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5 Rated Very Good 10 8 What's Happening to Pinoy Teenagers 10 Deliver Our Children from Food Marketing 14 Helmet Use Saves Lives 15 Pushing Standards for Auto LPG 17 The Ruthless Act of Road Rage 21 Health Concerns of Gay Men and MSM 24 Sperm Health 25 Isometric Exercise 14 29 Hear the Signs 33 Helping the Blind to Regain Eyesight 21 36 35 Practice to be Happy 36 Rehabilitation of Ostomates – Let's Be Heard! 38 Doctors to the Barrios - Joy in Service 41 10 Trending Health News in 2012
jokes n'yo stress RELIEF 13 beatBOX 16 KALAbeat 28 laughter HEALS 32 SAbeat 50 XX41 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] The End is Near
A Secretary's fatal plane crash, a Chief Justice's impeachment, a Former President's another arrest, a second Filipino Catholic saint, the Bangsamoro agreement, and the fielding of candidates in next year's elections – with such big stories that happened in the country in 2012, could a health issue squeeze its way in to be of national interest? But there are 366 days in this leap year and there are so many forms of media nowadays that health issues still get some right amount of public attention. Any Filipino could not resist hopping in the discussions and debates of the neverending drama (and even comedy) unfolding in Congress to decide the fate of the controversial Reproductive Health (RH) and Sin Tax bills before it ends its sessions by election time next year. That is, if the so-called cataclysmic or transformative events will not occur on December 21, 2012.
Although 2012 nor the so-called end-of-days, whichever goes first, has not happened yet Editorial Board Ivanhoe C. Escartin, MD by the time we print and release this HEALTHbeat issue, we choose to bring you our annual Rosemarie G. Aguirre countdown of the Top 10 trending health news now instead of the next issue. We find it to be more relevant and interesting at this point of the year than reading it by the end of January Editors-in Chief Anthony R. Roda May Elenor R. de Guzman or early February 2013. Anyway, if any big news occurs in these last two months of the year, you will still be reading them not as part of a countdown but as regular articles next issue. Managing Editor Donato Dennis B. Magat Staff Writers Elizabeth G. Mascareňas Glen S. Ramos As the yearend nears, the Department of Health takes pride too in its achievements for Photographer Paquito P. Repelente the year. For the record, the DOH is the biggest organization, both public and private, to be Cover Photo certified as ISO 9001:2008 for quality management. The DOH is also one of the first national & Design Diosdado G. Angeles, Jr. government agencies to be in the “Proficient” stage of the Performance Governance System. Graphics Design Joerem P. Ceria And, the DOH led all other agencies in the executive branch of government (second only to the Rhoderic N. Domingo Office of the President) to get a net sincerity rating from “Good” + 37 in 2009 to “Very Good” Frederick C. Pereňa + 60 in 2012 in fighting graft and corruption. This is according to the 2012 Social Weather Contributors (Words) Ronald S. Lora Station (SWS) Survey of Enterprises on Corruption. These achievements are perfect signs that Nichel V. Marquez the DOH is proving that the Aquino government’s “Matuwid na Daan” can be realized. Victoria M. Medina Sara J. delos Reyes Tato M. Usman, MD And speaking of signs, let us not only be vigilant of the end-of-days signs; as health workers, (Photos) Neil Bryan S. Hipolito, RN let us also learn the sign language of the Deaf in order for us to give them the right health and Carlo Alejandro Ilagan, MD social services that they may need. (Art) Paul Ritz O. Magtrayo Antonio Totto, Jr. Malusog na Pasko at Ligtas na Bagong Taon sa inyong lahat! Circulation DOH-NCHP Production, – The Editors Dissemination & Collection Unit
FOR EDUCATIONAL PURPOSES ONLY. NOT FOR SALE. Opinions expressed in this publication do not necessarily represent those of the DOH. The mention of specific companies or of certain manufacturer’s products does not imply that they are endorsed or recommended by the DOH in preference to others of similar nature. Articles may be reproduced in full or in part without prior permission, provided credit is given to the DOH for original pieces. A copy of the reprinted or adapted version will be appreciated. Articles, artworks, photographs, caricatures, letters and other contributions are most welcome. Materials will be edited for clarity and space. Unsolicited manuscripts will not be returned. Contributors must indicate their names and addresses.
4 HEALTHbeat I November - December 2012 inside DOH A Great DOH Yearender Rated Very Good He may not be very 950 companies in the National visible in media like what his Capital Region, Cavite-Laguna- predecessors did. Many of his Batangas, Metro Cebu, Metro opinions and the decisions Davao, Cagayan de Oro-Iligan, may turn out to be unpopular. Metro Angeles and Metro Iloilo. But the one thing that is clear The preliminary report is based and consistent with the Health on interviews of executives Secretary is his vision to realize of 826 companies (281 large, Kalusugan Pangkalahatan or 545 small/medium) from the universal health care, the Aquino period of July 16 to September administration’s health agenda 14, 2012. The said survey was to ensure that all Filipinos, supported by the Australian beginning with the poor, are able Agency for International to use quality health services Development (AusAID) through at affordable cost, by being The Asia Foundation, and Based on the ratings of sincerity in fighting corruption, the DOH has improved enrolled in the National Health from "good" to "very good" and leads the agencies under the executive done in partnership with the Insurance Program; cared for in branch of government, followed closely with almost the same standing as Makati Business Club’s Integrity modern health care facilities; and the Department of Trade and Industry. These two agencies trailed behind the Initiative program and the prevented from falling ill by using Office of the President with a remarkable jump from "bad" to "excellent." This National Competitive Council. public health services to improve is according to the 2012 Social Weather Station (SWS) Survey of Enterprises on The DOH is one of the Corruption. health outcomes and attain first national government the country's health-related Millennium the Second Integrity Summit on September agencies to be in the “Proficient” stage of Development Goals (MDG). 18 showed significant progress made by the Performance Governance System (PGS). And two years at the helm of the the DOH in fighting corruption. From a net The PGS, under the Policy Improvement health sector, the Department of Health is sincerity rating of “Good” + 37 in 2009, Process is a commitment of the Philippine starting to reap what he has sowed. Health the DOH improved to “Very Good” + 60 in Government to the Millennium Challenge Secretary Enrique T. Ona has put the DOH 2012. The SWS terminology for net ratings Corporation (MCC) for fighting corruption on the right track in the so-called straight includes: Excellent +70 and up, Very Good and improving the performance of key path of governance. The accolades and +50 to +69, Good +30 to +49, Moderate government offices. good ratings this year speak loudly of Ona's +10 to +29, Neutral-9 to +9, Poor -29 to Earlier, on July 17, 2012, the leadership in the DOH. -10, Bad -49 to -30, and Very Bad -69 to -50. DOH officially set the record as the first Net sincerity rating is computed by getting government agency to have a department- Survey Says the percent sincere minus the percent wide ISO ISO 9001:2008 certified for insincere. implementing quality management system. The preliminary report of the 2012 The 2012 SWS Survey of The DOH – with its 17 bureaus, centers and Social Weather Station (SWS) Survey of Enterprises is the tenth in a series since services inside the Central Office compound Enterprises on Corruption presented during 2000, the last survey being in 2009, covering and the two pilot Centers for Health
November - December 2012 I HEALTHbeat 5 Development (CHDs or regional offices) in the Harvard Kennedy School of Government services, especially in the field of medical Metro Manila and CaLaBaRZon – is now in Cambridge, Massachusetts. The forum science.” the biggest organization, both public and aimed at strengthening the effectiveness of Ona also received the Lifetime private, to be certified. ministerial leadership as a key component in Distinguished Achievement Award from the The scope of the DOH quality management sustainable health systems' improvement. University of the Philippines (UP) Alumni system includes: health policies, programs, Following the forum, the ministers were Association during the 2012 General Faculty- systems and standards development; to submit proposals outlining a low-cost/ Alumni Homecoming and Reunion held at health research management; capacity high return health systems innovation that UP-Diliman in July. He added another feather building; health regulation; and health has the potential to result in more general to his cap when Quezon City Mayor Herbert program monitoring and evaluation. All the health systems strengthening and improved Bautista and Vice Mayor Joy Belmonte remaining 14 DOH regional offices are also health outcomes in their countries. awarded him in October the Quezon set to be certified next year. In September, Ona became the City Gawad Parangal for his invaluable very first Filipino to receive the Honorary contribution to Quezon City residents in the Ona's Numerous Awards Fellowship of the American College of field of organ transplantation. Ona served Surgeons (ACS), the highest honor the as the Executive Director of the National Of course, the DOH success takes institution can confer to any surgeon. Kidney and Transplant Institute from 1998 off from its leader. Secretary Ona, himself, He also has the distinction to be the first to 2010 when he assumed the post of Health has garnered several awards this year for his from Southeast Asian to receive the said Secretary. outstanding performance. recognition since its conception in 1913. The Ona declared that the honor In June, Ona was named 2012 ACS website said that Honorary Fellowship and awards he received this year are a Harvard Health Leader. He was selected, is awarded to “individuals who possess "recognition of the massive efforts our along with 16 other health ministers from an international reputation in the field of government is putting into to provide around the world, to participate in the surgery or medicine” and those who “have Filipinos with access to affordable yet quality Harvard Ministerial Health Leaders’ Forum at rendered distinguished humanitarian health care. We are on the right direction
Health Secretary Enrique T. Ona (sixth from left) receives the ISO 9001:2008 Certificate of Registration in behalf of the 17 bureaus, centers and services of the Department of Health Central Office as well as the Centers for Health Development in Metro Manila and CaLaBaRZon. Renato V. Navarette, managing director of the Certification International Philippines, Inc. and Magdalena Mendoza, senior vice president of the Development Academy of the Philippines (fifth and fourth from left, respectively) officiate the awarding. Also in photo are DOH Executive Committee members and regional directors of Metro Manila and CaLaBaRZon. (Photo by Paking Repelente)
6 HEALTHbeat I November - December 2012 Health Enhancement and Local Service) and midwives to Conditional Cash Transfer (CCT) areas, as well as 221 medical doctors to doctor-less municipalities. P1 billion under the National Pharmaceutical Policy Development (including provision of drugs) will provide Complete Treatment Packages to 1,395 rural health units and 160 district hospitals in 4Ps municipalities. The proposed budget for Expanded Program on Immunization is P 1.9 billion for the full vaccination coverage of eligible children 0-11 months for BCG (Bacillus Calmette Guarine), DPT (Diptheria Pertussis Tetanus), OPV (Oral Polio Vaccine), Hepatitis B, Measles, Tetanus Toxoid, Health Secretary Enrique T. Ona making a response during the announcement that the Philippines is now a member of the World Health Organization-Asia Pacific Observatory Steering Committee on Measles-Rubella, pneumococcal conjugate Health Systems and Policies. (Photo by Paking Repelente) vaccine, and rotavirus. The cost of vaccines for indigent senior citizens (pneumococcal and we should take this a signal to do more.” P54.6 billion for health includes P39.5 and influenza) is included under the Family billion for the Office of the Secretary; P304.5 Health and Responsible Parenting program. Doing More in 2013 million for the Commission on Population; The proposed budget for infectious diseases P327 million for the National Nutrition program include the procurement of anti- In September, Secretary Ona Council; P13.5 billion for the Health Facilities TB drugs, anti-malarial drugs, anti-rabies revealed that the 2013 proposed budget of Enhancement Program, lodged under the vaccines, diagnostic kits, and insecticide- P 54.6 billion for the DOH and its attached Priority Social and Economic Projects Fund; treated beds, among others. agencies will further bolster the Aquino P908 million for the specialty hospitals; and Even with the steady and administration’s integrated economic and P40 million for the Philippine Institute for substantial increase in the health budget, development framework, which centers on Traditional and Alternative Health Care. Ona asked the Senate to ensure the poverty reduction and empowerment of the About 69% of the proposed 2013 sustainability of KP by passing two critical poor and vulnerable. This proposed budget is budget will finance priority programs, pieces of legislation, namely, the tobacco about 25% higher than what was approved activities, and projects in support of and alcohol excise tax reform bill and the in 2012. Kalusugan Pangkalahatan. The subsidy reproductive health (RH) bill. DOH’s Kalusugan Pangkala- for health insurance premium, amounting to Ona also expressed the need hatan is a vital component of this integrated P12.6 billion, will ensure the enrollment of for other priority legislations like the anti-poverty framework, which includes the 5.2 million indigent families to PhilHealth. amendment of the National Health Pantawid Pamilyang Pilipino Program (4Ps), P13.5 billion underthe Health Facilities Insurance Act, laws for corporate governance education and housing. Its initial focus on Enhancement Program will be used to of hospitals, and the amendment of the poorest 5.2 million families identified upgrade and modernize selected barangay selected laws governing practice of health by the National Household Targeting health stations, rural health units, district, professionals. Ona recommended an System for Poverty Reduction (NHTS-PR) provincial and DOH-retained hospitals. alternative to passing specific pieces of of the Department of Social Welfare and P2.8 billion is allocated to the Doctors legislation would be to pass an omnibus law Development will maximize health gains for to the Barrios and Rural Health Practice on universal health care that shall contain those who are most vulnerable. Program for the deployment of 22,500 specific provisions necessary to enact The proposed 2013 budget of batch 4 RNheals (Registered Nurses for required policies or amend existing laws.
November - December 2012 I HEALTHbeat 7 HEALTH survey What's happening to PINOY TEENAGERS Results of the 2011 Philippines Global School-based student Health Survey (GSHS)
The Global School- As of December 2011, dietary behaviours; hygiene; were selected with probability based student Health Survey a total of 73 countries, including mental health; physical activity; proportional to enrollment size. (GSHS) was developed by the the Philippines, have completed protective factors; tobacco use; At the second stage, classes World Health Organization a GSHS and more than 420,000 and violence and unintentional were randomly selected and (WHO) in collaboration with students have participated in injury. all students in selected classes United Nations' UNICEF, the survey. A two-stage cluster were eligible to participate. The UNESCO, and UNAIDS; and with The 2011 Philippines sample design was used to school response rate was 97%, technical assistance from the GSHS involved first to fourth produce data representative the student response rate was US Centers for Disease Control year high school students and of all students in the country. 84%, and the overall response and Prevention (CDC). GSHS is a measured their alcohol use; At the first stage, schools rate was 82%. A total of 5290 school-based survey conducted students participated in the primarily among students aged Philippines GSHS. Students 13 - 15 years. self-reported their responses to The purpose of the each question on a computer GSHS is to provide data on scannable answer sheet. For health behaviors and protective comparison purposes, only factors among students students aged 13-15 years are to help countries develop included in the analyses for the priorities, establish programs, fact sheet (see table next page). and advocate for resources The numbers inside the for school health and youth parenthesis are statistically health programs and policies; termed as "confidence interval," allow international agencies, or the results are 95% sure that countries, and others to make the true value lies within that comparisons across countries range. regarding the prevalence of For additional infor- health behaviors and protective mation, please contact thru factors; and establish trends email Dr. Agnes Benegas- in the prevalence of health Segarra of the Department of behaviors and protective factors Health-National Epidemiology by country for use in evaluation Center at
8 HEALTHbeat I November - December 2012 Results for students aged 13 - 15 years Total Boys Girls
'Naykupo!
EMY: Nakakita ako ng stick ng sigarilyo sa bag ng dalagita ko. Iniisip ko tuloy kung naging smoker na siya.
IETH: Ako nga nakakita ng stick ng marijuana sa bag ng dalagita ko. Iniisip ko rin tuloy kung naging drug addict na siya.
JOYCE: Ako naman nakakita ng condom sa bag ng dalagita ko. Inaykupo! Naging lalaki na kaya siya?!?
November - December 2012 I HEALTHbeat 9 FOOD marketing Lead us not into temptation, Deliver Our Children from Food Marketing* by VICTORIA M. MEDINA, SARAH J. DE LOS REYES and NICHEL V. MARQUEZ
How are we tempted? What is the harm? cconsumption trends show a shift towards unhealthy pattern over the past few decades. An advertisement is defined as Food marketing and advertising Food marketing is considered to be a major signs with product information and or has been linked with childhood food- contributor to this situation. the company logo and related images. related behavior, such as food preference, Outdoor advertising is considered to be purchasing influence and spending power. What makes children consume more essentially any form of advertisement that No wonder then that children are often unhealthy (energy-dense but nutrient- a person encounters outside of the home, targeted and their continuous exposure to deficient) food? and includes a wide variety of displays food advertisements are facilitated because which may include poster, billboards, bus of children’s ability to influence their parents’ Studies have shown that stop signs, banners, tarpaulins, painted spending (pester power) and their potential outdoor advertising has the ability to buildings, store appliances (refrigerators, as a market for these companies in the years geographically target potential consumers, freezers) with brand logo and even trash to come. and have an immediate impact on product bins. In the Philippines, neighborhood In the Philippines, child food awareness. Furthermore, it was noted convenience (sari-sari) store signages are FOOD ADVERTISEMENTS often sponsored by a company and would within 500-meter radius of 30 schools in the study often have the company logo written beside FOOD TYPE OBSERVATIONS the store’s name. In some cases the logo or n % the advertised product may occupy an even Soft drinks bigger space than the store name itself. 4,643 46.7 Energy Drink 763 7.7 Advertisements are practically Alcoholic Beverage 708 7.1 everywhere – schools, offices, churches and Ice Cream 640 6.4 even in the neighborhoods, trying to get the Fruit Drink 596 6.0 attention of the public even just for a split Fast food 451 4.5 Pizza second. They exist and seem to be harmless. 304 3.1 Processed meat products 218 2.2 Well at least that is what most people Restaurant 216 2.2 Unhealthy food items were the type of food most think. But are these, oh so ubiquitous and Sweetened tea 206 2.1 advertised near schools in all five areas covered omnipresent, advertisements as harmless as All others 1,191 12.0 in the study. These are food items that are high in they appear to be? TOTAL 9,936 100.0 fat, salt and calorie content. ----- *Based on the study entitled "Outdoor food advertisements around schools in Metro Manila and Rizal," supported by the Department of Health, World Health Organization and University of Sydney.
10 HEALTHbeat I November - December 2012 that in circumstances where out-of-home advertisements are co-located with food outlets near schools, messages that are related to food can reach the students, with a chance for immediate purchase of products that are being promoted. This is true in the Philippines where it is common to see houses near schools that also serve as sari-sari stores where people can buy almost anything they need at affordable single- serve packages. Companies spend a considerable sum to reach their market directly in the local communities. Unlike other forms of media like print, radio and television, a strategically placed outdoor advertisement guarantees exposure for a relatively less amount of investment.
How dense is the advertisement near schools?
A study entitled "Outdoor food advertisements around schools in Metro Manila and Rizal" conducted in July to October 2012 clearly showed that majority of the food items being advertised in several areas in Metro Manila were for unhealthy food products or food rich in energy and have little nutritional value. Unhealthy food items, as defined in the study, are those that are high in fat, salt, and caloric content and includes soft drinks and other sweetened beverages, ice cream, fast food, pizza, among others. There were 9,687 food advertise- ments within the 500-meter radius of the 30 schools covered in the study and 85% of these were advertisements for unhealthy food products. The advertisements in Metro Manila were four times as much as food advertisements observed in a similar study covering 40 schools in Australia that only had 2,289. Outdoor advertisements for
November - December 2012 I HEALTHbeat 11 unhealthy food items were highest near endorsed a set of recommendations in 2010 public and private schools in all the five on the marketing of foods and nonalcoholic areas (Cities of Makati, Manila, Marikina, drinks to children, “Recommendation 5 – Las Pinas, and Municipality of Taytay in Settings where children gather should be Rizal Province) covered in the study. It was free from all forms of marketing of foods further noted that advertising was denser in high in saturated fats, transfatty acids, free the areas near schools (<250 meters) than sugars, or salt.” those farther away (251 - 500 meters). On A law restricting the advertising the average there were 5.6 advertisements of unhealthy food items can be patterned for unhealthy food items every 100-square after the Tobacco Regulation Law where meter area within the 250-meter radius advertisements of unhealthy food items from the school. The largest number of will not be allowed within a certain radius. advertisement observed were for sugar What can be done? The sale of Junk foods and soft This is similar to the green zone that is being sweetened beverages like soft drinks, energy drinks can be prohibited in and within schools implemented in Korea where junk foods and (top). Food items can be coded after the traffic drinks and sweetened tea. Soft drinks lights – red means unhealthy, yellow means soft drinks are prohibited from sale within accounted for almost half of the food items somewhat unhealthy, and green means healthy 200 meters of schools. being advertised. (bottom). One of the first steps is to come Another alarming result of up with a standard definition of what an the study was that alcoholic beverages What can be done? unhealthy food is. The limits on the calorie, accounted for 7% of the advertisements fat, and salt content should be set. Once located near schools. Local legislation Children are a vulnerable popula- this has been settled, local authorities in some cities and municipalities in the tion in this unfortunate social situation. may want to take cues from success stories Philippines often disallow selling to minors Young children are unable to understand from the United Kingdom , Australia , and and near schools. But the alcohol posters that advertising is not just a means to provide Korea. Just like the color coding scheme in sari-sari stores near schools indicate the information but also provides a biased of the Metropolitan Manila Development likelihood of their availability, and the extent view in favor of the company. Subliminal Authority, the Philippines can follow the of enforcement of local policies, if available, marketing practices such as the use of logo initiative of the United Kingdom and prohibiting access to alcoholic beverages placements, associations with popular Australia where food items are coded after among minors is unfortunately not known. characters were designed to create lifelong the traffic lights – red means it is unhealthy, The Philippines 2011 Global customers by imprinting brand meaning yellow means it is somewhat unhealthy, and School Health Survey (GSHS) indicate among children. It is therefore imperative green means that the product is healthy. This that 18.7 % of adolescents currently drink that the government should take a more way, government can introduce measures on alcohol. Exposure to alcohol advertisements active role in protecting schoolchildren from which and how much of these food items has the potential to increase the prevalence overexposure to advertisements. can be advertised and/or sold near school on alcohol use among the youth. The World Health Assembly premises.
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Photo by Joerem P. Ceria 12 HEALTHbeat I November - December 2012 stress RELIEF CONSUMER protection Laba Langaw Lambingan
JENNY: Mare, samahan mo ko sa DIOSDADO: Miss, nung una akong kumain AILEEN: Mabuti pa ang saging may puso! grocery, bibilhan kita ng Pride. dito, may langaw sa lugaw ko! Pero ikaw, WALA! AURING: Hindi naman ako maglalaba! Ngayon naman, may lamok! BOY: Aba’y kung ganyanan din lang, JENNY: 'Papakain ko sa 'yo Pride mo! Ano ba yan? eh... Mabuti pa ang sisig may WAITRESS: Ay naku sorry po, Sir. utak! Ikaw, WALA! Bula Naubusan po kasi kami ng langaw eh! Palengke PROMODIZER: Misis, kapag pinaghalo ang Surf at Tide, bubula kaya? Fishball FRED: Hahaha. 'Pre, nautusan ka ba ng MAIBELLE: Aba syempre! asawa mong mamalengke? PROMODIZER: Mali! BECCA: Kahit nagtitinda lang ako ng JOEREM: Hoy, hindi ako nautusan noh. MAIBELLE: Bakit naman?!? fishball dito sa eskwelahan n'yo, Nagkusa ako. PROMODIZER: Dahil wala pang tubig! may mga anak ako na nasa Ateneo, La Salle at UST. Kambingan Kape STUDENT: Wow, anong pong kurso ang kinukuha nila? IAN: 'Pre, alam mo bang kapag nag- PAKING: Miss, magkano kape ninyo? BECCA: Wala! Nagtitinda rin sila ng sex ang kambing at ang aso, for WAITRESS: P50. fishball doon. sure, ang anak nila ay pusa?!? PAKING: Eh, magkano ang refill? EDWARD: Owww. At paano ka nakasiguro? WAITRESS: Libre po. Pizza IAN: Kasi ang kambing, "Mee, Mee" at PAKING: Paki-bigyan mo nga ako ng ang aso naman ay "Aww Aww". refill. WAITER: Heto na po ang order ninyong Pag pinagsama mo ang dalawa, pizza. Ilang slice po ba ang "Meeaww, Meeaww." O, di ba Panis gagawin natin, 6 o 8? pusa 'yun! DONATO: 6 nalang at baka hindi ko Sa isang Appliance Center... maubos ang 8. Beer SALESLADY: Ma'am free taste... CHIT: Anong food ito? WiFi ALLAN: Beer is better than Milk. SALESLADY: 'Yan po ay menudo. MARWIN: Bakit? CHIT: Pwe! Ba’t lasang panis?” MAYA: Meron po ba kayong WiFi ALLAN: Kasi ang beer, nililibre ng SALESLADY: 'Yan po ang mangyayari sa dito sa fastfood chain n'yo? barkada. Ang milk hindi. pagkain ninyo kapag hindi CREW: Huh? Naku, sorry Ma'am, MARWIN: Sigurado ka? kayo bumili ng tinda naming wala po eh. Apple Fie lang ALLAN: Bakit may nagsabi na ba sa 'yo refrigerator! ang meron kami. nang, "Tara na 'tol, dede tayo"?!?
November - December 2012 I HEALTHbeat 13 Photo by Diosdado Jr. G. Angeles, road SAFETY
HELMET USE Saves Lives! MANY FILIPINOS DIE IN MOTORCYCLE injuries. HELMETS ARE DESIGNED TO PREVENT COLLISIONS... WEARING A STANDARD PROTECTIVE HEAD INJURIES BUT NOT INJURIES TO • In 2010, a total of 6,941 Filipinos HELMET IS IMPORTANT... OTHER PARTS OF THE BODY... died as a result of road traffic crashes, • Helmet standards ensure that helmets • Obeying road traffic rules, including and thousands more were injured or allowed for distribution and use by adhering to speed limits and not driving disabled. motorcyclists are of appropriate quality. while drunk, will reduce the chance of a • Users of motorcycles make up a large • Standard helmets are recognized by motorcyclist being involved in a crash, proportion of those killed on the road. the presence of the Philippine Standard and their likelihood of incurring any Data in Metro Manila indicate that 34% (PS) or Import Commodity Clearance type of injury. of all fatal road crashes and 37% of non- (ICC) mark provided by the Bureau of • Appropriate clothing can be helpful to fatal injuries from road traffic crashes Product Standards (BPS)of Department reduce other types of injuries. involve motorcycles. of Trade and Industry (DTI). THE NATIONAL MOTORCYCLE HELMET HELMET USE IS EFFECTIVE AT REDUCING • Helmets create an extra layer for the LAW (REPUBLIC ACT NO. 10054) MUST BE HEAD INJURIES... head and thus protect the wearer from ENFORCED... • Injuries to the head and neck are the severe brain injury. • Motorcycle helmet legislation has main cause of death, severe injury and HELMETS SHOULD BE PROPERLY been proven in reducing head injuries disability among users of motorcycles. FASTENED... and deaths from motorcycle crashes in • Wearing a helmet is the single most • Chin and neck straps, which are many countries. effective way of reducing head injuries specifically designed to keep the helmet • Legislation is most likely to work and fatalities resulting from motorcycle on the head during an impact, must be where high-quality helmets are crashes. correctly used. accessible and affordable, enforcement • Motorcyclists who do not wear helmets • If a helmet is not fastened, it will is comprehensive, and there is are at a much higher risk of sustaining come off during a crash, therefore, not widespread community education on head injuries and from dying from these providing protection. the benefits of helmet use.
14 HEALTHbeat I November - December 2012 Photo by Diosdado Jr. G. Angeles,
road SAFETY Pushing Standards for AUTO LPG The improper conversion of vehicles to Auto-Liquefied Petroleum Gas (ALPG) may cause health hazards to those exposed, revealed Director Eduardo C. Janairo of the Department of Health's Center for Health Development-National Capital Region (CHD-NCR). This claim was based on the study entitled "Rapid Assessment for Monitoring Exposure Risks in Conventional and Alternative Fuel Use Among the Public Transport Sector" by the DOH in coordination with the UP-National Poison Management and Control Center (UP-NPMCC). This study was made to ascertain the validity of reports coming from the private sector as well as the rising number of health complaints of taxi drivers whose vehicles were LPG-converted. Majority of taxis plying Metro Manila run on auto LPG. (Photo by Neil Bryan S. Hipolito) Janairo explained, “We would like to set policy directions on the ALPG and 13 conventional male drivers typically found in petroleum product, such implementation of standards and guidelines who were randomly selected from the as gasoline and diesel fuel. in auto LPG-driven vehicles and determine list of users of auto LPG-driven vehicles The findings also discovered that the potential exposure and health effects and users of conventional vehicles (diesel the amount of hydrogen sulfide (H2S) was among population groups exposed to these and gasoline). Ages of the drivers ranged 68 times higher and carbon monoxide (CO) vehicles as compared to population groups between 18-45 years old, with 2 years of levels were eight (8) times greater for auto- exposed to conventional-driven ones." experience driving only one type of vehicle/ LPG retrofitted vehicles than those measured According to the study, among working in the station, and are non-smokers. in conventional vehicles. the effects of being exposed to auto-LPG There were a total of 53 taxi units included In the United States Centers for include headaches, back pain/nape pain, in the study, 28 ALPG units and 25 gasoline/ Disease Control, the prescribed Occupational chest pain, cough, dizziness, dry throat, diesel taxis. These units were checked and Safety and Health Administration (OSHA) fatigue and muscle weakness, nausea and tested for butane, carbon monoxide (CO), standard and permissible exposure limit difficulty in breathing. These effects are due hydrogen sulphide (H2S) for ALPG and (PEL) for LPG is 1000 parts of LPG per million to the decreased delivery of oxygen to the total BTEX/HC content, CO, H2S and O2 level parts of air (ppm) averaged over an eight- body’s vital organs. Overexposure may cause for gasoline/diesel taxis. BTEX is the term hour work shift. This can be expressed as unconsciousness and even death. used for benzene, toluene, ethylbenzene, 1800 milligram of LPG per cubic meter of air The study was composed of 26 and xylene-volatile aromatic compounds (mg/m3).
November - December 2012 I HEALTHbeat 15 According to Janairo, several total of 19,052 taxis converted from 2005 to remote refuelling connectors. There were factors that may result in the emission of 2011, an average of 2000 taxis per year and 25 accidents reported during refuelling dangerous chemicals within the vehicle 217 refilling stations nationwide. There are indicating the danger inherent in that stage includes, inaccurate and improper conversion 31 auto-LPG conversion shops licensed to of operation. of vehicle to auto-LPG, lack of regular operate. The joint study by the DOH and environmental monitoring of vehicles, poor Among the countries with UP-NPMCC strongly advocates the following maintenance of the vehicle and the long large number of LPG vehicles and high recommendations; to review and revision exposure to the elements within the vehicle consumption of ALPG are US, Japan, of occupational health program for drivers by drivers. Australia and Canada. ALPG has been used to prevent the occurrence or progression of The passage of the Clean Air for years to power their vehicles, but drivers disease/sickness brought about by exposure Act of 1999 and the Biofuels Act of 2006 or passengers have raised no major health ALPG, strict air quality testing to determine introduced the addition of biofuels and use issues on the use of the fuel. adequate oxygen (O2) level, ventilation and of other alternative fuel sources to reduce Studies from these countries chemical contaminants in the vehicle which dependence on petroleum-based fuels. One concluded that there is no evidence to can be done during the resealing process of of the most widely used alternative fuel for show that LPG is more dangerous or less the LTFRB, ventilation of the vehicle should road transport is the autogas also known as dangerous than petrol or diesel. Their be considered during idle times to allow automotive liquified petroleum gas or auto- studies revealed that human factor played fresh air to enter the vehicle and establish LPG. a major role in affecting the safety in using regulatory standards on the permissible ALPG is cleaner than conventional LPG fuel. In Japan, there was no recorded level of odorants that can be added to auto- automotive fuels. It is a mixture of light explosion or a serious accident for 30 years LPG fuel. hydrocarbon gases propane (30%) and since introducing various safety measures Further recommendations include butane (70%). Because of its environmental regulating the use of LPG fuel. Canada also the strict observation of maintenance and economic benefits, auto-LPG was reported human error as the major cause of schedule for both ALPG and conventional considered as one of the best alternative accidents involving LPG vehicles like careless vehicles prior to car registration, introduction automotive fuels in the country and was fuel handling and faulty workmanship of a realistic work schedules for drivers introduced in 2005. There are a total of a such as poor sealing of bodywork around that consider the needs for breaks and rest periods, and the inclusion of physical, ergonomic and other chemical hazards beatBOX in the evaluation of occupational hazards among transport workers. “It is also important that ALPG installations should be done only by service providers duly certified or accredited by the Department of Trade and Industry to ensure that the setup is correctly done, and the list of legitimate service providers should be disseminated to the transport sector in order to avoid the proliferation of fly-by-night operators,” Janairo said. “Only by introducing regulations and standards to ensure the safe use of ALPG can we ensure the health and safety not only of drivers but also passengers as well,” Janairo concluded. It's a Bird? It's a Plane?!? - o O o - Photo grabbed from a Facebook post.
16 HEALTHbeat I November - December 2012 road SAFETY The Ruthless Act of
ROADby RAGE GLEN S. RAMOS HEALTHbeat Staff Psychology of individual may have the urge Road Violence or tension and then pleasure, gratification or relief after the Road violence, or act is done." commonly termed as road According to Escartin, rage, may start from a simple road age captures the confrontation but sometimes intermittent explosive disorder. it can lead to unnecessary This manifests as discrete casualties. It is a serious and episode of losing control of ruthless act that endanger aggressive impulse, and this one’s personal security and a can result in serious assault or violate property rights. the destruction of property. The Road rage is defined symptoms, which individual as a deliberately dangerous may describe as spell or and/or violent behavior under attack, appear within minutes the influence of heightened, or hours, and regardless of violent emotion such as anger duration, remit spontaneously and frustration, involving an and quickly. After the episode, automobile in use. It also refers the individual usually show to the use of physical force by genuine regret or self- individuals or groups within reproach. public spaces, the result of Escartin said, "Inter- which may involve injury or mittent explosive disorder is death. It happens on the underreported but is more streets every day and road rage Art grabbed from
November - December 2012 I HEALTHbeat 17 abuse as well as mood, anxiety and eating with his fists, banging the person’s vehicle, get the registration/plate number disorders. knocking vehemently on the windows, of the other vehicle. If the driver Road rage is aggravaviated by cursing and yelling insults. attempts to follow you, do not several factors like the weather. Driving in "It is better to leave all worries go home, instead proceed to the hot weather can actually make a person behind while driving and concentrate on nearest police station and report the feel more tired and sluggish, lowering our the road. It is best to practice patience and incident. overall mood. Circumstances can also be road courtesy to avoid getting into a road • Avoid the indiscriminate use of considered, if a person is in a hurry and altercation," Escartin advised. horn, flashing of light or any action pressed for time, he/she tends to drive faster The Department of Health that may worsen the situation. disregarding other motorists just too cope recommends some useful tips on how to • Do not make eye-to-eye contact with the deadline. Indiscriminate honking avoid road violence while driving. These are: (eye ball)with the angry driver. and loud noise, such as deafening music • Keep your mind on the road. • Be courteous and exercise patience played by motorists can also cause irritation Concentrate on driving and forget especially when being provoked. to others and may start an altercation. And your problems for the time being. emotional problems are also a cause for • Plan your trip. Wang-Wang Mentality frustration that can lead to irascibility or • Play music to lessen the stress. outbursts of temper. • Think positive. Road rage happens not always Incidents of road rage may involve • Always keep the door of your between drivers, but also between drivers intentionally striking another person, vehicle vehicle locked while driving and and traffic enforcers. The Metro Manila or object with the opponent’s own vehicle or stay inside your vehicle if there is a Development Authority (MMDA) records a firing a weapon from it. Some other violent commotion. monthly average of five incidents of road acts include deliberately hitting the person • If you are a victim of road violence, violence between enforcers and drivers, including officers being intentionally harmed, berated, fought with, side swept and even run over by callous drivers. The seemingly most popular incident of road violence happened in August and this involved a Philip Morris executive who assaulted an MMDA traffic enforcer. The violation was beating the red light, and the confrontation was caught on video by a TV5 staff and shown on their television and online news and ultimately went viral on the Internet. As a result the public was outraged and the MMDA wasted no time and immediately took lawful steps by filing a case in the prosecutor’s office for direct assault and asked the Land Transportation Office for the cancellation of the assailant’s driver’s license. Atty. Yves Randolph P. Gonzalez, director of the MMDA Traffic Discipline Dr. Ivanhoe C. Escartin, director of DOH National Center for Health Promotion who is also a psychiatrist, Office, said the most serious case of road said road age captures the intermittent explosive disorder. This manifests as discrete episode of losing rage he witnessed in his two years in office control of aggressive impulse, and this can result in serious assault or the destruction of property. involved MMDA Officer Larry Fiala who was
18 HEALTHbeat I November - December 2012 shot due to a number coding violation which happened last year. Fiala apprehended a motorist but the motorist hit him in the face before driving away. The officer chased and caught up with the driver, but the motorist shot Fiala three times in the abdomen. Luckily he is alive. Another case was that of Officer Raul Reuterez who confronted a group of alleged drag races along Macapagal Avenue in February. He was hit on the back of the head by one the alleged drag racers sending him to the hospital unconscious for a day. Gonzalez said it is the policy of the MMDA to file a case against motorists who provoke and attack enforcers as it is against the law to assault a person in authority. On the other hand, motorists can also file a complaint against discourteous and abusive enforcers, especially when violence Atty. Yves Randolph P. Gonzalez, director of Traffic Discipline Office of the Metropolitan Manila is involved, at the MMDA office in order Development Authority (MMDA) says road rage is really a case of the so-called “wang-wang mentality" to properly address the case and provide that has been part of our system for many years. disciplinary actions immediately to erring officers. "Learn also to accept your fault. road discipline in Metro Manila’s largest and "Road rage is really a case of the Drivers tend to avoid being caught and will busiest highways are not that easy. Every so-called “wang-wang mentality" that has provide a dozen excuses once spotted by day, they are either directly under the heat of been part of our system for many years. What enforcers. And when you commit a traffic the sun or the rain just to keep our roads safe we must do is to take part and denounce violation, surrender your license voluntarily and to uphold traffic rules from violators. these abusive and violent behaviors and to and do not try to buy your way out of it by Other tips on how to drive safely support positive efforts to achieve a much getting back at the enforcer and making a include: needed social and moral change," Gonzalez scene by retaliating and bad mouthing the • Never drink while driving. remarked. officer,” he added. • Follow the speed limit. (Wang-wang, according to Gonzalez appealed to all motorists • Always use seatbelt. President Benigno S. Aquino III in his first State to exhibit the proper behavior while on the • Be sure that your vehicle is in good of the Nation Address in 2010, is someone road. condition before using it. who blows his vehicle’s horn, counter-flows “Keep your cool at all times. If • Follow traffic lights – “red” to stop against the traffic, always beats the red light, flagged down by an enforcer, do not fight and “green” to go. accepts bribes, and cultivates corruption. back. Ask politely for your violation and don’t • Stay on the right lane. Wang-wang, the President emphasized, is the utter foul words against the person. It is what • Use the proper signal light when very symbol of abuse and corruption.) we expect from all our traffic enforcers and changing lanes or making a turn. Like many accidents on the road, we hope that motorists will do the same,” he • Avoid tailgaiting. traffic altercations can be avoided. Gonzalez said. • Always consider the safety of urged motorists to obey traffic rules. He said Gonzalez also asked the public pedestrians, especially the children this is the basic and most important thing to to provide some consideration because the and the elderly. do. tasks of traffic enforcers in maintaining “And remember to always be
November - December 2012 I HEALTHbeat 19 respectful while driving and treat an unknown assailant riding a other people the way you want them motorcycle which also resulted into to treat you. Always be calm and a fiery argument and ended up with drive safely,” Gonzalez concluded. the assailant drawing a gun and firing it at Llamas at close range three Rewind and Fastforward times causing his death. In July 2011, Senator Ferdinand There are many extreme Marcos Jr. filed Senate Bill 2923, examples of senseless violence known as the Road Rage Law. The resulting to meaningless deaths bill aims to curb the occurrences involving ill-tempered motorists. of senseless violence on Philippine Notable cases of road violence even roads, and to instill discipline, control involve prominent individuals, and restraint among road users. including: Jason Ivler, son of Freddie Marcos said that the bill is Aguilar's sister - Mylene, the prime now pending for consideration in suspect in the killing of Renato Ebarle the Senate Committee on Public Jr., a son of Presidential Chief of Order. Once passed into law, the Staff Undersecretary Renato Ebarle measure seeks to subject offenders Jr., during a traffic altercation at the to administrative proceedings by corner of Santolan Road and Ortigas the LTO, which would result in either Avenue; Raul Bautista and Sowaib the cancellation of their driver's Salie traffic altercation in Cavite that PERSPECTIVE. Image floats in the Internet, source from
20 HEALTHbeat I November - December 2012 men's HEALTH Art by Antonio Totto, Jr. Art Antonio Totto, by HEALTH CONCERNS OF Gay Men and MSM by ANTHONY R. RODA, MaHeSoS HEALTHbeat Staff Let’s face it, the stigma and the among MSM in the Philippines is HIV/AIDS. Dr. Robert Baytan, an openly gay discrimination attached to being gay or While in most parts of the globe, HIV/AIDS HIV/AIDS prevention advocate, said that two having a gay relationship are still strong cases are said to be decreasing, the Philippines decades to less than a decade ago, he would even if Philippine society is said to be or is remains one of seven countries in the world proudly tell his audiences in seminars, seemingly tolerant on gay and bisexual with a steady increase in cases. This year, the communities and classrooms that MSM or men and other men who have sex with men number of cases recorded by Philippine HIV/ male-to-male transmission comprised, at (MSM). All men have certain health risks, AIDS Registry of the Department of Health – most, 20% of HIV infections in the country. but MSM have specific physical and mental National Epidemiology Center since 1984 has He said that the recent surge in MSM health concerns because of their sexual surpassed the 10,000 mark. As of September transmission is curious and is worth looking orientation and practices as well as their 2012, a total of 10,830 cases have been into, HARD. ability to seek and receive quality health diagnosed, but of course, this total is just Baytan practices Medicine in services. the tip of the iceberg because not everyone Marilao, Bulacan. He is a founding individual has been tested. Sexual contact still showed member of Task Force Pride, Philippines, a HIV/AIDS and Sexually as the leading mode of transmission, but health columnist of the now-defunct gay Transmitted Infections unlike in the past, men having sex with men magazine "L," and is a member of the Board has now become the predominant type of of Trustees of Action for Health Initiatives. Topping the list of health issues transmission in recent years. Aside from HIV/AIDS, other
November - December 2012 I HEALTHbeat 21 sexually transmitted infections (STIs) – been no recurrence for at least a year. This infections that can spread through including gonorrhea, chlamydia, syphilis does not mean, though, that one can no sexual contact.Also consider the human and genital warts – are health concerns that longer transmit the virus to others." papillomavirus (HPV) vaccine which is now confront MSM. Protecting yourself from STIs Protect yourself by doing the available for men aged 9 to 26 years old to is the best way to stay healthy. There is still following: help prevent genital warts. no cure for HIV/AIDS and many STIs, such as • Get tested and have your • Limit the amount of alcohol the human papillomavirus (HPV) that causes partner tested. Don’t have unprotected sex you drink and don't use drugs. If you are genital warts, and genital herpes. unless you are certain you and your partner under the influence of alcohol or drugs, you According to Baytan, public health are not infected with HIV or other STIs. are more likely to take sexual risks. If you use reports list chlamydia as one of the leading, Testing is important because many people injectable drugs, don't share needles and if not the leading, STI in the Philippines. In do not know they are infected, and others syringes. his practice, “tulo” (discharge) is the most might not be honest about their health. • Know the risks associated common STI. He said, "Tulo, generally in • Use a condom or other with sexual venues. Sexual venues such as the local setting, is either chlamydia or protection. Use a latex or polyurethane bathhouses, sex parties and the Internet can gonorrhea. Since many patients prefer condom every time you have sex — facilitate multiple sexual partnerships and treatment without going through rigorous especially during anal sex. Use only water- anonymous sexual encounters, as well as lab tests, treatment regimens are tailored based lubricants, not petroleum jelly, higher risk sexual behaviors. for both kinds of tulo. Tests are expensive hand lotion, cold cream or oils. Oil-based And when you are diagnosed and are not very practical in poverty-stricken lubricants can weaken latex condoms and with STIs, follow doctor’s orders in taking communities." cause them to break. medications. Antibiotic use for certain STIs He added that while there is In the issue of oral sex, sexual has been beneficial when prescribed and no cure for HPV, health advocates ideally advise to use a taken correctly. However, these drugs have one is likely to be condom, if doing oral sex could not be been used so widely and for so long that symptom-free prevented at all. Baytan, however, noted that the infectious organisms the antibiotics for a long time, using condom in oral is not exactly enticing. are designed to kill have adapted to them, if not for life, Rubber does not taste good. Flavored making the drugs less effective. Remember if there has condoms taste good for less than a minute. that a drug-resistant infection may kill, can Also, the lubricant in condoms can irritate spread to others, and imposes huge medical the internal lining of the mouth, and costs to patients. this can cause pharyngitis. For those who have been Do not also share sex diagnosed with HIV, although here is no cure toys, and keep them safe by for AIDS at this time, a variety of treatments protecting them with a condom are available that can help keep symptoms and cleaning them before and at bay and improve the quality and length after every use. of life for those who have already developed • Be monogamous. Another symptoms. reliable way to avoid sexually transmitted infections is to Substance Abuse stay in a long-term mutually monogamous relationship According to the US Center for with a partner who isn't Disease Prevention and Control, studies infected. have shown that, when compared with the • Get vaccinated. Vaccinations general population, gay and bisexual men as can protect you from hepatitis well as lesbian, and transgender individuals A and hepatitis B, serious liver are more likely to: use alcohol and drugs;
22 HEALTHbeat I November - December 2012 have higher rates of substance abuse; are an intimate relationship for MSMs who live On the other hand, Baytan less likely to abstain from alcohol and drug together. The Mayo Clinic website lists the said there are people who continue to use; and are more likely to continue heavy warning signs specific to gay men which engage in a violent relationship but they drinking into later life. might include a partner who: threatens are not necessarily suffering. Some are Alcohol and drug use can be a to tell friends, loved ones, colleagues sadomasochistic. A sadist likes to inflict reaction among some MSM to homophobia, or community members your sexual pain. A masochist likes to receive pain. discrimination, or violence they experienced. orientation or gender identity; tells you While generally considered a deviant sexual Substance abuse is also associated in some that authorities won't help a homosexual, behavior, sadomasochism works for some MSM's reliance on bars and clubs for bisexual or transgendered person; tells you people, but it does not exclude them from socializing and peer support. However, that leaving the relationship means you are practicing safer sex. substance abuse can lead to a wide range of admitting that homosexual relationships are mental health and physical problems as well deviant; and tells you that domestic violence Body Image as it can disrupt relationships, employment, is a normal part of homosexual relationships and threaten financial stability. or that men are naturally violent. Body image concerns are constant If you or someone you know has a Staying in an abusive relationship throughout human history, that is why there problem with alcohol or drug addiction, go might leave you depressed, anxious or is a continued quest for immortalizing potions to a substance abuse treatment facility for hopeless. If you do not want to disclose your and proliferation of anti-aging products. help. Civic and health organizations also may sexual orientation, you might be less likely Gay men are more likely to experience body provide referrals. to seek help after an assault. Still, the only image problems and eating disorders, such way to break the cycle of domestic violence as anorexia and bulimia nervosa, than are Depression is to take action, the sooner the better. their straight counterparts. One potential Consider creating a plan to explanation is that gay The risk of depression and anxiety leave your abuser. If you suffer may be higher for MSM, especially the from domestic violence, adolescents and young adults who try to tell someone about the hide their sexual orientation or those who abuse. lack social support. The contributing factors to depression include: social alienation, discrimination, rejection by loved ones, bullying, and other forms of abuse and violence. Left untreated, depression can lead to risky sexual behavior and a downward spiral of emotional, behavioural and health problems. Depression may also lead to suicide. If you think you might be depressed, talk to your doctor or seek help from a mental health provider. If you are reluctant to seek treatment, confide in a trusted friend or loved one. Sharing your feelings might be the first step toward getting treatment.
Domestic Violence
Domestic violence can threaten
November - December 2012 I HEALTHbeat 23 men identify with the cultural value placed on an ideal – yet often unattainable – body image. Gay men might also be more likely to view their bodies as sexual objects, which Sperm Health can lead to dissatisfaction and poor body image. Whaaaat, even sperm the rate of miscarriage is high. If you are struggling with body should be healthy? Oh yes! Include physical activity or exercise image concerns or an eating disorder, get Healthy sperm is not always a in your daily routine to have stronger hormone help. Talk to your doctor or a mental health given. signals and healthier sperm production. On the provider about treatment options. The state of your sperm’s other hand, stress can decrease sexual function health depends on various factors, and interfere with the hormones needed to Routine Health Care including: QUANTITY - if in a single ejaculation produce sperm. So, it is also important to you produce more than 15 million sperm per manage stress. Do not let the fear of homophobia millilitre; QUALITY - if you have more sperm Stay cool. Increased scrotal or the stigma associated with homosexuality with normal shape and structure, meaning temperature can hamper sperm production. they have oval heads and long tails which To protect your fertility, don't wear tight prevent you from seeking routine health work together to propel them forward; and underwear or athletic shorts. If you bike or care. Instead, take charge of your health. MOVEMENT (or motility) – if more that 40 remain seated for long periods of time, take Look for a doctor who puts you at ease. percent of your sperm are moving, wriggling frequent breaks. Don't place a laptop computer Identify yourself as gay or bisexual, and ask and swimming through a woman’s cervix, directly on your lap. Avoid hot tubs, saunas and about routine screenings recommended uterus and fallopian tubes to reach and steamy baths. for men in your age group – such as blood penetrate an egg. Aside from these lifestyle factors, pressure and cholesterol measurements and The lifestyle you choose affect watch out for toxins also. Exposure to screenings for prostate, testicular and colon sperm health and consequently your fertility. pesticides, lead and other toxins can affect cancer. If you are not in a long-term or a If you are still young, meaning those who sperm quantity and quality. If you must work mutually monogamous relationship, then are in the reproductive age group, you can with toxins, do so safely. For example, wear you should schedule regular screenings for take simple steps to increase your chances of protective clothing and equipment, and avoid producing health sperm. How? Practice safe skin contact with chemicals. And, be cautious STIs. Share any other health concerns you sex to avoid sexually transmitted infections with medications. Calcium channel blockers, might have with your doctor as well. Early such as chlamydia and gonorrhea – the tricyclic antidepressants, anti-androgens and diagnosis and treatment help promote long- leading cause of infertility for both men and various other medications can contribute to term health. women. Stay in a mutually monogamous fertility issues. Anabolic steroids can have Baytan lamented that routine relationship with a partner who is not infected the same effect. Chemotherapy drugs and health care is a must but is easier said or use a condom each time you have sex. radiation treatment for cancer can cause than done, especially in the country where Eat healthy diet and maintain a permanent infertility. If you're considering majority of the people are poor. He said, healthy weight. Choose plenty of fruits and medications, ask your doctor about the impact "Who can blame them? Why spend for lab vegetables which are rich in antioxidants that on your fertility. tests if one will go hungry and suffer from will help improve sperm health. On the other Finally, there is aging and you hyperacidity?" hand, some research suggests that being cannot do anything about it. Women are not obese and overweight negatively affects the only ones who have biological clocks. Sperm However, he was quick to add, sperm quality, reducing both sperm count and movement and the number of healthy sperm there are public clinics and hospitals movement. might decline after age 50, affecting a man's where medical services are free or are not Don't smoke, don’t use illegal fertility. Some research suggests that women very expensive. The one thing that must drugs and don’t drink alcohol or keep alcohol who become pregnant by older men have a change, though, is the behavior of Filipinos consumption within recommended limits. slightly higher risk of miscarriage. A father's – whether straight, lesbian, gay, bisexual, Tobacco, drugs and excessive use of alcohol increasing age has also been associated with a transgender – that prefer to postpone a damage the sperm making it incapable of higher risk of both autism and schizophrenia in clinic visit until it is too late. fertilizing the woman’s egg cell, and if it does, children.
24 HEALTHbeat I November - December 2012 PHYSICAL activity ISOMETRIC EXERCISE as part of your daily routine
Stop lighting up a cigarette, improve digestion and lower cholesterol strongly advised against trying isometric munching unhealthy food or remaining levels. Moreover, it is prescribed as part exercises without getting clearance from a chained to your desk when stressed out from of injury rehabilitation programs and in physician. As a general precaution, do not a demanding job. Take a break, get up and physiotherapy. hesitate to stop at any point during the do some relaxing isometric exercises. Almost anyone can do isometric exercise if dizziness, nausea, shortness of Isometric exercise is a form of exercises. However, it must also be recognized breath or chest pains manifest. physical activity that is needed by your that for some people, especially those with And a final word of advice, body without going to a strictly formal, high blood pressure or heart ailments, isometric exercise to be truly beneficial aggressive, uninterrupted workout program. isometric exercise can cause potentially must be taken only as a part of a whole Introducing even smalll amounts of exercise dangerous outcomes because the workouts range of physical activity you must do daily. or physical activity in your daily life will pumps up the blood pressure and metabolic The Philippine Physical Activity Guidelines improve your health and help you lose rates. Thus, people with such conditions are generally prescribes 30 minutes to one hour of weight. physical activity and exercise per day Isometric exercise is an which can be done in accumulated 10 anerobic exercise (does not need minute bouts throughout the day or increased oxygen production) in one continuous session. For older because it is done only for a population, 60 years old and above, at few seconds that involves static least 30 minutes of light to moderate contraction of muscles. This means physical activity, accumulated or in that in this exercise, the muscle one session, is needed for most days length remains the same even if it of the week, if not daily. Of course, has been tensed by pressing against too, whatever benefits you get from a static object such as a wall or an of physical activity and exercise are opposing pair of muscles. Isometric nullified if you continue to smoke, comes from the Greek "iso-" or equal eat unwisely, drink alcohol much and and "metron" or measure which deprive yourself of sleep. describe maintaining the same In the manual for the "Galaw measure, dimension or length. Galaw Araw Araw - The Pinoy Exercise The intensity of the Video" produced by the Department isometric exercise can be adjusted of Health - National Center for Health at will. It is found to be effective Promotion, Philippine Coalition for in building muscle strength and the Prevention and Control of Non- burning excess fat. It slows muscle Communicable Diseases and the erosion and enhances the tone and University of the Philippines - College shape of muscles. It also help to of Human Kinetics, the 10 isometric improve bone density. Long sessions exercises in the next pages are of isometric exercise are found to recommended.
November - December 2012 I HEALTHbeat 25 Seated Leg Hold Seated V-Holds 1 (Works the outer thigh muscles, shoulders, triceps) 2 (Strengthens the abs, back)
A. Open/push legs outward while hands are pushing legs to close. While seated, lift legs together until whole body is in a "V" position, hold for up to 30 seconds.
B. Close/push legs inward while hands are trying to open the legs. For advanced: Raise arms sideward, hold for 1 minute.
Squat Against The Wall Holds Calf Raise Holds 3 (Works the thighs, legs) 4 (Works the calf muscles, ankles)
Lean against the wall until thighs are parallel to the ground, hold for up to 30 seconds. For advanced: lift toes. Raise heel and tiptoe to maximum, hold for 30 seconds.
26 HEALTHbeat I November - December 2012 Neck Holds (All Sides) Hands Clasp Holds 5 (Works the neck muscles) 6 (Works the chest triceps, deltoids)
Push head sideways, push head against hand, hold for 30 seconds. Press hands against each other full force, hold for 30 seconds.
Hands Pull Holds Hands, Triceps and Biceps Holds 7 (Works the biceps, shoulders) 8 (Works the biceps and triceps)
Bring fists together, one on top of the other, push upward and Hold hands together across chest, pull and hold for 30 seconds. downward against each other, hold for 30 seconds.
November - December 2012 I HEALTHbeat 27 Chair Dip Hold Towel Pull 9 (Works the triceps, backs of shoulders, lats) 10 (Works the triceps and shoulder blades)
Hold edge of chair and lower buttocks to the floor, hold for 30 Bring towel to back, one hand pulls upward and the other seconds. downwards, hold for 30 seconds.
KALAbeat Cyber Temptations
Jesus and Satan competed on the computer. They started typing. They did reports, e-mails, attachments and downloads. But before the time was up, the power went off. Satan cursed. Jesus sighed. When electricity came back, Satan lost everything he had done but Jesus started printing all His files. Satan shouted "YOU CHEATED!" Jesus just smiled. Jesus did what Satan didn't know. HE SAVES . The devil is in the internet. Don't fall into its prey. Art grabbed from
28 HEALTHbeat I November - December 2012 COVER story Hear the Signs by GLEN S. RAMOS HEALTHbeat Staff
The Hearing Impaired and The Deaf communicating using a manual language or sign language. Everyone falls somewhere between the two extremes of hearing ability Sign Language from perfect hearing on the one end to total inability to perceive any sound at the other. Sign language is used all over Some are hearing impaired while others the world by the hearing-impaired to are Deaf, with deaf in this case always communicate with each other and written with a capital “D.” with those that hear. It is more than A hearing impaired person just moving the fingers or hands; it may have physical hearing that ranges is a viable, visible language in which from mild loss to profoundly deafened. gestures and facial expressions play a very They can interact socially with speech and important role. with hearing, often with the aid of a hearing Sign language is a combination instrument. For those who are profoundly of finger spelling, lip formations, and signs deafened, they may have adequate hearing which are all heavily reliant on gestures earlier in life, but lost hearing ability as a and facial expressions to effectively, convey result of genetics, injury or disease. Because Deaf people have limited intelligence and meaning. Signs use visual imagery to convey of this, they may have developed spoken cannot be taught. Research shows they ideas instead of single words. Signs are more language skills but have a problem of have the same range of intelligence and reliant on gestures and facial expressions communication. capabilities as the hearing population. With than finger spelling. Sign language has On the other hand, the Deaf may intensive training by skilled professionals, crossed barriers because of its beautiful have been either born without hearing most Deaf can be taught to speak. The expressive characteristics. The facial or lost it very early in life, before spoken voices are often strange and pronunciation expressions and gestures that accompany language was well developed. They may use may be imperfect, but with desire to sign language have opened the way for hearing instruments or not, but when used communicate, most hearing people can visual articulation in art, drama, therapy, they are primarily for awareness of sound for become accustomed to Deaf speech. and many other non-traditional settings. safety reasons and to assist them to a limited It has been said that communi- It has become a language for both the extent when they need to interact with a cation is the very basis of our existence. hearing-impaired and the hearing. hearing person. Without communication we cannot interact Each country has its own sign Please do not refer to the hearing with our peers, we cannot learn language language. Sign languages have similarities impaired and the Deaf as “deaf and dumb” and at a very basic level we cannot even in terms of hand shapes, positioning, hand or “deaf-mute.” These outdated terms foster think. For most hearing impaired and location, movement, facial expression, and the belief that the hearing impaired and the Deaf, they are most comfortable palm orientation, but they differ in terms of
November - December 2012 I HEALTHbeat 29 grammar, conversation and communication gain better understanding and appreciation activities of such individual; (2) a record of depending on the culture. of the unique language and culture of Deaf such impairment or (3) being regarded as The use of sign language in the persons. having such impairment. Philippines dates back from 1907. It was There is also a Basic Filipino The definition is wide enough to known as the American Sign Language (ASL) Sign Language course at University of the include persons who may not traditionally and was used by the Filipino deaf community Philippines College of Education which is be regarded as disabled. In fact, the Magna through the School for the Deaf and Blind, open for all students who want to be trained Carta for Persons with Disabilities (PWD) now known as the Philippine School for in FSL. It offers a 10-meeting Basic Filipino further defines disabled persons as those the Deaf. The ASL became the basis for the Sign Language course at the UP College of who have restrictions or different abilities, development of the Filipino sign language Education and the Philippine Deaf Resource as a result of a mental, physical or sensory (FSL). Center. impairment, in performing an activity in According to the Department of In Congress, Representative the manner or within the range considered Education - Special Education (SpEd) Council, Antonio L. Tinio filed House Bill (HB) No. normal for a human being. the use of FSL by Deaf Filipinos has increased. 6079, entitled “An Act Declaring Filipino Sign The Philippine Coalition on the UN In 2007, 60 percent of Deaf Filipinos used ASL Language as the National Sign Language of Convention on the Rights of Persons with while 40 percent used FSL. Today, there are the Filipino Deaf and the Official Language Disabilities claims that most of the PWD in about 54 percent recorded of Deaf Filipinos of Government in All Transactions Involving the Philippines are among the marginalized who use FSL. the Deaf, and Mandating its Use in Schools, sector in the country. The top three region The FSL, however, has not been Broadcast Media, and Workplaces” on April with the most number of PWDs are: Region accepted in most schools as the medium 12. It was later referred to the Committee on 2 (Cagayan Valley) with 3,149; Region 3 of instruction (most SpEd schools use ASL Social Services on May 8 for review. (Central Luzon) with 3,004; and Region 4B courses, and colleges and universities do (MiMaRoPa) with 1,559 cases. NCR ranked not offer FSL in their curriculum). The Deaf Sign Language in Health Care fourth with a total of 1,112 (650 males and community has been advocating for the use 462 females) registered PWDs. of FSL as their native language. There is no Constitutional Among the nine types of identified The Filipino Sign Language definition of disability in the 1987 Philippine disabilities in the country – chronic illness, Learning Program of the School of Deaf Constitution. However, there exists a statutory speech and hearing, learning, mental, Education and Applied Studies at the De La definition in Section 4 of the Magna Carta for orthodontic (persons with cleft lip and cleft Salle – College of Saint Benilde offers classes Disabled Persons (Republic Act 7277) which palete), psychosocial, visual and those with each trimester to all interested Deaf, hard- defines disability as follows: (1) A physical or multiple disabilities – hearing impairment of-hearing and hearing people. It is handled mental impairment that substantially limits ranks first according to the latest PWD by Deaf instructors and each class integrates one or more psychological, physiological Registry collected by the Department of linguistic principles in its instruction to help or anatomical function of an individual or Health Center for Health Development –
30 HEALTHbeat I November - December 2012 Training some health workers in Metro Manila in basic sign language.
National Capital Region (DOH CHD-NCR), as Regional Director Eduardo C. Janairo started Medical Center in Dagupan City. of April 2012. Of the total 1,112 registered a program to educate and equip health Janairo explained language PWDs, 476 were hearing impaired, 167 were workers in Metro Manila on sign language barriers can affect patient-provider orthodontic disabled, and 167 were visual to allow them to communicate effectively to communication negatively and that service impaired. patients who have these disabilities. provision may result in insufficient care that The DOH estimated about 90 Effective communication ensures can lead to misdiagnosis, incorrect treatment percent with hearing disabilities in the impartial access to care and fosters healthy and failure to follow treatment instructions. country are born to parents who are deaf. exchange of discussion between medical “For patients to receive the proper Consequently, these children grow without staff and the patient. It is important treatment care, a health worker must learning any language – whether spoken or that health facilities have sign language communicate effectively. The inability to sign/signals. In 2004, there were 8.4 million interpreters to have communications access do so may result in unnecessary tests and PWD in the country while those with hearing for the Deaf and those with difficulty in inadequate treatment management. If there and speech disabilities totaled 87,809. hearing. The presence of interpreters create are language interpreters present in every The World Health Organization better health outcomes such as accurate health facility, a hospital staff can determine estimated that in 2000, 250 million diagnosis, treatment and adherence to a the most appropriate course of action that persons worldwide suffered from hearing treatment plan because all of these require will result in better patient care,” he said. “If disabilities – about 4.2 percent of the effective two-way communication. every health worker understands the sign world’s population. Two-thirds of the cases It was during Janairo’s assignment language, they can effectively communicate were from developing countries. Of the total, as director of CHD-Ilocos Region that he saw with a patient who is also using the same. As 222 million were adults while the rest were the need for health workers to be skilled a result, errors and inaccuracies in the filing under 15 years old. in the sign language, especially those in of information of patient and other pertinent Because of the growing number the hospitals. The project was initially records can be avoided. Messages coming of PWD in the country, especially those with introduced in Ilocos Training And Regional from both parties can be easily understood,” speech and hearing impairment, DOH-NCR Medical Center in La Union and the Regional he concluded.
November - December 2012 I HEALTHbeat 31 laughter HEALS Class Dismissed Problem Solving Nangangamote FilAm
TITSER: Who can solve this problem TITSER: Ano ang kamote? Vegetable CHICCO: May bago daw tayong kaklase. that I wrote in the blackboard: or fruit?!? JACKY: Eh, ano naman? 3 x 5 - 4 x 9 / 10 x 6 = __? KRISTAL: Fruit, Ma'am. CHICCO: Fil-Am daw eh... CLASS: (Walang imik lahat.) TITSER: Bakit mo nasabing fruit? JACKY: Maniwala ka naman dun... TITSER : Joel, go to the blackboard and KRISTAL: Kasi po kapag kumain ka ng CHICCO: Totoo, Fil-Am... Finalaki sa Am! solve the problem! kamote, mauutot ka at ang JOEL: (Tumayo, pumunta sa harapan, tunog nito ay FRUITTTTTT... Boba kinuha ang eraser at binura lahat...) 'Yan Ma’am , your Kinds of Verb TITSER: Sino ang pinaka-boba na problem is solved! babae sa buong sanlibutan?!? CLASS: (Nagpalakpakan.) TITSER: There are three kinds of verb. (Tumayo at sumagot agad ang What are they, Tony?!? baklang estudyante...) Wannabe A Billionare TONY: No, Ma'am! There are FOUR!! EDWIN: Si Eba, Ma'am! Nakita na TITSER: Oh really? What are they? nga niyang nakahubo si TITSER: Imagine you're a billionaire. TONY: Linking Verb, Helping Verb, Adan, 'yung apol pa Then, write an essay. Action verb, and ANGRY VERB! ang isinubo!!! IVAN: (Hindi nagsusulat.) TITSER: Ivan, why are you not writing? Tulog Bobo IVAN: Ma'am, hinihintay ko po ang secretary ko! TITSER: Bakit ka natutlog sa gitna AJIE: 'Tol, may TITSER: Ambisyoso. ng klase ko? nakalimutan ako. DENPOT: Napakalambing po kasi boses BORGY: Ano 'yun? Yamashita Treasure ninyo, Ma'am. Ito po ang AJIE: Bobo ka ba?!? dahilan kung bakit nakatulog Nakalimutan TITSER: Class, alam ba ninyo kung saan ako. ko nga eh! nakatago ang Yamashita TITSER: Bakit yung iba hindi nakakatulog? Treasure ? DENPOT: Kasi po hindi sila nakikinig sa CLASS: (Walang imik lahat.) inyo eh. TITSER: Ikaw Elenita, alam mo ba? ELENITA: Ayan na! Basta may nawawala Tunay na Pinoy ako agad pinagbibintangan! TITSER: Paano ninyo ilalarawan ang isang Pakpak? Tunay na Pinoy?!? PAULO: Ma'am, ang Tunay na Pinoy, LIEZEL: Ma'am bakit ang elepante kapag may nakitang gulo walang pakpak? o rambulan, hindi "Pulis" ang TITSER: Eh kung magkapakpak kaya unang sinisigaw o tinatawagan 'yan at dinapuan ka?!? kundi, "Mga kapitbahay!"
32 HEALTHbeat I November - December 2012 Muslim HEALTH Helping the Blind to Regain Eyesight by TATO M. USMAN, MD, MPAIM DOH Center for Health Development - Autonomous Region in Muslim Mindanao
Blindness in ARMM groups including warring factions between poverty. private armies. There are private practicing Blindness is one of the most Another factor is the high ophthalmologists in the proximal regions common types of disabilities in Autonomous incidence of poverty that hinders seeking but it will cost at least Php 25,000 for Region in Muslim Mindanao (ARMM). The health care from higher health facilities cataract surgical operation and Php 5,000 Disability Registry in AMMM (2007) puts outside ARMM. If the productive member for pterygium surgery excluding hospital- more than 1,709 adults of both sexes with of the family becomes blind, then there will related expenses. Records show that only visual disabilities, and of these, 1,272 were be a big financial setback to other members five ophthalmologists visit ARMM, but not from Tawi-Tawi Province. These figures of the family. The blind cannot take care of on regular basis. will continue to soar if no cost-effective oneself and therefore somebody has to take Cataract is a clouding of the lens intervention is instituted. care of him/her most of the time. This further in the eye and affects vision. On the other Blindness in ARMM stems primarily aggravates and impoverishes local folks into hand, pterygium is a non-cancerous growth from lack of visual health care knowledge and the high incidence of noncommunicable diseases particularly complications from diabetes and hypertension in the eyes. These are further aggravated by the absence of resident ophthalmologists which is in paradox to the DOH-ARMM’s Mission that states, “Ensure affordable, responsive, equitable, accessible, sustainable and exemplary healthcare in ARMM” and it is inconsistent with the principle of Kalusugan Pangkalahatan or Universal Health Care. Other hindering factors include non-contiguous geographical setting, no budget allocation for Prevention of Blindness Program (PBP) and erratic peace and order situation in some parts of the Some of the patients who benefited from the Oplan: Pangalawang Paningin of the DOH Center for ARMM localities involving several armed Health Development - Autonomous Region in Muslim Mindanao.
November - December 2012 I HEALTHbeat 33 of the clear, thin tissue (conjunctiva) that free. These patients came from communities in the Medical Code of Ethics to treat the covers the white part of the eye (sclera). in ARMM and they were operated in indigent patients regardless of creed and different hospitals, namely: Wao District socio-cultural affiliations. And as a practicing Kasama Mo si Sec – Hospital, Malabang District Hospital, Tuan ophthalmologist, Sinolinding said, “OPP Oplan Pangalawang Paningin Ligadung, Maguindanao Provincial Hospital, is dedicated to all of us who believe that Sulu Provincial Hospital, Balindong District the right to sight must be protected and Because of these enormous Hospital, Tamaparan District Hospital, Sibutu respected at all times”. challenges, ARMM Health Secretary Kadil Hospital, Upi District Hospital, Sarifollah M. Jojo M. Sinolinding, Jr. - a practicing Dipatuan Hospital, Aisah General Hospital, Merits of Helping the Blind surgeon and an internationally acclaimed Datu Halun Sakilan Memorial Hospital, ophthalmologist - proposed and spear- Deseret Ambulatory Referal Center, Buluan In Islamic facets, worships headed “Oplan: Pangalawang Paningin” or District Hospital, Lamitan District Hospital, (‘ibadah) and charitable deeds (sadaqah) (OPP) under the “Kasama Mo si Sec (KMS)” Pangutaran District Hospital and Parang are numerous from simple to complex. It is Project of the DOH-ARMM in partnership District Hospital. beyond reasonable doubt that helping the with Vision 20/20 Cataract Charities Project. The KMS and OPP are continuously blind to regain good eyesight is a part of KMS is unique and perhaps the only and regularly done ARMM-wide. worship and a form of charity. one in the country that addresses the often In fact, there are many hadiths (or neglected services that were long sought The Right to Eyesight ahadith) which rank cheerfulness towards in the far flung and geographically isolated other Muslims helping the blind, the deaf areas. KMS is a health mission that includes The 1987 Philippine Constitution and the weak, advising those who are lost not only eye surgical operation but also states, “Health is a right of every Filipino and confused, relieving the distress of the medical consultation and treatment (with citizen and the State is duty-bound to needy, etc., as forms of worship and charity. full medicines package), oral health (tooth ensure that all Filipinos have equitable Moreover, charitable deeds done for the extraction and dental care), women’s health access to effective health care services.” The welfare of the poor and marginalized and safe motherhood (reproductive health) right to health and other social services is community are the best forms of worship health promotion and advocacy, and other also embodied in the speech of President and are considered branches of faith. In health activities at the community level. It Benigno S. Aquino III during the signing of fact, simply removing harmful things from a is a hands-on impact project Sinolinding the Government of the Philippines (GPH) pathway are all charitable deeds. in support to OIC Regional Governor Mujiv - Moro Islamic Liberation Front (MILF) During the Prophets’ era, the Hataman, provincial governors, mayors and Framework Agreement on the Bangsamoro Messenger of Allah (peace and blessings other local officials. that said, “A child in Lamitan will be offered be upon him) said: "Charity is prescribed The first OPP was done in Wao the same education as a child in Quezon City; for every person every day the sun rises. To District Hospital in Lanao del Sur as the the sick of Patikul will gain access to the administer justice between two people is host hospital during the “Araw ng Wao“ same healthcare as those in Pasig; tourists charity. To assist a man upon his mount so celebration in January 2010. With the initial visiting Boracay will also have Sulu in their that he may ride it is charity. To place his success of the program, OPP then became itineraries; a businessman will earn a profit luggage on the animal is charity. To remove a byword and a source of attraction among whether he sets up shop in Marikina or harm (or harmful things) from the road (or people to join and participate the various Marawi.” pathway) is charity. A good word is charity. KMS activities. Needless to say that indigent Each step taken toward prayer is charity." From January 2010 to February blind, with curable blindness, has right This was narrated by Ahmad et al. 2011, a total of 802 cataract and 411 from his/her local chief executives to be In addition, the Messenger of Allah pterygium patients underwent operations, funded, like PhilHealth enrollment, in order (peace and blessings be upon him) said: and a total of 1,213 patients were served. to regain eyesight and be integrated to the "Allah, the Majestic and Mighty, shall say on Four of these patients benefited from mainstream society. the Day of Judgment: 'O son of man! I was ill PhilHealth while the others were served for As a physician, it is enshrined and you did not visit me.' He will reply: 'O my
34 HEALTHbeat I November - December 2012 Lord! How could I visit You and You are the Similarly, the Messenger of Allah upon some phlegm in a masjid (mosque) Lord of the Worlds?' Allah shall say: 'Did you (peace and blessings be upon him) said: is charity, removing an obstruction from a not know that My slave, so-and-so, was ill "Every Muslim has to give charity." The people pathway is charity”. and you did not visit him? If you had visited asked: "O Prophet of Allah, what about the However, Umar bin al-Khattab him, you would have found Me with him. O one who has nothing?" He said: "He should related that the Prophet (peace and blessings son of man! I asked you for food and you did work with his hands to give charity." They be upon him) said: “Deeds are (a result) not give it to me.' He will reply: 'O my Lord! asked: "If he cannot find (work)?" He replied: only of the intentions (of the actor), and an How could I give You food – You are the Lord "He should help the needy who asks for individual is (rewarded) only according to of the Worlds?' Allah shall say: 'Did you not help." They asked: "If he cannot do that?" He that which he intends. Therefore, whosoever know that My slave, so-and-so, asked you replied: "He should then do good deeds and has emigrated for the sake of Allah and for food and you did not give it to him? Did shun evil, for this will be taken as charity." His messenger, then his emigration was you not know that if you had given the food, This was related by al-Bukhari et al. for Allah and His messenger. Whosoever you would have found that with Me? O son Likewise, Buraydah (RA'A) narrated emigrated for the sake of worldly gain, or of man! I asked you to quench My thirst and that the Prophet (peace and blessings be a woman (whom he desires) to marry, then you did not.' He will say: 'O my Lord! How upon him) said: "A man has three hundred his emigration is for the sake of that which could I quench Your thirst--You are the Lord and sixty (360) joints. He must give sadaqah [moved him] to emigrate" - Narrated by of the Worlds?' Allah shall say: 'My slave, so- for each one of them." They ([the Prophet's Bukhari and Muslim. and-so, asked you to quench his thirst and companions) said: "Who can afford to do so, Finally, a wise man once said: you did not. If you had given him to drink, O Apostle?" thinking that It was a financial "Rather than cursing darkness, try to light a you would have found that with Me.' " This charity. The Prophet (peace and blessing candle for the road." was narrated by Muslim. be upon him) then said: "Heaping earth Allah Almighty knows best. Practice to be Happy Happiness does not come from discover the purpose of your life, you are being born rich, beautiful or popular. living a life of mediocrity. Build your career Happiness is the sum of your life choices, or start a business around your passion. Do thoughts and actions. Get started and what you love, you will never work a day practice to be happy. in your life. Ask yourself these questions: Invest in relationships. What excites and energizes me? What Studies suggest that relationships provide are my proudest achievements? How do I the strongest meaning to your life. Friends want others to remember me? and family help you celebrate life's Cultivate optimism. Develop the Live in the moment. Don't successes and support you in difficult habit of seeing the positive side of things. If postpone joy waiting for a day when times. Although it's easy to take friends you are not an optimistic person by nature, your life is less busy or less stressful. That and family for granted, these relationships it may take time for you to change your day may never come. Instead, look for need nurturing. pessimistic thinking. Start by recognizing opportunities to savor the small pleasures Express Gratitude. Build up negative thoughts as you have them. Then of everyday life. Focus on the positives in your emotional account with kind words take a step back and ask yourself these key the present moment, instead of dwelling and actions. Be careful and gracious questions: Is the situation really as bad on the past or worrying about the future. with critique. Let people know that you as I think? Is there another way to look at --- appreciate what they do for you or even the situation? What can I learn from this Article based on "How to be happy: Tips for just that you're glad they are part of your experience that I can use in the future? cultivating contentment" posted in the Mayo life. Find your purpose. Until you Clinic website. Photo floats in the Internet.
November - December 2012 I HEALTHbeat 35 personal HEALTH Rehabilitation of Ostomates Let's Be Heard! by RONALD S. LORA National Federation of Ostomates of the Philippines, Inc. (Email Address: [email protected])
“Let’s be heard!” This is the theme of World Ostomy Day 2012 which was celebrated on October 6 that aimed at improving rehabilitation of ostomates worldwide by bringing to the attention of the general public and the global community to the needs of ostomates and their families. An ostomate is one who has undergone ostomy or a surgical procedure creating an opening in the body for the discharge of body wastes. Certain diseases of, or injuries to, the bowel or urinary tract involve removing all or part of the intestine or bladder. This creates a need for an alternate way for feces or urine to leave the body. An opening is surgically created in the abdomen for body wastes to pass through. Ronald S. Lora, the writer, giving a presentation to ostomates during World Ostomy Day Celebration in The opening that is created at the end of the Batangas Regional Hospital. (Photo by Dr. Carlo Alejandro Ilagan) bowel or ureter is called a stoma, which is pulled through the abdominal wall. A bag In a country where there is very little order to send the correct signal and called a stoma appliance or ostomy bag is awareness about ostomy, several myths and strong consciousness to other people is placed around the opening to allow stool or misconceptions surround people wearing for ostomates to support each other and urine to drain. an ostomy bag. The initial reaction they get strengthen one’s ranks. It is very sad for There are three kinds of ostomies: other people is varied. Some get so surprised people having the bag to think so little of 1) a colostomy is made from the large and curious while others get so excited oneself when the possibilities for a quality of intestine or colon; 2) an ileostomy is made making it such a big deal. On the other hand, life is still one and the same. I encountered from part of the small bowel when the whole there are some who empathizes with the people who have fallen desperately to colon is removed; and 3)A urostomy is made condition of ostomates. depression because of the inability to accept when there are bladder issues. And there are It all boils down to positive having a bag. It was not colon cancer that people who actually wear two ostomy bags. information that brings awareness. In took away their lives but depression and the
36 HEALTHbeat I November - December 2012 feeling of disgrace. and behold, there have been a few Whenever I get the chance who have courageously responded to attend speaking engagements to join and step forward. It takes a in lay forums with ostomates and lot of work and so much initiative to doctors, I always say in my opening invite people with a personal touch statement that having the bag is to create self-supporting groups not that bad at all. One of the perks where ostomates help ostomates. ostomates like me enjoy is that we It is not a far-fetched vision but a no longer have to rush and run when doable one. It will take time but very we have to use the toilet. This will achievable. send smiles to the faces of ostomates The partnership we built but I go deeper to my message. with the Department of Health in It has been for a long supporting the advocacy of building time that society dictates how ostomy support group for patients unacceptable an ostomy bag can has been well supported by hospital be. This time around we are here to chiefs and staff of the surgery disprove that it is not the ostomy departments. And with Health bag that runs our life. In fact, we Secretary Enrique t. Ona around, we control our life and it is not the other are assured that we can continue to way around. There have been a lot of propagate our advocacy to reach out success stories that ostomates have to poor and indigent ostomates by achieved and trials overcomed that empowering them that life is good, tells the world, “Yes we can!” After training them to assist and counsel all, having a ostomy is the second fellow ostomates, and cover the chance to life and having one is whole islands of the Philippines with taking a shot to inspire others and the message that having a bag is an spread awareness. extension of life. Whenever the World World Ostomy Day too is a time Ostomy Day is celebrated in the of reverence and respect for fellow Philippines, I get the chance to meet ostomates and friends who has ostomates from different parts of already gone before us. I bow in the country. Six years ago after my silent prayer remembering them and surgery, I felt so isolated and alone thanking them for the friendship that I might be the only person with and time spent together. They will this kind of special condition. I never be missed but they will be with us as TOP: Turnover of ostomy appliances from the DOH Warehouse to DOH thought that there were “others” hospitals. (Photo by Dr. Carlo Alejandro Ilagan) BOTTOM: Dhon Joseph we trail blaze in meeting new fellow too. I have started building support Cailes, 15 years old, recipient of colostomy bag. (Photo by Ronald S. ostomates. groups in different hospitals, and lo Lora) - o O o -
Share your PERSONAL HEALTH stories. Email your article and photos at [email protected].
November - December 2012 I HEALTHbeat 37 HEALTH resources DOCTORS TO THE BARRIOS Joy in Service by ELIZABETH G. MASCAREÑAS HEALTHbeat Staff
Revisiting the DTTB Program due to exigency of service. However, other basic health services; improved health doctorless municipalities were identified, as seeking behavior by the community; In 1992, when the country’s the movement of the much needed medical improved RHU systems e.g. referral, disease population was estimated at 64.4 million, professionals was becoming more evident. surveillance, emergency response, among there were 271 municipalities that were Thus, the scope of coverage was expanded others; active local health boards; and local identified as doctorless for 10 years or to the depressed municipalities where poor, health executives have more consultative more. The inadequate distribution of health marginalized and vulnerable populations and participatory approach to planning and resources contributed to high morbidity are most prominent, disaster prone areas, decision making on health issues. and mortality rates not only in the said hard-to-reach municipalities especially municipalities but also in the whole country those that are geographically isolated and 19 Years of DTTB Program as well. disadvantaged, conflict areas, economically For this reason, the Department underdeveloped municipalities giving Now on its 19th year, 29 batches of Health created the Doctors to the Barrios priority to fifth and sixth income class of DTTB have been deployed with 553 (DTTB) Program in 1993. The program municipalities, and the 609 poorest physicians serving 390 municipalities since is lodged under the DOH Health Human municipalities identified by the National the start of the program. Currently, the DTTB Resource Development Bureau and its Anti-Poverty Commission based on poverty Program is host to 110 municipalities in 16 main objective is to deploy competent and incidence. regions, and this is composed of 43 scholars dedicated doctors to doctorless, hard to Other considerations include: under the Pinoy MD Medical Scholarship reach, and economically underdeveloped doctor to population ratio using the World Program, 61 scholars of the First Gentleman municipalities. The doctors to the barrios will Health Organization trend of 1:20,000; (FG) Foundation, Inc., and six (6) walk-in render two (2) years of service and they have replacements for current municipal applicants. Four (4) of the 110 doctors have an option to continue if they opt to. health officers who are on study leave; been absorbed by the LGUs. The DOH Centers for Health and municipalities with health programs/ To fully maximize the potential of Development (CHDs) are responsible for the projects whether locally or foreign funded the DTTB as health leaders and managers implementation of the DTTB program in their and requiring a doctor as program/project of local health systems, the DOH partnered respective areas with the coordination and manager. The benefits from having a doctor with the Development Academy of the participation of the local government units will result to quality health care even to Philippines (DAP) for a graduate degree (LGUs). The doctors assume the position as the remotest of the municipalities in the programs tailored fit for them. The Master local health leader, rural health physician Philippines. in Public Management Major in Health and municipal health officer. The direct benefits of having Systems and Development equips the doctor Through the years, the DTTB doctors in the community are seen in in health governance, health financing, Program has served all 271 municipalities, improved and more efficient rural health service delivery, health policy, standards and many of which were served more than once unit (RHU); access to adequate and effective regulations, human resources for health, and
38 HEALTHbeat I November - December 2012 health information. This Master’s program, become part of the DTTB Program, two of Pangkalahatan or universal health care is which started in 2009, blends both learning whom have already been absorbed by LGU well on its way to becoming a reality.” and deployment in its curriculum over a 2 hospitals. The new batch is composed of 67 year period. products of the Pinoy MD Program and 46 FG Special Merit Awards Apart from the academic Medical Scholars. incentive, the DTTB receives a competitive Health Secretary Enrique T. Ona, One of the highlights of the salary including benefits from Magna Carta. in his keynote address during the DTTB graduation ceremony was the giving out of The DTTB also receive additional benefits graduation ceremony, said, “This course Special Merit Awards to some doctors to the from LGUs (e.g. modest board and lodging, honed your skills in critically examining barrios who have shown exemplary actions honoraria, among others). The DTTB also has health and development issues and concerns and innovations to respond to the needs of access to a vast network of government as confronting health professionals in the his/her community to improve and promote well as non-government institutions as part public sector at the national and local level. their health status at present and in the of their professional support. Your studies gave you a clear understanding future. In October 2011, DAP recognized of the causes and factors that bear on health Dr. Rosalyn C. Panao of Tubo, 18 DTTB with the Diploma in Health and development issues and concerns. Abra garnered the Special Merit Award as Systems and Development while 26 DTTB Completing this course allowed you to polish Community Organizer for bringing together have completed all the requirements for and apply leadership and management all sectors in the community to help improve the Master in Public Management Major in strategies in planning, implementation, the health status of the people. She led the Health Systems and Development degree. monitoring and evaluating health policies, community and different stakeholders in This year, on October 20, a total programs, projects and interventions.” her programang pangkabuhayan, like the of 38 DTTB have been conferred the degree He added that the enthusiasm “May Pera sa Basura Project” as well as in of Masters in Public Management major in and energy in the doctors to the barrios implementing healthy lifestyle and nutrition Health System and Development Program, reassures “not only is there hope for the programs. while 113 new doctors have officially health sector, but our dream of Kalusugan Dr. Jan Krisna M. Rodriguez of
Photo by Paking Repelente
November - December 2012 I HEALTHbeat 39 Mapanas, Northern Samar received the Special Merit Award as Health Advocate for her aspirations to spread different health information to the community. Her health information caravan helped the community to know and learn about the different health programs of the LGU and the DOH. Her advocacy was sustained by the enactment of 10 local ordinances to respond to the health needs of the community. Dr. Edgardo N. Samson of Alegria, Surigao del Norte got the Special Merit Award for Service Orientation. Adversity and harsh conditions did not stop him to render excellent service to his community. His dedication to implement the different health programs led his municipality to win Dr. Michael S. Caampued (third from left) – a doctor to the barrios who started serving in Polilio, the Outstanding Rural Health Unit of Surigao Quezon since September 2010 – receives the Grand Distinction Award, the highest honor among the del Norte, based on the indicators set in the Special Merit Awards during the graduation ceremony for the Doctors to the Barrios Program at the LGU scorecard for Kalusugan Pangkalahatan. Development Academy of the Philippines, Tagaytay City in October. Also in photo from left to right are: Dr. Cherylle G. Gavino of Sabtang, Assistant Secretary Enrique Tayag, Undersecretary Nemesio Gako and Health Secretary Enrique Ona. Batanes received the Special Merit Award for Performance Excellence Award. Being Award, the highest honor among the Special benefits of the employees. Moreover, he an outsider and the youngest among Merit Awards. He showed his expertise and was able to get funds from the Philippine the health workers, she did not easily knowledge in all aspects of being a DTTB. Charity Sweepstakes Office (PCSO) and achieve the support and trust of her local With the realization of his 3K his congressman to put up the “Land and chief executives. However, she continued (Kilusang Kumpletong Kalusugan) program, Sea Ambulance.” Dr. Caampued likewise showing them dedication to work and good he was able to share to his constituents received funds from different sectors worth intentions to help her community. Her RHU his knowledge to attain good health. For P5.4 million and used the said amount to was the first and only RHU in the province this he was awarded with the “Exemplary augment the funds from the DOH Health to be accredited in implementing Philhealth Implementation of the Program on 3K: Facility Enhancement Program to modernize 3-in-1 plus 1. Also, her “Bote Drive” project Kontra Lamok” to fight against malaria and their RHU. The community now enjoys not was able to gather 40,000 bottles worth filariasis, that also paved the way for his only a beautiful facility but also good health P36,070 which the community used to municipality to be recognized as the second services from their RHU that they long support and implement the nutrition and ranking performer in the whole province. deserved. In fact, his municipality got the healthy lifestyle programs. Because of these He was also able to help the youth with his “Top Performing RHU on Electronic FHSIS” programs, the municipality was awarded “Beauty for a Cause” program where beauty for health information dissemination in the the Green Banner Award for Nutrition in pageant candidates also serve as the models whole region. 2011, the Most Outstanding Municipality in for health. He also started the “Facility-Based Sec. Ona said that he is very proud the Province, and second place in the whole Delivery” that reached 58.50% from 0%. of the current batch of doctors to the barrios region. Moreover, Dr. Gavino received the His innovation in raising funds because they have chosen the more difficult Exemplary Leadership Award for her drive to for his projects led to fruitful partnerships path, which is serving the rural and far-flung fight dengue. with public and private institutions that areas of the country. "May they find joy in Dr. Michael S. Caampued of Polilio, resulted to the legislative approval for the service and that they may bring this joy to Quezon acquired the Grand Distinction increase of salaries and other Magna Carta the people they will serve,” he concluded.
40 HEALTHbeat I November - December 2012 YEAREND review T R E N D I N G HEALTH NEWS I N 2 0 1 2 HEALTHbeat brings you the Top 10 trending health news that stirred the Department of Health as gleaned not only from the traditional media (print, broadcast and film) but also from the new media (Internet and including the social networking sites), with some opinions from the editorial staff. Let's do the countdown... 10 Dance for Health
Assistant Secretary Enrique dance moves appealed to audiences “Eric” A. Tayag is known as the everywhere. He is a strong advocate DOH spokesperson giving tips on of healthy lifestyle and he finds time preventing all sorts of illnesses in for a routine workout at the gym since media, but this is not the reason why five years ago. he is in our health news countdown – On June 2, his dance grooves were he literally danced his way in. again in the news as he led some 20O In late December 2011, people to a flash mob entitled “Dance Tayag tried to convince Filipinos not to for Life” at the Greenbelt Activity use firecrackers to celebrate the New Area in Makati City. This was held Year with his cool moves. This was in collaboration with Fitness First caught by ABS CBN cameras and was Philippines to build awareness on first featured in their late newscast, Health Assistant Secretary Eric A. Tayag leads a surprise dance flash fitness and exercise. “Bandila.” The following day, his mob. (Screen grab from GMA's 24 Oras) Now, whenever and wherever dance moves were spoofed in the popular but three times during the holiday season. Tayag is invited to speak, he would lead his TV Patrol segment – “Mga Kwento ni Mark Almost instantly, Tayag became a trending audiences in a dance exercise that feature Logan.” This was shown not once, nor twice, topic in social media when snippets of his the latest upbeat dance music. Paputok: Hard Habit to Break 9
Towards the end of 2011 and onto fingers as a result of firecracker blast and Reduction. The acronym hinted at a common the first few days of January, the Department instead focused on a complete set of fingers goal and symbolized people in agreement of Health and its parners took a 360-degree that represented five reminders to prevent and Filipinos as one in reducing or even turn in its fireworks and firecrackers injury injury and five suggestions to keep safe while eliminating paputok-related injury cases. prevention campaign strategy that veered celebrating the holidays. The campaign The DOH even launched "Goodbye away from showing graphic mutilated was called APIR or Aksyon Paputok Injury Paputok," a compact disc (CD) containing
November - December 2012 I HEALTHbeat 41 Two versions of the TV ad on APIR (Aksyon Paputok Injury Reduction) that veered away from the gory pictures of blast victims that the Department of Health did in the previous years. nine tracks of firecracker sounds produced one was due to stray bullet. And for the number of injuries has hit a plateau. Could by the rock band, 6 Cycle Mind and packaged whole surveillance period from December it be that whether the campaign strategy like a big triangle firecracker. 21, 2011 to January 5, 2012 in 50 sentinel becomes negative or positive, there would After all that was said and done, sites, the DOH registered a total of 1,021 not be a big change in statistics? Let's all the year's revelry turned out to be the injuries – only one case less from the total wait and see, same time this year and next deadliest with a total of 4 deaths recorded. injuries in the previous year. Analyzing the year. Three deaths were due to blast injuries while surveillance reports in the last five years, the - o O o -
8 Stem Cell Therapy
What do Former President and Disease), metabolic diseases (e.g., now Pampanga Representative Gloria diabetes), and immune cell therapy are Macapagal Arroyo, Senate President still under clinical evaluation and study. Juan Ponce Enrile and Former President The advisory added that while Joesph Estrada have in common? They research has shown that adult stem are among the high profile politicians cells and umbilical cord stem cells are and celebrities who are reported and the safest and most ethical, the public have confirmed undergoing stem cell is warned that claims of preventive therapy. and curative benefits of stem cell Stem cell treatment is a type therapy are still on their investigative of intervention strategy that introduces Embryonic stem cells. Photo grabbed from
42 HEALTHbeat I November - December 2012 Vibrio Cholera & Rotavirus 7
On June 20, the province of Ona and Catanduanes Governor Joseph Cua local government to educate the people on Catanduanes was placed under a state of spearheaded the distribution of potable proper hand washing and other measures to calamity because the number of diarrhea water to affected barangays in Virac in prevent further spread of diarrheal diseases, cases increased significantly particularly order to reduce diarrhea cases in the area. including cholera. in the municipality of Virac. This sudden The Department of Health Center for Health Meanwhile, on July 2, the increase of reported cases coincided with the Development in Bicol also worked with the Philippines became the first country increase in cholera suspects in the area. in Southeast Asia to implement the The suspected source of contamination recommendation of the World Health was the improvised spring located Organization (WHO) to introduce the along Sto. Domingo River and used by life-saving rotavirus vaccines in the affected communities as their source expanded programme on immunization. of drinking water near the quarry site. No less than President Benigno S. Aquino Also, 12 water sources were positive from III launched the giving out of rotavirus contamination- eight samples for E. Coli, vaccines, starting with 700,000 infants two for Aeromonas, and two from vibrio from 1-1/2 to 3-1/2 months living in the cholera. poorest communities which have the From January to June 19, 2012, highest child morbidity and mortality diarrhea cases in Catanduanes reached rates from diarrheal diseases. 1,730 with 14 validated deaths. Of the Rotavirus is a virus that infects 250 samples taken from residents, 31 the bowels. According to WHO statistics, tested positive for vibrio cholera. All rotavirus is the most common cause of 11 municipalities of Catanduanes were diarrhea in infants and children resulting affected with Virac (809), San Andres in deaths of about 600,000 children Health Secretary Enrique T. Ona administers the oral (447), and San Miguel (87) having the rotavirus vaccine to an infant while President Benigno and over two million hospitalizations most number of cases. S. Aquino III looks on during the ceremonial launch in worldwide each year. Health Secretary Enrique T. Malacaňan Palace. - o O o - 6 Alert on Emerging Viruses
In July, the World Health disease (HFMD) caused by Enterovirus 71 which has been associated with serious Organization (WHO) and the Ministry of (EV-71). complications, and may be fatal. One of the Health of the Kingdom of Cambodia issued The WHO explained that HFMD is complications is dehydration since some a press release that reported a respiratory a common viral illness that mostly affects are not able to swallow enough liquids disease with neurological system symptoms infants and children below five years old. due to painful mouth sores. Moreover, EV- affecting children under seven (7) years HFMD is usually a mild disease, and nearly all 71 has been associated with meningitis old. It was announced as a “mysterious patients recover in seven to 10 days without and encephalitis, and may cause severe disease,” and as part of the International medical treatment. It is most commonly complications, including neurological, Health Regulations, neighboring countries caused by coxsackievirus A16 which usually cardiovascular and respiratory problems. are forewarned to act appropriately. results in a mild self-limiting disease with In the Philippines, the Department Extensive investigations concluded severe few complications. However, HFMD is also of Health said that EV-71 infections occur complications of hand, foot and mouth caused by Enteroviruses, including EV-71, in the country but are not included in the
November - December 2012 I HEALTHbeat 43 rreportable diseases. The fatal including the coronavirus that EV-71 infection is still very rare in caused severe acute respiratory the Philippines. Health Secretary syndrome (SARS). Moreover, Enrique T. Ona instructed the a comparison of viral genetic National Epidemiology Center sequences from the two patients to include EV-71 infection as a indicated that the two viruses notifiable disease in the country are closely related. Treatment is where all health providers, supportive because no specific particularly physicians, must report therapy has been shown to be individual cases or even outbreaks. effective. Laboratory screening of specimens By October, no additional and confirmation of cases are done Symptoms of Hand, Foot and Mouth Disease. (Photos courtesy of DOH- confirmed cases have been reported National Epidemiology Center) at the Research Institute of Tropical and there is no evidence so far of Medicine. person-to-person transmission In September, the WHO worked closely to better understand the of the novel coronavirus. The WHO did not alerted again health authorities around public health risk presented by the new advise special screening at points of entry the globe about the recently detected, coronavirus strain. with regard to this new strain, nor did it novel coronavirus in two patients, both Coronaviruses are a large, diverse recommend any travel or trade restrictions. previously healthy adults who suffered group of viruses that affect many animal The WHO recommended health severe respiratory illness. The first patient, species. A few of these viruses cause a wide workers to be alert to anyone with acute a man aged 60 years from Saudi Arabia, range of respiratory illness in humans, respiratory syndrome and needing hospitali- was hospitalized in June 2012 and died; typically with "common cold" symptoms. zation who had been in the Middle East the second patient, a man aged 49 years The genetic sequence data indicate that this where the virus was found or in contact with from Qatar with onset of symptoms, who new virus is a beta-coronavirus similar to bat a suspected or confirmed case within the last was transported to the United Kingdom for coronaviruses, but not similar to any other 10 days. intensive care. The WHO and its partners coronavirus previously described in humans, - o O o - Mosquito Bites 5
In June, during the observance January 1 to August 18 and 14.14 percent clinical signs with, but is not as deadly as, of ASEAN Dengue Day (June 15) in San higher compared to the same period last dengue. There is no cure for this viral disease. Fernando Pampanga, the Department of year at 70,745 cases. Deaths from dengue Treatment is focused on relieving the Health and the Philippine Information also increased from 424 last year to 496 this symptoms. Moreover, chikungunya merits Agency launched the dengue "text blast." year. Majority of the cases continued to be in the same urgency from doctors and patients. Under the system, the PIA conducts a mobile the National Capital Region (NCR), Central Health Assistant Secretary Enrique phone ‘text blast’ about dengue prevention Luzon and CaLaBaRZon. Tayag said that chikungunya is not new in in an affected area while the health teams Despite these news, dengue did the Philippines as cases have been reported conducted investigation. In July, the not end up as the top health news, and in fact in the previous years. He said that in 1990s, encouraging result of the rigorous testing became just one of three mosquito-borne the country already had cases and last year, of anti-dengue mosquito traps landed in diseases in the news this year. Hogging the there were more than 1,000 cases reported. the State of the Nation Address of President news limelight with dengue is the disease This year, the first to report Benigno S. Aquino III in Congress. In the called "chikungunya" – a mosquito-borne chikungunya was Cagayan de Oro. Tayag middle of August, dengue cases breached disease that affects mainly adults which said in news reports it is possible that the 80,000 mark, that is 80,745 cases from causes fever, severe joint pain and shares Chikungunya-causing Aedes aegypti
44 HEALTHbeat I November - December 2012 mosquitoes bit some of the relief workers On the brighter side of prevention who went to Cagayan de Oro during the and control of mosquito-borne diseases in devastation caused by Typhoon Sendong and the country, Health Secretary Enrique T. Ona they brought the virus when they returned announced in August the possibility of the home. Philippines being malaria-free by 2020 as Chikungunya cases are being he cited data that showed an 80% decrease way to elimination reported in Ilocos, Cagayan Valley, Metro in malaria cases in 2011 as compared to status, reporting less Manila, Calabarzon, Albay, Western Visayas, 2003. He said that this decrease is the than one case per 1,000 Northern Mindanao, Davao and Caraga. In lowest malaria level on record for the population-at-risk, and September, the DOH monitored the reported country in 42 years, with only 9,642 10 provinces have their outbreak in Surigao del Sur, and on reports cases in 2011 as compared to 43,441 in cases under control. that some 114 cases were recorded, Tayag 2003, and that the country’s Millennium The nine provinces that have said only a few of them were confirmed to Development Goal No. 6 of halting and reached elimination status are: Abra, be chikungunya. reversing the incidence of malaria by 2015 Batanes, Camarines Sur, Cavite, Dinagat, In October, Tayag said that the DOH have already been met. Laguna, Misamis Oriental, Quirino, and has been analyzing if cases of the disease He also explained that of the Romblon. Only two provinces (Palawan and reported in several parts of the country 58 provinces which are currently listed Tawi-Tawi) report more than 1,000 cases are connected to the cases in Cagayan de as endemic, nine have actually reached a year and only four have more than 100 Oro. He added that the 600 cases recorded elimination status (or do not have malaria cases but less than 500 cases a year (Sulu, nationwide this year are not likely to surpass cases for at least 3 years) and are in various Maguindanao, Mindoro Occidental, and the more than 1,000 cases in 2011. stages of evaluation. Forty (40) are on the Zambales). 4 Internet, Prostitution & HIV/AIDS
The number of HIV/AIDS cases in gay but about men having unprotected the Philippines has surpassed the 10,000- sex with men. mark in July. The Department of Health's In October, the DOH announced Philippine HIV/AIDS Registry showed the results of its study conducted last year that from 1984 to September 2012, there that showed online social networking were 10,830 HIV cases and 1,078 of them contributes to the rise in the HIV/AIDS became AIDS with 353 deaths. To date, cases in the country. The study covered about 10 new cases are reported daily. 180 MSM respondents. Of the 180 Since the first AIDS case was respondents, 124 admitted to using online diagnosed in 1984, the HIV/AIDS level network sites for dating and sex, while in the Philippines has been regarded as 133 said they had sex with people they mysteriously “low and slow.” However, Photo from a DOH HIV/AIDS poster targeting men who contacted through online network sites. latest statistics seem to suggest that the have sex with men. Those who engaged in sex were between country's luck is running out. Although HIV from 2007 there has been a shift in the the age of 14 and 36. prevalence remains below one percent of the predominant trend of sexual transmission Health Assistant Secretary and general population, it has already breached from heterosexual contact (20%) to males Director of the National Epidemiology Center one percent among key population at higher having sex with other males (MSM, 80%). Dr. Enrique Tayag said, “Through online risk. The DOH clarified that men who engage in networking sites, MSM can meet without Sexual contact is the most sex with men were not all homosexuals. It fear of negative social consequences. He common mode of HIV transmission, but reiterated that HIV/AIDS is not about being added that with the Internet increasing
November - December 2012 I HEALTHbeat 45 the rates of risky behavior, online social said the criminalization of sex-related jobs Enrile made a strong statement on the networking can now be included as an increases workers’ susceptibility to HIV by recommendation in media and said, "We evolving risk factor for HIV/AIDS. The list “fuelling stigma and discrimination, limiting can't just obey what the UN wants. If other the risky behaviors contributing to the rise access to sexual health services, condoms countries want all their women to become of HIV/AIDS includes not using condoms, and harm reduction services; and adversely prostitutes, then it's up to them." multiple sex partners, men having sex with affecting the self esteem of sex workers and Meanwhile, the Philippine men and injecting drug users. their ability to make informed choices about Commission on Women is echoing the UN Also in October, the United their health.” The recommendation is also a call for the decriminalization of prostitution Nations (UN) report that recommended to move to stop the exploitation of sex workers but is opposing its legalization. It views legalize prostitution jolted the nation. The and to give them basic rights by suggesting prostitution as an exploitative system that UN said the decriminalization of the world’s that their jobs, too, should have typical commodifies and dehumanizes women, oldest profession in the Asia and the Pacific workplace standards in line with the law and men and children who are being victimized Region help curb the spread of sexually government. within the system. transmitted diseases, especially HIV. It also Senate President Juan Ponce - o O o - Surge of Leptospirosis 3
Leptospirosis cases and deaths (Habagat) rains. The DOH conducted a quick members. A case rate of P 11,000 shall be rose early this year as an aftermath of flood count for admissions of Leptospirosis in 20 paid for moderate leptospirosis, while severe brought by typhoon Sendong in Region 10 Metro Manila hospitals already noted 783 leptospirosis shall be reimbursed fee for on December 17, 2011. In the first week of cases and 34 deaths. Half were recorded service. January 2012, the Department of Health in San Lazaro Hospital. By August 18, the A controversial news on Center for Health Development (CHD) in number of leptospirosis cases in the country leptospirosis was announced by President Northern Mindanao reported a total of 599 reached 2,471, with 129 deaths. This is 62.35 Benigno S. Aquino III during one of his relief suspected cases and 16 deaths in Cagayan percent higher compared to the 1,522 cases operation visits on August 8. He said an de Oro and Iligan, giving a case fatality rate recorded during the same period last year. unidentified pharmaceutical company that of 4.2 percent. Health Secretary Enrique T. Ona allegedly raised the price of its leptospirosis In August, another surge in announced that persons in areas affected medicine, doxycycline, by up to 750 percent. leptospirosis cases occured due to the by the Habagat rains and diagnosed amid the heavy flooding in many parts of massive flooding in many areas of Luzon, with leptospirosis shall be automatically Luzon. The company was allegedly selling including Metro Manila, resulting from the covered by the Philippine Health Insurance its leptospirosis medication between P50-75 heavy and continuous southwest monsoon Corporation (PhilHealth), including non- from its previous price of P10.
Grabbed from cozza-chan!'s photostream at flickr
46 HEALTHbeat I November - December 2012 Doxycycline is an antibiotic that particularly antibiotics at affordable or some cases it can take as little as two days or is currently recommended to prevent reduced prices. as many as 30 after exposure. leptospirosis among those with increased Leptospirosis is caused by The common signs and symptoms risk of exposure. However, doxycycline does leptospira bacteria found in both wild of early-stage leptospirosis include high not totally protect against leptosirosis. and domestic animals, including rats, fever, severe headache, muscle pain, Those who will develop fever even after dogs, cattle, pigs, horses and insectivores chills, redness in the eyes, abdominal taking doxycycline should go to their doctor (carnivorous mammals that survive by pain, jaundice, haemorrhages in skin and for examination. Moreover, doxycyclin is eating small insects). Rats shed large mucous membranes, vomiting, diarrhea and NOT recommended for pregnant women amounts of leptospires in their urine, and rashes. When patients are not managed, and children below eight years of age. human transmission occurs through contact the kidneys, lungs and intestinal tract can Ona, for his part, appealed to drug of the skin and mucous membranes with be affected, causing decreased urination, manufacturers, distributors and pharmacies urine-contaminated water, damp soil, coughing out of blood, breathlessness and throughout to country to keep, if not vegetation or mud. It takes about 10 days intestinal haemorrhage. reduce, the prices of drugs and medicines, before manifestations appear, though in - o O o - 2 The RH Bill Emoticons
Emoticons are emotional graphics and massive flooding, or visual ways to express the way a person a Twitter post made by feels when words alone are not enough. This Zambales Representative also best describes what has happened and Milagros "Mitos" Magsay- still happening in the country on tackling say, a very vocal anti-RH the most devisive piece of legislation, the lawmaker, landed in an Reproductive Health (RH) Bill. Laughing article of a national paper at Senator Miriam Defensor-Santiago's where she said, “Heaven pick-up line jokes has been overshadowed must be crying, we should by too many varied emotions in this year's undo what has been done.” neverending soap opera on the RH Bill. The report noted that Grabbed from
November - December 2012 I HEALTHbeat 47 in the last part of his turno en contra unacceptable and that the paper should speech, netizens were again alerted and "reevaluate itself" to be "worthy of its accused Sotto of committing the same reader's respect," while the LaSallian, blunder, this time translating parts of a the student publication of De La Salle, 1966 speech of then US Senator Robert although commending the Varsitarian Kennedy without attribution. But Sotto for taking a courageous stand against RH insisted in media reports, "The people bill said, "the method of expression used who think this is plagiarism should think to express the matter veered away from again. I did not copy it. I translated it. the real issue, while creating new and Do they know the spelling of ‘copy’ and unnecessary ones." ‘‘translate’? Mahina tuktok nila.’’ Towards the end of October, the One thing led to another, the new and compromised version of the drama turned into comedy as people RH Bill was announced by the House were coining new words like "sotto copy" of Representatives. Albay Rep. Edcel Grabbed from
Sin tax is a tax levied on goods alcoholic drinks are among the cheapest new excise tax law that would be compliant that are neither luxuries nor necessities, in the world! Cigarettes, for example, with the global standards. and in general considered to be harmful to have become cheaper relative to basic At the House of Representatives, society. The most common of these goods commodities such as food, education, and there were at least 12 measures seeking are alcohol and tobacco. Sin tax is usually health in the past 10 years. The current to restructure the excise tax on alcohol imposed to generate additional revenue multi-tiered tax system puts the youth and and tobacco products, but the one being for the government, and to discourage and the poor in a trap by the ills of smoking and supported by the Aquino administration reduce the consumption of these harmful drinking as it encourages them to shift from is House Bill (HB) No. 5727, penned by products, protecting public health and higher-priced to lower-priced brands. then Cavite Representative Joseph Emilio saving lives. President Benigno S. Aquino III Abaya, the chair of the House committee on The country’s cigarettes and classified urgent a bill that would enact a appropriations. Abaya is now the secretary
48 HEALTHbeat I November - December 2012 of the Department of Transportation and report, saying it is his intellectual property. a bigger market than tobacco. She said that Communication. Recto also attacked civil society groups health advocates have thrown their support The original Abaya bill moved for a that received funding from New York Mayor behind her Sin Tax measure. unitary tax instead of a multi-tiered system, Michael Bloomberg to fight the powerful On November 6, Senator Franklin indexed taxes to inflation, and dedicated tobacco lobby. Health advocates retaliated Drilon took Recto's place as committee taxes to universal health care and alternative by saying the senator should not go after chairman, said in his sponsorship speech livelihood for tobacco farmers. This bill groups that promote public health and help said he intends to to generate at least P40 sought to raise P60 billion (P30 billion each save the lives of millions of Filipinos. They billion to P45 billion revenue from the Sin from tobacco and alcohol products.) But reminded legislators that their mandate Tax. President Aquino who was in Vientiane, what the House of Representatives approved was to protect the people, particularly their Lao People’s Democratic Republic attending on the last day of its second regular session health, and not business interests of the the 9th Asia Europe Meeting at that time in June was the compromised version of HB tobacco industry. said, “At 40, we’re happy. At 60, we’ll be 5727. This means it would only generate P31 On the other hand, Senator Miriam happier." He added, “But 40 is already, I billion (P27 billion from tobacco and only P4 Defensor-Santiago urged the Senate to think, sufficient to meet the objectives both billion from alcohol) in revenues, practically adopt her version of the sin tax measure and in terms of gaining more resources and half of what was originally sought. use it as the basis for plenary debates. She managing the deficit, but most importantly According to economist Solita Monsod, said that under her bill, 85 percent of the P60 addressing the health issues." this compromise was made possible to get billion would be used for the government The Sin Tax supporters, meanwhile, the crucial votes of the National People’s health program while the remaining 15 remained vigilant on the events that will Coalition who has affiliation with the San percent would be used for safety nets that transpire on this piece of legislation because Miguel Corporation. would ensure that tobacco farmers can shift they know that the powerful tobacco Then, it was the Senate's turn to alternative crops like vegetables that have industry will surely put up a good fight. to deliberate on the Sin Tax. The Senate ways and means committee headed then by Senator Ralph Recto, insisted that the proposed legislation was a revenue and not a health measure. During the committee hearings, Recto kept on saying that he would strive “to come up with a tax structure that would benefit all players equally.” In October, when the committee report was released, Recto's version turned out to generate only a measly amount of P15 billion. Health advocates have dubbed it as the “Recto-Morris” report because it basically adopted the proposal of tobacco giant Philip Morris-Fortune Tobacco. They added that the report not only “watered down” the sin-tax bill, but “drowned it." After getting these heavy criticisms, Recto NO TO WATERED-DOWN SIN TAX BILL: From left to right: Dr. Antonio Dans of the University of the resigned as chairman of the Senate ways and Philippines; Former Health Secretary Alberto Romualdez; Health Secretary Enrique Ona; Dr Anthony means committee. He then said that he does Leachon, DOH consultant for non-communicable diseases; and Atty. Chicco Castro of the New Vois not want his colleagues to use his committee Association of the Philippines. (Photo by Paking Repelente)
(-: Health News beyond November 15, 2012 is not included in this countdown :-)
November - December 2012 I HEALTHbeat 49 SAbeat LOVE STORY Oh, Babe Ang Daya Parlor
Tinawagan sa celphone ang girlfriend... BONG: Iiwan na kita may iba na akong Lumabas ng beauty parlor ang mag-asawa... DENNIS: Babe, saan ka? mahal... ROSE: How do I look? Maganda na ba CHE: Eto nasa park. Nakaupo, ikaw? CHELY: Ganon? Ang daya naman. ako, sweetheart? DENNIS: Eto nanonood ng LOVE STORY. Ako nga matagal nang may iba, JOJO: Ah, eh, at least sinubukan mong CHE: Talaga? Ang sweet naman. Saan iniwan ba kita?!? magpaganda. ka nanunood? DENNIS: Sa park. Pinapanood kita habang Pangit Mamahalin may kayakap kang iba. AVIC: Bakit ayaw mo sa 'kin? JOEL: 'Pre, pag-uwi sa bahay, Sawang-Sawa Pangit ba ako? sinumbatan ako ng Misis ko na NOEL: Shhh... Maganda ka... dalhin ko daw naman siya sa NEIL: Sawang-sawa na ko sa girlfriend Mula PAA hanggang LEEG. isang mamahaling lugar. ko sa kakabanggit at kaka- JOB: Saan mo dinala Misis mo, 'Dre? kumpara sa akin sa dati niyang Hayaan JOEL: Eh di sa gasolinahan. Ang mahal boyfriend! kaya ng petrolyo ngayon! MIKE: Wala yan pare. Yung girlfriend Sa mataong concert, dalawang lalaki na ko nga lagi niyang binabanggit hindi magkakilala ang nahiwalay sa kanilang Sunog at kinukumpara ako sa susunod girlfriends kaya hinahanap nila ang mga ito... niyang boyfriend. CHRIS: Ano ba itsura ng GF mo, 'Pre?!? Nagsilang ng maitim na bata ang mestizuhing JERRY: Mga 5'6" ang height, mestiza, mag-asawa... Tangay long straight black hair, brown JOSEPH: Bakit maitim ang anak natin? eyes, pouting red lips, hot at AMELITA: Honey, hot ka... hot ako... kaya ROMMEL: Bakit ba sobrang lungkot mo? napaka-sexy. Ikaw, 'Pre, ano heto, nasunog ang baby natin! RON: 'Yung bestfriend ko, tinangay itsura ng GF mo?!? ang Misis ko. Pangatlong araw CHRIS: Naku, hayaan mo na siya. Ang Dasal na ngayon na hindi ko sila mabuti pa ay hanapin nalang mahanap. natin ang girlfriend mo! DITAS: Ang dasal ko sana bigyan pa ROMMEL: Kawawa ka naman. ako ng konti pang talino para RON: Oo nga. Miss na miss ko na Susi maunawaan ko ang Mister ko... ang bestfriend ko. REMY: Ako, bigyan ako ng konti pang RELLY: Alam mo babe, para kang SUSI. pasensya para matiis ko pa ang Katulong MARIZ: Bakit naman? pag-uugali ng Mister ko... RELLY: Kasi binuksan mo ang sarado PRESCY: Ako, konti pang pag-ibig para TESS: Ginagawa mo lang akong kong puso. mapatawad ko ang Mister ko... katulong mo! Mabuti pa MARIZ: Sinungaling! Eh sino yung kasama BAMBI: Ako naman, ang lagi kong dasal maghiwalay na tayo! mong babae noong isang araw, ay bigyan ako ng maraming lakas, ERNIE: Hindi! Simula sa araw na ito, aber? para tuluyan ko nang mapatay sisante ka na! RELLY: Siya 'yung DUPLICATE! ang hayop na Mister ko!
50 HEALTHbeat I November - December 2012