Malaysia leadership take on health and environment

Malaysia’s general elections on 5 May 2013 saw the existing government being re-elected, much to the chagrin of many who wanted a change in the government, seeking reformation and true democracy.

In the past, Malaysia’s development agenda was primarily driven by economic growth, with the government aiming to be a high-income country. New ministers have been appointed but we foresee that the development policies would remain the same with the Prime Minister pushing for the Economic Transformation Programme, launched on September 2010.

We fear of the price that has to be paid by us and the future generation in Malaysia’s pursuit to become a recognizable, developed nation of international standing. Is this what Malaysians really want? Is material wealth or living in a high-income country what we aim for in life? What about our health and well-being?

Rapid modernization and unsustainable development in the past have led to the exploitation and abuse of the environment in Malaysia. Hazardous industries pollute the air and water sources whilst forests are indiscriminately cleared for development or industrial agriculture, hence leaving the environment devastated.

In most cases, the destruction of the environment affects the livelihood and health of communities. Industrial chemicals, pollutants, pesticides, heavy metals are prevalent in our environment, bodies, food, air and water.

Environmental health problems in Malaysia are mostly attributed to atmospheric pollution, water pollution, climate change, waste management and disposal comprising of solid, toxic and hazardous waste.

Sadly, Malaysia's approaches to environmental management through policy and legal measures had not evolved from a mandate to afford the public with a right to clean air, water and a liveable environment. Rather, they emerge more out of a response to intolerable environmental conditions.

We do have substantial legal and policy initiatives that require proper consideration and action towards protecting the environment. However without a real commitment to strictly enforce laws and properly apply sound principles across the environmental landscape, Malaysia will continue to be at risk to pollution and the loss of its natural identity.

There is also a problem of general lack of transparency in decision-making and frequent high-handedness demonstrated towards the concerns of ordinary folk who dare to question development at the cost of health and the environment.

Although there are parts of the civil service who genuinely understand the practical common sense of integrating environment with development, sadly, the overriding perception among policy makers is that environmental concerns are an impediment to progress. Sometimes they even condemn communities opposing destructive projects as barriers to economic progress. This has forced many affected communities to seek international attention or legal redress.

Our angle of vision needs to shift from skyscrapers to observing what is happening closer to the ground in nature and in the everyday lives of Malaysians struggling with the consequences of development gone awry. At this more humble level await insights which question not just our quality of life but also the quality, nature and meaning of the journey towards modern development.

What is needed is a strong political will to address the issues of environmental health degradation and an environmentally and socially conscious public to push for concrete changes! For our own sake and the sake of our future generations, we must start to act responsibly before the momentum of irreversible changes overwhelms us.

(Partly extracted from paper jointly prepared by Sahabat Alam Malaysia & Consumers' Association of Penang)

Mageswari Sangaralingam currently works as Consultant for Sahabat Alam Malaysia (SAM) and Consumers' Association of Penang (CAP). HCWH-Asia partners with both SAM and CAP.

Global Green and Healthy Hospitals connects with Asian hospitals

The Global Green and Healthy Hospitals initiative is a network of hospitals and health organizations spanning over 3,500 hospitals in six continents. This network is composed of members who are committed to implementing GGHH’s ten interconnected goals. These goals are all geared towards reducing the environmental impact of health care, and promoting environmental health.

A vital part of GGHH’s platform is the sharing of case studies and best practices. The breakthroughs of one hospital, for example, can inspire another institution thousands of miles away. The network thrives on this free exchange of ideas, which is why it decided to create GGHH Connect, a site that combines social networking, content creation, and interaction.

We’re pretty excited about this, because the Health Care Without Harm and GGHH teams have been looking for ways to encourage members of our networks to interact in even better ways. While HCWH and GGHH already use Facebook and Twitter, we also wanted to give professionals another platform to engage.

Unlike Facebook and Twitter though, GGHH Connect is exclusively for members of GGHH. This means members can share and receive information in a safe, professional environment. Everyone can be assured of the credentials and expertise of each participant. This will tighten the global network of GGHH and create a climate more conducive to sharing information and breakthroughs.

The platform, which was developed by GGHH, Cisco Systems, and the Skoll Foundation, will enable all GGHH members to share and receive information, feedback, as well as work together to achieve their sustainability goals.

The Cisco-powered site is set to open on the fourth week of May. Right now, I’m working on spreading the word to hospitals and other potential members. If you’re interested on hopping onboard, I’d be happy to tell you more. Email me at Inigo@no-harm.org.

To learn more about the GGHH network as a whole, visit greenhospitals.net.

Iñigo de Paula is a Manila-based digital marketing consultant and freelance creative director. He is currently doing consultancy work for HCWH-Asia.

Topic for Today: Chemicals

Looking towards the front part of the conference room, the projector has presentations on cue and the lecturers are reviewing their notes. At least 40 people in uniforms are waiting. It was announced that the topic for today is chemicals.

Could this be a déjà vu of my days in high school, sitting in my Chemistry class? The dreamlike sequence was: We were being told that matter is anything that occupies space and has mass. We were shown examples of matter in three different phases: the water in the beaker as liquid, the spoon as solid, and the released air from a balloon as gas. The next days became a tedious memorization of the periodic table of elements. I was happy with my easy codes Al for aluminum, Au for gold and Au for silver. But the rest of the elements are tongue-twisters and where they are found in the periodic table is an unsolved crossword puzzle for me.

Snap back to reality. It is a work day in March 2013 and I am at St. Paul Hospital Tuguegarao preparing for the afternoon’s forum on chemicals in health care. I sit among the hospital staff in different uniforms representing their work areas. The slides for presentation, the scribbled notes, and what the people will be hearing are all about chemicals.

What was taught is applied chemistry, but not another science subject though. The forum focused on how chemicals are being used in a health care set-up and its effects on people. The opening slide showed the vicious cycle of chemicals with text “the risks of hospital chemicals” which stirred the interests of nurses, midwives, medical technologists, housekeeping staff and others in the audience.

Ruth Stringer, International Science and Policy Coordinator of Health Care Without Harm gave a run-down of hazardous chemicals found in hospitals. Ingredients of disinfectants may include glutaraldehyde, triclosan, ethylene oxide, sodium hypochlorite, and silver. Intravenous bags, tubings, catheters and other plastic medical supplies may contain polyvinyl chloride (PVC), di(2-ethylhexyl)phthalate (DEPH), and bisphenol A (BPA). Formaldehyde is another chemical that laboratories use for preservation of specimen to study.

The quicksilver mercury, which is encased in old types of thermometers and sphygmomanometers, is neurotoxin. No less than the Philippine Department of Health has prescribed year 2010 for the complete phase-out of these medical devices. However, some dental clinics still have not shifted from mercury dental amalgams to the composite resin fillings.

The list could go on and a three-hour forum would not be enough to give details for every chemical. Hence, the speaker picked glutaraldehyde to discuss since most of the hospital staff can identify with it. Using some sense organs as science tool will surmise that glutaraldehyde is a colorless pungent liquid. Its primary purpose in hospitals is for cold sterilization of surgical instrument and scopes. Some hospital also uses glutaraldehyde formulations for infection control procedures.

Glutaraldehyde is a respiratory irritant and linked to occupational asthma and asthma-like symptoms such as throat and nose irritations, sneezing, breathing difficulty, and wheezing. Other health concerns with glutaraldehyde are hand stains, rash and dermatitis from direct skin contact with the liquid while its inhalation can also cause headaches, nausea and eye irritations.

The irony is that hospital workers themselves are at high risk to health hazards of glutaraldehyde. These are the doctors, nurses, and other hospital staff who work in areas with glutaraldehyde exposures like the operating room, endoscopy unit, gastroenterology and cardiology departments, dialysis unit, intensive care unit, and sterilization room. Patients who are supposed to be taken cared in these special areas are also at risk.

The other speaker, Michael Ravago, President of Philippine Society of Endoscopy Nurses and Assistants validated the issues and concerns on glutaraldehyde. Being a nurse supervisor assigned to the endoscopy unit of a tertiary private hospital in Metro Manila, he shared their experience with glutaraldehyde. Aside from reported staff illnesses from chemical exposure, patients also forwarded complaints about the strong irritating smell inside the unit. Soon after, they began to observe discoloration and damage at the distal end of the scope.

The general sentiment of the participants during the open forum is how to minimize the negative effects of toxic chemicals considering that they have to deal with these until alternatives are available. The speakers offered recommendations:

• Wearing appropriate personal protective equipment;

• Improving ventilation system in work areas;

• Using disinfectants wisely. Regular good cleaning is enough for some application;

• Choosing non-chemical and least toxic disinfection where possible;

• Requiring full disclosure of product ingredients from suppliers; and

• Setting-up a green purchasing policy

The forum ended like a usual class wrap-up. Participants get up from their seats. A group buzzes about the day’s inputs, some exchange opinions and afterthoughts, while some went to the speakers to ask more questions.

The topic for the day has been well discussed. But there is still homework for HCWH-Asia’s Safer Chemicals campaign. The goal is to pilot two hospitals for chemical substitution and management. Research is underway for the feasibility of introducing chemical products with lesser harm for the people and the environment.

Library work (I mean, surfing the internet at this day and age) will be online searching for materials related to glutaraldehyde, tabbing and bookmarking different web sites, downloading pdf files of product literatures, clicking on the http links to material safety data sheets, and all the other cursor works that did not come in handy when I had my Chemistry class.

The work continues beyond the day’s topic.

Note:

Health Care Without Harm-Asia is currently cooperating with KEMI (Swedish Chemicals Agency) and SAICM (Strategic Approach to International Chemicals Management) for the campaign on “Chemical Substitution and Management in the Health Care Sector”. The project aims to (1) identify the hazardous chemicals used in health care, (2) introduce safer alternatives, and (3) document case studies from two pilot hospitals in the Philippines. This experience will later on be used for broader dissemination and for future policy recommendations on chemicals management.

Ayeth Enrile, SAICM Project Coordinator, Safer Chemicals Campaign, HCWH-Asia

Winning the elections

Now that the Philippine national elections is less than a month away, campaign jingles are heard from every street corner. After hearing most for several straight days, you start wishing that the elections will be over soon.

But not soon enough. Not until you have voted for candidates who support your cause or causes.

Health Care Without Harm-Asia always pushes for a greener and healthier health care system. So we need leaders who can look us straight in the eye and passionately declare, yes I am for green and healthy health care.

There are 10 criteria, following the 10 goals of the Global Green and Healthy Hospitals .

1. Priority: environmental health. There’s no more denying that environment and health are two sides of one coin. You cannot protect and save the environment without looking at the health care sector, same way you cannot go on focusing on the health of the people without looking at the health of the environment. We need leaders who see and acknowledge this connection. We want them to work on these issues.

2. Support for substitution of hazardous chemicals. Sadly, several chemicals used in the health care are not safe for our health. But the good news is, there are alternatives. We’d go for leaders who can see this happen during his term.

3. Anti-incinerator. Anti-burn. Yes, we do not like to burn our wastes, be it health care or regular household wastes. We want them to uphold the law in banning incineration of wastes.

4. Energy-efficient. We want those who support energy efficiency and renewable energy generation. But it should be energy efficiency in its truest sense. Not the fancy names that some would use to appear green and clean.

5. With the summer heat, we’d vote for candidates who see the wisdom behind water conservation, recycling and treatment.

6. We’d like those who support transport strategies that reduce climate footprint.

7. And those that buy local and organic food.

8. We’d also like someone who will pledge to policies on safe management and disposal of pharmaceuticals.

9. With the budget allocated to elected officials, we’d go for those who would support green and healthy building design and construction.

10. And those who’d push for purchasing safe and more sustainable products and materials.

These are just the first ten. There are plenty more. We’re not asking too much. The reality is, if we don’t keep our standards high enough, we’d have to put up with the same old leaders that we had for a long time.

So we say, set the examples. Go Green and Healthy Honorables! May you be truly green and healthy!

Vote wisely.

Sonia G. Astudillo, HCWH-Asia Communications & Press Campaigner

What does Climate Change Have to Do With Health Care?

In the last six months, we have witnessed Superstorm Sandy flooding New York City, New Jersey and surrounding areas, a massive Midwest drought impacting 40% of the US corn crop, and unprecedented air pollution from burning fossil fuels that forced Chinese authorities to tell Beijing residents to stay in their homes. When we think about climate change, we are no longer thinking about polar bears stranded on melting ice caps. Climate chaos has come home and its impacts are being felt all around the world.

What health scientists are telling us is that climate change will bring increased asthma, more virulent allergens, medical emergencies from heat stress, the spread of water- and vector-borne diseases and increased severe weather events. The Lancet, Britain’s premier health journal, calls climate change “the biggest global health threat of the 21st century.”

Given these dire warnings, one would expect that the healthcare sector would be prepared for the coming public health storm. Nothing could be further from the truth. When Hurricane Katrina hit New Orleans, the hospitals were completely flooded along with everyone else. But because they all had their electrical equipment as well as their back-up generators in the basement, , they lost all power. And because none of the windows in the hospital were operable, hospital staff had to break all the windows in the hospitals’ upper floors to get air into the facility.

Five years later during Hurricane Sandy, a similar story occurred. Both Bellevue Hospital and New York Langone Medical Center had to be evacuated because all their electrical systems were in the basement. At NYU Langone, millions of dollars of medical research specimens were destroyed because of lack of consistent refrigeration. It took Bellevue more than ten weeks to clean up the mess and reopen its doors to patients.

We are learning the hard way that the healthcare sector’s understanding and ability to respond to climate change is still in a primitive stage of development.

What, then, should the role of healthcare be in dealing with climate change?

First, hospitals need to focus on preparedness and resilience in their design and operations so they can be critical players in responding to extreme weather events, rather than being one of the victims. Spaulding Rehabilitation Hospital in Boston is one example of a hospital that has taken the reality of climate change to heart. The hospital, which is scheduled to open in April 2013, employs on-site power generation, operable windows to provide natural ventilation and has put all the mechanical/electrical equipment on the roof of the facility. These innovations are part of the overall business strategy of Partners Healthcare (Spaulding’s owner) which has added climate change to its top “business risks” category.

The second critical role for health care should be to model the transition to a post-fossil fuel economy. In the U.S., health care represents 18% of the entire GDP, and is likely to increase to more than 20% when health care reform is in full swing. In other industrialized countries, health care represents 10% of the economy. Given its enormous economic clout and its healing mission, health care is well positioned to “model” the transition away from our addiction to fossil fuels, which not only contributes to global climate change but also has local pollution and public health impacts. Reliance on coal, for example, contributes dramatically to increased asthma and respiratory diseases while fracking for natural gas contaminates local groundwater and vents toxic chemicals into the community air. Health care has a mission-related imperative to lower its own extensive carbon footprint and lead the effort to a secure and sustainable energy economy.

Reducing hospital dependence on fossil fuel energy through conservation efforts improves resilience – the less energy that hospitals require, the longer they can operate during and after extreme weather events. An alternative source of power independent from the electrical grid also helps in weather emergencies; while all hospitals have diesel generators, much of this infrastructure has proven to be vulnerable and inadequate for prolonged grid outages.

During Sandy, hospitals that had on-site power generation continued to provide critical care to their patients, and offered safe haven for those hospital patients that were evacuated from flooded areas. Known as co-generation (or Combined Heat and Power), this technology not only dramatically improves the hospital’s energy efficiency and saves money, but it also turns out to be a critical climate resiliency strategy. Kiowa County Hospital, destroyed by a massive category 5 tornado in 2007 that damaged 95 percent of the town of Greensburg, Kansas, has been reconstructed with a 100 percent renewable wind energy system. According to FEMA, renewable energy infrastructure has performed well in extreme weather events, demonstrating that sustainable design and increased resilience go hand in hand.

The third central role of the health care sector is in education and advocacy around climate change policy. Health care professionals, especially doctors and nurses, enjoy an unprecedented role as positive messengers for health in society. As we begin to calculate the enormous health care and social costs of climate change, health care professionals are in a position to educate their patients about the public health impacts of climate change and help prepare them for these impacts, and also become potent spokespersons for policies at all levels of government that would rein in climate change. As Margaret Chan, director general of the World Health Organization, has stated, “the health sector must add its voice – loud and clear – and fight to place health issues at the center of the climate agenda. We have compelling reasons for doing so. Climate change will affect, in profoundly adverse ways, some of the most fundamental determinants of health: food, air, and water.”

Climate change will bring us many more heat waves, hurricanes and droughts in the years to come. We need to engage the health care sector in climate change mitigation so they can help communities be prepared to weather these crises and help lead us to a healthier and more sustainable future. Who else is going to play this role?

Gary Cohen, Co-founder and President, Health Care Without Harm

[This article was published as part of a special series for World Health Day and in advance of the 2013 Skoll World Forum. Watch the live stream on April 10-12.]

Wastewater management in healthcare

My 2nd year with Health Care Without Harm-Asia on its 10th year celebration.

There are 10 goals to achieve and hopefully more hospitals will be involved in the Global Green Healthy Hospital (GGHH) network. The Network sets out to support existing efforts around the world to promote greater sustainability and environmental health in the healthcare sector, and thereby to strengthen health systems globally.

One of GGHH goal is on Water. We know that water is crucial for all aspects of life but only 1% of all freshwater on Earth is available for human use. Wastewater management is essential for a most effective and sustainable future.

The Philippines is made up of over 7,000 islands, and has the longest total coastline in the world. Given this, many Filipinos rely on the ocean as a source of food. Eating seafood from, and actually consuming, contaminated water puts the person in grave risk.

This put emphasis on the need to protect the Philippine waters from contaminants. Small bodies of water such as rivers, streams, and waterfalls are also used for drinking, washing, and cooking. People relying on these may be harmed by the toxins present in the water.

Concern over the world's water supply is likewise increasing. Industrialization and urban development is often seen as a marker of progress, but these developments may also compromise the cleanliness and safety of water supplies. This concern is as relevant as ever, as freshwater demand for industrial applications will increase to 120 billion cubic meters by 2025. (Babu, 2008). An increase in industrialization brings an increased need for better waste management.

The Philippines had made several positive steps to protecting our waters. The Philippine Clean Water Act (2004) requires facilities to obtain a wastewater discharge permit.

Hospitals are also bound to this law. One hospital that sets a positive example is the Philippine Heart Center (PHC). Considered one of the top facilities for cardiovascular treatment, the hospital implements stringent waste water processing.

PHC has noted an increase in water consumption in line with the increase in patients. To process the wastewater produced, the hospital has introduced a Sewerage Treatment Plan (STP). The STP has its own staff to monitor smooth operations around the clock. The facilities also undergo a monthly examination of its water output by independent laboratories.

The STP project cost PHC a big sum of Php10.5 million (approx US$260,000). Although the return of investment (ROI) is not yet significant, PHC expects it in the coming years of operation.

The recycled water is being used to water ornamental plants in the hospital grounds and gardens, and for toilet flushing. As of now they are saving quite a lot in the water consumption because the areas for the ornamental plants and gardens are quite considerable.

The work in waste water treatment takes up time, knowledge, experience, lots of passion, and commitment. As Engr. Barzaga, engineer IV of PHC’s Mechanical Department shares, “For proper wastewater treatment facility to work properly, adequate manpower plus an experienced, knowledgeable, and passionate team should be working on the facility fulltime. As hospital people, it is not only their responsibility to comply with laws but also to make sure to keep the environment healthy for the surrounding communities.”

Setting-up wastewater treatment facilities is a huge investment, but it is the surest way to sustainability of water management and secure our water resources.

A healthier future needs urgent global action for smart investment to improve wastewater management. Wise investments will generate greater return.

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Joyce C. Lanuza, HCWH-Asia Admin/Finance Officer

Medical Waste Awareness at an All-time High in Nepal

A front-page news article in the Himalayan - one of Nepal's leading English language newspapers - reports the government warning that hospitals that do not treat their waste will lose their licences and be forced to shut down. A team lead by a representative from the Prime Minister's office visited three Kathmandu Hospitals in December and found that only one was treating their waste properly. That one hospital was Bir, where HECAF has created a sustainable waste management system with support from HCWH and the World Health Organisation. A short HECAF video about the progress at Bir, by filmmaker Russ Pariseau, can be seen here.

The Prime Minister and the Minister of Science and Technology also came to the Energy Week Workshop organised by the Alternative Energy Promotion Centre and visited HECAF's stall, where they were raising awareness about HCWH's Global Green and Healthy Hospital's, and the potential of biodigestion to treat waste and generate renewable energy in hospitals. Biodigestion is just one of the innovative technologies that are being piloted at Bir, and plans for other hospitals are under development.

Outside of the capital, the Chitwan District Public Health Office, a government institution responsible for Public Health, is also backing HECAF and HCWH's work. The District Public Health Officer is supporting our project to develop waste systems suitable for the small healthposts that so many of the rural population depend on. Suitable pilot facilities have already been identified and the next step will be to raise awareness with facility bosses across the region and field testing some of the priority technologies.

Health Care Without Harm has been working with strategic partners Healthcare Foundation Nepal (HECAF) since 2008 and the issue has never been hotter.

Ruth Stringer, HCWH International Science & Policy Coordinator

Minamata Treaty: Mercury-free Health Care by 2020!

One of the ten Global Green and Health Hospitals goals is to substitute chemicals with safer alternatives. A top action item under this goal is to substitute mercury-based thermometers and blood pressure devices with accurate, affordable alternatives. Thousands of hospitals around the world— many members of GGHH– have already made the switch and more are doing so every day.

Going mercury-free just became both more urgent and easier to do. On January 19 in Geneva, as part of the final text of a global mercury treaty, the world’s governments agreed to end the manufacture, import and export of all mercury-based medical devices— effectively phasing them out by 2020. They also called for a phasing-down of dental amalgam— a major source of mercury in the global environment. Negotiated over several years, the Minamata Treaty is set to be signed at a diplomatic conference in Japan in October 2013.

The health care aspect of the Minamata treaty is a major victory for all who have worked to substitute mercury thermometers and sphygmomanometers (blood pressure devices). The agreed upon 2020 phase-out date represents the global acceptance and institutionalization of 15 years of work by HCWH and many others around the world to substitute mercury-based medical devices with safe, accurate and affordable alternatives. From the nurse on the ward, to the hospital director, to the public health official, to health professional associations, federations, governments and international organizations who have organized for mercury-free health care around the world—all should share in the credit for and celebrate this important achievement.

As a result of the ongoing global efforts, mercury-based medical devices are already phased-out or being phased out in the United States, Europe, Asia, Africa and Latin America. The treaty will further expand and engage new elements of government and civil society from around the world. We are extremely pleased with this outcome.

HCWH, as part of the joint Global Mercury-Free Healthcare Initiative that it co-leads with WHO, will be focusing on the target date of 2020 set by the treaty. We will be working with health professionals, hospitals, manufacturers, health systems and ministries of health to assure the rapid transition to accurate, affordable alternatives in order to achieve global mercury-free healthcare by 2020. Furthermore, we will be continuing our effort in promoting and advocating the environmentally sound management of mercury waste from health care facilities.

Click here to view the press release issued by Health Care Without Harm and the World Health Organization on behalf of the Global Mercury Free Healthcare Initiative.

Josh Karliner, HCWH International Coordinator

HCWH-SEA is now Asia

The year 2012 was a great year for us and the people whose lives we hope have touched. We have expanded our campaigns. The mercury campaign was expanded, and is now the Safer Chemicals program which now includes other hazardous chemicals in the health care setting. The Medical Waste campaign has ventured into a deeper look at the Philippine Health Care Waste Management Manual and continuously worked with the Anti-Incineration Road (AIR) Show (a collaboration between Philippine-based NGOs Ecowaste Coaliton (Ecowaste), and Mother Earth Foundation (MEF), and the international group Global Alliance for Incinerator Alternatives/Global Anti-Incinerator Alliance (GAIA) in the Philippines. Our office staff has expanded in numbers too.

2013 promises to be an even more exciting and at the same time a challenging year for us. We do not only celebrate a decade of meaningful years of work, we are also expanding the advocacy for environmental health in the whole Asian region.

We are now HCWH-Asia.

Asia region is the most diverse culturally, the one with the fastest growing economies and where several mega cities are situated. The cause for health and the environment should be the norm in this growing and dynamic region, as it should be too globally.

This year and in the coming years ahead, we hope to highlight more the encompassing issue of climate change and how it relates to other equally crucial issues such as toxic chemicals, improper health care waste management, burning of wastes, unsustainable infrastructure and how it impacts on our health and the environment.

This year, we go full blast in engaging hospitals to be part of the Global Green and Healthy Hospitals. GGHH is a global network and a movement of hospitals and health care systems that practices 10 interrelated goals: leadership, chemicals, waste, energy, water, transportation, food, pharmaceuticals, building and purchasing.

We call on private and public health care systems, hospitals and clinics to be part of this dynamic movement. We strongly believe and trust our partners in the government, international government and non-government groups, academe, scientists, donors, supporters, and other stakeholders that they will continue to be with us in this important work that we are doing.

We invite you to be part of our 10-10-13. Ten goals, ten years in 2013.

To our partners, supporters and friends, you all are a big part of HCWH Asia’s growth, substance and success.

Let’s continue the advocacy and the collaboration.

You ALL ROCK!

Merci Ferrer, HCWH-Asia Director

EcoGroups urge Pampanga to focus on zero waste, not waste-to-energy

San Fernando, Pampanga –Environmental justice and health networks Mother Earth Foundation, EcoWaste Coalition, Global Alliance for Incinerator Alternatives (GAIA), and Health Care Without Harm (HCWH) call on the Province of Pampanga to defend the Clean Air and Ecological Solid Waste Management Acts, and be wary of waste-to-energy combustion projects being offered at no-cost to municipalities of the province at the Anti-Incineration Road Show (AIR Show), a series of workshops and community consultations about waste-to-energy held around the country.

Froilan Grate, President of the Mother Earth Foundation, pointed out that they key to solving waste problems in the province is already in the hands of the municipalities considering most of them have their own solid waste management ordinances. “Firm enforcement of waste reduction, re-use, segregation, recycling and composting measures maybe done within the province. Not only will it bring savings from collecting and transporting waste to landfills or incinerators, it will also contribute to the conservation of our dwindling natural resources by reducing the need to extract virgin resources to manufacture new products.”

National laws mandating proper waste management abound in the country. “We have the Clean Air Act that prohibits burning of waste and the Ecological Solid Waste Management Law that aims to set a systematic, comprehensive and ecological waste management program leading to zero waste Philippines,” said Christina Vergara, Zero Waste Officer of the EcoWaste Coalition. “Burning waste in incinerators conflict with every effort to properly enforce our ecological waste management law that ensures materials conservation,” she emphasized.

Although the promise of waste-to-energy may seem too good to resist, Paeng Lopez, National Campaigner of GAIA, was quick to point out the problems related to waste-to-energy incineration facilities. “Waste-to-energy burn facilities are as unsustainable as they are polluting. They burn useful materials that maybe reused, recycled, or composted to produce energy that is five times less than what we can conserve by reusing, recycling, and composting in the first place.”

He also added, “In 2011 US EPA found out that incinerators release 14 times more mercury as coal-fired power plants per unit of energy, and emit far higher levels of greenhouse gas throughout their lifecycles than source reduction, reuse and recycling of the same materials.”

Lopez pointed out that pyrolysis, gasification, plasma arc are all incinerators in disguise.

Sonia Astudillo, Communications & Press Campaigner of HCWH, shared that waste management even in hospitals is indeed no sweat if we know the right thing to do. “Hospital wastes especially infectious wastes which were once considered the worst nightmare for any waste management program and often the excuse used to bring back incineration may be treated and disinfected through the use of autoclaves and microwaves.” Non-infectious wastes maybe recycled and treated as regular household waste.

The EcoGroups highlighted the economic impact of non-burning citing examples of too-good-to-be-true-WTE that turned sour and simple non-burn practices that eventually lead to extra income for the community.

“The aim is to move Pampanga towards zero waste and we will surely accomplish this with their determined cooperation,” said Grate.

ENVI-HEALTH GROUP QUESTIONS DAVAO’S PYROCLAVE

Environmental health group Health Care Without Harm-Asia Pacific (HCWH-AP) today raises alarm over a proposed Memorandum of Agreement (MOA) to be entered into by the Mayor of Davao City to use Pyroclave technology to address the disposal of hospital waste. The same proposal is currently in negotiation in Davao del Norte, Cagayan de Oro and Cebu City.

“We would like to point out that contrary to claims of RAD Green Solutions, the proponent of Pyroclave technology, that this is not a non-burn technology,” said Merci Ferrer, HCWH-AP Director “The name is clear ‘pyro’ meaning fire.”

“Proper disposal of medical waste is very important and we have been campaigning to hospitals and the Department of Health on how to treat and handle infectious medical waste,” said Ferrer. “We would like to emphasize that there are available clean technologies in the country that we can use such as microwave and autoclave.”

The Clean Air Act banned the use of incinerators for both solid and medical waste making the Philippines the only country in the world to ban incineration.

The Philippines is likewise among the eight participating countries to the UNDP-Global Environment Facility which aims to reduce environmental release of dioxins and mercury by promoting best techniques and practices for reducing and managing health care waste. In the Philippines, the project is promoting the use of non-burn technology specifically autoclave. The DoH is the implementing agency of the project.

According to the website of RAD Green Solutions, Pyroclave reduces waste to its original form and turns them into carbon within 15 to 20 minutes using intense heat. The gas produced inside the chamber is collected, processed then re-introduced into the burners as fuel.

“We would like to warn the City Council and other local government officials to be wary of incinerators-in-disguise proposals,” said Ferrer.

The 2000 EU directive on incineration states that incineration plant means any stationary or mobile technical unit and equipment dedicated to the thermal treatment of wastes with or without recovery of the combustion heat generated. This includes the incineration by oxidation of waste as well as other thermal treatment processes such as pyrolysis, gasification or plasma processes in so far as the substances resulting from the treatment are subsequently incinerated.

“It is clear that what they are promoting is incineration,” said Ferrer. “But the bigger question is how a dirty technology such as Pyroclave received a certification from the DoH.”

In 2011, Special Rapporteur Calin Georgescu to the UN Human Rights Council called for an end to the incineration of medical waste in order to protect human health and the environment. He is pushing for the replacement of incineration as a disposal method of hazardous medical waste with more environmentally-friendly and safe methods of disposal, such as autoclaving.

“Again, we need to go back to proper management of waste through waste minimization, segregation and then proper treatment and disposal of infectious waste which more often than not is just 15% of all the waste produced in the hospital.

“We have documented hospitals around the country who managed their waste properly and successfully without resorting to burning,” said Ferrer.

The group will be sending a letter to the City Council of Davao and other localities to present a strong case against using technologies that is harmful to the environment.

Media Contacts:

Sonia G. Astudillo, +63 9189182369; sonia@no-harm.org

Merci Ferrer +63 9209056113; merci@no-harm.org

HCWH is an international coalition with over 483 member organizations in 53 countries, working to transform the health care sector world-wide, without compromising patient safety or care, so that it is ecologically-sustainable and no longer a source of harm to public health and environment. For more information on HCWH-SEA, visit www.noharm.org

On World Environment Day, EVEN HOSPITALS ARE GOING PLASTIC- AND STYRO-FREE

Chief Seattle’s “take only memories, leave nothing but footprints” often seen at tourist places as a gentle reminder not to spoil a precious travel destination may now be used in health care facilities.

Yes, nowadays, even hospitals are cleaning their grounds by going plastic- and styrofoam-free.

“The move to go plastic and styro-free in hospitals started several years ago,” said Merci Ferrer, Director of Health Care Without Harm-Asia Pacific, an environmental-health NGO. “It is fair to say that some of our hospitals got the ball rolling, way before local government units and the Congress”

No styro-No plastic policy

At San Lazaro Hospital (SLH) in Manila, a no plastic-no styro memorandum has been in place for a few years now. While the implementation has been gradual, the dietary section is no longer using styrofoam for food served to patients.

“The dietary section is completely free from styrofoam and we are looking at alternatives to the plastic cling wraps used to cover food. The canteen, which is zero-styrofoam zone too, is slowly minimizing the use of plastics,” said Dr. Karen Arago, Program Manager for SLH Health Care Waste Management Committee. “We are likewise thinking of ways to discourage people to use plastic spoons and forks for take-out food while looking for alternatives that are reusable and/or biodegradable.”

Hospital employees are encouraged to bring their own utensils but problem arises for visitors who request for plastic spoons and forks.

According to Daniel S. Tuglao, head of the dietary section, volunteer nurses, medical technologist, radiology technicians, mortuary attendants and 24-hours doctors are even instructed to bring their own containers for their free meals courtesy of SLH dietary section.

SLH is also in the process of removing drinking straws in their canteen.

“Eventually we want those coming in the hospital to know that we are moving away from plastic,” said Arago. “We want them to see the complete picture of health and that it is a complete work-out. It is not just about going to hospitals, getting medicines and being treated by doctors. It is also about using resources that are safe for your health and the environment.”

“Some hospitals are also moving away from plastic admission kits and are using paper or reusable bags,” said Ferrer. Among these are St. Paul de Chartres (SPC) health care ministry 14 hospitals around the Philippines and St. Loius University Hospital of the Sacred Heart in Baguio City, to name just a few.

“Right away, it meant a few less plastic bags,” said Ferrer. “The admission kits may also be made of cloth from flour bags which would otherwise be discarded. People from the community can get together and help make these bags providing them a source of livelihood.”

In March, Maria Reyna Xavier University Hospital, a SPC hospital in Cagayan de Oro City, implemented a no styrofoam policy. While still in transition phase, patients and doctors are starting to adjust to the new policy. Even fast food stores delivering food to hospital staff and patients are getting the message.

PVC medical device

“Aside from plastic and styrofoam for food packaging, hospitals are also looking at alternatives to PVC plastic medical devices such as IV bags and tubing,” said Ferrer.

Manufacturing PVC generates highly toxic dioxin, one of the most persistent organic pollutants known to science and it poses the greatest risk to hospital patients.

In its pure form, PVC is stiff and brittle. It can only be made into consumer products by the addition of modifying chemicals, the most common of which for PVC medical device is the DEHP.

“DEHP can leach out from products like IV tubing directly into the body of the patient. Its risks are acknowledged by several medical associations and government agencies and thus we advocate replacing PVC and DEHP-containing products with alternatives,” Ferrer added.

Health Care Without Harm has developed a list of alternatives to PVC-DEHP medical devices. The list is available at www.noharm.org.

Media Contacts:

Sonia G. Astudillo, +63 9189182369; sonia@no-harm.org

Merci Ferrer +63 9209056113; merci@no-harm.org

HCWH is an international coalition with over 483 member organizations in 53 countries, working to transform the health care sector world-wide, without compromising patient safety or care, so that it is ecologically-sustainable and no longer a source of harm to public health and environment. For more information on HCWH-SEA, visit www.noharm.org

Global Green and Healthy Hospitals Network launched in Asia

Taipei--- Hospitals, health systems and health organizations representing the interests of more than 2,500 hospitals from six continents today launched the Global Green and Healthy Hospitals Network (GGHHN), an international initiative to reduce the health sector’s ecological footprint and promote public environmental health.

One in a series of events to be held around the world in 2012, the launch took place at the 20th Annual Conference of the International Health Promoting Hospitals, where 33 new hospitals from countries as diverse as Thailand, Sweden, the Philippines, Nigeria and Taiwan committed to endorse the Network and undertake a series of initiatives to green their facilities.

“We know that in many parts of the world, hospitals consume large amounts of energy, chemicals, water and other resources,” said Josh Karliner, International Coordinator for Health Care Without Harm, which has led the establishment of theNetwork. “What is new here is that hospitals and health systems are coming together across borders and committing to take leadership to address their impacts on the environment and human health. As part of the Network they are setting goals to transform everything from how they build, to the products they use, to how they manage their waste, in order to promote healthier environments.”

A similar launch took place in early April in the United States, where a sister Network facilitated by Health Care Without Harm, the Healthier Hospitals Initiative, was joined by major health systems representing 500 U.S. hospitals and US $20 billion in purchasing power. Other founding members of the GGHHN include a broad set of organizations, ranging from the Sustainability Unit of England’s National Health Service, to the Indonesia Hospital Association, the international health NGO FHI360, the Environment Task Force of the Health Promoting Hospitals (HPH) Network, as well as individual hospitals from Argentina, Brazil, Mexico, Canada, India and Nepal.

“We are pleased to join the Global Green and Healthy Hospitals Network,” said Dr. Shu Ti Chiou, Chair of the HPH Environment Task Force and host of the event. “By reducing our greenhouse gas emissions, reducing waste and implementing green purchasing policies, hospitals can promote greater public health, while also providing leadership for the rest of society. We look forward to taking on this challenge.”

Members of the Network will establish specific goals for reducing their environmental footprint and the report on their progress on an annual basis. They will also share case studies and best practices with one another via the Network’s website, www.greenhospitals.net.

“This launch represents both the bringing together of wide array of initiatives for sustainability in the health sector, and the global scale-up of the green health care movement,” said Merci Ferrer, South East Asia Coordinator for Health Care Without Harm. “We will be working with hospitals, health systems and health organizations throughout world to realize this potential.”

Launch events for the Global Green and Healthy Hospitals Network will also be held in Brazil, Sweden, the Philippines, Australia and other countries over the course of 2012.

For more information see: www.greenhospitals.net

WORLD WATER DAY: Hospitals in the forefront of water conservation

Just in time with the World Water Day, Health Care Without Harm-Southeast Asia (HCWH-SEA) warns that improper practices in a hospital’s daily operation may worsen water problem.

“Health care facilities consume a large volume of water in its daily operation. While this may contribute to the burgeoning water supply problem worldwide, there are numerous ways on how health care facilities may help alleviate the problem,” said Merci Ferrer, Director of HCWH-SEA.

A 2009 research conducted by the Asian Development Bank reported that clean water supply in the Philippines are fast deteriorating with rapid urbanization and only 33 per cent of river systems are still suitable as clean and safe supply of water and up to 58 per cent of the country’s groundwater are now contaminated. The annual freshwater availability per capita is only 1,907 m3 compared to Asian and world averages of 3,669 m3/person and 7,045 m3/per person, respectively.

The Philippine Heart Center in its report to HCWH-SEA identified actions it has taken to reduce hospital water consumption and increase supply of potable water. PHC is among the first hospitals in Southeast Asia to join the Global Green and Healthy Hospitals Network, a virtual community for hospitals and health systems seeking to implement and evolve the ten Global Green and Healthy Hospitals Agenda (GGHHA). The ten goals include (1) prioritizing environmental health, (2) substitution of harmful chemicals with safer alternatives, (3) reduction, treatment and safe disposal of healthcare waste, (4) implementation of energy efficient and clean renewable energy generation, (5) reduction of hospital water consumption and providing potable water, (6) improving transportation strategies for patient and staff, (7) purchase and serving of sustainably grown, healthy food, (8) safe management and disposal of pharmaceuticals, (9) supporting green and healthy hospital design and construction, and (10) buying safer and more sustainable products and materials.

Among the first steps taken by PHC for its water conservation strategies is installing efficient faucets and toilets in its facility. Routine check on plumbing and pipes to prevent leaks and elimination of seal and cooling water on medical air compression and vacuum were also implemented.

Clean water

Toxic chemicals such as methylacrylate, xylene, organic solvents, formaldehyde and cleaning and sterilizing compounds such as ethylene oxide, sodium hypochlorite, glutaraldehyde and phenols are commonly used in health care facilities. “If we do not pay attention to the toxicity of these chemicals and where and how we dispose them, these chemicals will eventually find their way into the water stream,” said Ferrer.

Among the initiatives of PHC is switching from film-based radiological imaging equipment which uses large quantities of water to digital imaging which uses no water and no polluting radiological chemicals. The hospital is currently using digital x-ray.

“Indiscriminate dumping of chemicals from hospitals where they will go directly to our water system, the health care sector, without them knowing it, is causing not only health problems but severe environmental problems as well,” she added. “And worst, they are adding to the water problem faced worldwide.”

No to bottled water

In 2006, Pacific Institute estimates that producing the bottle for bottled water for American consumption alone required the equivalent of more than 17 million barrels of oil, not including the energy for transportation. They added that bottling the water produced more than 2.5 million tons of carbon dioxide and it took 3 liters of water to produce 1 liter of bottled water.

PHC has eliminated bottled water throughout the hospital and partially filtered water tank were installed in some nurse station with regular bacteriological analysis test to check the water quality. The facility also has a memorandum of agreement with Manila Water for 24-hour assurance of water supply. In return, they took initiatives in cleaning with the central drainage system.

Harvesting of rainwater and recycling water through the sewage treatment plant or the sequencing batch reactor (SBR) is also being done by PHC for gardening and cooling tower.

When it comes to giving back to the community, PHC develops joint projects with the community to improve and protect water supply support initiatives for public system to improve water quality, water delivery and wastewater system.

“The health sector can contribute a lot in helping provide cleaner and safer water,” said Ferrer. “And the PHC has taken a leap in this respect.

“We encourage hospitals around the country to follow the example of PHC and to share with us at HCHW, what other initiatives they have taken towards greening their hospital.”

World statistics show that 1.1 billion people lack access to safe drinking water while an estimated 2.5 billion people have no access to proper sanitation and more than 5 million people die each year from water-related diseases, most victims are children under the age of five. This is equivalent to one child dying every 15 seconds. In Asia, one in five Asians does not have access to safe water supply and one in two does not have access to improved sanitation. One in three Asians still has to walk at least 200 meters to fetch drinking water.

Media Contacts:

Sonia G. Astudillo, +63 9189182369

Merci Ferrer +63 9209056113

HCWH is an international coalition with over 483 member organizations in 53 countries, working to transform the health care sector world-wide, without compromising patient safety or care, so that it is ecologically-sustainable and no longer a source of harm to public health and environment. For more information on HCWH-SEA, visit www.noharm.org/seasia For more information on the Global Green and Healthy Hospitals Agenda, visit www.greenhospitals.net. Note: GGHH Agenda was launched in 2011 in Buenos Aires, Argentina. Hospitals and health systems from Argentina, India, Nepal and England including the Sustainability Unit of England’s National Health Service which works with more than 200 hospitals have already signed as Founding Members. A sister network in the US, the Healthier Hospitals Initiative, has more than 300 hospital members. On April 11, the GGHH Network in Asia will be launched in Taipei. HCWH, together with the Environment Task Force of the International Health Promoting Hospitals Network and the Bureau of Health Promotion for the Department of Health, Taiwan are the organizers of the Asia launch.

Open letter to world leaders calls for an end of the threat of nuclear power

Just days before Japan marks the anniversary of March 11, 2011 tsunami and the nuclear disaster that followed, leaders from more than 50 organisations and prominent individuals from all around the world today released an open letter to world leaders calling for investments in safe, renewable energy in order to end to the threat of nuclear power and put protecting people ahead of protecting the nuclear industry.

The signatories include: Archbishop Dr. Desmond Tutu, Nobel Peace Laureate; Marina Silva, former Brazilian Environment Minister; Senator Bob Brown, Australian Green Party Leader, Ralph Nader, USenvironmental activist; John Hall, former US Congressman; Richard Harvey, international Human Rights lawyer; several artists; leaders of human rights, labour, development and environment organisations, such as Action Aid International, Health Care without Harm, Greenpeace International, Friends of the Earth US, CIVICUS, the Feminist Task Force of the Global Call to Action against Poverty, and many national non-governmental organisations.

The letter begins: “On behalf of the millions of people in the world who live with the threat of a nuclear disaster ruining their lives, we are writing to ask you to recognize that now is the time to put people ahead of the nuclear industry and hold the industry fully liable for the risks and damages of its disasters. It is time to remove the risks of nuclear from people’s lives and shift our economies to clean, safe energy systems.”

The impacts of the nuclear disaster at Fukushima continue for hundreds of thousands in Japan. They are exposed to radioactive contamination, displaced from their homes, dislocated from their communities, have lost their jobs and live with the ongoing fear that their children may suffer from the long-term effects of radiation exposure. This kind of suffering would be repeated in any country where there is a nuclear disaster.

The letter notes that the Fukushima nuclear disaster was a result of the failure of institutions in Japan to protect people from such an accident. These institutional failures are repeated in every country with nuclear reactors,putting millions at risk, because governments “are more concerned about protecting the profits of the nuclear industry than in fulfilling their responsibility to protect people.”

Greenpeace will send the open letter to world leaders to encourage them to remove the risks of nuclear power from the world.

Full letter and signature list

MARINDUQUE GEARS UP FOR MERCURY-FREE HEALTH CARE: Bringing mercury-free system at the heart of the country

Boac, Marinduque - In a continuous bid to make the Philippines 100% mercury-free, Health Care Without Harm-Southeast Asia (HCWH-SEA) today turns-over non mercurial thermometers to the Province of Marinduque, the province that seats at the heart of the country.

“This is a very symbolic event,” said Merci Ferrer, HCWH-SEA’s Executive Director. “If we make the heart of the country mercury-free, how can we not make the whole country 100% mercury-free?”

The non-mercurial thermometers from OMRON Healthcare, a partner of HCWH-SEA in the mercury campaign, are turned over to the Office of Marinduque Governor Carmencita Reyes for distribution to the 6 municipalities and the Provincial Health Office.

“We support the initiative of the province to encourage their hospitals to shun away from mercury and to serve as a model to other local government units,” said Ferrer.

In July, the Regional Development Council (RDC) of MIMAROPA (Mindoro, Marinduque, Romblon and Palawan) region passed two resolutions pertaining to the mercury issue. RDC MIMAROPA is chaired by Gov. Reyes.

Formed in the early 1970s, the RDC which is under the National Economic Development Authority (NEDA) serves as the regional machinery to coordinate national and local government activities particularly in formulating and implementing development plans and programs for the region.

RDC Resolution No. 036-208-2011 bans the entry of mercury in all Philippine markets with reference to the Department of Health (DoH) Administrative Order 2008-0021 on the phase-out of all mercury-containing devices in all Philippine health care facilities and institutions by 2010.

RDC Resolution No. 036-209-2011 requests the DENR-EMB to formulate procedures and guidelines pertaining to storage/disposal of mercury in support.

“We commend Marinduque and the whole of MIMAROPA region,” said Ferrer. Both Resolutions will be furnished to all RDCs to enjoin them to concur with its objectives and likewise come-up with a similar resolution.

“Further, the resolution on mercury storage addresses the issue beyond mercury in health care,” said Ferrer. The Resolution on mercury storage will deal with both health care facilities and mining companies’ safe storage of mercury and mercury-containing devices.

“We likewise commend Dir. Gloria J. Balboa, Regional Director of DoH-Center for Health Development-IV-B, for bringing the mercury issue to the attention of the RDC and for actively working for mercury-free health care,” said Ferrer. “We are positive that this will serve as an impetus for the other RDCs to play a big role in the mercury phase-out in health care and beyond,” Ferrer added. “This is a good way for us to end the year and we are hopeful with Marinduque and MIMAROPA’s precedent, all the regions in the country will be geared up for mercury-free Philippines.”

The RDC also serves as a forum to raise and discuss regional development issues and concerns. Likewise, it serves as a venue where national development is translated into specific regions and local objectives. It provides the mechanism to raise local and regional issues to the attention of the national government.

Photo caption: To a mercury-free Marinduque. Representatives of rural health units from the different municipalities of Marinduque receive non-mercurial thermometer from Health Care Without Harm-Southeast Asia and OMRON Healthcare. (center: Merci Ferrer, Executive Director of HCWH-SEA, right: Marinduque Gov. Carmencita Reyes)

Media Contacts:

Sonia G. Astudillo, +63 9189182369

Merci Ferrer, +63 9209056113

HCWH is an international coalition with over 483 member organizations in 53 countries, working to transform the health care sector world-wide, without compromising patient safety or care, so that it is ecologically-sustainable and no longer a source of harm to public health and environment. For more information on HCWH-SEA, visitwww.noharm.org/seasia

‘SHOULD HAVE BEEN A KNOCK-OUT’ FOR INCINERATOR PROJECTS

For five consecutive years, environmental-health group, Health Care Without Harm-Southeast Asia (HCWH-SEA) once again called on the executive and legislative governments for the debt cancellation of a 15-year old medical waste incineration project that continues to be a huge burden to the people.

“Today marks the anniversary of the signing of the P503-million Austrian Medical Waste Incinerator Project that provided medical waste incinerators to 26 public hospitals around the country,” said HCWH-SEA’s Merci Ferrer. “Another year will pass and we are still paying for a loan that should have been diverted to other health care needs and services.

The Philippine and Austrian Governments entered into the loan to help in the proper disposal of medical waste. In 1999, however, the Philippines successfully banned the use of incinerators for general wastes and subsequently the use of incinerators for medical waste in 2003. The country remains the only country in the world to ban incinerators. However, the government continues to pay close to US$2 million every year and is set to pay until 2014.

Government agencies such as the Department of Health (DoH), Department of Environment and Natural Resources (DENR) and the Metro Manila Development Authority (MMDA) lack the initiative to explore other alternative technologies to properly handle waste,” said Ferrer. “They seem bent on pushing for the incineration of medical wastes when hospitals all over the country have proven that proper waste management is possible without resorting back to incineration,” she added.

In 2007, HCWH-SEA together with the Alternative Budget Initiative (ABI) for health groups lobbied the national government for a P100 million fund to be part of the DoH 2008 budget for the purchase of autoclaves that will be used to disinfect wastes,” said Ferrer. The allocation was approved and included in the 2008 General Appropriations Act but was never released to date.

“P100 million is a small amount of money compared to the billions of loans and ‘investments’ that the government is entering to bring back incinerators,” said Ferrer. “…or even compared to the US$2 million we are allocating for incinerator debt payments.

“Studies show that 80% of hospital wastes are regular wastes and treatment technologies are needed only for the remaining 15 to 20% infectious wastes,” said Ferrer. “Proper waste management is our best and only option.”

Last week, the World Health Organization (WHO) posted a factsheet highlighting health impacts, risk associated, reasons for failure and steps towards improvement on health care waste management.

According to the WHO factsheet, among the reasons for the failure in health care waste management is the lack of awareness about the health hazards related to health care waste, inadequate training in proper waste management, absence of waste management and disposal systems, insufficient financial and human resources and the low priority given to the issue. It added that many countries do not have appropriate regulations or do not enforce them.

“Indeed we have existing policies but strong will is lacking,” said Ferrer again citing recent moves by the Congress to revive incineration of waste particularly medical waste. “We have banned incinerators long time ago because we know that incineration is harmful and that there are safer alternatives available in handling our wastes. There are in fact safe, less costly alternative systems and technologies such as autoclaves and microwaves that are being used by hospitals. What we need is the government’s support to public health care facilities and to encourage investments on safe alternatives.”

The factsheet pushes for three key elements in improving health care waste management. These include: (1) building a comprehensive system, addressing responsibilities, resource allocation, handling and disposal, (2) raising awareness of the risks related to the health care waste and of safe and sound practices, and (3) selecting safe and environmentally-friendly management options to protect people from hazards when collecting, handling, storing, transporting, treating or disposing of waste.

Government commitment and support is crucial towards an improved health care. “We reiterate that our government should stop the payment of the unscrupulous debt,” said Ferrer. “The money that we are allocating for this payment should be used to fund other health care needs and improvements in health care waste management.”

HCWH-SEA also cited a report submitted in September by the Special Rapporteur to the United Nations Human Rights Council calling for an end to the incineration of medical waste in order to protect human health and the environment.

The campaign against medical waste incineration in the Philippines is taking grounds with hospitals making their strong case against any form of medical waste incineration revival. Recently more than 10 hospitals unfurled a banner that says Incineration harms, Burn not in their façade. Twenty personalities from politics, entertainment and cause-oriented groups also made their strong statement against incineration in a 3-part Public Service Announcement dubbed Burn Not.

Copies of the reports are available at:

Toxic Debt: The Onerous Austrian Legacy of Medical Waste Incineration in the Philippines

Report of the Special Rapporteur on the adverse effects of the movement and dumping of toxic and dangerous products and wastes on the enjoyment of human rights

Medical Waste and Human Rights: Submission to the UN Human Rights Council Special Rapporteur

Waste from health-care activities (WHO Factsheet)

Media Contacts:

Sonia G. Astudillo, +63 9189182369

Merci Ferrer, +63 9209056113

HCWH is an international coalition with over 483 member organizations in 53 countries, working to transform the health care sector world-wide, without compromising patient safety or care, so that it is ecologically-sustainable and no longer a source of harm to public health and environment. For more information on HCWH-SEA, visit www.noharm.org/seasia

BURN NOT, GOV’T WARNED

Amidst on-going push from different government sectors to amend the Philippine Clean Air Act, Health Care Without Harm-Southeast Asia (HCWH-SEA) today released a 3-part Public Service Announcement on incineration. ‘Burn Not’ cautions the national government to stop burning and the local governments to shun from legitimizing waste-to-energy or “incinerators-in-disguise” contracts recently signed by different LGUs, particularly in Mindanao.

Incineration Harms, Burn Not, participated in by 20 entertainment, politics and cause-oriented personalities reminding the public of the evils of incineration, is currently being played in the waiting rooms of 13 private and government-owned hospitals. A copy of the PSAs will also be sent to government officials most particularly PNoy, MMDA Chairman Francis Tolentino, Sen. Antonio Trillanes IV, and DENR Sec. Ramon Paje.

“When other countries are moving away from incineration, we ask,” says HCWH-SEA Executive Director Merci Ferrer, “why are we going back to burning?”

The Philippines is the 1st country in the world to ban incineration. In the 2004 Philippines Measles Eradication Campaign (PMEC), the country demonstrated that there are viable alternatives to burning wastes. As a result, the Philippines became the first country to deal with waste from a nationwide vaccination program without resorting to incineration or open burning.

“Burning is not the answer to our waste problem,” Ferrer said. “What we need is stricter implementation of the law.” The group cited that several incineration-in-disguise projects abound in the country which is a “complete violation of the law.”

“We want our officials to see these videos and really understand what we mean when we say ‘incineration harms’.”

The videos aim to go viral and call for national and international support against incineration.

The 1st video disputes claims that incineration is the answer to lessening the volume of wastes. According to the video, the volume of wastes may have decreased but dioxins and furans remain exposing the public to the most toxic substances known to man. The 2nd part went on to emphasize that there are cleaner and safer alternatives that are already being used in the country and worldwide. The last part showed that incineration in fact makes its users losers. The group cited the US$2 million debt that the country is still paying for 26 defunct medical waste incinerators. These were retired following the ban on medical waste incineration. But prior to the ban, the incinerators were already found to have failed the “acceptable” emission levels.

Along with the videos, a copy of the report to the UN Human Rights Council of Special Rapporteur Calin Georgescu on the adverse effects of the movement and dumping of toxic and dangerous products and wastes will be sent to concerned government officials. The report highlights the adverse effects that unsound management and disposal of medical waste may have on the enjoyment of human rights. It also calls for the replacement of incineration as a disposal method of hazardous medical waste with more environmentally-friendly and safe methods of disposal, such as autoclaving.

The personalities who took part in the 3-part PSA are actor/director Albert Martinez, events host Judah Paolo, WLS FM DJ Papa Dudut, celeb mom Suzi Abrera, Youtube sensation Bekimon, actress Say Alonzo, former Rep. Risa Hontiveros, filmmaker Kidlat Tahimik, running priest Fr. Robert Reyes, tattoo artist Gene Testa, sculptor Salvador Joel Alonday, fashion designer Joel Acebuche, cyclist Chiqui Tronco, indie-pop band Bad Days for Mary, Philippine College of Physicians’ (PCP) Dr. Gina Nazareth, Framework Convention on Tobacco Control’s (FCAP) Dr. Maricar Limpin, Philippine Heart Center’s Dr. Manuel Chua Chiaco Jr., Global Alliance for Incinerator Alternative’s (GAIA) Gigie Cruz, and child volunteer Buwan Lila Sayajon.

The hospitals playing the PSAs are Philippine Heart Center (Quezon City) and San Lazaro Hospital (Manila). Next week, 11 hospitals owned, co-owned and administered by St. Paul de Chartres (SPC) Health Care Ministry will join in. These are Dela Salle University (DLSU) Medical Center (Dasmarinas Cavite), General Santos Doctors Hospital (General Santos City), Julio Cardinal Rosales Memorial Hospital (Dalaguete, Cebu), Notre Dame de Chartres Hospital (Baguio City), Our Lady of Peace Hospital (Paranaque City), Perpetual Succor Hospital (Cebu City), St. Joseph Southern Bukidnon Hospital (Maramag, Bukidnon), St. Paul Hospital in Dasmarinas, Cavite, St. Paul’s Hospital in Iloilo City, St. Paul Hospital in Tuguegarao City, and Maria Reyna Xavier University Hospital (Cagayan de Oro City).

Watch Burn Not on YouTube, click on Burn Not 1, Burn Not 2 and Burn Not 3.
Or visit our Vimeo page at www.vimeo.com/hcwhsea and watch:
BURN NOT1
BURN NOT2
BURN NOT3

Media Contacts:
Sonia G. Astudillo, +63 9189182369
Merci Ferrer, +63 9209056113


HCWH is an international coalition with over 483 member organizations in 53 countries, working to transform the health care sector world-wide, without compromising patient safety or care, so that it is ecologically-sustainable and no longer a source of harm to public health and environment. For more information on HCWH-SEA, visit www.noharm.org/seasia

HOSPITALS OPPOSE INCINERATION

Incineration harms. Burn not.

Hospitals today unfurled a black banner expressing their strongest opposition to the planned return of incineration in the country.

These hospitals from Luzon, Visayas and Mindanao hang a black banner calling no to the revival of incineration of hospital wastes after several government officials said that incineration is the key to addressing the country’s waste problem.

“As doctors, we want to provide quality and healthy life to our patients. Reviving incineration is a complete contrast to this,” said Dr. Manuel Chua Chiaco Jr., Medical Director of the Philippine Heart Center. “It is a total disregard for the waste management practices of our hospital.”

The hospitals hanging the banner are Philippine Heart Center (Quezon City) and San Lazaro Hospital (Manila). Next week, all 11 hospitals owned, co-owned and administered by St. Paul de Chartres (SPC) Health Care Ministry will join in. These are Dela Salle University (DLSU) Medical Center (Dasmarinas Cavite), General Santos Doctors Hospital (General Santos City), Julio Cardinal Rosales Memorial Hospital (Dalaguete, Cebu), Notre Dame de Chartres Hospital (Baguio City), Our Lady of Peace Hospital (Paranaque City), Perpetual Succor Hospital (Cebu City), St. Joseph Southern Bukidnon Hospital (Maramag, Bukidnon), St. Paul Hospital in Dasmarinas, Cavite, St. Paul’s Hospital in Iloilo City, St. Paul Hospital in Tuguegarao City, and Maria Reyna Xavier University Hospital (Cagayan de Oro City).

Sr. Arcelita Sarnillo of the SPC Health Care Ministry said that “Incineration ban is the best thing that has happened to the country when it comes to waste management.” She added, “The health care sector can attest that there are safe and clean alternatives to incineration.”

In 2004, medical waste incineration was banned in the country following the banning of general waste incineration in 2001 as mandated by the Clean Air Act.

While health care facilities regularly use some of the most toxic substances known to man, solid waste comprises the largest portion of a healthcare facility’s waste (75-80%). “Thru proper waste management such as waste minimization, efficient segregation, green purchasing, re-use, recycling and composting, we can greatly reduce the volume of our waste,” said Health Care Without Harm-Southeast Asia’s (HCWH-SEA) Merci Ferrer.

Of the remaining 20-25% hazardous waste, only 15-20% are infectious wastes which are commonly raised as an excuse for reviving medical waste incineration. “These can easily be dealt with using alternative technologies which are widely available in the country,” she added.

Among the alternative treatment technologies for treating waste, without burning, are autoclave, microwave, and dry heat treatment technologies.

A good example of proper health care waste management without burning are SPC hospitals who other than reducing the volume of waste even earned money thru recycling programs and composting. In 2009, St. Paul Hospital in Cavite earned Php40,000 from recycling wastes. While St. Paul Hospital in Tuguegarao City earns Php3,500 to 5,000 per month.

“All SPC-owned and administered hospitals in the Philippines are opposed to the return of waste incineration,” said Sr. Sarnillo. “Environmental stewardship is one of the advocacies of SPC Health Care Ministry. Each of our hospitals has worked on their own waste management practices and systems and they all have proven that the hospitals can earn a few extra money from waste segregation and that technologies such as autoclave and microwave are far more effective means of disinfectingg infectious wastes.”

“The Philippine Heart Center has implemented proper waste management in compliance with the law,” said Dr. Chua Chiaco Jr. “It has been very effective and we encourage the government to learn from our example.”

“We also encourage other hospitals to take their stand against the effort to bring back incineration to the country. We have a moral responsibility to our patients and to take care of people’s health. We must not go back to incinerating our wastes,” said Dr. Chua Chiaco Jr.

Media Contacts:
Sonia G. Astudillo, +63 9189182369
Merci Ferrer, +63 9209056113

HCWH is an international coalition with over 483 member organizations in 53 countries, working to transform the health care sector world-wide, without compromising patient safety or care, so that it is ecologically-sustainable and no longer a source of harm to public health and environment. For more information on HCWH-SEA, visit www.noharm.org/seasia

UN Human Rights Report Calls for An End to Medical Waste Incineration

Contact: Sonia G. Astudillo; +63 9189182369
Merci Ferrer; +63 9209056113


UN Human Rights Report Calls for An End to Medical Waste Incineration

Manila. Health Care Without Harm (HCWH) today praised an official report by a Special Rapporteur to the United Nations Human Rights Council that calls for an end to the incineration of medical waste in order to protect human health and the environment.

The report focuses on "the adverse effects that the unsound management and disposal of medical waste may have on the enjoyment of human rights." It details a broad range of human rights impacts derived from poor health care waste management in a diversity of countries.

"This is a ground breaking document," said Ruth Stringer, International Science and Policy Coordinator for HCWH and author of the HCWH submission to the process. "Not only does the Special Rapporteur document heinous conditions in around the world, but his recommendations call for a progressive series of actions to protect people’s right to health and a clean environment."

In his prepared statement to the Human Rights Council, the Special Rapporteur, Calin Georgescu called for "The replacement of incineration as a disposal method of hazardous medical waste with more environmentally-friendly and safe methods of disposal, such as autoclaving."

"The findings of the Special Rapporteur draw from clear scientific evidence and validate the direct experience of thousands of communities around the world who have suffered from the negative health impacts of medical waste incineration" said Merci Ferrer, Executive Director of HCWH South East Asia. “This is a very timely report especially for the Philippines where government officials are proposing the revival of incinerators by making medical waste as the primary excuse to do so.”
Affirming that "medical staff, patients, workers in support services linked to health-care facilities, workers in waste disposal facilities, recyclers, scavengers and the general public" are all impacted by medical waste, the Special Rapporteur also recommends dedicating greater financial resources to sustainable health care waste management. He further calls for the development of "a comprehensive international legal framework" to protect human health and the environment from the scourge of healthcare waste.

To complement the report from the Special Rapporteur, HCWH today publicly released its own report, which HCWH staff, with the assistance of network members and waste management experts across Africa, Asia and Latin America, assembled. It represents a large body of information which was submitted to the Special Rapporteur for his consideration. HCWH's submission was joined by submissions from the secretariat of the Basel Convention, the secretariat of the Stockholm Convention, the World Health Organization (WHO), and the Centre for International Environmental Law.