contents 5 Health in Paradise 8 Household Helpers to Benefit from PhilHealth 9 9 Cementing DOH-LGU Partnership 12 QMMC Goes on a Meatless Monday 13 Bantay Presyon 16 News and Views on Stem Cell Therapy 16 Regulating Stem Cell Therapy 18 Permissibility in Islam 16 20 Hype or Hope? 22 Health Secretary's Cup 26 Hold It, Let's Debate 30 Health Bus Tours 33 GP Awards 36 Health Promoting Schools 37 Paputok Summit Calls for Culture Change 39 Neurocysticercosis 41 Kuliti (Sty in the Eye) 42 Manscaping - Dare to Go Bare, Guys! 45 Sustaining the Fight Against Leprosy 47 DOH-MSD-Zuellig 26 49 DOH Runners' Club jokes n'yo 33 42 beatBOX 21 stress RELIEF 25 KALAbeat 28 laughter HEALS 29 SAbeat 50 DEPARTMENT OF HEALTH - National Center for Health Promotion 2F Bldg. 18, San Lazaro Compound, Sta. Cruz, Manila 1003, Philippines HEALTHbeat Tel. No. (63-2) 743-8438 Email: [email protected] Health Debates On March 14 (Manila Time), the 1.2 billion-member Catholic Church celebrated the announcement of a new Pope - Pope Francis. On March 15, Health Secretary Enrique T. Ona together with its partners signed the Implementing Rules and Regulations (IRR) of Republic Act 10354, otherwise known as the “Responsible Parenthood and Reproductive Health (RPRH) Act of 2012” in Baseco, Tondo, and calling it a momentous event in the history of health care. After the prescriptive period of 15 days, the IRR would have started full implemention on March 31 - Easter Sunday.
But that would not be too easy for government agencies that are tasked to implement the said law. On March 19, news reports carried the status quo ante order issued by the Supreme Court to suspend the law's implementation for 120 days. The oral argument is slated on June 18. Is this a "Twist of Faith?" We will not comment on that, of course. We will just wait for the turn of events and see and hear more discussions and debates. Editorial Board Oh well, at least the State, Church (both Catholic and Muslim), and medical organizations Ivanhoe C. Escartin, MD do not debate on the position the Department of Health has taken on Stem Cell Therapy Rosemarie G. Aguirre issue. Although this technology holds promise, it is not yet part of standard of care and is Editors-in Chief Anthony R. Roda considered an investigative procedure for compassionate use. And they all agree and would May Elenor R. de Guzman want to prevent the practice of human-derived allogenic stem cells from aborted fetuses in Managing Editor Donato Dennis B. Magat the country. Staff Writers Elizabeth G. Mascareňas Glen S. Ramos Debate, in principle, is a platform to generate arguments for or against a particular issue. The DOH welcomes debates. In fact, it has organized the six-month Health Secretary's Cup Photographer Paquito P. Repelente campaign to increase public awareness on Kalusugan Pangkalahatan (universal health Cover Design Diosdado G. Angeles, Jr. care). It used nationwide inter-college debates, community townhall meetings, round table Graphics Design Rhoderic N. Domingo discussions with various sectors of society, and media conferences. Frederick C. Pereňa Contributors As Secretary Ona puts it, "as guardians of the health of the people, the DOH needs to know what (Words) Maria Victoria C. Madura the people feel about the current health system and the reforms it is trying to implement." Riza Caldoza-De Leon, MD Tato M. Usman, MD So, bring on the discussions and debates, but we hope that everything will be resolved (Photos) Romeo S. Caparas Joerem P. Ceria immediately and everyone will be working in harmony toward the attainment of the country's Marlito Tasitorno health goals. Circulation DOH-NCHP Production, Dissemination – The Editors and Collection Unit
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4 HEALTHbeat I March - April 2013 COVER story
HEALTHbeat travels to some awesome views in Batan, one of the three inhabited islands of Batanes. (Photos by Tony Roda) Health in Paradise by GLEN S. RAMOS and ANTHONY R. RODA, MaHeSoS HEALTHbeat Staff Batanes is the smallest province northernmost tip of the Philippines, about 29 barangays and a lone congressional and could be the remotest island in the 860 kilometers (kms) north of Manila, 280 district. The six municipalities are Ivana, Philippines, but its breathtaking landscapes kms north of Aparri, Cagayan and 190 kms Uyugan, Mahatao, the island municipalities and seascapes, the preserved stone houses south of Taiwan. It is surrounded on all of Sabtang and Itbayat, and Basco – the with cogon roofs, and the resilience of the sides by vast turbulent seas and rugged capital and center of commerce and where people's spirit to keep their culture unsullied topography, and nearly half of the province most inhabitants and government offices make the place truly a splendor! It may be consists of hills, mountains and cliffs. are located. hard to imagine if serious health threats Batanes is composed of 10 small Batanes is also known as the occur in this island-paradise. islands, of which three - Batan, Itbayat and “Home of the Winds.” It is subjected to Sabtang - are inhabited. The province is the frequent typhoons, but it does not mean Island-Paradise smallest province in terms of land area (230 that the province is constantly battered square kilometres) and population (17,237 by typhoons. If Batanes is mentioned in Batanes is situated in the as of 2012 estimate). It has six municipalities, connection with weather disturbances, it is
March - April 2013 I HEALTHbeat 5 because Basco holds the last weather station transportation from Manila as well as from of Batanes is under CHD-Cagayan Valley in the north. It is a reference point for all Tuguegarao, Cagayan by small local airlines. (Region 2), the DOH-retained hospital typhoons that enter the Philippine area. When traveling to Batanes, however, you in Basco – the Batanes General Hospital The islands’ inhabitants are called must have a very flexible schedule as flights (BGH) – is under CHD-NCR because of its “Ivatans,” and they have learned to live with get canceled at the last minute. accessibility to Manila. the temperamental weather – sunny one Acting Chief of Hospital Dr. Jeffrey moment and stormy the next. They live Health in Paradise Anthony T. Canceran said that the BGH in stone houses made of limestones with has a total bed occupancy rate of 34.14% cogon roofs to withstand steady winds and The remoteness and isolation of with total admissions of 1,484 in 2012. The rains that often sweep the province. Because Batanes from the rest of the Philippines did recorded live births were 194, while deaths of this traditional architecture, Batanes not spare the province from one of the most were 36. is included in the list of UNESCO’s world dangerous viruses – dengue. He quipped, “Although some heritage site. In July 2011, a dengue outbreak people may think that health services The Ivatans are also known for occured in five of six municipalities with are not tedious in Batanes due to the few their frugal and humane lifestyle. Tourists 900 cases recorded, and the whole province admissions and people are seldom getting may get surprised if they will be greeted by was placed under a state of calamity. The sick. This, of course, is not the case. At the children by "pagmamano." It is the practice residents believed that tourists brought the end of the day, we find it rewarding to know of respect by asking for an elder’s hand and virus to the province, others theorized that that we have prevented illnesses and other touch one’s forehead while bowing.Elderly the dengue mosquito arrived from ships health incidents from occurring through residents, on the other hand, are generous to coming from Manila. health promotion and education activities greet tourists with a smile. However, according to the findings being done by the hospital staff." The Ivatans live out basic noble of the Department of Health - National Canceran added that the values, as proven by the fact that there is Epidemiology Center (DOH-NEC), the improvement of health facilities and services very low crime rate in Batanes. According outbreak was caused by poor solid waste in other municipalities may have prevented to the Philippine National Police in Region management and environmental sanitation, the influx of patients to the BGH. 2, crime incidents in the province are the presence of the vector (aedes aegypti and In 2012, hospital admission lowest in the region with 21.43 percent. aedes albopictus), storage of water in records showed that the top three causes of It is only in Batanes that “Honesty Shops” key containers which served as mosquito hospital admission were dengue, diarrhea are possible. It exists not for profit but for breeding sites, and human movement. and gastroenteritis, and hypertension. genuine communal camaraderie. There The DOH-NEC further revealed that Meanwhile, the top three causes of seems to be a strong need among the people the improper management of swine and morbidity (illness) were acute upper to protect and preserve Batanes’ prestine poultry production in the areas intensified respiratory infections, disorders of teeth and culture against commercialism and other the situation because the water used for supporting structures, and hypertension. The vicious practices. cleaning pigsty were openly exposed to top three causes of death were pneumonia, There are no malls, clubs and vector and poorly unattended in several hypertension and cancer. fastfood chains in Batanes, and excessive places of the province. Non-communicable diseases noise, rudeness and lack of cultural and Before the outbreak, there were are seemingly on the rise in Batanes, and environmental concern are frowned upon only two dengue cases recorded per year. that may be due to excessive drinking and not only by the Ivatans but travelers who Because of the incident, the Environmental smoking. are protective of the stunning beauty of the Health and Sanitation Service of DOH Canceran said, “Even with the high islands. Tourists and visitors are asked to Center for Health Development - National prices of alcohol and cigarettes, people still take the initiative of helping Batanes be the Capital Region (CHD-NCR) is now regularly continue to consume them maybe because “breath of fresh air” by keeping it clean and conducting routine inspection to ensure these are the only vices that people can green and by respecting its culture. that the incident will never be repeated. indulge after an exasperating labor in the Batanes can be reached by air Although the health services field or sea.”
6 HEALTHbeat I March - April 2013 About 75% of the Ivatans are who may have come into contact with an and public health services of Batanes were farmers and fishermen, while the rest are infected person) to ensure that the virus will placed under the provincial health office employed in the government and services not spread and no resident will further be in 1984. However, by virtue of the Local sector. Liquors and alcohol drinks in the infected. Government Code of 1992, the hospital was province are sold in liters and with much devolved to the provincial government and higher prices. The distance and weather BGH: From Past to Future was renamed as Batanes Provincial Hospital. conditions of Batanes make certain When it was upgraded into a tertiary level commodities carry a 75% to 100% mark-up The history of BGH dates back II hospital under Republic Act No. 8454 over Manila retail prices. Meanwhile, even after World War II when it was created dated January 19, 1998, through the efforts simple forms of gambling do not exist at all as a dispensary under the Philippine of then Congressman now Department in the province. Rehabilitation Act of 1946 and eventually of Budget and Management Secretary And then there is sex. Sexually was upgraded to a 25-bed capacity Florencio "Butch" Abad, it came to be known transmitted diseases, particularly HIV/ emergency hospital. It became the Batanes as BGH. The complete re-nationalization AIDS, are becoming a concern. This year, General Hospital in 1955 with the same bed took place in 2000. three HIV cases have been reported. Health capacity and was later elevated to a 50-bed Today, Canceran revealed, the BGH officials and epidemiologists are now capacity in 1974. It was then made into a 75- is in the process of transformation to become doing investigation and contact tracing bed capacity hospital in 1977. one of DOH’s premier hospitals outside of (identification and diagnosis of persons Canceran said that the hospital Metro Manila through the Health Facility
Acting Chief of Hospital Dr. Jeffrey Anthony T. Canceran (front row, center) and the rest of the staff of the Batanes General Hospital.
March - April 2013 I HEALTHbeat 7 At the back of a beautiful facade of the Batanes General Hospital (left) there is construction currently going on (right) that will transform the hospital into one of the DOH premier hospitals outside Metro Manila. (Photos by Tony Roda)
Enhancement Program of the department. care. The Philippines is fast becoming one leading medical institutions and health care BGH is now being provided with ample of the most sought after tourist destination facilities in the world, and at a lower price budget for improvement and purchase of for health and vacation, and the unspoiled, without sacrificing quality and safety. essential equipment needed for its daily idyllic beauty of Batanes makes it a perfect With the right investment operation. A big portion of the hospital is site for medical tourism. that should not be misconstrued as now under construction. It has been proven many times commercialization of medicine and health, There is currently a move to make that health care providers in the Philippines, BGH can readily offer health and wellness the hospital offer health care services for including doctors, nurses, paramedical services for medical travellers. medical travellers or foreign and local tourists professionals and support staff deliver Now that would truly be health in who seek specialized medical treatment and quality services at par with those offered in paradise!
2.5 Million Household Helpers to Benefit from PhilHealth
An estimated 2.5 million domestic Under the new law, a domestic Registration Form (PMRF) which is available household helpers will benefit from worker and his/her qualified dependents such at any PhilHealth office or can also be PhilHealth after President Benigno S. Aquino as legal spouse, children below 21 years old, and downloaded from www.philhealth.gov.ph, III recently signed into law Republic Act No. parents 60 years old and above shall be covered attach supporting documents for qualified 10361 that aims to protect the welfare of by PhilHealth. dependents, and submit them to the nearest domestic workers in the country. Members are entitled to full inpatient PhilHealth Local Health Insurance Office. The new law defines the labor benefits when confined in any government and Annual contributions of P1,800 rights of domestic workers, standardizes their private hospitals accredited with PhilHealth. per year is also payable in quarterly or pay, and entitles them to social protection To be able to avail of PhilHealth semi-annual basis and are borne by their benefits such as health insurance under the coverage, domestic workers need to submit employers for those earnings a monthly PhilHealth program, among others. a duly accomplished PhilHealth Member salary below P5,000.
8 HEALTHbeat I March - April 2013 HEALTH facility Health Facility Enhancement Program Cementing DOH-LGU Partnership Health Secretary Enrique T. Department of Health to attain Kalusugan to further cement partnership with local Ona continues his rounds to the different Pangkalahatan (universal health care). government units (LGUs) for Kalusugan government hospitals and health facilities The other two thrusts are financial risk Pangkalahatan. around the country to monitor the protection through expansion in enrollment progress of implementation of the Hospital and benefit delivery of the national health Nueva Vizcaya, Isabela & Ifugao Facility Enhancement Program (HFEP), insurance program and the attainment of which provides funds to allow immediate the country’s health-related targets in the In January, Ona inaugurated the rehabilitation and construction of critical Millennium Development Goals (MDGs). Diadi Emergency Hospital and the Trauma health facilities and improve their services. In the first quarter of the year, Center of the Veterans Regional Hospital, It is one of the three strategic thrusts of the Ona visited several areas in the country both in Nueva Vizcaya. He also visited the
Health Secretary Enrique T. Ona monitors the progress of implementation of the Health Facility Enhancement Program in Marinduque. (Photo by Paking Repelente)
March - April 2013 I HEALTHbeat 9 provinces of Isabela and Ifugao to affirm Hospital (SIGH) and Cauyan District Hospital and they expect to be provided services the DOH support to LGUs and personally in Isabela, Nueva Vizcaya Provincial Hospital without shelling out a single centavo. check on the status of the rehabilitation and (NVPH) in Bambang, Nueva Vizcaya, and Thus, Ona instructed the PhilHealth expansion of health facilities under the HFEP. Ifugao General Hospital (IGH) in Lagawe, officers to provide services to every indigent Ona said that attaining Ifugao. Philhealth member despite the absence of Kalusugan Pangkalahatan is a tough The DOH is also committed to give their membership cards. He added that the job that the national government cannot do more assistance to the following facilities legitimacy of these members can always be alone, and the cooperation and dedication of under HFEP: relocation and construction of checked at the Philhealth Central Office. all stakeholders will be its driving force. the new of IGH in Lagawe, Ifugao; upgrading Without any ready proof to support The health chief stressed in his of the Panupdupan District Hospital in Lamut, their membership claim, these patients are meetings with Isabela Governor Faustino Ifugao, and SIGH in Santiago City, Isabela; automatically classified as indigents by the “Bojie” Dy, Nueva Vizcaya Governor Luisa rehabilitation of Pediatric Ward of Nueva hospitals. Non-availment by members of Lloren Cuaresma and Ifugao Governor Vizcaya Provincial Hospital; and provision their entitlements deprives these members Eugene Balitang that one way to attract of equipment for Diadi Emergency Hospital. of the needed services and at the same time medical and other health professionals Other rural health units and barangay health drains the funds of the hospitals resulting to to practice in the rural areas is to provide stations will also be beneficiaries of this low hospital income. facilities with modern equipment in the commitment. “We are committed to serving area. This way, he said, people do not need the Filipinos’ health needs,” Ona stressed. to travel to Manila and other cities to get Bicol Region Moreover, he reminded PhilHealth officers, quality medical care and treatment, making including local government officials that it is travel expenses minimal and at the same Also in January, Ona visited the the President’s marching order to extend the time decongesting the medical centers in Bicol Region and was impressed to learn that best healthcare possible to every Filipino. Manila. the ongoing construction and renovation of Ona also stressed that common Ona also reminded local officials to health facilities in the Bicol region will be law wives/husbands of legitimate members maximize Public-Private Partnership (PPP) finished according to plans. “Soon no more should be given privileges like that of to improve their health facilities. He said Filipinos will die without seeing a doctor,” he married couples. He said that just because that the DOH has a PPP office located at the said. they are not married does not mean that National Kidney and Transplant Institute and Albay Governor Joey Salceda they are not entitled, especially if they are is always willing to provide assistance. aired his concern about the poor people in poor. He added that this is the very essence Some of the facilities visited by the their municipality who are used to going to why PhilHealth exists – to provide health health chief were: Southern Isabela General government hospitals without any papers services to the poor.
LEFT: Health Secretary Enrique T. Ona with DOH and Nueva Vizcaya Provincial Government staff. RIGHT: Sec. Ona with Cauayan, Isabela Mayor Bojie Dy (center in green t-shirt) and the DOH and Cauayan District Hospital staff. (Photos by Paking Repelente)
10 HEALTHbeat I March - April 2013 Health Secretary Enrique T. Ona with Albay Governor Joey Salceda (left photo) and Marinduque Governor Carmencita Reyes (in pink blazer, right photo). (Photos by Paking Repelente) Sorsogon Governor Raul Lee This will ensure the prevention of water- to fully utilize their allocated budget for pledged to monitor and increase PhilHealth borne diseases among patients confined in facilities enhancement and said that “every membership in his province. In fact, Lee the hospital, hospital staff and caretakers. Filipino should have access to modern, committed to shoulder 50% of all premium Governor Carmencita O. Reyes reasonable, and affordable healthcare.” payments of his constituents. During a revealed that there is no private hospital in He also moved for the 100% PhilHealth discussion with Ona, it was discovered that Marinduque, which means that the local enrollment that will greatly reduce medical only 15 out of the 30-50 average monthly government is able to provide the needed expenses of patients, especially the poor. women who delivered their babies in his medical and health services of the people. Ona promised to provide more assistance to area are PhilHealth members. Marinduque currently has three hospitals Marinduque in the next three years as Gov. Ona visited Putiao Health Center and eight rural health units. Reyes also promised to work for a 100% and Birthing Homes, Dr. Fernando Duran Sr. The health chief also visited the PhilHealth enrollment. Memorial Hospital, Irosin District Hospital, Gasan Rural Health Unit and Birthing Facility. Bulan Memorial Hospital, Bulan Rural Health During the visit, there were five mothers Antique, Las Piñas and Bataan Unit and Birthing Home, Matnog Medicare who delivered in there. Mayor Victoria A. and Community Hospital, Matnog Rural Lim of Gasan and Mayor Senen M. Livelo of In March, Ona handed over new Health Unit and Birthing Home, Josefina Mogpog said that this is the first time that equipment to the birthing facility of San Duran District Hospital, Bicol Regional they received assistance to upgrade their Remigio, Antique. He also met with the Teaching and Training Hospital, City Health health facilities. officials of Las Piñas General Hospital and Office and the Philhealth office in Albay. In line with the MDGs of reducing Satellite Trauma Center, led by Director maternal and infant mortality by 2015, Edmundo Lopez, to personally check the Marinduque Marinduque exceeded its MDG targets for partially delivered equipment which maternal mortality and infant mortality, included panoramic dental x-ray machines, In February, Ona visited the pegged at 18% and 9%, respectively. In defibrillator, electrocardiogram (ECG) province of Marinduque to inaugurate the fact, Gov. Reyes reported that most mothers, machine, infusion pumps, instrument Dr. Damian Reyes Provincial Hospital in if not all, deliver in health facilities which sterilizer, and resuscitators. Boac and the Rural Health Unit and Birthing account for the low maternal and infant And finally in Bataan, Ona turned Facility in Mogpog. mortality rates in the province. over the Samal Rural Health Unit and The provincial hospital is the Aside from achieving its MDGs, inaugurated the Mother Bles Birthing Clinic, ultimate referring facility in the province Marinduque has also been declared by a health facility enhancement project of the catering to all six municipalities with a total the DOH as free from malaria, rabies and DOH, Samal LGU headed by Mayor Gene M. population of 240,000. This 100-bed hospital filariasis. Dela Fuente, and KaKaK Foundation. boasts its own water purification system. Ona urged local chief executives - o O o -
March - April 2013 I HEALTHbeat 11 hospital HEALTH Quirino Memorial Medical Center goes on a Meatless Monday On March 18, a Monday, the Quirino Monday gripped the Philippines when an proper nutrition.” Memorial Medical Center (QMMC) launched internationally recognized local chapter, He explained that health messages the "Meatless Monday," and that means "Luntiang Lunes," was launched during the from most health campaigns tend to fizzle-out vegetables dishes will be the main course that Nutrition Month of July. to oblivion as people revert to their old ways will be served its cafeteria. In 2012, the Nutritionist-Dietitians’ in due time. The strength of the cost-effective Dr. Angeles T. De Leon, QMMC chief, Association of the Philippines (NDAP) and powerful Meatless Monday campaign lies said that Meatless Monday will increase the threw its support for the Meatless Monday in the "maintenance phase" that may result in variety of healthy food choices available in the movement and issued a position paper habit formation. cafeteria and fits well with the hospital's vision calling for the passage of House Bill 6311 or “If you're a meat-eater, you will of promoting public health and sustainability. the “Luntiang Lunes" Bill. The bill shall create develop the love for veggies,” professed The QMMC will also bring its environments in schools and workplaces for Deocaris. He added that as the health message movement to the community by creating the increased consumption of vegetables as gets repeated every week, Monday being the greater awareness on the health benefits of a strategy in curbing the growing epidemic January of the week allows us to reset our eating vegetables as a practical and cost- of noncommunicable diseases, such as intentions. Meatless Monday can recommit an effective strategy to fight malnutrition, and hypertension, cardiovascular diseases (CVD), individual to a healthy-way of eating 52 times metabolic diseases. diabetes mellitus, cancer and obesity. a year. "If we fail, we have next week to bring Meatless Monday is an international Custer C. Deocaris, a Balik Scientist us back on track,” Deocaris concluded. movement that started by the Johns Hopkins of the Department of Science and Technology At the Meatless Monday launch, Bloomberg School of Public Health in 2003 in and founder of Luntian Lunes, said ,“It is sad representatives from other Department of an effort to promote forgoing meat one day a that Filipinos have the lowest vegetable Health hospitals like Amang Rodriguez, Jose week for public health and the health of the intake in Asia; on average, we eat a measly 39 Reyes, Lung Center and Philippine Children’s planet. Public figures, celebrities and athletes kilograms (kg) of vegetables per year. This is a Medical Center were present to witness this have been active in promoting the health far-cry from the vegetable intake of Chinese landmark history for QMMC. advantages of reducing the intake of meat. which is pegged at 250 kg.” The international Meatless Monday in 2011, Sodexo, a global food The 2008 National Nutrition movement, with headquarters based in New services giant in the US, launched Meatless Survey (NNS) of the Department of Science York, sent praises to QMMC for becoming the Monday in more than 900 hospitals to & Technology - Food and Nutrition Research first hospital in the Philippines to join the advance health and wellness by reducing Institute that showed vegetables account for international nutrition movement. meat consumption. Sodexo followed up the only about 7% of the total daily intake food launch with a survey of its customers and among children 6-12 years old. found that meat sales have gone down and Deocaris lauded the efforts of QMMC vegetable sales have markedly increased in for the Meatless Monday and he said, “Doctors these hospitals. are the best PR (public relations) persons It was also in 2011 that Meatless to promote healthy lifestyle, which include
Photo grabbed from the international Meatless Monday Facebook page
12 HEALTHbeat I March - April 2013 world HEALTH Bantay Presyon World Health Highlights Hypertension
World Health Day (April 7, the blood pressure – the lowest pressure in anniversary of the founding of the World blood vessels in between heart beats, Health Organization in 1948) highlights when the heart muscle relaxes. hypertension for its theme for 2013 with Normal adult blood pressure is the ultimate goal to reduce heart attacks defined as a systolic blood pressure and strokes. of 120 mm Hg and a diastolic blood In the Philippines, one in pressure of 80 mm Hg. However, four adults has high blood pressure. cardiovascular benefits extend to Cardiovascular disease, largely due to lower systolic (105 mm Hg) and lower hypertension, is the leading cause of diastolic blood pressure levels (60 death, and hypertension is a leading mm Hg). Hypertension is defined as cause of morbidity. a systolic blood pressure equal to or Hypertension increases the above 140 mm Hg and/or diastolic risk of heart attacks, strokes and kidney blood pressure equal to or above 90 failure. If left uncontrolled, high blood mm Hg. Maintaining normal ranges pressure can also cause blindness, of both systolic and diastolic blood irregularities of the heartbeat and heart pressure are particularly important for failure. The risk of developing these the efficient function of vital organs complications is higher in the presence such as the heart, brain and kidneys of other cardiovascular risk factors such and for overall health and well-being. as diabetes. Early detection is key. All There is a common misconception adults should know their blood pressure. Health Undersecretary Teodoro Herbosa makes a face while his that people with high blood pressure This is a good piece of information about blood pressure is being taken during a "fitness camp" - one of will always experience symptoms. health. the healthly lifestyle intevention activities of the six-month Most people with high blood pressure waist circumference reduction challenge, "Belly Gud for Health - The Executive Edition." (Photo by Marlito Tasitorno) actually have no symptoms at all, Understanding Hypertension and may not even know they have it. Sometimes high blood pressure High blood pressure – also known as it is pumped by the heart. can cause symptoms such as headache, as ‘raised blood pressure’ or ‘hypertension’ – Blood pressure is expressed shortness of breath, dizziness, chest pain, is a condition in which the blood circulates at in millimetres of mercury (mm Hg). It is palpitations of the heart or nose bleeds. If persistently raised pressure. Blood is carried recorded as two numbers usually written people ignore measuring blood pressure from the heart to all parts of the body in one above the other: the first (or top) because they think symptoms will alert arteries and veins. Each time the heart beats, number is the ‘systolic’ blood pressure – the them to the problem, it can be dangerous it pumps blood around the body. Blood highest pressure in blood vessels, which because high blood pressure is often a ‘silent pressure is created by the force of blood occurs as the heart contracts (heart beat). killer’. Everybody should know their blood pushing against the inside of blood vessels The second (or lower) number is the diastolic pressure numbers.
March - April 2013 I HEALTHbeat 13 High blood pressure is the result growing burden of NCDs. an impact because the metabolism rises of many factors. Demographic transition, Civil society has an important when the workload is heavy and work is rapid and unplanned urbanization role to play in helping to address high physically demanding, leading to a rise in and globalization are the underlying blood pressure. Industry can contribute to blood pressure. And people who do not have determinants. They contribute to unhealthy the solution, for example, by reducing salt control over their jobs, as high-demand behavioral risk factors. High blood pressure in processed food and making essential jobs with low levels of control lead to health is one of the metabolic risk factors that diagnostics and medicines more affordable. issues like stress, burnout, and poor physical leads to many non-communicable diseases health which includes hypertension. (NCDs). (The main factors contributing to Hypertension and Work Other work-related risk factor for high blood pressure and its consequences are hypertension and coronary heart disease illustrated below.) Certain work situations or identified in recent years are long work hours The risk of developing high blood requirements may affect the stability of and work shifts. Patients with hypertension pressure can be minimized by: cutting their blood pressure which individuals, may forget to take medicine because of their down on salt; eating a balanced diet; particularly those with hypertension should busy work schedule, adversely affecting the avoiding harmful use of alcohol; getting pay attention to. This includes working in effectiveness of treatment. This should be regular exercise; and avoiding tobacco cold environments since this may induce observed despite heavy workload. use. For many people, lifestyle changes constriction of blood vessels causing the And lastly, unemployment can are sufficient to control blood pressure. For blood pressure to rise. Hot and humid work have an effect on blood pressure. Studies others, medication is required. Inexpensive environment also affect the blood pressure, have shown a significant relationship medication exists, which is effective when for example, through manual work which between the duration of unemployment and taken as prescribed. may result in excessive sweating and dilation the extent of blood pressure increase . It is essential that detection and of blood vessels that may cause postural control of high blood pressure (measurement, hypotension, a condition that causes a drop Hypertension and Tobacco health advice and treatment), are coupled in blood pressure (hypotension) due to a with simultaneous reduction of other risk change in body position (posture) when a Although there are some studies factors that cause heart attacks and strokes, person moves to a more vertical position: that have demonstrated that hypertension such as diabetes and tobacco use. They from sitting to standing or from lying down incidence is higher among heavy smokers, should be core elements of primary health to sitting or standing there is still not clear evidence to confirm care, and integral to efforts to reduce the Physical demands also have that tobacco smoking and exposure to
Main Factors Contributing to High Blood Pressure and Its Consequences
14 HEALTHbeat I March - April 2013 secondhand smoke (or the smoke that comes occurrence of high blood pressure during pressure and the eye. People at increased out from a lighted cigarette) are risk factors childhood is likely to continue into adulthood risk of hypertension, including a family for hypertension. Right after someone thus increasing the risk of hypertension and history, require regular eye examinations, smokes a cigarette, the nicotine can raise cardiovascular diseases in later life. even without any symptoms. both the blood pressure and the pulse rate, Despite strong evidence of the but the duration and burden that this creates benefits of salt reduction, a proportion of Hypertensive Disorders of Pregnancy is not as well known. the food industry remains reluctant to take But one thing is clear tobacco up salt reduction programs for commercial Hypertensive disorders of use induces arterial stiffness which may reasons. pregnancy (HDP) affect about 10% of all persist for a decade after cessation. Smoking pregnancies around the world. HDP are an should be always avoided but specially in Hypertension and Eye Health important cause of severe acute illness, any hypertensive patient because it can long-term disability and death among markedly increase the risk of secondary Untreated hypertension can have women, fetuses and newborns. cardiovascular complications and enhance profound effects on various parts of the eye, In Asia, about 10% of maternal the progression of renal insufficiency. but mainly the retina. Classically, elevated deaths are associated with HDP, the second The good news is that there are blood pressure results in a series of retinal leading cause of maternal deaths. The great benefits of quitting smoking among microvascular changes called hypertensive majority of these deaths related to HDP those who have hypertension: Risk of having retinopathy. If untreated, these changes can be avoided by providing timely and a heart attack will be reduced after the first can be serious and sight threatening. effective care. Thus, optimization of health year if you quit smoking. Furthermore, hypertension is one of the care for women during pregnancy to prevent major risk factors for development and and treat HDP is a necessary step toward Hypertension and Salt Intake progression of diabetic retinopathy – an ever achieving Millennium Development Goals, increasing cause of visual impairment in our particularly MDG 4 and 5, reduction of Although salt is an essential region. infant mortality and maternal mortality, mineral needed for our bodies to function, Although symptoms may include respectively. people in the Asia, including the Philippines, decreased vision and headaches, most Avoiding unwanted pregnancy consume too much sodium as part of salt. patients with hypertensive retinopathy are in women with hypertension protects Many people are unaware of how in fact symptom free and the condition is women's health because women with pre- much salt they are consuming, and are not commonly discovered during routine eye existing high blood pressure are more likely able to cut their salt intake. There are food examination. Signs of mild hypertensive to have complications during pregnancy and condiments that most Filipino taste retinopathy are seen in nearly 10% of the (e.g. cerebrovascular diseases, growth cannot do without – dried fish, bagoong, general adult non-diabetic population retardation of foetus, premature birth). For fish sauce and soy sauce – which are and are commonly associated with other these, becoming pregnant is a risk. obviously high in salt, and then there are indicators of end-organ damage, e.g. renal The Responsible Parenthood and “hidden salt” in processed food, snacks and impairment. Reproductive Health (RPRH) Act of 2012 other food products like bread and cheese. Research has shown that by (Reproductive Health Bill) provides health In addition, some fast food chains and other controlling blood pressure, visual loss from benefits to all Filipino women and families restaurants are key suppliers of foods high in hypertensive retinopathy can be prevented. who need reproductive health services. If salt as well as fats and sugars. In addition to taking blood pressure all women and family can avoid unwanted High salt intake across all age medications, patients should be encouraged pregnancy through effective contraceptives, groups results in heightened blood pressure. to a healthy lifestyle to avoid hypertension, women with hypertension or other pre- Children are particularly susceptible to salt including a healthy diet and regular exercise. existing complications will also be protected taste habituation, which can spur increased In management of patients with from risky pregnancy. The World Health demand for highly salted products and hypertension, physicians should be aware of Organization fully supports the RPRH Act initiate life-long behavioral trends. The the full spectrum of the relationship of blood and its enforcement.
March - April 2013 I HEALTHbeat 15 HEALTH regulation News and Views on STEM CELL THERAPY Regulating Stem Cell Therapy
As promised, the Department Stem Cell Medicine (PSSCM) 1st National body, it could lead to fatal complications." of Health published on March 20 in major Convention, Ona said, "Some stem cell He added that although some people dailes the Administrative Order (AO) programs here have expert personnel and experience few problems with a transplant, 2013-0012, also known as the "Rules and clinical facilities and advanced laboratory others may develop complications including Regulations Governing the Accreditation of equipment and technologies, reputed to graft-versus-host disease (allogeneic trans- Health Facilities Engaging in Human Stem be more advanced than other institutions plant only), stem (graft) failure, organ injury, Cell and Cell-based or Cellular Therapies in abroad. We are concerned, however, that infections, cataracts, infertility, new cancers, the Philippines" to ensure that human stem other facilities might not have the minimum and even death. cell and cell-based therapies in the country capabilities especially trained personnel On February 5, it was the are safe and effective for their intended use. staff and equipment needed to perform 1,500-member strong Philippine Heart Health Secretary Enrique T. Ona stem cell therapies safely and effectively." Association's (PHA) turn to declare that it declared, “Our efforts at regulating the He also reiterated, "Although this does not recommend stem cell therapy of practice of stem cell therapy in this country technology holds promise, stem cell therapy any kind (from bone marrow, adipose tissues are aimed at safeguarding the welfare is not yet part of standard of care and is and non-human sources) as a standard of of our patients and the general public by considered an investigative procedure for care to reduce cardiovascular risk in patients making safe, effective and ethical stem compassionate use. Applications of stem with heart disease (coronary heart disease cell modalities and practices are within cells for the treatment of malignancies, and heart failure). emerging international and global standards blood disorders, degenerative diseases (e.g., The PHA supports ethically considering the very complex nature of this Alzheimer’s Disease), metabolic diseases conducted research studies that will help therapy.” (e.g., diabetes), and immune cell therapy shed light on some of the uncertainties Since late last year, the DOH and are still under clinical evaluation and study." regarding this modality before it can be other medical professional organizations Ona's statement was supported by recommended as a standard of care in heart expressed their concern over the proliferation PSSCM, and according to its spokesman who disease. This basically acknowledges that of “centers” offering stem cell treatments for is also the Philippine Medical Association vice more studies with robust designs are needed medical and aesthetic purposes. On January chairman, Dr. Leo Olarte, said, "If the stem to further elucidate on the role of stem cell 16, 2013, during the Philippine Society for cell that you received is not from your own therapy as a strategy for heart disease.
16 HEALTHbeat I March - April 2013 PHA President Dr. Saturnino Javier human embryos and their derivatives, the from Ukraine and Russia to several doctors in said, "This conclusion is basically aligned use of aborted human fetal stem cells and the Philippines. with the pronouncements of the DOH that their derivatives, and plant parts labeled as He also said that this practice poses such treatment should be considered "highly stem cells. ethical and moral questions and the country investigational for compassionate use." It can be recalled that on February should prevent the entry of human-derived The new DOH Order intends to 23, the PSSCM issued warning through allogenic stem cells from aborted fetuses. prevent the introduction, transmission, media that the stem cells used in some Olarte even called on the Catholic Church to and spread of communicable diseases by anti-aging medical procedures in the help put an end to this practice. ensuring a minimum quality of service and country were harvested not from recipients And on March 3, in a radio staff qualification rendered by hospitals and themselves or donors but from “elective interview over the Church-run Radio Veritas, other health facilities capable of utilizing abortion of human babies abroad. Bishop Jose Oliveros, the chairman of the human stem cell preparations and cell- Olarte, who at that time just came Episcopal Commission on Bioethics of the based therapies. These guidelines will a scientific forum in the US that tackled Catholic Bishops of the Philippines, said classify which stem cell preparations and the issue of human commoditization for the Church is against such practice since it therapies will be registered and allowed commercial and economic purposes, said that is tantamount to murder. He said, "When with certain restrictions. Preparations that in countries like the Ukraine, Switzerland, you take the stem cell of an embryo, you kill will be allowed include those with adult Russia, and even Malaysia, harvesting the embryo. We believe that the embryo is human stem cells, human umbilical cord human fetuses for stem cell transplant already a human person. It’s a human, it’s stem cells, and human organ-specific cells. has become so prevalent that even normal a living human being. So therefore parang The AO restricts the use of healthy babies are being used to generate pinatay mo na yung tao kapag pinatay genetically altered stem cells and tissues of the cells that are supposed to make older mo na yung embryo na yun." He added, human adults and the umbilical cord, fat- people look and feel younger. Olarte claimed “Kapag galing sa embryonic stem cell, ito ay derived human stem cells, and live animal that a Malaysian pharmaceutical group has immoral. This is against our belief." stem cells; the AO also prohibits for human already offered human-derived allogeneic In the DOH Order, health facilities treatment and research the creation of stem cells (or those harvested from a donor) utilizing stem cell preparations and cell-
Health Secretary Enrique T. Ona (third from left) is keynote speaker in the 1st National Convention of the Philippine Society for Stem Cell Medicine (PSSCM). Also in photo from left are: Dr. Oscar Tinio, Dr. Jose Asa Sabili and Dr. Rey Melchor Santos. (Photo by Paking Repelente)
March - April 2013 I HEALTHbeat 17 based or cellular therapies will be mandated Meanwhile, an Institutional regulation will professionalize the practice of to comply with the guidelines set by the Review Board will review and approve stem stem cell therapy in the country. This will re- Bioethics Advisory Board composed of cell therapies, based on the guidelines set open the gateway for a real and sustainable the DOH, the National Transplant Ethics by the Bioethics Advisory Board. There medical tourism industry in the Philippines. Committee, the Philippine Food and Drug are minimum standards for personnel For a long while medical tourism here did Administration (FDA), a government health qualifications, physical facilities, equipment not flourish due to the absence of a viable facility, a private organization or health and supplies and work environment which product. With regulation, a high standard, facility, academicians, researchers, local and will be prescribed by the guidelines. Proper effective, ethical and safe stem cell industry international experts. record keeping in each facility that will can be that viable product that can be unique This Board will ensure that ethical provide readily available information on to the Philippines for it to offer and promote and professional standards are upheld each donor, patient, procedures on stem cell to the entire world.” and that contentious scientific, ethical and and cell-based therapies will be mandated AO 2013-0012 takes effect legal issues are addressed. Charges and as well. 15 days after its publication date, and complaints shall be addressed to the DOH With the release of the AO, Olarte shall be reviewed three years after its Bureau of Health Facilities and Services and said in a statement, “We welcome this implementation. the Philippine FDA. development because proper government - o O o - Permissibility in Islam
by TATO M. USMAN, MD, MPAIM DOH Center for Health Development - Autonomous Region in Muslim Mindanao
Stem cells are cells that have the cells. Pluripotent stem cells can be isolated cannot be studied directly in a human potential to develop into some or many from human embryos that are a few days embryo, which sometimes are linked with different cell types in the body. Serving as a old. Cells from these embryos can be used major clinical consequences such as birth sort of repair system, they can theoretically to create pluripotent stem cell "lines" —cell defects, pregnancy-loss and infertility. A divide without limit to replenish other cultures that can be grown indefinitely in the more comprehensive understanding of cells for as long as the person or animal is laboratory. Pluripotent stem cell lines have normal development will ultimately allow still alive. When a stem cell divides, each also been developed from fetal tissue (older the prevention or treatment of abnormal "daughter" cell has the potential to either than 8 weeks of development). human development. remain a stem cell or become another type Limbs and organs could be grown of cell with a more specialized function, such Advantages & Disadvantages in a lab from stem cells and then used in as a muscle cell, a red blood cell, or a brain transplants or to help treat illnesses. This will cell. Stem cell provides medical help scientists to learn about human growth According to the US National benefits in the fields of therapeutic cloning and cell development. Institutes of Health, stem cells may be and regenerative medicine. It also provides Scientists and doctors will be pluripotent or multipotent. Pluripotent stem great potential for discovering treatments able to test millions of potential drugs and cells can give rise to any type of cell in the and cures to a plethora of diseases including medicine, without the use of animals or body except those needed to support and Parkinson's disease, schizophrenia, human testers. This necessitates a process develop a fetus in the womb. Whereas stem Alzheimer's disease, cancer, spinal cord of simulating the effect the drug has on a cells that can give rise only to a small number injuries, diabetes and many more. specific population of cells. This would tell if of different cell types are called multipotent. Stem cell research also benefits the drug is useful or has any problems. There are several sources of stem the study of development stages that Stem cell holds the key to reversing
18 HEALTHbeat I March - April 2013 the effects of aging and prolonging our lives. donor. Stem cells for transplantation are It has already found many treatments that given by living individuals, either collected help in slowing the aging process, and a from the bone marrow or from the peripheral bonus of further research is a possible 'cure' blood. for aging altogether. Stem cell transplantation can be The use of adult stem cells to treat performed with an autologous transplant disease is that a patient's own cells could be i.e the patient is his own donor, or with an used to treat a patient. Risks would be quite allogeneic (another person) compatible reduced because patients' bodies would not donor. Stem cells for transplantation are reject their own cells. On the other hand, given by living individuals, either collected embryonic stem cells can develop into any from the bone marrow or from the peripheral cell types of the body, and may then be blood. more versatile than adult stem cells. And The first trial of stem cell with embryonic stem cells come some transplantation treated irradiated nuclear disadvantages. workers. It then developed into a routine The use of embryonic stem cells treatment that can cure more than 90% of involves the destruction of blastocysts patients with haematological malignancies (embryonic stage) formed from laboratory- and non-malignant disorders in the early fertilized human eggs. For those people who stage of the disease if an optimal donor believe that life begins at conception, the recipient combination is available. Today Dr. Tato M. Usman of DOH-Autonomous Region in Muslim Mindanao, HEALTHbeat's regular blastocyst is a human life and to destroy it is more than 50.000 transplants are carried out contributing writer for Muslim Health. immoral and unacceptable. annually worldwide and they are increasing Embryonic stem cells may not each year. Stem cell transplantation also League, it is permissible to obtain, grow and be the solution for all ailments. Like any remains the last hope for patients with use stem cells for therapeutic or permissible other new technology, it is also completely advanced or refractory disease. scientific research purposes if obtained from unknown what the long-term effects of For many years stem cell a permissible source, including: such an interference with nature could transplant action was restricted to patients materialize. According to a research, the with matched family donors (only some • Adults, provided they give embryonic stem cell treatment was used on 30% of the patients). For patients without permission to do so and if no harm heart disease patients. It was found that it a family donor, unrelated donor registries comes to them as a result; can make their coronary arteries narrower. have been set up to find a tissue type • Children, if their parents give Also a disadvantage of stem cells match but the chances are small e.g. 1 out permission to do so for a permissible is that they are pre-specialized, for instance, 500,000 individuals and many volunteers reason and if no harm comes to blood stem cells make only blood, and brain are necessary from all ethnic backgrounds them as a result; stem cells make only brain cells. Embryonic in order to maximize the chance of meeting • The placenta or umbilical cord with stem cells are derived from embryos that are needs. More recently cord blood has also the permission of the parents; not a patient's own and the patient's body been used as a stem cell source for patients • Embryos or fetuses that have been may reject them. without a donor and more than 2000 Cord miscarried of their own accord or blood Haematopoietic Stem Cell Transplants aborted for therapeutic reasons Stem Cell Transplantation are performed annually. allowed by the sharia (or Islamic Ruling) and with the permission of Stem cell transplantation can be Permissibility in Islam the parents; and performed with an autologous transplant • Leftover fertilized embryos from in i.e the patient is his own donor, or with an According to the Fiqh (Islamic vitro fertilization that are donated by allogeneic (another person) compatible Jurisprudence) Council of the Muslim World the parents. It must be remembered
March - April 2013 I HEALTHbeat 19 that these cannot be used for and without a medical reason therapy, government authorities should impermissible pregnancies. permitted by sharia; come up with implementing guidelines On the other hand, it is • Willful fertilization of a donated as a tool for regulating health institutions impermissible to obtain and use stem cells ovum and sperm; and health care professionals proving these if taken from impermissible sources, which • Therapeutic cloning. therapeutic modalities. include: Finally, with the anticipated Allah Almighty knows best. • Fetuses that are aborted willfully increase of people patronizing stem cell - o O o -
Hype or Hope?
by RISA CALDOZA-DE LEON, MD
“Similia Similibus Curantur” unrelated match) are allogenic while those (Like Cures Like) from different species such as rabbits and - Paracelsus, 16th century sheep are xenogenic.
When prominent political and The Swiss Way entertainment personalities proudly touted they have undergone stem cell therapy Dr. Paul Niehans in the 1930s in Europe, the “secret” was revealed. The proposed that prescribing healthy and fountain of youth is now a reality. bioactive cellular materials for the specific Stem cells are specialized cells disease of a patient will rebuild or revitalize that give rise to more specialized cells or ageing or diseased organs of the same tissue differentiate into a specific cell type. They type. This foundation gave birth to cellular can self-renew by going through a number therapy. of cycles of cell division while maintaining Swiss cellular therapy is a natural its undifferentiated state. They are the body’s rejuvenation method that originated from great ally for self-repair. Switzerland to effect against ageing and Dr. Risa Caldoza-De Leon, the contributing writer, When a disease or injury happens, chronic diseases. It is simply administering is a Clinical and Aesthetic Skin Care Specialist, is stem cells respond to certain signals and cellular materials from fetal tissues into the diplomate of Philippine Skin Healthy Physicians, start about the healing process by becoming human body for therapeutic purposes. Inc. and diplomate of Philippine Academy of specialized cells required for the body's These cellular materials, from Aesthetic and Age Management Inc. She trained repair, as long as they exist in adequate placenta and organ-specific extracts, may in the Use of Swiss Live Cell Therapies, Precursor Stem Cell and Peptides in Switzerland, and a amounts and receive the correct healing be in the form of oral capsules, topicals, member of the Philippine Stem Cell Society. She signals. When they do not, the result is intradermal injectables, and intramuscular holds clinic at Vanity Skin Aesthetics in One Ecom, compromised healing. As we age, stem cell injectables. They are obtained from fetal Mall of Asia. Alabang Hills and Crown Tower, numbers dive, or malfunction, thus, the organs and tissues of rabbits and/or sheep Makati. inevitable diseases of ageing. from closed colony of animals for more than Stem cells coming from the patient 40 generations as per requirements of global pollution free environment under controlled are called autologous, those coming from regulating bodies such as the U.S. Federal dietetic organic conditions. genetically different donors of the same Drug Administration, and World Health Stem cells are injected intra- species (parents, siblings, children, or an Organization. These animals are bred in muscularly into the patient’s buttocks.
20 HEALTHbeat I March - April 2013 Months after the treatment, patients notice youth-inducing effects such as glowing skin, higher energy levels, reduced symptoms of beatBOX diseases, and even longevity. Different stem cells are given depending on the particular organ targeted. Intradermal (under the skin) injections are done on the face and neck to promote collagen and elastin production to regenerate skin, making it firmer and smoother. Even children afflicted with autism and Down’s syndrome are said to benefit from stem cells by enhancing the brain’s metabolism, which leads to better cognitive functions. It boosts brain development and the body’s immune system. Treatment cost ranges from P20,000 to P1.5 million and done as outpatient basis. Gossip Can Have Health Benefits To Each His/Her Own We’ve all heard the familiar saying, “If you don’t have something nice to say, don’t say anything at all.” Well, that may not be healthy anymore. Fresh adult stem cells may be harvested from one’s own bone marrow, A study from the University of California Berkeley, which was published last year in umbilical cord, blood or fat. There is no risk the online edition of the Journal of Personality and Social Psychology, suggest that of rejection since it’s taken from the same one category of gossip – “prosocial gossip” or spreading information about a person patient. who has behaved badly – may be beneficial for our emotional health, particularly in Autologous fat stem-cell therapy lowering stress. It can also do something good for humanity, especially in maintaining is used for aesthetic and/or medical reasons social order and warning people about the untrustworthy or dishonest behavior of such as diabetes, blood disorders and heart others. problems. Fat from the patient’s tummy is A little bit of gossip is healthy; it is what keeps the culture going, greasing the social harvested through aspiration and processed machinery. But remember, if you don’t do your gossiping well, then you may get into in a machine. The resulting fresh stem cell is trouble. then injected into the patient. Once injected, these stem cells replace and regenerate ABOUT THE PHOTO old and malfunctioning cells to stimulate growth and function of organs in the body. Totie Dingle (left) and Ged Basaca (right) of DOH Center for Health Development- The procedure costs around P500,000 to P2.5 National Capital Region are NOT rumor mongers but they look like sharing a bit million. of interesting information in the photo provided to us by Glen S. Ramos. Stem cell therapy is not the Do you have funny (but not offensive) photo you want to publish in HEALTHbeat. standard of care and is considered an Just email your high resolution photo with caption at
March - April 2013 I HEALTHbeat 21 KALUSUGAN pangkalahatan
Two debating teams from Xavier University battle it out in the championship round and debate on a socialized versus tax-based health system on March 16 at the Century Park Hotel. The team on the right wins and Arvin Gogo (center), the team's "prime minister," is declared as best speaker. (Photo by Romy Caparas) Health Secretary's Cup based on the presentation of JUAN ANTONIO RICARTE, MD Universal Health Care Study Group, UP Manila - National Institutes of Health
Inter-School Debates will be alright, or at least bearable? When will ultimately be the future health leaders Kalusugan Pangkalahatan is mentioned, of the country. It's not golf nor football, the Health are people hopeful, or are they cynical The debate tournament was Secretary's Cup is a six-month campaign and think this is just another grandiose hosted in six different schools in the country. to spread awareness on Kalusugan government promise?" A total of 96 debate teams from the different Pangkalahatan (universal health care) Debate, in principle, is a platform universities and colleges were able to through a nationwide debate tournament to generate arguments for or against a discuss different issues revolving around which discussed the different issues that particular issue. In the process, debaters the six building blocks of Kalusugan impact on universal health care. have to research on the premises of their Pangkalahatan, President Benigno S. Health Secretary Enrique T. Ona stances, and express their ideas in the most Aquino III's health agenda. said that as guardians of the health of the comprehensible and persuasive manner The debates started in August people, the Department of Health needs to possible. The adjudication panel and the 2012 in the University of the Philippines know what the people feel about the current audience can then weigh the contribution (UP) Los Baños where issues on Health health system and the reforms it is trying to and the logical strength of speakers, and Governance were discussed. In September, implement. decide which side was able to defend their students debated about Health Regulation He added, "For example, what stance best. in UP Manila. By October, the Secretary's Cup does it mean to have a PhilHealth card or Ona emphasized that the reached Mindanao, where Xavier University to have PhilHealth benefits? Does it give DOH also needs to know the aspirations hosted the debates on Health Financing. them a sense of well-being, an assurance and sentiments of students regarding In November, debates on Health Service that whenever they go to sleep, that things Kalusugan Pangkalahatan because they Delivery were held in Ateneo de Davao.
22 HEALTHbeat I March - April 2013 The Secretary's Cup eventually the tax-based health system won the grand informal debates that involved partners and reached Visayas, where Siliman University prize and they received a trophy (cup) and members of a particular sector of society, hosted the debates on Health Human coverage for the registration fee of their e.g. patient groups, mothers, health workers, Resources in January 2013. The last leg of the team to the World Championship Debates. teachers, local government leaders, people’s debate elimination was held in UP Visayas, The team's "prime minister," Arvin Gogo, organizations, among others. Miag-ao, where issues on Health Information also received the best speaker prize. The main objective of the town Systems were discussed in February. Meanwhile, the best speakers hall meetings was to gather feedback and Sixteen (16) semi-finalistsamong the semi-finalists were also opinions regarding key issues from the emerged in elimination rounds, and recognized during the awarding ceremonies, grassroots. This was also an avenue to make they came from: UP Los Baños; De La namely: Jake Bustos (UP Los Baños); Garie the issues more relevant and close to home. Salle University; UP Diliman; Far Eastern Ouano (UP Diliman); Harold Odangan Through discussions of issues and solutions, University; Mindanao State University - (Cebu Institute of Technology); Giano Libot the town meetings aimed to gather support Iligan Institute of Technology; three teams (Xavier University); Yona Gutierrez (Ateneo and solidarity from the general public. from Xavier University; two teams from Cebu de Davao) and Teressa Puzuelo (UP Visayas, Ona said the innovative debate Institute of Technology; two teams from Iloilo). format activities held during the past several Ateneo de Davao University; UP Visayas, months have enabled the DOH and its Iloilo; two teams from UP Visayas, Miag-ao; Community Townhall Meetings partners to talk about reforms in the health and Southern Baptist College. sector, cutting across various stakeholders. On March 15, the semifinal debates The Health Secretary's Cup Communities from Abra to Zamboanga were were held at the Ateneo de Manila University campaign was not all formal debates. heard about what they feel about health which determined the top two teams to go One of the activities that branched out issues. on to the championship round and debate on was the Community Townhall Meetings "I am told that in Nueva Ecija, a socialized versus tax-based health system. on the six building blocks of Kalusugan the people expressed excitement about In the end, two teams from Xavier University Pangkalahatan in nine differentKalusugan Pangkalahatan, saying that it will battled it out in the finals on March 16 at the provinces. These meetings were formatted be a great help to people who are poor. On Century Park Hotel. The team that defended as a mixture of focus group discussions and the other hand, the idea of universal health care was met with cynicism in some urban communities. What they say means a lot to us because they give us a feel of what is truly happening in the street, in the field, and more so in the local government health care system," he concluded.
Round Table Discussions
Another activity that was organized for the Secretary's Cup were round table discussions and press conferences which featured the efforts and directions of the current members of the Cabinet on Kalusugan Pangkalahatan. In October 2012, Department of Health Secretary Enrique T. Ona (center), Alexander Padilla of PhilHealth (third from right) and Dr. Budget and Management Scretary Butch Ernesto Domingo of University of the Philippines-National Institutes of Health (fourth from left) pose Abad talked about financing in the context with the Secretary's Cup best speakers in the elimination rounds. (Photo by Romy Caparas) of health care. He presented how and
March - April 2013 I HEALTHbeat 23 where the Philippines gets its money Health Secretary and now Civil Service for health. In November, Department of Commission Chairman Francisco Duque Social Welfare and Development Secretary talked about the different issues in Dinky Soliman who talked about the financing health care in the social services provided by the country. In November, Dr. government. She discussed Esperanza Cabral shared her the importance of giving insights and experiences value to health care, on health service delivery. specifically in the form of In January 2013, Dr. Jaime maternal and child health. Galvez Tan talked about In January the importance and 2013, Department impact of health human of Labor and Employment resources to Kalusugan Secretary Rosalinda Baldoz Pangkalahatan. And lastly, prepared a speech that Dr. Alberto Romualdez talked was presented by her about health information undersecretary. In her systems in the context of speech, she discussed issues revolving the Philippine Health Care System" was universal health care. around health human resources such as the organized in the Batasang Pambansa contractualization of health care workers, the complex. Health experts gave an orientation Health Partners decline in the quality of health professional to the legislative staff on issues related to schools and training institutions, and the universal health care. Among the speakers The Secretary's Cup was organized diaspora of Filipino nurses and doctors. were Dr. Ramon Paterno, Dr. Alberto and supported by the following institutions: And in February, Department of Romualdez, Dr. Esperanza Cabral, Dr. Orville DOH - Office of the Secretary and National Science and Technology Secretary Mario Solon and Dr. Soe Nyunt-U of the World Center for Health Promotion; Philippine Montejo talked about the advancements in Health Organization. Health Insurance Corporation (PhilHealth); health technology spearheaded by Filipino Universal Health Care Study Group of scientists. He also shared the importance of Health Talk Series UP Manila National Institutes of Health; science policy research and how it impacts Philippine Council for Health Research and the health care of every Filipino. Finally, the Secretary's Cup Development; PHAP; Asian Institute of From the executive branch, the campaign was made special with the Health Management (Zuellig Center for Business Secretary's Cup campaign trail also involved Talk Series by former DOH secretaries. Transformation); Asia Society; Journalism the legislative branch of government. The talks were also set on the six building for Nation Building Foundation; Philippine In October 2012, through the assistance blocks of Kalusugan Pangkalahatan and Debate Union; Alliance of Young Health and support of the Pharmaceutical and the presence of former health secretaries Advocates/Alliance of Young Nursing Healthcare Association of the Philippines reaffirmed the universal health care goals of Leaders and Advocates; and Ayala Young (PHAP) and the House of Representatives, the present administration. Leaders Foundation. a legislative forum entitled "Strengthening In October 2012, former - o O o -
24 HEALTHbeat I March - April 2013 stress RELIEF
HIRAP KUMITA Breadwinner Pulis Dentista
EDWIN: Oy Pare, kamusta na? Kamusta JOAN: Mamang Pulis, may nanghalik po ARIEL: Doc, meron ho akong madidilaw ang mga anak mo?" sa akin sa park... na ngipin. Ano po kaya ang NOEL: 'Yung panganay ko engineer na, PULIS: Description nung nanghalik? marerekomenda n'yo? 'yung inaanak mo, accountant, JOAN: Sorry po, di ko namukhaan... DENTISTA: (Tiningnan) Polo, t-shirt o 'yung babae, nars. Kaya lang PULIS: Ha? Bakit? kurbata na kulay maroon. 'yung bunso ko magnanakaw." JOAN: Eh sir, I usually close my eyes Terno yan sa kulay ng ngipin mo. EDWIN: Ano? Bakit 'di mo na lang when being kissed... palayasin kung ganun?" Duktor NOEL: Hindi pwede, 'Pre. Siya ang Warden breadwinner namin, sya lang DUKTOR: Bukod sa akin, may nauna ka ang may trabaho sa amin eh." WARDEN Last year nag-donate ka ng na bang kinunsulta tungkol dito dugo. Last month, cornea sa sakit mo? Konduktor naman. Ngayon, kidney na? DONATO: Sa albularyo po! RAUL: Opo, Sir! DUKTOR: At ano namang kalokohan MARIVIC: Mr. Konduktor, could you WARDEN: Aha! Unti-unti kang tumatakas, ang pinayo niya sa iyo? please get my luggage, ano?!? DONATO: Magpunta daw po ako sa inyo, heavy kasi eh! Dok! KONDUKTOR: Alin dito Miss? Sekyu? MARIVIC: There oh... 'yung sako! BOYET: Pare, puyat na puyat ako sa Taxi Driver napanaginipan ko kagabi! JOB: Paano ka napuyat na natutulog? Grabbed from the Internet. May sumakay na Madre sa taxi ni Neil... Ano ba panaginip mo? NEIL: Sister, paumanhin pero pantasya BOYET: Security guard daw ako na ko po na makahalik ng Madre... naka-duty! MADRE: Ok lang, pero may kondisyon – dapat ay Katoliko ka at single pa. Titser NEIL: Katoliko po ako at walang asawa. (At natupad ang pantasya ng taxi TITSER LIZ: Iha, talagang ganyan. driver...) Salamat, Sister. Pero, Kapag maganda karaniwan sorry po at nagsinungaling ako bobo, kapag matalino sa inyo. Born Again ako at may madalas naman ay pangit, asawa. kaya dapat matuto ka nang MADRE: Ah, okay. Papunta naman ako sa tanggapin 'yan. costume party at ang tunay kong ESTUDYANTE: Salamat po Ma'am, ang pangalan ay Brando! tali-talino n'yo talaga!
March - April 2013 I HEALTHbeat 25 HEALTH policy Hold it, Let's Debate Suspending the Implementation of Republic Act 10354 (Responsible Parenthood and Reproductive Health Act of 2012)
On March 19, media carried reports that the Supreme Court (SC) has issued a status quo ante order to suspend the implementation of the controversial Republic Act (RA) 10354, otherwise known as the “Responsible Parenthood and Reproductive Health Act of 2012” (RPRH Act of 2012) for 120 days. The news came four days after Health Secretary Enrique T. Ona signed the law's Implementing Rules and Regulations (IRR) at the Corazon Aquino Health Center and Lying-in Clinic in Baseco, Tondo, Manila, on March 15. The IRR also went through a series of public consultations in key cities of the country – Davao City on March 5, Cebu Health Secretary Enrique T. Ona leads the signing of the Implementing Rules and Regulations of Republic Act 10354 in Baseco, Tondo on March 15. (Photo by Paking Repelente) City on March 6, and Manila on March 8. The RPRH Act was signed by Commenting on the high court's Kalusugang Pampamilya." President Benigno S. Aquino III on December resolution, news quoted presidential 21, 2012, and after the Yuletide holidays, on spokesperson Edwin Lacierda who said the Why does the RA 10354 need IRR? the first working day of the 2013 (January government will observe the halt order. The IRR defines the mechanisms, 2), the same day that the law was published "We are confident that the processes and responsibilities for the in two major dailies, the first petition government will be able to defend the application of the Law to concrete programs. was filed before the SC seeking to bar its merits of the Responsible Parenthood Law," implementation, saying that the law is he added. What is the national policy and guiding "unconstitutional." The high court did not Meanwhile. health advocates have principles on responsible parenthood act on the petition then and the law became always been saying that the goal of the and reproductive health? effective on January 17. RPRH Act is to save mothers' lives, and not • It is the duty of the Government In early 2012, the RPRH Act was to control population. And to further gain to protect and strengthen the family, and certified as urgent by the President, and understanding about the law, HEALTHbeat the right of couples to raise a family and Congress finally passed it after 14 years of reprints the following frequently asked make informed decisions about their family lobbying, discussions and debates. Now that questions on the IRR of the RPRH Act that are consistent with their preferences, the law is rearing to be implemented, it has disseminated by the DOH during the convictions and the responsibilities of been stopped momentarily. public consultations, dubbed as "Usapang parenthood.
26 HEALTHbeat I March - April 2013 • It is the constitutional duty of the on the DOH to lead the implementation, as PhilHealth will cover serious Government to protect the life of the mother well as the role of local government units and life-threatening reproductive health and the unborn. (LGUs), health professionals, barangay conditions among its benefits so the poor • The Government guarantees and health workers, as well as private and need not worry about expenses associated protects the rights of women, children and non-government health care institutions with treatment. Also, essential family families to basic health care, which includes in delivering reproductive health services, planning drugs and supplies will be included reproductive, maternal and child health. RPRH information and supplies. in government procurement. • The Government guarantees Mobile health care service vehicles universal access to reproductive health How can the DOH ensure that all have may be provided to reach remote areas, and care information and services without adequate access to family planning, access to facilities and services by persons discrimination or bias. especially the poor and those in remote with disabilities will be improved. • The Government shall promote areas? A nationwide public awareness consistent policies and programs that fulfil The DOH, with the help of LGUs, campaign on reproductive health and rights the above duties and responsibilities, giving will ensure that public health facilities at the will be launched to help the public make priority to poor client and enjoining the national, provincial, municipal and barangay informed choices. active participation of relevant civil society levels are adequately equipped to provide the organizations and interest groups. full range of safe and effective modern family Will the government force people to use planning methods as mandated by the Law. contraceptives and have fewer children? How does the IRR ensure that the law will It will ensure that emergency The government will make sure be implemented properly? reproductive health services are available 24 that people have adequate information The IRR are promulgated to hours a day. It will also ensure that public about all their options when it comes to prescribe the procedures and guidelines for health workers are properly trained and family planning so that they can decide the implementation of the RPRH Act of 2012, accredited to deliver services that protect, for themselves based on their preference. to facilitate compliance therewith, and to promote and strengthen reproductive rights Government will also ensure that the achieve the objectives thereof. to all who have unmet needs for family methods, supplies and services are available It places primary responsibility planning. to those who want them but will never force anyone to act against his/her personal convictions. The only exception is the provision of abortifacient drugs, which is prohibited; the Food and Drug Administration shall determine which drugs are abortifacient based on scientific evidence.
Will public health facilities now start performing abortions? No. Abortion is illegal under Philippine law.
Will private hospitals, health facilities and professionals be forced to provide family planning services even if they Then Health Assistant Secretary, now Undersecretary Madeleine de Rosas-Valera, head of the DOH Health Policy Finance and Research Development Cluster, being interviewed by media in one of three don’t want to? public consultations of the IRR on RA 10354 where she clarified, "The law is not to promote abortion, it The burden of responsibility to is to provide and to strengthen the rights and access to health care." provide the full range of family planning
March - April 2013 I HEALTHbeat 27 Health Secretary Enrique T. Ona (fifth from left) poses with some members of the drafting committee of the IRR of RPRH Act at the DOH Convention Hall. (Photo by Romy Caparas) services and supplies rests on government. parenthood and reproductive health resources really reach those who need However, the government will offer program. them? incentives to private and non-government If a private facility will not provide The DOH and the LGUs will monitor groups to support the responsible services and supplies on the basis of procurement, distribution and utilization of conviction, it has the duty to refer clients/ supplies using a clear set of indicators. The patients to facilities that will. responsible parenthood and reproductive KALAbeat health program will be integrated in How will information about repro- government’s anti-poverty programs to ductive health be provided to the public, ensure it reaches the targetted beneficiaries. especially adolescents? The DOH with the LGU will conduct Adolescents will be given an annual program implementation review reproductive health education through its to determine the effectiveness of the various integration in the public formal and non- interventions. It is also obliged to report formal education system. Couples will be progress to Congress annually. Congress, given responsible parenthood information for its part, will monitor implementation and instructions as a requirement for through a Congressional Oversight marriage. Committee on the RPRH Act.
Will sex and sexuality education promote What if a public health worker or health promiscuity among the youth? facility refuses to deliver informa-tion, Reproductive health education services or supplies for family planning? includes making the youth aware of the There are penalties stipulated for ATTENTION TO DETAIL risks of engaging in sexual activity, as well public officers and health care providers A simple detail can destroy as their options to protect themselves from who refuse to deliver family planning a multitude of beliefs. those risks. Education will empower them to information and services. There are also make informed choices and decisions. penalties for prohibiting or restricting If Adam and Eve others from performing these functions. were the first people on earth, Can government ensure that family Penalties include imprisonment, fines, then why do they have belly buttons? planning and other reproductive health suspension or termination from service.
28 HEALTHbeat I March - April 2013 laughter HEALS Biday KASAMBAHAY Konti Mantsa Lipstick
LITA: Marunong ka bang magwalis? DON MAC: Biday, natanggal mo ba 'yung LUZ: Biday, napansin mo ba ang BIDAY: Konti. mantsa sa barong ko? barong ni Sir mo? Lagi na LITA: Marunong ka ba maghugas BIDAY: Opo Sir, tanggal na tanggal! lang may lipstick! ng plato? DON MAC: Good! Ano pinantanggal mo? BIDAY: Opo nga Ma'am! Mukhang BIDAY: Konti. BIDAY: Gunting po! niloloko na tayo ni Sir, ah! LITA: Marunong ka ba maglaba? BIDAY: Konti. Dugu-Dugo Secret LITA: Marunong ka ba mag-plantsa? BIDAY: Konti. Kring... kriiiiiiing... JOSHUA: Mom, I know the truth... LITA: Ok. Tanggap ka na! BIDAY: Hello... ROSE: Ha?!? Heto ang P500, huwag ka BIDAY: Magkano naman po ba ang DANNY Si Sir mo ito, nabangga ako, lang maingay sa Dad mo!! sweldo ko? I need cash! JOSHUA: Dad, I know the truth... LITA: Konti! BIDAY: Aru! Dugu-dugo gang ka 'noh? JOJO: Ha?!? Heto ang P1,000 at DANNY: Biday, si Sir mo ito! huwag kang maingay sa Bitin BIDAY: Weeeh, hindi nga?!? Hoy, Mommy mo. impostor ka, para sabihin ko JOSHUA: (Okay pala ito... Subukan BIDAY: (Pinasok ang bata sa sako at sa 'yo, ang tawag sa akin ni Sir ko nga sa katulong) isinabit sa puno...) 'Yan ang ay CUPCAKE! Manang Biday, I know bagay sa 'yo! Ang kulit kulit the truth! mong bata ka! Kulasisi BIDAY: Sa wakas! Yakapin ED: Yaya, Yaya... mo ako, anak! BIDAY: Ano?!$%^# DELIA: May babae siguro ang Sir mo, ED: Yaya! laging maaga pumasok! Paalam BIDAY: Ano? Magbabago ka na? Anong oras ba siya umalis ED: Yaya, pa-swing naman ng sako, kanina? BIDAY: Ma'am, magpa- o. Please! BIDAY: Naku Ma'am, ewan ko ba d'yan paalam na po ako. kay Sir. Paggising ko, wala na Uuwi na po ako Sakit Ulo siya sa tabi ko! sa probinsya. ERMA: Nagpaalam ka na BIDAY: Ate, kailangan ba talagang Selos ba sa Sir mo? ipa-EXTRAY ang ulo ni Junior?!? BIDAY: Nauna na po EDNA: Ano ka ba naman Biday, ELLEN: Alam mo Biday, 'yang Sir mo siya. Doon hindi EXTRAY! ang daming babae! na raw BIDAY: Eh ano po ba ang tawag 'dun? BIDAY: Hay naku, si Ma'am talaga... po kami EDNA: CT SKULL! Pinagseselos pa ako! magkikita!
March - April 2013 I HEALTHbeat 29 HEALTH promotion Health Bus Tours The Department of Health's caravan is a nationwide comprehensive mothers, children and fathers. bus that travelled to 18 areas all over the and multi-channeled health promotion At eight in the morning, the entire Philippines reaching over 38,000 individuals campaign that aims to bring information and place was already teeming with people and in 2011 and 2012 has been refurbished, education to families in remote communities excitement of all sorts. renamed and relaunched on February 21. in congruent to the government’s health With their five kids in tow, Margie It is now called "Lakbay Buhay Kalusugan: reform agenda of universal access to health and Pedro Pagulayan from North East Solana Kalusugan Pangkalahatan on Wheels" and care. did not mind travelling thirty minutes on dons a more colorful theme that proudly The bus is customized with foot to the Solana Municipal Gym. Drenched showcases Filipino family values and the consultation and examination clinics and in sweat, the Pagulayans easily made health caravan’s essential services through a health promotion arena of an interactive themselves comfortable and relieved that caricatures that defy ethnic boundaries. exhibit, health classes, storytelling sessions, the place was welcoming and the team Health Secretary Enrique T. Ona and entertainment shows. of doctors, nurses, health workers and said that the health caravan will deliver For 2013, the communities to be volunteers manning the bus and exhibits the same maternal, child and family visited are: Solana, Cagayan; Santiago City, was accommodating. health components the bus is known for Isabela; Calumpit, Bulacan; Trece Martires, They said there were told about by stimulating behavior changes in how Cavite, Sta. Rosa, Laguna, Ilocos Norte, the caravan by a midwife assigned to their to embrace and practice safe motherhood, Benguet, Capiz, Iloilo, and Zamboanga barangay. “Parang fiesta, masaya,” said child care and nutrition and family planning Sibugay. Margie. But more than the festive setting, as a matter of healthy living. she said her family came to get some help for “We are not just passengers but Solana and Santiago City their children and education on health. Her the drivers in our journey to better health," husband Pedro who attended the session Ona said. He added that more than anything On February 25, the bus left the “Usapang Macho” for fathers admitted to else, the health caravan and the entire DOH Central Office compound and headed having insufficient knowledge on the basics campaign is actually about Filipinos being up north to Solana in Cagayan and Santiago of health care for his family but realized healthy in body, mind and soul. City in Isabela, and attracted 1,700 and afterwards that it is important to have a The Lakbay Buhay Kalusugan: 2,500 residents, respectively, who trooped good share of responsibilities at home. Kalusugan Pangkalahatan on Wheels is to the fiesta-themed venues to avail of “Tulad po ng tamang pagkain gaya ng gulay designed as a festive event, the health health services and education for pregnant at paghuhugas ng kamay bago kumain,” he
After the simple media launch at the DOH Central Office compound on February 21, the Lakbay Buhay Kalusugan: Kalusugan Pangkalahatan on Wheels takes off to Solana, Cagayan and Santiago City, Isabela on February 25.
30 HEALTHbeat I March - April 2013 Maternal and child health services inside the bus and health promotion exhibits, lectures and entertainment for the whole family outside the bus. said. He also added that “katuwang ng mga through a barangay nutrition scholar who lang naman maging maayos ang aking mga kababaihan ang mga tatay sa pagtaguyod ng visits houses in her barangay at least twice a anak at makapagtapos sila. Sa tingin ko po malusog na pamilya.” year to educate mothers on safe pregnancy. mahalaga ang kaaalman na binibigay ng A pregnant 37-year old Evelyn A Pantawid Pamilyang Pili- ganitong programa sa kung paano maging Jacinto who lives in a nearby barangay in pino Program’s (4Ps) beneficiary of maayos at malusog ang pamilya ko.” After Santiago brought only three of her eight the Department of Social Work and attending the safe motherhood health class, children to avail of pre-natal check-up. Development, she said her monthly P2,800 she easily shared what she learned such as She also knew of the health services being from the agency which is equivalent to four creating a birth plan, breastfeeding, taking offered by the DOH through the bus, from children below 14 years old, means a lot to heed of the food pyramid, and keeping a a barangay midwife. “Sa awa ng Diyos, her. It does not only sustain their education clean environment. magiging pang-siyam ko na po tong anak but she is able to set aside some amount The Pagaluyans and Evelyn were pero okay naman po ang kalagayan ko,” for their health and nutrition. “Malaking among the many families who spent the she said. Evelyn admits to getting regular bagay po talaga. Nakakabili ako ng vitamins. rest of the day making rounds of the series check-ups from the barangay health center Kahit papano, pati na rin masustansyang of stations while enjoying the music-and- which she learned from her past pregnancies pagkain paminsan minsan. Ang gusto ko dance entertainment that had contests in
March - April 2013 I HEALTHbeat 31 between gaps. The emcees asked questions reduced by one percent. “Kaya nga awardee written in English or Filipino. Entries in local related to the health and nutrition lectures kami in nutrition plus madadagdan pa language are accepted but must also include and the interactive exhibits and illustrations ng 5,000 Philhealth card holders from the an English translation. on tarpaulins. existing 65,000,” she said. Interested individuals must submit Solana Mayor Meynard Carag one story on health along with an entry attributed the success of his municipality’s Health Media Awards form. For print – submit the material in word health caravan to public-private partnership format and pdf version of the published and volunteerism which made the This year, as part of the Lakbay work; for radio/tv – submit an audio/video preparations easier and faster. “The support Buhay Kalusugan: Kalusugan Pangkalahatan file of the material or CD; and for online/blog of other sectors and the many volunteers on Wheels campaign, the "Parangal sa mga – submit the link and the file of the material contributed to easily mounting the entire Kuwentong Kalusugan Pangkalahatan" (word, pdf, jpg, video). A person may submit promotional health campaign. Hindi madali Health Media Awards will recognize up to five (5) applications. Entries may be ito, yung nagagawa ng months ay nagawa Manila and province-based journalists submitted via courier. Emailed submissions naming ng weeks lang,” Carag said. He from mainstream and non-traditional are also encouraged. also emphasized the importance of raising media (television, radio, print and online) Entries should be submitted on or awareness on health consistently and for excellent stories that tell of ordinary before May 31, 2013 to: Parangal sa mga empowering people to take care of their folks' strides in making a health-conscious Kuwentong Kalusugan Pangkalahatan, health. “Kahit walang LBK, dapat tuloy tuloy community and healthy family. A special c/o Probe Media Foundation, Inc., 116 ang pangangalaga ng kalusugan sa bayan prize for bloggers will also be given. Maginhawa Street, Teacher’s Village East, namin.” Entries should fit the following Quezon City 1101. For details, email Mayor Amelita Navarro of Santiago criteria: focused on various issues related
Photo by Joerem P. Ceria their struggles and little successes in life, our friends in the media will be powerful instruments in getting the message across. Needless to say, we should have healthy citizens to be able to build empowered communities.” The Lakbay Buhay Kalusugan: Kalusugan Pangkalahatan on Wheels is an initiative of the DOH through the National Center for Health Promotion. The Probe Media Foundation, Inc. provides technical assistance in the project implementation. Partners such as Victory Liner, Alliance Catch HEALTHbeat Online of Young Nurse Leaders and Advocates International Inc, Philippine Press Institute
March - April 2013 I HEALTHbeat 33 child reach their fullest potential, starting in the sense that rarely would tooth decay on infant oral health care and advise on with a child’s good health. We all play a vital contribute directly to death. However, its exclusive breastfeeding. Preschoolers are role in nurturing children’s health whether or chronicity is insidious and does not sound provided with toothbrushing drills while not we are parents. Indeed the responsibility any alarm until it cause them significant dental sealants and fluoride therapy are of child care is primarily in the hands of pain, disfigure their face and distract them provided to school children and curative mothers and fathers. But every child belongs from eating and from productive playing services to adults. to a community. So, each person in the and learning. The child affected with such However, Ona appealed to community has to keep his community a handicap becomes withdrawn and avoids communities and schools to integrate dental safe place for children to live in." socializing with people and so lessens his care programs, to make sure the availability opportunities for advancement. More critical of logistics, specifically toothbrush and Orally Fit Communities is the effect of poor or defective teeth to toothpastes and preventive supplies such and Day Care Centers overall nutrition to maintain good general as sealants and fluorides, constant source health that begins with the first bite and of water that is safe for toothbrushing and This year, the "orally fit child," chewing the food efficiently. sink for handwashing. He also added that a component of GP program was also Ona said the national oral health the prohibitive cost of dental services is highlighted in the awards. program has been providing promotive, obviously one potent barrier in the fight to An orally fit child is one who has preventive and curative dental health care have a good oral health for children. healthy gums, no dental caries, and no through package of essential basic oral Great efforts are now being dental plaque, among others. An essential health care across all ages. Newborns are done to address these problems. The component of the orally fit child program provided with dental check-up as soon as Departments of Health, Social Welfare for under-six children is the Oral Hygiene his first tooth erupts and health instructions and Development, Education, the Interior Program as it recognizes that oral hygiene is a basic personal Orally Fit Community Orally Fit Day Care Center measure to prevent and control I Rosales, Pangasinan Don Dimas Querubin Day Care Center, Caoayan, Ilocos Sur tooth decay and gum disease. It includes, among others, II Alicia, Isabela Burgos Day Care Center, Alicia, Isabela teaching children in daycare III Bulakan, Bulacan San Jose Day Care Center, Bulakan, Bulacan centers regular and proper IV - A Tayabas, Quezon Sitio Felix Day Care Center, Landicho St. Felix Cainta, Rizal tooth brushing techniques. IV - B Boac, Marinduque Brgy. Mainit Day Care Center, Boac, Marinduque Unfortunately, Ona said, the oral health picture V Ligao City, Albay Poblacion District 2 Day Care Center, San Jacinto, Masbate of Filipino children is quite VI New Lucena, Iloilo Brgy. Bita-og Gaja Day Care Center, New Lucena, Iloilo disturbing. Nine (9) out of 10 VII Duero, Bohol Camudlas Day Care Center, Bindoy, Negros Oriental of our six-year old children VIII Ormoc City, Leyte Malibago Day Care Center, St. Bernard, Southern Leyte are unnecessarily suffering from tooth decay and other IX Polanco , Zambo del Norte Labrador Day Care Center, Polanco Zamboanga Del Norte dental ailments. The epidemic X Lagonglong, Misamis Oriental Benoni Daycare Center, Mahinog, Camiguin of tooth decay continues to go XI Davao City Mintal Day Care Center, Barangay Mintal, Davao City unchecked leading to millions XII Malapatan, Sarangani Province Liberty Day Care Center, Liberty Tampakan, South Cotabato of school hours lost among our school children and surely to NCR Quezon City Belmonte Day Care Center, Sampaloc, Manila more productive days wasted CAR La Trinidad, Benguet Banaao Day Care Center, Tadian, Mt. Province during their adult years. CARAGA None Poblacion Barobo Day Care Center, Barobo, Surigao del Sur The child with an oral ARMM Wao, Lanao Del Sur Kasalamatan Day Care Center, Jolo, Sulu health problem is complacent
34 HEALTHbeat I March - April 2013 E, Folic Acid, Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B6, Iron, Iodine, Copper, Zinc, and Selenium. It is easy to use as can be mixed in any household food being given to children, and it will not change the taste of the food. The distribution of Vita Mix is now a part of the GP program. According to WFP Representative Dipayan Bhattacharyya, the use of the micro- nutrient powder has been proven effective to reduce anemia and other micronutrient deficiencies in several countries like Indonesia, Nepal and others. He added that the first Philippine experience of the Health Secretary Enrique T. Ona receives from Dipayan Bhattacharyya of the World Food Programme micronutrient powder supplementation was the symbolic pack of Vita Mix or micronutrient powder for home fortification that will become part of in 2010 for the children in Typhoon Ondoy- the GP program. (Photo by Romy S. Caparas) affected areas. The powder was then named and Local Government, local governments in each region which provided outstanding VITA SANGKAP. Another supplementation and non-government organizations came work performance, contribution and project was done under the Millennium out with initiatives to achieve sustainable achievement in the promotion of oral Development Goal Achievement Fund for improvements in our country’s oral health health were given due appreciation and nutrition was done in Zamboanga City specially to lower the prevalence of tooth recognition. They received P50,000 cash and Aurora, Zamboanga Del Sur using the decay among under-five children. This is prize and a plaque. product name VITA NUTRIENT MIX. the Orally Fit Child program which was Bhattacharyya also revealed a launched in 2011 as a nationwide campaign Vitamins & Minerals Supplementation study made in Misamis Oriental where to highlight the importance of proper about 60% of anemia reduction was found behaviors to maintain optimum oral health The GP Awards this year also and that the success was credited to the to under-six children. recognized as special awardees three functionality and commitment of LGU health The goal is to make every child in municipalities with the most improved and nutrition workers. communities caries-free by age six and every vitamin A supplementation coverage. They The outcome of these micro- child growing well into their adult years received P20,000 and a plaque. nutrient powder projects were achieved free from all sorts of dental problems. One Also, the Awards ceremony served together with DOH, National Nutrition strategy is that LGUs and other stakeholders as a venue for the World Food Programme Council (NNC), Helen Keller International, are empowered to develop their own (WFP) to symbolically hand-over to the and the LGUs. strategies unique to their communities and DOH the Vita Mix – a vitamin and mineral For the nationwide GP program, be responsible for finding local solutions to supplement in powder form for children 6 a new name and design "Vita Mix" were attain the highest percentage of orally fit to 24 months old that will help boost the crafted for better acceptance by mothers children in their schools and communities. immune system of children. Vita Mix has and guide them on how to properly use the Thus, in the GP Awards, the one 15 vitamins and minerals like Vitamin A, product. orally fit community and one day care center Vitamin B12, Vitamin C, Vitamin D, Vitamin - o O o -
DAD: Gabi na! Bakit ngayon ka lang umuwi? Busy ANAK: Dad, not now please. Im tired. Dami projects, dami events sa school, nag-meeting pa kami with the teachers. Me... DAD: Magtigil ka nga! KINDER ka pa lang!
March - April 2013 I HEALTHbeat 35 school HEALTH
Anna Dominique Coseteng, president and CEO of Diliman Educational Corporation and Health Secretary Enrique T. Ona (seated, center and right) sign a Memorandum of Agreement for a Health Promoting School Initiative while faculty and students of Diliman Preparatory School look on. (Photo by Romy S. Caparas) Health Promoting School The Department of Health, and maintenance of adequate health attitudes and practices; through the National Center for Health services and involvement of the family and • Health and Nutrition Services Promotion, and the Diliman Educational community.” or appropriate interventions designed to Corporation (DEC) that runs the Diliman Under the MOA, the DOH and the improve health and nutritional status of the Preparatory School, a private school in DEC will collaborate to apply the following school population; and Quezon City, forged a Memorandum of implementation approaches and strategies: • School Community Partner- Agreement (MOA)on February 21 to effect • Healthful School Living or ship or a coordinated endeavor to link the the first Health Promoting School initiative. the provision of wholesome healthy and school with home and community so that Health Promoting Schools, as safe environment, harmonious relationship there is an effective carry-over of health defined by the World Health Organization, among the school staff, teachers to pupils, and nutrition practices learned in school to “is a place where all members of the school pupils to pupils, teachers to parents, and home and community. The involvement of community work together to provide school to community as a whole; the community will compliment the school students with integrated and positive • Health and Nutrition Educa- financial and human resources for effective learning experiences, which promote and tion which pertains to the learning and efficient school health promotion. protect their health, and includes formal experience such as formal and informal The DEC is headed by its President and informal health curricula, safe and teaching directed towards the development and Chief Executive Officer Senator Anna healthy school environment, promotion of favorable health and nutrition knowledge, Dominique M. Coseteng.
36 HEALTHbeat I March - April 2013 injury REDUCTION Paputok Summit calls for Culture Change by ANTHONY R. RODA, MaHeSoS HEALTHbeat Staff
For three years in a row, the the barangay level, the Departments of Secretary Enrique T. Ona read by Health Department of Health gathered various Health (DOH), Education (DepEd), Trade and Undersecretary Teodoro Herbosa, the DOH stakeholders to a Firecracker/Fireworks- (or Industry (DTI), Environment and Natural considered the paputok-injury reduction what is collectively termed as "Paputok-") Resources (DENR), the Interior and Local campaign as its year-ender and year-opener Related Injury Summit on February 27 in Government (DILG), Social Welfare and campaign. For 21 years now, the DOH has Manila. Its purpose is to evaluate the extent Development (DSWD), Philippine National tried to address the problem of paputok of injuries, assess issues and concerns in Police (PNP), Bureau of Fire Protection injuries, and it never ran out of creative our program implementation, and come up (BFP), Philippine Information Agency, Metro ideas to remind people to be safe during the with new strategies and approaches for the Manila Development Authority (MMDA) holidays – from teaching the public how to coming years. Ecowaste Coalition, media and even the handle and use paputok properly, to using Among those who attended were: fireworks industry. scare tactics by showing hospital equipment Metro Manila local governments down to According to the speech of Health in cutting fingers and limbs and gory pictures of victims, and later changing the messages using the more positive approach by advocating a community fireworks display, using alternative noise-making materials and doing other merrymaking activities, and even dancing the Gangnam Style in greeting the New Year. Herbosa added, "We even prayed that it rains on New Year’s Eve because there was a year when cases significantly went down because it rained a few minutes before midnight." Although the DOH had brought the cases down in the early years of the campaign, the number of cases in recent years has been observed to have reached its plateau, just like in the surveillance of other diseases. "Maybe this is the right time for culture change," Health Undersecretary Teodoro J. Herbosa speaks in behalf of the Last year, there was a modest 9% Department of Health. (Photo by Paking Repelente) drop in the number of injuries
March - April 2013 I HEALTHbeat 37 Representatives from various agencies involved in Aksyon Paputok Injury Reduction (APIR) advocacy campaign (left) answer questions and hear recommendations from the audience (right). (Photos by Romy Caparas) compared to the figures during the same injury; safety seminars for the paputok period in the previous year, however this • Amend Republic Act 7183 (An Act industry and police and fire officers by decrease was not significant compared to Regulating the Sale, Manufacture, the DTI, PNP and BFP; the five-year average. Distribution and Use of Firecrackers • Early conduct of health education The DOH said that behavior and Other Pyrotechnic Devices) to: classes and public awareness activities change communication approaches and - delist kwitis, watusi, small on the harmful effects of the use of activities may no longer be enough because trianggulo, El Diablo (labintador) paputok for schoolchildren and out- the most affected population group are and whisle bomb as legal fireworks; of-school youth by the DepEd, DSWD, the 6 to 10 years old who are too young to - include a provision in the law DOH, PIA and MMDA; make informed and right choices that will for safety measures of workers • Monitor air quality from DENR Metro affect their health and life. Thus, the DOH engaged in different stages of Manila stations and release reports on is now calling for a "culture change" by manufacture to prevent undue particulate matters from air pollution highlighting the role of policymakers. This exposure to occupational/health caused by the use of paputok; means implementing what is termed as hazards that may be encountered • Continue public awareness campaign “downstream” interventions which include by workers in the fireworks on the toxic chemicals of, and health legislation, regulation, fiscal incentives, and industry; hazards of air pollution caused by information provision, as well as “upstream” - include a provision in the law that paputok by the Ecowaste Coalition; interventions, such as parenting, peer and specifies the role of the Bureau of • Continue and expand surveillance of mentoring programs, or development of Customs in conducting monitoring cases of respiratory problems during social and community networks. and surveillance activities in New Year’s Eve celebration by the DOH; At the end of the Paputok-Injury relation to smuggling/illicit trade • Enjoin all private hospitals to actively Summit, the following recommendations of imported fireworks and other participate in paputok surveillance; were reached: pyrotechnic devices; • Conduct study to determine the • Ban on the residential use as well as • Reassess the safety of the so- knowledge, attitudes and behaviors of retail selling of paputok; called “legal” firecrackers/fireworks, Filipinos on the use of paputok during • Total gun ban during the holiday particularly by DTI; New season; • Strict enforcement of the ban on • Officially create and hold regular • Shift to local government-led piccolo as well as the indiscriminate meetings of the multi-agency task community fireworks display; use of guns by the PNP and local force for planning and implementation • Hold parents accountable if their government units; of paputok injury prevention. children become victims of fireworks • Continuous conduct of fireworks - o O o -
38 HEALTHbeat I March - April 2013 disease SURVEILLANCE NEUROCYSTICERCOSIS When Worms from the Meat You Eat Get into the Brain by GLEN S. RAMOS HEALTHbeat Staff An unusual case occurred on were assumed as one of the reasons for the inside the body. It can grow in a number of January 23, 2013 when a 24-year old female Islamic dietary prohibition of eating pork. tissues located in the central nervous system was rushed in one of the hospitals in Metro And in the 1850s, German investigators first and can cause neurocysticercosis. Manila complaining of headache, fever, illustrated the life cycle of Taenis solium. In 1993, the International Task nausea, vomiting and left-sided weakness. In the Philippines, neuro- Force for Disease Eradication stated that She was diagnosed and found out to be cysticercosis is not included in the DOH theoretically, the disease can be controlled suffering from neurocysticercosis. disease surveillance and monitoring report and preventable, however it still remains to The case was reported by the which makes the total number of cases be one of the neglected parasitic infections Event Surveillance and Response Unit difficult to determine. as of this day. of the Department of Health-National Mapue defined neurocysticercosis The tapeworm that causes Epidemiology Center to the Regional as the most common parasitic disease of cysticercosis is prevalent in Latin America, Epidemiological Surveillance Unit (RESU) of the nervous system and the main cause of Asia, and sub-Saharan Africa. In the United the Center for Health Development National acquired epilepsy in developing countries. It States, there are about 1,000 new cases Capital Region (CHD-NCR) that promptly is caused by a pork tapeworm called Taenia of cysticercosis diagnosed yearly. It is the coordinated with the admitting hospital and solium. The cysticerci (larval cysts) develop leading cause of onset-seizures in adult the Manila City Health Office. According to RESU Chief Dr. Manuel C. Mapue, the city health office immediately conducted investigation and sanitation teams were dispatched to inspect vendors selling barbeque in the area of Sta. Mesa, along the Light Railway Transit (LRT)- Line 2, where the victim frequently bought the isaw, barbequed pig intestines usually soaked in a sweet and sour sauce. The inspection team found no vendors as they are reported itinerant. A case of neurocysticercosis case was also reported by the Philippine Daily Inquirer last December, the victim was Cebu traffic chief Sylvan Jakosalem. According to the report, the disease dates back during the Egyptian times 2000 B.C. It is also later Media are certainly interested in stories like neurocysticercosis. Photo shows Dr. Manuel C. Mapue, chief described by Aristotle as prevalent in pigs. of the Regional Epidemiological Surveillance Unit (RESU) of the DOH Center for Health Development- Muslim physicians also recognized it and National Capital Region (CHD-NCR) being interviewed by media. (Photo credits: Rodel Recio Fotograpix)
March - April 2013 I HEALTHbeat 39 globally. According to Mapue, the latest victim of neurocycticercosis is fond of eating pork barbeque sold by ambulant vendors. “We have to assume that the meat being peddled was infected with tapeworm and may also be improperly handled and undercooked. Improper food handling is a major cause of infection,” he stated. In Metro Manila, precooked pork meat like barbeques and isaw are openly sold on streets usually along populated areas. After the infected pork meat was ingested, the tapeworm inside the body hatches eggs. Once these microscopic eggs are exposed to the gastric acid in the stomach, their protective capsule will be dissolved, they will turn into larval cysts. These larvae will eventually find their way into the brain where they can cause severe infection. “The larvae in the brain may stay for a long period of time and may remain as a cyst until removed. If the infection in the brain is severe, brain surgery will be needed”, Mapue added. Neurocysticercosis are often Life cycle of Taenia solium with resulting cysticercosis. (Illustration courtesy of the US (Centers for spread through food, water, or surfaces Disease Control and Prevention) contaminated with infected feces. It can also spread through direct contacts from Symptoms of cysticercosis may number of cysticerci. Some persons may infected persons. “The best thing to do is to develop from several months to several never develop any symptoms at all. practice proper hygiene. Always wash hands years after initial infection. A victim may A complication that may arise with soap and water to avoid contracting or suffer from headache, vomiting, weakness includes seizure, stroke, change in vision and spreading infection,” Mapue reminded. or numbness depending on the location and even death. chat ka pa...
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40 HEALTHbeat I March - April 2013 eye HEALTH Sty in KULIT the Eye There’s a stigma attached to having kuliti may also arise from an infected hair not squeeze or puncture the kuliti because a “kuliti” (hodeolum or sty) in the eye, and that follicle at the base of an eyelash. However, more serious infection may occur as a result. is having a habit of secretly sneaking and in most cases, kuliti is caused by bacteria, Antibiotic ointments and/ maliciously looking on somebody’s private most commonly Staphylococcus bacteria, or steroid ointments sometimes are parts. In other words, you are a “Peeping frequently found on the skin. prescribed to treat kuliti. Over-the-counter Tom.” Well, there might be a medical basis Kuliti is harmless in the majority pain medications may be used to alleviate on this accusation as you might be putting of cases, and it ruptures on its own within pain and tenderness. Contact lenses and your eye in dirty peepholes as you sneak a few days to a week, leading to relief from eye makeup should never be worn during and peek, but not all who gets kuliti are sex symptoms. It often recurs, but it does not treatment. maniacs. cause damage to the eye. Kuliti is sometimes It is always better to consult an People of all ages can develop confused with a chalazion which is a form ophthalmologist to prescribe you the right kuliti, and men and women are equally of scarring of the glands in the eyelid that treatment, and especially if any of the affected. There is a slight increase in the may include the formation of cysts. It is the following problems occur: the eye is swollen incidence of kuliti in people in their 30s to most common complication that develops shut; redness appears around the entire eye; 50s. People with certain chronic conditions from kuliti. A chalazion is usually painless any change or disturbance in vision; swelling (diabetes mellitus, chronic blepharitis or and may already require medical or surgical that lasts for more than three weeks; inflammation of the eyelid, seborrhoea or treatment. bleeding; falling out of eyelashes; the kuliti is chronic inflammatory skin disorder, and The first signs and symptoms of located on the bottom eyelid, near the nose; other chronic debilitating illnesses are more kuliti are usually redness, tenderness, and pus or thick discharge continues to drain prone to develop kuliti than the general pain in the affected area. The eye may feel from the eye; excessive persistent tearing; population. In many susceptible people, irritated or itchy. Later signs and symptoms and fever higher than 380C. stress seems to trigger the development of may include swelling, discomfort during Nobody can completely avoid kuliti. Studies have also shown that those blinking of the eye, watering of the eye, and getting kuliti, but good hygienic practices, who have high levels of blood lipids (fats) sensitivity to light. A common sign of kuliti including proper hand washing, can are more susceptible to blockages in the oil is a small, yellowish spot at the center of help prevent all forms of infection. Other glands, including the glands of the eyelid the bump that represents pus rising to the measures to prevent kuliti include: not and are, therefore, more likely to develop a surface. sharing cosmetics or cosmetic eye tools, kuliti. The application of a warm like eyelash curlers or combs, with others; Kuliti is a tender, painful red bump compress or warm washcloth to the affected keeping eye tools clean; discarding old or located at the base of an eyelash or under or area for 10 minutes, four to six times a day, contaminated eye makeup; keeping all inside the eyelid. It results from a localized can speed rupture of the kuliti and aid in the cosmetics clean; and not touching the eye infection of the glands or a hair follicle of the relief of symptoms. You can also gently scrub and surrounding areas. eyelid. It results from an infection of the oil the eyelid with tap water or with a mild, And don’t peek at other people’s (meibomian) glands of the eyelid that help non-irritating soap, or baby shampoo may private parts not because you may get kuliti, to lubricate the eyeball. The infection occurs also help with drainage. Close your eyes as but because you may just get caught and go after these glands have become clogged. A you scrub so you do not injure your eyes. Do to jail. Hahaha.
March - April 2013 I HEALTHbeat 41 men's HEALTH MANSCAPING Dare to Go Bare, Guys! by DONATO DENNIS B. MAGAT HEALTHbeat Staff
Dare to go bare, guys? Try A lack of pubic hair does not, to reduce hair permanently but settings manscaping! in itself, affect health, but the method of for IPL machines must be tailored fit to the Manscaping is the modern term hair removal can affect health, particularly patient. If not properly done, the skin can for the removal of unwanted or unsightly among those with a weakened immune get burned causing hyper-pigmentation hair in any part of the man's body and by any system. In trimming pubic hairs, it would or darkening of the skin. Skin infection can way – shaving, waxing, plucking, laser hair be best to use a shaver/razor specifically occur as well. Caldoza-De Leon cautioned removal or electrolysis. This new trend has designed for the job. But before shaving, that one should always consult a licensed become a central issue in men’s grooming, cut the hair short first by using scissors. And dermatologist, especially on the use of IPL. fashion, and even health and hygiene. remember, the skin in the genital area is far What once was the concern of too sensitive, thin and stretches easily. Small Removing Body Hair: bodybuilders, models and porn stars is now a skin tears can become an entry point for A Personal Preference question every man must consider. To shave sexually transmitted infections. Moreover, or not to shave? growing the pubic hair out again will be an Chest hair is the most common itchy experience. hair that is removed. It does not only make Shaving the Pubic Hair Dr. Risa Caldoza-De Leon, a a man younger but also more comfortable, diplomate of the Philippine Skin Healthy especially during hot summer months. Some Manscaping is usually attributed Physicians and the Philippine Academy women may pretend to like some chest hairs to the removal of pubic hair. Pubic hair is an of Aesthetic and Age Management, Inc., on men but rubbing these chest hairs with important marker of puberty, and signifies said trimming men’s pubic hair is not new, their body during intimate moments may a transition toward adulthood. There is a lot either here in the Philippines or abroad. spoil the fun and excitement, as these hairs of debate about the actual function of pubic She said that in the US and other European can bring itchiness and irritation. hair (like cushioning, warmth, catching dust countries, shaving it all off is popular, but in Trimming chest hairs can be done or bacteria) but no real conclusion. the Philippines, it is not that popular. with scissors or razors, but using a beard Pubic hair trimming is said to Caldoza-De Leon said that about trimmer is more recommended. Caution have some advantages. Men feel more five or six years ago when waxing became must be observed when trimming on the comfortable without those extra hairs, and a common to remove hair, some Filipino nipple area, as some inexperienced men shaved regions reduces heat and sweat and men would avail of the service, but when accidentally cut themselves. Waxing is also also eliminates hair rubbing against briefs dermatology clinics started offering intense a better way to trim chest hairs, although or boxer shorts which oftentimes causes pulse light (IPL) hair reduction, a rise in the some men may look at the process as too discomfort. Then, there is the visual effect: number of men who want to go bare has feminine. the penis look bigger, cleaner and more been observed. Aside from chest hairs, back hairs desirable. IPL is a safe and effective method are also removed by men. The process of
42 HEALTHbeat I March - April 2013 removing back hairs is the same as removing hair. chest hairs but this should be done by In 2003, shaving company Gillette somebody because it is very tiresome, if found that one in every three men shave not impossible, to rid yourself completely of hair under their arms, backs, chests, or back hairs. groin area. Gillette capitalized on this new Even eyebrows can be trimmed phenomenon in a video dubbed as “Go but should be done by professionals in the Further With The World of Body Shaving”. barber shop or parlor in order to arrive with Gillette further revealed that men a neat trim. wanted affirmation that the behavior is Another hair that needs constant masculine, that there are benefits in doing and regular trimming is the nose hairs. manscaping, and that they want to know There are specially-designed nose trimmers how to do it correctly and comfortably. available in the market. Some men may not In their video series, removing hair be aware of this unsightly hair coming out in the underarms is followed by a caption “An of their nostrils. It is good grooming to keep empty stable smells those nose hairs on check. better than a full "Removing body hairs is a personal one,” in the chest preference," Caldoza-De Leon emphasized. area – “Sweaters are meant to be About Manscaping bought, not g ro w n”, There is no exact date when and down manscaping started but it would interesting under – to know that a 2008 study conducted by researchers at Flinders University in Australia concluded that “hairlessness is rapidly becoming a component of the ideal male body”. Of the 228 heterosexual males who participated in the anonymous survey, 66% said they had removed their pubic hair at least once, in comparison to 82% of homosexual males. Also, a 2005 study published in the journal Sex Roles, it was found out that 63.6% of 118 men at the University of South Florida said that they have trimmed or removed body hair to be hygienic and “Wherever attractive. there’s no In Caldoza-De Leon’s practice, underbrush, the tree about 60% of women shave their armpits, looks taller”. about 20% pluck, and another 20% wax Because of the growing their armpits. About 30% shave their legs madness to remove unwanted hair and only about 10% shave their pubic body hairs, manscaping equip- hair. Among men, about 10-15% of men ment has become a vital shave their chest hair, legs hair and pubic tool. A dedicated razor and shaving cream or gel is very important. This Some women shave their heads for body hair of patients is also a move to equipment can now be bought at the health cultural or social reasons. A small number of eradicate lice, fleas or other parasites and to and beauty section of some department Western women also shave their heads either minimize body odor due to the accumulation stores or even supermarkets, alongside hair as a fashion or political statement. In India, of odor-causing microorganisms in hair. gel, beauty creams, and other pampering tradition requires widows in some sections Many cancer patients shave their heads products. of society to shave their heads although the before starting a chemotherapy session government and society are now working because chemotherapy will result to Why Men Shave to end the practice of ostracizing widows. irregular or severe hair loss. Moreover, it is a common practice for both In the military, a short-cropped or Aside from vanity and hygiene, men and women to shave their heads prior completely shaven head will make it hard for there are other reasons why men shave to embarking on a pilgrimage. an enemy to grab or hold him during hand- unwanted hairs. These reasons ranged Head shaving can also be a part to-hand combat. A short hair also makes from cultural, religious, medical, military of Christian, Buddhist or Hindu traditions. fitting gas masks and helmets easier. requirement, or as a form of punishment. Buddhist and Christian monk usually under- In sports, it is a common practice Exposure of body hair other go some form of head-shaving during their for professional and amateur cyclists to than head hair, eyelashes, and eyebrows induction into monastic life. In Thailand, remove hair legs in order to clean wounds in several societies is generally considered monks shave their eyebrows. Brahmin efficiently in case of road crash. Also, to be unaesthetic, undesirable, and children have their heads shaved as a ritual legs without any hair reduces friction embarrassing. In Middle Eastern countries, before beginning school. In Judaism, there is and increases comfort and effectiveness removal of female body hair is considered no obligation for men to remove their hair, during massage which professional cyclists proper hygiene. however, there is a prohibition for men using regularly gets. Professional swimmers also In the United States, a vast razor to shave their beards or sideburns. shave their leg hairs in order to propel them majority of women regularly shave their The Sikhs, on the other hand, faster under water. armpits, legs, while about also a half shave opposes all forms of hair removal. To them, Shaving one’s head hair can also be their bikini lines. However, some women in the maintenance and management of long a punishment or a form of humiliation. After Western cultures choose not to remove body hair is a manifestation of one’s holiness. World War II, head-shaving was common in hair, either as personal preference or as an Ancient Egyptian priests shaved their bodies France, Netherlands, and Norway for women act of defiance against what they regard to daily in order to present a “pure” body before who had collaborated with the Nazis and be as an oppressive ritual. the images of the gods. for women who had sexual relations with Some men shave their heads as Sometimes, shaving body hair soldiers. In Arab countries, shaving off head a fashion statement or because they find a may be due to medical reasons. Before hair is sometimes used to humiliate male shaved head preferable to the appearance of any surgery, body hair of patient near the prisoners. Convicted inmates also have their male pattern baldness. operation site must be removed. Shaving heads shaved upon entry at certain prisons. kalbo... Q. Bakit hindi dapat magsuot ng turtleneck ang kalbo? A. Kasi magmumukha siyang ROLL ON. Q. Bakit hindi pwedeng magsuot ng hair net ang kalbo? A. Kasi magmumuka siyang MICROPHONE. Q. Bakit hindi pwedeng maligo nang sabay-sabay ang mga kalbo sa isang jacuzzi? A. Kasi magmumuka silang nilulutong FISHBALLS.
44 HEALTHbeat I March - April 2013 infectious DISEASE Sustaining the Fight Against
LEPROSYby ELIZABETH G. MASCAREÑAS, RN, MPH HEALTHbeat Staff Still Detecting New Cases
Leprosy is a chronic infection of the nerves with skin manifestations and also known as Hansen’s disease, with local terms as “ketong," "sanla," or "kulion.” While leprosy has been eliminated as a public health problem at national level in 1998, there are still some areas in the country where new cases are being detected. Dr. Belen Lardizabal-Dofitas, vice- president of the Board of Trustees of the Philippine Leprosy Mission said, “It may be one of two things – the country really has more cases than other countries or we are more active in finding cases.” The detection of new cases is actually an indicator of the degree of Public and private sector stakeholders converged in Coron, Palawan. Photo shows representatives from implementing leprosy control. The number the Department of Health, Novartis Foundation for Sustainable Development, Novartis Healthcare Philippines and World Health Organization. of new cases is not significantly declining worldwide, and it is not just the Philippines country where we have not yet achieved meeting for leprosy control in Coron, Palawan that is experiencing this trend. their elimination target, that is why we have during the observance of World Leprosy Day Dofitas added, “There must be to continue all efforts to control the disease. on January 29. It also became the venue to another factor in play which is actually Leprosy is a slow growing bacillus making it launch the “Best Practices and Innovative causing new cases to rise. And we always more difficult to control, Dofitas concluded. Ideas in Fighting Leprosy Contest.” And on look at new cases detected as a sign that the March 18, the winners were announced and control or the transmission of the diseases The Fight Against Leprosy Continues awarded during DOH Central Office regular still has not been controlled.” She added that flag-raising ceremonies. aside from finding new cases, they are also In order to sustain the fight Health Secretary Enrique T. Ona looking on how many children are infected. against leprosy in low endemic areas and explained that the contest aims at sustaining If there are still many children prevent the reemergence of the disease, the fight against leprosy in the post- below 15 years old being detected with the the Department of Health and Novartis elimination phase. He said, “Although the disease, then that is a sign that the leprosy Healthcare Philippines in partnership with Philippines has met the elimination target control measures are not yet enough. the Novartis Foundation for Sustainable of a national leprosy prevalence rate of less “There are some more areas in the Development organized a multi-stakeholder than 1 in 10,000 population, there are still
March - April 2013 I HEALTHbeat 45 areas in the country with relatively higher and treatment, monitoring and evaluation, Institute for Tropical Medicine Department prevalence rates of the disease.” and media coverage and updates. First of Dermatology’s poster on “A Model for On the other hand, Thomas implemented in early 2007, the campaign Sustainable Actions Towards Leprosy Weigold, country president and managing was collaboration between the Local Elimination” received special citation. director of the Novartis Healthcare Government Units (LGUs) of the three The panel of judges is composed of Philippines, said, “New challenges in cities; DOH Center for Health Development DOH Assistant Secretary Paulyn Jean Rosell- leprosy control have emerged that require (CHD) Northern Mindanao; World Health Ubial, WHO Representative Dr. Woo-Jin Lew innovation. Novartis is privileged to work Organization (WHO); national and local and Novartis Foundation for Sustainable with the DOH in seeking effective approaches media; and community members. Development Corporate Responsibility and novel ideas that can overcome these “Mobile Teledermatology Adviser Dr. York Lunau. challenges and prevent reemergence.” E-Referral System for Active Case Finding The contest which was opened of New Leprosy Case” aims to enable Novartis Long-Term Commitment to organizations and individuals working midwives, nurses and physicians in rural on leprosy control has two categories: Best areas to refer suspected leprosy cases Christine Fajardo, corporate affairs Practices (ongoing or completed projects) by using a mobile phone to photograph and market access director of the Novartis and Innovative Ideas. Three winning entries skin lesions and send such pictures and Healthcare Philippines, said “Novartis and per category were chosen. For the Best patient details via MMS (multimedia the Novartis Foundation for Sustainable Practices category, the best entry won messaging service) and SMS (short Development have a long-term commitment P100,000 while the second and third best message service). It was conceptualized by to leprosy treatment and control. We are entries received P40,000 and P20,000, MetaHelix, a local technology company with working with the DOH in developing and respectively. For Innovative Ideas category, extensive expertise in health information implementing a leprosy post-elimination the best entry won P15,000 while the second management systems, electronic patient strategy as part of the broader national and third best entries received P10,000 records, software development, telehealth, leprosy control program.” and P5,000, respectively. The criteria for public health information systems, and Two of the three drugs used in judging included: impact on beneficiaries, disease surveillance systems. multi-drug therapy (MDT) were developed innovation, and sustainability; potential for Other winners in the Best by Novartis in the late 1970s. Since 2000 replication; and overall quality and scientific Practices category were: “Best Practices Novartis, through WHO, has donated more validity. of Western Visayas Sanitarium in Fighting than USD77 million worth of MDT to help There were a total of 35 contest Leprosy” (Silver Award) and the Philippine cure approximately 5 million leprosy patients entries (19 for the Best Practices category Leprosy Mission’s “Partners in Leprosy worldwide. Novartis has supplied around and 16 for the Innovative Ideas category), Action” (Bronze Award). The runners-up 50,000 MDT courses to the Philippines. and a collaborative community-based in the Innovative Ideas category were: “All The high-quality MDT drugs are currently campaign in Northern Mindanao and a for Juan, Juan for All” of the Jose Reyes produced by the generic arm of Novartis, mobile phone-based referral system won the Memorial Medical Center’s Department of Sandoz, and made available for free by Gold Award for Best Practices and Innovative Dermatology (Silver Award) and a P10,000 Novartis. Ideas, respectively. cash prize in the Innovative Ideas category; Dr. Francesca Gajete, DOH “Modified Leprosy Elimination and “Mobile Phone for Dermatology: Handy national leprosy control program manager, Campaign in Three Cities of Northern Tools for Leprosy Control” of the Philippine explained that the MDT, the highly effective Mindanao” reduced the prevalence rate of General Hospital’s Section of Dermatology, standard leprosy treatment recommended leprosy in the cities of Cagayan de Oro, Iligan and “Utilizing the Nursing Process in Fighting by the WHO since 1981, interrupts disease and Oroquieta through active case detection Hansen’s Disease” by Garey Joseph Geneta transmission with the first dose, cures and standard treatment. Key actions of (tied for the Bronze Award). patients and prevents disabilities. The MDT the campaign include disease mapping, Meanwhile, Ethan Rosca, a 12-year consists of three drugs: dapsone, rifampicin advocacy and information dissemination, old high school student initiative on “Leprosy and clofazimine. community mobilization, case detection Awareness Campaign” and the Research - o O o -
46 HEALTHbeat I March - April 2013 HEALTH partners Public-Private Partnership in Action DOH-MSD-Zuellig No Mother Should Die Giving Life reduce maternal mortality in the country. health, public-private partnerships like this The MSD for Mothers and ZFF Community would enable us to combine our resources Every mother’s death is a human Health Partnership: The Joint Development and deliver more impact to as many of our tragedy – and the ripple effects on her Initiative will implement the Health countrymen as possible.” family are enormous: her baby is more likely Change Model, a systematic and systemic MSD Asia Pacific President to die before the age of two and her other approach to enhance health leadership and Patrick Bergstedt said, “We launched the children are 10 times more likely to leave governance in 21 geographically isolated ‘MSD for Mothers’ program slightly more school, suffer from poor health, and die and disadvantaged areas (GIDAs) in the than a year ago in September 2011, at the prematurely. In the Philippines, 11 mothers island of Samar, Eastern Visayas. United Nations in New York. The aim of this die of pregnancy and pregnancy-related Health Secretary Enrique T. Ona very significant Corporate Responsibility causes daily. welcomed the effort of the private sector initiative is to help create a world where Global pharmaceutical company in helping reduce maternal mortality in no woman has to die from pregnancy and MSD (Merck Sharp & Dohme, also known the country. He said, “The problem cannot childbirth, and to help reduce the burden as Merck in the US and Canada) and the be solved by one party alone. Thus, in of maternal mortality globally. It is a 10- Zuellig Family Foundation (ZFF) heeded the addition to our existing health programs to year commitment in which MSD will apply call of the Department of Health to help address the country’s problems in maternal its scientific and business expertise, human,
LEFT PHOTO: Health Undersecretary Teodoro Herbosa builds up the pieces for public-private partnership. RIGHT PHOTO: Taking part in the commitment exercise are the stakeholders for The MSD for Mothers and Zuellig Family Foundation (ZFF) Community Health Partnership – (from left) Patrick Bergstedt, MSD Asia Pacific President; Health Undersecretary David Lozada, Jr.; Dr. Esperanza Cabral, former health secretary and ZFF board of trustee; Health Undersecretary Teodoro Herbosa; Ambassador Roberto R. Romulo, ZFF chairman; Dr. Jacqueline Flores-Kitong, World Health Organization; Prof. Ernie Garilao, ZFF President; Dr. Mary Ann Avalon, provincial health officer of Northern Samar; and Sanjiv Navangul, MSD Philippines president and managing director. (Photos courtesy of MSD)
March - April 2013 I HEALTHbeat 47 The Philippine team presenting one of the posters of "Babae, Mahalaga Ka!" to Health Secretary Enrique T. Ona. Shown in photo, from left are Dr. Maricar Quevedo, POGS vice president; Health Undersecretary Teodoro Herbosa; Sanjiv Navangul, MSD managing director; Dr. Raul Quillamor, POGS president; Dr. Cecilia Llave, SGOP president-elect; Health Secretary Ona; Health Assistant Secretary Enrique A. Tayag; Health Assistant Secretary Gerardo Bayugo; Dr. Rey delos Reyes, POGS immediate past president. (Photo courtesy of MSD) and financial resources to delivering life- The most current statistics shows its commitment to finding solutions to the saving solutions to women.” that the Philippines is lagging behind the health challenges we face today. We remain MSD and ZFF entered into a 3-year Millennium Development Goal (MDG) 5 committed to making our vision a reality – joint development initiative to help Samar. target with maternal mortality ratio (MMR) a world where no mother has to die giving Being the first initiative in Asia of the MSD increasing from 162 to 221 per 100,000 life,” says Sanjiv Navangul, president and for Mothers Global Giving Program, MSD live births. The program focuses on the managing director of MSD in the Philippines. is providing a Php20 million grant with a three provinces of Samar having the lowest counterpart of Php18.4 million from ZFF. human development index with MMR as DOH-MSD Cervical Cancer Advocacy “The Health Change Model follows: West Samar at 134, Northern Samar Wins Public Affairs Asia Award begins with training the local government at 89, and Eastern Samar at 110. The over- executives and health officers, empowering all MMR of Samar is influenced by the poor The Philippines recently garnered them in reforming and strengthening performances of the GIDA municipalities the Gold Standard Award for the category the local health systems and building the which the program hopes to improve. on Public-Private Partnership (PPP) given capacity of the barangay health workers and “This partnership aims to help annually by the Public Affairs Asia Network. midwives to ensure the quality and delivery the country attain the MDG of reducing The Award recognizes the long-standing of antenatal and obstetric care services. The maternal mortality. It also supports the DOH partnership between the Philippine govern- empowerment of the LGU and its people is in its vision of Kalusugan Pangkalahatan ment and the private sector regarding key to the sustainability of the program even (universal health care) and empowers Cervical Cancer Awareness and Advocacy. after the 3 years we are there,” explained local government units towards health The program entitled Babae, Mahalaga Ka! Prof. Ernie Garilao, president of ZFF. leadership and governance. MSD is firm in is a PPP between the Department of Health,
48 HEALTHbeat I March - April 2013 key medical societies Philippine Obstetrical national policy focused on prevention, early The Gold Standard Awards is an annual and Gynecological Society, the Society of diagnosis and treatment. event run by Public Affairs Asia to showcase Gynecologic Oncologists of the Philippines, Cervical cancer is the second most excellence in communications, public and the Philippine Society of Cervical common cancer in women worldwide. affairs, sustainability and governmental Pathology and Colposcopy, and MSD. In the Philippines, 12 Filipino women die communications. Launched in 2008, the program from cervical cancer each day. It is caused This year, it received more than first sought to launch the celebration of by the human papillomavirus (HPV) which 200 entries from different countries in the Cervical Cancer Awareness during the is the most common sexually transmitted region, across all 17 categories. The PPP month of May and later succeeded in infection in both men and women. Aside award category recognizes excellence in integrating efforts from different sectors in from cervical cancer, HPV can cause genital projects involving both the public and private order to increase education, screening and warts and cancers of the head, neck, and sectors for health promotion, environmental vaccination. In its five year run, the program genital area. Screening and vaccination can protection and the delivery of public services. staged many activities, including lay fora on help prevent cervical cancer and other HPV- The excellence award recognizes the public disease education and prevention, a national related diseases. affairs and communications engagement, cervical screening program in DOH-retained Public Affairs Asia is the network execution and outcomes connected to hospitals, and a national symposium on for senior government relations, corporate the PPP program. Other finalists for the cervical cancer prevention and control. To affairs and corporate communications category were Microsoft India, Pilipinas Shell date, more than 30,000 women between professionals operating across the Asia Foundation and Kraft Foods Indonesia/Save 25-45 years old have been screened through Pacific region. It offers news, features, the Children Foundation. the program. With the increased public analysis and intelligence on practice and Babae, Mahalaga Ka! is the only awareness, key stakeholders from the policy through Public Affairs Asia magazine, Gold Standard Awards recipient from the public and private sectors have pushed for a online channels, intelligence and events. Philippines. DOH Runners' Club Are you physically fit or at least wanting very much to be Pasig (2011-2012). The Club also supported the passage of the fit? You might want to join the Department of Health Runners’ Club Sin Tax and Responsible Parenthood, Reproductive Health laws in the Central Office! through three fun run events while wearing advocacy t-shirts and The DOH Runners’ Club is organized to provide an avenue holding tarpaulin with health messages. for officials and employees to be active and healthy. It is also Interested DOH Central Office employees regardless of designed to have a pool of DOH staff that can readily be mobilized appointment status (i.e. permanent, Contractual/Job Order, and for the numerous advocacy fun run/walk events. even outsourced janitorial and security services) may fill-out a Among the events the Runners’ Club participated registration form and pay the one time registration fee of P100. were: PhilHealth-DOH Run at the Quirino Grandstand (February Members are encouraged to attend the regular run events twice 17, 2013); Freedom Run in Taytay, Rizal (October 2012); Run for a week within DOH compound and one major activity at least in a Breastfeeding at SM Mall of Asia (February 2012); and Run for month.
March - April 2013 I HEALTHbeat 49 SAbeat BANAT ng PUSO Break Na! Walang Ganda Pag-ibig
Nagalit si babae sa kanyang nobyo... DIANE: Humanap ka nalang ng mas MICHAEL: Miss, tanong ko lang kasi JEAN: Break na tayo! maganda sa akin. Sorry. monthly may nade-deduct JUN: Tara, gutom na din ako. HAROLD: Ikaw ngang pangit, hindi ko sa sweldo ko, sa iyo ba mapasagot. Maganda pa kaya? napupunta 'yun? Saksak FRANCES: Eh bakit naman sa ’kin Ex-Lovers mapupunta 'yun?!? PULIS: Bakit mo siya sinksak?!? MICHAEL: Nakalagay kasi sa payslip ko, LEN: Sinubukan ko lang po naman Mag-ex sa telepono... PAGIBIG! kung totoo 'yung kasabihan na AILEEN: Hi, kamusta?!? FIRST LOVE NEVER DIES. BOY: Okay lang, ikaw? Dota o Ako? AILEEN: Okay lang din, Kamusta ang Dentista lovelife mo d'yan? JOYCE: DOTA? Dota na naman! Pumili ka BOY: Okay lang naman. ngayon sa amin – Dota o ako?!? IGGY: Dad, hingi po ako ng payo. AILEEN: Kayo pa ba 'nung pangit FRED: Dota!!! Nagkakalabuan kami ng mong girlfriend?!? JOYCE: Huh?!? Bakit? girlfriend ko, eh. BOY: Hindi na noh! Hiwalay na tayo eh. FRED: Kasi ang dota pwede paglaruan. BENJIE: Anak, dentista ako. Ang payo Ikaw, masyado kitang mahal ko lang ay ituring mo ang Tira para paglaruan lang. girlfriend mo na parang toothbrush. Magkaribal sa telepono... Third Eye IGGY: Huh?!? SHEILA: Hello, I called to let you to BENJIE: Oo, toothbrush – huwag mo know that I'm dating your ex. TITSER: Kung kayo ay magka-third eye ipagamit sa iba... at palitan mo TERE: Great! I'm eating sandwich. saan ninyo ilalagay at bakit?!? buwan-buwan! SHEILA: And so?!? (Maraming sumasagot, pero isa TERE: Gusto mo ulit ng tira ko? lang ang tumayo.) GRACE: Sa puso ko po para hindi ako Condolence mabulag sa pag-ibig na hindi naman totoo. CHRIS: Condolence nga pala, Pards. MIGZ: Ha? Para saan? Bakit? My God! CHRIS: Sa syota mong patay na patay sa akin. AU: Honey, tumataba na yata ako, don't you think so?!? Iyak JERRY: You look like a GOD! AU: Ahihihi. Sinong GOD? Aphrodite? WILSON: Kapag iniwan kita, iiyak ka ba? Venus? Who ba talaga?!? EMY: Oo naman. JERRY: (Tinitigan ang kanyang mga WILSON: Bakit?!? mata at hinipo ang kanyang EMY: Tears of Joy! bilbil, at sinabing...) BUDDHA!
50 HEALTHbeat I March - April 2013