Archive for the ‘MIND:For Medical Students’ Category

6 Bad Habits That Can Harm Others

Monday, June 4th, 2012

Dr. Willie T. Ong, The Philippine STAR

1. Not washing hands after defecating or urinating.

Experts agree that hand washing is the best way to avoid infections. However, based on studies, around 56% of Filipino adults do not wash hands after urinating. And this isn’t about the lack of soap and water. Many times, these are available but the people simply refuse to use it. What about after using the toilet? There are so many disease-causing bacteria in our feces that we should wash our hands thoroughly with soap and water. This is especially true for food handlers. Based on observation, around 40 to 50% of people do not wash hands after defecating. So many diseases can be transmitted to others like hepatitis A, salmonella, typhoid fever, cholera, amebiasis, worms, sore eyes, and various skin infections. Telling people to wash hands while singing “Happy Birthday” may not be enough. It is no wonder that diarrhea is the number 2 cause of sickness in the country with 1,568 cases of diarrhea being reported daily. We need everyone’s help to find the best ways to change public behavior.

Health Advice: Wash hands thoroughly with soap and water after using the toilet. Be careful to wash the area at the back of the hands, between the fingers, under the fingernails and around the thumb. These areas are commonly missed during hand washing. If there’s no water, use 70% rubbing alcohol to wipe your hands.

2. Not covering the mouth when coughing. (This includes the bad habit of spitting in public places.)

A most annoying and potentially dangerous habit is coughing in front of other people’s faces. Such utter disregard for hygiene and the health of others can lead to the quick spread of flu, pneumonia, colds and tuberculosis. Based on studies, children are often at fault in spreading disease because they have not been taught the proper cough etiquette.

Health Advice: Use a tissue or handkerchief when coughing. After coughing into a tissue, throw it away in a waste basket. Do not cough in front of others, especially within a 4 feet distance. If possible, don’t cough into your hands because if you don’t wash your hands, you can easily infect others. When spitting, expectorate phlegm on a bathroom sink and wash away with water. If you’re sick with the flu, stay at home to avoid spreading the virus.

3. Unsafe food handling and preparation.

Because some people do not prepare and store food properly, we have the unfortunate cases of food poisoning, diarrhea and sometimes deaths. Personal hygiene and common sense are important in food preparation. First is the need to wash your hands before handling or eating food. A DOH study shows that only 25% wash their hands before preparing food. Second, separate raw meat from cooked meat. Raw meat may have parasites and bacteria that can be passed on to the cooked food. Wash chopping boards and kitchen utensils before and after using. Third, buy only safe food items. This means buying safe meat (not double dead meat) and safe fish and seafoods (not fish kill or red tide contaminated). Fourth, cook your food thoroughly. Fifth, cover and protect your food from flies, ants and cockroaches. Just a few seconds with a fly and your food might be contaminated already. Sixth, if the food is not eaten within 2 to 3 hours, store these immediately in the refrigerator. And lastly, make sure you label all your ingredients at home. Lack of proper labels has harmed others because the cook had mistakenly placed poison instead of salt.

4. Unsafe sex practices for high risk groups.

The Department of Health is alarmed over the rise in new HIV cases in the country. In 2007, there were only 25 HIV positive cases per month. But in 2012, this figure has increased 10 times with around 250 HIV positive cases per month. In high risk populations, like MSM (men having sex with men) and female sex workers, the use of condoms is only at 30% and 70% respectively. This is way below the target rate of 90% condom use for high risk populations. Just think about it. If an HIV positive person doesn’t use a condom during sex, then this is tantamount to directly harming another person (if the other person gets infected). The HIV virus is passed on to others by blood, childbirth, semen and vaginal fluids.

To prevent the increase in HIV-AIDS, follow the ABCs of prevention. A is for abstinence. B stands for “be faithful to your partner.” Having only one partner decreases the chance of transmitting the disease. C is for proper condom use. There is no debate about the use of condoms to prevent HIV transmission during sex. It’s the only way. You have to physically block the semen and vaginal fluid from the infected person. D is for “don’t share needles.” Recently, the use of illegal drugs has caused HIV to spread in this high risk population. Of course, people should be weaned away from drug use. But if this isn’t possible yet, then the use of clean needles can decrease the spread of HIV-AIDS.

5. Unsafe driving habits.

Did you know that road accidents are now the number 4 leading cause of death in the country? Reckless driving, over speeding, tired drivers and drunk driving all contribute to fatal accidents. There are also other factors such as poor road conditions, poor lighting and faulty traffic signals. Often, we see buses racing each other and pedestrians jumping over road islands to cross the highway. To prevent road accidents, the government needs to strictly enforce traffic rules and ensure safer roads, among other measures.

6. Smoking in front of others.

Finally, there is one dangerous habit that has been scientifically proven to harm another person. Around 56% of Filipino men and 12% of our women engage in this habit. Studies show that smoking, on the average, reduces your life expectancy by 6 years. Smoking in front of other people, called passive smoking, also reduces other people’s lifespan by 2 years.

Finally, I would urge our policy makers, the government, media and everyone to focus on these 6 unhealthy habits that can cause harm to others. Let us pass and implement the necessary laws to protect the public’s health.

DOH Secretary Ona’s Health Strategies

Tuesday, May 8th, 2012

Dr. Willie T. Ong, The Philippine STAR, May 8, 2012

For the past two years, I have been fortunate to be part of the Department Of Health (DOH) family. In 2010, I was invited by newly-appointed DOH Secretary, Dr. Enrique T. Ona to be a consultant to help in the agency’s advocacies. Thanks to Secretary Ona, I was able to see how the government is set up to care for the public’s health.

How DOH Does Its Job:

First, the agency has 72 DOH retained hospitals under its control, including the likes of East Avenue Medical Center, National Kidney Institute, Philippine Heart Center and many more. The DOH also has its Centers for Health and Development (CHD) in every region with a Regional Director as the head. These CHDs help the local government units perform its health programs.

The DOH also has a huge 2 billion peso program every year on free childhood immunizations called the Expanded Program of Immunization. This EPI program covers diseases like polio, tetanus, tuberculosis and measles. On top of this, the DOH has strong regulatory powers on the price of drugs, food and drug companies, among others.

Health Challenges:

In DOH, I found out about the top health problems the government must address. These include (1) improving health facilities, (2) employing more health workers, (3) increasing PhilHealth coverage, (4) reducing the number of mothers and children dying, (5) reducing non-communicable diseases, (6) lowering the cost of medicines, (7) controlling outbreaks like dengue, and (8) controlling the HIV-AIDS epidemic.

For each of these problems, the DOH has already mapped out their strategic plan. However, the implementation part is easier said than done. If the solutions to our health problems were easy, then these diseases should have been eradicated already.

After close to two years in office, here are some of the things Secretary Ona has done.

  1. More people enrolled in PhilHealth – During Secretary Ona’s first interview with President Benigno Aquino, he was asked by the President how he would improve the health sector. Dr. Ona answered that after long years of study, he believes that the Filipinos’ health can be improved by getting everyone to enroll in PhilHealth. Only a government insurance can pay for emergency expenses incurred by poor families. Dr. Ona politely said that he would be happy to help in PhilHealth. To his surprise, the President did not appoint him to PhilHealth but rather gave him the bigger portfolio, which is DOH. As DOH secretary and chairman of PhilHealth, Secretary Ona has made his presence felt, even holding office in PhilHealth regularly. One survey shows that PhilHealth enrollment has increased to 80% from around 56% two years ago. This is on the strength of a multi-billion peso budget allocation for PhilHealth and two successful PhilHealth Sabados (enrollment campaigns).
  2. Highest budget ever for DOH – Under Secretary Ona’s term, the DOH received the biggest budget increase and the highest budget ever for DOH, which is at 42 billion pesos for 2012. This figure is almost twice the DOH budget of 23 billion pesos in 2009. In our conversations, he had said, “As a surgeon, I know how much our people need hospital care and medicines. I want the DOH to get its needed budget. People are saying that I am thrifty. Yes, I am thrifty when it comes to unnecessary luxuries. But when it comes to helping the poor, I will need a substantial amount of money to rehabilitate our hospitals.”
  3. He is one of the most-travelled DOH secretary in terms of visiting government hospitals, rural health units and birthing centers. He looks at the buildings, talks to the director, the architect and sometimes even the janitor to check the restrooms. The government hospitals must be “malinis and mabango” (clean and smelling fresh). But in the bureaucracy of bidding and building, it takes some time to get things going. Secretary Ona has already shuffled and reshuffled his people to find the best fit to get the Department going.
  4. DOH has employed more nurses and health workers through the RN heals volunteer nurses program.  Batch 1 deployed 10,000 nurses, batch 2 had 11,500 nurses, and the latest batch 3 will recruit 10,000 nurses and 3,000 midwives.
  5. Seeing how the poor cannot buy their medicines, DOH has also started a new program of giving free maintenance medicines for poor patients. Dubbed as the ComPack (complete treatment packs), this program has an initial budget of Php 500 million in a year.
  6. Secretary Ona has implemented his own version of “doctors to the barrios” with his Community health teams or CHT. These teams of health workers travel house to house to teach the people about vaccination, cleanliness, maternal and child care, and common diseases.
  7. With his increased budget for DOH, Secretary Ona has found extra funds to provide novel vaccines for the poor that will target diarrhea and pneumonia. These two diseases are the top causes of sickness in children. With this added free vaccination against Rotavirus (costing Php 560 million for 2012), the DOH hopes to see diarrhea cases being reduced afterwards.

Of course, there are perennial hard to solve problems like Dengue, HIV-AIDS and firecracker injuries. Dengue is tied up to a dirty environment, HIV-AIDS is connected to risky sexual behavior, and firecracker use is already part of the Filipino culture. Still, Secretary Ona has been very open to new strategies and ideas, like the study of tawa-tawa plant for dengue.

In our conversation, Secretary Ona always tells me that he is proud to be both a clinical doctor (a surgeon) and a public health man. He can see the problem from both angles.

How does he handle criticisms and complaints? What I found out is that Secretary Ona is a most forgiving man. Even if a person has wronged him before, he would still give the person another chance.

Early on during his term, some anti-smoking advocates have accused the Secretary of being “soft” on tobacco companies. But Secretary Ona just kept quiet because he believes there are always two sides to every issue. Then later on, to the surprise of his critics, Secretary Ona suddenly held a press conference giving his full support to the passage of “Sin Taxes.”

Did he change his stand on smoking? I believe he never did. “I need the money to rehabilitate our hospitals. There are so many poor people that need our help,” says the good DOH secretary.

The Country’s First Medical Museum

Saturday, April 28th, 2012

By Henrylito Tacio, SunStar Davao

Friday, April 27, 2012

THE nightmare started on March 20, 1902. At 2:30 p.m., two people were admitted at San Juan de Dios Hospital for treatment. The doctor who checked the patients was totally aghast by what he found.

Hospital physicians immediately notified the board of health. In just a matter of one hour, Dr. L.M. Maus, the health commissioner, arrived. He confirmed the diagnosis: cholera.

Just like what cholera had done in other countries, the disease was soon to wipe out thousands of Filipinos. In the first three days, thirty-seven were confirmed. It ballooned to 102 ten days later – with an astounding death rate of ninety percent!

Realizing the enormity of the situation, the health board (mostly Americans) carried a government order, which called for the burning of infected nipa huts – to the confusion of the natives. It also advocated cremation of bodies, outlawing of funerals, and land quarantine. All these conflicted with Filipino customs of funeral visits and visiting of the sick.

Despite these measures, the cholera epidemic continued to take its toll. People were not aware on how to prevent the disease from spreading. The contaminated water supply, rampant defecation in the rivers, and lack of hospitals contributed to the rapid spread of cholera.

All in all, 200,222 lives – including 66,000 children – perished. Three percent of the population was decimated in what touted to be “the worst epidemic in Philippine health history.”

New generations would never know this had it not been for the Co Tec Tai Medical Museum, which showcases the history of medical practice and health care in the Philippines.

Perhaps the first and only medical museum in the country, it has various collections of rare photographs, health artifacts, memorabilia, mementos, medical books and instruments, and paintings.

One of the things that captivated me during the recent visit was the two paintings by Thomas Daquioag. One was titled “Barrio Doctors,” where physicians are depicted helping the needy barrio folks. The other one is “Panata Ko… Bayan Ko,” a reminder of their oath: to save lives.

Touring around the museum is like walking through times – starting from the Spanish era (when three great epidemics hit the country: cholera, smallpox and beri-beri) to present time (the photograph of Health Secretary Enrique Ona interviewed by broadcaster Joe Taruc at the DZRH radio station).

There are lots and lots of historic photographs. Each photo is arranged according to the time it was taken: epidemic years (1891-1909), American health initiatives (1910-1919), training Filipino leaders in research and public health (1920-1929), passing the torch (1930-1939), the war years (1940-1949), golden age (1950-1959), medical progress (1960-1969), and Martial law years (1970-1979).

The year 1980-1989 was considered the primary health care years, 1990-1999 as burden from infectious and lifestyle diseases, and 2000 to the present time as health in the New Millennium.

The museum also has complete photographs of health secretaries – starting from Dr. Jose Fabella (1941-1945) down to Dr. Enrique T. Ona (2010-present). Among the most popular health heads were Dr. Francisco Q. Duque, Dr. Jesus C. Azurin, Dr. Alfredo (who received a Ramon Magsaysay Award), Dr. Juan M. Flavier, and Dr. Manuel M. Dayrit. So far, only two women became health secretaries: Dr. Carmencita N. Reodica (1996-1998) and Dr. Esperanza I. Cabral (2010).

The medical museum is named in honor of Mr. Ong Yong – better known as Co Tec Tai in the Chinese community. He was born in Jinjiang, China but came to the Philippines in 1922. He had been very active in charity works and was president of several civic organizations. He died in 2009 after a lingering illness.

“My father gallantly fought alongside the guerrillas in World War II,” said daughter Julie Ong-Alonzo. “When the war was over, he did small businesses until he built his fortune in later years. He then though of sharing what he had to the Filipino people to show his gratitude to the Philippines which he considered his second home.”

The Co Tec Tai Medical Museum is the brainchild of her brother, Dr. Willie T. Ong. A cardiologist at Manila Doctors Hospital and Makati Medical Center, Willie graduated from De La Salle University College of Medicine in 1992 and completed his training in Adult Cardiology at the U.P.-Philippine General Hospital in 1999.

During his early years in medical school, Willie was in search of role model Filipino doctors that could serve as his inspiration. But he couldn’t find any. So, after graduating from school, he and his wife, Dr. Anna Liza R. Ong, went to the United States and studied History of Medicine at the University of Wisconsin.

“For months, we toiled through the icy winter of Madison, collecting anything and everything related to Philippine medicine,” Willie recalled. The couple also went to Washington, D.C., Maryland, Boston, and Wisconsin to gather “any scrap Filipino health workers had left behind.”

Almost daily, the two doctors searched various libraries and American government agencies until finally they brought home 19 boxes of pictures, journals and books about the “secret of our past.” Willie admitted, “Many of these historical sources were destroyed in the Philippines by the bombs of World War II.”

The couple also traveled to other countries in quest for other information. In Spain, they went to Biblioteca Nacional in Madrid, Universidad Complutense de Madrid, Ministerio De Sanidad y Consumo, and Museo Nacional de Antropologia. In Japan, they went to Tokyo and visited the National Diet Library.

“Though this medical museum, all the good works and noble projects of our countrymen in the health sector can be safely stored and remembered,” said Willie, who writes a health column for a national daily and has a weekly television and radio show. “And as we look at the pictures and listen to their stories, it is our fervent hope to continue to tell and retell their stories for the younger generations to learn from.”

It took the Ongs twelve years to collect all what are now being displayed at the museum. First opened to the public in 2006, it is now located at the fifth and sixth floor of the Warner Building, 2540 Taft Avenue Pasay City (between Edsa Rotunda and Libertad Street). It is open from Mondays to Saturday from 9 am to 5 pm, with telephone number (632) 831-9842. Visitors are welcome to visit in large groups. Students in high schools and colleges, especially those interested in health sciences, are welcome to tour the museum. Admission is free.

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