In recent years, cholera and influenza A virus subtype H1N1 have reappeared, more of which are caused by environmental pollution, particularly improper treatment of medical waste.

Dr Nguyen Huy Nga, director of the department, said that Vietnam has more than 13,600 hospitals and medical establishments, of which only 44 percent have medical wastewater treatment systems.

In addition, most of the medical waste-water treatment systems at the hospitals are overloaded or in bad shape.

As a result, more waste is not treated but discharged directly into the environment, or is treated improperly.

Medical waste water often contains 20 percent of the hazardous substances that could cause disease if not treated properly.

Healthcare facilities each day discharge between 120,000 and 150,000 cubic metres of waste water and between 350 and 400 tonnes of medical waste, including 42 tonnes of hazardous waste, according to Nga.

Although the 10-year-old Decision No 64/2003/QD-TTg requires organisations that cause serious pollution to treat their waste, 80 hospital still remain on the list of serious environment polluters.

Directors of many local hospitals said that they acknowledged the importance of waste and wastewater treatment but dit not have enough capital for the construction and instalment of such facilities.

In addition, other hospitals do not know how to properly treat solid waste as well as wastewater. Many of them do not have facilities to collect and classify solid waste to cut costs.

Only Hanoi and HCM City have incinerators for medical waste, while other localities treat medical waste, while other locoalities just bury it together with daily waste.

To help Vietnam settle its medical waste problems, the World Bank has lent 150 million USD to treat medical waste water for a three-year period.

However, Nga said that Vietnam would need capital 10 times higher than the Bank’s fund to build waste water and solid waste treatment facilities at all medical establishments nationwide.

The Government, he said, should develop a legal framework and allow healthcare experts to participate in the construction of hospitals.

Nga also emphasised the need to further educate medical workers, including doctors, about the importance of sorting rubbish at the source of discharge to improve environmental protection.