WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR SOUTHEAST ASIA

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WORLD HEALTH ORGANIZATIONREGIONAL OFFICE
FORSOUTH-EAST ASIA
Overview of Poison information Centres in SEA
Region, 2004 A.v.Hildebrand/ SEARO Nida Besbelli
/ WHO Geneva
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Poison Information CentresBackground 1996-2003

• Regional activities
• Consultation on Poison Centres -12/98 SEARO
• Workshop on Strengthening Poison Prevention and
  Treatment Programme - 9/1999 Nepal
• Training Programme on using IPCS INTOX System in
  Poison Centres 3/2002 Thailand

• Country activities
• Public Education Day for Prevention of Toxic
  Exposures 1996 India
• Poison Control Network 1998 Indonesia
• Poison Centre Networking meeting 2001 India

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SEAR Poison Information CentresSituation in 2003
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SEAR Poison Information CentresSituation in 2003
- India
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SEAR Poison Information CentresSituation in 2003
- Indonesia
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Strenghts

• Commitment from individuals
• Do a lot with little availablle
• Using Poisons databases (Harmonised)
• Having Websites (AIIMS, NIOH, Chennai, Cochin)
• Support from WHO (Guidelines, Training, and
  Meetings)
• Small regional professional pool of Toxicology
  experts
• Fifteen functioning Poisons Information Centers
  in SEAR ( not counting Thailand)

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Weaknesses

• Little political will/attention
• Little awareness
• Number and quality of manpower
• Insufficient funding
• Legal implications to reduce calls
• Not working 24 Hours
• Clinical Toxicology not recognized in Curriculum
• Data on Poisoning cases too poor
• Concerned with HiTech (Concentrating on
  wrapping, not content)
• Limited or no funds available for training or for
  participation at international meetings or
  conferences
• Poor Networking among existing Poisons centers

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Opportunities

• 1. Working with forensic science departments,
  medical colleges and other laboratory facilities
• 2. Support from the Ministry of Environment and
  Forests (33)
• 3. Access to internet
• 4. Indian software-Toxline
• 5. Piggy back on issues that are already a
  priority e.g emergency preparedness, BCR

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Threats

• Funding often adhoc and dependent on good will
  and donations
• Not enough Publicity will keep unknown and on
  the other hand too much publicity will overload
  the existing system
• In many cases it is dependent on One Man Show
• No sustainability,may mean short success

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Epidemiology of Pesticide Poisoning Project

• Overall objective
• To estimate the extent of human exposure and
  poisoning in selected regions/countries,
• To implement preventive and education
  strategies
• To reduce morbidity and mortality from
  pesticide poisoning.

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Projects activities in SEAR

• India10 hospitals,5 regions
• Indonesia7 hospitals, 1 health office
• Myanmar 8 hospitals, 4 states
• Nepal4 hospitals, 1 institute
• Thailand10 hospitals, 1 province

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SEAR hospital-based studies
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Current activities

• Community-based studies emphasised
• The survey questionnaire pilot tested in
• India, Myanmar and Sri Lanka
• Diagnosis and Management of Pesticide
  Poisoning Manual (CD) will be pilot tested in
  India

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Analytical toxicology

• Bangladesh- government and university
  laboratories which analyse food and environmental
  samples for pesticide residues, metals and
  especially arsenic
• Myanmar-new analytical toxicology laboratory
  established at the Department of Medical Research
• Nepal- National Forensic Science and Police
  laboratories are providing clinical analytical
  services
• Indonesia-Food and Drug Control laboratories have
  toxicology laboratories but not analytical
  toxicology
• Sri Lanka-Industrial Technology Institute(ITI)
  provides analytical services. It is accredited 5
  heavy metals, 16 pesticides and 10 other
  parameters

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Analytical toxicology

• Although some countries have well equiped
  laboratories,
• Maintenance, spare parts, obtaining reference
  standards are a problem
• Quality assurance (internal, external),
  accreditation should be established
• Capacity building is needed
• Country specific training programmes would be
  more efficient
• Training programmes could be organized with
  collaborating centres e.g Guys and St Thomas
  Medical Toxicology Unit

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• Thank You
• for your attention!