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1ST IN SOUTHEAST ASIA
RP hospitals to phase out devices containing mercury

By Tessa Salazar
Philippine Daily Inquirer
First Posted 00:22:00 09/13/2008

Filed Under: Health, Hospitals and Clinics

MANILA, Philippines?Mercury presented unacceptable risks to human health and the environment. This is the reason Sister Arcelita Sarnillo, spc, administrator of General Santos Doctor?s Hospital in General Santos City, banned in 2006 the use of mercury thermometers in the hospital she works for.

Sarnillo is also a nurse and a nun of St. Paul of Chartres. In all her roles, however, she takes pride in calling herself a ?basurera??an ecological waste (eco-waste) advocate.

Sarnillo also developed a hospital solid waste management system using a compost pit in 2001. Six months ago, the hospital also ventured into food crop planting and vermicomposting.

With her transfer to St. Paul Hospital in Cavite this August, Sarnillo hopes to duplicate her achievements in Mindanao.

The basurera?s effort of banning devices containing mercury in hospitals isn?t a lonely fight, however. Over 2,000 hospitals in the country are now required to comply with the Department of Health?s Administrative Order 2008-0221, a directive to gradually phase out all mercury-containing devices?including sphygmomanometers?by 2010.

The AO also requires all hospitals to immediately discontinue the distribution of mercury thermometers in the patient?s admission/discharge kits.

First to ban

According to Faye Ferrer, Health Care Without Harm-Southeast Asia (HCWH-SEA)?s program coordinator for Mercury during an Aug. 22 press conference, ?We?re the first (country) in the world to ban waste incineration, and the first country in Southeast Asia to phase out mercury in healthcare.?

Ferrer added that about 50 hospitals had started the phaseout procedures even before the AO was formulated. Ferrer cited the Philippine Heart Center as the first to do it. Other Metro Manila-based hospitals, such as San Juan de Dios, Philippine Children?s Medical Center, San Lazaro Hospital, Ospital ng Muntinlupa, Lung Center of the Philippines, the National Kidney and Transplant Institute, Manila Adventist Medical Center and Las Pias Hospital have also initiated the phaseout.

?We?re getting congratulatory notes all over the world,? said Merci Ferrer, HCWH coordinator for SEA. She commended the DOH for pushing through with AO 2008-0221.

Leah Paquiz, PhD, president of the Philippine Nurses Association, said this was a ?milestone? as it would protect the nurses?the frontliners?as well as the environment.

Faye added, ?The (AO) is a very good move because in October, the United Nations is going to be holding the second open-ended working group in Nairobi on the phaseout of mercury in the world not only in healthcare. This is how significant the contribution of the Philippines is.?

In line with the ban, a directory of suppliers of mercury-free medical devices, their brands and the current market prices in the Philippines have been listed in the Guide to Alternatives for Healthcare Personnel of the HCWH. One can download the list at www.noharm.org/globalsoutheng.

?The shift to mercury alternatives is doable, affordable and is economically feasible,? said Carmencita Lingan, Philippine Heart Center nurse.

The HCWH-SEA proposed the essential points of the AO to the DOH. It organized the first Southeast Asian conference on mercury, where the DOH was invited.

?Secretary Duque?s commitment two years ago was to work on the gradual phaseout, and this is the realization of the commitment,? said Merci Ferrer.

Toxic, inherited effects

Mercury, also known as quicksilver with an atomic symbol Hg, has been an essential component in various medical and industrial equipment such as thermometers, sphygmomanometers, dental amalgam, gastrointestinal products, dilation and feeding tubes, batteries, fluorescent lamps, thermostats and bleaches.

In thermometers and sphygmomanometers, mercury is enclosed in glass cases that can break and spill.

Mercury spills expose health-care workers and patients to elemental mercury. Liquid mercury, even at room temperature, can evaporate and significant amounts of ingested or inhaled mercury may lead to harmful effects on the kidneys, brain, liver, lungs and spinal cord, as reported in the HCWH fact sheet.

Prolonged exposure to mercury can also cause erratic changes in the victim?s personality, and eventually to coma.

Mercury exposure may also cause permanent harm to a developing fetus.

Improper disposal

The improper disposal of broken thermometers, sphygmomanometers and other mercury-containing products has led to mercury contaminating the environment, experts have noted. Instructions for the proper disposal of mercury and mercury-containing devices will be available at www.noharm.org/globalsoutheng on Monday (Aug. 25).

Once mercury is deposited into lakes and rivers, it is transformed into methylmercury. This toxic form of mercury travels through the food chain and accumulates at deadly levels in some fish species. As humans consume the contaminated fish, the chemical is released into the human body.

Methylmercury interferes with the nervous system and can result in a decreased ability to walk, talk, see and hear. High levels of methylmercury consumption may eventually lead to coma and even death.



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