The Freudian Slip Of A Bacolodnon

I have always dreamed of becoming a doctor. The doctor is after all perceived as somebody smart, an expert in the field of medicine, a successful professional whose noble duty makes him separate from the crowd. He is the guy in immaculate white coat, strolling along the halls of the hospital, where he finds out what makes people sick and tells them the solution to their sickness. His every word is gospel truth for he is seen by his patients as somebody who knows everything. Of course, a doctor is expected to know a lot of things. After all, he has spent at least 10 years of his life reading column after column of books, not to mention consulting patients day in and day out. Of course he must learn how to diagnose and apply the appropriate treatment. That is why people seek the doctor's presence: to be cured of their illness. In the old English language, a Doctor means somebody who is "learned" or "smart", a "teacher", an intelligent almost philosopher-...

Due to the persistent floodwaters in the recently-storm-stricken Luzon, cases of Leptospirosis have been increasing in the areas. In fact, last October 16, DOH Secretary Francisco Duque declared an outbreak of leptospirosis in the barangays of Tumana, Malanday, and Concepcion I in Marikina, Metro Manila. As of October 17, the Department of Health has recorded a total of 1,665 leptospirosis cases and 104 deaths in 15 hospitals in Metro Manila. It is important therefore to know what is Leptospirosis and how one can get infected with this deadly disease. Leptospirosis is an infectious disease caused by a particular type of bacteria called a spirochete. Leptospirosis can be transmitted by many animals such as rats, skunks, opossums, raccoons, foxes, and other vermin. It is transmitted though contact with infected soil or water. The soil or water is contaminated with the waste products of an infected animal. People contract the disease by either ingesting contaminated food or water or by br...

While Doc Jen Coritico was describing the awardee of the Grand Distinction Award for the graduating Doctors to the Barrios for Batch 23, my heart was beating very fast. The description was very clear. She was actually describing the efforts we initiated in the municipality of Candoni. More specifically, she was actually describing the pet project I implemented in Candoni: The CHART, the Community Health Allies and Reform Team. The CHART came to be out of an inspiring experience during my first CME as a doctor to the barrios. During that first CME, we had a session on Primary Health Care. I was captured by the words enscribed in the Alma Ata Declaration: "The people have the right and duty to participate individually and collectively in the planning and implementation of their health care." I felt I discovered the missing link and the answer to the riddle of sustainability. As soon as I came back from that first CME, I immediately designed a module, gave out invitations to key...

The Candoni RHU opens 24 hours a day, 7 days a week. From 8 a.m. to 5 p.m., the Public Health staff would report to work. After 5 p.m., the Night Emergency Clinic staff will take charge. The NEC is supposed to cater to emergency cases however, there are times that some patients would even visit the NEC to see consultation, even have their BP's checked. Mostly, the NEC would serve only emergency cases such as: severe abdominal pains, trauma cases, loss of consciousness, difficulty breathing, etc. A typical "day" at the NEC would start with me asking one of the staff, usually my night utility staff, to buy me my dinner (which is usually inasal na manok and 1 cup of rice). If there are no patients, then I would join the night staff during dinner while watching the news. Sometimes, patients would start coming in at around 6:30 p.m.: skin abrasions, foreign body, etc. A few nights ago, I had to cater to a patient who had a metal rod sticking out the sole of his foot. He accide...

I received an email tonight asking HLMP fellows to send in questions to the Presidentiables regarding queries on their health agenda. I have decided to post some of my questions to them here in my blog. Any one of them can choose a question to answer. Maybe some of the readers of my blog has answers to these questions as well. 1) There are some who believe that the Devolution of Health has done more harm than good. What is your stand on the proposal of re-centralization of our health system? Why? 2) Until now, some LGUs have yet to fully implement the Magna Carta for Public Health Workers. As potential President, what can you do that will ensure that all LGUs will be able to implement the Magna Carta for Public health workers? 3) What is your stand on the Cheaper Medicines Act? 4) What is your stand on the present Reproductive Health Bill? Will your administration push for the implementation of Population Control through artificial means? 5) Currently, the Department of Health has a pr...

Last August 19, two doctors from the Department of Health, one coming from the Center for Health Development Region 6 and one from the Central Office - Health Human Resource and Development Bureau (HHRDB), visited me in my area, as part of the monitoring procedure conducted among the outgoing Doctors to the Barrios. My contract shall end on October 2009 and according to latest information (still to be confirmed though), the next CME (which is going to be my final CME) will be at Clark, Pampanga. I have never been to Clark and it is going to be my first time in Pampanga. I was hoping that the final CME will be in Bohol, because it is nearer and therefore more convenient to bring my "stuff" for the traditional gallery presentation. Anyway, the two doctors, one of whom is a former DTTB herself, met with my staff at around 5 pm already, since they had to drop by Lorenzo D. Zayco District Hospital to also monitor the N.A.R.S. volunteers currently assigned in the district hospital ...

Last August 11, as one of the pre-town anniversary celebration of the municipality, the Main Health Center conducted our Breastmilk Contest as our way of promoting our advocacy for breastfeeding. It was an exciting day, with around 24 lactating mothers coming to the Poblacion area carrying their babies together with other family members. Of course, an acceptable crowd came to watch and support their barangay. The mother with the most breastmilk collected in 10 minutes was declared winner and the barangay with the most accumulated breastmilk in 10 minutes was also awarded as winner. For this year, our mother who won the top prize was able to collect 185 ml of breast milk. She came from Barangay Payauan. The other runners-up came from Barangay Agboy and Barangay Caningay. The barangay with the most breastmilk accumulated was Barangay Payauan with around 265 ml of breastmilk collected. The othe runners-up were Barangay West and Barangay Agboy. Before the contest started, one of our midwiv...

Now I have enough energy to look back and reflect on the week that was. It was actually a hectic week for the Main health center. Not only that there were relatively many emergency cases this week, the week was actually PIR week. PIR is program implementation review and we conducted our PIR for the mid-year of 2009. I was too frustrated that it was more of data reconciliation rather than assessment and planning for our acceleration plan. I told my staff that we must be able to reach our target by the end of the year and that those who can reach their targets and even surpass the expected targets will be receiving performance bonuses on top of their other year-end bonuses. I do hope they can reach their targets and I do hope the community will really appreciate the value of the work of these frontliners. If not for these front-liners in public health, there will be no Strong Republic. It is so unfortunate though that these frontliners are the least appreciated. Health it would seem is n...

Yesterday was the culminating activity of our annual Nutrition Month Celebrations. I was the resource speaker of the Culminating Program. Despite the heavy rains, many students, teachers and barangay health workers still flocked to the Public Plaza to witness the simple culminating program. We were supposed to do another round of Hataw Exercise but because of the bad weather, we proceeded to the various contests instead. There was cooking contests involving all the high schools of the town. While the cookfest was going on, there was the Nutri-jingle contest. There was also a Nutrition Masscot Making contest. There was also a Nutri-speech Contest, sort of a declamation contest but with Nutrition as the theme. Meanwhile, at the Municipal Hall, the Poster Making contest and Slogan Making contest were held. At the Rescue Center, we held the Awarding of our Well-Baby Contest which was held last Friday and conducted our Nutri-quiz, participated by high school students from various barangays....

Survey on Sexual Attitudes Among Teenagers Link to powerpoint presentation on our recently conducted It Can Wait: No To PMS in Silay last week.

I read in the news this morning that the Philippines is among the countries worldwide that has the least number of AIDS/HIV cases because the Filipino society practices circumcision among males. Experts say, circumcision reduces transmission of HIV. It used to be a medical enigma why we practice circumcision. There was a time when its medical purpose was questioned and was solely referred to as a cultural practice (especially among Jews, Catholics, and even Muslims). Now, it is widely accepted that circumcision can prevent AIDS among males and females alike! So perhaps a circumcised penis should be one of the qualifications for a husband among the females! But how does the removal of the foreskin of the penis a "saving grace" against HIV? According to a website called About.Com, recent studies have proven conclusively that uncircumcised men are at a much greater risk of becoming infected with HIV than men who are circumcised. In some studies, infection rate was 50 percent les...

This morning, the ECCD team of the municipality went to Brgy. Gatuslao, a far-flung barangay of the municipality of Candoni, to conduct advocacy classes regarding early childhood care and development (ECCD). Participants of the ECCD advocacy class were purok presidents of various puroks and sitios of the barangay, including the barangay officials. Members of the ECCD team include the MSWD, DILG, MNAO and other department heads of the municipality. During my time to speak, I shared to them the many programs of the government which address the various health concerns of both the children and the parents particularly the mother. "But, these programs will not be successful if the community will not support them," I told them. I told them that the local government is doing its best to bring the programs closer to the front lines. It is up to the community to embrace it as their own and support it. My analogy was, " Daw parehus man na bala sang lamesa nga puno sang pagkaon. Na...

I am quite lucky considering that I have lots of volunteers working for free in my main health center. All of them are licensed nurses and are residents of Candoni. Three of them are deployed under the NARS program of the government, although one of them used to volunteer in the past in our main health center. Six of them are unpaid volunteers. I have a total of 9 volunteers so far. Plus, I have 2 casual nurses who are as young as the new volunteers. My staff therefore is a good mix of old and young. With this balance, it is a tough job how to ensure harmony between these seemingly two separate generations. Of course, being young as well, I know for a fact the enthusiasm and idealism of the youth. It is important therefore to tap this energy and pull them into doing the best that they can in their work in order for them to contribute significantly in our output as a team. The old ones of course are the very source of experience and wisdom. They have been doing this kind of work even be...

She wasn't the only kind of patient I would encounter in my clinics. This 18-year old pregnant girl went to the main health center yesterday to have her first ever pre-natal check up...for her third pregnancy! Her previous two pregnancies were delivered by a traditional birth attendant at home and she never had any history of prenatal check up. Her visit yesterday to my health center was her second prenatal visit already. When one of my midwives heard that there was this 18-year old girl who is pregnant and never had any prenatal check ups in her life, she immediately advised the girl to proceed to the main health center and start her prenatal check up. Her expected date is already this June 13, 2009. She is one of many in the countryside who get pregnant early either by choice or by "accident". She first got pregnant at the age of 15 years old. She is no longer studying and her supposed "husband" is in Bacolod working. According to her, her "husband" ...

There is miracle in a can of milk. This is what I have learned when I happened to answer a "trivial" add in a local paper. The person who posted the ad perhaps made it sure that such "trivial" add will catch anyone's attention. It did catch mine. It was an invitation, whether or not one would like to earn as much as 100,000 pesos a month. Who wouldn't? When I did answer the ad, I discovered that the advertiser was actually a businessman married to a Pediatrician based in Bacolod, both of whom have been into the Reliv International business for almost 2 and a half years now. In the span of 30 months time, they told me during our dinner meeting the week after we started communicating through phone, they have already earned a total of 4.5 million pesos. The doctor has a successful practice in Bacolod as a pediatrician and she is not the only doctor who is into the business. She introduced me to other doctors also who have been enjoying both the financial and he...