CORDILLERA HEALTH VOICE Official Publication of the Department of Health - Cordillera Administrative Regional Office Vol. 8 No 1. January - June 2015

DOH Gawad Kalusugan Awarding Held DOH-CAR Office VISION: TABLE OF CONTENTS A global leader for attaining better health outcomes, competitive and National Dissemination Forum 4 responsive health care system, on the “Cordillera-wide Strengthening of the Local Health System and equitable health financing for Effective and Efficient Delivery of Maternal and Child Health Services Patrick P. Pineda, HEPO III, DOH-CAR MISSION: To guarantee equitable, sustainable Universal Health Care High Impact Breakthrough Strategy 6 and quality health for all people Melanie June P. Caleno,~ Nurse V, DOH-CAR in the Cordillera Region, especially the poor, and to lead the quest for excellence in health DOH deploys 600+ HRH in the Cordillera Region 6 Rex A. Bate, Training Specialist II, DOH-CAR

DOH CORE COMPETENCIES An “F” for an “F” 7 Geenie Ann I. Austria, Nurse V, DOH-CAR Organizational Commitment Integrity Quality Service Focus DOH Gawad Kalusugan Awarding Held 7 Teamwork Benelyne M. Balag-ey, HEPO II, DOH-CAR Stewardship of Resources Self-Development Keeping up with counterfeits 8 Attention to Communication Nadia D. Navarro, FDRO II, DOH-CAR

Provincial DOH-Kalinga conducts Buntis Congress 8 Lea Angelica B. Velo, NDP Nurse, Kalinga

Davao City hosted this year’s Observance to ASEAN Dengue Day Celebration 9 Patrick P. Pineda

Abra Now Malaria Free Province 10 Diana D. Palangchao, Planning Officer II, DOH-CAR

Health Services Summer Ritual 11 NDP - La Trinidad

(on the cover) Regulation, Licensing & Enforcement Division at its Peak 12 Health Secretary Janette Loreto-Garin led the event during the 1st Harmonized Nora J. Benavides, Licensing Officer III, DOH-CAR Gawad Kalusugan Awarding on February 20, 2015 New Classification of Hospitals and other Health Facilities 13 (Photo/design by P. Pineda) Charis I. Taguibos, Licensing Officer III, DOH-CAR

Published by: Promoting Camote Production and Consumption 14 Department of Health Cordillera Administrative Regional Office Rita D. Papey, Regional Nutrition Program Coordinator, NNC-CAR BGHMC Compound, Baguio City Tel.nos.: (074) 442-8096 to 98 PIDSR ESR New System to detect various health related cases 15 Opinions expressed in this publication Karen B. Lonogan, SHPO, DOH-CAR do not necessarily represent those of the DOH-CAR Office. Regional Kapihan (Press Conference) held 16 Benelyne M. Balag-ey/ Patrick P. Pineda

2 Message

Let me first greet all fellow health workers and stakeholders a very warm welcome, We, in the DOH-CAR Office appreciate your taking the time to read this first issue of the Cordillera Health Voice Magazine for CY 2015.

It was a busy start of the year for us with the implementation of the rationalization plan which started in 2014. We have a responsive health plan for 2015. Several important activities were held like the Cordillera National Dissemination Forum for strengthening the Local Health System for Effective and Efficient Maternal and Child Health Services in CAR. The Province of Abra was officially declared as a malaria-free province.

One of the major programs this year is the the Universal Health Care High Impact 5 under the leadership of Health Secretary Janette Loreto-Garin. The program, with the theme “Kalusugan Tuloy-tuloy Para sa Pamilyang Pinoy”, focuses on five critical UHC interventions with high impact on health and prioritizing the poor. Special breakthrough services will focus on reducing maternal, infant, and under-five mortality; reducing the burden of HIV/AIDS, and the establishment of responsive Service Delivery Networks. The priority provinces in CAR are Abra, Apayao and Benguet, with high poverty incidence and/or vulnerability to shocks and disasters.

Activities done under the HI-5 in CAR were the Launching cum Service Delivery Network Summit in May 2015, HI-5 Caravan on June 23, 2015 at Conner District Hospital, Conner, Apayao and on June 30, 2015 at Abra Provincial Hospital, Bangued, Abra. A Buntis Congress was held on July 16, 2015 at BSU, La Trinidad, Benguet covering clients from the municipalities of Benguet, and also the City of Baguio.

Indeed, the continuing success of implementation relies on the efforts of all stakeholders and the community with unselfish dedication of services rendered by our health workers.

Thank you and happy reading to all.

January - June 2015 Cordillera Health Voice Magazine Issue

Health Voice Consultants: Valeriano Jesus V. Lopez, MD,MPH,MHA,CESO IV Amelita M. Pangilinan, MD, MPH Janice Z. Bugtong, MD, MM Contributors: Patrick P. Pineda Lea Angelica B. Velo Benelyne Balag-ey Diana D. Palangchao Melanie June P. Caleno~ NDP - La Trinidad Geenie Ann I. Austria Nora J. Benavides Nadia D. Navarro Charis I. Taguibos Rex A. Bate Rita D. Papey Karen B, Lonogan

Lay-out/photography: Patrick P. Pineda

3 National Dissemination Forum on the “Cordillera-wide Strengthening of the Local Health System for Effective and Efficient Delivery of Maternal and Child Health Services by: Patrick P. Pineda, HEPO III, DOH-CAR

he National Dissemination T Forum on the “Cordillera- wide Strengthening of the Local Health System for Effective and Efficient Delivery of Maternal and Child Health Services” was held on January 21-23, 2015 at Crown Legacy Hotel, Baguio City. The event was spearheaded by DOH- CAR AND JICA-SSC, and was attended by stakeholders of the project sites from Abra (six municipalities), Apayao and Benguet, and Baguio City. Partners from DOH Central Office and other Regional Offices, development partners (USAID), NGOs, Media and Regional Line Agencies also attended. Assistant Secretary Gerardo Bayugo acted as the keynote speaker in lieu of Secretary Janette Loreto-Garin, who attended an equally important event The event was also a “star- studded” one, , with DOH Assistant The forum started with a Dr. Amelita M. Pangilinan, Secretary Gerardo Bayugo as the welcome program and mini-cultural OIC Director III of DOH-CAR keynote speaker in lieu of Secretary show with key messages from presented the project highlights and Janette Loreto-Garin, who attended Baguio City Mayor Mauricio said that in terms of Facility-based an equally important event; ARMM Domogan, DOH-CAR Director delivery (FBD), CAR is still far Health Secretary Kadil M. Valeriano Lopez and Mr. Noriaki behind the national target of 90%, Sinolinding Jr. Stakeholders from Niwa, Chief Representative of JICA aimed to be achieved by 2016. Cordillera led by Governors Hon. Philippine Office. The cultural CAR is only 68% in 2010 but with an Elias C. Bulut Jr. of Apayao, Hon. presentations delightfully showcased increasing trend. In 2011 there was Eustaquio Bersamin of Abra, and the different native dances of Abra, already 73% achievement in terms Vice Governor Hon. Nelson Apayao and Benguet. During day of FBD, in 2012, 78% and in 2013 – Dangwa of Benguet. Each gave two, the participants shared 84%. inspiring messages and expressed important experiences on how the their gratitude to the DOH and JICA- program assisted in the effective and It is along this line that the SSC for their support in the Project for Cordillera-wide efficient facility based delivery of implemention of Health Facility maternal and child health services in Strengthening of the Local Health Enhancement Program (HFEP) System for Effective and Efficient the project areas. projects as well as through the Delivery of Maternal and Child donation of equipment and provision Health Services was born. of important trainings.

4 With the Community Health Teams as the link/bridging partners in the community, DOH-CAR along with its development partners such as JICA was able to provide IEC flipcharts and conducted a series of conventions to enable or equip the CHTs with the capacity, skills and knowledge, specifically in ensuring that pregnant women have La Trinidad Mayor Edna Tabanda asked questions during the forum(top left). Fude Takayoshi emergency birth plans and that they presented the mechanics of the best service delivery photograph contest(top right). Abra Gov. will complete at least 4 prenatal Eustaquio Bersamin answers a question check-up in the health facility during the Press conference together with other officials (below right). including post partum care.

The general objective of the Unit (RHU) delivery in rural areas Presenting in the forum, project is health systems with flat terrain in Abra: in Director Lopez discussed the Health strengthening for Maternal, Neonatal Lagangilang there was a 40% Facility Enhancement Program of and Child Health and Nutrition increase while Dolores and the Department of Health, and said (MNCHN) while the specific Villaviciosa the increase was almost that DOH had disbursed a total of objective is Maternal Mortality Rate at 20% from 2012 to 2013. 56.2 million pesos for the 12 hospital (MMR) reduction thru increasing in all the 6 provinces of the region in facility-based delivery, especially in 2014 as infrastructure support, 8.4 Facility-Based Delivery Rate rural areas of CAR. The Project runs Million pesos for 8 Rural Health from February 2012 to February from 2012 to 2013 also increased: Units and 50.4 million pesos for the In Abra, from 73% in 2012, to 86% in 2017. 51 barangay health stations. There 2013 in RHU deliveries. In Apayao, will be close monitoring of the FBD increased from 67% to 80% for Project strategies include implementation of DOH-HFEP to upgrading of birthing facilities in the hospital and BHS deliveries while in ensure that implementation will be Benguet, FBD increased from 83% rural areas; increasing the coverage done as scheduled. In addition, 51.9 of National Health Insurance to 87%. The total increase in FBD in million pesos worth of equipment project sites was from 79% to 86%. Program (NHIP); empowering the was released for the 16 hospitals in Community Health Teams; the region, 6.3 million pesos for the improving patient referral system Also, through the Health 10 RHUs and 15.2 million pesos for thru inter-LGU collaboration and Facility Enhancement Program the BHSs. ensuring the sustainability of quality (HFEP), the DOH and development health services. partners including JICA and USAID In 2015, the Department of upgraded 14 primary hospitals, 19 Health is programmed to disburse of Some results of the project Rural Health Units, and 61 Barangay 112 million pesos for the 4 hospitals, included an increase in Barangay Health Stations. These were also 2 million for 1 RHU and 18.4 million Health Station (BHS) delivery in provided health equipment. To pesos for the 20 BHSs as mountainous remote areas in ensure the provision of quality basic infrastructure support. The DOH will Apayao; in Calanasan, there was an services are provided, DOH-CAR also provide equipment support to 1 increase to 20% while in Kabugao trained more than 300 doctors, hospital amounting to 1.1 million and Conner, there was an increase nurses and midwives on basic pesos, 0.64 million pesos for 1 RHU to 10% from 2012 to 2013. It also emergency obstetric and newborn and 7.75 million pesos for the 19 showed an improved Rural Health care (BEmONC). BHSs. (Continued on page 23)

5 Universal Health Care High Impact Breakthrough Strategy by: Melanie June P. Caleno,~ Nurse V, DOH-CAR

he Department of Health The priority areas are: T (DOH) has developed a provinces where opportunities for Universal Health Care High Impact growth may be present but the poor Breakthrough (UHC HIB) strategy are unable to participate in the which will be a nationwide growth process; provinces with endeavour from April 2015 to June lesser opportunities for growth as 2016. The UHC HI-5 five model plans logos they are generally characterized by There are five model plans small population, low density, and The UHC HIB aims to for the strategy; (1) the maternal remote areas; and provinces where address the gaps and challenges in care model plan aims to reduce the marginally non-poor can easily the attainment of the Millennium maternal mortality and improve slide to poverty, and the poor can Development Goals (MDGs) and maternal health, (2) the infant care slide deeper to poverty. National Objectives for Health. model plan aims to reduce infant mortality, (3) the under five care The UHC was launched to The UHC HIB was developed aims to reduce mortality among address the remaining gaps and through implementation of model children below five years old, (4) HIV challenges on inequity in health and plans on key impact interventions. AIDS model plan aims to halt the achievement of the Millennium spread of HIV AIDS in the region, Development Goals (MDGs) by and (5) Service Delivery Network 2015. The government has been model plan aims to establish of organizing and maximizing all Service Delivery Networks. possible resources to respond to this call. The implementation of UHC in In each model plan are several phases from 2011 up to intensified regional operations to be present has been spearheaded by The UHC HI-5 proposed logo implemented in priority areas. the DOH. DOH deploys 600+ HRH in the Cordillera Region The deployed Human Resources for Health (HRH) assists

by Rex A. Bate, Training Specialist II, DOH-CAR in the development of plans and o improve health strategies in the implementation of T outcomes, provide financial health programs, projects and risk protection and provide quality activities; provide technical support access to health services especially in the preparation of project the poor, the Department of Health proposals, plans and programs; (DOH) through its Deployment of initiate health education and Human Resources for Health A Nurse under the NDP assist in the pre-testing promotion activities; assist in the of IEC materials at Atok, Benguet Program deployed health efficient collection, validation, professionals in various Provinces Medical Technologists and Public analysis of data and information; and Municipalities in the country. Health Associates were deployed in assist in the installation of effective various provinces and municipalities and efficient Monitoring and In the Cordillera with high poverty magnitude, high Evaluation system for programs and Administrative Region (CAR), 666 poverty incidence and vulnerable to projects, and perform laboratory Doctors, Nurses, Midwives, Dentists, shocks and disasters. examinations. (Continued on page 23)

6 AN “F” FOR AN “F” by: Geenie Anne Austria, Nurse V, DOH-CAR

o address the “fast and As of February 2015, 20 expanding counseling and testing, T furious” spread of HIV Filipinos get infected every day, maximizing prevention through infection, the Department of Health accounting to 645 new HIV protective commodities (eg. has come up with another key antibodysero-positive individuals, Condom), supporting treatment, message for the public. according to the Philippine HIV/AIDS investing in strategic information and and ART Registry. New HIV cases in strengthening health systems. Aside from the Abstinence, the Cordillera accounted to 1% of Being faithful (mutually), Consistent the national data. Who would have thought that and correct condom use, Do not use the virus would pick up and be illicit drugs or do not share needles, One would think that HIV is ravenous? I once believed that HIV Educate yourself and know your HIV not alarming. Having no data in most is a vague concept and mainly status or the ABCDE against HIV, of the municipalities does not mean afflicts OFWs. Back then, I failed to the message now is: Fornication that HIV is not there. This may realize that OFWs had spouses, comes with responsibility! indicate that HIV is not yet detected partners and families that can get and just like any epidemic, it would infected too. The introduction of the suddenly explode in numbers, virus in the country leads to local The new message supports before we knew that our community transmission. Now, there is a shift of the DOH resolve to reduce new STI got infected. the main driver of the HIV infection, and HIV infections by 50% among the male having sex with male. the most-at-risk and vulnerable The latest message Though individuals vary on the risks population by 2016. complements the strategies already of having the infection, we are still in place against HIV, which includes vulnerable. Yes, all of us. (Continued on page 23) DOH Gawad Kalusugan Awarding Held Four Provinces and One Barangay in CAR are National Health Awardees by Benelyne M. Balag-ey, HEPO II, DOH-CAR

ive CAR provinces F received various Public Health Awards from the Department of Health on February 20, 2015 during the occasion of the first harmonized DOH Gawad Kalusugan Awarding Ceremonies held at SMX Convention Center, Pasig City. These awards were also The awards were Mountain Province delegates show given as a way of saying “thank you” categorized into major awards and their prize during the awarding for the untiring service and special awards where in Mountain These awards are given to recognition for their best Province LGU landed 6th place in the LGUs and health workers throughout performance to continue selfless Provincial Category of the the country who shared and worked service and to leverage them in their Excellence in Kalusugan hard for the DOH vision of participation in achieving Pangkalahatan, a major award strengthening health systems to KalusuganPangkalahatan(Universal given. Other awardees were the increase efficiency and effectiveness Health Care), according to Secretary provinces of Abra, Apayao and of delivery of basic health services. Janette P. Garin. Benguet.

7 KEEPING UP WITH COUNTERFEITS by: Nadia D. Navarro, FDRO II, DOH-CAR

ver the years, the demand For some who do not really know 5. For more information and Oo for medicines increased how to evaluate the medicine on advisories about counterfeit/fake not only in the Philippines but hand as to whether it is authentic, medicines, visit the FDA website or the DOH-FDA Regional worldwide. With the discovery, safe and effective, here are some Office. detection and diagnosis of numerous friendly reminders: diseases, one can logically say that 1. Buy medicines only from FDA pharmaceutical industries have licensed drug outlets. Usually, the increased production too. With the License to Operate of drug stores/drug establishments must be high demand for medicines and placed in a conspicuous place. following news about fake or 2. Check the registration numbers of counterfeit medicines both on the products printed on their boxes or on their immediate containers television and newspapers, most of (For medicines/drugs – DR the consumers nowadays have Number, For food supplements – become very vigilant with the FR Number). The Food and Drug Administration(FDA) website medicines they take in to the extent 3. Do not buy products written in foreign language without English of carefully going into the details of it translation. … and always remember “Ang before buying. 4. If in doubt, check/verify if the pekeng gamot ay salot at hindi product is registered in the FDA website (www.fda.gov.ph) or nakakagamot.” immediately seek for assistance from the Regional DOH-FDA Office. Provincial DOH-Kalinga conducts Buntis Congress by: Lea Angelica B. Velo, NDP Nurse, Kalinga

abuk City- To awareness on how to protect T commemorate the themselves from contracting celebration of the Word Malaria Day, diseases such as Malaria. PDOH Kalinga in collaboration with Tabuk II RHU and the Provincial Health Office successfully conducted The participants were a “Buntis Congress” last April 25, lectured on malaria control updates, use of insecticide treated nets, 2015 at Hotel Davidson. Pregnant women gather to avail health services indoor residual spraying and information about Family Health With the theme “Invest in the Diary (FHD) and on the DOH High future; Defeat Malaria”, the activity Impact Breakthrough (HIB) of the was participated by at least 70 Aquino Administration. Mother and participants from 20 barangays with child kits filled with baby kits plus at least three barangay health insecticide treated nets were also workers each and at least three distributed to the participants pregnant mothers. The congress Kalinga health officials distribute mother and particularly the pregnant mothers. was aimed at raising their child kits to women

8 Davao City hosted this year’s Observance to ASEAN Dengue Day Celebration by: Patrick P. Pineda, HEPO III, DOH-CAR

engue remains a D serious health threat, with the Asia Pacific Region bearing 75% of the current global disease burden. ASEAN countries have the highest number of dengue infections in the Asia-Pacific and this has significant impact on the socio- economic status of the member states.

Acknowledging the fact that the ASEAN member states shoulder a large part of the global burden of dengue, the ASEAN Health Ministers declared June 15 as “ASEAN Dengue Day” during the 10th ASEAN Health Ministers Meeting held in Dir. Lyndon Lee Suy and USEC Vicente Belizario Jr. led the start of the celebration with a press conference(above left), Dir. Abdullah Dumama Jr. assisting in the awarding of winners for dengue Singapore on July 22, 2010. bulletin board making contest (above right), Davao City Mayor Rodrigo Duterte speaks about the importance of dengue awareness (below left), Walk against dengue conclude the day’s activity led by Director Eric Tayag (below right). This year, Regional Office XI- Southern Mindanao hosted the The objectives of the activity According to Sanofi Pasteur, conduct of the Observance of were: increase the community’s a vaccine company, anti-dengue ASEAN Dengue Day in Davao City involvement and awareness on vaccine will be commercially on June 15, 2015 and revitalized the Dengue and strengthen available by October 2015. The “Four o’ Clock Habit / STOP, LOOK, collaboration and partnership among vaccine should protect as many AND LISTEN!”. This is a campaign various stakeholders, partners and people and children and elderly are strategy adopted by DOH and in other government and non- the priority. partnership with the LGU’s where government agencies that will help community members search and in the reduction of dengue incidence Let us all practice the “Four destroy mosquito breeding places in the country. O’Clock Habit / STOP, LOOK and every 4:00 pm. Stop at 4:00 PM; LISTEN” in our community. “Sama- Look inside and outside their houses Preventive Alert system and sama nating puksain ang dengue” to search and destroy possible Brigada Eskwela were adopted by mosquito breeding places; Listen to schools in Davao City for Barangay officials about the dengue cleanliness and to prevent status in the barangay. mosquitoes to breed. Dengue awareness is a shared responsibility among the community, the Department of Health and the media.

9 ABRA NOW A MALARIA-FREE PROVINCE by: Diana D. Palangchao, Planning Officer II, DOH-CAR

He is optimistic that with the commitment of the local government unit and the local health workers, disease elimination programs in the region will be successful.

Based on record, the province was malaria endemic with 2770 cases from 1989 to 1992, down to only eight cases in 2005. In photo are the Provincial Malaria Field Personnel recognized during the awarding. With them The last recorded death in the are DOH-CAR Regional Director Valeriano Jesus Lopez, Regional Malaria Program Coordinator Dr. Alexei P. Marrero, Provincial Health Officer Dr. Godofredo Gasa and Dr. Alex province was in 1999 while the last Bayubay of PDOHO-Abra. indigenous case recorded was in He stressed that while this is 2008 with one case. Since then, no bra is the only declared a great breakthrough in the malaria malaria cases were recorded. A malaria-free province in program of the region, maintaining the country this year at the national and sustaining these gains will be as Abra Board Member Ramon level and the first Global Fund challenging as the efforts done to Dickson, who chairs the provincial project through the Pilipinas Shell attain these gains. He said that while board committee on health, Foundation, having zero malaria Abra has an excellent surveillance expressed gratitude and assured cases in the past five years. The system and malaria outbreak that the province will continue to province was earlier cited during the response team dubbed as malaria sustain and strengthen more its Harmonized Awarding of Disease elimination hub, this has to be more malaria surveillance system and Free Zones in Manila. resilient and strengthened to avert outbreak response team. possible re-introduction of the The Department of Health disease. will give P1 million cash grant to the DOH-CAR Regional Malaria province to sustain its malaria-free Program Coordinator Alexei Marrero status and active surveillance acknowledged the support of the system. Global Fund through the Pilipinas

Shell Foundation and the local Assistant Secretary of Health health workers for their commitment Gerardo Bayugo, in his message that led to another commendable during the World Malaria Day success in the malaria elimination Celebration and Regional program of the region. He noted the Recognition of Abra as Malaria-free, The Provincial Government of Abra received its DOH-CAR will continue its disease commended the province for its plaque of recognition as Malaria-free province for elimination and surveillance effort for having no indigenous cases having zero malaria case in the past five years. In photo are DOH-CAR Regional Director program, as Mt. Province and Ifugao and local transmission in the past Valeriano Jesus V. Lopez (now assigned in will be pre-assessed for malaria-free five years, citing it as a great DOH-Cagayan), Abra Board Member Ramon Dickson, Regional Malaria Coordinator Dr. Alexei status this year. achievement towards a Malaria-free Marrero and Provincial Health Officer Godofredo region and country. Gasa and Dr. Alex Bayubay of PDOHO-Abra. (Continued on page 23)

10 Health Services Summer Ritual: Assisting in the boys’ “rite of passage” to puberty

by NDP La Trinidad

hroughout the country, T circumcision has become a staple event in summer. La Trinidad – the nation’s strawberry capital – is no exception. It is, in fact, right in the thick of it, as it endeavours to fully dispense medical and other health services to its people, thru its Municipal Health Services Office.

Thus, in support of the Circumcision in Barangay Betag, La Trinidad where NDP nurses with other health partners and volunteers Department of Health’s advocacy to a total of 118 children were catered in April 16-17,2015 posed for picture taking after a tiresome but fulfilling day of circumcising 181 children during the BLISTT Interlocal initiate safer means for circumcision Health Zone dental and circumcision activity in May 7, – which is essential to better hygiene 2015. – La Trinidad spearheaded said The DOH is also reminding medical operation in its barangays. Male circumcision is on the advocacy of the Department of parents on the importance of Health for its several health ensuring the completion of the taking As earlier stated, protection and promotion purposes. of antibiotics among boys circumcision is usually preferred to Male circumcision is surgical undergoing circumcision for be done during summer since the removal of the foreskin – the complete healing to prevent the long break provides time for the retractable fold of tissue that covers onset of infection. According to healing period. the head of the penis. The inner Secretary Garin, the antibiotics will aspect of the foreskin is highly help in faster healing after On April 16 and 17, during susceptible to HIV infections. In circumcision and serve as a way to the annual fiesta of Barangay Betag, 2007, WHO and UNAIDS issued eliminate any infectious disease that the nurses under the Nurse recommendations on medical male may occur. She also said that newly- Deployment Project (NDP) of La circumcision as an additional HIV circumcised boys should not be Trinidad actively participated in prevention strategy based on strong allowed to bathe in dirty bodies of rendering circumcision to 118 and consistent scientific evidence. water as the presence of dirty children of Betag as well as from particles contaminated with bacteria other barangays on various dates. can irritate the open wound caused The DOH warned young by circumcision. On the occasion of the boys and their parents of the According to DOH Secretary circumcision activity on May 7 potential adverse effects of the Dr. Janette Garin, circumcision sponsored by the BLISTT Interlocal traditional manner of circumcision, through the “pukpok” method is Health Zone (BeGH, La Trinidad, referred to in many parts of the unsafe, and exposes young boys to Itogon, Sablan, Tuba, and Tublay) country as ‘pukpok’. Under the old infection and tetanus. Circumcision conducted at the municipal gym of tradition, young boys undergo the rite of passage during the summer should be done by a medical La Trinidad, the NDP nurses also months with the use of unsterilized professional to ensure that the tools actively participated in circumcising and crude sharp tools and a wooden to be used have been properly 181 children along with other block. sterilized, and that the procedure is participants. done in a medically acceptable manner.

11 Regulation, Licensing & Enforcement Division at its Peak by: Nora J. Benavides, Licensing Officer III, DOH-CAR

egulation, Licensing & R Enforcement Division or RLED is the legal name of the regulatory division of the Department of Health – Cordillera Administrative Regional Office (DOH-CAR) under the Rationalization Plan. Its mandate is to regulate hospitals and other health facilities in the region.

Prior to the implementation of the rationalization during the second and third quarter of 2014, the division was manned by a Nurse,

Medical Technologist, Health The DOH-CAR Licensing team led by Dr. Erwin A. Baclig and Dr. Eduardo Calpito with Atty. Timothy Physicist(one for each division), Galvez of RLED Region IX pose in a light moment (Above). Monitoring/inspection at Pudtol Main Health Center (below left) and Luis Hora Memorial Regional Hospital (below right). three (3) Food & Drug Regulation Officers and headed by a Medical Doctor in the person of Dr. Erwin A. Baclig. This staffing compliment was considered to be inadequate following the composition required for One Stop Shop (OSS) Licensing Team whereby an Architect/Engineer & Dentist were lacking. The involvement of the RLED This is despite of an agreed when the monitoring/inspection of staff in the recently conducted High scheme, in which that assistance hospitals and health related facilities Impact Five caravans and Buntis from dentists and engineers from the reached one hundred five (105%). Congress in Apayao, Abra and region may be requested as This was attributed to the increase of Benguet slightly caused disruption of necessary. However, this did not technical staff with two (2) additional its inspection accomplishments but a work well due to several factors one Medical Officers, five (5) Licensing catch up plan is in place with its of which is the unavailability of the Officer III, four (4) Licensing Officer implementation coming from the said staff which eventually resulted II and two (2) Administrative Assistants who were all hired under highly spirited RLED staff. to not highly commendable accomplishments from calendar year the Rationalization Plan. Likewise, proper planning and implementation 2007 up to 1st quarter of 2014. of activities coupled by teamwork A sudden change of the from all the members led to the RLED’s accomplishment particularly attainment of its goals and in the 1st Quarter of 2015 was objectives. noticed by the management

12 New Classification of Hospitals and other Health Facilities by: Charis I. Taguibos, Licensing Officer III, DOH-CAR

Most of the facilities lack one or more of the above minimum standards which is required for the provision of effective, efficient and quality health services. Upon compliance of these minimum standards, re-classified facilities may immediately apply for upgrading. Applications will be reviewed and ensuing inspection will be conducted before processing and issuance of Licenses to Operate (LTO). Although many facilities clamored for the retention of their old service capabilities, the Department of Health (DOH) – Cordillera Regional Office through its Regulation, The DOH-CAR Office Licensing Team and guests during the ISO Internal Audit by DOH - Region IX Licensing and Enforcement Division is ensuring execution of this order. ith the advent of All the re-classified facilities re- classified did not meet the W Administrative Order Eighteen (18) facilities remained requirements for a Level I facility (A.O.) 2012-0012, several hospitals to be Level I hospitals due to their which includes the following: in the Cordillera were re-classified capability to provide services under

as Primary Care Facilities. Of fifty the new classification. Some 1. Consulting Specialists in (50) Level I hospitals in 2014, 32 persevered and labored to complete Medicine,Pediatrics, facilities are now classified as all their deficiencies to retain their Obstetrics-Gynecology and Infirmary Care Facilities. capacity as hospitals. Aside from Surgery; non-compliance to minimum 2. Emergency and Out-Patient A.O. 2012 – 0012, otherwise standards, other deficiencies noted Services; known as the “Rules and were lacking personnel especially in 3. Isolation Facilities; Regulations Governing the New the laboratory and lacking 4. Surgical/Maternity Facilities; Classification of Hospitals and Other equipment. With the Health Facility 5. Dental Clinic; Health Facilities in the Philippines”, Enhancement Program of the DOH, 6. Morgue; presents several reasons for this it is envisioned that the latter will be 7. Secondary Clinical change. For instance, the previous addressed. Laboratory; categorization of Level 1 hospitals is 8. Blood Station; not consistent with Section 8 of The biggest effect of this Republic Act 4226 on “Minimum 9. 1st Level X-ray; and change is the reimbursement of 10. Pharmacy Standards and Construction of a PhilHealth claims. This depends on Hospital”. There are legal mandates the classification of the facility. The that are not met with the old DOH is positive that all facilities will classification per Republic Act 4226. (Continued on page 23)

13 Promoting camote production and consumption

by Rita D. Papey, Regional Nutrition Program Coordinator, NNC-CAR

amote (impomea Today, camote is hardly part Camote should be part of daily C batatas) has many of the diet of present day diet because of its nutrient contents. names in the Cordillera such as Ubi, Cordillerans. The increased buying Camote is a complete food with tugui (Kankanaey), gattuk (Tuwali), carbohydrates, fats, proteins and capacity of the population made lapne(Tuwali, Ayangan), various micronutrients that help maintain atila(Kalinga) ,dukto(Ibaloi), lukto almost every family able to buy rice good health and nutrition. Eating camote and other more sophisticated food is like eating rice with different kinds of (Kankanaey, Kalanguya, etc.) It is vegetables and meat. an herbaceous perennial vine that commodities from the market food has palmately lobed leaves and and animal consumption. As a Camote tops are rich in Vitamin bears large starchy sweet tasting result, the Cordillerans ignored and A and also have Vitamin C. One cup of tuberous roots. The plant has a wide forgot the camote. Today, camote camote tops contains the same amount variety with tubers in different colors, could no longer be classified as food of vitamin A equivalent to 30 cups of sweetness and moisture content. cauliflower. Camote tops help sustain Camote is a staple food in the for the poor because it has become good eyesight, smooth skin, fight, Philippines and other countries as very expensive and often difficult to infection and anemia and help sustain Uganda, Japan and Papua New find in the market. Cordillerans good gums and teeth. Guinea. should recognize camote as a They also contain protein, dietary nutritious food for good health and fiber, lipid, and essential minerals and There are claims that the its other benefits and let it abound nutrients such as calcium, phosphorous, plant was domesticated 5000 BC again. magnesium, sodium, potassium, sulfur, and have originated in Central iron, copper, zinc, manganese, aluminum Camote as food during disasters America. Camote is considered an and boron. They are important sources and emergencies indigenous crop in the Cordillera of vitamin A, thiamin, grown by almost every family before Camote can be an important Call to Action the advent of modernization. It food commodity during disasters and served as staple food for humans emergencies. In disasters and - Advocate for the consumption of and the main food for domesticated emergencies where the food supply camote and camote leaves for good animals. Early Cordillerans is adversely affected, camote could health and nutrition considered rice as a special gift from be the saving grace. Camote is a Kabunyan and as such a premium - Advocate for the production of camote resilient crop that can grows in by families for family consumption as staple food with some cultures almost all areas of the region and well as an alternative source of income. revolve around the rice cycle. with a good education campaign, it Unfortunately, the limitations of the would not be difficult to have every - Conduct studies on the indigenous local environments allowed only a family in farming communities start systems of camote processing and few families (the kadangyans or the growing camote and ensure a supply storage, local rich who owns a larger area of of camote and contribute to food - Disseminate and encourage the rice terraces) to produce rice security in times of the worst application of available research outputs for year round consumption. The disasters affecting food supply. Dug regarding the production, storage and majority of families considered camote can be stocked for more processing of camote to improve commoners therefore consume than a month and the taste becomes camote technology more camote than rice in a year. sweeter with storage. Rural families - Encourage LGUs to create a can also start relearning the mechanism of managing the sufficient indigenous technologies on supply of camote as food during preserving camote. disasters and emergencies.

14 PIDSR-ESR, new system to detect various health related cases by: Karen B. Lonogan, SHPO, DOH-CAR

The PIDSR logo and system interface

o strengthen the capacity of Since PIDSR is based on In the Cordillera Region, T Local Government Units signs and symptoms and not on the protecting the health and lives of the (LGU) in the early detection and medical diagnosis, the nurses, people against the threat of midwives and barangay health response to epidemics, the infectious diseases is still a workers can report cases even in the challenge. However, with the Department of Health-Epidemiology absence of a physician. Bureau (DOH-EB) in collaboration effective, continuous partnerships with the World Health Organization Despite the establishment of and with conduct of capability and (WHO) has institutionalized the use PIDSR was already established in capacity building activities, this of the Philippine Integrated Disease the country, the approach is not yet threat can be mitigated. Surveillance and Response (PIDSR) fully functional in some and the Event-Based Surveillance municipalities. Hence, the Event- Currently, 96 Disease based Surveillance Response (ESR) and Response (ESR) system in the Surveillance Officers (DSOs) were system was designed to country. trained with the use of PIDSR-ESR complement this approach. In detecting health related system( 26 in Mt. Province, 35 in cases, PIDSR implementers use a Compared to PIDSR, ESR the Provinces of Benguet and standard case definition. Standard Kalinga) The Department of Health- only captures information about a case definitions are the signs and Cordillera Regional Epidemiology public health event that may affect or symptoms of a disease or syndrome Surveillance Unit (DOH-CAR has already affected an individual, manifested by the person, and are RESU) will still be conducting the eventually the basis for inclusion in groups of people or an institution, same training in next six months to reporting and investigation. In yet it is organized and quick. the remaining three provinces to essence, a person can be reported Through the information and reports ensure that health workers are with many diseases or syndromes received, it will allow the rapid under PIDSR as long as the updated and skilled in investigating assess of the risk the event may manifested signs and symptoms fit and managing disease outbreaks the standard case definition of a pose to public health, and enables and other health emergencies in disease or syndrome. respond immediate and appropriate the region. response.

15 Regional Kapihan (Press Conference) Held by Benelyne M. Balag-ey / Patrick P. Pineda January

1. RESU Updates ·Dr. Amelita M. Pangilinan reported a 35% increase in firecracker related injuries with 52 cases in 2013 and 68 cases in 2014. ·3 CAR provinces namely Benguet, Baguio City and Kalinga has a decrease while Apayao, Ifugao, Mt. Province and Abra showed more that 100% increase with Abra topping the list with 29 cases in 2013 and 13 in 2014. ·There were no reported amputations, loss of finger and cut of hand. According to Dr. Pangilinan, this is attributed to the strong advocacy and IEC campaign of the Department. ·For the diseases and syndromes under surveillance, rabies increased by 50%, malaria by 225%, influenza like illness by 30% and meniggococal by 33%. ·No cases of measles from November- January. 2. Hon. Mauricio Domogan (City Mayor- Baguio City) ·He asked DOH to change the slogan to “Ban Firecrackers instead of Iwas Paputok” ·According to the Hon. Mayor, the ban on the sale of firecrackers helped in the safety of our visitors during the holiday season. ·He asked the city council to pass a law to limit firecrackers and only the experts will fire the firecrackers and to dispatch medical teams and fire marshalls at the area. ·He ask the public to support the city in their advocacy to ban the sale of firecrackers ·Plans for the influx of tourist on the PANAGBENGA celebration: - Stackholders meeting on January 20, 2015 to address the traffic problem - A Standard Operating Procedure (SOP) to call for volunteers to help manage the traffic when the city has big events - To coordinate the traffic with the neighboring towns and to include private properties for parking areas during events. 3. Dr. Honorio Pangilinan (Chairman, Emergency Room- BGHMC) ·He reported 13 injuries compared to 9 in 2013 and 5 among the victims bought the firecrackers to sidewalk vendors. ·There was an increase in active users and the average age of users was 12 years old. ·Consultations started early as December 5, 2014 up to January 6, 2015 ·Generally the ER department of BGHMC is calm during the holiday season ·No road accidents reported during the holiday season. 4. Dr. Donnabel Tuvera ( City Epidemiologist, Baguio City health Services Office) ·She reported a decrease in firecracker related injuries with only 2 cases monitored in BGH and 1 in Notre Dame Hospital ·60% of the injuries were caused by “piccolo” ·She attributed the decrease in the increase of prices of the firecrackers and the decrease in the access of paputok. ·The youngest victim was 7 yrs. old and the oldest was 36 years old ·No “watusi” and stray bullets related injury reported ·The advocacy is for all injured patients to seek consult ·Advocate an alternative livelihood for the sellers 5. Mr. Clark Dizon (Health Emergency Management System Coordinator, DOH CAR) ·Started the monitoring of paputok last December 21, 2014- January 5, 2015 ·Code White was declared preparation for the monitoring of the “Iwas Paputok”Campaign of the DOH. ·Reported 68 cases of firecracker related injuries, 61 were active users and 9 were passive users ·63 were blasting injuries, 5 were eye injuries and 2 were bullet related ·41% were 6- 10 years old

6. Atty. Samuel Gallardo (Chief, CWBRD- DTI CAR) ·Informed the public of the diskwento caravan of the DTI at 5- 10% discounts and Christmas Bazars in every province where in prime commodities were sold at lower prices than the SRP. ·No cause of alarm in terms of prices for commodities. ·There should be a PS or ICC mark for firecracker standard. 7. SFINSP. EDISON F. PINO ( OIC Chief Operation, Bureau of Fire Protection- CAR) ·Informed the public of the implementation of the OPLAN PAALALA, a yearly activity of the Bureau of Fire Protection wherein they do information drive on fire prevention and fire drill ·Inspection of van/ bus terminals and shopping malls for the safety of travelers. ·Inspection of firecrackers ·Reported 6 fires related to firecrackers in Abra and 1 grassfire related to firecracker in Tuba. ·Battlecry is “ Iwas Paputok, Sakuna at Sunog”

16 8. PSUPT. LOREANO ALEXIS MARINIAS (Deputy City Director for Operations, BCPO) ·Reported an indiscriminate firing incident inside a disco bar in the early morning of December 31, 2014 ·Coordinated with other stakeholders on the yearly “OPLAN LIGTAS PAKUHAN” of the Baguio City Police Office to assure the safety and security of the Baguio Populace ·Generally peaceful in Baguio City during the holidays.

9. PSUPT. Cherry M. Fajardo ( Public Information Officer, PRO COR) ·Generally peaceful in the region ·Supported the gun mussel taping and untaping which is conducted yearly to prevent indiscriminate firing among the police personnel · A total of 371 firearms were accounted as part of the 2014 campaign on loose firearms. ·More than 4,000 kinds of illegal firecrackers were confiscated and still at their custody while waiting for further instruction.

10. FO1 Leo Mendoza (Public Information Officer- Baguio City Fire Station) ·Reported a zero fire incident due to pyrotechniques ·Enforced the campaign on paputok. ·Firetruck visibility, house to house campaign and coordinate all efforts with other agencies, LGU's and tri media emergency response February 1. Dr. Amelita M. Pangilinan (ARD, DOH CAR)- RESU Updates ·Of the 24 diseases and syndromes under surveillance, there is a 100% increase in non- neonatal tetanus with 1 death in Abra, a 30 day old infant. Another case of laceration on the upper extremety in La Paz, Abra and a case of dental wound in Langiden, Abra ·Abra and Apayao had 71% and 63% increase in Dengue Suspects with 1 death from Luna Apayao in the early part of 2015 but generally the cases in CAR decreased from 181 in 2014 to 102 in January 2015 which was 44%. ·There was a 61% decreased in influenza like illness from 980 cases in 2014 to 386 in January 2015. The decrease was attributed to the flu vaccinations available and pneumococcal vaccinations for senior citizens from the DOH centers and the efforts done by the Influenza Surveillance Research Project from Tohoku University. ·Advised everybody to keep warm, take a lot of fluids don't self- medicate and visit the nearest health facility for consultation. ·Observe also wound care and visit health centers and avail of free anti tentanus shot.

2. Dr. Emmanuel F. Acluba (BGHMC- Medical Center Chief)- Updates ·Informed the public that they are strengthening their system of operation and told his staff to move fast especially on the infra projects. ·BGHMC is coping up with the expectation of their constituents ·Of the 254M targetted budget of BGHMC, 115M is provided by the Government and 100M is from the trust fund (PHILHEALTH and patients) ·The budget is used directly for patient care ·Planned to go into a consignment policy on drugs for the purpose of accessibility ·He made clear that the Public Private Partnership (PPP) they are pushing is not privatization ·He made an appeal to channel to the concern/talk with BGHMC regarding any complain and not just to anybody else, he further said that lets all be together as BGHMC is ours. ·On the complains at the emergency room that patients were not attended immediately and it takes a longer time in the queue of patients: - He explained that patients are assessed on the severity of life saving activity to be done - BGHMC is trying to put in the manpower needed and strengthen the capability in the ER.

3. Dr. Jasmin Igama (MS IV, BGHMC- Internal Medicine)- National Cancer Consciousness Week ·Reported that breast and lung cancer are the leading cause of mortality followed by liver cancer. ·2/3 of cancers are lifestyle derived and 1/3 is genetics ·Cancer starts from a normal cell and when exposed to carcinogens like chemicals, alcohol, smoking, it proliferates and mutates and it takes 2 years to detect a cancer cell. It usually starts in a 2cm size ·To advocate the 9 danger signs of cancer and to conduct cancer surveillance in offices to curb the incidence of cancer patients ·To teach barangay health workers to do screening because of the increasing trend. · BGHMC was chosen as the cervical cancer screening center of the north by the DOH among 9 regional centers. ·The on-going construction will house in the future a comprehensive one stop shop cancer center, a place where all patients diagnosed or not stop and consult. ·It will also house a state of the art linear accelerator and a facility for mammogram and screening ·Admits patients without PHILHEALTH using the point of care, no balance billing, no professional fees ·Accredited for the Z package

17 ·Planned to go into a consignment policy on drugs for the purpose of accessibility ·He made clear that the Public Private Partnership (PPP) they are pushing is not privatization ·He made an appeal to channel to the concern/talk with BGHMC regarding any complaint and not just to anybody. He further said that” “lets all be together as BGHMC is ours”. ·On the complains at the emergency room that patients were not attended immediately and it takes a longer time in the queue of patients: - He explained that patients are assessed on the severity of life saving activity to be done - BGHMC is trying to put in the manpower needed and strengthen the capability in the ER.

4. Dr. Flora B. Pelingen ( Dentist III- BGHMC)- Oral Health Month ·February is dental health month with the general objective of improving the general dental health of all the population by reducing the prevalence rate for dental carries ·Target was 71.3% but only 63% was achieved in 2011 ·Balbalan, Tabuk and Alfonso Lista recorded a high accomplishment ·The primary target is to increase the % of orally fit child meaning, the under five children should have no periodontal disease, no dental carries and no dento facial anomaly. ·The 1,000 window nutrition of the mother and child and brushing 3 times a day every after full meal is very important in order to achieve an oral healthy teeth ·To visit a dentist at least 2 times in a year. ·BGHMC plans to upgrade its dental facilities and aim to be a state of the art tertiary referral dental center ·Plan to cater at least 700- 800 patients per month with the following dental procedures - Tooth extraction, oral prophylaxis, major surgery, restorative treatment, chairsite counselling, fixed incisive for the under five

5. Dr. Ray Aswat ( MO IV, BGHMC- Internal Medicine)- Heart Month ·March is heart month with the theme” Alagaan ang puso, Maghealthy lifestyle” ·Cardiovascular disease remains to be the top cause of mortality worldwide ·5 out of 10 Filipinos according to 2012 NSO survey die of heart disease because of unhealthy lifestyle. ·Each Individual play a major role in managing cardiovascular care. ·Advise everybody to manage hypertension, diabetes, quit smoking, do aerobic exercise, manage cholesterol and practice healthy lifestyle. ·Advocacy from the Philippine Cardiologist Association: - 5 servings of fruits and vegetables a day - 2: Limit use of electronic gadget to 2 hours per day - 1: aerobic exercise 1 hour a day - 0: sweets - 0: smoking ·To refrain from using the word “mental retardation” because it is stigmatizing instead, use mentally challenged or intellectual disability. ·Mental retardation/ mentally challenged/ intellectual disability is not a single specific disorder, it's a description of a functional disability. ·Mental retardation has no treatment, early identification of the treatable conditions leading to such is important like congenital hypothyroidism,and phenylketonuria can be detected by newborn screening. ·Majority of cases at BGHMC are victims of abuse. ·On Depression: trend during cold season also known as seasonal affective disorder causes disability and suffering, don't hesitate to visit a psychiatrist. ·Do not suffer in silence, it is ok to consult a psychiatrist

6. Dr. Gwendolyn Cayad ( MS III, BGHMC, Head- Psychiatry )- National Mental Retardation Week ·Refrain from using the word “mental retardation” because it is stigmatizing. Instead, use “mentally challenged” or “intellectual disability”. ·Mental retardation/ mentally challenged/ intellectual disability is not a single specific disorder, it's a description of a functional disability. ·Mental retardation has no treatment, early identification of the treatable conditions leading to such is important like congenital hypothyroidism,and phenylketonuria can be detected by newborn screening. ·Majority of cases at BGHMC are victims of abuse. ·On Depression: trend during cold season. Also known as seasonal affective disorder causes disability and suffering, don't hesitate to visit a psychiatrist. ·Do not suffer in silence, it is ok to consult a psychiatrist

18 7. Ms. Magnolia Del Rosario ( Public Information Officer, PHILHEALTH CAR)- National Health Insurance Program Month ·Sa PHILHEALTH kalusugan natin ay sigurado. ·Around 1.4M in the Cordillera Region are members including dependents which is around 86% coverage. ·Called on the media to help in the advocacy to ensure that everybody will be PHILHEALTH members with only P2,400.00 as membership fee. ·Encouraged everyone to enroll in PHILHEALTH because of the Z benefit package which caters to more debilitating types of diseases like CABG and Tetralogy of Fallot which gives as high as 550,000.00 and 320,000.00 as premiums and no balance billing. ·Inviting everybody on the upcoming simultaneous 2nd nationwide PHILHEALTH run on February 15, 2015 in line with the Heart Month Celebration. The beneficiary for CAR is North Luzon Association of the Blind (NLAB). MARCH

1. Dr. Gene Estandian (Plastic Surgeon)/Rabies Coordinator, BGHMC Rabies Awareness Month ·There is high prevalence of Rabies in the Philippines ·BGHMC saw 51 animal bite cases (46 dog bites, 5 cat bites) in 2014 ·The Emergency Room administered first aid and gave vaccines to bite victims ·There are 2 types of vaccines (passive –given immediately, active – scheduled) ·In case of bites, apply first aid by washing the bitten area with soap and running water and go immediately to the nearest hospital or Animal Bite Treatment Center Burn Injury Prevention Month ·Plastic surgery-to fix deformities, cosmetic surgery (facial) ·Enhance well being of patients (who are not satisfied with their physical attributes or want to enhance their looks) ·Removal of eye bags, liposuction are the top most plastic surgeries in BGHMC. But patients should be assessed as fit and undergo the CBC, Cardio Pulmonary, Psychological tests among others before undergoing such surgery.

2. Dr. Ofelia Pacio (Department of Agriculture-Livestock Division)

Rabies Awareness Month ·Rabies virus originated from wildlife (like bats). Dogs and cats were bitten and transmission from dog to dog or cat to cat biting were observed. ·Vaccination is done to lessen rabies cases ·Schedule of vaccination of dogs starts at 3 months and yearly there after ·Rabid Dog – Free laboratory testing from February 2015 to December 31, 2016 for submitted sample ·March is Rabies Awareness Month – there will be a free anti rabies vaccination at People's Park, Baguio City on March 27, 2015, freebies will be given and with tips/techniques in taking care of dogs will be demonstrated ·Scheduled vaccination of animals at Lamut, Ifugao is April 23, 2015 while from March to May, other areas in the Cordillera have mass vaccination as well Local Government Units – should schedule time of vaccination and the Department of Agriculture-CAR will provide syringes, vaccines, IEC and personnel as support to Anti Rabies Campaign ·Dog meat is safe to eat but it is in violation of the Animal Welfare Act and therefore should be avoided

3. Dr. Angelita Padilla – Igorota Foundation

International Women's Month/International Women's Day ·The General Theme of the Gender Violence Against Women is to “END Violence Against Women or VAW” ·The celebration started right after the women's movement – burdened factory workers in New York, USA, fire broke out and the women cannot escape, their rights were violated. ·Celebration of women's month-more women joining governance, there should be gender balance and more women starting to be in the forefront, at least 40% representation of women in any undertaking should be present ·Monthly Theme: “Juana and desisyun mo ay mahalaga, sa kinabukasan ng bawat isa” women should echo the theme to other women and invite also the men to be supportive in the family. ·IGOROTA foundation - Serves as an education and organization for indigenous women as well as addresses Gender issue in the Cordillera - Direct service empowering women thru education - Gives direct service to victims of Violence Against Women

19 APRIL

1. Dr. Amelita M. Pangilinan, Director III/Office-In-Charge-DOH-CAR ?Dr. Pangilinan reported that of the 24 diseases under surveillance from January 1 to April 11, 2015, Morbidity week 14, there was one case of Acute Flaccid Paralysis compared to zero last year, three cases of Adverse Events Following Immunization compared to two last year, one Rabies case compared to zero last year, three cases of Neonatal Tetanus compared to two last year, 12 Chikungunya suspects, compared to zero last year. The rabies case was a 65 year old male from Pangasinan who sought consultation in Baguio City. The two cases of AEFI were from Baguio City and Itogon. The AFP – suspect was an 11 y/o from Buguias, Benguet, whose specimen was brought to RITM, Manila. The neonatal tetanus cases were from Abra and Pangasinan. ?Director Pangilinan also warned the public about the onset of summer diseases from March to May which is vacation time or fiesta mode. To avoid food poisoning, diarrhea, heat associated illnesses and recreation related injuries from beaches and eco tourism spots, precautionary measures on food and drink preparation should be observed, like (1) eating well-cooked food immediately after cooking; (2) avoid keeping leftover foods; (3) refrigerate and reheat food before eating especially in hot temperature areas; (4) wash hands properly before and after preparing food; (5) avoid preparing food for others while you are sick and (6) avoid drinking doubtful quality of water especially if source is unknown; if so, bring water to a rolling boil for two minutes and (7) peal and wash fruits before eating. ?Director Pangilinan explained that common summer skin diseases can be associated with swimming at pools and beaches. Some safety measures are: (1) avoid exposure to extremely hot temperatures (2) apply sun block before swimming, (3) avoid staying under the sun with scanty clothes for more than three hours, for these may cause sunburn, exhaustion and heat stroke. Heat stroke is a serious form of heat illness when the body overheats and cannot cool down. The causes are vigorous exercise in hot weather, dehydration, too much direct exposure to sunlight. Signs and symptoms are dehydration, weakness/discomfort, dizziness, anxiety, headache, very high fever, convulsion, rapid heartbeat, unconsciousness. Prevention includes limiting the amount of time spent outdoors, drinking plenty of water, avoid tea, coffee, soda and alcohol. Wear wide brimmed hat and long-sleeved clothing when outdoors. Schedule heavy-duty activities at the beginning or end of the day, when is cooler.

2. Dr. Alexei Marrero, Medical Officer IV, DOH-CAR ?Dr. Marrero discussed the World Malaria Day, celebrated on the 25th of April with the theme: “Invest in the future, defeat malaria”, He said there was a drastic decrease of the number of malaria cases in 2014 in the Philippines. There were 4,900 indigenous cases nationwide while CAR reported eight cases, plus five imported cases. Imported cases are those who come from other regions or countries. Dr. Marrero warned the public that malaria can be transmitted through blood transmission or the bite of an infective Anopheles mosquito. Some signs and symptoms of malaria are chills, fever and sweating. Cases are confirmed through laboratory-blood smear and rapid diagnostic test. Medicines and services for malaria are given free in DOH hospitals. Mosquito endemic areas are found in Abra and Benguet. Abra had no reported malaria cases in the last five years. ?Dr. Marrero also said that the DOH emphasis is on the elimination phase. He advocated increase investment for malaria elimination to Local Government Units and said that some DOH sustaining activities were distribution of malaria treated nets, spraying and surveillance activities in endemic areas. The public was advised not to self medicate in case symptoms occur. For fever, take paracetamol and apply cool packs. ?He also discussed about the World Health Day on April 7. It focuses on food safety with the theme “From farm to plate, make food safe”. The five keys to safer food are: (1) keep everything clean and follow the proper handwashing techniques, (2) separate raw from cooked food,(3) cook food thoroughly, (4) keep food at safe temperature and refrigerate food for a prolong lifespan and to prevent bacteria from growing and (5) always use safe water and safe raw materials for cooking.

3. Dr. Sherwin Biasura, Medical Officer IV, BGHMC ?Dr. Biasura spoke about Head and Neck Consciousness Week. He said head and neck is one of the most common cancers in the body. Pharyngeal carcinoma is the 13th most common cancer, oral cavity (cancer of the mouth) is the 14th most common cancer, laryngeal (voice box) is the 15th most common cancer. Head and neck tumors can be benign or malignant. Benign tumor is not a cancer while malignant tumor is cancer. Statistics show that in 2014, BGHMC had a total of 211 admissions or cases of head and neck tumor, of these 66 were benign and 145 or 68% were found to be cancerous. The breakdown shows laryngeal (voice box) 38-cases, thyroid (goiter)-32 cases, mandible-20 cases, maxillary-17 cases, salivary-14 cases, skin-two cases, oral cavity 15 cases, pharyngeal 6 cases and ear 1 case. Some common symptoms of head and neck cancers are Nose, ear, mouth bleeding, unexplained growth of mass in the head and neck, sudden change of voice (history of heavy smoking), hoarseness and pain in parts of the head and neck. Risk factors include cigarette smoking, heavy alcohol intake, poor oral hygiene. Diagnosis methods are endoscopy, biopsy, CT scan, MRI and X-ray. Curative modalities are radiotherapy or chemotherapy. MAY 1. Dr. Amelita M. Pangilinan (DOH- CAR Officer In Charge)- RESU Updates ·Of the 24 diseases under surveillance, she reported a 100% increase in Leptospirosis which may be attributed to the early rainy season. ·There was also an increase in Non- Neonatal Tetanus, Paralytic Shellfish Poisoning, Adverse Events Following Immunization, Acute Flaccid Paralysis, Rabies and Chikungunya Suspects. ·Called on the public to enjoy a healthy summer by observing the 6S of the DOH namely sore eyes, sunburn, sipon at ubo, suka or tae, sakit sa balat or boil, sakmal ng aso which can lead to rabies. ·On climate change, there is a health impact on the increasing temperature globally. - Dengue happens during the wet season 10 years ago, but as early as January we already have cases. ·There was also a drastic lowering of measles cases and DOH believes that it is because of the nationwide immunization conducted last year. ·Reminded everybody that “An ounce of prevention is better than cure”

2. Engr. Basilio Munar- (Licensing Officer III- DOH CAR Office) “Road Safety Month” ·Reported 26 road injuries from Jan-April 2014 and 48 last Jan-April 2015 which accounts to a 184.6% increase and a decrease in deaths with 5 from Jan-April this year and 22 from Jan- April 2014. ·The causes of death reported is attributed more of mechanical error and human failure, attitude of the driver and road conditions. ·DOH- CAR advocacy is, not to put obstruction on our roads as “Road safety is everyone's priority”. ·Another concern of the department is the health status of every driver. ·Remind road users to observe road safety everyday and ended by saying “ Road Safety is no accident” 3. Ms. Teresita Foman-eg- (Nurse V- DOH CAR Office) “World No Tobacco Day” · Theme: (2015 Worldwide) Stop illicit trade of tobacco products · From the global tobacco survey, more young people are smoking than 5 years ago. · The age range of smokers globally is from 10-90 years old and most are smoking at age 15- 57 years old.

20 · Smokers have the same sex disaggregation · Smoking is no longer a habit, it is a disease which needs intervention. · One among the program of the DOH- CAR on smoking is health education on healthy habits for schools. · Tarpaulins and posters on no smoking are also available at the PDOH Office for distribution. · DOH is giving awards to LGU's, Government Offices and Hospitals who has policies, issuances and practices on No Smoking through the “Red Orchid Awards” · Another award given by the department is the “Search for Outstanding Healthy Lifestyle Advocacy Awards” to promote a healthy lifestyle including no smoking. This is open to local government units, workplaces(government or private and academic instituions.(schools, colleges,universities) · Called on the public to remember the risk on health when we smoke and for those who are not smoking not to start smoking. 4. Dr. Maria Lorena Santos- (Medical Specialist II- BGHMC) 1. Cervical Cancer Awareness Month ·Cervical Cancer is a lifestyle disease, it is caused by a human papilloma virus and is acquired through sexual contact. At risk are those with multiple sexual partners and those who have had early coitus ·Cervical Cancer is the 2nd cause of mortality in women. Manifestations are vaginal discharges, bleeding on contact ·Cervical Cancer is preventable, treatable and stage II is curable ·Reported 299 cases with abnormal findings in 2014 ·Provided 3 cervical cancer screening services to 342 women, 82 of them were diagnosed with the disease and 3 of them died. ·Made an announcement to the public to avail of a free annual cervical cancer screening at BGHMC from Mondays to Saturdays, 8:00 AM to 4PM for the whole month of May and at your birthday month. 2. AIDS Candlelight Memorial ·A global movement where a candlelight is done to commemorate those who died of HIV-AIDS ·This is also to remind everybody that AIDS is here and we have to do something. ·There are already 23,709 HIV diagnosed cases. ·Reported that from May 2006 to April 30, 2013, there were 179 recorded cases at BGHMC with ages ranging from 25- 34y/o with 90 cases, 35- 49y/o with 48, 15-24y/o with 39. The latest are 2 pediatric cases, a 4y/o female and a 2y/o male of which both mothers are HIV positive. · DOH declares May 11-15 as National HIV Testing Week and is encouraging the public to visit the HIV-AIDS Core Team Office at the OPD section of BGHMC for a voluntary HIV testing and to be inform about HIV-AIDS. Rest assured that all information and results are treated with utmost confidentiality. 5. Dr. Florence Gomez- (Medical Specialist III- BGHMC) “World Asthma Day” ·Asthma is an inflammatory and chronic disease that is not treatable but can be controlled given the right medication. ·Reported that there were 245 recorded asthma cases treated at BGHMC in 2013 and 193 in 2014, 28 of which are females. ·She noted that weather can cause/provoke asthma, tuberculosis is totally different from asthma, there is no link between asthma and snoring, most fatalities in asthma comes to the health facility too late and nobody should die on asthma now a days. ·Calling on the public for a free pulmonary function testing on May 18, 2015 at BGHMC, OPD Department and every Wednesdays to assess the severity of their asthma.

JUNE 1. Dr. Alexei Marrero- (Medical Coordinator, Infectious Disease Cluster, DOH CAR) “Dengue Awareness Month & ASEAN Dengue Day” · June is Dengue Awareness Month with the theme: “Sama sama natin sugpuin ang dengue, walang kitikiti, walang lamok, walang dengue” · Asean Dengue day was also celebrated last June 15, 2015 in Davao City and was attended by the ASEAN region representatives to celebrate information on Dengue and to increase awareness of people regarding the disease. · Reported a 70% decrease in dengue cases for the whole region from 691 last year to 575 this year from Jan- June. · Expect the cases to rise with the coming of the rainy season, He advised the public to be vigilant · Some municipalities in Abra particularly Luba, Kalinga, Apayao and Baguio City are increasing in dengue cases. · DOH- CAR Office is preparing all our health offices to be able to respond if there would be cases reported. · The 1st management for dengue is IV fluids/oral rehydration salts before blood tansfusion but if positive for bleeding, go to the hospital immediately for management. · Updated on Middle East Respiratry Syndrome Corona Virus (MERS CoV): § Baguio and the whole of CAR is MERS CoV free § Preparations are on-going, advisories were given throughout the region and meetings with the Korean Community for preparedness in cooperation with the baguio City health Office. § Provided trainings on how to handle cases including ebola and other emerging and re emerging diseases · Announced also the upcoming health caravan of the DOH CAR on June 23, 2015 in Conner District Hospital, Conner Apayao and June 30, 2015 in Abra Provincial Hospital, Bangued Abra. § The objective is access to quality health care services through direct health care service delivery to mother and child, infant, women of reproductive age, adolescent and senior citizens. § The battle cry of the DOH: “Walang nanay na mamamatay sa pagbibigay ng buhay” and “Bawat bata ay mahalaga.”

2. Mr. Anthony Baigen (Blood Program Coordinator- DOH CAR Office) “World Blood Donor Day- June 14” · Theme: “Thank you for saving my life” · 82 units of blood was collected during the mass blood donation at the Baguio Convention Center as one of the activities in celebration of the World Blood Donor Day in coordination with the Philippine National Red Cross · Educational materials were also given to let everyone be aware of the importance of blood donation. · Informed that we have blood centers available in all provinces of the region, they are all represented by a blood service facility and they have also networks with other regions like for Apayao, they have Far North Luzon Regional and Training Hospital but they also networked with Cagayan Valley Medical Center of Region II. · These blood service facilities has already started their blood registry.

21 3. Dr. Donnabel Tubera- (Medical Officer IV- Baguio City Health Office) “No Smoking Month” · June is no smoking month for the whole region. · The Baguio City Health Services Office is campaigning for a smoke free environment, no to indoor smoking including the access of students to these cigarettes and the tobacco industry at the back of this product · Discussed the disadvantages and risk factors with cigarette smoking like cancer, cardiovascular disease and chronic obstructive pulmonary disease. · Informed the effect of the so called 2nd hand and 3rd hand smoke specially to kids, they are prone to pneumonia, otitis media and all infections related to childhood illnesses. · Informed also that smoking does not have only health effects but also economic effects especially to a family who is depending on a smoker breadwinner. · Also included in the policy (City ordinance #75 s 2013) they were pushing regarding the smoke free Baguio which is now on its 2nd reading last July 2014 is the total ban on advertizing, promotion and sponsorship. · Reported that the youngest smoker in the city according to a survey done by their office is 8 years old · On the e- cigarette: She clarified that the electronic nicotine delivery system is not a health product, it has the same effect with the traditional cigarette and is not use as a device in exchange pf the traditional cigarette. · Updates on dengue: § There were 82 cases recorded from Jan-June of this year with 1 death from La Union. § On the vaccine for dengue which is rumored to be out by 3rd quarter of this year, we have to wait for the approval from DOH- FDA. There is also a priority population for that. · Cautioned the public on the possible rise of Influenza together with Dengue because of the rainy season, gave some public health measures like handwashing, good ventilation in the house, covering the mouth when sneezing, infection control and if you are sick, please stay at home.

4. Dr. Virginia Mangati (Medical Officer IV- BGHMC) “National Kidney Month” · June is declared as the National Kidney Month by virtue of Presidential Proclamation #184 · Reported that there was an increasing number of patients undergoing dialysis with an incidence rate of 35.9% in 2014, 13-14 patients per month are on dialysis at BGHMC and most of them comes from Baguio City. · Hypertension is the no. 1 cause of kidney disease in CAR · Diabetes and hypertension are the risk factors for kidney failure so as an advice please maintain your medications, eat a healthy diet, do exercise, no to pain relievers as much as possible and drink a lot of fluids. · Kidney disease is a silent killer, it takes time to develop. The incidence is 29.5% in CAR and more are males because of the risk factors like cigarette smoking and alcohol. · On kidney transplant: Immediate family members are preferred to be the donor. · The BGHMC Dialysis Center will be having 31 stations with 4 shifts by the end of July this year. (Private Public Partnership)

5. Ms. Belita Fe C. Pena (Assistant Chief Nurse- BGHMC) “ National Patient Safety” · Patient safety is the prevention of harm to patients for a safe, effective, efficient and reliable health. · Activities for the health worker includes infection control, monitoring of adverse events, medication protocol, waste management and for the patients, this includes provision of fire extinguishers, a security guard to monitor people who enters the hospital premises but don’t belong to the organization, 24 hr watcher for suicidal patients, nurses to do frequent rounds, bedrails for unconscious patients, stretchers should be locked and defective equipments to be monitored and should not be used. · There should also be enough nurses to cater to all patients at least 1:12 and 1:3 for ICU. · There should also be an Immunization for personnel for their protection. · Tender Loving Care is also needed in order to deliver the quality nursing care.

6. Atty. Ernesto Marzo (Administrative Officer- PDEA CAR) “ International Day Against Drug Abuse and Illicit Trafficking” · One of their program is the implementation of the drug free workplace to government and non government agencies to lessen the impact of drugs to the employees. · Reported that illicit drug trading for shabu comes from the lowlands through the transport sector as there were no reported laboratories yet in the region. · Clarified that they don’t inspect counterfeit drugs, they only inspect and monitor the compliance of the drugstores that have license to sell dangerous drugs on the regulatory inspection of PDEA. · Informed that nubain, valium and morphine are classified under dangerous drugs but is also considered a medical drug. · Informed that nurses can administer dangerous drugs as long as the prescription of the drug comes from a PDEA licensed physician. · Doing strict monitoring and implementation on the administration of dangerous drugs · Closely monitoring the dispensation and supply of dangerous drugs · Provide trainings for PDEA license holders · There is an ongoing training at the Benguet General Hospital for nurses and medical practitioners on the strict implementation guidelines on the administration of dangerous drugs.

(Continued on page 23)

22 (DOH deploys...... from page 6) (Cordillera...... from page 5) They are installed in the Rural On personnel augmentation, Aside from project highlights Health Units (RHUs) under the DOH deployed a total of 11 doctors and HFEP updates, Dr. Makoto Tobe, supervision of the Local Chief through the Doctors-to-the Barrio the project Chief Advisor, JICA-SSC Executives (LCE), Municipal Health program and 10 of these were sent to also presented a suggested Officers in close coordination with the the non-project sites in Abra. DOH-CAR measurement of facility-based delivery Provincial DOH Officers (PDOHO). The also deployed 92 nurses in all the 6 rate reflecting actual status at municipal HRHs are engaged in two year service provinces through the Nurses level. of contract renewable every six months Deployment Program and 125 midwives A press conference was also based on a very satisfactory through Rural Health Midwife Placement held and Asec. Bayugo said that DOH performance during their tour of duty. Program. Implementation of the noted Pope Francis’ call for support on program is continued up to 2015. Currently, 173 HRH are the increasing number of family deployed in the province of Abra, 55 in Director Lopez also noted that members in the Philippines and he Apayao, 24 in Baguio City, 143 in DOH-CAR certified 15 hospitals from the noted the significant improvement of Benguet, 93 in Ifugao, 88 in Kalinga, 86 non-project sites, 30 RHUs and 18 BHSs Maternal Mortality Rate in the country. in Mt. Province and four in the for BEmONC. This implies that these Director Lopez discussed the Department of Health-Cordillera facilities have met the required standard implementation of HFEP projects in the Administrative Regional Office (DOH- for both facility and personnel skills of the Cordillera. The Department of Health CAR Office). Department of Health on operating supports facility based delivery by birthing facilities and complied the quality service and construction of requirement of PhilHealth for the health facilities under HFEP. Dr. Amelita Pangilinan informed the public (Abra now...... from page 10) Maternity Care Package. These were processed using the Regional Standard about the importance of facility based Meanwhile, 16 Provincial delivery and suggested that harmful Malaria Field Personnel were also Operating Procedure on Certification of Facilities as BEmONC Capable. cultural practice of cutting the umbilical recognized during the awarding for their cord of a newly born child using contribution to the malaria elimination Most of the facilities in Ifugao, bamboos should be avoided as it could program of the province. Six of them Kalinga and Mt. Province are part of the result to tetatus infection. Dr. Pangilinan were recently recognized during the HFEP projects in 2013-2014 and are also noted that home deliveries in Gawad Pagkilala sa mga Natatanging currently ongoing construction. They will Cordillera is at 20% while facility based Malaria Field Workers held in Davao be assessed for the certification once delivery is at 80% of the total population. City. Among them was retired Diego the facilities are completely constructed. Palangdao, who worked in the (An “F”.....from page 7) There will, however be a continuing Provincial Malaria Control Program for Our health is in our hands. The assessment of the birthing facilities in 40 years. risk of having HIV infection lies in the 2015 for both initial and renewal decision an individual makes. As Health certification to make sure the quality of workers, let us provide our clients the delivering birthing services. information they need and would need. (New Classification...... from page 13) Let’s not get stuck with A; HIV eventually be able to comply and deliver Prevention is ABCDEF. complete and sustainable health (Kapihan...... from page 22) services to the Cordillera people. 7. Ms. Mary Leah S. Serna (Nurse Toxicologist- BGHMC) “ National Poison Prevention Week” · June 22-26 is the National Poison Prevention Week A new addition to the regulatory · Most common cases they have are kids/children who accidentally ingest kerosene, insecticide placed in empty water bottles and the most common insecticide ingested is organophosphate. functions of the DOH is the licensing of · Cautioned everyone on what we drink, take note of the labels and expiration dates. Birthing Homes. As of July 2015, · Be watchful also of too much alcohol drinking, it might lead to alcohol intoxication · The management for the common poison ingestion is not to induce vomiting as it might cause twenty-six (26) facilities have complied more trauma to the stomach lining instead bring them to the nearest health facility for with the requirements and were duly management (X ray and meds) licensed. In 2016, all Birthing Homes are · For snake bites, have to know what kind of snake, give ATT, ATS, anti biotic and pain relievers, check also for respiratory depression. required to apply for a LTO. · Informed that there will be a forum on poisoning at the OPD on June 29, 2015 in celebration of the National Poison Prevention Week.

23 Adolescent Health Summit and Awarding on January 7-8, 2015 Ebola Safe Management Training at Health Leadership and Management for the DOH-CAR on March 25, 2015 Poor Training Module 2 on March 10-12,2015

UHC High Impact 5 Launching cum Service Delivery Network(SDN) Summit on May 27-28, 2015 Launching of Smoke-Free La Trinidad on May 29, 2015

Cabiten BHS turn-over ceremony Am-Am BHS turnover ceremony Bottoms Up Budgeting(BuB) program on February 24, 2015 on May 13, 2015 issuance of logistics at Tubo, Abra on June 28, 2015 Health and Wellness update by Dir. Eric Tayag January - June 2015 Health Activities on February 12, 2015

UHC High Impact 5 Caravan held at Conner District Hospital on June 23, 2015

UHC High Impact 5 Caravan held at Abra Provincial Hospital on June 30, 2015