Law Enforcement Against Environmental Pollution from B3 Waste from Regional Hospitals in Karo District

The management of Hazardous and Toxic Waste (B3) generated by hospitals is an urgent legal obligation considering its potential danger to public health and the ecosystem. This research aims to analyze the effectiveness of administrative environmental law enforcement regarding B3 waste management in hospitals within Karo Regency, as well as to identify structural obstacles and strategic efforts undertaken by the local government. This study employs an empirical juridical method with a sociology of law approach to dissect the operation of law in society through field data and in-depth interviews. The results indicate that law enforcement in Karo Regency remains sluggish and ineffective because the Environmental Authority prioritizes a persuasive and coaching approach (preventive) over the application of strict administrative sanctions (repressive), despite the discovery of severe violations such as mixing medical waste with domestic waste and storage exceeding the time limit. This weak law enforcement is caused by an accumulation of interrelated obstacles, including a deficit in the supervision budget, the absence of certified Environmental Supervisory Officials (PPLH), and the deterioration of incinerator facilities in regional hospitals, creating high dependency on third parties who frequently default on their obligations. In response to the failure of these conventional mechanisms, new strategies are being implemented through the transformation of digital-based supervision (e-monitoring) to bridge geographical and personnel gaps, as well as the planned centralization of medical waste processing through the Regional Public Service Agency (BLUD) mechanism to break the chain of dependency on private sectors and ensure compliance with emission quality standards. This research concludes that without improvements in the legal structure and infrastructure aspects, waste management regulations will remain mere paper rules without real coercive power.