Faye V. Ferrer

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Towards a Mercury-Free Health Care The
Philippine Mercury in Health Care Experience
Faye V. Ferrer Health Care Without Harm -
Southeast Asia
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The Philippine Situation

• Policy to give out mercury thermometers to every
  incoming patient.
• Mercury thermometer breakage are not reported and
  are generally thrown into the black bag or
  regular wastes bin.
• No laws that controls unregulated disposal of
  health care related materials and supplies that
  contain mercury.

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The Philippine Heart Center

• A 283-bed semi-government controlled hospital. A
  leading institution in the Philippines committed
  to caring for the patients with cardiovascular
  diseases.
• On its 32nd year, the Philippine Heart Center
  has gone mercury-free.
• In early 2006, together with Health Care Without
  Harm, the center hosted the First Southeast Asian
  Conference on Mercury Free Health Care.

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The Philippine Heart Center

• In 2006, it still exclusively used mercury-based
  medical devices.
• That year alone, they distributed 13,000 mercury
  thermometers to all incoming patients as part of
  their admission kits.
• By the end of that year the center decided to
  take action.

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Rapid Transition
February 2007 established mercury spill
clean-up procedures and made mercury spill kits
made available in every nursing unit in the
hospital.
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Rapid Transition
March 2007 formulated an evaluation process for
measuring devices. June 2007 based on their
evaluation, the hospital began purchasing digital
thermometers and sphygmomanometers. July 2007
began substituting the mercury devices. September
2007 achieved a full phase-out of all mercury
containing measuring devices.
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Thhhhld
Nurses Taking Action

• Nurses provided valuable support for the
  phase-out after realizing the dangers of
  cleaning-up mercury spills.
• Nurses helped the hospital administration in the
  formulation of the phase-out procedures for the
  center.

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Moving Forward
More than 200 participants
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Moving Forward
The Heart Center is one of the first hospitals in
the Philippines to completely make the
switch. Fifty more hospitals have committed
and/or are in the process of switching towards a
mercury-free health care.
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China First Steps Pilot Hospitals

• In 2006, the US EPA and SEPA began a pilot
  project with two Beijing health care facilities.
• Tiantan Hospital 1000 bed facility known for
  neurological research.
• Jishuitan Hospital 1050 bed specializing in
  burn treatment, bone and major reconnective
  surgeries.
• The US EPA invited HCWH US partner Institute for
  Sustainable Futures to assist with this effort.

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China First Steps Pilot Hospitals

• Jishuitan Hospital
• Hospital assessment at the beginning of the
  project showed 4,500 thermometers are lost every
  year. The hospital estimates that 67 of this
  loss was a result of breakage.
• By the end of the project, this number had been
  reduced to 4000 per year.
• Tiantan Hospital
• The Hospital was replacing approximately 8000
  thermometers a year.
• By the end of the pilot this number had been
  reduced to 6000.

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China First Steps

• Project partners performed
• Staff-wide training and education
• Conducted pre and post-training surveys to assess
  participants new awareness.
• Educational posters were developed and posted in
  the hospital.
• Maintenance are were remodeled to better control
  potential spills and protect worker health
  safety.
• Thermometer breakages and loss decreased
  significantly, as did the quantity of spills from
  mercury-containing blood pressure devices.

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China First Steps
Thermometer breakages and loss decreased
significantly, as did the quantity of spills from
mercury-containing blood pressure devices.
After the one year project completion point, the
directors of the hospitals shared their
experiences at a workshop for other Beijing
hospitals and other stakeholders.
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China First Steps The Future of Substitution
Several economic and legal hurdles must be
addressed before a substitution program can begin
in earnest. Yet, the one-year project was an
important beginning to mercury reduction efforts
in Chinas health care sector, and has already
demonstrated progress.
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China First Steps
Tiantan Hospital committed to spend more than US
65,000 of its own resources to substitute
mercury-based medical devices.
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www.noharm.org www.mercuryfreehealthcare.org