Indonesia: Doctors Without Borders conducts methanol poisoning workshop for health workers in Jakarta

26/10/2023

Indonesia

The participants of the methanol poisoning workshop are from hospitals in Jakarta, as well as the Jakarta Health Office and the Ministry of Health. © Cici Riesmasari/MSF

Methanol (CH3OH) is a dangerous alcohol that can be found in various household and industrial products. Exposure to methanol can cause poisoning, which can cause severe metabolic disorders, loss of vision, lasting neurological disorders, and even death. Unfortunately, methanol poisoning is one of the neglected medical emergencies, happening worldwide, including in Indonesia.

Looking at publicly available data from the last two decades, Indonesia seems to have a very high number of confirmed and suspected cases of methanol poisoning. Since 2017, there have been more than 200 confirmed incidents of methanol poisoning reported by Indonesian national media. But the total number of reported cases of people confirmed with or suspected of methanol poisoning is likely more than 1,100, with more than 700 deaths.

With Doctors Without Borders only recording cases identified in news reports, the real scale of this public health problem is significantly underestimated. There is an urgent need for improved reporting and surveillance, public health measures to raise awareness and scale up prevention, and strengthening the timely diagnosis and medical management of these patients in healthcare facilities.

In the opening remarks of the workshop, Dr. Roger Teck, Country Director of Doctors Without Borders Indonesia, explained,

“In Indonesia, we are implementing the E-Hub (Emergency Hub) project, involving capacity building for emergency preparedness and response, designed, planned, and implemented in partnership with the Health Crisis Centre of the Ministry of Health (MOH). The capacity building program includes the medical emergency of methanol poisoning. Through this workshop, we can learn and share about useful tools, for better and timely diagnosis and management of this medical emergency, which often affects several people at once in a community and can even affect whole families.”

Doctors Without Borders is supporting the Ministry of Health of the Government of Indonesia in developing and implementing activities aimed at reducing health risks and responding to the impact of natural disasters and other causes of health crises. Through the Capacity Building Hub for Emergency Preparedness and Response (E-Hub) Project, Doctors Without Borders aims to increase awareness, support prevention, and strengthen medical practices for methanol poisoning as a neglected medical emergency.

Dr. Eva Susanti, Director of Prevention and Control of Non-Communicable Diseases of the Ministry of Health welcomed the commitment of Doctors Without Borders to collaborate with the MOH on strengthening the prevention and management of methanol poisoning.

“Today’s workshop facilitated by Doctors Without Borders will increase the capacity of health workers, who work as the front line to increase wider public awareness, so the health workers can conduct detection, prevention, and control, as well as treatment of methanol poisoning in Indonesia.”

Dr. Eva Susanti (left), Director of the MOH Directorate of NCDs of the Ministry of Health of Indonesia, and Dr. Roger Teck (right), Country Director of Doctors Without Borders in Indonesia, opened the first day of the methanol poisoning workshop, which was organized by the Emergency Hub team of Doctors Without Borders Indonesia. © Andrea Ciocca/MSF

Dr. Knut Erik Hovda, medical doctor specialising in intensive care medicine and clinical toxicology from Oslo University Hospital in Norway, is explaining the mechanism of methanol poisoning to the participants. © Cici Riesmasari/MSF

By the end of the workshop, Doctors Without Borders handed over the posters outlining practical guidance for clinical treatment in health facilities that they could display in their workplaces. © Andrea Ciocca/MSF

For this workshop, Doctors Without Borders Indonesia invited Dr. Knut Erik Hovda, a medical doctor from Oslo University Hospital in Norway whose specialty is intensive care medicine and clinical toxicology, to share his extensive expertise about methanol poisoning--including emergency interventions with Doctors Without Borders. The workshop discussions included diagnostic procedures, treatment options, and prognosis assessment. Additionally, the participants explored the importance of emergency preparedness, and discussed the possibility of developing specific guidelines tailored to the Indonesian context.

During the workshop, the participants also heard from Indonesian experts such as Dr. Tri Maharani, MOH Research & Development and President of Indonesia Toxicology Society, and Dr. Elvine Gunawan, a psychologist who spoke on the psychological aspects of the methanol poisoning survivors. Professor Hossein Hassanian Moghaddam, President of the Asia-Pacific Association of Medical Toxicology from Iran, joined the workshop via Zoom, to share on the recent dramatic nationwide outbreak of methanol intoxication in Iran during the Covid-19 response, because of the increased use and consumption of methanol in hand sanitizers.

The discussion acknowledged the significant work that needs to be done in Indonesia to raise awareness among health care workers and in communities. There is need for an open dialogue with community, religious leaders, and traditional leaders, about the right messages on prevention of methanol poisoning, promotion of health care seeking behavior overcoming taboos and stigma, and the acceptance of the use of antidotes, including ethanol as a lifesaving medicine. It is critical that the cost of diagnosis and treatment of methanol poisoning be covered by the National Health Insurance, to ensure access to this life-saving treatment for all people affected by methanol positioning.

By equipping participants with the necessary knowledge and skills, the workshop aims to empower health care professionals to effectively respond to methanol poisoning cases. This not only ensures prompt treatment for affected individuals, but also helps in raising awareness about the dangers of methanol poisoning within the community, potentially preventing future incidents and saving lives.