Testing The Waters

During our 2008 list of Morbidities and mortalities, we were able to identify Diarrhea as one of the top 10 leading causes of morbidity in the municipality. In fact, during the 3rd and 4th quarter of 2008, our community surveillance had noted a steady increase in cases of diarrhea. I had to release a memo instructing all of my health care workers especially in the field to report weekly cases of diarrhea within their catchment areas. Through this surveillance, we were able to map out "hot zones" of diarrhea. Some of the patients who were able to afford a laboratory exam were reported to have amebiasis. We immediately launched a campaign promoting the boiling of water and the early mitigation to avoid complications of diarrhea such as dehydration and eventually death (such as the early intake of ORESOL or Hydrite and early consultation). We were able to contain our diarrhea cases and so far, we only had 1 death last year due to severe dehydration secondary to acute gastroenteritis. For 2009, we planned to test our water supplies in Candoni, to check whether our water supplies in all barangays are contaminated and still safe for drinking.

During the first half of 2009, we were able to have few diarrhea cases, mostly mild, and without dehydration. A week prior to the month of June, we were finally able to conduct water testing in our water supplies. Our rural sanitary inspector and our team in the field were able to start testing the water supplies in our farthest barangays. By the end of June, they would be able to finish testing the water supplies in the Poblacion Area. So far, about 70 to 80% of all water supplies tested came positive for E.coli.

Last week, I already informed the Acting Mayor about this predicament and I told him that once all water supplies are tested, we will be sending a report to the Office of the Mayor for proper action. Currently, the municipality is investing on establishing a water system within the area, considering that despite the abundance of springs and watersheds, Candoni does not have a water system. This morning, I heard from the radio that the municipality is currently processing a grant worth 12 million pesos from a German bank which will be used to set up the water system for the community.

So far, I have yet to receive reports of deaths due to severe dehydration. My only problem with regards to this is the distance of some villages from the main health center. There are still houses situated far from the Poblacion area, and the distance can contribute to the delay of seeking proper treatment.

The Main Health center is open 24 hours a day, 7 days a week and with an Observation Ward which we established since we arrived in Candoni, we were able to attend to dehydrated patients, giving them intravenous fluids whenever indicated and at least preventing further dehydration and possibly even death. The nearest hospital is 1 and 1/2 hours and with bad weather and terrain, travel time can extend even beyond 1 and 1/2 hours.

Another problem is the lack of supplies. The main health center at times would run out of IVF bottles and patients would often opt to buy IVF bottles from pharmacies outside of the health center. Indigent patients could not afford to buy so most often than not, poor patients would only opt for oral rehydration for lack of options.

Fortunately, we were able to identify this problem and having proposed such plans to purchase more medical supplies, including IVF bottles, the municipal development council has approved our proposal of half a million pesos for the purchase of much needed supplies and equipments in my main health center. By the end of June, we will be able to purchase some of these supplies and replenish our stocks.

Hopefully though, I hope that the main health center of Candoni can ensure the sustainability of the many projects we have initiated. Of course, this will depend on the support of the community and the municipal government.