By Rina Jimenez-David
Adding to the already long list of advocacies that various groups have laid out before presidential candidates and their parties, Health Care Without Harm-Southeast Asia challenges them to “make green health care part of their agenda,” and all voters to support “green health candidates.”
This may be the reason the next president and other senior officials need to express their commitment to the “mercury-free” initiative, demonstrating high political will for this important and worthy advocacy, which is at the same time quite simple and straightforward and not at all complicated or even expensive to carry out.
In support of this initiative, the group is asking both candidates and voters to sign “The Green Health Covenant: Covenant of the Filipino People for a Healthy Environment.” (Download the covenant at: Green Health Covenant Web
Its main thrust is for a health care system and environment that is “mercury-free,” in line with the Department of Health’s Administrative Order (DoH-AO) 21 mandating the gradual phase-out of mercury in all Philippine health care facilities and institutions.
“The deadline for the phase-out of mercury is September 2010. Since we are electing new leaders this May, we deem it necessary that we choose candidates who are supportive of greening the health care sector,” said Faye Ferrer, HCWH-SEA program officer for mercury. “Phasing-out of mercury devices is as urgent as this year’s elections.”
The group says mercury in the health care setting is commonly found in thermometers and blood pressure devices, and may also be present in “fixatives, preservatives, laboratory chemicals, cleaners and building products such as thermostats, pressure gauges and switches.
Before the DoH order, hospitals in the Philippines had a “one-is-to-one” policy in distributing mercury thermometers, meaning every patient admitted in the hospital was entitled to one thermometer. “In 2007,” said HCWH-SEA, “one tertiary hospital with more than 280 beds distributed 20,000 thermometers to its patients.”
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OUT of a total of 1,847 hospitals in the country, only a little more than 50 have phased out or are phasing out mercury. That means more than 90 percent of hospitals still use mercury, the group points out.
“Mercury spills in hospitals expose patients and health workers to mercury, possibly causing lung damage at high doses and damage to the kidney, nervous, digestive, respiratory and immune systems at lower doses,” says the group. “If discarded as waste, mercury will eventually find its way into the water transforming it into highly toxic methyl mercury. This can affect the brain and the nervous system and even impair neurological development of infants and children as mercury can pass through a women’s placenta.”
A gram of mercury, the amount contained in one thermometer, the group claims, can contaminate nearly 81,000 square meters of lake water, an area about the size of SM MegaMall.
“Acknowledging the dangers of mercury to people and the environment, the DOH and several civil society organizations are keen on phasing out mercury in health care. Thus we appeal to all Filipino voters to take a stand and say no to mercury and take it a step further and encourage candidates, both in the national and local elections, to support these green health measures,” Ferrer added.
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THE MOST serious case of mercury poisoning in the country took place in 2006, not in a hospital but in a school, when high school students of St. Andrew’s School in Parañaque spilled about 50 grams of mercury that they were using in a science class. At least 80 students were exposed to the mercury and 24 were hospitalized after they manifested rashes and other symptoms of mercury poisoning. Several underwent chelation therapy to remove the mercury in their blood.
To prevent any more contamination, the school was closed for about a month, and the DoH had to hire experts from the United States and other countries to conduct a thorough clean-up. After about a month, the Inter-Agency Committee on Environmental Health, led by the DoH and with help from the US Environmental Protection Agency, finally issued a clearance to St. Andrew’s School and allowed it to re-open.
This is just a single incident, in a relatively isolated location. But how about the tons of mercury dumped through the decades in our open dumps, landfills and rivers, lakes and seas? What should be done in case of a mercury spill not just in hospitals but also medical supply factories or during transit?
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THE DoH issued its administrative order on the phase-out of mercury in hospitals over two years ago, but the hospitals, it seems, have taken their own sweet time in replacing their old mercury thermometers and other devices, such as blood-pressure monitors. Already commercially available are more modern, safe and just as accurate digital devices, so it’s a mystery why hospitals cannot phase out the mercury devices more speedily.
In a forum in 2007, reported Mira Mendoza in the PCIJ website, Dr. Esperanza Cabral, who has just been appointed health secretary, pointed to another factor in the slow, lackadaisical response of the health community to the DoH order: sheer habit. Doctors who were trained in the use of mercury devices, she said, resist switching to alternatives because of their adherence to “tradition.”
This may be the reason the next president and other senior officials need to express their commitment to the “mercury-free” initiative, demonstrating high political will for this important and worthy advocacy, which is at the same time quite simple and straightforward and not at all complicated or even expensive to carry out.
But sometimes, it’s the candidates’ willingness or reluctance to get behind such a straightforward measure as the phasing-out of mercury from the environment that provides voters the clearest insight into their worth as leaders.