Civil society initiative of mercury-free healthcare services and dentistry in Nepal
Ram Charitra Sah*
Large mercury, mercury based equipment and products imported and used in Nepal have become sources of dietary and occupational exposure among health workers, general public and are ultimately adding heavy pollution load to the environment, especially to the aquatic ecosystem.
The paper aims to share learning experiences and outcomes of mercury-free healthcare services and a mercury-free dentistry campaign in Nepal based on mercury bio-monitoring results among health care professionals at dental sites.

Bio-monitoring of mercury among 50 dentists, including senior government dentists and four dental assistants confirmed 100% positive mercury contamination in their body, with concentration range from 0.097 to 0.547 ppm (CEPHED and NDA 2013), clearly indicating high occupational exposure to mercury while preparing mercury amalgam, fillings, removal and improper waste handling.

A pilot project ‘Mercury Free Health Care Services’ has shown great improvements in hospital environmental conditions. After a year of intervention, 99.9% of visited hospital locations showed zero mercury contamination in the air, as measured by ZEROME mercury analyzer. As a result of CEPHED’s successful campaign with the Government of Nepal, the Health Ministry took the bold decision of banning ‘Import, Purchase and Use’ of mercury-based equipment effective from 17 July 2013. Furthermore, a joint advocacy campaign is also in progress, for Mercury-Free Dentistry, dental curriculum improvements and required mercury phase-out plan with a necessary legislative framework in Nepal. All these initiatives help strengthen oral improvements and the realisation that early implementation of  the Minamata Convention on Mercury is the best way to reduce mercury use for safeguarding public health.

References
CEPHED and NDA 2013, ‘Bio-Monitoring of Mercury among Dental Health Care Professional in Nepal’, Center for Public Health and Environmental Development (CEPHED) and Nepal Dental Association, Nepal.
* Mr. Ram Charitra Sah works as the Executive Director with the Center for Public Health and Environmental Development (CEPHED), Nepal.