Issue No. 67 - November to December 2011 - DOH

HEALTH examQuotes of the YearMake a Wild Guess on Who Said What_____ 1. “Go out and multiply.”a) Genesis b) God c) Manny Pacquiao_____ 2. “Although most major religions look negatively at suicide, the Catholic Church tends to be the most judgmental,with threats of eternal damnation and some Catholic priests refusing a church burial.”a) Michael Tan b) Dr. Dina Nadera c) Miriam Santiago(Anthropologist) (Psychiatrist) (Senator)_____ 3. [Referring to Nora Aunor] “If you want to be popular again, be wholesome. Gusto n’yo ba gayahin ka namin?Ang trabaho n’yo is to inspire us, not to scandalize us.”a) German Moreno b) Father Robert Reyes c) Ronnie Ricketts_____ 4. [On PhilHealth’s new payment scheme] "Ang dengue, tests pa lang ubos na ang P8,000. Paano pa yungprofessional fees ng mga duktor? Ang tatamaan nito yung ordinaryong tao.”a) Dr. Rustico Jimenez b) Gwendolyn Pang c) Dr. Lyndon Lee Suy(Private Hospital Association President) (Phil. Red Cross Secretary General) (DOH Dengue Control Program Manager)_____ 5. [On the plight of volunteer nurses] “Nag-o-on-the-job training volunteerism, sila pa ang nagbabayad, tapos‘yung certificate, hindi naman po siya qualified maging employment certificate.”a) Dr. Rustico Jimenez b) Dr. Leah Paquiz c) Dr. Gerardo Bayugo(Private Hospital Association President) (“Ang Nars “ Founding President) (DOH OIC-Undersecretary)_____ 6. [On the enforcement of MMDA’s smoking ban] ”Yung Philip Morris ang naaapektuhan kasi. Dahil sa pinapatupadna paghuhuli na ‘yan, syempre ‘yung negosyo, naaapektuhan.”a) Complainant Antony Clemente b) Attorney Jesus dela Paz c) Judge Carlos Valenzuela_____ 7. "The lost productivity and high health care costs of catastrophic outcomes resulting from non-communicablediseases can certainly drive any family into impoverishment and poverty."a) Chris Nelson b) Dr. Enrique T. Ona c) Dr. Oscar Tinio(Managing Director, Philip Morris- (Health Secretary) (President, Philippine Medical Association)Fortune Tobacco Corporation)_____8. “Clean Habit, Clean Air, Clean City.”a) DOH b) DPWH c) MMDA_____ 9. "The Philippines is the 12th most populous country in the world with about 94 million people."a) National Nutrition Survey b) Philippine Health Statistics c) 2011 State of theWorld Population Report_____ 10. “Huwag ang anak ko ang pakialaman n’yo... Yung malaswa, yung malaswa!”a) Dionesia Pacquiao b) Annabelle Rama c) Chavit SingsonAnswers on Page 49November - December 2011 I HEALTHbeat 3

HEALTHbeatDEPARTMENTOF HEALTH - National Center for Health Promotion2F Bldg. 18, San Lazaro Compound, Sta. Cruz, Manila 1003, PhilippinesTel. No. (63-2) 743-8438 Email: healthbeat@ymail.comDoing Desiderata“Go placidly amid the noise and haste, and remember what peace there may be in silence...”This is the first line of Max Ehrmann’s famous poem, “Desiderata.” Is this what theDepartment of Health is doing nowadays?!?Since after EDSA Revolution I in the mid-80’s, the DOH led the pack of government agenciesas the most active and very visible in providing and promoting services to the people. Ithas topped social and people surveys, satisfaction ratings as well as international studiesas THE best performing agency several times. It is also well known for being a “trainingground” for political wannabes, and has successfully seated a health secretary in theSenate. Secretaries come and go, but they left becoming household names.Those days are gone now, but it does not mean that the DOH has stopped performing itsfunctions well. It’s just that Health Secretary Enrique T. Ona seemingly chooses to stay out ofthe limelight, and he is seen facing the media only when serious health issues arise. The bigchunk of his time is diligently spent in fulfilling universal health insurance coverage withinthree years, meeting the country’s targets in the Millennium Development Goals by 2015, andlaying out plans and programs to better enhance government health facilities and services.Sadly, these are health issues that have not been truly prioritized by previous administrations.Moreso, these are issues that are not so popular in the news.Silently as it may seem, the DOH has already built the foundation of bringing health, especiallyto low-income and indigent families, who are still the great majority of the population. Fortoday’s DOH, becoming superficially popular takes a back seat, and turning into a driving forcethat delivers the most wanting policies and programs takes the stand.The Desiderata ends with the lines, “With all its sham, drudgery, and broken dreams, it is still abeautiful world. Be cheerful. Strive to be happy.”Have a truly blessed Chirstmas and a happy new year.– The EditorsEditors-in ChiefManaging EditorStaff WritersCover DesignGraphics DesignPhotographerContributorsCirculationEditorial BoardIrma L. Asuncion, MD, MHA, CESO IVRosemarie G. AguirreAnthony R. RodaMay Elenor R. de GuzmanDonato Dennis B. MagatElizabeth G. MascareňasGlen S. RamosDiosdado G. Angeles, Jr.Joerem P. CeriaPaquito P. RepelenteJoerem P. CeriaRiza C. De Leon, MDTato S. Usman, MDDOH-NCHPProduction, Disseminationand Collection SectionThis issue is dedicated in memory of HEALTHbeat staff, FEDELINO "Nong" MENDOZA.(See our tribute on page 32.)FOR EDUCATIONAL PURPOSE ONLY. NOT FOR SALE.Opinions expressed in this publication do not necessarily represent those of the DOH. The mention of specific companies or of certain manufacturer’s products does not imply that they are endorsed or recommendedby the DOH in preference to others of similar nature. Articles may be reproduced in full or in part without prior permission, provided credit is given to the DOH for original pieces. A copy of the reprinted or adaptedversion will be appreciated. Articles, artworks, photographs, caricatures, letters and other contributions are most welcome. Materials will be edited for clarity and space. Unsolicited manuscripts will not be returned.Contributors must indicate their names and addresses.4 HEALTHbeat I November - December 2011

contents172066 The 7 Billionth Baby9 Partnerships in Essential Newborn Care13 Resarch Brief: Oral Contraception14 Bloody Sperm15 How Your Balls Hang17 Thoughts and Feelings of Having Vasculitis20 Aging Matters25 Chairman Francis N. Tolentino: Health Champion32 Goodbye, Nong Mendoza33 Health News - Top 10 in 20113433 Voluntary Blood Donation34 Smokin’ Superstars35 Iligtas sa Tigdas Ang ‘Pinas37 Woeful Suicide38 PhilHealth Schemes and Things39 Plight of the ‘Nightingales’40 Dengue Surge in Luzon42 Global Concern for Non-Communicable Diseases44 Smokefree Metro Manila46 RH Bill Circus46JOKES N’YOKALAbeat 23laughter HEALS 24stress RELIEF 31FACEbeat 48SAbeat 50November - December 2011 I HEALTHbeat 5

world POPULATIONTHE 7 BILLIONTH BABY AND THE 3 KINGS?!? Danica May Camacho, the Philippines’ symbolic 7 Billionth Baby, calmly lies on the chest of her mother – CamilleCamacho, while the “three kings” look over. From left to right: Florante Galura – the proud father, Health Secretary Enrique T. Ona and Dr. Ruben Flores –director of the Dr. Jose Fabella Memorial Hospital. (Photos by Paking Repelente)The 7 Billionth BabybyDONATO DENNIS B. MAGATHEALTHbeat StaffThe world population now standsat seven billion. At the first few minutesof October 31, the Philippines welcomedwith much enthusiasm its symbolic seven6 HEALTHbeat I November - December 2011billionth inhabitant. Is it good news? Or badnews?Health Secretary Enrique T.Ona welcomed the news of seven billionpopulation as a forum to discuss issues athand, but also urges all citizens to makeconcrete actions so that everyone does notbecome part of the problem but instead be

part of the solution.Ona added that the seven billionpopulation is an achievement since thismeans that the average life expectancy atbirth of Filipinos has increased from 57 yearsin 1970 to 65 in 1990 and 72 in 2010, andthat people are now living healthier lives.However, according to healthexperts, disparity in health care accessbetween the rich and the poor has beenwidening, in terms of access to information,services, and even health facilities, socialstatus acts as determinants.The country’s symbolic sevenbillionth baby, named Danica May Camacho,is the second of two siblings. She may beconsidered luckier among other babies bornduring her era because she was awarded awell-baby package from United Nations,a college scholarship grant from the AsianCollege of Science and Technology, and ahealth insurance from Philhealth.Danica May’s parents, FloranteGalura and Camille Camacho, were also lucky.They were given a sari-sari store packagefrom PureGold grocery and a dealershiporientation from Natasha, a direct marketingfirm.Well-wishers of baby Danicaincluded Secretary Enrique T. Ona, UnitedNations Resident Coordinator JacquiBadcock, United Nations Population Fund(UNFPA) Country Representative UgochiDaniels, Jose Fabella Memorial HospitalDirector Dr. Ruben Flores and media fromdifferent networks. It was, indeed, a happyand momentous event that time, but is therereally a cause to celebrate?Ona noted that the arrival ofthe seven billionth addition to the worldpopulation poses a big challenge to thecountry’s healthcare system. Is the countrystill meeting its obligations to look afterthe needs of its people now numberingapproximately 94 million?The health chief noted that suchis an opportune time to assess wherethe Philippines is in terms of addressingpopulation-related issues focused on health.Also, what actions can be done individuallyand collectively in responding to thechallenges of a world with seven billionpopulation.Many economists would frownon this new development as more peoplewould be competing for even scarceresources. About 26% of the world’spopulation live below poverty line, and evenmore intriguing is that poverty incidence indeveloped regions is at 1% while it is 54% inleast developed regions.The 2011 State of the World PopulationReport noted that great disparities existamong and within countries and in rightsand opportunities between men and womenas evidenced by the fact that 215 millionwomen of child-bearing age in developingcountries lack access to voluntary familyplanning, millions of adolescent boys andgirls have little access to sex education andinformation on ways to prevent pregnanciesand protect themselves from HIV.UNFPA Representative to thePhilippines Ugochi Daniels said that Filipinowomen belonging to the poorest quantilehave an average of six children, which istwo more than what they really want. Thishappens because women in the lowesteconomic strata lack access to reproductivehealth information and services.On the other hand, more affluentwomen only have an average of twochildren, which is what they generallydesire. This only points to the fact that thesewomen have more control of their fertilityas they have access to information, services,and contraceptives.Today, the Philippines, accordingto the 2011 State of the World PopulationReport, is the 12th most populous country inthe world with about 94 million people andAsia remains home to 60% of the world’spopulation.Statistics reveal that it took 123years for the world population to increasefrom one billion to two billion, but it onlytook 84 years for the population to increasefrom two billion to seven billion. The journeyfrom six billion world population to sevenbillion only took 12 years (1999-2011). Theprojected number of years for the world toreach eight billion range from 10-11 years.China still holds the record forthe most share in the world population at1.35 billion. India follows at 1.24 billion.However, the Population Division of theDepartment of Economic and Social Affairsestimates that India in 2025 will overtakeChina with a projected population of 1.46billion compared to China’s 1.39 billion.In many parts of the developingworld where population growth rate isoutpacing economic growth, the unmet needfor reproductive health care, focused mainlyon family planning, remains enormous. Thereport also said that governments that areserious in eradicating poverty should alsobe serious about providing the services,supplies, and information that men, womenand young people need to exercise theirrights.In some of the poorer countries,high fertility rates hamper developmentand perpetuate poverty, while in richercountries, low fertility rates and too fewpeople entering the job market are raisingconcerns about prospects for sustainedeconomic growth and the viability of socialsecurity systems.Daniels noted that the world ofseven billion presents some essential globaltruths. Within countries, wide disparitiesbetween the rich and the poor are glaring.About 43% of the worldpopulation is under 25 years. The averageNovember - December 2011 I HEALTHbeat 7

Health Secretary Enrique T. Ona (left) poses with 12-year old Lorrize Mae L. Guevarra (center, thesymbolic 6 Billionth Baby who was born on October 12, 1999) and her mother. (Photo by PakingRepelente)number of children that a mother bearsduring her entire reproductive life has gonedown from 5 in the 1950s to 2.5 in 2010.However, fertility rates in least developedregions remain at a high of 4.2%.Daniels also noted that in thePhilippines, 49% of the population lives incities as more people from the rural areaslook for better opportunities elsewhere.Internal migration, according to Daniels,poses issues that have to be addressed suchtrafficking of women.Also, Daniels said that thePhilippines is composed mostly of youngpeople under the age of 25 years making upfor 54% of the population. Because of this,there is a need to respond to the needs ofyoung people by providing them with lifeskills, including proper information abouttheir sexuality.Presently, about 10% of Filipinogirls between the ages of 15 and 19 are nowbecoming mothers. These young people arealso becoming increasingly vulnerable to HIVinfections. Latest data from the Departmentof Health revealed that an average of eightnew cases of HIV infection are reportedeveryday compared to one or two some fouror five years ago. What makes the situationeven worse is that these new cases belong tothe most productive age.Former Health Secretary AlbertoRomualdez urged that people shouldbecome impatient on the promise of qualityhealth care for all and start demanding forit. The whole sector should work doubly hardand outrun the pace of population growthif it were to provide quality health careservices for all and achieve its MillenniumDevelopment Goals.The world’s population willcontinue to increase but the time to act isnot now, but yesterday.BinyagPARI:MAGULANG:PARI:MAGULANG:PARI:MAGULANG:PARI:MAGULANG:PARI:Pagkaganda-gandang kambal. At babae't lalaki pa. Sino sa inyo ang mga magulang?Kami po, Father.Ano ang ipapangalan ninyo sa sanggol na babae?Mercedes po, Father.Ah, napakagandang pangalan. At dito naman sa sanggol na lalaki?Ferrari po, Father.Ano? Mercedes at Ferrari?Opo, Father. May problema po ba?At ano naman ang gusto ninyong gamitin ko na pambinyag sa kanila? UNLEADED o DIESEL?8 HEALTHbeat I November - December 2011

...continued from page 9Demographic and Health Survey (NDHS,2008), less than half of births (44%) in thePhilippines occur in health facilities – 27%in the public sector and 18% in private sectorfacilities – and 56% of births occur at home.Home births are much more common in ruralareas which are 70% while urban areas are40% . Overall, 62% of births are delivered bya skilled provider (doctor, nurse, or midwife).Another 36% are assisted by a traditionalattendant or “hilot,”The Field Health ServiceInformation System in Autonomous Regionof Muslim Mindanao (FHSIS-ARMM, 2008),reported that home deliveries are 90.16%while hospital deliveries are only 9.03%.On one hand, 51.47% of birth deliveriesis handled by physicians (4.58%), nurses(2.26%), and rural health midwives(44.63%), while the bulk of deliveries(48.41%) is handled by traditional birthattendants.In ARMM, it has been a practice ofMuslims to deliver babies at home becauseof cultural practices and Islamic rituals beingpracticed freely such as but not limitedto spiritual support of families like givingsupplication through a sip of water byexpectant mothers since time immemorial.Another reason that counts most whybirthing mothers prefer home deliveriesis the Islamic rituals surrounding birthparticularly perfoming of azan (Islamic call toprayer) on the right ear of the newborn andthe iqamah (second call to Islamic prayer) onthe left ear immediately after delivery andbefore the initiation of breastfeeding. Thesepractices are indispensable among Muslims.However, with the advent ofevidence-based intra-partum techniquesand protocols particularly the ENC, highmaternal and infant mortality will continueto persist if the aforementioned practicesand rituals are not interfaced.With the present realities amongMuslims in ARMM, there is an urgent needto establish a strong partnership betweenthe health professionals and the traditionalbirth attendants by delineating the rolesand responsibilities without necessarilyTwo of the 12 messages that will be imparted by Community Health Teams to 10.8 million households, particularly especially the poorest Filipino familiesidentified through the National Household Targeting System of the Department of Social Welfare and Development, are on essential newborn care. Hopefully,these information and services will greatly contribute to the attainment of the countrys targets to the Millennium Development Goals No. 4 and 5 (reductionof child and maternal deaths, respectively) by 2015.November - December 2011 I HEALTHbeat 11

compromising the ENC protocols and theMuslim cultural sensitivities and Islamicrituals.The health professionals will dothe ENC protocols while the traditionalbirth attendants will handle the culturalpractices and Islamic rituals such as spiritualsupplications, azan & iqamah, and properburying of placenta.Under the Aquino Health Agendaon Kalusugan Pangkalahatan (UniversalHealth Care), public-private partnershipis one of the strategies and interventions,like community health team (CHT) andbreastfeeding advocates and educators(BAE), a group of women of Noorus-Salam (light of peace) in partnership withPhilippine Center for Islam and Democracy(PCID), Magbasa kita Foundation, UNICEFand NNC-ARMM that are homologous to CHTand peer counselors in non-ARMM areas.Islamic GuidanceAllah Almighty said, “So ask thespiritual HEALTHpeople of the Reminder if you do not know...“(An-Nahl: 43 and Al-Anbiya’: 7).This verse indicates that seekingthe one who has the expertise over illnessesshould be given top priority. For example, ifwe are dealing with birthing, then look forobstetrician who is most knowledgeable. Inthe absence of obstetrician or if the client isa pauper, then look for other qualified healthservice providers within reach.Imam Malik narrated in hisMuwatta that Zaid bin Azlam said, “Duringthe time of the Prophet (peace and blessingsbe upon him), a man was injured and theblood was congested in the wound. The manthen called two doctors from Bani Anmar toexamine him. The man then claimed thatthe Messenger of Allah (peace and blessingsbe upon him) asked them, “Who is the bestdoctor between the two of you? They asked“Is there a preference in the medicine, OMessenger of Allah? He said, ‘The One whosent down the disease also sent down thecure.’”This Hadith (a report of the sayingsAma at AnakMay isang anak ang gustong iligaw ang kanyang ama sa gubat dahil sa sakit nitongwala nang lunas at pagod na rin siyang mag-alaga dito. Ipinasan niya ang kanyang amahanggang sa makarating sila sa kasuluk-sulukan ng gubat. Ngunit, habang naglalakaday napansin ng anak na pinuputol ng kanyang ama ang bawat sanga ng punongmadaanan nila. Tinanong ng anak kung bakit niya ginagawa ito. Ang sagot ng ama,”Pinuputol ko ang sanga dahil ayaw kong maligaw ka sa pag-uwi mo, anak.”Photo from or actions of The Prophet) indicates thatMuslims should seek the best authority ineach and every matter and field, becausesuch expertise will ensure that the job isdone with excellence.The Prophet (peace and blessingsbe upon him) also said, “Those who know itare aware of it, and those who do not knowit are ignorant of it.”On the other hand, Abu Dawud, An-Nasai and Ibn Majah said that the Messengerof Allah (peace and blessings be upon him)said, “Those who practice Tibb (medicine),but are not knowledgeable in this professionare responsible for their actions.” (Also AlHakim narrated this Hadith).This Hadith is a good reminderto non-skilled birth attendants who arepracticing birthing even in the presence ofskilled health professionals.Thus, seeking knowledge iscompulsory. The Prophet (peace and blessingsbe upon him) said, “Seeking knowledge is amust for every Muslim – male and female”(Ibn Majah).Muslims have to work in anorganized group, for the collective effort ofa group of people is always better and moreeffective than the arithmetic sum of theirindividual efforts. Such collective work of agroup should however be aimed at achievinga certain goal otherwise it loses its raisond’ētre.Allah Almighty said, “Help oneanother unto righteousness and piousduty. Help not one another unto sin andtransgression.” (Al-Maidah: 2)Hence, to resolve the predicamenton birthing issues and thereby mitigate highmaternal and infant mortality rates, a strongpartnership on ENC between midwives andtraditional birth attendants is commendableespecially in communities that are leasturbanized like in ARMM.Allah knows best.12 HEALTHbeat I November - December 2011

RESEARCH briefWith research growing rapidly and changes happening so often, finding andsorting facts can sometimes be diffi cult and confusing. This brief aims toprovide you with concise evidence-based information to keep you abreast ofstate-of-the-art medical practice.Oral Contraception Offers Long-TermProtection against Ovarian CancerOral contraceptives (commonly known as pills) protect women againstovarian cancer. When a woman uses oral contraception for a longerperiod, the risk of ovarian cancer is greatly reduced.In a systematic review of 45 studies, The Lancet, a highly acclaimed medicaljournal, concludes that women who had ever used oral contraceptiveswere signifi cantly less likely to develop ovarian cancer than women whohad never used oral contraceptives. iFor every fi ve years of use of oral contraceptives, the risk of ovarian cancerreduces by 20%. Even if all or a combination of factors – like ethnicity,education, age at fi rst birth, age at fi rst menstruation, family history ofbreast cancer, height, weight, body mass index, use of alcohol or smoking– are considered, the reduction risk is altered only by less than 1%. Thismeans that prolonged use of oral contraception regardless of a woman’sbackground is strongly associated with the reduction in the risk of havingovarian cancer.The risk of ovarian cancer for a woman who stopped using pills less than10 years ago is reduced by 29%. If a woman stopped using pills about 10to 19 years ago, the risk is reduced by 19%, and by 15% if contraceptionceased 20 to 29 years ago.Estrogen dose in pills has decreased substantially over time. However,the Lancet research sees no signifi cant difference on risk reduction if thecontraceptive use took place in the 1960s, 1970s, or 1980s. The systematicreview gives strong evidence that, even with minimal estrogen dose, oralcontraceptives offer long-term protection against ovarian cancer.Oral Contraception and Cervical Cancer:the Recent EvidenceProlonged use of oral contraceptives (pills) among women increases therisk of cervical cancer. However, more recent research established that thenumber of cervical cancer cases associated with pills use is very small. Thisi Beral V, Doll R, Hermon C, Peto R, Reeves G. Ovarian cancer and oral contraceptives: collaborativereanalysis of data from 45 epidemiological studies including 23257 women with ovarian cancer and87303 controls. Lancet 2008; 371: 303-314.risk also disappears 10 years after a woman stopped taking oralcontraceptives. iiIn 2003, a systematic review of 28 studies worldwide iii published by TheLancet, the peer-review medical journal, concluded that women who arecurrent users of oral contraceptives are more at risk of developing cervicalcancer compared with women who never used oral contraceptives. Thelonger a woman uses pills, the higher her risk of developing cervicalcancer.Cervical cancer is caused by HPV, a common sexually transmitted infection(STI) found on skin in the genital area, in semen, and also in the tissuesof the vagina, cervix and mouth. It is primarily transmitted throughskin-to-skin contact. Vaginal, anal, and oral sex also can spread HPV, butother major factors proven to increase cervical cancer risk are multiplepregnancies, having fi rst pregnancy at the young age, and smoking. HPVusually clears on its own without treatment, but sometimes persists.For women with persistent existing HPV, using the pills for more than fi veyears appears to speed up the development of the infection into cervicalcancer.Providers should therefore advise combined oral contraceptive pillsusers – and all other women – to be routinely screened according to thenational guidelines to detect any changes or abnormal cells on the cervixwhich can be removed. ivii Franceschi S. The IARC commitment to cancer prevention: The example of papillomavirus and cervicalcancer. Recent Results in Cancer Research 2005; 166:277–297.iii Smith J S, Green J, Berrington de Gonzalez A, Appleby P, Peto J, Plummer M, Franceschi S, Beral V.Cervical cancer and use of hormonal contraceptives: a systematic review. Lancet 2003; 361: 1159-1167.iv WHO. Family Planning Global Handbook for Providers. Evidence-based guidance developed throughworldwide collaboration. 2007.November - December 2011 I HEALTHbeat 13

men’s HEALTHBLOODYSPERMbyGLEN S. RAMOSHEALTHbeat StaffRed semen comes oozing outinstead of sticky white fluid. The disturbingsight of blood appearing in the semen cancause great concern to men who experienceit.The condition is known ashematospermia or the presence of bloodin semen. The blood content may not bedistinctly obvious, but trace amounts canbe determined due to discoloration in thesemen. The excretion of reddish or brownishsemen is an indicator of hermatospermia.Hematospermia has been writtenabout for centuries. Even Hippocrates, thefather of Medicine, has commented on thiscondition. It can occur in males of any age.In younger men, less than 40 years old,hematospermia is uniformly benign. Buteven in older men, it is rarely associated withmalignancy.This condition does not necessarilypoint to a serious underlying cause thatneeds treatment because it will revert tonormal after a few days. In some cases,antibiotics are prescribed by doctors tohasten treatment.Hemastospermia may happenafter a recent accident to the penis ortesticles from either a blunt or sharp object.Sometimes, however, blood vessels inthe testicles can also occasionally becomedamaged and burst even without beingphysically struck by an object, causing ashort-term appearance of blood in thesperm.The condition may also occur afterundergoing certain medical procedures like aprostate gland biopsy. More than 80 per centof men who have undergone this procedurehave experienced ejaculating semen withblood for as long as four weeks. Vasectomy(the process of blocking the passage ofthe sperm cells during ejaculation, thusrendering a man incapable of impregnatinga woman) may also result to this conditionone week after the surgery.Growth of tumors, whether benignor malignant, in the key parts of the malegenital system (prostate, testicles, seminalvesicles and urethra) and even the urinarybladder may also result to bloody semen.In addition, urinary tract infectionand various forms of sexually transmittedinfections such as chlamydia, herpes,trichomoniasis and AIDS are also conditionsthat may cause hermatospermia.Other causes may includeinflammation (such as prostatitis,epididymitis and urethritis), hypertension,leukemia, scurvy, lymphoma, liver cirrhosis,cancer, intraductual carcinoma andhemophilia.Certain signs and symptoms mayindicate that blood may soon appear in thesperm. These include: having difficulty andpain when urinating and ejaculating, havingtraces of blood in the urine, pain in the lowerback, scrotum and testes, as well as theinflammation of the general groin area.Although hermatospermiais benign and commonly idiopathic(spontaneously occurring without knowncauses), it is important to closely monitor itsoccurrences to see if it is a simple case or itcould stem from a more serious condition.Seeking medical attention is necessary ifblood appears in the semen for more thanseven days.To prevent having a hemastospermia,a person can wear protective gearwhile playing sports or engaging in anysort of strenuous activity where damage ortear could possibly occur in the groin area.Wearing a supporter will do the trick. Getone that is not too tight to cause constrictionand not too loose or relaxed.And always be careful in thatparticular section of the body. There may bewisdom to the usual male toilet graffiti thatsays, “The future is in your hands.”Photo from 14 HEALTHbeat I November - December 2011

HOW YOURBALLSmen’s HEALTHHANGSorry guys, this is notabout how you should hangthose balls on your Christmas treeor elsewhere, but this is aboutyour balls down there - testicles,scrotum and all.Be AwareBoys can see more easilytheir sex organs developing thangirls because these are outside thebody. First the testicles get biggerat around 12 to 14 years old andthe penis gets bigger a year later.Males, human andother mammals, usually have twotesticles in their scrotum. Theseare firm, oval-shaped glands. Mostmen have testicles that match insize, but some men's testicles aremuch larger or smaller than othermen's. It is normal for an adult manto have testicles that are between 14 cm³ to35 cm³ in size.Nearly all men have one testiclethat hangs lower than the other. Scientiststhink this may be so that they do not hitagainst each other. It can be either the leftor the right that hangs lower, but in 85% ofmen, it is the left.The testicles hang in the scrotumby the spermatic cord. They are outside thebody because they need to be cooler thanthe temperature inside the body, in orderto make sperm. If a man's testicles get cold,they are automatically pulled closer to thebody. The spermatic cord is tightened bythe cremasteric muscle. If the testicles aretoo warm, the cremasteric muscle relaxes orgets longer. This lowers the testicles to keepthem cooler. This is how the testicles arekept at the right temperature. This is calledthe cremasteric reflex. (A reflex is somethingyour body automatically does without youthinking about it.)There are other uses for thecremasteric reflex apart frommaking the testicles at the righttemperature. Stress can also makethe cremasteric reflex work. If amale human or mammal gets into afight, then its testicles are in danger.They automatically pull up close tothe body. The cremasteric reflex alsohappens during sexual intercourse.Sometimes the size of a man'stesticles changes. The testicles getsmaller if a man takes testosterone.The testicles do not have to work tomake testosterone, so they becomesmaller. Meanwhile, if a man'stesticles are kept more warm thanusual, they make less sperm andthey get smaller. Steroids takenfor muscle enhancement oftenhave the undesired side effect oftesticular shrinkage. Also, if thetesticles are injured or hurt, they can becomesmaller. So, we can only hope that those gaydancers splitting their legs in talent contestson television or stage shows will watch outfor the health and safety of their balls.On the other hand, the testiclesget bigger if a man takes hormones fromthe pituitary gland (called gonadotropins).Gonadtropins are the hormones that tell thetesticles to make sperm and testosterone.Moreover, some diseases cause testicles toNovember - December 2011 I HEALTHbeat 15

swell.Sometimes, the testicles stayinside the lower abdominal tract or whatis called undescended testes. Surgery cancorrect and put the testicles in the scrotum.Like the ovaries of the female,testicles are components of both thereproductive system (being gonads) and theendocrine system (being endocrine glands).The respective functions of the testiclesare: producing sperm (spermatozoa) andproducing male sex hormones, of whichtestosterone is the best-known.The testicles are well-known tobe very sensitive to impact and injury. Blueballs is a slang term for a temporary fluidcongestion in the testicles and prostateregion caused by prolonged sexual arousal.The most prominent diseases oftesticles are: testicular cancer and otherneoplasms; swelling of a testicle, causedby hydrocele testis; inflammation of thetesticles, called orchitis; inflammation of theepididymis, called epididymitis;spermatic cord torsion alsocalled testicular torsion;varicocele or swollen vein fromthe testes, usually affecting theleft testicle; and anorchidismis the absence of one or bothtesticles.The removal of oneor both testicles is termed asorchidectomy, in medicineand castration in generaluse, especially when done aspunishment or torture, or as acatch-all term for orchidectomyin a veterinary context. On theother hand, it is called geldingspecifically in the equine sense.Know Your Own BallsBecome familiar with16 HEALTHbeat I November - December 2011the look, feel and shape of your own testiclesbecause this will help you notice just in caseanything goes wrong.Let’s do a recap. The characteristicsof healthy testicles include:• each testicle feels like a smooth,firm egg;• one testicle tends to hang lowerthan the other;• one testicle may be slightly largerthan the other;• there is no pain or discomfortwhen the testicles and scrotum arehandled gently; and• the testicles and scrotum will bepulled up close to your body whenthey are cold. They will be hangingdown loose when hot. This is handledautomatically to keep the testicles atthe right temperature.Once a month, check each testicleby gently rolling it between your thumb andone or two fingers. Perform this check afterOrchidometer - used to measure testicle size and track sexual developmentin boys.a warm shower or bath when the scrotumskin is soft and the testicles are down furtherfrom the body. You need to get to know whatyour testicles feel like and what is normal foryou.Look for lumps (usually on the frontor side of the testicle), swelling, discomfort,change in size and shape (other than normalteenage growth of the testicles), a sensationof heaviness in the testicles. If you have aproblem, it is important to realize that youmay have only some of the symptoms listedhere and not all of them.In case of injury, you canunderstand what it feels like to have thetesticles hit by something - even lightly. Thepain and discomfort is beyond words andgoes right up through the whole body. If thepain does not go away after a reasonableperiod of time or new lumps or swellingappears, have your balls checked by a doctor.Immediately swallow your prideand get medical advice. A doctor willexamine your testicles andadvise you if there is a problem.If testicular cancer is detectedearly in its development, thenthe cure rate is almost 100%.If there is a problem, the longeryou put off going to the doctor,the less chance of total recovery.The lifetime risk of amale developing testicularcancer is 1 in 316. It is the mostcommon cancer experiencedby men, 15-35 years old. Thoseoutside this age group canstill develop this cancer, theonly difference is that it is notthe most common cancer forthat age range. The cause oftesticular cancer is unknown,but the rate of having thiscancer is rising.- o O o -

personal HEALTHThoughts and Feelings of HavingVASCULITISbyJOEREM P. CERIA, RNDOH National Center for Health PromotionFrom Bad to WorseIt was a typical happyfamily day - Sunday, September11. Everything was okay, until thetime I took my pants off to changethat night and noticed a rash on myright leg. I ignored the rash thinkingthat maybe I had scratched my legearly that day, not knowing thiswas the start of almost a monthlong misery.Two days passed,Wednesday after lunch, I feltsomething wrong with my left leg.At first I thought I was just havinga slight cramp but it was gettingbad and I got home limping. Therash on my right leg had alreadyspread all over to both legs andfeet. The condition of my legs hadgone bad to worse because asidefrom the rashes, my legs and feetbecame swollen. At this point, mybrain cells were shifting gears fromcool mode to panic mode! Whereon earth did I get this disease? Inmy exciting 29 years of existence, itwas my first time to encounter thiskind of disease – not only to see but also toexperience it myself! I was not able to go towork the next day and Friday.I am a Department of Healthemployee and also a registered nurse,but with an unknown condition like this, Ieasily turned to folkloric culturalbeliefs of kulam (witchcraft spell),sumpa (curse) and other unseenelements of nature. Bewildered,confused and getting impatient toknow more about my condition,I began to point to the nuno sapunso (dwarf-like creature inPhilippine mythology). I recalledan incident a day before I felt thesigns and symptoms, of killing bigants crawling my feet. I thoughtI may have disrespected the littlepeople who live in their dwellingand they have put a hex on me. Thisis the reason why before I broughtmyself to a hospital, I had a stop atLola Ana’s house. Lola Ana is a wellknown“magtatawas” in our place.("Pagtatawas" is a ritual inFilipino superstition where anaffliction or psychological disorderis diagnosed by interpreting theform produced in a basin of wateras heated alum or molten wax dropfrom a lighted candle as the onecausing the condition.)She performed a ritual, whichwill tell what or who caused mycondition. She melted a candle using a flatiron and then let the wax drop in a basinof water. After a few seconds, she took theNovember - December 2011 I HEALTHbeat 17

formed wax out of the water and looked atit. In an instant Lola Ana saw a figure of agirl but could not exactly identify whetherit is an elemental, a spirit or a human. Sheshowed it to me, but I could not see what shewas seeing and I just agreed with her. BeforeI left, she wiped my rashes with oil. Thatwas my first time to consult a magtatawas,and I must admit it was a pretty interestingexperience.Then, I finally proceeded to Dr.Jose N. Rodriguez Memorial Hospital andconsulted a dermatologist, thinking mycondition was a skin disease. But the doctortold me it was vasculitis.VasculitisVasculitis (vas-kyu-LI-tis) is aninflammation of the blood vessels. It happenswhen the body's immune system attacks theblood vessel by mistake. Vasculitis can affectarteries, veins and capillaries. Arteries arevessels that carry blood from the heart tothe body's organs. Veins are the vessels thatcarry blood back to the heart. Capillaries aretiny blood vessels that connect the smallarteries and veins.When a blood vessel becomesinflamed, it can narrow that will make theblood more difficult to get through, closeoff completely so that blood cannot getthrough, or stretch and weaken so much thatit bulges and may burst and cause dangerousbleeding inside the body. Inflammation mayinvolve pain, redness, warmth, swelling, andloss of function in the affected tissues.In vasculitis, inflammation canlead to serious problems. Complicationsdepend on which blood vessels, organs, orother body systems are affected. There aremany types of vasculitis, but overall thecondition is rare. Moreover, the cause ofvaculitis is often unknown.Wow, I have a disease that is rareand with still unknown cause. I must besomebody that special, or so I thought.This increased my desire to find out moreinformation about vasculitis, and my searchbrought me to the website of the NationalHeart Lung and Blood Institute of the USDepartment of Health and Human Services.Surprisingly, I found out that KawasakiDisease - a rare childhood disease in whichthe walls of the blood vessels throughoutthe body become inflamed and Buerger'sDisease – a smoking-related disease thattypically affects blood flow to the hands andfeet causing ulcers on the fingers and toesand leading to gangrene are included in thelong list of types of vasculitis.According to the website, vasculitiscan affect people of all ages and races andboth sexes. Some types of vasculitis seemto occur more often in people who havecertain medical conditions, such as chronichepatitis B or C infection; those who havecertain autoimmune diseases, such a lupus,rheumatoid arthritis, and scleroderma; andsmokers.Treatment for vasculitis willdepend on the type of vasculitis you have,which organs are affected, and the severityof the condition. People who have severevasculitis are treated with prescriptionmedicines which include corticosteroids andcytotoxic medicines. Rarely, surgery maybe done. People who have mild vasculitismay find relief with over-the-counter painmedicines, such as acetaminophen, aspirin,ibuprofen, or naproxen.The main goal of treating vasculitisis to reduce inflammation in the affectedblood vessels. This usually is done byreducing or stopping the immune responsethat caused the inflammation.Moreover, the medicines usedto treat vasculitis can have side effects. Forexample, long-term use of corticosteroidsmay lead to weight gain, diabetes, weakness,a decrease in muscle size, and osteoporosis(a bone-thinning condition). Long-term useof these medicines also may increase yourrisk of infection.And, while being treated forvasculitis, the patient needs to see the doctorregularly and consult any new symptomsand other changes in health status, includingside effects of the medicines.From Worse to HellAt the Rodriguez Hospital, I wasgiven a prescription of corticosteroids,specifically prednisone. The following weekmy condition did not improve at all andprogressed from worse to hell.I was able to go to the office onMonday, but my condition prevented mefrom doing my work and with so muchprodding from my officemates, I went tosee a dermatologist from Dr. Jose R. ReyesMemorial Medical Center to have a secondopinion. Still, there was no clear answeras to what caused my illness. The doctorjust increased the dosage of my prednisonefrom 30 milligrams (mg) to 60 mg per day.That afternoon, the swelling of my feet andlegs had gone worse, but I managed to gohome. There, I really got bothered becausewhen I checked on my rashes, the pinkishcolor became deep red or maroon and theyalready spread to other parts of my body,going up to my thighs, stomach, lower back,stomach, elbows and hands.I was absent for two weeks. It wasvery hard. Every step I made was so painful,it was like my muscles got stuck and bothlegs and feet were really swollen. My leftknee also started to swell. I could hardlymove my lower extremities and becamesemi-paralyzed at that time. I was losingweight because of too much worrying. AndI often had sleepless nights because my feetwere hurting.18 HEALTHbeat I November - December 2011

Days passed without anyimprovement. I consulted again anotherdoctor who specializes in rheumatologyand Internal medicine. I showed to her allmy laboratory results – complete bloodcount, red blood cells, white blood cells,complement 3 in blood, blood urea nitrogen,cretanine and urinalysis – which wereall in normal levels. except for my serumglutamic-pyruvic transaminase result whichwas a bit at a high level because at the timeI was taking high doses of medication. Thelady doctor again just prescribed anotherdrug for the swelling.Walking in pain, my mother boughtme crutches to support my swollen legs. Atthis point, I was feeling disgusted becauseI was religiously taking the numerousprescribed medicines but there was still noprogress on my legs. The third week washell week! And on the Friday of that week,a neighbor told us to try and visit Lola More,a manghihilot (a practitioner of the ancientFilipino art of healing through massage) anda devotee of the Black Nazarene (the darkcolored,wooden sculpture of Jesus Christ,believed to be miraculous by many Filipinos).We went to her house in Valenzuela Cityand had my legs massaged. Her first strokewas terribly painful but as she went on, Iwas feeling relieved. It felt like my bloodstarted to circulate again. That was the startof my recuperation. Thanks to Lola Mores’gentle hands, I would not need my crutchesanymore.Feels Like HeavenEveryone will have a set of healthconditions occurring in his/her lifetime.Some will experience rare diseases or stillunexplainable conditions. For me, theremust be a reason why I went through anordeal that is called vasculitis. Althoughit has already been described by medicalexperts, there is much to be discoveredabout the illness. What caused my vasculitisis still mind-boggling for me.The three weeks that I was sickseemed like forever. But going through thepain and suffering have made me realizequite a lot. As they say, God works in so manymysterious ways.First, pushing your body to thelimit can be a very bad habit. Before I hadvasculitis, my legs are always on the run,playing basketball for two straight hoursthen straight to the showers without givingtime out for my legs to relax for a while. Forthe record, I’m not categorically saying thishas caused my disease, but who knows, untilnow nobody has the answer, anyway.Second, many Filipinos, no matterhow educated they maybe or how competentmedical science hasto offer, would turn tofolkloric practices, orbetter yet, turn to faithin God, to find solutionsto their most difficulthealth situations.And finally,I realized that God hasalways been thereeven though most ofthe time we tend toforget Him due to toomuch enjoyment weare having in our lives,and only to rememberHim when we are badlysick or in need. I believethat giving an hour ortwo of our time to Godat Church once or twicea week is healthy for thebody and great for thesoul.I thank God fornot leaving me in my trials and enlighteningmy life once more. Thank you, God!And of course, the people aroundme are worth thanking for the support, careand prayers they have made. Those are myfamily, my other family at the DOH NationalCenter for Health Promotion, neighbors andfriends. I thank you very much from thedeepest of my four chambered heart. I neverlost hope but rather gained strength fromthem.And for the pain reliever linimentwhich I use until now when I massage mylegs, thanks. (Hehehe)Please indulge me if this seems anappreciation speech heard during awardsnight. It just feels like heaven.- o O o -Without the pain and suffering of vasculitis, Joerem can now comfortablytake care and play with his daughter, Jamaira.November - December 2011 I HEALTHbeat 19

anti-aging MEDICINEAGING mattersbyRIZA C. DE LEON, MD“Life would be infinitely happier if we couldonly be born at the age of eighty and graduallyapproach eighteen.”- Mark TwainAging inspires fear in the heartof any man, and women especially. Theancient Greek poet Homer decried old ageas "loathsome," and Shakespeare termedit "hideous winter." As such, countlessmen have dreamt of finding the legendaryFountain of Youth, a magical spring whichrestores the health and youth of anyone luckyenough to bathe in its waters. Alchemists of20 HEALTHbeat I November - December 2011old desired to create common metal intogold, once believed to be the most potentanti-aging substance. But the search forlongevity remains fruitless and endless andsimply a captivating tale, or so we thought.Medical science has come to the rescue.As we age, there is a build up ofrandom damage to the building blocks ofour body (DNA, proteins, carbohydrates andfats). This begins early in life and eventuallyexceeds the body’s self-repair capabilities.The damage slowly impairs the work of cells,tissues and organs, making one prone todisease and giving rise to the ravages of age -loss of muscle and bone mass, slow reaction,poor hearing and vision, and wrinkling ofthe skin. Aging is inescapable, or is it?The United Nations Children’s Fund(UNICEF) estimates that the average Filipinowill live until 72 years of age, an upwardtrend compared to 57 years in 1970 and 65years in 1990. We live longer now simplybecause we have altered the way we live.Anti-aging Medicine, one ofthe fastest-growing medical specialtythroughout the world, is based on applyingadvanced scientific and medical technologiesfor early detection, prevention, treatment,

and reversal of age-related dysfunction,disorders, and diseases. Anti-aging Medicinesimply aims to prolong the healthy life spanin humans and ensure that those years areenjoyed in a productive and vital fashion.Anti-aging Medicine is scientificand well documented. The US NationalLibrary of Medicine hosts more than 3,000peer-reviewed articles on the subject.ACEing the test of timeWhat are the weapons to combataging? The use of antioxidant supplements,such as beta-carotene, selenium, lycopene,and vitamins A, C, and E, is widespread.Occurring naturally in the body and in fruitsand vegetables, antioxidants are toutedas the key to long-lasting youth. They aresaid to neutralize the bad guys called freeradicals, molecules produced when our bodybreaks down food, or by exposure to tobaccosmoke and radiation.Since the 1950s, one theory ofaging states that oxidation caused by freeradicals is a central process of aging, andat the heart of age related deterioration. Itis believed that aging is, in fact a processof oxidizing or "rusting." Free radicals candamage cells, and may play a role in heartdisease, cancer and other diseases.According to the National CancerInstitute at the US National Institutes ofHealth, studies show that antioxidants mayslow or possibly prevent the developmentof cancer. However, data from recent clinicaltrials are less clear and point to inconsistentconclusions.Nonetheless, the US National EyeInstitute study on age-related eye disease,found that combining antioxidants andzinc cut risk of having advanced stages ofage-related macular degeneration (AMD)by a quarter. Antioxidant supplements usedalone slashed the risk by about 17 per cent.In 2007, a study published in theAmerican Journal of Clinical Nutrition foundthat people who ate foods rich in vitamin Chad fewer wrinkles and less age-related dryskin than those whose diets had only smalldoses of the vitamin. Vitamin C helps formcollagen, and may guard against ultravioletrays from the sun, the cause of freckles and amottled complexion.From the BeginningStem cells have the unusual abilityto renew themselves over the lifetime ofthe organ while making daughter cells thatdifferentiate into one or multiple lines. Nearly30 years ago, scientists discovered waysto derive embryonic stem cells from earlymouse embryos. In 1998, stem cells fromhuman embryos were created and grownin laboratories for reproductive purposesthrough in vitro fertilization procedures.Given their unique regenerativeabilities, stem cells offer new hope fortreating diseases such as diabetes and heartdisease. However, much work remains to bedone for cell-based therapies to treat disease,which is also referred to as regenerative orreparative medicine.Skincare specialists are also ridingthe bandwagon of stem cells. The skin stemcells are found near hair follicles and sweatglands and lie dormant until they receivesignals from the body to begin the repairmode.The use of topical productsstimulates the stem cell to split into twotypes of cells: a new, similar stem cell and adaughter cell, which can create almost everykind of new cell in a specialized system. Thismeans that the stem cell can help repair finelines and wrinkles, and restore and maintainfirmness and elasticity. Since it is impossibleto incorporate live materials into a skincareproduct, embryonic stem cells cannot beused. Products with plant stem cells arenow widely available. An example of plantstem cells comes from the Swiss UttwilerSpatlauber apple, known for its ability toheal its own bruises and damage to its skinand can last for months after picking.Some researchers believe that theuse of stem cell technology for a topical,anti-aging cosmetic trivializes other moreimportant medical research in this field. But,all’s fair in the war on aging.Magic ShotsIn 1989, Botox (Botulinum toxintype A), by Allergan, Inc., was approved bythe U.S. Food and Drug Administration (FDA)for treating misaligned eyes (strabismus),uncontrollable blinking (blepharospasm),and spasm of the face (hemifacial spasm) inadult patients. Three years later, Botox wasapproved to temporarily improve appearanceof moderate-to-severe frown lines betweenthe eyebrows (glabellar lines).A youthful face, sans wrinkles cannow be yours by a single shot, or eight, or12. The cosmetic use of botulinum toxin typeA has now become widespread with manycelebrities viewing it as less intrusive thanplastic surgery.The results of Botox procedurescan last up to six to eight months. It is fastand not that painful. Instant youth in a shot!Three out of my 10 patients come in regularlyfor this procedure. In my practice, its usesrange from removal of facial wrinkles, suchas crow’s feet in the side of the eyes, tocontrol of severe underarm sweating. Of thethree patients who come in for Botox, twoare men.Botox, a drug made from a toxinproduced by the bacterium Clostridiumbotulinum, is the same cause of foodpoisoning called botulism. It works byweakening or paralyzing certain muscles orNovember - December 2011 I HEALTHbeat 21

y blocking certain nerves. Doctorsuse it in very small doses.How about laugh linesaround the mouth and deeperforehead grooves? A populartreatment involves injecting cosmeticwrinkle fillers into the face. Cosmeticwrinkle fillers are soft tissue fillersinjected into the skin to give theface a smoother contour. The filler isalso used to plump lips, ala AngelinaJolie. Results are temporary, about sixmonths, depending on the filler used,because the body eventually absorbsthem. Cost starts from P25,000.Wrinkle fillers are madeof various types of materials suchas collagen and hyaluronic acid gel,and some include a combination ofproducts. Some products also containlidocaine, which numbs the skin at theinjection site.As with any medicalprocedure, Botox and fillers pose riskswith possible side effects of allergicreaction, infection, bruising and raisedbumps on the skin. It is very importantthat a skilled and trained skin carephysician does the procedure.Honing on HormonesAnti-aging hormone supplementsare said to work wonders, giving youyouthful looks and generally making you feelhealthier. These treatments are a cocktailof prescription-only hormones includinghuman growth hormone (HGH), estrogen,testosterone, Dehydroepiandrosterone(DHEA) and pregnenolone.Hormones, chemical messengersneeded to keep the body working properly,affect metabolism, reproduction, growthand immune function, among others. Theirlevels dwindle in middle age and this naturalOUR CONTRIBUTOR: Dr. Risa C. De Leon, a diplomate of thePhilippine Association of Primary Skin Health Physicians, Inc.and member of the World Society of Anti-Aging Medicine and askin care consultant at Vanity Skin Aesthetics Dermatology Clinicslocated at the Ground Floor, One Ecom Center, Ocean Drive, Mall ofAsia Complex, Pasay City and 5th Level, SM Manila.slowdown has prompted an interest in theuse of synthetic hormones to stave off therealities of old age.The use of anti-aging hormonesis still shrouded in controversy. Their longtermeffects are still unknown. There arestudies suggesting a link between HGHand cancer, diabetes and joint pain. DHEAand pregnenolone may cause irregularheartbeats and irreversible hair loss. Takinghormone replacement drugs or supplementsshould be done strictly under medicalsupervision.Small short-term studies by the USNational Institute of Aging show that dailyHGH injections can add muscle mass butdon’t translate into greater strengthor function. Patients receiving HGHreport lesser pain, better flexibility anda sense of well being they did not havebefore. Thicker skin, enhance immunesystem, more energy, cholesterolbalance shifted in a positive way, andmore calcium deposited on bones areother said benefits.Over-the-counter dietary pillsupplements, known as HGH releasers,and HGH in spray form are currentlymarketed as low-cost back-ups. Butclaims of their anti-aging effects, likeall those regarding HGH, are arguable.Testosterone in men regulatessex drive (libido), bone mass, fatdistribution, muscle mass andstrength, and production of redblood cells and sperm. FDA-approvedtestosterone drugs come in the formof patches, injections, and topicalgels. Testosterone supplementation isthe standard treatment for men whoproduce little or no testosterone ontheir own only. Although other menreport bigger muscles, sturdier bones,and a higher sex drive, more rigorousstudies are needed to see if possiblebenefits outweigh its potential risks.Estrogen in women helpsmaintain bone strength and may cut riskof heart disease and memory problemsbefore menopause. For more than half acentury, drugs with estrogen have relievedmenopausal symptoms, like hot flashes andvaginal dryness, and prevented or treatedbrittle bones or osteoporosis. However,some studies show that estrogen maycause thickening of the lining of the uterusand raise the risk of endometrial cancer,and hike the risk for developing dementia(Alzheimer’s disease).DHEA supplement advocates toutthat the hormone improves energy and22 HEALTHbeat I November - December 2011

strength, boost immunity, bulks musclesand lessens fats. Sadly, there is no conclusivescientific evidence proving these benefits.The Real DealHundreds of studies clearly provethat eating right and exercise significantlyimpact healthy function in old age. In 2006,the Harvard School of Public Health foundthat an anti-aging lifestyle, which includesadvanced preventive care such as screenings,early disease detection, aggressiveintervention, and optimal nutrition, all ofwhich are cornerstones of the anti-agingmedical model, can boost lifespan by 24.6more years.In skincare, there are several factorsthat can cause the skin to change as we age.“The negative effects of sun exposure, suchas melasma, wrinkles, freckles and a toughleathery appearance of the skin, are oftenquite visible in people who have failed toprotect their skin. My best advice is to avoidthe sun, and protect your skin with a highSun Protection Factor (SPF) sunscreen everyday of the year, rain or shine.The secrets of old age are nowrevealed: A 10-year study of Canadiansshowed that the most important predictorsof excellent health were absence ofchronic illness, income over US $30,000,having never smoked, drinking alcohol inmoderation, maintaining a positive outlook,and managing stress levels. Yes, commonsense is still the best framework for lifelonghabits for a happy and healthy living, nomatter what the age.- o O o -KALAbeatSTOP: Grandparents At PlayIt cannot be denied that more and more senior citizens are texting and tweeting nowadays and there is already a need to disseminateand understand STC or Senior Texting Code. So, for the “techie” lolo and lola out there, learn these codes and pass them on to yourchildren and grandchildren to bridge the communication and generation gaps and have a common understanding of your texts andtweets.ATD: At The Doctor'sBFF: Best Friend FaintedBTW: Bring The Wheelchair/WalkerBYOT: Bring Your Own TeethCBP: Covered By PhilHealthCGU: Can’t Get UpCMD: Changing My DiaperCUATSC: See You At The Senior CenterDWI: Driving With IncontinenceFWB: Friend With Beta-blockersFWIW: Forgot Where I WasFYI: Found Your InsulinGGPBL: Gotta Go, Pacemaker Battery Low!GHA: Got Heartburn AgainHGBM: Had Good Bowel MovementIMHO: Is My Hearing-Aid On?LMDO: Laughing, My Dentures OutLOL: Living On LipitorOMG: Oh My GoutSGGP: Sorry, Gotta Go PoopTTYL: Talk To You LouderWAITT: Who Am I Talking To?WTF: Wet The FurnitureWWNO: Walker Wheels Need OilYou know you're getting old when everything hurts.And what doesn't hurt doesn't work.- Hy GardnerNovember - December 2011 I HEALTHbeat 23

laughter HEALSKAHAYUPANBaboyDOK: Magmula sa araw na ito, angpwede mo lang kainin ay ang mgahayop na lumalangoy.One week later, pinuntahan ng duktor angpasyente sa bahay para kamustahin...DOK:MAID:PusaNandyan ba ang Sir mo?Ay dok, nasa swimming pool posi Sir. Tinuturuan pong lumangoyyung mga baboy!EDGAR:BRIAN:EDGAR:Alam mo, kahit nakalagay angulam namin sa mesa at walangtakip, hindi kinakain ng pusanamin!Maniwala ako?! Ano ba ang ulamn’yo?Asin!LEARN DISCIPLINE FROM THE DOGS: Teach Me How to Dougie. (Photo grabbed from the Internet)ParrotFairy TaleGarapataWENG: Anak, dumudugo ang daliri mo?Lumapit ka nga dito.At sinipsip ang dalari ng anak.WENG:LANCE:AsoED:LOLA:Saan nasugat ito, ha?‘Nay, hindi po sugat yan. Tiniris kolang ang mga garapata ng aso.Lola, ingat po kayo dyan...nangangagat po ang mga asod’yan.Alam ko, iho. Sa tanda kongito wala pa kong nakitang asona nanununtok. Adik ka ba?Sa pet shop, a customer talks to the parrot...AJIE : Hoy! Can you talk, ha?!? Bobo!PARROT: Yes I can. Eh ikaw, can you fly?ENGOT!!!DagaANAK:TATAY:ANAK:TATAY:ANAK:TATAY:ANAK:TATAY:ANAK:‘Tay may daga sa kusina!Paalisin mo.Oy daga, umalis ka!Bobo, gulatin mo.Oy daga! BULAGA!Engot, takutin mo.Daga, aswang ako! Awoooooh!Peste! Bugawin mo!Boss, rats?!? 300 pesos lang.Batang bata pa.A dark-skinned ugly baby was given a pair ofwings by a fairy...BABY CHIT: Does this mean I’m an angel??FAIRY: (Laughing out loud) Of coursenot! Ambisyosa ang kulay ulingnato! Paniki ka!Tunay na KahayupanJANET: Nakakaasar yang kumpare mo.MENCHU: Bakit na naman, Mare?JANET: Ang gusto ba naman ay magdogstylekami?MENCHU: Eh, ano naman ang problemadun? Okay naman yun.JANET: Anong, okay ka dyan?!? Ang gustoniya ay gawin namin sa kalsada!24 HEALTHbeat I November - December 2011

MMDA Chairman Francis N. TolentinoHEALTH partnerHealth ChampionbyELIZABETH G. MASCAREÑASHEALTHbeat StaffPolitical Will“Political will” has been used,misused and abused by politicians,bureaucrats and advocates promotingchange, but nobody seems capable enoughto define it or measure it. Craig Charney,president of Charney Research - a leadingpollster on political issues in the US, said that“political will is the ghost in the machine ofpolitics, the motive force that generatespolitical action.” He said that political willcan be defined as the combination of threefactors: opinion plus intensity plus salience.Strong opinions form political will only ifthey are salient to public choice. There isno political will if there is no connection topublic affairs.The definition seems vague, untilsomebody comes along to show peoplethe meaning and essence of political will.Atty. Francis N. Tolentino, chairman of theMetropolitan Manila Development Authority(MMDA), fits to a tee the image of a leaderwith strong political will. His programs andprojects – like dismantling oversized andillegal billboards, enforcing smoking ban inpublic places, putting speed limits in majorhighways and implementing the bus taggingsystem – are shunned by some profitorientedindustries and businesses but arebadly wanted and very much appreciated bythe public. Despite the odds, Tolentino hasendured and persevered.Tolentino is a graduate of Bachelorof Laws at the Ateneo de Manila UniversityLaw School and a Doctor of Judicial Science(International Environmental Law) atthe Tulane University Law School in NewOrleans, Louisiana, USA. He passed the 1984Philippine Bar Exams with a general averageof 86.25% (with scores of 94%, 95% and100% in Labor Laws, Taxation and CriminalLaw, respectively), and also passed the 1991New York State Bar Exams.Tolentino, who is a member of theNatural Resources Defense Council in NewYork City and Tulane Environmental LawSociety in New Orleans, Louisiana, USA, isa true champion of promoting health andenvironment. He also wrote an article for theIntegrated Bar of the Philippines Journal,2010 entitled: An Environmental Writ: ThePhilippine's Avatar.Before his stint as the MMDAChairman, Tolentino was appointed officerin-chargeMayor of Tagaytay City afterEDSA I Revolution and duly-electedMayor for three consecutiveterms (1995-2004). Hebecame presidentof the League ofCities of thePhilippinesas well asexecutive vicepresident of the Union of Local Authoritiesof the Philippines from 2001 to 2004. Healso holds the rank of full Colonel, PhilippineArmy (Reserve) and he was awarded as thePhilippine Army Officer of the Year in 2000and the Armed Forces of the Philippines(AFP) Reserve Officer of the Year in 2001.There seems to be no other personthat is more able capable than Tolentinoto be at the helm of MMDA – the agencythat performs planning, monitoring andNovember - December 2011 I HEALTHbeat 25

coordinative functions, and in the process,exercise regulatory and supervisoryauthority over the delivery of metro-wideservices within Metro Manila, comprising 16cities and the lone municipality of Paterosand the home to 14 million residents.MMDA originally started out asMetro Manila Commission (MMC) which wascreated by Presidential Decree 824 issuedby then President Ferdinand Marcos onNovember 7, 1975, which integrated Manilaand adjacent Quezon City with two cities and12 municipalities of the province of Rizal andone municipality of Bulacan. On January 9,1990, during President Corazon Aquino'sadministration, that MMC became the MetroManila Authority (MMA) through ExecutiveOrder No. 392 and now Vice PresidentJejomar Binay was its first chairman. OnMarch 1, 1995, the agency was officiallyrenamed as MMDA through the passage ofRepublic Act (RA) 7924.Now on its 36th year, MMDAhas never been so strong and diligent inimplementing its seven functions, namely:development planning; transport and trafficmanagement; solid waste disposal andmanagement; flood control and seweragemanagement; urban renewal, zoning andland use planning and shelter services;health and sanitation, urban protection andpollution control; and public safety.Civil WillOn July 27, 2010 President BenignoS. Aquino III announced the appointment ofTolentino as MMDA chairman. On his waythe MMDA office for the turnover ceremony,he was caught in traffic and was late foraround 15 minutes which was scheduledat 10 am. This led him to resolve to reviewsome existing methods to decongest EDSA'straffic problems, he vowed for a more vibrantand accessible organization through “civilTOP: 100% Smokefree Metro Manila - seemingly the most controversial of all MMDA's programs.BOTTOM: Measuring the speed limit.will,” which he roughly defines as entailingpeople’s participation and the involvementof various sectors. He said, “All sectors andstakeholders will be consulted as we arehoping for civil acceptance on all aspects ofour operations.”According to Tolentino, the mantraof his administration will be disciplinewith compassion, reiterating that humanrights will not be compromised with theimplementation of the agency’s variousthrusts. “I have accepted the position withgreat hope of attaining a better quality oflife in Metro Manila and making MMDA amodel agency,” Tolentino said during thesimple turnover rites.That was over a year ago, and thosewho have been banking on his statementsthen are now asking what he cannot do.People are noticing the big change over atMMDA, and media has their keen eyes onevery step Tolentino makes. Manila Standard26 HEALTHbeat I November - December 2011

TOP: Inspection of Ali Mall bus terminal with President Benigno S. Aquino III. BOTTOM: The first inPhilippine History motorcycle lane.lifestyle columnist, Harold Geronimo, evenrated MMDA as one of the top Aquinogovernment performing agencies. Hewrote, “Gone are the days when MMDA isonly visible through their traffic enforcers.Today, the agency is very active physically inthe streets and virtually real-time on socialmedia.”And the Department of Health isproud to have Tolentino as a partner becausemany of his priorities are focused on healthand the environment, not only because RA7924 mandates the MMDA to protect andsafeguard public health, but also becausehe is an expert on environmental issues.The improvement of traffic and transportmanagement, for example, contributes toefforts to have clean air in the metropolisand thus address the increasing burden ofnon-communicable diseases.A recent health and environmentprogram that puts Tolentino’s civil willto a test is the enforcement of the 100%smokefree environment policy in MetroManila which regulates the use of tobacco inconfined public places in accordance with theFramework Convention on Tobacco Control(FCTC) for which the Philippines becamea signatory in 2005 and with RA 9211 orthe Tobacco Regulation Act of 2003 and RA8749 or the Clean Air Act. The Philippineshas good laws, but many laws lack properimplementation. And when someone likeTolentino puts his foot down to enforce thelaw, hell and high waters came rushing onhim.While non-smokers who comprisethe majority of the population hailed theprogram and several national and localgovernments as well as the civil societysupported it, the tobacco industry not onlyfrowned at it but became very persistent tostop it. The MMDA’s anti-smoking programhas been a case where the tobacco industryblatantly showed its force in interferingwith public health policies in order to resistregulations that will affect their productsvis-à-vis their profits. (See related story onpage 44.)The MMDA was taken to court forapprehending violators caught smokingin public places. And after months ofcontroversial battle in the courtroom aswell as in the media, the MandaluyongTrial Court still issued a writ of preliminaryinjunction against MMDA's anti-smokingprogram. The order stated, "Pending thedetermination of whether or not therespondent MMDA has valid authority toimplement RA 9211, there is an obvious andimperative need for preliminary injunction,a provisional measure to prevent or restrainin the meantime the MMDA to implementits Smoking Ban in open areas not coveredby the definition of public places in RA 9211so that its implementation may not rendermoot and academic the main issue in thisNovember - December 2011 I HEALTHbeat 27

case."Tolentino said that despite thecourt-ordered setback, they will continuethe campaign within the limits prescribedby law, but, will again file motion forreconsideration and petition for certiorari (adocument which a losing party files with theSupreme Court asking the Supreme Courtto review the decision of a lower court. Itincludes a list of the parties, a statementof the facts of the case, the legal questionspresented for review, and arguments as towhy the Court should grant the writ).“Everyone deserves to breatheclean air. The MMDA, with its mandate touphold public health and anti-pollution,is committed in its efforts to minimize thedeadly effects of smoking. We have done so,and shall continue to do so, in accordancewith the parameters set by the law,” saidTolentino.“Cleaning” the AirAside from the anti-smoking,another program that MMDA strictly enforceto “clean” the air is the Anti-Smoke BelchingProgram, which is in accordance with RA8749 or the Clean Air Act. Recent air qualitymonitoring of major thoroughfares of MetroManila revealed an average value of 140micrograms per nano centimeter – far fromthe acceptable 80 microgram per nanocentimeter based on Philippines and USstandards. In fact, the value of 140 on USAAir Quality Index is considered unhealthyfor sensitive groups or those persons withcardiovascular and respiratory conditions.To reduce the total suspendedparticulates (TSP) in the air at particulatematter size 10 micrograms (PM 10) andparticulate matter size 2.5 micrograms(PM 2.5, which tobacco smoke has plentyof), the MMDA in partnership with theLand Transportation Office (LTO) and theDepartment of Environment and NaturalResources (DENR) including the antismokebelching units of the Metro ManilaLGUs apprehends smoke belching vehiclestravelling along the major thoroughfares.Motor vehicle plates are confiscatedand turned over to LTO which conductsImpounding colorum buses – one of the many moves to reduce the number of vehicles along majorthoroughfares.subsequent smoke emission testing. Vehicleswith no license plates are not allowed totraverse Metro Manila roads.Corollary to this is the UnifiedVehicle Volume Reduction Program (UVVRP)or a means by which MMDA reduces thedaily volume of vehicles along majorthoroughfares. Through this program, thetotal suspended particulates (TSP) in the airare lessened as traffic becomes manageable,while stalling of vehicles as well as release oftoxic gases while running idle is minimized.The UVVRP, particularly the numbercoding for public utility vehicles such as cityand provincial buses was approved by theMetro Manila Council and was implementedlast year on an experimental basis. Thisbrought about a reduction in the volume ofbuses to an average of 2,817 bus units/dayor about 18 per cent or 618 units less thanthe pre-UVVRP average bus count daily.With this, the program was permanentlyimplemented through a MMDA resolution.Moreover, prior to implementationof UVVRP and one of Tolentino’s firstdirectives as MMDA Chairman was thecancellation of all exemptions (except formedical and media practitioners) from theprogram. It has effectively cancelled 6,500previously-granted exemptions.On the average, travel time alongthe 24 kilometers stretch of EDSA has beenreduced by almost 16 per cent and travelspeed increased by more than 24 percent.To further reduce the numberof vehicles along major thoroughfares,the MMDA and the Land Transportationand Franchising Regulatory Board (LTFRB)implemented a campaign against "colorum"buses. Buses with legal franchises andwhich chassis numbers matched with theLTFRB record of legitimate 'certificate ofpublic convenience' was given bar-coded"authorized EDSAbus" yellow stickers by theMMDA. This resulted in the tagging of 8,62728 HEALTHbeat I November - December 2011

uses or 70.81 percent of the total 12,689authorized city and provincial buses plyingalong EDSA.The MMDA is also currently gearingup its Mega Manila-Provincial Integrated BusAxis System (Mega Manila-PIBAS) based onPresident Benigno S. Aquino III’s instructionsto Tolentino to take the lead in consolidatingthe different provincial bus terminals intocommon terminals.Metro Manila has a total of 85provincial bus terminals spread all-over themetropolis – 49 terminals for northboundbuses and 36 terminals for southboundbuses. There are 60 bus companies operatingin these terminals with approximately 7,368buses. These provincial bus terminals,majority of which are located along EDSA,disrupt the continuous flow of trafficwhenever buses maneuver in and out of theterminals and during loading and unloadingof passengers.The Mega Manila-PIBAS isenvisioned to be "a world-class terminalcomplex" patterned after centralized andintegrated bus terminals in other countries,and will promote the delivery of efficienttransport service and maximize road usage.Two major terminals are currently beingproposed, one in the north and the otherin the south. It will also adapt a centralizedticketing system designed with an automaticfare collection system for all bus operators toimprove bus transport service and promoteconvenience to the riding public.Reducing Vehicular Accidentsconcerned citizens became louder forgovernment to curb the spate of vehicularand pedestrian accidents in MacapagalAvenue. This road linking Metro Manila toand from the province of Cavite, becamefamous for reckless and unlawful drag racing.The MMDA together with the Metro Manilamayors agreed to impose a maximum speedlimit of 60 kilometers per hour (kph) for alltypes of vehicles including motorcycles,traversing the 35 meters wide by almostfive kilometers in length four-lane road.The speed limit is monitored by strategicallylocated laser speed guns that record vehiclesthat go beyond the speed limit.Meanwhile, over at CommonwealthAvenue, which has been brandedas the “killer highway” of Metro Manila,the MMDA deployed 140 traffic enforcersto carry out the 60 kph speed limit. Asidefrom this, the agency designated lanes todifferent vehicles plying the highway. Thetwo rightmost yellow lanes on both sidesof Commonwealth Avenue are reserved fordedicated use by public utility buses andpublic utility jeepneys.The MMDA also implemented theuse of dedicated loading and unloadingzones as well as footbridges for pedestriansalong Commonwealth Avenue to ensuresafety of motorists, commuters andpedestrians. Violators are fined Php 1,200.Names of violators are posted on the MMDA'swebsite until such time fines and penaltiesare settled.And for the first time in Philippinehistory, as Tolentino puts it, the MMDA hasestablished motorcycle lanes, now called the“blue lanes” along the two thoroughfares.Effective October 17, non-exclusivemotorcycle lanes were designated on thefourth lane from the curb of CommonwealthAvenue, and the first lane of MacapagalAvenue. Motorcycle riders are also requiredto observe a 60-kph speed limit.For one week, violators were notissued traffic tickets but were required toundergo a 15-minute seminar at designatedspots along the thoroughfares. A specialsticker was given to a rider who completedthe seminar that could be attached tohis motorcycle. And starting October 24,MMDA is serious in addressingthe increasing deaths due to vehicularaccidents, and two Metro Manila highways– Commonwealth Avenue in Quezon Cityand Avenue of Diosdado Macapagal in PasayCity – are on Tolentino’s watch list.Early this year, pleas fromMMDA disaster relief operations go beyond Metro Manila – aiding even the recent flood-strickenBulacan residents.November - December 2011 I HEALTHbeat 29

traffic tickets were issued toviolators and a Php 500 finewas meted to those whobreached the designatedlane, except when makingturns or U-turns, in whichcase motorcycle riders areto gradually shift lanes100 meters away from theturning point.Next year, Tolentinois planning to implement themotorcycle lanes in RoxasBoulevard, C5 Road andEDSA.Flood ControlAnd then there’s flooding. Amongthe major problems the MMDA faces isthe “never-ending work" in cleaning upMetro Manila of garbage that partly causesflooding when heavy rains come. People inMetro Manila have yet to learn the lessons ofTyphoon Ondoy, which dumped heavy rainsthat triggered killer floods in the metropolisin September 2009.Aside from the usual esteroand barangay clean-up drives, the MMDAinaugurated on August 3 its Flood ControlInformation Center (FCIC), a nerve centerfor the agency's flood control and disasterrelatedoperations. Tolentino said the FCICwill comprehensively monitor Metro Manilaflood-prone areas and provide crucialinformation needed to make policy decisionsin crisis situations.The Center is equipped with 16monitors connected to over 70 closedcircuittelevisions stationed on key MetroManila intersections, flood-prone areas andpumping stations. The Center will tap thenational and international satellite-basedweather monitoring services and utilize anIncident Management and Map Navigation30 HEALTHbeat I November - December 2011Aren't you glad MMDA is watching us, Metro Manila? (All photos in this article iscourtesy of MMDA.)Software that will collate information onflood and other disaster-related incidents. Ithas a floor map of Metro Manila and outlyingwaterways that will help trace communitiesthat would be affected when water systemsoverflow.The information generated fromthe center will be available to all the MetroManila local government units and thepublic, to guide them on what to do duringcalamities, Tolentino added.In September, almost exactly twoyears from the Ondoy flooding, Luzon wasvisited by two to three strong typhoons insuccession. Although Metro Manila wasnot badly hit by floods, Central Luzon,particularly Bulacan, was inundated. TheMMDA immediately dispatched personneland equipment to provide rescue and reliefoperations to the people in the flooded areas,which were already beyond its jurisdiction.This showed MMDA’s dedication andcommitment to assist and serve anywhere itis needed.No Time to Relax?Day in and day out, the MMDA thatTolentino is building does not seem to rest.The agency is also involvedin Street Dweller Care thatassists mentally-challengedpeople living in Metro Manilastreets to be referred to theDOH National Center forMental Health for appropriatecare and attention. Substanceabuse victims using thestreets as their homes arereferred to the Departmentof Social Welfare andDevelopment’s Fabella Centerfor eventual confinement tothe Camp Bagong Diwa DrugRehabilitation Center.And for provincial residentsvisiting Metro Manila and have no roof tostay and rest, the MMDA has establishedthe Workers’ Inn which charges only Php30 for an overnight stay. This alleviates thestress of temporary residents who may haveto process documents over a certain periodof time. Stress is known to contribute tonon-communicable diseases affecting thecardiovascular system. For this year alone,the Workers' Inn was home for 176,128transient residents, serving roughly 29,354people per month.And towards the end of the year,during the Yuletide season, the MMDAstages the Metro Manila Film Festival.While at it, the agency also involves itselfin the prevention and control of firecrackerrelatedinjuries. And by next year, MMDAis already laying the groundwork for theimplementation of the anti-drunk drivingpolicy.Tolentino has the determination toimprove the health of Metro Manila residentsby making the environment a better place tolive in. And the whole MMDA organizationmoves forward to build “Clean Habit, CleanAir, Clean City.”- o O o -

stress RELIEF“Sa hinaba-haba man ng prusisyon, bading naman pala ang iyong makaka-relasyon.”Sobrang SarapIRMA:SIONY:IRMA:Bigote’t BalbasABBY:MAY:Wet and WildAlam mo ba, girl, sa sobrangsarap ng mga lalaki...Ano?!?Pati sila, nagtitikiman na!Hay naku, bakit maraming baklaang may bigote o balbas? Minsan,balbas sarado pa nga. Tuladnalang ng dating boyfriend ko.Siyempre, gurl, para matago angmga stretch mark nila, noh?!?Dalawang girlaloo sa swimming pool...MARK: Tulong! Tulong! Hindi akomarunong lumangoy!!!ACE: O, eh, ano naman?!? Kung akonga hindi marunong magluto,ipinagsisigawan ko ba?!? Wag kangang pampam d’yan!Dry LipsEDGAR: Ang dry ng lips mo, ah.AURORA: Talaga?EDGAR: Halika nga dito para ‘di mag-dry.AURORA: Weh? Baka halikan mo lang ako?EDGAR: Gagah! Lalagyan ko lang nglipstick. Ambisyosang ‘to! Tseh!Family MealPamilyang salu-salong kumakain ng instantnoodles...ANAK: Dad, baka ‘di na po ako makagraduatedahil buntis po ako...DINKY: Ano?!?ANAK: Mom, mahirap po ba ang magbuntis?!?TERE: Mas mahirap ang maging ina,lalo na sa isang ambisyosangbakla na kagaya mo! Kumainka nalang nga ‘dyan at bakamaingudngod ko sa nguso moang noodles!ChampoyDEMPOT: Daddy, bakit po yung ‘bird’ ngclassmate ko parang champoy?OBET: Hahaha! Bakit anak maliit ba?!?DEMPOT: Hindi po... MAALAT!AwayJEFF:JUN:JEFF:‘Tay, nakipag-away po ako...Aba, at nagbibinata na talaga anganak ko! Pero, bakit ka naikapagaway?Kasi po tinutukso nila ako ngbakla... Kaya pinalo ko ngshoulder bag ang mgachuvacheners na ‘yun! Mgagagah sila!Gay Crime SceneMay holdapan sa beauty parlor...PULIS1:Hoy Ateng! Nanditey nasi Darna, sumuko ever ka na!Super surroundings ka nanamin, teh!HOLDAPER: Wiit! Keri ko kayo, teh!Tumbang preso yan si Darnasaken!PULIS1:PULIS2:Ay, echuserang frolet ka!Mga bakla, sugod na tayis!!!O, narinig n’yo si Mother Earth.Gora na, mga bayot! Puuush!Pigilan ang KabaklaanMga payo ni Lolo Tonyo sa mga lalaking naumaalingasaw ang matris...• Isang beses lang maligo sa isang arawat huwag madalas maghilamos ngmukha.• Iwasan ang kulay pink, purple at redsa kasuotan, lalung-lalo na kungpantalon, shorts, belt at sneakers.• Wag kang palatili. Tigasan ang bosesat iwasan ang masyadong paggalawng kamay habang nagsasalita.• Huwag titigan ang musles ng ibanglalaki at mas lalong huwag tumitig samata ng ibang lalaki na sosobra satatlong segundo.• At iwasan ang heart-to-heart talk sakatropang lalaki.“Walang matinong lalake, sa malanding kumpare.”November - December 2011 I HEALTHbeat 31

TRIBUTEGoodbye,NONG MENDOZAJanuary 29, 1961 - November 11, 2011TOP: Nong Mendoza's story in HEALTHbeat July-October2010 issue. LEFT: Nong doing a Boy Abunda look-alike inthe Celebrity Christmas Party of the National Center forHealth Promotion last year.As we bid farewell to 2011, we alsosay goodbye to FEDELINO “Nong” MENDOZA– Information Officer III of the Departmentof Health’s National Center for HealthPromotion, graphic artist, HEALTHbeatstaff who used to do artworks and coverdesigns, and most especially, a dear friend.Nong lost his more than twoyears battle with lung cancer after he wasdiagnosed at Stage 4 in September 2009.He shared his personal health story inHEALTHbeat July-October 2010 issue, thefirst time this magazine went into full color.In his story entitled "BattlingLung Cancer," Nong narrated his ordealwith the disease, not only in dealing withthe physical pain but also in experiencing agamut of medical and financial difficulties.He said, "with a disease like lung cancer, itis very important that people around youand the institutions behind you are able toprovide you with the best care and supportphysically, emotionally and financially."Henry Ward Beecher, a Protestantclergyman and reformer, said, "So we fallasleep in Jesus. We have played long enoughat the games of life, and at last we feel theapproach of death. We are tired out, and welay our head back on the bosom of Christ andquietly fall asleep."Nong was survived by his wife,Bambi, and two kids, Justin and Zen Zen. Youwill surely be missed, Nong! Rest in peace.32 HEALTHbeat I November - December 2011

YEAR-END reviewHEALTH NEWSTop 10 in 2011byANTHONY R. RODA, MaHeSoSHEALTHbeat StaffIt’s a tradition. It’s an obligation. HEALTHbeat brings you once again the Top 10 health stories that rocked the Department ofHealth in 2011, based on media monitoring of health news coupled with the opinions of the editorial staff. If the news is a reflectionof the state of health of the nation, then we are quite in trouble because it starts off in blood and ends up in a circus. Let’s do thecountdown...10 Voluntary Blood Donation“More blood, more life.” This wasthe global theme for World Blood Day onJune 14. This was also the theme adopted bythe Department of Health when it observedthe National Voluntary Blood DonationMonth in July. A few heeded the call inblood letting activities, mostly from comingfrom the health sector and some from thepolice and the military. Others were alreadyregular donors and for a few newbies they,shall we say, “forced volunteers.” The act ofvoluntarily donating blood has not exactlycreeped in the consciousness of Filipinos.Many would only think of donating bloodwhen a member of the family or a closefriend is the one in need.One thing good that happenedduring the surge of dengue cases in Luzonwas the hype media created on the need ofblood for dengue patients, mostly children.And for the first time, news on voluntaryblood donation reached Healthbeat’scountdown of the Top 10 health news.On August 15, Philippine RedCross (PRC) Secretary General GwendolynPang urged more people to donate blood assevere dengue cases need blood.Data provided by PRC show thatOIC Undersecretary Gerardo Bayugo (right) shakes the hand of Enchong Dee (left) - matinee idol,swimmer, regular blood donor and instant DOH voluntary blood donation program poster boy. (Photoby Paking Repelente)November - December 2011 I HEALTHbeat 33

annual blood collection falls short of whatis needed. The PRC has an average collectionof 2,500 to 3,000 units of blood dailynationwide.Pang explained that in 2010, PRCcollected a total of 273,000 units of blood,representing 49.6 per cent of the totalnational collection of 550,000 units fromall blood collecting agencies, including theDOH and the Philippine Blood CoordinatingCouncil. But the total collection wasstill 440,000 units short of the nationalrequirement for 950,000 units last year. ThePRC uged the public to “be more resolute inpromoting voluntary blood donation” withthe rise in dengue cases in mind.Dr. Lyndon Lee Suy, programmanager of the DOH Emerging and ReemergingInfectious Diseases, emphasizedthe need for donated blood by severedengue patients. He said, “While only fiveper cent of dengue patients need blood, westill encourage blood donation.”Quite a coincidence, Enchong Dee,matinee actor, swimmer and a regular blooddonor, was scheduled to donate his preciousblood in the DOH, the following day, August16. This donation landed on the news andeasily he became a DOH poster boy for theblood program.Soon after, the Philippine MedicalAssociation, ABS CBN, TV 5, among othersheld their own blood letting activities.The DOH hopes that this good deed wouldbe sustained any day of the year, with orwithout dengue.Filipinos have to remind themselvesthat giving blood is giving the mostprecious gift to another person: the gift thatwill extend the life of the sick while at thesame time, reinvigorate the giver. As HealthSecretary Enrique T. Ona emphasized, “We donot lose blood when we give because as wedonate blood, we refill our bodies with newand fresher blood.9 Smokin’ SuperstarsWhen health and showbiz newscombined this year, the issue was smokin’hot because it was dangerously treadingon artistic freedom. But shouldn’t we all beconcerned about the health of the peopletoo?On June 2, when the MetropolitanManila Development Authority (MMDA)announced the extension of the submissionof scripts for the 37th Metro Manila FilmFestival (MMFF), MMDA chairman FrancisTolentino also called on participating movieproducers to exclude scenes that show actorsand actresses smoking cigarettes. The MMFFruns from December 25, 2011 to January 7,2012, and within that period no foreign filmsare shown in cinemas.He said, “When a popular actor or amovie lead character lights up a cigarette onscreen, it sends out a message – subliminalor otherwise – that smoking is cool. Wedon’t want to send the wrong message toour children. We want to inculcate positive,health-conscious values and awareness,”Tolentino said.As soon as it was announced,34 HEALTHbeat I November - December 2011

the movie industry warned Tolentino thathe may be treading on questionable legalgrounds since filmmaking is covered by theconstitutional right of free expression. LilyMonteverde, a perennial supporter of theMMFF with her various horror and dramaentries over the years, said, “Hindi pupuwede.Actors have to bring life to any role and iftheir character is smoking, it does not meanthat they are setting a bad example to theyouth.” Veteran director Soxy Topacio, on theother hand, insisted filmmaking is essentiallybuilt on the nuances of characterization andif smoking will project the nature of a role orenhance cinematography, it is justified.Artistic freedom and being truthfulor factual are often raised when artists delveinto the topics of sex, violence, morality,politics and now health. These, too, werethe protective shield that the entertainmentindustry used in September when“Smokefree Philippines” spearheaded bythe Philippine Medical Association criticizedsuperstar Nora Aunor for the bad image shewas conveying in her photo on the cover ofYes! magazine as well as Anne Curtis and herParis setting cover of Rogue magazine.Father Robert Reyes, a staunchsupporter of Smokefree Philippines, wasquoted as giving a strong statement toAunor, “Nora, you are ill-advised. Youthink you are moving forward, it’s a stepbackwards.” He added, “The Filipino readingpublic is not dumb… If you want to bepopular again, be wholesome. Gusto n’yoba gayahin ka namin? Ang trabaho n’yo is toinspire us, not to scandalize us.”In an ABS CBN news report, Aunorexpressed her dismay and said, “Kriminalba ‘yung ginawa ng tao o ano? Masyadongpinapalaki ‘yung isyu. Bakit, ngayon langnapansin na naninigarilyo ako?” Yes! editorin-chiefJoan Maglipon also defended thesuperstar by saying the said pose depictsthe freedom of Aunor today. Magliponadded, “In a perfect world, we will not haveanyone smoking or drinking or gambling orlying. Not just in magazines, but out therein the real world... But apart from being inan imperfect world, there is the very realconcern with freedom of expression, whichnot even the most well-meaning advocatesshould trample on.” She later, however,stressed their magazine’s support to thesmokefree campaign.Curtis, on the other hand, in herinterview with ABS CBN’s “Bandila” said,“Siyempre na-sad din kami that it wasgiven that kind of publicity but at the sametime naiintindihan din naman namin angpoint nila.” To set the record straight, shemaintained that it was not the magazine’sintention to promote or to engage theyouth into smoking. “I don’t smoke. So I donot promote smoking. Just to be clear also,”Curtis added.Over at ABS CBN’s “The Buzz,”KC Concepcion said that the magazinecovers are within a gray area. “Hindi siyaadvertisement. Hindi siya commercial. Hindisiya photograph na magpo-promote ngisang brand ng sigarilyo. So, yung tobaccoregulation or Tobacco Act is really targettedsa tobacco industry, sa mga nagpo-promoteOn April 4, the Department ofHealth launched its month-long, nationwide,door-to-door measles vaccination campaigndubbed “Iligtas sa Tigdas ang Pinas” forabout 18 million children aged nine monthsto below eight years. The main objective ofthe campaign is to reduce the number orpool of children who are at risk of getting orsusceptible to measles and achieve at least95% measles-rubella immunization.From April 4 to May 4, vaccinationng smoking at nagpo-promote ng brand ngcigarette. So, in terms of personal choicesng mga artista, katulad ng mga nalalagay samga magazines, it can be seen as an artisticexpression.”The tobacco industry must havebeen laughing its heart out with the newsbecause it has been circumventing the banon advertising and promotion by the wayit has positioned cigarette smoking. Youthand women, as the two magazine coversprojected, are lured to smoking because ofthe social image they want to present toothers. All these years, the tobacco industryhas created an image of smoking as beingtough, cool, sexy, sophisticated, attractive ora form of rebellion.However, what the tobaccoindustry doesn’t say is the reality thatsmoking causes debilitating and painfuldiseases and death. Anti-tobacco advocateswould want to see the day when theentertainment industry would invoketheir artistic freedom in showing graphicvisualization of the hazards of smokingin movies or magazine covers. Until thathappens, they could only be more vigilantin protecting women and youth to the falserepresentation of smoking in media.8 Iligtas sa Tigdas ang ‘Pinasteams, aptly called “bakunadoors,” knockedon doors to give free Measles and GermanMeasles vaccines to targeted children,even if they already had previous measlesvaccination or if they had already acquiredmeasles. Aside from vaccines, some localgovernments also provided free capsulesof Vitamin A which is an importantmicronutrient for good eyesight, strongbones, and a healthy immune system.The “doors” referred to in thisNovember - December 2011 I HEALTHbeat 35

campaign included doors of houses,condominiums, apartments, tenements aswell as the so-called non-conventional doorsin the community. These non-conventionaldoors included informal settlements suchas families living under the bridge, insidethe parks, cemeteries and open spaces,in tents, carts, abandoned buildings,commercial establishments, market stalls,and institutions where children may reside.Measles is a highly contagiousdisease which can be fatal. It is spread bycoughing and sneezing, close personalcontact, or direct contact with infectednasal or throat secretions. Immunity againstmeasles is developed following vaccination.Likewise, German measles, alsoknown as rubella, is a highly contagious milddisease characterized by flu-like symptomsfollowed by a rash. Immunity againstGerman measles is also developed followingvaccination. However, the primary dangerwith rubella is the infection of pregnantwomen as it poses a serious threat to the lifeof the unborn. It may cause miscarriages,premature delivery, and serious birthdefects, including heart problems, hearingand sight problems, cognitive impairment,and liver or spleen damage.According Health SecretaryEnrique T. Ona, measles-rubella vaccine issafe, effective and inexpensive. Moreover,he stressed it costs between P500 to P15,000to treat a child with measles but preventingmeasles through vaccination is free.On May 6, Ona announced thatBarangay Suaverdez in the municipalityof Anao, Tarlac province became the firstbarangay in the country to achieve itstarget of zero missed child and a 95% housemarking accuracy during the month-longcampaign.The DOH also received partialresults that revealed that 11.8M children(63%) of the targeted 18M children werealready vaccinated against measles andrubella.Among the top three regions withthe highest percentage of vaccinated childrenwere Region 9 (Zamboanga Peninsula),which has been a consistent top performersince the first week of the campaign, with81% (or 565,255 of their 695,329) eligiblechildren; Region 12 (SOCCSKSARGEN) with80% (or 658,160 of their 818.197) eligibles;and Region 9 (Davao Region) with 79% (or688,009 of their 868.764) children.Since the campaign fell duringthe Holy Week, many children were still notreached. To enable some areas to catch up,the campaign was extended until May 30 oreven beyond in order to attain at least 95%coverage of eligible children nationwide.And to measure the success ofthe campaign, an internal and externalrapid coverage assessment (RCA) aftera barangay has declared completion ofvaccinations was conducted. The internalRCA team is composed of the DOH RegionalCenter for Health Development and theProvincial Health Office while the externalteam is composed of the national DOH andthe World Health Organization and otherpartners. A measles-free certification will begiven to the areas that will meet the criteriaof “no missed child and no measles cases forthree months after the campaign.- o O o -LEFT: A child happily shows proof that she’s just been immunized (Photo by Jezzierette Clyde Cafe-Daquilanea). RIGHT: “Bakunadoors” or health workersgoing door-to-door giving measles-rubella vaccinations to children 9 months to less than 8 years old.36 HEALTHbeat I November - December 2011

7 Woeful SuicideOn February 8, controversial formermilitary chief and Energy Secretary AngeloT. Reyes was reported to have committedsuicide while visiting his mother’s grave atthe Loyola Memorial Park in Marikina Citywhere he shot himself in the chest usinga Caliber .45 pistol which pierced throughhis heart. Before this incident, he has beenin the hot seat due to allegations that hereceived P50 million in “send-off” moneyafter he retired from the AFP as claimed byretired Lt. Col. George Rabusa.On August 2, Attorney BenjaminPinpin, 32, assistant chief legal counsel ofthe Development Bank of the Philippineswas reported to have strangled himself witha nylon cord in the bathroom of a hotel inZapote Alabang Road. In a suicide letter,Pinpin revealed how upset he was aboutbeing investigated for a P510-million loangranted to a businessman during the pastDBP administration. He said he did not wanthis family to be affected by the controversy.On September 19, the newsreported that a 13-year old alleged “gay”shot his 17-year old “boyfriend” twice in thehead before turning his .22 calibre pistol onhimself. This was said to happen inside SMSan Fernando, Pampanga in what has beentermed as a “crime of passion.” Both teenersdied a few days later.And on October 27, MartinGuingona Lamb, 20, grandson of formerVice President Teofisto Guingona, made thenews when he jumped off to his death fromthe 31st floor of a hotel in Muntinlupa Citybefore dawn. Police said Lamb was havingdrinks with his friend at the hotel bar beforethe incident happened. His friend told thepolice that Lamb talked about his problems.These are just some of the highDepression may lead to suicide. Photo grabbed from the Internet.profile reported cases of suicide thathappened this year. There are more news ofpeople committing suicide, and many morecases in the country went unreported, andstatistics on suicide are also blurry.A study entitled, “Suicide in thePhilippines: Time Trend Analysis (1974-2005) and Literature Review” by MariaTheresa Redaniel, David Gunndell (of theUniversity of Bristol in United Kingdom)and May Antonnette Lebanan-Dalida (of theUniversity of the Philippines-Manila) postedin BMC Public Health website this year, saidthat more women than men attempt suicidein the Philippines, but as seen in mostother countries, the case fatality is higherin males due to their preference for moreviolent/lethal methods of suicide. The maleto-femaleratio for suicide (3.3:1) in thePhilippines is higher than in China or Indiabut comparable to that seen Thailand, Japanand New Zealand.The study also said that suicideattempts and mortality were generallyhigher in adolescents and young adults thanin the older age group. This contrasts withpatterns seen in most countries where ratestend to increase with age. This could be dueto increased vulnerability of young people tosocial stressors. Adolescence is a period of lifechanges and most teenagers struggle withissues such as independence and developinga sense of identity and a system of valuesand responsibilities.Meanwhile, a Department ofHealth survey in 2007 found that 15 out of900 teenagers tried to commit suicide.Dr. Dina Nadera, a psychiatrist anddean of the University of the PhilippinesOpen University, said suicide is so sensitivean issue that, in fact, the 2004 PhilippineHealth Statistics euphemistically called it“intentional self-harm.” Quite often, too,families would have the cause of death listedas something other than suicide, she added.As Michael Tan, anthropologist,November - December 2011 I HEALTHbeat 37

wrote in his column “Pinoy Kasi” in thePhilippine Daily Inquirer on September8, “The suicide rate in the Philippines isrelatively low compared to other countries’.This is explained by the fact that the countryhas a Catholic majority population. Althoughmost major religions look negatively atsuicide, the Catholic Church tends to be themost judgmental, with threats of eternaldamnation and some Catholic priestsrefusing a church burial.”But as to cases of depression, theWorld Health Organization, says otherwise.The Philippines has the highest incidence ofdepression in Southeast Asia. In 2004, therewere over 4.5 million cases of depressionreported in the country and 3 per centof Filipinos were clinically diagnosed asdepressed. However, of the 90 depressives,only 30 will seek help. The other 30 willsuffer the symptoms but will be ashamed toseek help because of the stigma associatedwith the illness. These symptomatics wouldrather keep it to themselves and suffer inpain and in silence. The other 30 will sufferthe symptoms not knowing what is wrongwith them.Knowing what depression is allabout is already a big step in managingthe illness. There is an urgent need toempower individuals suffering from theillness with resources, professional helpand organizational linkages that can opennew doors and bring light in their journeyof suffering and pain to that of positive selfdiscoveryand well-being. The families andfriends of people suffering from depressionare equally important and they need toknow and understand the illness to enablethem to respond and provide constructivesupport to their loved ones during thesedifficult times.On September 9, a day ahead ofthe World Suicide Prevention Day, the DOHjoined the Natasha Goulbourn Foundation- a non-government organization thatadvocates for better understanding ofdepression, in several activities targeting theyouth in leading schools and universities,particularly holding lectures and discussionson depression and suicide.6 PhilHealth Schemes and ThingsOne of the two health issues thatmade it to the second State of the NationAddress of President Benigno S. Aquino IIIon July 25 is the enrolment to PhilHealth’sThe Department of Health and PhilHealth advise all eligible Filipinos to enrol in the national socialhealth insurance program and use their benefits. (Photo from PhilHealth)insurance program of 5.3 million poorfamilies identified in the Department ofSocial Welfare and Development’s NationalHousing Targeting Survey for Poverty Reduction(NHTS-PR). (The other health issue isimmunization which the President utteredtwice in passing.) PhilHealth enrolmentand its consequent utilization of benefitsby indigent families are considered thecenterpiece of the Aquino Health Agenda’sKalusugan Pangkalahatan (universalhealth care) within three years. That’s byJune 2013 already, and time is ticking fast.Effective September 1, the DOHand PhilHealth implemented the case ratesscheme for in-patient treatment of 22common medical and surgical conditions.Simply put, Health Secretary Enrique T. Onasaid that this scheme is akin to a “pakyaw,”or wholesale system where all the fees arefixed, but for 22 most common cases onlyand not for all types of cases which willbe paid directly to both government andprivate hospitals and clinics.The case rates payment covers:dengue 1 (P8,000); dengue 2 (P16,000);pneumonia 1 (P15,000), pneumonia 238 HEALTHbeat I November - December 2011

(P32,000); essential hypertension (P9,000),cerebral infarction cerebro-vascular accidenthemorrhage 1 (P28,000); cerebro-vascularaccident hemorrhage 2 (P38,000); acutegastroenteritis (P6,000); asthma (P9,000);typhoid fever (P14,000); and newborn carepackage in hospitals and lying-in clinics(P1,750).On the other hand, the surgicalprocedures include radiotherapy (P3,000 persession); hemodialysis (P4,000 per session);maternity care package (P8,000) coupledwith the normal spontaneous delivery (NSD)Package in Level 1 (P8,000) and Levels 2to 4 hospitals (P6,500); caesarian section(P19,000); appendectomy (P24,000);cholecystectomy (P31,000); dilatationand curettage (P11,000); thyroidectomy(P31,000); herniorrhaphy (P21,000);mastectomy (P22,000); hysterectomy(P30,000); and cataract surgery (P16,000).This is much different from the originalscheme of PhilHealth which was to payfor services where rates were based on thecategory of hospital, length of stay at thehospital, kind of illness and complications,among others.An added feature to the new caserates scheme is the “no balance billing forNHTS-PR PhilHealth members admitted ingovernment hospitals for these conditions.This is why Ona encourages indigents to goto government hospitals instead because thescheme does not cover private hospitals.The Private Hospitals Associationof the Philippines (PHAP) was up in armsover new regulations and warned thatpatients’ bills would go up. They alsothreatened to remove themselves from thelist of PhilHealth-accredited hospitals.In an ABS CBN news report, Dr.Rustico Jimenez, PHAP president, was quotedas saying, “Ang dengue, tests pa lang ubos naang P8,000. Paano pa yung professional feesng mga duktor? Ang tatamaan nito yungordinaryong tao.”DOH and PhilHealth maintainedtheir position saying that they have to puta ceiling on payments to protect the fundsof members and ensure hospitals do notovercharge.Also in September, the DOH andPhilHealth announced its public-privateinitiative to encourage more people tobecome part of PhilHealth and to assistPhilHealth in improving its services.Members are now entitled to discounts formedicines and other health services in someparticipating pharmacies and shops.5 Plight of the ‘Nightingales’In December 2010, Dr. LeahPaquiz, founding president of “Ang Nars”told ABS CBN “Bandila” that the governmentshould look into the practice of hospitalsthat require registered nurses to pay fortheir training. She revealed, “Nag-o-onthe-jobtraining (OJT) volunteerism, sila paang nagbabayad, tapos ‘yung certificate,hindi naman po siya qualified magingemployment certificate.” Paquiz also saidmore than 500,000 nurses in the country areeither jobless or underemployed.The news report also showedinterviews of partly-hidden nurses narratingtheir sad plight and showing proofs ofpayment they made as volunteer nurses inundisclosed hospitals.On the other hand, GMA newsreported Dr. Rustico A. Jimenez, presidentof the 600-member Private HospitalsAssociation of the Philippines (PHAP), assaying his organization has asked volunteernurses and their supporters to showevidence so they can investigate the issue.He said, “If we cannot see any written proofsuch as receipts or contracts, we cannot actaccordingly,” Jimenez said. “We want to seecontracts that say nurses were made to workin a hospital and yet were even asked topay instead of the hospitals paying for theirservices rendered.”Nevertheless, in the first halfof January, the legislators were quickto investigate the sad plight of nurses,particularly on some OJT nurses who arereportedly made to pay between P5,000 toas much as P10,000 for their certification inthe course of their “training period” or “workexperience” with a hospital, which may lastfrom 6 weeks to 8 months.On January 17, the Department ofHealth, in coordination with the Departmentof Labor and Employment (DOLE) andthe Department of Social Welfare andDevelopment (DSWD), announced the startof recruitment of 10,000 registered nursesfor its “RNheals” program. RNheals, anacronym for Registered Nurses for HealthEnhancement And Local Service, is expectedto address the shortage of skilled andexperienced nurses in 1,221 rural and farflungcommunities.Nurses would undergo trainingand development, and a certificate ofcompetency and employment will be givenby the DOH, DSWD, and the ProfessionalRegulation Commission – Board of Nursingto those who will satisfactorily completerequirements. While on deployment, thenurses would be given an allowance ofP8,000 a month by the DOH while the localgovernment unit where they are assignedshall supervise them, ensure their safetyand security, and provide modest boardand lodging. LGUs were also encouraged toprovide additional allowances and benefitsNovember - December 2011 I HEALTHbeat 39

Nurses Kaycie, Allen, Avy and K-anne, RNheals Batch 1 assigned in Naujan, Oriental Mindoro. Photo byDr. Chen del Mundo, grabbed from his blog .worth at least P2,000 for these nurses.However, after a few months ofservice for the RNheals program, the nursesaired their concern about not receiving theirstipends. In May, the DOH apologized for thedelay and assured the nurses that it has fasttrackedthe requirements necessary for therelease of funds earmarked for the programas well as guaranteed them that for thesucceeding months they would be paid ontime.In September, Health SecretaryEnrique T. Ona issued a memorandumorder directed to all DOH hospitals to stopall volunteer training programs for nurses.He pointed out that the current practice ofregistered nurses “volunteering” in hospitalsis not consistent with the provisions of law.Ona stressed, “Many hospitals haveimplemented ‘nurse volunteerism’ in theguise of ‘training programs’ in order to justifythe collection of ‘training fees,’ whereby suchbasic skills training put no added value tothe professional career of the nurses.”According to the Republic Act 9418or the Volunteer Act of 2007, “volunteerism”as an act involving a wide range of activities,40 HEALTHbeat I November - December 2011including traditional forms of mutual aid anddevelopment interventions that provides anenabling and empowering environment4 Dengue Surge in LuzonWhen dengue cases peaked inJuly and August in Luzon and a number ofchildren died, one angle that some mediapeople in news and commentary hyped wasthe inaction of government in what they sawas a crisis. For the Department of Health, thiswas uncalled for and very much unjustified.For more than a decade thatdengue mosquitoes have been attacking thecountry, the DOH has already institutionalizedits dengue prevention and control programin public health and hospital services as wellas in health promotion. But as the alreadya-clichégoes, “the government cannot doit alone.” In dengue prevention and control,communities and the whole society shoulddo their big part.Since the first day of June, the DOHhas alerted the country that it was Dengueboth on the part of the beneficiaryreceiving, and the volunteer rendering theact, undertaken for reasons arising fromsocial-developmental, business or corporateorientation, commitment or conviction forthe attainment of the public good and wheremonetary and other incentives or reward areNOT the primary motivating factors.Instead of “forced volunteerism,”Ona wanted the DOH by itself or inconjunction with the Board of Nursing tocraft a residency program for nurses. Underthe proposal, the government-fundedresidency program will give nurses 6-18months of training in a public or privatelyownedhospital. He said this includes all DOHregional medical centers.By October, the DOH and itspartners started the recruitment andeventual deployment of RNheals batch 2nurses.Prevention Month. Although dengue is nolonger a seasonal disease, epidemiologicdata in previous years still show that theonset of the rainy season cause the diseaseto rise. On June 15, it was not only thePhilippines that conducted a massive antidenguecampaign, but the whole ASEAN(Association of Southeast Asian Nations)as well. ASEAN Dengue Day was declaredthis year and would be observed every yearthereafter to foster more awareness aboutthe disease. This year’s observance has forits theme, “Dengue is everybody’s concern,causing socio-economic burden, but it ispreventable.”On this day, the DOH urged topofficials and leaders of the country’s publicschools, churches, public markets, andcommunities to conduct search and destroy

activities in their areas of jurisdiction toprevent dengue. Barangay officials, throughthe Liga Ng Mga Barangay, were also urgedto seriously undertake government’s antidenguecampaign by allocating a part of itsbudget for dengue prevention and control.At the launch ceremonies held in KalookanCity, Health Secretary Enrique T. Ona said,“Dengue is everybody’s concern, but withour concerted efforts, dengue can becontrolled starting today.”And then it happened. Towardsthe end of July, a sudden increase of denguecases happened in Metro Manila, CentralLuzon and the Ilocos region. The nation,as what was being reported in media, wasalarmed when a surge of about 2,000 newcases occurred in the first two weeks ofAugust. This incident prompted officials todeclare health emergencies in a number ofareas in Metro Manila and affected areas ofthe country.Even with the Department ofHealth’s assurance that the total number ofcases nationwide is lower than that of lastyear, the DOH National Epidemiology Centerreported dengue cases at the NationalCapital Region, Region 1 and 2 nearlydouble, with 10,487 cases recorded in thefirst seven months of 2011 compared to5,416 in the same period last year.An off-the-cuff remark of areporter in a DOH press conference of havinga “Ilocano strain” of dengue went haywire inthe news and even attributed Secretary Onafor it.This sudden rise in cases causedpressure and panic among public healthfacilities in Metro Manila, especially at theQuirino Memorial Medical Center (QMMC),where it was shown on television numerousaffected patients sharing beds, hallwayswere converted to wards, and temporarywards were made outside the hospitalpremises to house dengue patients, mostof were children aged 0-15 years. Addingmisery to QMMC at this time was the factthat the nearby government and privatehospitals were partially closed due todamages caused by the recent floods.On August 25, the DOH togetherwith the Departments of the Interiorand Local Government, Science andTechnology, Education, Environmental andNational Resources, and the Metro ManilaDevelopment Authority launched a newcampaign against dengue dubbed, “AksyonBarangay Kontra Dengue” (or ABaKaDa), inan effort to stir up community action thatwill be sustainable, target-driven and thatcan be adopted by LGUs with perennialthreats of a dengue epidemic.ABaKaDa seeks to reinforce thecountry’s drive against dengue by going backto the basics of comprehensive vector controlsupported by environmental manipulationand modification. ABaKaDa calls for regularweekly clean-up drives spearheaded by thebarangay leaders and includes the activeparticipation of community volunteers, civilsociety and others in government.Lessons from past dengueepidemics showed that communitiesdetermine the dengue burden dependingon their seriousness and commitmentto eliminate mosquito breeding sites.Specifically, the campaign urges families,barangay leaders and youth councils(Sangguniang Kabataan) to do communityclean-up drives and to aggressively seek andclean out possible mosquito breeding sitesevery week especially in areas that continueto experience clustering of dengue cases.At about the same time, theDOH and PhilHealth (Philippine HealthInsurance Corporation) introduced andbegan implementing effective September1, the new case rate payment scheme,where members would be able to predicthow much PhilHealth would be paying forthe services provided. Included in the newcase rates is dengue, classified into Dengue1 (dengue fever and dengue hemorrhagicfever (DHF) Grades I and II) and Dengue II(DHF Grades III and IV) with reimbursementIn Quezon City, because of the high number of dengue cases, the DOH Center for Health Development- Metro Manila, conducted space spraying on mosquitoes and their breeding sites. Unlike traditionalfogging where chemical-based insect repellant is used, space spraying only involves the use of waterbasedinsect repellant. It produces a mist instead of a fog. (Photo by Glen Ramos)November - December 2011 I HEALTHbeat 41

ates amounting to P8,000 and P16,000,respectively.Complimenting the case-ratesystem is the no balance billing schemewhich applies only to indigent patientscovered by the national household targetingsystem for the poorest of the poor when theygo to government hospitals only. Under thisscheme, Philhealth beneficiaries no longerhave to pay extra in case their medicalexpenses go beyond the amounts covered bythe packages in the case rate system.Everything has been done bygovernment to minimize the impact thatdengue brings to the country - from advocacycampaigns to dengue fast lane in healthfacilities to scientific research altering thegenes of the dengue carrying mosquitos toclinical testing of a potential vaccine againstthe disease. This is not inaction in the partof government. What may truly be wantingis for people to change their behaviors andpractice the recommended cost-effectivemeasures to prevent dengue.3 Global Concern for Non-Communicable DiseasesIn August, the news that JukeboxKing April Boy Regino was sufferingfrom prostate cancer shocked the localentertainment industry. By October, thenews that he was “cured” bytaking the food supplementwas even more shockingto many outside showbiz.Anyway, the news died anatural death, so-to-speak.But the real shockingnews happened on September23 when it was announcedthat the non-showbizhusband of television actress,Camille Prats, succumbedto nasopharyngeal (throat)cancer. Anthony Linsanganwas only 32.And then therewas the revelation made byactor Albert Martinez as hiswife, Liezel, struggles withrecurring cancer. In ABS CBN’s“The Buzz” on October 16Martinez said that when hefound out about the healthcondition of his wife, hiswhole world shattered again.He said he thought that herwife’s condition was alreadydoing well for the past two42 HEALTHbeat I November - December 2011years. Earlier, Liezl was diagnosed withstage 3 breast cancer and went throughmastectomy, a surgery done for removingthe breast. In 2010, she was cleared of theHealth Secretary Enrique T. Ona speaks before the UN High-Level Meeting on Non-Communicable Diseases in New York.deadly disease.Cancer and other noncommunicablediseases (NCDs) are nowmajor threats to public health, globally.In 2008, the World HealthOrganization reported thatNCDs cause an estimated 35million deaths each year, and60 per cent of these deathsare due to four main noncommunicablediseases,namely cardiovasculardiseases (heart disease andstroke), diabetes mellitus,chronic respiratory diseases,and cancers. Worse, 80 percent of these deaths occurin low to middle incomecountries, where thePhilippines belong. In fact,the seven out of 10 leadingcauses of death in the countryare due to NCDs.And recent demographicsshow that peoplehaving NCDs are not confinedto the older generation asit used to be, but they areaffecting the younger andmost productive age group,just like what happened toPrat’s husband. NCDs are

ought about by tobacco use,excessive alcohol drinking,unhealthy diet and physicalinactivity. These are lifestylesthat most people love to doand habits that are too hard tobreak.NCDs seldom hit bigin media’s attention maybebecause these diseases are notcontagious and do not crowdhospital beds at any giventime. Nevertheless, globalattention this year focusedon NCDs. From Moscow inApril to Geneva in May, andon to New York in June andSeptember, health ministersand world leaders tackledthe prevention and control ofnon-communicable diseasesin international meetings andconferences.At the UnitedNations (UN) High-Level Meeting held inNew York on September 19 and 20, worldleaders unanimously adopted the PoliticalDeclaration on NCDs, agreeing that “theglobal burden and threat of NCDs constitutesone of the major challenges for developmentin the 21st century, which undermines socialand economic development throughout theworld.” However, this meeting fell short ofsetting goals or targets. Countries now areurged to factor in NCDs into their longer termhealth planning alongside other pressinghealth challenges. Global investments forNCDs and stronger commitments and actionsby countries and their leaders are important.But measures to control NCDs often needgovernment action such as taxation,regulation and advertising curbs that bringpoliticians into conflict with tobacco, foodand alcohol industries. If nothing is to bedone now, the world is bound to have a sickPresident Benigno S. Aquino III shows off his biking form during a campaign topromote “Ehersisyong Pangkalusugan Para sa Lahat” in May. (Photo by PakingRepelente)future ahead.Health Secretary Enrique T. Onasaid that lost productivity and high healthcare costs of catastrophic outcomes resultingfrom NCD can certainly drive any family intoimpoverishment and poverty. He added,“You can just imagine how this will impactto those who are already very poor to beginwith. Sadly, this is always the story when itcomes to non-communicable diseases. As aclinician, I’ve seen this so many times in mypractice.”He stressed that the Departmentof Health’s health reform agenda ofKalusugan Pangkalahatan is directedtowards improving access of the poor toquality health care. It incorporates providingfinancial risk protection through theexpanded coverage and enhanced benefitsof PhilHealth (national health insuranceprogram) and improving the quality of healthservices particularly in thepublic sector through healthfacilities enhancement.The DOH is placing upto-datediagnostic equipmentthat will allow health facilitiesto respond to the commonhealth care needs whichinclude management of noncommunicablediseases andtrauma. Likewise, the DOHComplete Treatment Pack hasbeen introduced this year andthis will make a number ofmaintenance medications forhypertension and diabetesmore accessible for the poor.Interventions are alsodirected at making the societyand environment conduciveto healthy lifestyles. To agreat extent, NCDs can beprevented if Filipinos are ableto modify the risk factors. Onasaid that the restructuring of excise taxes forsin products is one of the priority legislationsof the Aquino administration. And to do this,he added, we need to empower people to beresponsible for their own health. We needto educate them about the potential harmthat unhealthy lifestyles would bring. Thisis essentially what health promotion is allabout.Ona said, “While many see itsvalue in infusing more funds for the healthsector, the government also recognizes itspotential in deterring potential smokers,particularly the youth, to engage in thedeadly habit. A long battle lies ahead ofus to pass this law, but I believe that witheveryone’s support we can do it.”Meanwhile, the DOH, togetherwith the Departments of Social Welfareand Development and Education, startedto mobilize the Community Health TeamsNovember - December 2011 I HEALTHbeat 43

in October to provide comprehensive publichealth services such as immunization,family planning counseling, among othersright at the doorstep of families. Part of theservices they will perform is to deliver thesekey messages on healthy lifestyles: avoidtobacco smoking and excessive alcohol use,have a balanced diet and regular exercise.The DOH believes that health promotionstrategies are best done at the level of thecommunity and the family.On May 15, the DOH staged“Ehersisyong Pangkalusugan Para sa Lahat”campaign which was participated in bythe President himself. This made a lotof attention especially since it was thePresident talking about healthy lifestyleand exercise. Then on May 31, World NoTobacco Day, the DOH was delighted by theincreasing number of local governmentunits, government hospitals and officesmaking great strides in protecting peoplefrom secondhand smoke, raising the numberof participants in this year’s DOH Red OrchidAwards. In September, the PhilippineMedical Association forged an agreementwith the DOH in a health promotion strategyutilizing all forms of media, including theInternet, to change people’s behaviorstowards healthy living and lifestyle.In the ASEAN (Association ofSouth East Asian Nations), the Philippinesis the lead country to undertake strategiesof revitalizing and facilitating enablingenvironments for ensuring promotion ofhealthy lifestyle for the people of the region.All the country’s current effortsin the prevention and control of NCDs alsoentail partnerships with all sectors of society- government agencies, local governments,private sector, and non-governmental andfaith-based organizations, among others.And most specially, the Philippines is onewith the world in the fight against NCDs.- o O o -2 Smokefree Metro ManilaWhy did this health news rank sohigh in HEALTHbeat’s countdown? Well,this is one of the very few instances whentobacco control advocates took the offensiveagainst the rich and mighty tobaccoindustry that for so long has considered thePhilippines as their “Disneyland” because ofthe lax and lenient tobacco regulation lawsand policies.On May 29, a few days beforethe World No Tobacco Day (May 31),the Metropolitan Manila DevelopmentAuthority (MMDA) announced to the mediaits smoking ban in public places. Deputized“environmental enforcers” were deployedin teams to apprehend persons caughtsmoking primarily in major thoroughfares(loading bays, footbridges, stairwells of trainstations), public utility vehicles and landtransportation terminals in coordinationwith the Land Transportation andFranchising Regulatory Board. Meanwhile,the LGUs are responsible for city roads andestablishments in their jurisdiction andthe Civil Service Commission is responsiblefor government vehicles and offices. Thepenalty ranges from P500 up to P1,000for the first offense, or 8-hour communityservice.As soon as it was announced, ABSCBN TV Patrol put on a text poll and showedthat 91% of the viewing public agreed withthe new MMDA policy. This is evident of asilent majority of the population who areagainst tobacco use, especially in publicplaces.After a month-long informationdrive, the new policy took effect on July1. Barely a week after the MMDA fullyimplemented its smoking ban policy, ChrisNelson, the managing director of PMFTC - aventure between Philip Morris and FortuneTobacco - said in a Malaya news report onJuly 7, the PMFTC is prepared to take actionagainst the MMDA on the regularity of theissuance. He was even quoted as saying, “Itmay not even be us, it could be a smoker whomay take action.”And like a Nicodemus prophesy,two smokers have really taken the MMDAto court after they were fined for smokingin public. On July 26, the PhilippineDaily Inquirer reported security guardsAntony Clemente and Vrianne Lamsen,in their petition, asked the MandaluyongRegional Trial Court to stop the MMDA fromimplementing a ban on smoking in publicplaces in Metro Manila. The two were saidto have been apprehended by an MMDAenforcer after they were caught smoking onthe sidewalk on EDSA, near Farmers Marketin Cubao, Quezon City, on July 6.Lawyer Jesus de la Paz toldthe Inquirer that the area where the twosecurity guards were caught smoking wasnot covered by Republic Act (RA) No. 9211or the Tobacco Regulation Act of 2003. Hewas further quoted as saying, “We alsocontest the authority of the MMDA to collectfees and impose punishment on supposedviolators.” In several interviews, de la Pazwas also quoted to exclaim that the smokingban of MMDA is unconstitutional.On August 2, a group of lawyerssupportive of the MMDA ban questioned de44 HEALTHbeat I November - December 2011

la Paz’s motives for going to court in a bidto halt the agency’s efforts. HealthJustice,a non-profit public health law thinktankthat has helped gain popularity forvarious tobacco control measures, issueda press release that claimed that one ofthe clients of de la Paz’s law firm (GonzalesBatiller David Leabres & Reyes) is PhilipMorris Manufacturing Inc., as listed on thecompany’s website. Eventually, ABS CBNnews report showed that Philip Morris wasalready removed from the list of clients.On August 15, Judge CarlosValenzuela of Branch 213 of theMandaluyong Regional Trial Court (RTC)issued the temporary restraining order(TRO) for 20 days ruling in favor of the twocomplainants. They were required to postthe P100,000 bond, which would coverthe claims of damages if the court’s finaldecision went in MMDA’s favor. The followingday, one of the complainants of the smokingban, identified as Antony Clemente, claimedin an interview with ABS-CBN News that hedid not pay for the required bond to file thecase. He said, “Hindi ko naman siya kayangbayaran kasi minimum wage lang namanako. Bale nagkakaugnayan lang d’yan,attorney lang ho. ‘Yung Philip Morris angnaaapektuhan kasi. Dahil sa pinapatupad napaghuhuli na ‘yan, syempre ‘yung negosyo,naaapektuhan.”The supposed admission sparkedan outrage among tobacco control advocates.Dr. Jaime Galvez Tan, former health secretary,expressed his dismay in a press statement,“The tobacco industry is obviously pullingout all stops to block laudable public healthmeasures like the MMDA’s enforcementcampaign Cases like these show how thetobacco industry belittles the competence ofmedical authorities in guarding the healthof our citizens. In planting a witness againstMMDA, they undermine the authority of thegovernment to take care of its people.”MMDA Chairman Francis Tolentinosaid, “The complainants were planted andtheir arrest by our environmental enforcerswas planned that’s why we can say that somebusinessmen were interested in this case.”The PMFTC, for its part, issued a statementdenying the allegations that the companywas behind the complaint. Meanwhile,the petitioners’ lawyer dismissed the newsinterview of Clemente as “unreliable,”claiming his client was misquoted.On August 19, tobacco farmersfrom La Union were reported to have helpedpay for the P100,000 bond required by thecourt. This signalled the start of a 20-dayTRO on the enforcement of the no-smokingpolicy on sidewalks and public thoroughfaresin Metro Manila.November - December 2011 I HEALTHbeat 45

After this temporary setback, theMMDA together with the local governmentunits still pursued the enforcement of itssmoking ban in areas covered by RepublicAct 9211 or the Tobacco Regulation Act of2003.Meanwhile, the Departmentof Health issued a press statement thatsupported MMDA’s smokefree programand said, “In its pursuit of KalusuganPangkalahatan, the DOH stresses thatthe right of a smoker ceases when he or sheviolates the rights of others to protect theirown health.”For the first three months ofimplementation, the MMDA recorded atotal of 8,772 smokers apprehended. InSeptember, Tolentino was awarded by thePhilippine Medical Association the title asa champion in his efforts in promoting andpursuing a Smokefree Metro Manila.But the story does not end there.The tobacco industry does not get tired ofputting a popular man and his steadfastanti-smoking efforts down. On October 25,a writ of preliminary injunction was issuedby Mandaluyong RTC by the same judge,Valenzuela, ordering MMDA to refrain fromapprehending violators of the RA 9211 inplaces not within the law’s coverage. The lawalso requires the establishment of smokingareas in places not covered by the absoluteprohibition. This is bad news for the majorityof the population who do not smoke butare exposing themselves to the hazards ofsecondhand smoke.Just to comply with the law,MMDA placed cigarette bins along majorthoroughfares where smokers can smokeand throw away their cigarette butts.Tolentino said they would take the RTCinjunction to the Court of Appeals. And thewheels of justice still grind for MMDA as wellas for several anti-tobacco advocates whoare supporting the Authority.46 HEALTHbeat I November - December 20111 RH Bill CircusIn the seemingly never-endingdiscussions and debates whether or notthe Reproductive Health (RH) Bill should bepassed in Congress, the side shows becamemore entertaining than the main feature,making it HEALTHbeat’s Top Health News of2011. Many stood and are still standing forwhat they truly believe in on the controversialissue, while many others are in the issue justfor the pleasure of grandstanding.Interesting news items on RH Billwere in abundance this year that putting itall here would require supplement pages. So,we picked a few that really tickled people’simagination, if not caused more confusion.First off is the barangay ordinancein the posh community of Ayala Alabangthat took effect on February 24 which seeks,among others, to penalize the sale andpurchase of “anti-conceptional substance ordevices." Suddenly, condoms, pills and otherartificial family planning methods becameprescription drugs and health devices.This is the community whereformer Health Secretary Esperanza Cabraland international singer/actress Lea Salongareside, and expectedly they were up in armswith the ordinance. But sadly, people livingin that posh village are not all rich andfamous who can have as many children asthey want. Many of those affected are lowincome residents who live outside the wallsof the village. Their access to health servicesbecame much more limited. They have to getthem from nearby communities.According to news reports, thecommunity council passed the ordinancebecause they wanted to be proactive in theirpro-life stance. Their parish, St. James theGreat Parish, is very active in fighting thepassing of the RH Bill.Next came World Boxing Championand Saranggani Representative MannyPacquiao dwelling on the issue and receivingflak from Senator Miriam Santiago.On May 14, fresh from hissuccessful title defense against ShaneMosley in Las Vegas, Pacquiao told radiodzMM that corruption is a bigger problemthan overpopulation. He said that hisopposition to the RH bill was based on hisown decision and, more importantly, on hisreligious beliefs.He said, “Hindi naman ako pwedemag pro-RH dahil madasalin akong tao. Maytakot ako sa Panginoon. Ang boss ko kasi angPanginoon. Ayokong labagin ang kautusan ngPanginoon.” He was further quoted as saying,“God said, ‘Go out and multiply.’ He did notsay, just have two or three kids.”That was the cue for the feistySenator Miriam Santiago, a sponsor of theRH bill, to give an unsolicited advice forPacquiao to not meddle in the contentiousdebate. She also criticized his use of thebiblical quote. Santiago said, “The Bible doesnot say, ‘Go out to the world.’ It sounds verymuch like God is encouraging us to go outand copulate in public. God said in the Bible,‘Go forth and multiply.’ That meant that Godwanted man, not necessarily to literallymultiply, but to go out to work with the restof the human beings of this planet and toapply the stewardship theory. Meaning tosay, taking care of each other, who are all inthe planet living together.”Santiago also said that there is an“element of hypocrisy” in Pacquio’s stand.“Pacquiao’s wife was quoted as sayingthat she uses the pill, while Pacquiao was

quoted as saying that he applies discipline tospace his children. In that case, apparently,Pacquiao would have to use violence on hiswife because she is not living in conformitywith his beliefs,” she said.This made “PacMom,” MommyDionesia, coming out “ready to rumble” in herson’s defense. She said, “Huwag ang anakko ang pakialaman n’yo... Yung malaswa,yung malaswa!” She also said her son hasa right to express his opposition to the bill.She added, “Ano tingin nila kay Manny, tautauhan?Di ba congressman s’ya?”And on the issue that JinkeePacquiao, Pacman’s wife, using contraceptivepills, Mommy Dionesia exclaimed, “Noon pagumagamit si Jinkee, noong bago palang silamag-asawa. Pero ngayon, wala na.”Well as for Sen. Santiago, “I’mspeechless. That’s my only comment. That’s asilly topic... maghanap na lang tayo ng ibangkalaban.”Speechless may have also beenthe predicament of Senator Manuelito“Lito” Lapid in September who was findingit difficult to join the RH bill debates inthe Senate because of his poor Englishand ultimately because of his supposedlyinadequate education.In Philippine Daily Inquirer report,Lapid said that his colleagues are lawyerswho spent 10 years in law school whilehe spent 10 years practicing his actionstunts. Lapid, a stunt man-turned-actorturnedpolitician, added much as he wantsto interpellate, his tongue is not used toEnglish.His statements went viral on theInternet, with netizens giving reactionsthat range from sheer amusement to utterdisappointment. Somehow, the RH billissue has branched out to the issue of thequalifications of elected legislators whowould vote for its enactment into law.Finally, Lapid had his time toquestion only Senator Pia Cayetano, one ofthe two sponsors of the bill, because Sen.Santiago was not present. Lapid, who hasno position yet on the RH issue, wanted toclarify whether contraceptives cause birthdefects in children. Inquirer quoted him assaying, “I have observed babies, especiallyin the provinces, who are born with club feetor a harelip. Do drugs cause that? Or whatabout those with [Down’s Syndrome]? Couldthat not be prevented? What causes that?Don’t the drugs a mother takes cause that?”The RH Bill has been the mostdivisive issue facing the country today.President Benigno S. Aquino III has madePhotos and artworks taken from the Internet.November - December 2011 I HEALTHbeat 47

it as his administration’s priority bill andthe Catholic Church has been vigilant inopposing its passage. Legislators are pittedagainst each other in the debates, and themedia is having a grand fiesta in reportingevery angle of the arguments. In fact, TVnetworks have produced their own RH billdebates in the mask of public affairs specials.The social divide has also been mirroredmany times over on Facebook and Twitter.For the Department of Health,there is the strong link between reproductivehealth and maternal health. On October 14,during the Association of Southeast AsianNations (ASEAN) Human Rights Conferenceon Promoting Maternal Health: Respondingto the United Nations MillenniumDevelopment Goal 5, Health SecretaryEnrique T. Ona said, “Health is a right that’swhy it is important that each and every oneof us has access to adequate health servicesand these include information and serviceson reproductive health.”He is also hopeful that thelegislative measure on reproductivehealth and responsible parenthood will bepassed into law to provide mothers accessto reproductive health information andservices, as cited numerous studies that showhow mistimed and unplanned pregnanciesput women at risk for maternal deaths. “Thedeath of mothers during childbirth - the actwhich breathes new life into this world – istotally unacceptable,” Ona added.The year of the “reproductive”rabbit is said to bring peace and tranquility,but for HEALTHbeat’s No. 1 health news of2011, the RH Bill is still an ongoing circus anddebates may still not end any time soon.(-: Health news beyond November 15, 2011 is not included in this countdown :-)FACEbeatPARAKtice Makes PerfectPhoto grabbed from a Facebook post.48 HEALTHbeat I November - December 2011

TEST resultsAnswers to “Quotes of the Year” on Page 31. c) Manny Pacquiao. Yes, the world boxing champion quoted this supposed Biblicalverse, “Go out and multiply,” to express his views on the Reproductive Health (RH) Bill. Butthe witty Senator Miriam Santiago’s quotation seems more fitting when she said, “TheBible does not say, ‘Go out to the world.’ It sounds very much like God is encouraging usto go out and copulate in public. God said in the Bible, ‘Go forth and multiply.’ That meantthat God wanted man, not necessarily to literally multiply, but to go out to work with therest of the human beings of this planet and to apply the stewardship theory. Meaningto say, taking care of each other, who are all in the planet living together.’ (See “RH BillCircus” on page 46.)2. a) Michael Tan (Anthropologist). In his column “Pinoy Kasi” on September 8 in thePhilippine Daily Inquirer, Tan explained, “The suicide rate in the Philippines is relativelylow compared to other countries’. This is explained by the fact that the country has aCatholic majority population. Although most major religions look negatively at suicide,the Catholic Church tends to be the most judgmental, with threats of eternal damnationand some Catholic priests refusing a church burial.” (See “Woeful Suicide on page 37.)3. b) Father Robert Reyes. The running priest and staunch supporter of SmokefreePhilippines spearheaded by the Philippine Medical Association criticized superstar NoraAunor for the bad image she was conveying in her photo on the cover of Yes! magazine.He gave a very strong statement saying, “Nora, you are ill-advised. You think you aremoving forward, it’s a step backwards... The Filipino reading public is not dumb... If youwant to be popular again, be wholesome. Gusto n’yo ba gayahin ka namin? Ang trabahon’yo is to inspire us, not to scandalize us.” (See “Smokin’ Superstars” on page 34.)4. a) Dr. Rustico Jimenez (Private Hospital Association of the Philippines orPHAP President). Effective September 1, the DOH and PhilHealth implemented thecase rates scheme for in-patient treatment of 22 common medical and surgical conditionswhich will be paid directly to both government and private hospitals and clinics. Up inarms with this new scheme, PHAP warned that patients’ bills would go up. They also havethreatened to remove themselves from the list of PhilHealth-accredited hospitals. In anABS CBN news report, Jimenez said, “Ang dengue, tests pa lang ubos na ang P8,000. Paanopa yung professional fees ng mga duktor? Ang tatamaan nito yung ordinaryong tao.” TheDOH and PhilHealth maintained their position saying that they have to put a ceiling onpayments to protect the funds of members and ensure hospitals do not overcharge. (See“PhilHealth’s Schemes and Things” on page 38.)5. b) Dr. Leah Paquiz (“Ang Nars” Founding President). The ABS CBN “Bandila” newsreport in December 2010 on the sad plight of nurses having made to pay between P5,000to as much as P10,000 for their certification in the course of their “training period” or“work experience” with a hospital, which may last from 6 weeks to 8 months sparkedcontroversy, Congress investigations, and implementation of new programs for nurses thisyear. Paquiz revealed, “Nag-o-on-the-job training volunteerism, sila pa ang nagbabayad,tapos ‘yung certificate, hindi naman po siya qualified maging employment certificate.” Shealso said more than 500,000 nurses in the country are either jobless or underemployed.(See “Plight of the ‘Nightingales’” on page 39.)6. a) Complainant Antony Clemente. Barely a week after the Metropolitan ManilaDevelopment Authority (MMDA) fully implemented its smoking ban in Metro Manilapublic places in July, Chris Nelson (managing director of the Philip Moris FortuneTobacco Corporation) was ready to take action against the new policy and was quotedin newspapers as saying, ‘It may not even be us, it could be a smoker who may takeaction.” And like a Nicodemus prophesy, two smokers (Antony Clemente and VrianneLamsen) caught smoking in public had taken MMDA to court. A Mandaluyong judgeissued a 20-day temporary restraining order in favor of the two complainant but theywere required to post the P100,000 bond, which would cover the claims of damages ifthe court’s final decision went in MMDA’s favor. This is when Clemente claimed in aninterview with ABS-CBN News that he did not pay for the required bond to file the case.He said, “Hindi ko naman siya kayang bayaran kasi minimum wage lang naman ako. Balenagkakaugnayan lang d’yan, attorney lang ho. ‘Yung Philip Morris ang naaapektuhan kasi.Dahil sa pinapatupad na paghuhuli na ‘yan, syempre ‘yung negosyo, naaapektuhan.” (See“Smokefree Metro Manila on page 44.)7. b) Health Secretary Enrique T. Ona. He said that lost productivity and high healthcare costs of catastrophic outcomes resulting from non-communicable diseases (NCDs)can certainly drive any family into impoverishment and poverty. He added, “You can justimagine how this will impact to those who are already very poor to begin with. Sadly,this is always the story when it comes to NCDs. As a clinician, I’ve seen this so many timesin my practice.” He stressed that the Department of Health’s health reform agenda isdirected towards improving access of the poor to quality health care that includes placingup-to-date diagnostic equipment that will allow health facilities to respond to themanagement of NCDs. Likewise, the DOH Complete Treatment Pack will make a numberof maintenance medications for hypertension and diabetes more accessible for the poor.(See "Global Concern for Non-Communicable Diseases" on page 42.)8.c) MMDA. "Clean Habit, Clean Air, Clean City" is the tagline used by MMDA to pushfor its health and environment programs, particularly the 100% Smokefree Metro Manilacampaign. Despite the odds the campaign is getting particularly from the tobaccoindustry, MMDA Chairman Francis N. Tolentino said, “Everyone deserves to breatheclean air. The MMDA, with its mandate to uphold public health and anti-pollution, iscommitted in its efforts to minimize the deadly effects of smoking. We have done so, andshall continue to do so, in accordance with the parameters set by the law,” (See "MMDAChairman Francis N. Tolentino - Health Champion" on page 25.)9. c) 2011 State of the World Population Report. Today, the Philippines is the 12thmost populous country in the world with about 94 million people, and the United NationsPopulation Fund (UNFPA) Representative to the Philippines Ugochi Daniels said thatFilipino women belonging to the poorest quantile have an average of six children, whichis two more than what they really want. This happens because women in the lowesteconomic strata lack access to reproductive health information and services. (See "The 7Billionth Baby" on page 6.)10. a) Dionesia Pacquiao. This is the culmination of our quotes of the year when inMay, “PacMom” came out all “ready to rumble” in defense of the criticisms her son, MannyPacquiao, received for expressing his opposition to the RH Bill, primarily from SenatorMiriam Santiago. Mommy Dionesia said, “Huwag ang anak ko ang pakialaman n’yo...Yung malaswa, yung malaswa!” She added, “Ano tingin nila kay Manny, tau-tauhan? Di bacongressman s’ya?” Well as for Sen. Santiago, “I’m speechless. That’s my only comment.That’s a silly topic... maghanap na lang tayo ng ibang kalaban.” (See “RH Bill Circus” onpage 46.)What Your Scores Mean10 You don’t need this magazine. Give it to someone and read something else!7 - 9 Aha, you’re getting new information. After reading this magazine, pass it to a friend so that our readership may increase too.4 - 6 Keep this magazine as a reference. You might need to browse and read it again.1 - 3 You have to be more concerned about health. Start now by reading this magazine from cover to cover. Don’t miss the inside pages, okay?0 What have you been doing lately? How about getting some English Reading and Comprehension classes?November - December 2011 I HEALTHbeat 49

SAbeatYABYU...FeelingMANNY: Isang feeling lang ang gusto ko...MARIVIC: Ang alin? Ang ma-in love?MANNY: Hindi. Ang maka-feeling ka.Next GirlFRANCIS: Tandaan mo, darating ang arawna may ibang babae akongmamahalin din.LUZ: (Napaluha) Ouch! Eh, di bahala ka!FRANCIS: The next girl I’ll ever love will beour daughter.Di HayopJUN:JEAN:Shut Up!JOJO:ROSE:JOJO:ROSE:JOJO:ROSE:JOJO:Hindi tayo hayop... Bagay tayo.Luma na yan. ‘Eto ang bago...Bagay na dapat tayo. Hayop kalang talaga!Miss, mahal kita...Shut up!Miss, I love you...Shut up!Miss, ang ganda mo!Really?!?Shut up!O, IlawMARVIN: ‘Nay, sabi ng titser ko ang ina ayIlaw ng Tahanan. Eh, ano namanpo ang tawag sa ama?LEVY: (Aburido) Sabihin mo sa titser mo,ang ama ang taga-pundi ngilaw!!!NaglolokoRICARDO: Luv, sorry hindi kita nasagotkagabi. Namatay kasi ang phoneko, eh. Nagloloko kasi eh.JOSIE: ‘Di ba nagloloko ka din?!?Bakit ‘di ka namamatay?PagtatapatPONS:LORIE:PONS:LORIE:Honey nakukunsyensya na ako.Dapat ay noon ko pa sanangipinagtapat ito sa iyo.Honey, kung anuman ‘yon ayokay lang sa akin. Mahal namankasi kita, eh.Alam mo, kapag nagse-sex tayo,iba ang pinapantasya kong babae.Ah, ganon ba?!? Eh, ikaw namanang nasa isip ko kapag ka-sex koang ibang lalaki!LasingJOEREM: Pare, sobra ang kalasingan kokagabi, naibenta ko ang Misis konang hindi ko alam.MEL: Mas sobra ang kalasingan ko pare.Hindi man lang ako nakatawad!Pulis at KriminalDONATO: Ang mga babae ay parang PULIS.Kahit hawak na nila lahat ngebidensya sa mundo, gusto pa rinnila na aminin mo ang totoo.ANGIE: Ang mga lalaki ay parangKRIMINAL. Kahit hawak mo nalahat ng ebidensya, ide-deny parin ang katotohanan!SuotBOY: Ayoko ng suot mong damit.Sobrang iksi.AILEEN: Okay. Sorry.BOY: Sa susunod, mahabang mahabana ang isuot mo. Do youunderstand?!?AILEEN: Madre ba ako?!?BOY: Tapos magsuot ka ng belo.AILEEN: Hindi ka nakakatawa!BOY: Tapos susuotan kita ng singsing.50 HEALTHbeat I November - December 2011Catch Healthbeat Onlinehttp://www.doh.gov.ph/healthbeat