Staying Up Late

I am currently staying up late tonight for at least two reasons: my parents are coming home later tonight and they needed me to open the gates for them and I am surfing the net for some lectures I will be sharing with my students in Family and Community Medicine tomorrow. Earlier this afternoon, I gave them a fictitious family profile which they have to study and analyze. The objective is, out of the given information, they have to identify the problems of the family, both medical and non-medical, prioritize these identified problems given the criteria provided, and make a family health plan for this fictitious family. The underlying objective here is to put into practice the lecture I gave them last semester, which was in fact my only lecture I was scheduled to give last semester, on situational analysis and community diagnosis. I wanted to start slow so instead of giving them a fictitious community to analyze, I gave them a family instead. It is much less complicated but at least it can help them prepare for a much bigger task later. Once they can get a grasp of how to do a simple problem identification, prioritization and health plan formulation, I will be sending them to their actual adopted community, pick out a family of their choice and do the same thing that they will be doing with their current fictional family.

Let me share with you what I gave them to study and analyze:

"Family Profile: Custodio Family

The Custodio Family is a typical Filipino family, living in the rural areas of La Carlota City, Negros Occidental. The father, Henrico, 51 years old, is the head of the family. His wife, Diana 46 years old, is a housewife and a mother of 5 children. Danilo, 15 years old, is an out of school youth and the eldest. Julie, 13 years old and is currently studying at a local elementary school, Grade 5. George, 10 years old, is also studying at the same local elementary school, Grade 2. Benedict, 5 years old, is attending day care center, together with his younger brother Rodel, 4 years old. Except for the youngest, all of her children were born at home. Rodel was born at the hospital because Diana was suffering from pre-eclampsia and had to be brough to the District Hospital.

Henrico and his wife live in a semi-concrete house, together with his own mother, Dianala, 78 years old. They have their own private toilet, simple pit latrine type. Their water source is an Artesian well, 25 meters away from their house. They would dispose their garbage by burning and recycling. Their next door neighbor is about 100 meters away. They reside in Sitio Uno, with a population of about 65 people and a population density of 1.4 per square hectare. Sitio Uno is about 5 kilometers away from the Poblacion area where the city hall, city health center and public market are located. It is accessible by tricycle. The regular fare for a tricycle is about 10 pesos per person. The family does not own its private transportation.

Their house is supplied with electricity, which they pay for at around 200 pesos/month. They have their own colored TV set and a radio. Neither of them has a cellphone. Their house is about 50 x 50 square meters in area, one storey. The yard is surrounded with green mango trees and a few coconut trees. They have a pet dog, not immunized against rabies.

Henrico works as a construction worker and is currently working on the construction of the town's new public market. The project started 3 months ago and is expected to be done within 1 year since construction began. Henrico is one of the carpenters and would receive a bi-monthly compensation based on his attendance at work. His compensation rate is 100/day and his shift works 5 days a week. Other than a construction job, Henrico has no other line of work. His eldest son, Danilo, also worked in the same construction site and started only a month ago. His rate is 60/day and his shift works 3 days a week.

Diana has no regular work. She would sometimes volunteer at the Barangay Health Center and would receive 100 pesos a month as her honorarium. She has been a barangay health worker for one year now. Her mother-in-law, Dianala, tends to the small children at home. Both Diana and Henrico finished only high school.

The family is deeply religious. Both Henrico and Diana are practicing Catholics. They also cling to superstitious beliefs.

Henrico is a known hypertensive, diagnosed at the Main Health Center 4 years ago and has been prescribed with medications to which he has poor compliance. The last time he has consulted at the Health Center was 3 weeks ago due to nape pain and numbness of the lower extremities. His BP was 160/100. He was prescribed with medications, of which until now he was not able to procure. Henrico nonetheless would resort to herbal medications sold by a popular albolario in their sitio. Henrico is a 20 pack-year smoker and occasional drinker.

Diana, on the other hand, had a miscarriage last 6 months ago. It was her 2nd miscarriage. Diana never had any D&C procedure done.

Henrico's family has a history of Diabetes; his father died due to a complication of Diabetes. Diana's family has a history of cancer; her mother died due to breast cancer. Her father died due to COPD.

Of her 5 children, Diana considers her only daughter Julie as the most sickly of all. Julie has frequented the Main Health Center for 5 times in a year due to productive cough and difficulty of breathing. Julie was once admitted last year at the District Hospital due to same symptoms. The diagnosis, according to Diana, was pneumonia. Other than the occasional cough and runny nose, there had been no significant illnesses on her other children. Benedict was previously admitted at the District Hospital due to Dengue fever when he was 3 years old. All of her children were fully immunized at the main health center.

Dianala, Henrico's mother, had been suffering from a chronic cough for almost 3 weeks and has never consulted a doctor or midwife in the rural health center. She has self-medicated with Dextromethorphan tablets and Co-trimoxazole.

With the meager budget, the family was asked about their priorities. They ranked the following:

1. Food
2. Education
3. Home Needs
4. Health
5. Recreational Activities and Things


Much of their budget is spent accordingly:

1. Food – 40%
2. Education – 25%
3. Home Needs – 25%
4. Health – 5%
5. Recreational Activities and Things – 5%

To fill in the gaps in their budget, Diana would sometimes loan from neighbors and/or relatives."