31 DECEMBER 2007

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THE HCWH identifies three fundamental challenges that implementing a transition to mercury-free healthcare faces: accuracy, affordability, and disposal.



HOSPITALS with biomedical units, where broken mercury sphygmomanometers are brought for repair, registered high levels of indoor mercury during a weeklong mercury monitoring conducted by the DOH last May. [photo by Mira Mendoza]
During the 2006 mercury conference, Dr. Esperanza Icasas-Cabral, now the social welfare and development secretary and former president of the Philippine Hypertension Society, added another hindrance: sheer habit. She pointed out that doctors who were trained in mercury-containing devices showed resistance to switching to alternatives. The mercury manometer, for instance, has occupied an eminent position in blood pressure measurement since 1926. "It's a long tradition that is not easily forsaken," Cabral said.

But Cabral added that mercury-free sphygmomanometers like the aneroid type are more economical in the long run as they eliminate the risk of spills and associated training costs. In addition, non-mercury blood-pressure monitoring devices have passed various studies in the United States and the United Kingdom that were conducted to test their accuracy. It has been established as well that as with any blood pressure monitoring device (mercury, aneroid, or digital), calibration is essential in ensuring accurate readings.     

On the issue of affordability, the HCWH recognizes that replacing mercury-based medical devices is seen as an expensive proposition for cash-strapped healthcare sectors in the developing world. Rivera cannot help but agree, saying, "There really is a resistance with the initial capital outlay.”

“But,” she says, “we explain that in the long term, training healthcare workers on how to handle mercury spills and the cost of cleanup and decontamination do balance out."

As for disposal issues, the problem lies with what will be done with the retired mercury-containing devices once healthcare facilities make the switch. There is still no single solution to the long-term retirement of mercury wastes, although there are short-term options being done in North America and many European countries like storing mercury waste on-site, extended product responsibility, national regulations, and collection programs.

Last July, DOH formed a technical working group (TWG) to address the local healthcare system’s problem with mercury, including disposal. The TWG is composed of representatives from its concerned bureaus, the DTI, DENR, hospital administrators, health sector representatives, technical experts, and environment groups such as HCWH and the Basel Action Network.

HCWH knows there are many obstacles in the path toward a mercury-free healthcare system. But it would rather emphasize the positive, citing the initiatives — however simple and slow-moving — from both government and private facilities as evidence that this is not impossible to achieve.

Mira S. Mendoza is a freelance writer-researcher and graphics artist.

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