s2 faye ferrer hcwh

8/4/2019 S2 Faye Ferrer HCWH

http://slidepdf.com/reader/full/s2-faye-ferrer-hcwh 1/24

The Phase-Out of Mercury Containing

Devices in Philippine Hospitals

Leading the global movement

for environmentally responsible

health care.

Faye V. Ferrer

Programme Officer

Mercury-Free Health CareHealth Care Without Harm Southeast Asia



o Based on the PHA’s 2009 list, there are 99,708 bed

capacity provided by 1,851 hospitals in the country.

o Hospitals have a policy of giving out one mercury

thermometer per patient admission or discharge kit.o Most of the thermometers either break during their

stay or are taken home never knowing their fate.

o Breakages are common occurrences that never gets

reported inside or outside of the hospital.o Disposal is done either through dumpsites, landfill or

incinerators.

Mercury Use by Philippine Health CareFacilities



Dangers of Mercury Introduced in the

Philippineso In January 2006, HCWH conducted the First

Southeast Asian Mercury in Health Care

Conference.

o Former DOH Secretary Francisco Duque IIIannounced an Administrative Order on the phase-

out of mercury is to be drafted.

o Health Care Facilities have pledged to move for aphase-out of mercury in their facilities.



HCWH continued to educate and call on the

phase-out of mercuryo In 2007, HCWH published the list of available

alternatives to mercury containing devices and

distributed to hospitals nationwide.

o HCWH organized and participated in conferences,forums and workshops promoting mercury-free

health care.

o Became part of the drafting group for the phase-out of mercury in health care



Health Care Facilities made their move

• Manila Adventist Medical Center, Pasay City

• Philippine Heart Center, Quezon City

• Saint Louis University Hospital of Sacred Heart, BaguioCity

• Sisters of St. Paul of Chartres, Health Care Ministry• Notre Dame de Chartres Hospital, Baguio City

• St. Paul Hospital, Tuguegarao City

• St. Paul Hospital, Dasmarinas, Cavite

• DLSU Medical Center, Dasmarinas, Cavite



• Memo on Mercury Spills Management was released to

guide health care facilities on proper clean-up of smallmercury spills.

• Rapid Mercury Assessment on several DOH controlled

hospitals was conducted to test their mercury levels.

• First Quarter of 2008 - Committee to draft AO on mercuryphase-out was formed.

• In July 2008, Secretary Duque signed DOH AO21.

• In September 2008, DOH AO21 took effect.



DOH Administrative Order2008-0021

Gradual Phase-out of Mercury in allPhilippine Health Care Facilities and

Institutions



• A two-year phase-out on the use of mercury containingthermometers and sphygmomanometers.

• Hospitals are to form Mercury Management Team aspart of the Health Care Waste Management Committee

• Inventory of existing mercury containing devices.

• Inform vendors of preference to use alternatives

• Patient, and patient companion education on thedangers of mercury.



• Php13.2 million was allocated in the 2009 GeneralAppropriations Act for the purchase of non-mercurythermometers in the government controlled hospitals.This, however, awaits to be released.

• The Philippine Health Insurance Corporation(PhilHealth), on the other hand, has included in itsBenchbook compliance to AO21.

• In December 2010, the Department of Interior and

Local Government released Memorandum Circular2010-140 on mercury reduction program for health carefacilities controlled by the local government units(LGUs).



• • In March 2010, Province of Rizal Governor Jun Ynares III announcedthat the province will phase-out mercury containing devices in their 5government hospitals. He issued a directive to the provincial health office(PHO) to include the procurement of non-mercurial apparatus to replace themercurial devices.

• • In November 2010, Cebu Provincial Board Member Arleigh Sitoy uponseeing the low mercury phase-out compliance in the province said that he will

author a resolution and an ordinance to fast track mercury phase-out andaddress the storage issue in Cebu. In the same month, General Santos CityCouncilor Marius Oco said that he will author a similar ordinance for the City.

• • The provinces of Cavite and Northern Samar have likewise expressed

support for mercury phase-out in their respective areas.

• • In a forum in Cebu, Provincial Board Member Sitoy said that he willinclude the mercury phase-out issue in the next budget deliberation and push itin the next meeting of the League of Municipal Mayors.



Information and Education Sustained



o University of PerpetualHelp

o De Ocampo MemorialMedical Center

o Manila Doctors Hospitalo Sto. Tomas UniversityHospitalo Ospital ng Muntinpulao Asian Hospital and

Medical Center

o Rizal Medical Centero The Medical Cityo AFP Medical Centero Capitol Medical Centero FEU Medical Center

o Lung Center of thePhilippines

o National Kidney andTransplant Institute

o Philippine Orthopedic

Centero St. Luke’s Medical Center o World Citi Medical Centero Cardinal Santos Medical

Center

o Fatima Medical Centero St. Paul Hospital

Zamboangao Central Luzon Doctors

Hospital

More hospitals are Phasing-outMercury in their Facilities



Status of Implementation of DOH Administrative

Order No. 2008-0021

(Gradual Phase-out of Mercury in All Philippine Health Care Facilities and Institutions)

There were 984 compliant hospitals

representing 53% of the total number of hospitals (1,851) in the

Philippines. (PHA 2009)



Breakdown of 984 per region

Regions

PHA List of

Hospitals

Implemented

AO 21 Percentage

Region 4B 63 56 89%

Region 8 75 62 83%

Region 1 130 101 78%

Region 12 106 82 77%

CAR 59 40 68%

Region 4A 242 162 67%

Region 10 111 69 62%

Region 5 120 72 60%

Region 13 60 31 52%

Region 3 206 103 50%

Region 2 83 41 49%

ARMM 28 13 46%Region 11 116 46 40%

Region 7 106 33 31%

NCR 183 51 28%

Region 9 76 14 18%

Region 6 87 8 9%

Total 1,851 984



Challenges Encountered

STORAGE

o Proper storage are not implemented by somefacilities, some do not know how to implement one.

o Concerns on the safety of maintaining on-sitestorage were raised

o Some facilities practiced recovery and placing allelemental mercury in one container.

o Others, before implementation of AO21 gave outall mercury containing devices to patients to avoidstorage.



Current Practices in Storage



Challenges Encountered

ACCURACY

o While many hospitals have phased-out mercury,others are still skeptical specially with digital BP

Apparatus.o There are no standards in terms of evaluating the

alternatives.

o Sale of mercury containing thermometers,

specially sphygmomanometers are prevalent.



Recommendations

o Continuous monitoring of compliance toAO21 and other future AOs, etc.

o Periodic reporting on the status and

developments on AO21 and other futureAOs, etc.

o Strengthen collaboration with different

sectors such as civil society organizations,professional organizations, etc.

o Implement a Ban on the Importation of

mercury containing devices.



MARAMING SALAMAT PO!Thank you!

s2 faye ferrer hcwh

Documents