Manila — Responding to the 1st initiative of the Department of Health (DoH) to keep all state-run hospitals stink-free and clean in support of P-Noy’s clean governance, Health Care Without Harm-Southeast Asia asks the President to include all hospitals in the mandate by ordering mercury importation ban and to shun away from revisiting medical waste incineration.
“A clean and stink-free hospital does not just mean it has pearly white floors or smells of roses, it must be free of chemicals that are harmful to people’s health and the environment and free of devices that contains toxic substances and free of machines that will release substances that are very harmful to the people,” said Merci Ferrer, Executive Director of HCWH-SEA.
The campaign launched by the DoH, Ospital ng PiNoy: Malinis at Mabango, requires all hospital authorities and workers to ensure that their respective health institutions are clean and stink-free and to improve their programs and practices.
The odorless mercury
“One toxic substance that we need to immediately rid of our hospital is mercury,” Ferrer pointed out. In 2008, DoH Administrative Order 21 mandates the gradual phase-out of all mercury-containing devices in all Philippine health care facilities and institutions by September 2010. “From our visit to hospitals, majority of health care facilities especially those run by the Local Government Units (LGU) are unaware of the mandate.”
Mercury is the silvery substance found in thermometers and blood pressure device. At low exposure, it may cause tremors, emotional changes, insomnia, neuromuscular changes, headaches, disturbance in sensations, changes in nerve response and performance deficits on cognitive function tests. At higher exposure, it causes damages to lungs and kidneys as well as to the nervous, digestive, respiratory and immune systems.
“Although mercury may be odorless, it is very harmful. It is not true that what you do not smell will not harm you,” Ferrer said. “especially not in the case of mercury.”
“If we are keen on cleaning our hospitals, first step is to make it mercury-free and what better way to do that than to order mercury importation ban,” Ferrer pointed out.
Stink-free is incineration-free
More recently, HCWH-SEA raises alarm on the DoH’s proposal to revive the use of incinerators.
Under the DoH’s draft Health Executive Agenda for Legislation (HEAL), there is a proposal to amend the Clean Air Act (1) to allow the use of incinerators designed in such a way that product combustion gases shall be treated and harmful emissions are removed before gases are released to the atmosphere and (2) advance emission control design and stringent regulation shall ensure wastes are disposed without detrimental impact to the environment.
“Now if we are going stink-free, reviving incineration must never be an option,” said Ferrer. “Not only does the technology stink but burning of waste—both general and medical wastes—releases toxins and furans that are dangerous to our health and the environment.”
In 1999, 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.
“Not only does it stink but for years now since 2001, we are paying an average of US$2 million a year for the P503-million loan used to fund a defunct Austrian Medical Waste Incinerator Project1,” Ferrer pointed out. “Unless this loan is cancelled, we will be paying until 2014 for a technology which contrary to claims was far from being state of the art(1).
“DoH should seriously look at initiative around the cancellation of the debt and rechanneling of resources to strengthen the waste management needs of public hospitals,” Ferrer emphasized.
She added that several hospitals, both private and public, have shown waste management practices that are not only stink-free and clean but are incineration-free and safe for the environment and the people(2).
An example is the use of autoclave to which the government allocated a P100 million budget in 2008 for DoH-controlled hospitals but remains undisbursed.
“As the DoH is gearing for a malinis and mabango hospitals, we urge them to take it a step further and be truly malinis and mabango in all levels.”
Endnotes: (1) One of the incinerators emitted nine times the limit for particulate matter, twelve times the limit set for hydrogen chloride, almost double the limit for lead and 870 times the limit for dioxins and furans compared to the CAA threshold. (2) HCWH-SEA has partnered with several hospitals in their health care waste management practices. St. Paul Hospitals are among the best hospitals that showcase waste minimization, 3Rs (recycle, re-use and reduce) and composting. These hospitals successfully lowered their volume of waste without incineration.