In response to the growing severity of the problem of methanol poisoning worldwide in recent years, Médecins Sans Frontières (MSF) has begun work that aims to improve our ability to respond to the issue, as well as enhance public education. Through the video interview, Dr Nason Tan, the Regional Operations Support Unit Director of MSF Hong Kong, who is leading the Methanol Poisoning Initiative (MPi), will share how his team tackles the problem.
About MSF Methanol Poisoning initiative(MPi)
In 2012, the Methanol Poisoning initiative (MPi) was established as a joint venture between Oslo University Hospital (OUH) and MSF. We had operating MP programmes in Indonesia, Libya, Kenya, Russia etc. The MPi team found that most cases are related to the drinking of “fake wine”, ingestions of methanol by mistake, and occupations in industries that are prone to methanol exposure. So far, the team has supported three outbreak interventions in Libya and Kenya. We also implement trainings in Kenya, Russia and Indonesia; and supported the development of local treatment protocols in countries like Cambodia.
As a regional office, MSF Hong Kong has been part of MPi since 2018, aiming to improve the ability of MSF and our partners to diagnose, treat and respond to methanol poisoning, at the same time raise public awareness of this issue through health education.
The major obstacles & challenges
- The symptoms of MP resemble many other medical conditions - apart from a hangover and alcohol poisoning - such as sepsis, heart attack and stroke. This can be misleading for healthcare workers and makes it difficult to make an accurate diagnosis, potentially delaying treatment.
- In some places where resources are lacking, the healthcare workers do not have the tools for early diagnosis and treatment, even they know what MP is and how to treat this issue. For example, fomepizole, the most effective and fastest antidote for methanol poisoning, is very expensive and not even a registered medicine in most countries.
- Due to religious and cultural norms, drinking is not encouraged in some countries, and there may even be prohibition on the manufacture, selling or drinking of alcoholic beverages. As a result, people turn to black markets or home brew. This can be very dangerous if they get methanol poisoned because they often don’t dare to seek immediate medical care, fearing stigma or prosecution. Even if they go to the healthcare facilities, they might not tell the truth to the healthcare workers and that increases the risk of misdiagnosis. That gets even worse when the patients hide the fact that they were drinking with a group and it can lead to a high human toll.
The outbreak of COVID-19 has been creating many new factors around MP. Disinfectants like hand sanitizer are now a much more commonly available commodity that is part of everyday life and if those products contain methanol, there is a risk of MP. Moreover, under anti-pandemic measures like quarantine, lockdown and the prohibition on group gatherings, people might not able to get a drink legally and turn to black market alcohol beverages or home brew. They can contain methanol impurities, that would pose a threat to consumers' health.
The pandemic has brought this public health issue to the surface and it is becoming better known. We need to seize the opportunity to enhance public education and work harder on monitoring. With people’s limited understanding of methanol poisoning, the reported cases in many places may involve missing information or misinformation, making it hard for us to have the full picture of the situation. We have tried to consolidate a database of suspected methanol poisoning cases from our news monitoring around the world. That gives us a better understanding of the pattern of this issue across countries.
According to the data we collected, between January and July 2020, at least 6,923 people were suspected of being affected by methanol poisoning, and 1,587 people are believed to have died from it. The figures in the same period this year have dropped, but are still higher than those before the pandemic. In the first half of 2020, when the pandemic was spreading fast, people were panic buying alcohol-based sanitisers and some of them may have contained methanol instead of ethanol. Some were affected by rumours suggesting that drinking methanol directly can cure or prevent COVID-19. We believe these might have caused the surge in the number of cases last year.
After a year of living under the pandemic, we see lowered risks of methanol poisoning from the use of alcohol-based sanitisers due to the improved public awareness of the potential harmful ingredients in these products, as well as a more stable supply in the market. However, we should stay vigilant. Methanol poisoning will still be a problem even if the pandemic slows down.
Watch the webinar recording on YouTube
Earlier in August this year, MSF Hong Kong organised a webinar that zoomed in on the challenges of diagnosing and treating cases of methanol poisoning.