AIDS Candlelight Memorial held
The country's AIDS warriors released doves and balloons, lit candles, and said a prayer to close the Philippine observance of the 22nd International AIDS Candlelight Memorial on May 13 to 15. Organized by the Philippine National AIDS Council (PNAC), the memorial was held in memory of the hundreds of thousands who have died of HIV/AIDS, to express support for people living with HIV/AIDS, raise public consciousness about the disease, and combat the stigma associated with it.
Began in 1983 in San Francisco and New York, the memorial has become a way for more than 4,500 communities in 93 countries (including the Philippines) to take action by publicly mourning for the loved ones they had lost to AIDS.
In the Philippines, the three-day candlelight memorial focused on youth-oriented activities, said Dr. Dominic Garcia, AIDS Society of the Philippines program manager. Among these were storytelling and art lessons for indigent children held at the Don Bosco Youth Center with the theme Empowering Children on HIV/AIDS through Arts and poster-design workshop for college students held at the St. Scholastica's College with the theme Youth for AIDS Artwork.
Globally, around 42 million people live with HIV/AIDS. The Department of Health's National Epidemiology Center reports that in the Philippines, 2,250 cases of HIV/AIDS have been recorded since 1984. Garcia noted that the figure may be low, but he said changing sexual practices, especially among the youth, are fueling fears of the spread of AIDS in the country. He cited results of the Young Adult Fertility and Sexuality Study, which showed that 57 percent of the first sexual experience of the youth were unplanned, unwanted, or unprotected.
Added Garcia, an internist and infectious-disease specialist: "There may be few cases of AIDS in our country today. But considering how government addresses this problem, it will boom in years. Sadly, [many] of our doctors hardly know how to handle AIDS cases." He said condom use must be promoted by making condoms accessible and cheap.
Bobby Ruiz, who has been battling HIV for 14 years, encouraged other people living with HIV/AIDS to go on living normal lives and not allow themselves to have a "dying attitude." "Filipinos living with HIV/AIDS [can] still be productive and contribute to the progress of our country. Our government should look at them as part of the workforce and address their social and skills development," said Ruiz, who now works for Positive Action Foundation Philippines.
Arnel Mendoza
50% cut in TB, malaria, AIDS cases
The Philippine Partnership to Fight TB, Malaria, and AIDS wants to halve the morbidity and mortality rates for these three diseases by 2015. The group made known its mission at a forum it organized on June 4 in conjunction with the 24th International Congress of Chemotherapy at the Philippine International Convention Center.
Led by the Department of Health, the partnership brings together various groups involved in programs to fight tuberculosis, malaria, and AIDS, among them the Philippine Coalition Against Tuberculosis (PHILCAT), Philippine National AIDS Council, Philippine Business for Social Progress, and Kilusan Ligtas Malaria.
It was established to enable the country to tap much-needed financing available through the Global Fund to Fight AIDS, Tuberculosis, and Malaria, a global initiative spearheaded by the World Health Organization to raise money for the campaign against the three infectious diseases.
The Tropical Disease Foundation (TDFI) headed by Dr. Thelma Tupasi has already received assistance from the Global Fund. As the country coordinating mechanism of the Global Fund in the Philippines, TDFI has been instrumental in setting up 28 public-private mix DOTS (PPMD) units nationwide. DOTS or directly observed therapy (short course) is a treatment strategy for TB in which a health worker, CAREgiver, or relative of TB patient supervises the patient to make sure that medicines are taken as prescribed.
"Through PPMD, we are eyeing a TB detection rate of 85 percent by 2007, up from 53 percent in 2004," said Tupasi.
The National Tuberculosis Control Program (NTP) started putting up PPMDs in 2003 to improve case detection and harmonize the management of TB by health-CARE providers involved in the program. Both public- and private-initiated PPMD units operate in a DOTS facility under NTP-approved operational policies, standards, and technical guidelines.
However, while the DOTS coverage is nearly in full force in the public sector, the global and national target of 70-percent detection rate "cannot be attained without involving the private sector," Tupasi stressed.
Ms. Amelia Sarmiento of PHILCAT noted that the Philippines has a large private health sector widely utilized even by those in the lower-income brackets that needs to be involved in the campaign against TB.
Other panelists in the forum were WHO representative to the Philippines Jean-Marc Olivé, Health secretary Francisco Duque III, Global Fund representative Stephane Rousseau, and Dr. Jean-Claude Pechère, International Society of Chemotherapy president.
Arnel Mendoza
Holistic CARE for cardiac patients
An integrated multidisciplinary approach to cardiac rehabilitation was the focus of the ninth Asia-Pacific Congress on Cardiac Rehabilitation held on June 9 to 10 under the auspices of the Asian Pacific Society of Cardiology (APSC). The congress, attended by APSC members from such countries as India, Malaysia, Nepal, Japan, Indonesia, Singapore, Thailand, and the Philippines, carried the theme Cardiac Rehabilitation: Towards an Integrated Cardiovascular CARE.
The scientific sessions tackled cardiac-rehabilitation (CARE) guidelines and practices in various countries in the region and ways to integrate them with daily practice.
Dr. Annette Borromeo, secretary-treasurer of the APSC said that the goal of a cardiac-rehabilitation program is to bring back a cardiac patient's health to the optimum.
While noting that CARE programs are available in upscale hospitals like St. Luke's Medical Center, The Medical City, Makati Medical Center, and the Philippine Heart Center, Borromeo said these may not be sufficient to meet the demands of an ever-iNCReasing CVD prevalence in the country.
The World Health Organization recommends that cardiac rehabilitation be made available to all cardiac patients. But the rising cost of health CARE makes this difficult, although Borromeo said it is cheaper in the long run than having to suffer a heart attack or stroke that may require surgical intervention. Moreover, "it helps bring back the patient to near normal conditions," she added.
Dr. Rene Librojo said that there is no ideal model yet for a cardiac-rehabilitation program as there are "cultural differences, diversity of patients, and limits to available resources. "A program should match the place where the facility will be set up," he pointed out, adding that it must have the important components required for comprehensive cardiac rehabilitation.
Other topics discussed in the congress were "globesity;" diabetes mellitus; the psychosocial aspects of CARE; and cardiac rehabilitation in patients with valvular heart disease, arrythmia, peripheral vascular disease, and pulmonary diseases.
The congress was the collaborative effort of the Philippine Heart Association, Cardiac Rehabilitation Society of the Philippines, and Philippine Association of Cardiac and Pulmonary Rehabilitation.
A. Mendoza
NCR midwives hold regional meet
Changing Focus in Changing Times was this year's theme of the ninth regional convention of the Integrated Midwives Association of the Philippines (IMAP)-National Capital Region Confederation of Midwives held on May 7 at the Armed Forces of the Philippines Medical Center auditorium.
The speakers were Josephine Hipolito of the Professional Regulatory Commission who discussed proposed revisions to the Philippine Midwifery Law (RA 7392); Josefina Tuazon, dean of the College of Nursing of the University of the Philippines-Philippine General Hospital, who talked about the overseas migration of nurses and midwives; and Dr. Alejandro San Pedro, private-practice director of PRISM for Family Planning, who proposed ways of increasing private-sector participation in family planning.
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Hipolito said that the proposed amendments to the midwifery law aim to enhance the standards of the profession by raising the passing rate in licensure examinations and expanding the functions of midwives. One of the proposals is to increase the minimum passing rate for any subject from 50 percent to 60 percent while retaining the general rating of 75 percent. The proposed amendments will also allow midwives to perform such functions as dispensing of oral and parenteral oxytoxic drugs, injection of vitamin K, newborn screening, and basic life saving.
In an interview, IMAP president Patricia Gomez said midwives are now involved in carrying out 34 programs of the DOH, and more hospitals are employing midwives to replace nurses migrating to other countries. "We provide health-CARE services beyond the call of our profession. Yet, midwives are probably the least paid health professionals in our country," she said. She added that IMAP is eyeing the possibility of turning midwifery into a four-year degree course to address these issues. But the more pressing need is giving midwives decent salaries to "mend their hurting souls," she said.
San Pedro said that the "admiring" role midwives play in family-planning counseling and information dissemination in barangay health centers should be extended to private practice, particularly in maternity hospitals and lying-in clinics.
Tuazon, meanwhile, advised midwives and other health workers seeking jobs overseas to take into account issues other than high pay. "Surely, working in other countries will give you compensation you'd hardly achieve in the Philippines. But is that everything you mean by quality of life?" she asked. Tuazon said those seeking work abroad should be ready to face the prospects of "discrimination and being second-class citizens, work-related violence, and being away from their loved ones."
A. Mendoza
AMHOP holds 52nd convention
The fight against the medical-malpractice bill is over," said Dr. Bu Castro, former president of the Philippine Medical Association (PMA), during the annual convention of the Association of Municipal Health Officers of the Philippines (AMHOP). However, he warned about another "threat" to the medical profession--the filing of another version of the patients'-rights bill.
Held at the Olongapo City Convention Center in March, the AMHOP convention had for its slogan
Kaya Tamo 'Ti!, which is Zambal for "We Can Do It!" Castro delivered a lecture entitled "The Looming Doctors' Crisis."
Castro stressed that their opposition to the patient's-rights bill does not mean they do not "love" their patients. The reason they do not approve of the new version, he said, is that certain provisions from the old malpractice bill--the one filed by then-representative Ted Failon, which had been heavily criticized--were "inserted" into the new version.
A patients'-rights bill, he said, should not contain provisions that tell doctors, "If you don't do this, you'll be imprisoned." "But if they start inserting those medical-malpractice provisions,
hindi na puwede yan, sabi namin," he said. "Dahil iyan ay isang distorted patients'-rights bill." He gave an example of one way the provisions in the bill could be "distorted": "Pag hindi mo sinabi sa pasyente, halimbawa, na ang ineksyon na ito ay medyo masakit ng konti…puwede kang makulong."
"Threat to national security"
This, he said, is just one of the challenges the profession is facing. Another one--something Castro said that President Gloria Macapagal-Arroyo had called a "threat to national security"--is the growing number of doctors taking up nursing. He estimated that 50 percent of doctors taking up nursing are government doctors, of whom 40 percent practice in the rural areas. Obviously, the first to feel the loss are people in the rural areas.
In the search for solutions to this problem, certain groups, he said, push for a "change in values." However, he said that those who make this recommendation are Manila-based doctors who have lucrative practices. He also slammed the media for making many doctors want to leave the country, saying that the media are easy to call the slightest complaint made by patients as malpractice.
He said: "For the first time, PMA is looking beyond PMA; for the first time…looking at the problem of rural doctors," those whom he said aren't even PMA members "dahil nga walang maibayad na membership
sa PMA."
Aside from the session on the migration of health workers, the three-day event also featured lectures on tuberculosis chemotherapy, pharmacoeconomics, contraceptives, and counterfeit medicines.
Front-liners
Dr. Raul Echipare, AMHOP vice president for Luzon and chair of the organizing committee, said that in the past 52 years of AMHOP, they have been "the front-line doctors managing the health system." The municipal health officers, he said, are always the first to attend to the health needs of the people in the community.
He said that one of the reasons they chose "Kaya Tamo 'Ti!" as the slogan--and "Sustaining Quality Public-Health CARE in the Midst of Crisis" as the theme--of their convention and 52nd anniversary celebration is that doctors are exposed to many problems, but are working hard to overcome them. "In spite of [the] crisis … we are continuing our job," Echipare said. "Committed
kasi kami sa trabaho namin."
The AMHOP, he said, is actively implementing a number of crucial projects in the community. One of these is "Operation Family Nutrition," which focuses on maternal and child health. They also conduct regular screening--and treatment, if necessary--for diabetes, which is always complemented with advice on healthy lifestyle. They also have projects to promote mental health, asthma management, and the use of quality generic drugs. Many of these are done in partnership with pharmaceutical companies and various community-based organizations.
The AMHOP has chapters in practically all regions in the country, with about 1,200 members. Its current president is Dr. Guia Abad, municipal health officer of Santa Cruz, Laguna.
J.P. de Guzman
Pharmacovigilance meet in Manila
Pharmacovigilance--A Global Concern: East Meets West will be the theme of the fifth annual meeting of the International Society of Pharmacovigilance (ISOP) on October 17 to 19 in Manila.
Dr. Kenneth Hartigan-Go, chair of the ISOP 2005 Manila, says that the ISOP forum, the first to be held in this part of the world, will address drug safety and rational drug use, issues that have iNCReasingly become more important in the context of therapeutics.
Drug safety is a global concern, he said. "The universal use of medicines for common diseases has spawned unwanted problems, many of them serious enough to cause deaths, in countries all over the world. By raising the drug-safety standards such problems can be prevented and patient CARE significantly improved."
Among the speakers in the plenary sessions are Prof. Klaus Kummerer (Germany) on "EcoPharmacology: an old concept revisited," Dr. David Henry (Australia) on "Quantifying alerts: the burden of ADRs to the individual and to the society," former president Fidel Ramos (Philippines) on "Pharmacopolitics: from raw data to signal intelligence," and Dr. Saad Shakir (United Kingdom) on "Risk Management and taking actions."
Interested individuals may get in touch with the conference secretariat (+63-2-5512748, psecp@vasia.com).
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