Election violence at PCP forum
Can election violence be explained by cultural, neurological, and genetic factors? With the elections just over and the violence toll exceeding usual expectations, the Philippine College of Physicians (PCP) tried to answer this question at its regular health forum carried out in cooperation with Zuellig Foundation. Three medical experts from top universities and medical associations discussed the roots and implications of election violence. According to psychiatrist Nina Jao, the principles of modeling and copying have a lot to say about the political killings. "People tend to copy behavior exhibited around them," she pointed out. Children raised in environments that demonstrate killings as a way of restoring honor are more likely to show traits of violence. This also happens to children who have been abused both physically and emotionally. Disorders also drive a person to react violently to his environment. For instance, antisocial personality disorder can be recognized by the disordered person's impulsive behavior, disregard for the rules, and indifference to the feelings and rights of others. Thus, people who suffer from this disorder are capable of doing unacceptable deeds without being threatened of the consequences that could befall them, Jao explained. Certain parts and systems of the brain are also blamed for violent behavior. As Dr. Encarnita Ampil put it, "human frontal lobes are far more developed than those found in animals. However, the lobes are connected to a part of the brain called the limbic system. These structures in the brain are responsible for our emotions." The frontal lobes play a vital part in impulse control, judgment, language production, problem solving, sexual behavior, socialization, and spontaneity. Together with the limbic system, a structure that influences the formation of emotions and memories, these can make a person behave violently, especially if he is exposed to a substandard living environment. However, certain parts of the brain are able to neutralize aggressive behavior. "Other parts of the brain are likewise highly developed to block these impulses. Violence cannot be solely attributed to the brain," explained Ampil. She pointed out that humans are capable of learning the behavior around them, and that this is a big factor to be considered in evaluating human behavior. "Thus, election violence may be the result of cultural and environmental differences," she said. For Dr. Cora De Ungria, head of the DNA laboratory at the University of the Philippines, a person deficient in monoamine oxidase (MAO) is more likely to exhibit violent behavior. She explained: "MAO is an important enzyme needed to break down serotonin, a transmitter of the brain. If a person is deficient in MAO, the buildup of serotonin will occur and could cause a person to act violently. But this would only happen if an outside force triggers a person to lose their temper and be enraged." However, De Ungria emphasized that this cannot be generalized, since the specificity of serotonin to violence and aggression still lacks proof. "Studies have shown that only a small number of people with violent behaviors possess a high level of serotonin. It's actually the way how we think that affects our behaviors." M Jill Jacela
"What we have is a health-care crisis," said Dr. Anthony Leachon, referring to the state of the country's health-care system and the "double burden" of disease that Filipinos face. Speaking in one of the plenary sessions at the 37th annual convention of the Philippine College of Physicians (PCP) in May, Leachon said his "final diagnosis" is based on the "vital signs" of an ailing health-care system and population. He cited a health-care-competitiveness survey last year that ranked the Philippine 60th in a field of 61 nations. Noting that Filipinos are facing a double whammy of communicable and noncommunicable diseases, he decried that 40 percent of the population go through life without ever seeing a doctor. Filipinos are dying of noncommunicable diseases brought by uncontrollable risk actors related to improper diet, smoking, lack of exercise, and exposure to illness-causing environmental elements. At the same time, the burden of infectious diseases continues to ravage millions of Filipinos, particularly the poor. These conditions are what prompted the PCP to embark on a health-education program that emphasizes prevention. Dubbed as Health Education Reform Order (HERO), the program is embodied under Executive Order 595 issued by President Gloria Arroyo in December at PCP's initiative. The program is to be carried out in partnership with the Department of Education, Department of Science and Technology, and Commission on Higher Education. It incorporates health education and prevention in the school curriculum from primary to postgraduate levels. It works under the premise that "education on the preventive aspects of the common causes of illness and death can inculcate a strong sense of treasuring one's health," said Leachon. "No matter how good we are with tertiary care, our failure to recognize primary-care problem would be the one read by the global community, and this is the true measure of a nation's wealth," Leachon added. He stressed the need for preventive measures, saying "education empowers people" and "education is the greatest equalizer." Poor people may be given an option to good health with knowledge on concepts of healthy and hygienic practices. He added that preventive health education is more cost effective, noting that transfer of knowledge would cost less than spending for hospitalization and treatment. "With an advocacy on preventive health education, we have reestablished our relevance in our ailing country. We have now recognized the urgent need for a culture change. As health-care professionals, we need to own the problem to form part of the solution. Our role now is to heal, teach, and lead an ailing nation," Leachon said in his foreword in the HERO module. M Mabelle Aban
Even as the country has yet to report a single case of bird flu, there is no room to be complacent because the threat of a worldwide pandemic continues to loom. Sounding the alarm at the 13th annual convention of the Philippine Hospital Infection Control Society, Dr. Jean-Marc Olivé, World Health Organization representative to the Philippines, described the risk as "great," stressing that a bird-flu pandemic can sweep 20 to 30 percent of the world's population and kill as many as four to seven million. The WHO fears that a bird-flu pandemic is likely to spread faster because of globalization and the ease of travel. The H5N1 virus continues to persist and it is difficult to predict how, when, and where a pandemic could start. The possibility that the next pandemic will be caused by another subtype is also not remote. Olivé noted that bird flu has seen a resurgence in Asia since January this year, with new cases reported in Indonesia, Laos, Cambodia, China, and Vietnam. He said that as of last count, there have been 306 human cases of bird flu and 186 deaths. "The fatality rate is about 60 percent," Olivé said, although he noted that the rate has declined since 2006. Like other countries, the Philippines must be equipped to handle a possible pandemic, Olivé said, stressing the need to beef up epidemiological and laboratory capacity. The who has drawn up a set of strategies to help countries contain a pandemic and enhanced pandemic preparedness of countries at high risk. A rapid surveillance system and effective sharing of data and information are among the systems that have been put in place. The development of vaccines is also underway that could help avert the spread of a pandemic flu virus. Empowering Infection Control was the theme of this year's PHICS meeting held on May 24 to 25 at the Occupational Safety and Health Center in Quezon City. Among other topics, the meeting tackled such concerns as local experiences in the implementation of infection-control programs, multidrug-resistant organisms and isolation practices, recommendations on immunization for health workers, infection-control issues in pediatrics, and clinical practice guidelines on health-care-associated pneumonia. M Mabelle Aban
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