Saturday, December 26, 2009

2009 Top Health News - Philippines

Everybody loves a countdown at the end of the year, or so it seems. Like many media companies, Healthbeat, the Department of Health (DOH) magazine, has its own countdown too called “The 10 Top Stories that Rocked the Department of Health.” This is based on media monitoring of health news coupled with the opinions of the editorial staff. Here goes...


No doubt, the devastation that four typhoons (Ondoy, Pepeng, Ramil and Santi) brought in the entire Luzon in September and October was the biggest story of the country in 2009. However, the relief and recovery operations of government agencies, including that of the DOH, were sidetracked as mere politicking in the eyes of the media. No matter how hard it tried, the DOH’s HERO (Health Emergency Relief Operations) found no match with Sagip Kapamilya or Kapuso Foundation efforts. The power of media prevailed.

Somehow, and without much fanfare, the DOH continued its operations by fielding medical teams and distributing medicines and safe water to evacuation centers and communities in devastated areas.


Hogging the media coverage on Influenza A (H1N1) in the middle of the year was the leaked sex videos of cosmetic surgeon Dr. Hayden Kho, Jr. with a number of female partners, notably actress Katrina Halili. The DOH was briefly dragged into the controversy in May when Halili asked the revocation of the license to operate of Vicki Belo’s beauty clinics for “recklessly” allowing Kho to perform liposuction on her despite the fact that he lacked qualification, training and specialization as cosmetic surgeon. Halili said Kho passed the medical board exam only in February 2007 and the liposuction surgery was done in August 2007. According to her legal counsel, this violated the DOH’s Rules and Regulations Governing the Licensure and Regulation of Ambulatory Surgical Clinics, which states that surgeons should at least have a four-year medical residency before practice.

In September, the Philippine Medical Association (PMA) suspended Dr. Hayden Kho for two years for “conduct offensive to the profession. However, on November 20, the Professional Regulations Commission (PRC) found Kho guilty of “immorality and dishonorable and/or unethical conduct offensive to the profession” and ordered his medical license revoked. According to news reports, Kho would appeal this decision.


Veteran actor Johnny Delgado passed away on November 19 at the age of 61. Former President Cory Aquino died on August 1 at age 76. Master rapper and TV host Francis Magalona died on March 6 at age 44. Delgado had lymphoma or cancer of the immune system; Aquino had colon cancer; and Magalona had leukaemia or cancer of the blood. Cancer is the third leading cause of illness and death in the Philippines, and in 2009, well-known personalities succumbed to the disease.

This year, the DOH started providing free opioid analgesics for indigent patients suffering from severe pain due to cancer, HIV/AIDS and other chronic diseases. They can avail of these drugs from DOH hospitals and participating hospices nationwide. Moreover, the DOH has boosted its “HL (Healthy Lifestyle) to the Max” advocacy to prevent and control the four major chronic diseases – cancer, cardiovascular diseases, chronic obstructive pulmonary diseases and diabetes.


The Senate and the judiciary seemingly undermined DOH health promotion efforts by relegating its “infomercials” (paid public service advertisements) as purely political in nature. In August, then Health Secretary Francisco T. Duque III and other cabinet members with infomercials were summoned to a Senate hearing. In another development, the Manila Regional Trial Court released a temporary restraining order to stop advertisements bearing the faces and campaign slogans of “political wannabes.”

For decades, the DOH has been using mass media as part of its health promotion strategies to disseminate important messages for disease prevention and control. The traditional means of community-organized lectures, classes and meetings could only do so much. With the country’s growing population, the DOH needs to expand its reach through mass media. It is not only effective, it is also cost-effective if it is compared to the expenses that may possibly incur when thousands of the public get sick.

It turned out, on December 1, the last day of filing the Certificate of Candidacy in Comelec, Duque did file for any elected positions.


In January 2009, the US Centers for Disease Control and the US Food and Drug Administration reported a Salmonella Typhimurium outbreak and the sources were peanut butter and peanut paste produced by the Peanut Corporation of America in Blakely, Georgia processing plant. Salmonella bacteria are responsible for causing typhoid fever, diarrhea and gastrointestinal diseases.

This prompted the Bureau of Food and Drugs (BFAD, now known as the Food and Drug Administration) here to issue advisories to the consuming public against certain US brands of peanut butter and other peanut-containing products. BFAD also conducted its own tests on products currently sold in the market.

In March, the BFAD confirmed that some local brands of peanut butter also tested positive for salmonella. The involved food manufacturing company was subjected to further inspection and BFAD found that it continuously failed in its Current Good Manufacturing Practice. As a result, its license to operate was suspended. In April, upon the orders of the DOH, the salmonella-positive products were destroyed through proper incineration by a qualified disposal facility in Taguig City and following the strict mandate of the Clean Air Act.


As early as 2007, an increase in pig mortality in swine farms in the provinces of Nueva Ecija and Bulacan occured. This prompted the government to initiate laboratory investigations on sick pigs and samples were sent to international reference laboratories. In October 2008, results confirmed that the pigs were infected wth a highly virulent strain of Porcine Reproductive and Respiratory Syndrome as well as the Ebola Reston virus (ERV).

In January 2009, a Joint Mission composed of animal and human experts from the Food and Agriculture Organization, the World Organization for Animal Health, the World Health Organization and the Departments of Agriculture and Health carried out a full risk assessment of the ERV situation in quarantined farms in Bulacan and Pangasinan. In February, upon the recommendation of the experts, the depopulation of pigs was done in affected farms to prevent the further spread of the virus.

The DOH enjoined the local governments, the hog industry and the public in the four lines of defense – 1) report unusual occurrences of sick or dying pigs to local agriculture authorities; 2) adopt security measures to prevent and contain outbreaks in pig farms; 3) prevent the entry of double-dead meat into the market; and 4) thorough cooking of pork and pork products by the public.


The “Alabang Boys” mess caused a stir in media and this prompted President Gloria Macapagal-Arroyo to proclaim herself as the “Drug Czar” and she ordered the immediate nationwide random drug testing of high school students to determine the current incidence of drug use, to provide a deterrent for those using drugs and to provide the necessary services they need to stop further use. Thus, starting in February 2009 and towards the end of the year, an estimated 85,000 students would be randomly selected and tested. The final results may take next year to be announced.

According to Section 36 of Republic Act 9165 (Comprehensive Dangerous Drugs Act of 2002), students of secondary and tertiary schools, shall, pursuant to related rules and regulations as contained in the school’s handbook, and with notice to parents, undergo drug testing, whether in public or private schools, and such cost will be borne by the government. Now, the DOH is proposing amendments to the law for drug testing to be made mandatory and the fees shall now be borne by the student. Also, in order for mandatory drug testing to be effective, the implementation scheme should provide mechanisms that would ensure that the students do not know the time when the drug testing will be conducted. This means that the students can be tested anytime during the school year (from enrolment to the closing of the school year). In this case, the problem of addiction can be nipped at the bud.


Dengue, the disease that usually end up in the Top 10 Health News, was ousted by another “rainy season disease,” leptospirosis. The great floods that crippled Luzon gave way to the surge of the flood disease. Leptospirosis is acquired not only from absorbing contaminated floodwaters through cuts in the skin but also by swallowing the bacteria directly from water or through food. Although the disease is commonly associated with rat urine, infection can also come from animals like cattle, pigs, horses, dogs, and wild animals. The disease causes a wide range of symptoms that begins with flu-like symptoms (fever, chills, muscle pain, intense headache) and may end up in meningitis, liver damage (causing jaundice), and renal failure. Death may also occur.

The DOH also saw a niche in the media coverage of disaster management with its efforts to employ and deploy health teams to help address the growing number of leptospirosis cases in typhoon-affected areas. On October 12, a few weeks after Ondoy devastated many parts of Metro Manila, CALABARZON and Central Luzon, the DOH had already recorded 383 cases of leptospirosis in nine Metro Manila hospitals. This is already half of last year’s annual figures. And as more typhoons came affecting Northern Luzon, more cases were being reported.

The DOH entered into a memorandum of agreement (MOA) with PhilHealth-accredited private medical facilities where the government can refer leptospirosis patients that state hospitals can no longer accommodate. The DOH subsidized the financial requirements of indigent patients that it referred to these hospitals. Moreover, the DOH invited a team of international experts to help the government respond to a large-scale outbreak of leptospirosis. The four-person team is made up of specialists from Australia, France, the Netherlands and Singapore.

As of November 13, there were 2,292 confirmed cases of leptospirosis with 178 casualties as reported by the DOH National Epidemiology Center. These cases were gathered from 15 government and private hospitals and medical centers in Metro Manila.

On the other hand, a total of 1,090 confirmed cases with 71 deaths have been recorded in Ilocos, Central Luzon, CALABARZON, and the Cordillera Administrative Region. The Ilocos Region had the most number of cases at 464.


After long and tedious battles with multinationals for years, the Universally Accessible Cheaper and Quality Medicines Act of 2008 (Republic Act No. 9502) was signed into law in April 2008 and it meant an expected price reduction of medicines in the Philippines. One of its most salient provisions is giving the President the power to set price ceilings on various drugs, upon the recommendation of the Secretary of Health. And on August 15, 2009, it is time for the public to reap, as a 50% price reduction took effect in 38 drug molecules (72 drug preparations) or medicines against hypertension, diabetes, influenza, hypercholesterolemia, cancer, arthritis, goiter, allergies and infections. This has been termed as the Maximum Drug Retail Price or MDRP.

Of course, the MDRP implementation was confronted with hesitations and objections. Small and medium-sized drug outlets with manual systems, except those in front or near hospitals, were given until September 15 to comply. Pharmaceutical companies cautioned the government against imposing price ceiling on some medicines, saying it might lead to the easing out of the Philippines on the list of priority countries that will get the newly released medicines. The Pharmaceutical and Healthcare Association of the Philippines threatened to hold “hospital holidays” and increase other hospital fees to cope with loss of income because of the cut in drug prices.

But then, Mother Nature intervened. The devastating typhoons came and the bickering stopped (momentarily?!?).


The novel disease that scared the globe is the No. 1 Health News for 2009.

At 10:30 pm of May 21, the DOH officially announced the first confirmed case of Influenza A(H1N1) in the Philippines, a 10-year-old girl who just in from a trip to the US and Canada. Since then, the health workers in the field and in hospitals worked diligently to stall the increase in the number of cases by testing each person who manifested flu-like symptoms and contact tracing as well as treating accordingly those who were affected. As this happened, several schools and workplaces with confirmed cases shut down for days to prevent further spread of the disease.

Influenza A(H1N1) is a highly infectious disease caused by a virus which mutated out of four different strains of the influenza A virus found in pigs, human and birds. The outbreak began in Mexico in April 2009, spreading across the Americas and Asia in a matter of months.

On June 11, the World Health Organization (WHO) declared that the world was facing the highest Pandemic Alert level (Level 6) on A(H1N1). The WHO described the virus as ‘‘contagious and highly transmissible from person to person.’’ At this point, the DOH informed the public that it was shifting its A(H1N1) measures from containment to mitigation should community-level transmission happen in the country. A community-level transmission is present when the source of the virus can no longer be traced clearly and was already widespread. On June 22, the first locally reported H1N1-related fatality was a 49-year-old woman who also suffered heart problems. She was also the first fatality in Asia and among the 180 fatalities reported worldwide.

On June 30, the DOH issued revised guidelines on the response levels for schools and on clinical care management of H1N1 cases as well as new guidance on major policy changes from containment to mitigation response. The shift would mean that A(H1N1) would be treated as the common flu, some patients can be treated at home while those with underlying conditions would still require hospitalization, i.e. if a person has progressive symptoms and preexisting conditions like asthma, heart disease, diabetes, pregnant, malnourished, and has HIV or TB.

On July 9, the WHO commended the DOH for its “leadership and tireless efforts in responding to this emerging threat.”

At of the last count, more than 99 percent of A(H1N1) cases in the Philippines had recovered, with the 30 who died having suffered from other diseases like heart and liver disease.

On August 5, the WHO reported that 1,154 cases worldwide have died since the virus emerged in April.

Sunday, June 28, 2009

Kidney Diseases Kill Filipinos

Kidney diseases rank as the No. 10 killer in the Philippines causing death to about 7,000 Filipinos every year. So, before June (or the National Kidney Month in the Philippines) ends, let me remind Filipinos to take care of their kidneys.

Based on the Philippine Renal Disease Registry of the Department of Health, the leading cause of end stage renal disease is now the complication in the kidneys due to diabetes mellitus.

This is followed by chronic glomenrulonephritis or the inflammation of small kidney vessels called the nephrons that filter the blood, separate toxic substances and remove them out of the body through the urine. This usually afflicts children, adolescents and young adults in their reproductive years. This kidney disease may start from tonsillitis, pharyngitis or skin infections.

Children and young adults with latent glomerulonephritis can escape detection for months or years, causing the condition to progress to a chronic state. The signs and symptoms include cola-colored or diluted, iced-tea-colored urine from red blood cells in your urine (hematuria); foamy urine due to excess protein (proteinuria); high blood pressure (hypertension); fluid retention (edema) with swelling evident in your face, hands, feet and abdomen; fatigue from anemia or kidney failure; and less frequent urination than usual.

Other causes of end stage renal disease in the country are complication in the kidneys due to hypertension and chronic and repeated kidney infections (pyelonephritis).
Latent disease implies that there are no overt of outward manifestations or clinical signs and symptoms, hence the patient would usually not seek medical consultation. The person may look or feel normal but when the urine is examined, it will reveal abnormal findings.

Kidney diseases are potentially preventable if diagnosed early in the cource of illness, avoiding the need for expensive treatment such as dialysis and transplantation. The only means to detect the presence of kidney diseases is through routine urinalysis or urine examination at least once a year.

The first urine in the morning is the best specimen to be collected for urinalysis. Prepare a sterilized 50 milliliters bottle or container. Wash your hands as well as your genital area with soap and clean water. Let them dry. Then, urinate a small amount into the toilet bowl to clear the urethra of any contaminants. Then, collect a sample of urine in the bottle or container. About 2/3 full of the 50 milliliters bottle is needed for a test. Remove the container from the urine stream without stopping the flow. You may finish urinating into the toilet bowl. Take the sample to the lab.

Act now. Consult your doctor and have your urine examined! For those with diabetes and hypertension, control and prevention of high blood sugar for diabetes and high blood pressure for hypertensives are very important to prevent and delay the development of kidney problems that usually lead to end stage renal disease.

Photo Source

Swine Flu: If Not Treated

This is the consequence of Swine Flu - if not treated.
(I received this from an email.)

Wednesday, June 24, 2009

Influenza A(H1N1) in the Philippines

Important Events: Philippines

On June 23, Health Secretary Francisco Duque III confirmed that there is now a “low-level community outbreak” of Influenza A(H1N1) virus in Metro Manila, even as 28 individuals were added to the list of cases in the country, raising the total to 473. Duque said those affected by the low-level outbreak are mostly areas in Quezon City, ParaƱaque City and Manila. But he clarified that there is no “huge clustering of cases” in any community in the metropolis. He maintained that a majority of the schools with confirmed cases were situated in these cities. “You can put it this way: where are the schools where you already have school community transmission beyond second level? But it is still a very limited number (of cases), therefore it’s just a low-level transmission,” he said.

On June 22, the first Influenza A(H1N1)-related death in the country and in Asia was reported by Sec. Duque. The fatality is that of a 49-year old female who is known to have a pre-existing chronic heart disease was also found to be positive for A (H1N1). He said that the patient presented with flu-like symptoms starting on June 17 consisting of dry cough, fever and chills and difficulty of breathing just before death on June 19. Duque said that post-autopsy findings disclosed that the death was caused by congestive heart failure secondary to acute myocardial infarction aggravated by severe pneumonia either bacterial, viral or both. He said a throat-swab revealed that she was positive for A (H1N1). This case turned out to be an employee of Congress’ House of Representatives which prompted House Speaker Prospero Nograles to order the suspension of work at the House of Representatives until June 28 for the sanitation of its buildings.

On June 11, Director-General Mararet Chan of the World Health Organization declared that the “world is now at the start of the 2009 Influenza pandemic ” after raising the Pandemic Alert Level for the novel Influenza A virus from Level 5 to Level 6. This means that the new A (H1N1) virus has now spread and caused sustained community level outbreaks in at least one or two countries in two WHO Regions. It has initially affected US and Mexico (North America) which are the epicenters of this pandemic and has shown a fast and steadily increasing number of cases particularly in the United Kingdom (Europe), Chile and Argentina (Latin America) as well as Australia, Japan and China (Western Pacific Region) which show that the virus is contagious and easily transmissible from person to person. As of this date, there are nearly 30,000 confirmed cases of A (H1N1) from 74 countries and this is expected to increase further in the coming days and months.

On May 22, Sec. Duque, while attending a World Health Organization in Geneva, Switzerland, confirmed via teleconferencing, the first case of Influenza A(H1N1) infection in the country in a 10-year-old Filipino girl who arrived from the United States with her parents on May 18.

In April, cases of human infection with Influenza A virus subtype H1N1 were first confirmed in the U.S. in Southern California and near Guadalupe Country, Texas. The outbreak intensified rapidly from that time and more and more states have been reporting cases of illness from this virus. This virus was originally referred to as “swine flu” because laboratory tests showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a “quadruple reassortant” virus.

What You Should Know About Influenza A(H1N1)

What is Influenza A(H1N1)?

Influenza A(H1N1) is caused by a novel virus that resulted from the reassortment of 4 viruses from pigs, human and birds. It is a new virus causing illness in people. It was first detected in people in April 2009 in the United States. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread. There is no vaccine yet to protect humans from this virus. There are existing and recommended medicines that are effective in treating Influenza A(H1N1).

What are the signs and symptoms of this virus in humans?

Similar to the symptoms of regular flu such as: fever, headache, fatigue, muscle or joint pains, lack of appetite, runny nose, sore throat and cough. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting.

How does A(H1N1) virus spread?

It is spread in the same way that seasonal flu spreads from person to person: through coughing or sneezing by people with influenza, or by touching things with flu viruses on it and then touching their mouth, nose, or eyes.

What should I do to protect myself from getting the flu?

• Cover your nose and mouth when coughing and sneezing.

• Always wash hands with soap and water for at least 15-20 seconds, especially after you cough or sneeze. You may also use alcohol-based hand sanitizers.

• Avoid touching your eyes, nose or mouth. Germs spread this way.

• Increase your body’s resistance: have at least 8 hours of sleep; be physically active; manage your stress; drink plenty of fluids; eat nutritious food.

• Avoid close contact with sick people. Stay home if you are sick until you are symptom-free to prevent the spread of the virus.

• Follow public health advice.

What should I do if there is a sick person at home?

• Immediately bring the sick person to a doctor.

• Provide a separate room in the house. If this is not possible, keep the patient at least 1 meter away from other family members.

• Make sure the sick person wear surgical mask.

• Have proper ventilation where the sick person stays.

• Wash your hands with soap and water thoroughly after each contact with the sick person.

• Keep the environment clean.

Where can I seek medical attention?

If you are in the Philippines, the following Department of Health hospitals are designated as Referral Centers for Emerging and Re-emerging Infectious Diseases like Influenza A(H1N1):

National Referral Center
Research Institute for Tropical Medicine
Alabang, Muntinlupa, Metro Manila
Tel No. 809-7599

Sub-national Referral Centers

Luzon and Metro Manila
San Lazaro Hospital
Quiricada St., Sta. Cruz, Manila
Tel. No. 732-3776 to 78

Lung Center of the Philippines
Quezon Avenue, Quezon City
Tel. No. 924-6101/Fax No.:924-0707

Vicente Sotto Medical Center
Cebu City
Tel. No. (032) 253-9882/2540057

Davao Medical Center
Bajada, Davao City
Tel. No. (082) 221-6574

Satellite Referral Hospitals
East Avenue Medical Center
East Avenue, Diliman, Quezon City
Tel. No. (02) 928-0611 to 22

Quirino Memorial Medical Center
Katipunan Road, Project 4, Quezon City
Tel. No. (02) 421-2250 to 61

Dr. Jose R. Reyes Memorial Medical Center
Rizal Avenue, Sta. Cruz, Manila
(02) 711-9491 to 98

Rizal Medical Center
Pasig Boulevard, Pasig City
(02) 671-9740 to 43

and the

Regional Hospitals/Medical Centers of 16 regions

Be vigilant! If you have fever for 2 days and history of travel to Influenza A(H1N1) affected countries, immediately consult a doctor. For more information on Influenza A(H1N1), call (02) 711-1001 or 711-1002.

Tuesday, June 16, 2009

Pinoy Joke 1