, in which everyone–from top to bottom, from the facility participates. A proper checklist is followed regimentally. Regular inspection of cleanliness in the CHC is now part of all doctors’ duty when they go to their routine rounds to see the patients. Good work is recognised with the honour of ‘Best Employee of the Quarter’. Employees, neglecting their duties are told about their mistakes during the bi-monthly orientation meetings.  

“What I tried to do was to imbibe a sense of ownership by leading from the top because if the seniors take ownership, the rest of the employees follow the footsteps,” Dr Sharma reveals his strategy that brought positive results. Having a strong belief in equality, Dr Sharma ensured that the award money for the employees was equally distributed amongst the employees irrespective of their post and cadre.  

The CHC is also using the award money to install hand driers in all OTs and planning to set in place the system for Liquid Waste Management.  

Aiming to excel and preserve that excellence, the facility is now ready to become the first CHC in any district of the country that has made its records online. Now anyone sitting anywhere will have remote access to any information about the CHC along with patients’ medical information available to their families.