Thursday, September 18, 2008

Baguio to clean-up hospital wastes

September 18, 2008

BAGUIO TO CLEAN-UP HOSPITAL WASTES

Baguio City - The Baguio City Environment and Parks Management Office (CEPMO), Baguio hospital administrators, Health Care Without Harm (HCWH)-Southeast Asia and Baguio Councilor Perlita (Pinky) Chan-Rondez, in a meeting yesterday on disposal of treated infectious hospital wastes, agreed that a centralized treatment facility is the immediate and long-term solution to Baguio hospital wastes disposal.

Setting-up the treatment facility--from approval of the City Government to bidding to procurement--will take approximately 75 days.

Since July this year, chemically-treated hospitals wastes from Baguio hospitals are not being collected by City Government for the lack of waste treatment facility for chemical and hazardous wastes in the Metro Clark Waste Management Facility. This forced the Baguio hospitals to take care of the final disposal of their treated wastes.

Faye Ferrer of HCWH-SEA, said that chemically-treating infectious wastes and disposing them within the hospital premises is a short-term solution. “Considering that Baguio does not have the luxury of land, we need a long-term solution.”

Following proposal from HCWH-SEA, the local officials present agreed that it is the local government’s role to purchase a treatment facility that will service all hospitals in Baguio and even nearby hospitals.

HCWH-SEA cited autoclave which uses steam to treat cultures and stocks, sharps, materials contaminated with blood and limited amounts of fluid, isolation and surgery wastes, laboratory wastes (excluding chemical wastes), and soft waste. An autoclave package[1] costs around P1 million.

“The City Government is currently paying P500,000 per day or P17.5 million per month to transport its wastes,” said Rondez. She added that P1 million for the autoclave is not a big amount if this will solve the problem of hospital waste disposal.

A study of 7 Baguio hospitals, approximated the volume of infectious waste produced in a month to 9,708 kg.

“An autoclave treating 50 kg of waste per hour and running for 10 hours a day can treat 17,500 kg of infectious wastes in a month. This is bigger than the amount of infectious wastes produced by Baguio hospitals thus the City Government may even extend its service to nearby hospitals,” said Chel Santos of HCWH-SEA.

The hospital administrators likewise agreed that for their part, each hospital will be responsible to transport the infectious waste to the former Irisan dumpsite where the autoclave is proposed to be set-up. From Irisan, the local government will handle the transport of waste to the proposed Baguio residual area.

The Baguio hospitals headed by the Philippine Hospital Association-Cordillera Administrative Region (CAR) President Dionisio Claridad, Jr., MD, MHA yesterday sent a petition to the City Government to certify the autoclave project urgent and thus expedite its approval.

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.



[1] An autoclave package includes Environmental Compliance Certificate, Standard Operating Procedures, Contingency Plan (risk management), One Hazard Spill Kit, One roll of Sterility Indicator Tape, Ten 55 liter yellow infectious waste plastic bins, 10 rolls of high density polyethylene bin liners, 5 A3 which bin to throw in laminated posters, 1 day staff training program for the operators, 2 hour staff training “Educate to Segregate” workshop.



Tuesday, September 16, 2008

HCWH-SEA supports move to amend Baguio 10-year Eco Waste Plan

September 16, 2008

Health Care Without Harm-Southeast Asia supports move to amend Baguio 10-year Eco Waste Plan

Health Care Without Harm (HCWH)-Southeast Asia supports the Baguio City Council resolution requesting the City Ecological Solid Waste Management Board to prepare an amended three-year action plan and budget for waste management in the wake of the closure of the Irisan dumpsite and to include health care waste disposal in the said plan.

Hospital wastes form a percentage in the total solid waste collection in the City. However, the Metro Clark Waste Management Facility in Tarlac does not accept chemically-treated hospital wastes from Baguio hospitals for lack of a waste water treatment facility for chemical and hazardous waste. This alone is enough reason for the City Government to include a plan and budget for the proper treatment and disposal of health care wastes coming from hospitals, private and public health clinics and centers.

Alternative technologies to treat medical wastes are ecologically-feasible and cheaper for the community. Thus, we are further urging the City Government to provide a centralized treatment facility to treat health care waste coming from all Baguio hospitals. This will ensure safe treatment and disposal of all hospitals? infectious waste.

Merci Ferrer

Executive Director

Health Care Without Harm-Southeast Asia

merci@hcwh.org

Monday, September 15, 2008

International group calls on Baguio LGU to give priority to medical waste treatment and disposal

September 15, 2008

INTERNATIONAL GROUP CALLS ON BAGUIO LGU TO GIVE PRIORITY TO MEDICAL WASTE TREATMENT AND DISPOSAL

Baguio City - Health Care Without Harm (HCWH)-Southeast Asia, alarmed with reports that treated hospital wastes from Baguio hospitals are not being accepted in the Metro Clark Waste Management Facility in Tarlac, urges the local government to provide a centralized treatment facility “that will ensure safe treatment and disposal of hospitals' infectious wastes”

“At present, solid wastes coming from non-hospital sources are sent to Metro Clark while the hospitals are left to take care of the final disposal of their treated infectious wastes,” said Merci Ferrer, Executive Director of HCWH-SEA.

Hospitals chemically disinfect their infectious waste and are required to set-up a final disposal area within the hospital facility.

“This is not sustainable and not environmentally-friendly. As soon as the final disposal area is full, hospitals would need to set-up a new one and of course the dangers of chemicals used in disinfection leaking to the soil is always there,” said Ferrer.

According to Ferrer, alternative technologies to treat medical wastes are available in the Philippines and “is very economically-viable.”

Autoclaves which uses steam to treat cultures and stocks, sharps, materials contaminated with blood and limited amounts of fluid, isolation and surgery wastes, laboratory wastes (excluding chemical wastes), and soft waste[i] costs around P500,000. “This is way below the P15million a month that the local government of Baguio pays to Metro Clark for its waste disposal.”

According to Ferrer, one treatment facility for the whole of Baguio is enough to cater to its eight hospitals.

She added that the local government of Baguio must take the lead in this citing the Environmental Code of the Philippines which mandates that each province, city or municipality provide measures to facilitate collection, transportation, processing and disposal of waste.

Earlier this year, HCWH-SEA and the City Government and seven Baguio hospitals signed a memorandum of agreement for the hospitals to undergo Health Waste Assessment Project (HWAP).

This came after HCWH-SEA found out that the Waste Assessment and Characterization conducted in Baguio did not include comprehensive data on hospital wastes.

According to Chel Santos, HCWH-SEA Program Officer for the Promotion of Best Practices, HWAP is aimed at closing the gap in the City’s Solid Waste Management Plan, improving the health care waste systems and procedures of the hospitals, and enabling the local government of the City and the regional office of the Department of Health to develop a monitoring system on health care waste management for Baguio and hopefully for the whole Cordillera Administrative Region (CAR).

“Now that results of the HWAP will soon be presented, collaboration between the LGU and the hospitals and other stakeholders are very much needed,” said Santos.

Result of the HWAP will be presented to the LGU and hospitals at the fourth quarter of 2008. [Copy of the HWAP Summary will be available at HCWH-SEA office]

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] Source: DOH Health Care Waste Management Manual

Tuesday, September 9, 2008

Gov't to pay US$2.2 million for 1950s technology in 2009 budget

September 9, 2008
Government to pay $ 2.2 million for 1950s Technology in 2009 Budget
NGOs demand condonation of Incinerator Debt, Repeal of Automatic Debt Servicing

"Fit for the museum not in our budget book."

This was the statement of different social movements belonging to the Stop Toxic Debt Campaign on the controversial Austrian Medical Waste Incinerator Project as the House of Representatives' deliberated the proposed P1.4 trillion National Government Budget.

The Ecological Waste Coalition of the Philippines (Ecowaste Coalition), Freedom from Debt Coalition (FDC), Health Care Without Harm (HCWH), Global Alliance for
Incinerator Alternatives (GAIA) and Greenpeace Southeast Asia all claim the incinerators brought to the Philippines through a loan agreement with Austria in 1996 were archaic.
Ancient Technology

"They are ancient, virtual antiques," HCWH Coordinator Merci Ferrer said. She cited a 2002 Greenpeace Report stating the basic structure of the incinerators provided to the Philippines was a controlled air type model developed in the 1950s. She said the technology was already banned in many European Union countries even during the time our government acquired them.
Ferrer, also a member of Ecowaste Coalition said due to the compounding nature of medical waste, refinements should have been made on the incinerators such as the setting of a secondary chamber as large as the primary chamber to cover other waste. It was reported that the incinerators provided to the Philippines did not have the said refinements and the essential pollution prevention devices.

She also said the incineration method itself was obsolete. "Incinerators are major sources of pollutants, particularly dioxins and mercury that can cause hazardous effects on the people' health. That's why we are equally upset of our government's poor choice of approach to eradicate medical waste and its negligent purchase of a '50s technology," Ferrer said.

The project was made possible through a loan from the Bank of Austria amounting to ATS 200,000,000 or P 500 million. The loan project was facilitated by the Austrian Embassy through the initiatives of Department of Health (DoH) officials during the Ramos Administration.

Dumping

Environment and debt watchdogs alleged that Austria deliberately dumped the incinerators in the Philippines to take advantage of our then lax environmental laws and to skirt stiff European Union Directives concerning the incineration of hazardous waste, which regulates, among other pollutants, dioxins and furans.

The incinerators were reportedly shelved in 2003 with the enactment of the Philippine Clean Air Act of 1999 strictly prohibiting the use of incineration. However, according to FDC, the government will still be paying for this debt until 2014. In the proposed 2009 Budget, payment for the mothballed incinerators amounts to $ 2.2 million.
Bizarre Debt

"How our government budget came out paying annually for a technology as old as the Quezon Government is truly bizarre and one for the books," FDC Secretary General Milo Tanchuling said.

"Yet, like many peculiar issues concerning government expenditures, it often points us to illegitimate loans and projects which adds up to the already heavy debt burden of the Filipino people," Tanchuling said.

Tanchuling gave a list of "bizarre" debts our government continues to pay or have fully paid through the years. Some examples he mentioned are The Bataan Nuclear Power Plant (BNPP) which was erected along an earthquake fault line and which did not produce a single watt of electricity, the Telepono sa Barangay Project (TBS) which provided unusable phones to different detached communities and the Small Coconut Farms Development Project (SCFDP) which was supposed to deliver fertilizers to farmers except that it didn't.

Congress Already Concurred

Meanwhile, GAIA Co-Coordinator Manny Calonzo said the issue of whether the Austrian Incinerator Project is an illegitimate debt and whether it is an archaic and anti-environment piece of technology is already a settled matter.
Calonzo said Congress in its version of the 2008 Budget included a special provision calling for the suspension of interest payments of specific loan agreements challenged as fraudulent, anomalous and/or wasteful. This includes the Austrian Incinerator Project. He also said as early as the passage of the Clean Air Act in 1999, our legislators already concurred that incinerators that emit poisonous and toxic fumes are in fact dirty technologies.

"For these reasons alone, our government's nonstop payment of this project in the 2009 Budget is totally unwarranted and a betrayal of the lawmakers' intent to spend more on truly beneficial expenses for the common good," Calonzo said.

The groups blame the automatic debt servicing policy of the government as the main culprit in this issue. They said the provision providing for automatic debt payment in the Revised Administrative Code of 1987 encourages corruption and the accumulation of more illegitimate debts.

"Thus, the real challenge to Congress in the 2009 Budget is to use the budget deliberations as a platform to urge the Executive to condone specific cases of illegitimate debt and to build the necessary legislative concurrence to repeal the automatic debt servicing provision," the groups said.

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.