STATE auditors have flagged four hospitals by the Cebu Provincial Government for violating Department of Health (DOH) standards on healthcare waste disposal, warning that these lapses pose risks to public health and the environment.
In its 2024 report, the Commission on Audit (COA) said funding cuts for cleaning supplies led to the failure of several hospitals to use proper color-coded waste bags and maintain safe storage areas.
The report named Cebu Provincial Hospital–Balamban, Cebu Provincial Hospital–Carcar City, Isidro C. Kintanar Memorial Hospital–Argao, and Minglanilla District Hospital as having failed to comply with the DOH’s Health Care Waste (HCW) Management Manual.
The manual outlines protocols for segregating, storing, transporting, treating and disposing of healthcare waste.
The audit was conducted in 2024 during the term of then-governor Gwendolyn Garcia.
COA said the hospitals did not strictly implement the DOH-prescribed color-coding scheme for healthcare waste, which includes:
[] Green for biodegradable waste;
[] Yellow for infectious and pathological waste;
[] Brown for pharmaceutical waste;
[] Black/colorless for non-biodegradable waste;
[] Orange for radioactive waste; and
[] Red for sharp objects.
Auditors found that waste was placed in incorrect containers or left outside designated areas.
“Hospital waste was found to be improperly placed, not in its designated location,” read a portin of the report.
At one facility, hospital waste was reportedly piled along the roadside, partially covered with roofing sheets and exposed to the elements.
“The existing storage facility and materials recovery facility lacked sufficient capacity to accommodate daily waste accumulation,” the report said.
Another hospital was unable to complete its wastewater treatment facility after the contractor abandoned the project.
Storage areas also lacked key DOH requirements such as impermeable flooring, lockable areas, flood protection, ventilation, proper signage, and separate compartments for general, hazardous, and recyclable waste.
In some hospitals, waste storage areas were located near food preparation and storage zones, raising further health concerns.
Infectious waste containers also lacked the required international biohazard symbol.
Government response
Asked by SunStar Cebu on Wednesday, December 3, if the Cebu Provincial Government had responded to COA, Cebu Province Assistant Administrator Aldwin Empaces said the Capitol had replied but declined to give further details.
The Capitol operates 16 province-owned hospitals: 10 infirmaries, four Level 1 hospitals, and two Level 2 facilities. Currently, Balamban and Bogo house the Level 2 hospitals. Carcar, Danao, Bantayan, and Camotes have Level 1 hospitals, while the infirmaries are in Minglanilla, Argao, Sogod, Badian, Barili, Tuburan, Pinamungajan and Daanbantayan.
Budget cuts
According to COA, healthcare workers cited a shortage of color-coded plastic bags due to funding constraints.
"Starting calendar year 2024, the Province of Cebu withdrew the cleaning supplies budget for all province-owned hospitals and directed them to procure supplies through public bidding," the report said.
The budget cut disrupted operations, forcing hospital personnel to use their own money to buy cleaning supplies.
The problem was aggravated by irregular waste collection schedules. The previous service provider halted operations due to unpaid fees. The current provider collects waste only upon the issuance of a purchase order.
COA also noted a lack of protective equipment for waste-handling staff and unlabelled containers for infectious waste.
In a February 20, 2025 letter to COA, one officer-in-charge chief of hospital acknowledged the persistent buildup of hospital waste despite mitigation measures. The official cited infrequent collection and the limited capacity of their materials recovery facility, which they plan to expand.
Another hospital chief confirmed that the withdrawal of the cleaning supplies budget significantly affected their waste management efforts.
Recommendations
To address the issues, COA recommended that the Cebu Provincial Government direct hospital chiefs to:
[] Enforce proper waste segregation using DOH-prescribed color-coded containers;
[] Allocate sufficient funding for cleaning supplies, protective gear, and waste management;
[] Construct compliant central storage facilities;
[] Provide regular training on healthcare waste management;
[] Hire a reliable waste collection service with consistent and proper disposal; and
[] Ensure timely payment for waste services.
State auditors stressed the urgent need for corrective action, saying poor waste disposal practices increase risks to public health and the environment and undermine safe healthcare delivery.
“Proper waste handling is essential not only for regulatory compliance but also for safeguarding public health and environmental sustainability,” COA said. (CDF)