For the 33 public hospitals in Buenos Aires to handle contaminated waste, they must have certificates issued by the Environmental Protection Agency (APRA, for its acronym in Spanish), both for medical waste generators, and hazardous liquids. These obligations include even two City laws, 154 and 2,214, and provide the steps for handling, storage, collection, transportation, treatment, and disposal of waste.

Also, for health centers to obtain those clearances they must submit an Environmental Impact Assessment before the APRA, a procedure by which you must pay a seal.

However, the Auditor General of the City of Buenos Aires (AGCBA) found that both the presentation of the Environmental Impact Assessment as well as the payment of the seal, were among the "major difficulties (of hospitals) for obtaining such certificates".

The data was found in a report approved last year by the Audit of the City of Buenos Aires -on monitoring data from a 2010 report- and was contributed by the Branch of Hospital Waste Operations. The latter also revealed that when AGCBA was gathering information "none of the hospitals had a Certificate of Environmental Aptitude, according to Law 154 (dedicated to medical waste) and 2,214 (hazardous liquids)."

Along the same lines, the Branch added that 13 of the 33 public hospitals in the city had not started -at the time of the audit- the research procedures of registration in the Register of Hazardous Liquid Waste generators, and so did two others in the enrollment related to Registration of Pathogenic Waste.

Money spares, documentation lacks

According to the work of the AGCBA, "we could not reliably determine the cause (of) the existence of available balances for the period audited (2010) because of lack of documentation." The balance in question amounted to $590,247.31, almost 10% of the total 2010 budget, amount that was meant solely for the management of contaminated waste.

From this observation, the Audit wanted to "reconcile" the budget executed in 2010 on the transport, treatment, and disposal of hazardous waste and liquids (what is called heading 3.3.8), collating data provided from both hospitals as well as the Ministry of Health. But "such information, in general, was partial" the report explains.

For this task, the AGCBA had asked of mostly everything: draft budget for liquids and hazardous waste, calculation bases, and even details on the arrangements for procurement of services related to the removal of waste from 2009 to 2010.

But only seven effectors (out of 33) sent the papers that would enable them to reconcile their executed balances: the Sarda, Alvarez, Pirovano, Quinquela Martin Dueñas, Alvear, and Marie Curie hospitals. The Audit says: "The rest sent partial information (six cases) or was supplemented with data (from) the Ministry of Health (11 effectors). Seven hospitals were not able to reconcile -balances- because they only had partial documentation sent by the effectors and unsolicited documents issued by the Ministry of Health. Also in Lagleyze Hospital and the Institute for Psychophysical Rehabilitation could not reconcile the amount due because they failed to send the required information by both the effectors and the Ministry."

The report of the watchdog is responsible for clarifying that when they speak of "incomplete submission of the required documentation," it refers, in some cases, to data provided in part by the locals hospitals, and others, poor information, requested, duplicates and unreadable.

With this scenario, the AGCBA appealed to the Ministry of Health to obtain the necessary information on the 2010 budget to complete its investigation. The report stated: "The response received did not contain the required documentation corresponding to nine effectors (Institute of Psychophysical Rehabilitation, and Rivadavia hospitals, Piñero, Penna, Moyano, Lagleyze, Gutierrez, and Fernandez Ferrer)."

But that was not all. The watchdog had problems even to begin the survey. The thing is that, by virtue of the powers conferred by the Buenos Aires Constitution, the Audit had requested information from 33 health centers in the City. An application that only three hospitals responded to: Tornú, Elizalde, and Sarda.

Then they proceeded to send a first iteration of the original order to the remaining 30 hospitals. The second call was answered by 22 hospitals.

There were still eight effectors, so a second iteration of the request for information was made. This last request was copied to the Chief of Cabinet of the City, the Directorate General for Legislative Affairs and Control Agencies, and the Buenos Aires Ministry of Health itself.

To this last request only Zubizarreta Hospital responded. That means that there were seven health centers that did not attend any request of the Audit of the City: Borda, Durand, Lagleyze, Ramos Mejía, Santojanni, Tobar Garcia, and the Institute of Psychophysical Rehabilitation.

"What is mentioned above is what caused the report to have a limited analysis of the management of medical waste and hazardous liquids in the hospitals mentioned above" completed the watchdog.