Jessica -- I feel your pain. Everyone's head tends to spin when talking the
WHO Code. I recommend that everyone actually, um, read the WHO Code. It is
not that long, and is pretty plain on its face. It is the **application**
part of it, in real life, that tends to make us dizzy.
It is OK for your facility to enter into an arms-length transaction with the
suppliers of any piece of equipment or materiel needed to provide health
care to patients. They can contract with one bed pan company to supply bed
pans for those patients who need them ... they can contract with one IV
company to supply IV lines for the patients who need them, etc. This is a
fairly common way for any business to negotiate attractive contracts. Size
and volume give you negotiating power. The reason Amazon can sell books so
cheaply is that they do size-and-volume business. They can negotiate with
the publishers to buy a mega-ton of books at a very low price, which they
then turn around to sell for a low price.
As for the WHO Code (and let's throw in BFHI, to make you dizzy AND tired),
this is absolutely positively permitted and indeed encouraged. Peoplel in
the health care system (like hsoitals and IBCLCs) are supposed to be
negotiating and paying for formula, bottles, teats, and pumps-sold-by-
companies-that-are-not-meeting-their-obligations-under-the-Code-for-the-bottles-they-market,
etc etc etc.
So. Part of the "deal" your facility negotiated with the company
supplying your pumps was a little frosting of educational conferences on
top. Do you think this was a coincidence? I don't either. Can you the
IBCLC attend -- even if you don't pay -- because that is a condition of your
employment? Yeah, probably. Even IBLCE has said they are not going to ask
IBCLCs to get fired for failing to do what their employer requires (this
mentioned back in the hey-day of formula discharge bag distribution, when
many IBCLCs were being told they "had" to hand them out).
But -- this may be an opportunity for YOU -- with a smile smile smile on
your face -- to start to chip away at your facility administrators. Educate
them. Show them your IBLCE Code of Ethics seeking health worker support of
the WHO Code, and explain why you have been put in a very uncomfortable
position. Show them the link to the National Academy of Science article
which takes a very long, hard and evidence-based look at the collusion
between health care systems and education providing by pharmaceutical or
medical-device manufacturers. Ask them if this is the model they, as a
health care institution that is supposed to be promoting good health, wants
to uphold.
Will you change your bosses today? Nope. Next month? Probably not. But
look around at all the IBCLCs who are NOT handing out discharge bags anymore
these days -- and all the hospitals that are NOT giving them out at all
anymore. It all started with some IBCLC, somewhere, standing up and yelling
"FOUL!" With a smile on her face.
Liz Brooks JD IBCLC FILCA
Wyndmoor, PA, USA
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