Substituting Mercury-Based Devices in India
A lot has happened after a small report was released which documented the yearly release of this toxic heavy metal from health facilities using mercury based instruments and products.
Many hospitals turned mercury free voluntarily and a few more shifted recently after the Delhi government order to phase out the use of mercury in the hospitals. To be mercury-free might be a voluntary decision for a few more years, but as environmental laws and quality accreditations become stricter this might be a mandatory requirement soon. Thus it is time for all of us to do some introspection and start changing. The experiences of people who have changed have been documented in the report and a small chronicle of what has happened on the mercury front has been profiled to help people in their journey to go ‘mercury free’.
Download the complete document here
You can also download the report on Delhi's declaration on mercury-free health care
Nepal
Bir Hospital, Mercury-free Zone
August 19, 2010, The Himalayan Times:
Bir Hospital is to be developed into a ‘model hospital’. The goal is to render the country’s oldest hospital a mercury-free and safe injection zone within a year.
Mahesh Nakarmi, director of Health Care Foundation Nepal (HECAF-Nepal) said as a first attempt, the hospital has declared the male medical ward a ‘model ward’ in waste disposal.
The hospital is working to treat health care waste, including sharp, non-sharp, blood, body parts, chemicals, pharmaceuticals, medical devices and radioactive materials.
After the male medical ward, the hospital will upgrade the post operation and male surgical ward. “It will take a year to fix the system in the entire hospital,” said Nakarmi, adding that they will hand over the system to the hospital authority upon completion of the project.
Around 40 per cent of the hospital area is occupied by scrap piled up there for the last several years. The scrap piles can be seen on the terrace, corners of every ward and stairs. The problem arose after the hospital stopped auctioning scrap five years ago. The hospital has a provision of calling auction every two years.
The hospital brought two autoclave machines a year ago to dispose waste, however, it has been lying defunct due to lack of guidance on use, added Nakarmi. An autoclave machine can destroy 15 kg waste in 30 minutes at 121 degree Celsius. The system is being developed as per World Health Organisation (WHO) guidelines.
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Nepal: Latest Initiatives on Medical Waste and Mercury
Best known for its spectacular scenery and ancient culture, Nepal is also starting to take serious action to tackle its medical waste and mercury problems.
At the moment, most hospitals still use mercury thermometers and blood pressure meters, and medical waste is disposed of with municipal waste, where it can pose a risk to the general public and rag pickers.
Health Care Without Harm, Health Care Foundation Nepal (HECAF) and Center For Public Health And Environmental Development (CEPHED) teamed up the second week of March 2010 to deliver a training on medical waste management for district health officials and nurses. HCWH strategic partner in India, Toxics Link, also shared their expertise, and other speakers come from the World Health Organization and Nepali hospitals.
HECAF have already created Nepal’s first safe and sustainable medical waste management system at the National Kidney Centre and is in the process of replicating the system to other hospitals in the capital, Kathmandu, the second city, Pokhara, and in small clinics in various locations across the country. At the National Kidney Centre, the waste is segregated at source in the wards, according to the material it is made of, and whether it is potentially infectious. Next, the infectious waste is disinfected in a dedicated autoclave. Needles are cut off the syringes before autoclaving. Recyclable materials are then sold to traders, and the income covers about 40% of the total waste disposal costs.
The National Kidney Centre is also Nepal’s first mercury-free hospital, and both HECAF and CEPHED are keen to see the toxic metal completely phased out. HECAF is focusing on assisting its partner hospitals to phase out use in medical devices, whereas CEPHED are creating educational materials and working on outreach to all addressing all uses of mercury across the country.
Ruth Stringer, from Health Care Without Harm’s International team, says “With the help of HCWH members, Nepal is really starting to wake up to the issues of health and environment. More and more health care providers are looking for alternatives to mercury, and for better ways to treat and dispose of their medical waste. National and local governments, universities and medical colleges and international agencies are all realizing the scale of the problems, but also the fact that real solutions are possible. 2010 is set to be the start of big changes in Nepal.”
Philippines
Anti-mercury awareness has taken root in the Philippines. It wasn’t always like that, though. Before our anti-mercury campaign started in 2005, the dangers of mercury in health care wasn’t that well-known.
All that changed after the first Southeast Asia Conference on Mercury was held in Manila in 2006. The conference brought the issue to light. The gathering was the tipping-point HCWH-Asia needed. Due to the convincing facts discussed,
Philippine Health Secretary Francisco T. Duque III pledged to author policies that mandate the phasing-out of mercury.
The next year, Philippine Heart Center, together with St. Paul Hospital in Tuguegarao, the Manila Adventist Hospital, and San Juan De Dios Hospital started their own mercury phase-out programs.
In August 11, 2008, Administrative Order 21 of the Department of Health was signed. It ordered the gradual phase-out of all mercury-containing devices in all Philippine hospitals by 2010.
By 2009, more than 50 hospitals had phased-out, or were phasing out, mercury-containing devices in their facilities.
To complement the mercury phase-out, alternatives should be presented. In 2009, the General Appropriations Act allocated Php 13.2 million for the purchase of non-mercury thermometers in government-controlled hospitals. The Philippine Health Insurance Corporation (PhilHealth) is also doing its part. It signed a revised accreditation policy that denied accreditation to hospitals that still use mercury.
South Korea
South Korea: World Medical Association Statement on Reducing the Global Burden of Mercury
Taiwan
Taiwan Restricts the Sale and Importation of Mercury Thermometers