Friday, August 22, 2008

HCWH welcomes DOH move towards a mercury-free RP health system

August 22, 2008

HEALTH CARE WITHOUT HARM WELCOMES DOH MOVE TOWARDS A MERCURY-FREE RP HEALTH SYSTEM

Health Care Without Harm (HCWH)-Southeast Asia commends the Department of Health (DOH) for the recent signing of Administrative Order (AO) 2008-0021 that will phase-out the use of mercury devices in all health care facilities in the Philippines over the next two years.

“We welcome this move from the DOH. By taking this step the Philippines is playing a leadership role in the world-wide effort to eliminate mercury in health care. [i] HCWH will make sure that the AO is fully implemented, until all mercury-containing devices--including sphygmomanometers-- are phased-out by 2010,” said Faye Ferrer, HCWH-SEA Program Coordinator for Mercury.

HCWH-SEA originally crafted the AO which mandates the gradual phase-out of thermometers, sphygmomanometers and other mercury-containing devices. The work in the Philippines is part of an international campaign led by HCWH and others to eliminate mercury in health care globally over the next decade.

The AO signed last week mandates all hospitals to immediately discontinue the distribution of mercury thermometers in the patient’s admission/discharge kits. Further, it requires all hospitals to follow the guidelines for the gradual phase-out of mercury in two years. [ii]

“With this Administrative order we are pleased that the DOH is committed to phasing-out not just the mercury thermometers but sphygmomanometers and all the other mercury-containing devices,” Ferrer added.

“The challenge for us and the Health Department is to make it happen and to make it happen within the specified two years,” she pointed out.

Ferrer said that even before the signing of the AO, more than fifty hospitals in the Philippines have either phased-out or is in the process of phasing-out mercury, first of these is the Philippine Heart Center (PHC).

According to Carmencita Lingan, Nurse at PHC, “the shift to mercury alternatives is doable, affordable and is economically-feasible.”

“This for us is the true essence of providing health care—a health care that is safe to the people and less toxic to the environment,” she added.

Philippine Nurses Association (PNA) president, Dr. Leah Pacquiz, on the other hand commends the signing of the AO saying this will make the health care system safe not just to the patients but to nurses and other health workers.

“The promotion of public safety is a key policy goal of Philippine nursing and we welcome this move of the DOH,” Pacquiz pointed out.

Sis. Arcelita Sarnillo, Administrator of St. Paul Hospital in Cavite added that the AO will make it easier for all hospitals to make the “necessary shift” from mercury devices to non-mercury alternatives. “With the AO and support from the government, we expect the shift to be done without delay.”

Ferrer, on the other hand pointed out that HCWH has worked with hospitals in other Asian countries, the US, the European Union, and Latin America to make the switch from mercury thermometers and other equipments that use mercury to mercury-free alternatives. “In the US you can’t buy a mercury thermometer anymore, and blood pressure devices are on their way out. Europe just banned mercury thermometers, and the city of Buenos Aires, one of the largest health care systems in Latin America is almost totally mercury-free.” [iii]

HCWH-SEA pledged to work closely with the DOH in providing support to hospitals around the country on its switch to an environmentally-friendly health care system.

Health Care Without Harm (HCWH) is a global coalition of 473 organizations in more than 50 countries working to protect health by reducing pollution in health care sector. For more information, visit www.noharm.org.



[i] In 2005, World Health Organization issued a policy paper with a 3-pronged short, medium and long-term measures that include (a) development and implementation of plans to reduce the use of mercury equipment and replace it with alternatives, (b) increase efforts to reduce the risk of unnecessary mercury equipment in hospitals and (c) a ban of mercury-containing devices and promotion of alternatives.

[ii] Another salient provision of the AO is the requirement to all new health care facilities applying for a license to operate to submit an inventory of all mercury-containing devices that will be used in their facilities and a corresponding mercury elimination program.

[iii] Countries around the world are banning the use of mercury-containing devices for its risk to people, wildlife and the environment. Mercury is a potent neurotoxin that affects the nervous system. It is fatal when inhaled and harmful if absorbed through the skin. High doses of vapors released by thermometer breakage may cause lung damage. While at lower doses it is harmful to the kidney and the nervous, digestive, respiratory and immune systems.

Tuesday, August 19, 2008

International group commends RP's mercury-free health care system

August 19, 2008

INTERNATIONAL GROUP COMMENDS RP’S MERCURY-FREE HEALTH CARE SYSTEM

Manila - Health Care Without Harm (HCWH)-Southeast Asia commends the recent signing of an Administrative Order that will make the Philippine health care system mercury-free by 2010.

“This is a very welcome move that will elevate the status of the Philippines as an environmentally-health conscious nation,” said Merci Ferrer, Executive Director of HCWH-SEA.

“Now, the Philippines is not just the only country in the world to ban the use of incinerators. It is also the 1st in the whole of Southeast Asia to phase-out mercury in its health care system,” she added.

Administrative Order 2008-0021 mandates all hospitals to discontinue the distribution of mercury thermometers in the patient’s admission/discharge kits. Further, it requires all hospitals to follow the guidelines for the gradual phase-out of mercury in two years.

According to Ferrer, as early as January 2006, the Department of Health has announced its commitment to gradually eliminate mercury-use in its health care system.

In a regional conference on mercury in February this year, the DOH in collaboration with HCWH promised to come up with the AO outlining gradual phase-out of mercury devices in the country including thermometer, sphygmomanometer and other mercury-containing devices.

Another salient provision of the AO is the requirement to all new health care facilities applying for a license to operate to submit an inventory of all mercury-containing devices that will be used in their facilities and a corresponding mercury elimination program.

The AO also mandates that all other health care facilities other than hospital shall make a Mercury Minimization Program.

“The challenge now is for the Health Department to make it happen and allow Philippines’ health care system join the ranks of responsible health care systems in US, Europe and the rest of European Union,” said Ferrer.

Health Care Without Harm (HCWH) is a global coalition of 473 organizations in more than 50 countries working to protect health by reducing pollution in health care sector. For more information, visit www.noharm.org.

Monday, August 18, 2008

Moving Away from Mercury

Moving Away From Mercury

Manila Bulletin, August 18, 2008

Time and again, we have heard stories of the dangers of mercury.

Exposure to mercury among infants and children (and even to the fetus inside a mother’s womb), affects the brain and nervous system of the child and impairs his neurological development. It also affects the child’s cognitive thinking, memory, attention, language and fine motor and visual spatial skills.

Some children after exposure to mercury experience impairment of the peripheral vision, disturbance in sensations, lack of coordination of movements and impaired speech, hearing, and walking, and muscle weakness.

Inhaling its vapor may cause emotional changes, insomnia, neuromuscular changes, headaches, disturbances in sensations, changes in nerve response, performance deficits in cognitive function and even kidney defects, respiratory failures and deaths.

You may go all day enumerating the dangerous effects of inhaling and absorbing mercury into your body. But the question is what must be done to avoid these harmful effects?

Switching to Alternatives

The Philippine Heart Center is the first hospital in the country to introduce the switch to non-mercury alternatives. The switch happened in just a span of 7 months when it started a mercury spill clean-up in February 2007 to September 2007 when it became a zero-mercury zone.

Alternatives to mercury thermometer and sphygmomanometers are now being used in the Philippine Heart Center and some other hospitals.

Alternatives are readily available in medical device distributors and the price ranges from Php165 to Php6,750 for non-mercury thermometers and Php290 to Php29,480 for sphygmomanometers.

The price may seem higher than mercury thermometers and sphygmomanometers. But taking into consideration the risk of mercury spills, cost of cleaning up the spill and cost of training medical practitioners to use mercury devices, mercury-free alternatives are so much cheaper in the long run.

Although alternatives are available, hospital workers, as well as ordinary people, need to be trained on how to properly handle existing mercury-containing devices and how to go about cleaning mercury spills.

Cleaning-up Mercury Spill in Your Home

Spent fluorescent lamps containing mercury in vapor form must be properly and safely stored to prevent mercury leak.

** It must be put in its original box and properly labeled and sealed to prevent leakage in case the lamp breaks. Or better yet, place them in a storage where it will not fall or tip over. Store it in a dry place.

** In case the lamp breaks, do not use vacuum cleaner. Instead, place the broken glass in a closed container.

** Remember that it is best to just keep the spent fluorescent lamp safely stored in your home than to dispose it through garbage trucks. Sadly, we still do not have the capacity to safely recycle fluorescent lamp.

For other smaller mercury spills, HCWH recommends 11 easy clean-up steps:

  1. Evacuate the area. Shut the door and turn off interior ventilation system to avoid dispersing mercury vapor.
  2. Wear protective face mask.
  3. Wear clothes and shoes that maybe discarded when contaminated.
  4. Remove jewelry so that it will not combine with the mercury.
  5. Wear rubber or latex gloves. Place broken objects on a paper towel then onto a lock bag, properly labeled.
  6. Identify the surface. Wood, linoleum and tiles may be easily cleaned while carpets, curtains and upholstery should be immediately disposed.
  7. Locate mercury beads. Carefully gather them together using a cardboard.
  8. Use eyedropper and sticky tape to pick-up the beads and then transfer it to an airtight-lid plastic container. Put in a sip-lock bag, properly labeled.
  9. Put all cleanup gloves and clothing in a leak-proof bag.
  10. Contact hospitals for advice on final disposal.
  11. Keep the area ventilated from the outside for at least 24 hours after the successful clean-up.

But remember that the best way is always prevention. Please, shy away from mercury devices.

** Health Care Without Harm (HCWH) is a global coalition of 473 organizations in more than 50 countries working to protect health by reducing pollution in health care sector. For more information, visit www.noharm.org or check out HCWH-SEA’s Guide to Alternatives.

Saturday, August 16, 2008

HCWH urges DOH to call for debt cancellation

August 16, 2008
HEALTH CARE WITHOUT HARM URGES DOH TO CALL FOR DEBT CANCELLATION

Health Care Without Harm (HCWH)-Southeast Asia calls on the Department of Health to take the lead in pushing for the cancellation of the P504 million loan the government entered into with Austria that involved the purchase of highly polluting incinerators for medical waste.

The loan agreement worth half a million pesos involves a buyer export credit facility agreement to purchase 26 medical waste incinerators and 36 disinfection units for government-run hospitals. Principal and interest payments for the loan amount to more than US$2 million per year and would be paid from 2002 to 2014.

According to the group, the Philippines is not the first to call on a move to cancel a 3rd world country debt.

"Even Sir Bob Geldof, a musician known for Live Aid and Live 8 concerts, and Bono of U2 echo the call for relief of Third World Debt. An erroneous loan agreement like the one we have with Austria must be scrapped off the Health's budget," said Merci Ferrer, HCWH Southeast Asia Executive Director.

She cited that in 2000, a controversial US Congress Report of the International Financial Institution Advisory Commission known as Meltzer Report concluded that total cancellation of poor-country debt was essential for development.

She added that in the 2008 National Budget alone, US$2 million is equivalent to the combined budget for the formulation and development of National Health Policies and Plans including essential National Health Research (Php41M), Health Systems Development (Php21M), provision for a pool of 60 resident physicians (Php11M), and provision for a pool of 136 part time medical specialists and 10 full time (Php19M).

Or better yet, "US$ 2 million should instead be used for non-burn treatment technologies such as autoclaves for disinfecting infectious waste from hospital, Ferrer pointed out.

In the 2008 General Appropriations Act, the Austrian loan was included in the list of those loans challenged as fraudulent, wasteful, and useless. Interest payment of the loan was put on hold in this year's GAA.

In 2003, Philippines' government expenditure on health as a percentage of total health expenditure is a measly 43.7% compared to Malaysia's 58.2% and Thailand's 61.6%. Total health expenditure as a percentage of GDP is only 3.2% vis a vis WHO recommended 5%.

Friday, August 15, 2008

International group renews call for debt cancellation between RP and Austria

August 15, 2008
INTERNATIONAL GROUP RENEWS CALL FOR DEBT CANCELLATION BETWEEN RP AND AUSTRIA

Health Care Without Harm (HCWH)-Southeast Asia calls on concerned government agencies to repudiate the 1996 “chronic and recurring” P504 million loan the government entered into calling it as “just what the doctor ordered” move in time for Hospital Week Celebration.

The loan agreement worth half a million pesos involves a buyer export credit facility agreement to purchase 26 medical waste incinerators and 36 disinfection units for government-run hospitals.

“While the intention is good, the project has become obsolete,” said Merci Ferrer, Executive Director of HCWH. “The 26 incinerators were decommissioned following the approval of the Clean Air Act.” Although the Act has been passed in 1999, the use of medical waste incinerators was extended up to July 23, 2003.

“After five years, we are still paying for incinerators that we no longer use,” Ferrer pointed out.

“Allocating close to US$2 million a year is too much burden to Filipinos. It should have been cancelled years ago. The loan agreement is past overdue,” Ferrer said.

Loan payment started in 2002 and now amounts to US$2 million a year. The government will continue to pay until 2014 with an interest rate of 4% annually.

“This money could go a long way for a country whose total health expenditure is way below than the recommended,” said Ferrer.

Other than being obsolete, Ferrer pointed out that in the years that the incinerators were in use; it failed to past the emission tests conducted by the Department of Environment and Natural Resources (DENR), Department of Health (DOH) and the World Health Organization (WHO).

She added that in a 2003 emission test, one of the incinerators exceeded the Clean Air Act limit set for dioxins. Exposure to dioxin has been linked to impairment of the immune, nervous and endocrine systems and the reproductive functions.

Health Care Without Harm (HCWH) is a global coalition of 473 organizations in more than 50 countries working to protect health by reducing pollution in health care sector. For more information, visit www.noharm.org.

Friday, August 8, 2008

Health Care Without Harm Calls for a Mercury-Free Health System Measure

August 8, 2008

Health Care Without Harm Calls for a Mercury-Free Health System Measure

In line with the celebration of Hospital Week in the Philippines, Health Care Without Harm (HCWH)-Southeast Asia, urged the Department of Health (DOH) and all hospitals all over the country “to be true to their Hippocratic Oath, To first do no harm, by gradually phasing out mercury use in the country’s health care system.”

According to Faye Ferrer, HCWH-SEA Program Coordinator for Mercury, “the risk of mercury to people, wildlife and the environment should push the government to fast-track and put in place a law that will eventually make the country’s health care system mercury-free.”

She added that hospitals in US, Europe and members of the European Union have banned mercury thermometers and other equipments that use mercury. In the Philippines, the Philippine Heart Center is the first to switch to non-mercury alternatives.

“Countries around the world have proven that switching to mercury alternatives is affordable and the alternatives give the same result minus the hazards,” said Ferrer. “It is time Philippines follow suit and serve as a model in the Southeast Asian region.”

An Administrative Order (AO) crafted as early as 2007 by the HCWH-SEA in collaboration with the DOH, mandates the phase-out of mercury-containing thermometers and blood pressure devices along with other products that use mercury. The AO is yet to be signed this year.

At the Senate, four separate bills on mercury have been filed. These include Mercury Use in Schools Prohibition Act of 2008 (SB 2278), Mercury Thermometer Regulation Act of 2008 (SB 2259), Mercury Reduction Act (SB 893) and the Mercury Health Advisory Act (SB 678).

A report by Philippine Center for Investigative Journalism (PCIJ), Power and Poisons: There’s Something About Mercury, said that the Philippines has no available statistics on the country’s mercury releases.

However, Ferrer said that in the US alone, mercury fever thermometers contributed 15 metric tons of mercury to solid waste landfills annually. “… and the worst thing about mercury is once it is released in the atmosphere, it is transported to the rest of the globe,” she added.

World Health Organization (WHO) reported as early as 1991 that a safe level of mercury exposure, below which there is no adverse effects, has never been established. In a policy paper they issued, it presented 3-pronged short, medium and long-term measures that include (a) development and implementation of plans to reduce the use of mercury equipment and replace it with alternatives, (b) increase efforts to reduce the risk of unnecessary mercury equipment in hospitals and (c) a ban of mercury-containing devices and promotion of alternatives.

The United Nations Environment Program (UNEP), on the other hand, formulated a Mercury Program designed to raise awareness of the global environmental hazards of mercury after its Governing Council concluded that there is sufficient evidence of significant global adverse impacts from mercury to warrant further international action.

In October this year, the 2nd UNEP Open Ended Working Group on Mercury will meet to discuss options and consensus recommendations with regards to the global challenges posed by mercury.

Health Care Without Harm (HCWH) is a global coalition of 473 organizations in more than 50 countries working to protect health by reducing pollution in health care sector. For more information, visit www.noharm.org.