Women and Environmental Women and Environmental Health in the Health Care Health in the Health Care

Setting Setting Faye V. FerrerFaye V. FerrerProgramme OfficerProgramme Officer

Health Care Without Harm Southeast AsiaHealth Care Without Harm Southeast Asia

www.noharm.orgwww.noharm.org

Sustainable Society, Health and Gender Sustainable Society, Health and Gender Seoul, South Korea Seoul, South Korea –– 5 July 20075 July 2007

What is HCWH?What is HCWH?HCWHHCWH’’s work sits at the intersection s work sits at the intersection of two core principlesof two core principles——

the right to health care andthe right to health care and

the right to a healthy environmentthe right to a healthy environment

We take the Hippocratic Oath: We take the Hippocratic Oath: ““First Do First Do No Harm,No Harm,”” as our point of departure.as our point of departure.

We address the paradox inherent in health We address the paradox inherent in health care systems that pollute and therefore care systems that pollute and therefore undermine human health. undermine human health.

We transcend that paradox by advocating We transcend that paradox by advocating for a healthier, more ecologically for a healthier, more ecologically sustainable health care sector and positive sustainable health care sector and positive alternatives to polluting technologies, alternatives to polluting technologies, products and practices.products and practices.

Who Is Health Care Without Harm?Who Is Health Care Without Harm?

““the Campaign for Environmentally Responsible Health Carethe Campaign for Environmentally Responsible Health Care””

Health Care Without Harm is an international coalition of 443 orHealth Care Without Harm is an international coalition of 443 organizations in ganizations in 52 countries working to transform the health care sector so it i52 countries working to transform the health care sector so it is no longer a s no longer a source of harm to people and the environment.source of harm to people and the environment.

Issues:Issues: Alternatives to medical waste incineration, mercury, PVC in thAlternatives to medical waste incineration, mercury, PVC in the health e health care sector. Green buildings. And more.care sector. Green buildings. And more.

Offices in:Offices in: USA, Prague, Buenos Aires, and Manila. Partners in South AfricUSA, Prague, Buenos Aires, and Manila. Partners in South Africa a and India.and India.

www.noharm.orgwww.noharm.org

Images of WomenImages of WomenThe most popular pictures presented about women The most popular pictures presented about women

of Southeast Asia are those of victims. of Southeast Asia are those of victims.

•• They are the victims of fundamentalist societies. They are the victims of fundamentalist societies. •• They are the victims of underdevelopment and They are the victims of underdevelopment and

povertypoverty--low life expectancy, high illiteracy. low life expectancy, high illiteracy. •• They are the victims of violence, of discrimination.They are the victims of violence, of discrimination.•• They are victims of environmental degradation.They are victims of environmental degradation.•• They are victims to unwanted diseases.They are victims to unwanted diseases.

These images of These images of ““helplesshelpless”” Southeast Asian Southeast Asian women are highlighted by the media and women are highlighted by the media and reinforced by academia. reinforced by academia.

WomenWomen’’s face changings face changingWomen constitute the majority of both the leadership and membership of local toxic waste activist organizations.

Women as activists transcend private pain, fear, and disempowerment and become powerful forces for change by organizing against toxic waste in their communities and their places of work.

Women take active role in changing policies that protect the environment and health of the people.

Two sides of WomenTwo sides of Women

As As Community Community

LeadersLeaders

Medical Waste IncineratorMedical Waste IncineratorIntegrated Waste Management Incorporated (IWMI)Integrated Waste Management Incorporated (IWMI)

Incinerator for treatment of medical wastesIncinerator for treatment of medical wastes

Barangay Aguado, Trece Martires in CaviteBarangay Aguado, Trece Martires in Cavite

In operation since 2003In operation since 2003

Emission level of toxic pollutants fail to meet Philippine Emission level of toxic pollutants fail to meet Philippine standards (dioxins and furans, mercury and cadmium).standards (dioxins and furans, mercury and cadmium).

Violates Philippine Incineration ban on incineration (Phil. Violates Philippine Incineration ban on incineration (Phil. Clean Air Act of 1999)Clean Air Act of 1999)

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Barangay Aguado is home to a community of informal Barangay Aguado is home to a community of informal settlers from the metro area.settlers from the metro area.

They have built their living and community when they They have built their living and community when they were transferred in 1997were transferred in 1997

After the construction of the incinerator children have After the construction of the incinerator children have started showing signs of different skin diseases, started showing signs of different skin diseases, primary complex and even decreased size in young primary complex and even decreased size in young boys testes.boys testes.

Men have had incidence of missing work due to Men have had incidence of missing work due to unknown illnesses.unknown illnesses.

Women who majority are stay at home mothers have Women who majority are stay at home mothers have also suffered unexplained sickness and most of all also suffered unexplained sickness and most of all have to suffer the consequence of a family getting have to suffer the consequence of a family getting sick which results to loss in family income.sick which results to loss in family income.

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their success storytheir success story……

Coverage in both print and broadcast mediaCoverage in both print and broadcast media

Moved the Philippine Senate committee on Moved the Philippine Senate committee on Environment and Health to reEnvironment and Health to re--investigate the ECC investigate the ECC given to IWMIgiven to IWMI

Several legislators have allied with the community of Several legislators have allied with the community of Brgy. Aguado for the closure of the incineratorBrgy. Aguado for the closure of the incinerator

Medical attention has been given to the affected men, Medical attention has been given to the affected men, children and women of Brgy. Aguado.children and women of Brgy. Aguado.

Two sides of WomenTwo sides of Women

As Health As Health Care Care

PractitionersPractitioners

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Nurses leading the wayNurses leading the wayNurses have chosen a health-promoting and healing profession and have elected to care for individuals, their families and whole communities.

Nurses as health care professionals would never intentionally place their charges in harm’s way, yet several of the elements of the current health care delivery system are placing the most vulnerable population at risk.

Annually millions of tons of medical wastes are generated.Contrary to claims, only 10% of the total medical wastes are hazardous in nature.Through this processes of waste disposal, incineration has been the most popular means of treatment.Incineration may happen on- or off-siteThe health care industry is one of the largest contributors to environmental dioxin and mercury.

MercuryMercuryMercury is highly toxic, especially when metabolized into

methyl mercury. It may be fatal if inhaled and harmful if absorbed through the skin.

In 2002 the UNEP has reported that various health care-related products and activities are important sources of man-made releases of mercury.

Significant concentrations of mercury, according to the report, are generated from improper treatment and disposal of medical waste including incineration of products containing mercury.

DioxinDioxin

Dioxin, a known carcinogen, poses a host of health problems as it is bioaccumulatedin the environment and eventually consumed by people.

Nursing leadership and AdvocacyNursing leadership and Advocacy

Living in a time of incredible possibilities. Nurses are also living in a time of troubling contradictions.

Many essential practices are not sustainable, not compatible with a healthy environment and thereby healthy people.

Nurses, as the foot soldiers and generals in the defense of public’s health, have the potential to lead patients and communities, as to the example shown by some of the nurses on this presentation.

Nursing leadership and AdvocacyNursing leadership and Advocacy

Nurses can educate and guide policy-makers, including elected officials, to a new way of seeing the relation between life’s choices (both individual and societal) and their impact on health.

Nurses are trusted and credible sources of information and education regarding environmental health issues.

After the first Southeast Asia mercury in After the first Southeast Asia mercury in health care conference, held in Manila, health care conference, held in Manila, Philippines last January 2006 and the Philippines last January 2006 and the launch of the Best Practices in Health launch of the Best Practices in Health Care Waste Management Program.Care Waste Management Program.

Nurses now are moving forward in making Nurses now are moving forward in making their health care facilities to phasetheir health care facilities to phase--out out mercury containing devices mercury containing devices –– mercury mercury

thermometer and mercury thermometer and mercury sphygmomanometer.sphygmomanometer.

Nurses are also becoming more conscious Nurses are also becoming more conscious of properly segregating hospital wastes.of properly segregating hospital wastes.

Drew up regular training/spill/labeling programs not only for the nurses but for all staff of the health care facility.

More than 30 hospitals in Metro Manila, called on the end to purchase new mercury-containing devices and equipment.

Became active advocates on the phase-out of all mercury containing devices in all health care.

their success storytheir success story……

Implemented proper waste segregation.

Affirmed the ban on incineration.

Conducts regular trainings and awareness seminars and forums for new health care personnel and even to patients.

their success storytheir success story……

still moving forwardstill moving forward……

Nurses continue their work to cause no harm to their patients, to themselves and to

the environment.

They continue to work raising awareness and educating themselves on the risk of

exposure to DEHP the chemical compound Di(2-ethylhexyl) Phthalate)

Acting together, with each nurse taking just one step, we can create a powerful collective force to reduce the pollution created by the health care industry and thereby keep ourselves, our families, our patients, and our communities

healthier.

--Barbara Sattler, DrPH, RN

Thank You!Thank You!