Archive for the ‘Medical’ Category

Tanging hiling

October 21, 2008

Darius R. Galang

SA GITNA ng tumitinding krisis pang-ekonomiya na lumalaganap sa buong mundo, patuloy pa rin na hindi naibigyang ng karampatang umento sa sahod ang mga manggagawang Pilipino.

Sa halip, aamyendahan pa ang batas na nangangasiwa sa antas ng sahod ng mga kawani ng pamahalaan. At sa ganitong senaryo, tatamaan din ang mga kawani at manggagawang pangkalusugan na naglilingkod sa publikong mga pagamutan.

Kamakailan, nagsagawa ng pagkilos ang iba’t ibang grupo ng mga manggagawang pangkalusugan, kasama ang Alliance of Health Workers (AHW), Philippine Nurses Association (PNA), at ilang grupo mula sa iba’t ibang ospital tulad ng RITM upang tutulan ang pagpapasa ng Joint Resolution number 24.

Matagal nang hiling, nakabinbin pa rin

Kasama sa hinihiling ng mga manggagawang pangkalusugan ang pagbabasura sa Kamara ng Joint Resolution Number 24 na naglalayon na amyendahan ang kasalukuyang sahod at benepisyo ng mga kawani ng gobyerno.

Ayon kay Jossel Ebesate, pangkalahatang kalihim ng AHW, mapanghati ang naturang iskema dahil papalakhin pa lalo ang pagkakaiba ng mga sahod lalo na sa antas ng ordinaryong mga kawani ng pamahalaan.

“Bukod pa sa mapanghati nito, mapanlinlang rin dahil wala talagang magiging increase sa sahod, bagkus liliit pa lalo ang tatanggapin ng mga kawani dahil babawasan ang mga benepisyong tinatamasa ng ating mga health worker,” ani Ebesate.

Sa tala, may P20 Bilyon ang nakatalaga sa Joint Resolution, kahit hindi pa ito naaaprubahan. Kuwestiyunable rin sa ilan pang sektor ang pagtatalaga ng ganitong halaga. Para kay Lea Pacuiz, national president ng PNA, malaking katanungan ito dahil hanggang sa ngayon ay hindi pa naibibigay ang karampatang sahod ng mga nars kahit sa kasalukuyang paghahanay ng antas ng sahod.

Sa implementasyon ng Salary Grade 15 na nakasaad sa RA 9173 o Nursing Act of 2002 para sa mga nars, ipinaliwanag ni Pacquiz ang katagalan ng pagbibigay ng karampatang sahod ng mga nars. “The starting salary of nurses should start at SG 15 which is equivalent to P16, 003. 2002 pa na-approve, 2008 na ngayon, 6 years after, [it is] not yet implemented,” sabi ni Pacuiz.

Lahat apektado

Kahit ang karaniwang empleyado sa pagamutan ay apektado ng iskema na ipapatupad sa loob ng apat na taon.

Para kay Remedios Maltu, nursing attendant sa isang pampublikong ospital, “Kawalang-pag-asa lalo para sa mga health worker” ang iskema. “Ang hinihingi ng mga health worker ay dagdag sahod, pero ano ang sinagot ng gobyerno? Dagdag nga sa basic salary, pero ang kakaltasin na benepisyo namin [sa ilalim ng RA7305 ng magna carta] ay mas malaki kaysa sa idadagdag.”

Kuwestiyonable umano ang lohika ng Joint Resolution 24. Isinaad ni Maltu na kayang makakuha ng tatlo, apat, hanggang limang libong piso sa halaga ng benepisyo ang isang karaniwang manggagawa.

“Pero ang idaragdag lamang sa amin ay P600 sa isang buwan. So ano ang logic nung JR24 na ang effectiveness naman ay four years. Nakikita namin na itong ipinanukala ni Cong Prospero Nograles ay hindi niya napag-aralan ito,” sabi ni Maltu.

Pangingibang bansa?

Matagal nang laganap ang pangingibang-bansa ng manggagawang pangkalusugan sa bansa. Itinuturing ng karamihan maging sa mga manggagawang pangkalusugan na ang ganitong senaryo ay dulot ng kakulangan rin ng wastong pagbibigay ng pansin sa kalagayan ng gobyerno sa kanila.

Simple lamang ang hiling kahit ng karaniwang health worker: Itaas ang suweldo.

“Kung kami ay bigyan ng mataas na suweldo, hindi na kami aalis ng bansa dahil mas gusto naming maglingkod sa aming mga kababayan kaysa magpunta pa sa ibang bansa at maghirap doon,” ang pahayag ni Maltu.

At kung maipapatupad ang lahat ng hinihiling ng mga manggagawang-pangkalusugan?

“Mas bubuti ang kanilang kalagayan, baka mas gugustuhin na nilang manatili rito sa bansa. Hangga’t maaari, ang produksiyon ng mga nars, para dito sa ating bansa. Kailangan ang dapat mag-alaga ng mga Pilipino, mga Filipino nurse din,” dagdag ni Pacquiz.(PinoyWeekly)

Melamine found in biscuit; 34 products hurdle test

October 16, 2008

THE Bureau of Food and Drugs yesterday said it found a fourth product, Lotte Strawberry Snack KOALA biscuit, positive for melamine.

It cleared 34 other products in the fifth batch of results it has so far released. BFAD has conducted tests on 144 products in the past three weeks and is testing around 50 more.

Health Secretary Francisco Duque III has said the agency was trying to complete the tests before the weekend.

The three others earlier found positive were Jollycow Slender High Calcium Low Fat Milk (more calcium & Vitamin D, 1 liter), Greenfood Yili Fresh Milk and Mengniu Drink.

The cleared products are Arla Instant White Milk Powder Milex 126, Baby Sucker Candy (Smart Plastic Mfg.), Baina Watch Milk Candy, Bainapie Coolmilk Bean, Barbie Milk Candy, Call and Text Candy (Smart Plastic Mfg.), Chang’s Chin Tai Chang Square Cookies, Changtai Food Lollipop Candy, Chaozhou-Zhancui Original Butter Scoth Classic Candy;

Cow’s Head Skimmed Milk Powder (Spray dried process), Dairy Cow Instant Whole Milk Powder, Dongguan Bairong Strawberry Biscuit, Dongguan HSU-CHI Orange Sandwich Cookies, Duke’s Choco Crunch Bar, Erko Marshmallows (Dairy Milk Flavor Filling), Galaxy Sweetened Milk Powder, and H&Y (Healthy & Young) Jollybee Eat & Drink Candy (orange flavor);

Jiayuan Shuang Le Tong Candy, Jollycow Sterilized Milk, Khong Guan Custard Cream Biscuit, Khong Guan Marie Biscuit, Lotte Nidoo Skimmed Milk Powder, MC Nation Confectionary Milky Beans Candy, Milk Land Milk Powder (Sweet Cream Buttermilk Powder), Orion “It’s Now” Custard Cream Cake, Palma Commercial Skimmed Milk Powder, Permen Ancka Rasa Buah Candy Granules;

Red Bull Skimmed Milk Powder, Sam’s Super Man Milk Candy, Strange Biscuit of Common Song/Guava Cookies, Sweetworld Almo Milk Powder Bottle, The New Zoland Company Omilk Bonbon Yogurt Milk Soft Drops (Original Taste), Tiwi Banana Split Chocolate, and Vitasoy Malted Soya Bean Milk.

The government late last month imposed a ban on milk and milk products from China where some 54,000 persons were downed by milk contaminated with melamine, an industrial chemical used in the manufacture of plastic products. – Gerard Naval(Malaya)

HOUSE BUDGET HEARING DoH ‘skewed’ priority hit

October 10, 2008

By Lira Dalangin-Fernandez
INQUIRER.net
First Posted 10:47:00 10/10/2008

MANILA, Philippines –As the House of Representatives deliberates on the proposed budget of the Department of Health (DoH) this Friday, a militant lawmaker criticized its “skewed” priority, which he said prioritized foreign patients.

Deputy Minority Floor Leader and Bayan Muna partylist Representative Satur Ocampo said the DoH budget showed a “skewed investment in government-sponsored medical tourism that targets foreign patients instead of millions of Filipinos who do not have access to quality government health care.”

“The DoH should explain government’s health priorities. They should tell Congress why healthcare is apparently being transformed by government into a money-making venture targeting foreign medical tourists over ordinary Filipinos in dire need of health care,” Ocampo said in a statement.

The DoH has a proposed P27.803 billion allocation for 2009.

Citing a study of the Health Alliance for Democracy (HEAD), Ocampo lamented that “past and current national health budgets under the Health Facilities Enhancement Program have not changed the general state of disrepair and lack of adequate facilities in public hospitals and government-run health facilities.”

The program got P1.66 billion in 2008 – a whopping 822% increase from its 2007 P180 million allotment.

For 2009, the program will be getting P2.03 billion or a 22.29% increase, the lawmaker said.

“This Health Facilities Enhancement Program only aims to refurbish certain specialty hospitals for the government’s medical tourism agenda. It has the highest appropriation compared to the potable water program (P1.5 billion) and the Tuberculosis Control Program (P1.3 billion) that will go directly to indigent Filipino patients,” he added.

The HEAD study also noted that the 2009 national budget would only give substantial increases to specialty hospitals like the Lung Center of the Philippines (an additional P157.6 million), National Kidney and Transplant Institute (P185 million), Philippine Children’s Medical Center (P236 million), and Philippine Heart Center (P185 million).

Ocampo said the DoH flagship hospital, the Jose Reyes Memorial Medical Center in Manila, is only getting P359 million in the 2009 budget. It is much worse for other public hospitals under the DoH, he added.

“Our government doctors and health professionals in HEAD aver that these are the same hospitals earmarked for integration as the ‘Philippine Center for Specialized Healthcare’ in line with the medical tourism program. If the Arroyo administration allocates hefty amounts to specialty hospitals, I do not see any reason why it should not give equal or greater budgets for government medical centers that cater to the general public and indigent Filipino patients,” Ocampo said.

2 Chinese products tested positive for melamine

October 3, 2008

MANILA (2nd Update 1:53 p.m.) — The Department of Health (DOH) released Friday names of two milk products from China sold in local supermarkets that contained melamine.

Health Secretary Francisco Duque identified Mengniu Original Drink Milk and Green Food Yili Pure Milk as the two China-made milk products that tested positive of melamine content.

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Mengniu Dairy Group Co., manufacturer of Mengniu Original Drink Milk and Yili Industrial Group Co., maker of Green Food Yili Pure Milk are China’s two largest dairy producers.

China’s General Administration of Quality Supervision, Inspection and Quarantine reported earlier that about 10 percent of liquid milk samples taken from Mengniu Dairy Group Co. and Yili Industrial Group Co. are positive melamine.

The DOH also released 28 milk and milk products that were found negative of melamine contamination.

These products are:
1. Anchor Lite Milk
2. Anlene High calcium low fat milk UHT
3. Bear Brand instant
4. Chic Choc milk chocolate
5. Farmland skim milk
6. Jinwei Drink
7. Jolly Cow pure fresh milk
8. Kiddie Soya Milk Egg Delight
9. Lactogen 1 DHA infant formula
10. M&M milk chocolate candies
11. M&M peanut chocolate candies
12. Milk Boy
13. Nestogen 2 DHA follow-up formula
14. Nestogen 3 DHA follow-up formula
15. Nido 3+ prebio with DHA
16. Nido Full Cream milk powder
17. Nido Jr.
18. No-sugar chocolate of Isomalt 2 Oligosaccharide
19. Nutri Express milk drink
20. Pura UHT fresh Milk
21. Snickers fresh roasted in caramel nogut in thick milk chocolate
22. Vitasoy soya milk drink
23. Wahaha Orange
24. Wahaha Yellow
25. Want want Milk Drink
26. Windmill Skim Milk Powder
27. Yinlu Milk Peanut
28. Yogi Yogurt Flavored Milk Drink

Duque said appropriate charges will be filed against the supermarkets that sold the two Chinese milk products found positive of melamine despite the earlier ban ordered by the health department.

He said the Bureau of Food and Drugs (BFAD) will release on Tuesday results of 30 more milk and milk products that were tested for melamine content.

The DOH is testing more than 200 products from China for any presence of melamine, a toxic chemical, which experts said increases the protein level in the baby formula and since it is insoluble protein, it causes precipitates in the kidney.

BFAD Director Leticia Gutierrez said the two milk products from China that contained melamine were smuggled into the country.

Gutierrez explained that the two milk products bare labels in Chinese character, which means that these two were not registered by BFAD.

She further said imported products registered in their office should have English translations of the label. (Sunnex)

CA denies appeal to dismiss case

October 1, 2008

The Court of Appeals (CA) has denied the plea of Philip Morris Philippines Manufacturing Inc. to dismiss the damage suit filed by a Makati City resident who claimed he was enticed by television advertisements to smoke Philip Morris cigarettes that led to his lung cancer in 2000.

In a decision written by Associate Justice Fernanda Lampas Peralta, the CA said that Judge Winlove Dumayas of the Makati City Regional Trial Court (RTC) did not abuse his discretion in denying the cigarette firm’s motion to dismiss the case filed by a certain Vincent Reyes.

In his complaint, Reyes claimed that through television advertisements, he was enticed to smoke Philip Morris since he was 14 years old and by year 2000, he was diagnosed with lung cancer.

Reyes pleaded the trial court to order Philip Morris Philippines Manufacturing Inc. to pay him R500,000 in damages.

The cigarette firm sought the dismissal of the complaint before the trial court on the ground of prescription and lack of cause of action.

On Aug. 12, 2005, the RTC dismissed the plea of Philip Morris. It also denied the firm’s motion for reconsideration on Jan. 14, 2006, prompting the firm to elevate the case before the CA.

In resolving the issue, the CA said that based on the pleadings and evidence presented the cause of action had not prescribed.

The appellate court said that the case against Philip Morris could not be dismissed on account of prescription because Reyes filed an amended complaint to correctly indicate the address of the cigarette firm, considering that the original complaint was not served upon Philip Morris because it was no longer holding office at the address indicated in the complaint. (RGP) (ManilaBulletin)

A Shortage amid the Glut in Nursing Graduates

August 21, 2008

The Philippines has an oversupply of nursing graduates especially with the visa retrogression in the US. But ironically, many government hospitals lack nurses and other health professionals. With low pay and poor working conditions in government hospitals, nursing graduates opt to work abroad or work here even as volunteers with no pay and allowance.

BY RITCHE T. SALGADO
Contributed to Bulatlat
Volume VIII, Number 28, August 17-23, 2008

Jay-R Manzano, 21, is all set for his review. He made sure to wake up early so that he could still go through his notes and not forget the discussion his class had the day before.

Jay-R and his friends, sisters Grethel Ann and Gretchen Mae Tubo, are reviewing for the licensure examination for nurses come late November. Like most of their friends and classmates, they have started their preparation early, the usual being a month before the scheduled exam. They have enrolled at a commercial review center, but by late October they will be undergoing a more intensive review in their school, the University of Cebu.

Despite the effort that they are making, they have already accepted the fact that they may not be able to get their dream job as nurses in the United States of America as soon as they hoped. But they are willing to work as volunteers abroad or even in private hospitals here, with no pay and no allowance.

“Just so we will gain the experience that we will need once the US will start accepting Filipino nurses again,” said Jay-R.

“We know that right now the US is not accepting Filipino nurses because of the (visa) retrogression, but then I am still optimistic that after the elections (in the US) this little obstacle will be lifted, and again they will open their doors for us,” Grethel said.

In order to protect American nurses and other health professionals, the US has set a limit on the number of foreign nurses that will be given access to the US. This created a shortage of nurses and physical therapists in the States and so the US Congress passed H.R. 5924 or the Emergency Nursing Supply Relief Act. However, the Hispanic block in the US Congress sets as a condition to passing the bill, the granting of amnesty to Mexican illegal settlers in the US. This created a deadlock in the progress of the bill and in the process, the hiring of foreign-trained nurses decreased, if not stopped.

In an article in The FREEMAN (August 11, 2008), Oscar A. Tuason, administrator of the Cebu Doctors University Hospital, expressed alarm over the decrease in the demand for Filipino nurses in the US. He said that this has a direct effect on the number of enrollees in the nursing program of schools, elaborating that at present most nursing schools are losing students at the rate of five to eight percent.

Tuason cited five reasons for the decrease in demand for Filipino nurses: the worsening quality of graduates, unskilled and inexperienced nurses, attitude problems that include lack of motivation and lack of commitment, signing up with more than one agency, and poor ability in conversational English due to the decline in the standard of education.

Judy Aragones, R.N., PhD., spokesperson of the Cebu chapter of the Health Alliance for Democracy (HEAD) and a professor at the University of San Carlos, however, expressed disagreement with Tuason regarding the trend in nursing enrollees.

“It is obvious that more and more of our young people are taking up nursing,” Aragones claimed. “There are those whose heart may not be in the profession but they see it as their way out of poverty. Even if the US is closing its doors, there are alternate destinations for our nurses like the Middle East, Singapore, Japan and European countries.”

Aragones, however, maintained that going out of the country for work is not the solution to the country’s economic problems. “I strongly disagree with our government encouraging our people to work abroad. It is the responsibility of our government to take care of our graduates. We are losing skilled and hard working people,” she lamented.

Aragones admitted that the main reason for the decrease, if not stop, in the hiring of foreign-trained nurses is mainly because of the visa retrogression policy of the US. As a consequence, many graduates have found themselves unemployed or under employed; and with schools producing more nursing graduates each year, the health sector in the country is now facing a dilemma in the oversupply of nurses.

“Some of them have to make do with being volunteers, receiving no pay or allowance. Their only consolation is that they would be able to use the certification that they would get from hospitals for possible employment in other countries,” Aragones said.

She admitted that hospitals in Cebu are understaffed. Because they could not afford to hire new nurses, they are forced to accept only volunteers.

“It is the government’s responsibility to ensure that our nurses are employed. To encourage them to stay and serve the country, the government should come up with a good socio-economic package that would include non-monetary compensations,” Aragones said.

She said the government must provide good working conditions, skills development, and such other non-economic benefits, saying that salary-wise the Philippines would not be able to compete.

“The starting pay of our nurses right now, on average, is at P15, 000 ($331) per month. Compare that to the salary they will be getting in the US and other countries (an average of US$20 per hour). This is very small,” she explained.

Jay-R, Grethel and Gretchen are now making efforts to pass the local licensure exam. Soon they will start to process their papers for the US, despite the retrogression. “We know that right now it seems impossible to get a job in the US, but then again, it does not mean that we should also stop trying,” Gretchen said.

Aragones explained that unless the government would do something to encourage health workers to stay in the country, more young people like Jay-R, Grethel and Gretchen would still desire to work in foreign countries like the US. Contributed to Bulatlat

Macapagal-Arroyo must go — Pol kill survivor

August 19, 2008

VICTORIA, Canada — “Gloria Macapagal-Arroyo must go,” was the call of Dr. Chandu Claver during his keynote speech on the occasion of the Commemorative Service for his wife, Alice, who was killed in an ambush by suspected government agents in the Philippines two years ago.

The public Forum on Human Rights and the Philippine Situation was held on August 2 at the Selkirk Montessori School in the City of Victoria, Canada. It was sponsored by the Victoria Philippine Solidarity Group and the Stop the Killings in the Philippines Network.

The video presentation entitled “The Philippines: Waging War on the People” was publicly shown for the first time in Victoria. The video indicates how on that fateful day on July 31, 2006, two riflemen hosed down the Claver family car containing the couple and one of their daughters. Alice did not survive her seven gunshot wounds. Dr. Claver and his daughter, though much wounded, survived. Since then, Dr. Claver has linked up with human rights groups in an international campaign called the Stop the Killings Campaign.

Alice Claver was one of 903 Filipinos victims of extra-judicial killings since 2001. Most of the victims were members and leaders of legitimate progressive social organizations working for social changes in the Philippines. Local and international bodies and investigators, notably from the United Nations, have indicated the direct involvement of the Philippine military in these killings. In his talk, Dr. Claver said, “. . . the present Philippine rule is a de facto martial rule, a far cry from the so-called ‘vibrant democracy’ that even the present Canadian government seems to stubbornly think and adhere to.” The killings have been linked to the Philippine Government counter-insurgency program – a program strongly and directly supported by the United States War on Terror.

The Stop the Killings in the Philippines Campaign has spread into numerous countries around the world. This culminated in a process involving the filing of charges against Presidents Gloria Macapagal-Arroyo and George W. Bush at the Permanent Peoples Tribunal. The international opinions court found both Arroyo and Bush guilty of crimes against humanity. “International solidarity of peoples across the world has made this possible.” Claver said. But he added, “The number of killings may have noticeably decreased in the last 6 months due to the local and international pressure, but (the killings) definitely have not stopped. . . Getting Arroyo and Bush out of the scene may not be the total answer, but may be a start for better things to come.”

He appeals to Canadians to continue to lobby their government to review Canada’s trade relations with, and military aid to the Philippines. He urged that Canada should find “means of making truly sure that Canadian tax payer’s money is not being used to make the Armed Forces of the Philippines a more efficient killing machine”.

Claver, who together with his three daughters had fled the Philippines due to continued threats and harassments, has been waiting for more than a year for the Immigration and Refugee Board to hear his case for a refugee claim. #(NorthernDispatch)

Editorial Cartoon: On the Eresarheads-Phillip Morris Concert

August 17, 2008

The New Music of E-Heads

Advertising and Promotion of Tobacco Encourage Smoking Among Youth: Study

August 17, 2008

(The report below is from The International Tobacco-Control Network and was prepared by Ronald M. Davis, M.D. in 1998. Dr. David was the director of the Center for Health Promotion and Disease Prevention of the Henry Ford Health System in the United States.)

CONTENTS

1. Background and author’s qualifications
2. How tobacco advertising and promotion affect tobacco consumption
3. Evidence that advertising and promotion affect overall tobacco consumption
4. Countries with tobacco advertising bans have lower consumption (or slower increases in consumption) than those without bans
5. Tobacco advertising and promotion have material effects on children and adolescents
A. Tobacco advertising and promotion reach children and adolescents
B. Tobacco advertising and promotion increase tobacco use by children and adolescents

# Cross-sectional studies
# Longitudinal studies
# Relationship between cigarette advertising and brand preference among youth
# Other evidence
# Billboards represent a particularly effective and intrusive medium for advertising in general, and for promotion of cigarettes in particular (especially to children)

1. Billboards are a favorite medium for tobacco advertising
2. Billboards are intrusive and cannot be avoided
3. Billboards are in people’s neighborhoods and are constantly exposing youth and adults to unsolicited messages
4. Billboards in urban, inner-city environments are more likely to carry tobacco and alcohol advertisements, often targeted to racial and ethnic minorities

# Conclusions

1. Conclusions of the 1994 Surgeon General’s report
2. Conclusions of the Food and Drug Administration
3. My own conclusions

# References
# Appendix. Author’s biographical sketch

I. Background and author’s qualifications

I have been asked by the City of Chicago Law Department to provide an expert opinion on issues related to the effects of tobacco advertising and promotion on youth, and the importance of legislation that would restrict the placement of tobacco billboards within the city. I have also been asked to describe my qualifications to render these opinions, and my involvement as an expert witness in other tobacco-related litigation.

A biographical sketch is attached as an Appendix to this report. It summarizes my professional career. A longer and more detailed curriculum vitae has also been made available. In brief, I am a physician with board certification in preventive medicine, and an epidemiologist trained at the U.S. Centers for Disease Control and Prevention (CDC). My current position is Director of the Center for Health Promotion and Disease Prevention at the Henry Ford Health System, a large managed care organization in Southeast Michigan serving approximately 850,000 residents of the state. I was Chief Medical Officer for the Michigan Department of Public Health from 1991 to 1995, and Director of the CDC’s Office on Smoking and Health from 1987 to 1991. I currently serve as chair of the American Medical Association’s Council on Scientific Affairs, and I am editor of Tobacco Control, an international journal published quarterly by the British Medical Association.

In this report, per the request from the City of Chicago Law Department, I will focus primarily on the epidemiologic evidence related to the effects of tobacco advertising and promotion on youth. I will not review in any detail the evidence on the psychosocial effects of advertising and promotion (e.g., how the imagery and messages in tobacco advertising appeal to the developmental needs of youth). Nor will I review the many industry documents that have come to light in recent months and years that bear upon this issue.

I will base my opinions on my background as a physician, as an epidemiologist, as one who has conducted substantial research on tobacco advertising and promotion for at least a dozen years, and as one who has worked extensively in the field of tobacco and health during the past two decades. The research I have performed is documented in the journal articles I have published, which are listed in my curriculum vitae.

Two roles in particular have put me in a position where I have been exposed to a breadth of information on this subject. One of these was my tenure as director of the CDC’s Office on Smoking and Health, which is the lead federal office relating to tobacco and health. The Office produces the annual Surgeon General’s reports on smoking and health, which use a rigorous peer-review process in summarizing the scientific literature in the field, and maintains the world’s largest bibliographic database containing technical material on the subject.

The other important role is my service, since 1992, as editor of Tobacco Control, which is the only journal in the world devoted to this subject. Serving as editor has ensured my awareness of the pertinent research being conducted in the field.

I have served as an expert witness in several other tobacco-related lawsuits, including the State Attorney General lawsuits filed in Mississippi, Texas, and Washington State, and the Broin and Engle class actions filed in Florida.

An important role for an epidemiologist — and a physician specializing in preventive medicine — is to identify the antecedents or determinants of disease. Eliminating or reducing those antecedents will then reduce the incidence or prevalence of disease. In this case, we know that smoking is a major antecedent in the causation of numerous diseases, including cancer, heart disease, emphysema, and stroke. We can extend this process further by assessing the antecedents or determinants of behavioral risk factors for disease, such as smoking. As indicated by the evidence reviewed in this report, exposure to tobacco advertising and promotion is an antecedent in the initiation of smoking among youth.

II. How tobacco advertising and promotion affect tobacco consumption

The 1989 Surgeon General’s report “The Health Consequences of Smoking: 25 Years of Progress”1 reviewed the mechanisms by which tobacco advertising and promotion may affect tobacco consumption. Four direct mechanisms by which advertising and promotion may increase tobacco consumption were discussed:

1. Advertising and promotion could encourage children or young adults to experiment with tobacco products and initiate regular use;
2. Advertising and promotion could increase tobacco users’ daily consumption of tobacco products by serving as a cue to tobacco use.
3. Advertising and promotion could reduce current tobacco users’ motivation to quit.
4. Advertising and promotion could encourage former smokers to resume smoking.

The Surgeon General’s report also discussed several indirect mechanisms by which advertising and promotion might increase tobacco consumption. One of these is that “the ubiquity and familiarity of tobacco advertising and promotion may contribute to an environment in which tobacco use is perceived by users to be socially acceptable, or at least less socially objectionable and less hazardous than it is in fact.”

The report reviewed the evidence bearing on these effects. Although it concluded that no single study would be likely to provide a definitive answer to the question of whether advertising and promotion increase the level of tobacco consumption, the report noted that “The most comprehensive review of both the direct and indirect mechanisms concluded that the collective empirical, experiential, and logical evidence makes it more likely than not that advertising and promotion activities do stimulate cigarette consumption.”

Substantial research on the effects of cigarette advertising and promotion has been conducted and published since the release of that report in 1989. As a result, the Surgeon General and the U.S. Department of Health and Human Services have extended and strengthened their conclusions about the effects of advertising and promotion on smoking behavior, particularly in regards to children and adolescents. These stronger and more recent conclusions were published in the Surgeon General’s 1994 report on smoking and youth (see Section VI (A) below)2 and by the U.S. Food and Drug Administration in documents related to its rule-making on tobacco sales and marketing.3,4

My own conclusions are similar to those of the Surgeon General, the Department of Health and Human Services, and the Food and Drug Administration. Tobacco advertising and promotion do indeed stimulate cigarette consumption, especially among youth.

III. Evidence that advertising and promotion affect overall tobacco consumption

Several time-series studies have assessed the relationship between tobacco consumption and tobacco advertising expenditures. Simply put, time-series analysis is the study of observations taken in a series of instances over time. It often uses statistical techniques such as multiple regression, a method for distinguishing among competing and simultaneous influences on the end result (tobacco consumption, in this case). It has been used to assess the relationship between tobacco advertising expenditures and tobacco consumption over time, taking into account (”controlling for”) other potential influences on consumption such as price and income.

The Economics and Operational Research Division of the British Department of Health (in the “Smee Report”) analyzed the results of 19 time-series studies of cigarette advertising, including seven in the U.S., seven in the United Kingdom, two in New Zealand, and one each in Australia and West Germany.5 They found that 13 studies showed positive results (i.e., that higher advertising expenditures are associated with higher tobacco consumption), one showed negative results, and five showed both positive and negative results. The main findings of their review were as follows:

“Year-to-year variations in advertising expenditure within countries: there are many studies of this type, both for the UK and for other countries, particularly the US. Details of the analysis vary from one study to another, but the basic approach is to model the demand for tobacco products by relating annual changes in consumption to corresponding changes in advertising expenditure and in other variables such as price and income. Some studies have found that advertising has a statistically significant effect on consumption; others, including our own study, have not. There are several possible reasons for failure to find a statistically significant effect of advertising, including data imperfections and the inherent difficulty of identifying the separate effect of advertising when this is only one of many potential influences on smoking behaviour. Taken together, however, the studies point to a more decisive result. Because the studies differ in specification and data, a range of results is always to be expected. If, however, advertising genuinely has no effect on consumption, it would also be expected that the number of studies reporting positive and negative results would be much the same; in other words, some studies would show that advertising increases consumption, but others that advertising reduces consumption. In practice this symmetry is not observed; the great majority of results point in the same direction — towards a positive impact. The balance of evidence thus supports the conclusion that advertising does have a positive effect on consumption.”

Andrews and Franke6 conducted a meta-analysis of 48 time-series studies of tobacco advertising and sales, which covered the period from 1933 to 1990. Twenty-five of the studies were based on U.S. data and another 13 used data from the U.K. The weighted mean advertising elasticity was positive and significantly different from zero, meaning that higher advertising expenditures were associated with higher levels of cigarette consumption. These findings are especially impressive given a basic limitation of such studies — they assess the effects of the annual fluctuations in advertising expenditures, which “presumably relate to the least productive slice of expenditure, on the reasonable assumption that advertising is subject to diminishing returns.”5 One would expect a much greater impact from a total ban on advertising, or from a ban on a particular method or medium of advertising (e.g., billboards) — “which cuts away the most effective core of advertising”5 — than from marginal changes in total advertising expenditures from year to year.

In a 1989 review of 14 time-series studies, the New Zealand Toxic Substances Board found that 11 of the studies showed that tobacco advertising significantly affected national cigarette sales.7 The Board concluded that

“Advertising is directly related to the number of cigarettes smoked; increased advertising means more cigarettes smoked, and less advertising means fewer smoked…. The effect of advertising on cigarette consumption can be substantial…. [E]ven a 10 percent rise in advertising will tend to increase consumption by 0.7 percent, that is by 37 million cigarettes [in New Zealand] in a year…. Changes in cigarette consumption of this magnitude will produce significant changes in death rates. This can be deduced from the high numbers exposed to the risk, the intensity and duration of that exposure, and the high relative risks for smokers of a number of common and serious diseases.”7

IV. Countries with tobacco advertising bans have lower consumption (or slower increases in consumption) than those without bans

The New Zealand Toxic Substances Board commissioned a study on the relationship between tobacco advertising and tobacco consumption between 1970 and 1986 in 33 countries with varying levels of controls on advertising. The study, published in the 1989 report7 referred to above, classified countries into four main categories: those allowing tobacco advertising in all media, in most media, or in a few media, and those not allowing tobacco advertising in any media. Countries prohibiting all tobacco advertising were further subdivided into countries not allowing tobacco advertising for “health reasons” and those not allowing tobacco advertising for “political reasons” (i.e., centrally planned Eastern European economies that did not, during the study period, permit advertising of consumables, including tobacco).

The New Zealand study found a clear pattern between rate of change in tobacco consumption and the restrictiveness of controls on advertising. In countries allowing tobacco advertising in all media, per capita tobacco consumption increased annually by 1.7% on average. Consumption decreased on average by 0.4% annually in countries with partial bans on advertising, and by a similar amount in countries that had banned advertising of any kind for political reasons. Consumption fell annually by 1.6% on average in countries that had banned all tobacco advertising for health reasons. Furthermore, the study found that the percentage of young people who smoke had decreased more rapidly in countries where advertising had been totally banned or severely restricted, than in countries where tobacco promotion had been less restricted.

A later study, published in the British Journal of Addiction,8 used a pooled cross-sectional time-series analysis to examine the relationship among tobacco advertising restrictions, price, income, and tobacco consumption in 22 OECD countries from 1960 to 1986. (See Section V. B. below for a definition of “cross-sectional.”) The investigators found that tobacco advertising restrictions after 1973 were increasingly associated with lower tobacco consumption.

The “Smee Report”5 (mentioned above) reviewed trends in smoking in four countries that banned tobacco advertising: Norway, Finland, Canada, and New Zealand. It reached the following conclusion:

“Though there are qualifications (for example, the bans in Canada and New Zealand are relatively recent and so may not yet have had their full impact), the current evidence available on these four countries indicates a significant effect. In each case the banning of advertising was followed by a fall in smoking on a scale which cannot reasonably be attributed to other factors.”

Based on this evidence, the Food and Drug Administration (FDA) came to the following conclusion in promulgating its rules on tobacco sales and marketing:

“FDA finds that the international experience provides empirical evidence that restrictions on tobacco advertising, when given appropriate scope and when fully implemented, will reduce cigarette and smokeless tobacco use among children and adolescents under the age of 18.”9

These findings from country-level data, described above in Sections III and IV, have been confirmed by studies on the effects of cigarette advertising at a “micro” level — i.e., involving individuals — as described below.

V. Tobacco advertising and promotion have material effects on children and adolescents

A. Tobacco advertising and promotion reach children and adolescents

In considering the effects of tobacco advertising on children and adolescents, the first issue to address is whether advertising and promotion reach children and adolescents. Although the tobacco and advertising industries deny that advertising is targeted to children — denials that are contradicted by internal industry documents that have surfaced in recent years — the key question is whether minors are exposed to advertising. Substantial evidence indicates clearly that they are indeed so exposed.

An example of a study confirming the exposure of children to tobacco advertising was published in the Journal of the American Medical Association (JAMA). Investigators showed that 91% of six-year-old children from five different states correctly matched a picture of “Joe Camel” with a picture of a cigarette, similar to the percentage who recognized the logo of the Disney Channel (a silhouette of Mickey Mouse).10

Confirmatory evidence came from two studies funded by R.J. Reynolds Tobacco Company (RJR). One of these studies found that 72% of six-year-olds and 52% of children aged 3-6 years could identify Joe Camel.11 The other study, conducted for RJR by Roper Starch, surveyed more than 1,000 children aged 10-17. Of these children, 86% recognized Joe Camel, in both aided and unaided recall, 95% of whom knew that he sold cigarettes.12

Further evidence derives from studies measuring children’s recognition of cigarette brands, models, logos, and slogans in cigarette advertisements in which identifying information has been obscured. Another study published in JAMA found that students in grades 9-12 in five different states were much more likely than adults to recognize Joe Camel as a character whom they had seen before, and to identify the products being advertised and the brand name of the product.13 In a study of 11- to 14-year-olds in Australia, Chapman and Fitzgerald found that children who reported smoking in the last four weeks were almost two times more likely to correctly identify the edited advertisements and to complete the slogans than were children who reported not having smoked during that period.14 Similar findings have been reported from Georgia,15 Massachusetts,16 and North Carolina17 (USA); the United Kingdom; 18-20 and Hong Kong.21

Additional evidence that tobacco promotions reach children and adolescents comes from studies showing that many youth obtain and use merchandise from “cigarette continuity programs” (e.g., Camel Cash, Marlboro Miles).22-25 Much of this merchandise bears cigarette brand names, such that children become, in essence, walking billboards by wearing Camel T-shirts, Marlboro caps, and so on. These programs are advertised heavily on billboards, as demonstrated by a photograph I took of a billboard for Marlboro Gear (in front of a Toys “R” Us store and a Chuck E Cheese’s Pizza establishment), which was reproduced with an editorial I wrote on the subject.13c

Exposure of children and adolescents to cigarette advertising and promotion is not surprising given the ubiquity of, and heavy expenditures for, these marketing activities. In recent years, cigarette companies have spent more than $5 billion per year ($160 per second) to advertise and promote cigarettes.27 Children and adolescents are exposed to most of the media used for tobacco advertising (especially billboards — see Section VI below).

The Institute of Medicine, in an expert committee report entitled “Growing Up Tobacco Free,” reviewed the evidence on the extent of tobacco advertising and its effects on youth.28 With respect to youth exposure to tobacco advertising and promotion, it concluded:

“Tobacco advertising is characterized by images and themes that are especially appealing to adolescents, and some are appealing to children. In addition, a large proportion of promotional expenditures associate use of tobacco with activities and products that are attractive to children and youths. The sheer amount of expenditures for advertising and promotion assures that young people will be exposed to these messages on a massive scale. It is clear that society’s efforts to discourage young people from smoking are obstructed — and perhaps fatally undermined — by the industry’s efforts to portray their dangerous products in a positive light.”

B. Tobacco advertising and promotion increase tobacco use by children and adolescents

1. Cross-sectional studies

Many cross-sectional studies have found that smoking status and smoking initiation among youth are correlated with awareness, recognition, and approval of tobacco advertisements and promotions; exposure to tobacco advertisements and promotions; “receptivity” to tobacco advertising and promotion; receipt or ownership of tobacco promotional items; and a feeling that cigarette ads make them want to smoke a cigarette.13, 25, 29-38

Cross-sectional studies evaluate correlations at a single point in time. Although the correlations between smoking behavior and cigarette advertising in these studies are compelling when considering the total body of evidence — which includes many different study designs, study populations, and investigators — the cross-sectional nature of these studies does not allow a definitive conclusion about the direction of causality. For example, if a cross-sectional study shows that teenage smokers are more likely than nonsmokers to “like” cigarette ads, two explanations (with opposite directions of causality between the associated variables) are possible: a) teens who like cigarette ads are more likely to become smokers over time than teens who don’t like the ads; or b) teens who become smokers are more likely to develop a liking of the ads than teens who don’t become smokers. Longitudinal studies, which assess correlations at two or more points in time, can determine the temporal relationship between two associated variables, and hence the causal relationship between the two. Two longitudinal studies of youth smoking in relation to tobacco advertising are described below.

2. Longitudinal studies

Two important longitudinal studies followed up on earlier cross-sectional investigations. In a cross-sectional survey of 6000 primary school children (10-12 years old) in New South Wales, Australia, the children were asked whether cigarettes should be advertised. Logistic regression was used to determine the relative importance of several factors, including approval of cigarette advertising, in relation to the children’s smoking status. Approval of advertising was the second most important predictor of smoking status, after friends’ smoking behavior but ahead of siblings’ smoking behavior, amount of money available to spend weekly, sex, age, and parents’ smoking status.29

The investigators then assessed changes in smoking behavior over 12 months among these 6000 children in a longitudinal study design.39 This design allowed the investigators to assess the strength of the association between several personal and social variables and the process of adopting or quitting smoking. Four study groups were defined: a) children who became smokers (adopters); b) those who remained nonsmokers; c) those who became nonsmokers (quitters); and d) those who remained smokers. As noted by the authors, “Children who approved of cigarette advertising were twice as likely to become smokers as children who disapproved, with the smoking behaviour of those who were ambivalent about advertising falling between that of the other two groups.” The smoking adoption rate per 100 children was 27.0 for those approving of cigarette advertising, 12.1 for those not approving, and 19.3 for those who said they “don’t know,” a difference which was highly statistically significant (p < 0.001). Similarly, children who disapproved of cigarette advertising were significantly more likely to quit smoking than those who approved of it.39

Pierce and colleagues have also used both cross-sectional and longitudinal study designs to establish the relationship between cigarette advertising and smoking initiation among youth. They have defined constructs for “susceptibility to smoking” and “receptivity to tobacco marketing.” With regard to the former, adolescents with no smoking experience are asked two questions to probe the likelihood of future smoking: “Do you think you will try a cigarette soon?” and “If one of your best friends were to offer you a cigarette, would you smoke?” Any answer other than “no” or “definitely not” to both questions results in classifying an adolescent as susceptible to smoking.34

In an earlier cross-sectional study, Evans et al. defined an “Index of Receptivity to Tobacco Marketing.”34 The index was based on the total score from five items: a) whether the adolescent felt that a tobacco advertisement contained at least one of nine messages (e.g., smoking is enjoyable, it helps people relax, it helps people stay thin); b) whether the adolescent could name a cigarette brand in response to either of two questions — “What is the name of the cigarette brand of your favorite cigarette advertisement?” and “Of all the cigarette advertisements you have seen, which do you think attracts your attention the most?”; c) whether the adolescent could name a cigarette brand in response to the question “If you wanted to buy a pack of cigarettes tomorrow, what brand do you think that you would buy?”; d) whether the adolescent said “yes” to the question “Have you ever bought or received for free any product which promotes a tobacco brand or was distributed by a tobacco company?”; and e) whether the adolescent said “yes” to the question “Do you think that you would ever use a tobacco industry promotional item such as a T-shirt?”

Using data from 3,536 adolescent never-smokers from the 1993 California Tobacco Survey in a cross-sectional, logistic regression analysis, Evans et al. found that receptivity to tobacco marketing was independently associated with susceptibility to smoking, after adjustment for sociodemographic variables (including age, sex, and race/ethnicity) and perceived school performance. Adolescents who scored 4 or more on the Index of Receptivity to Tobacco Marketing were 3.91 times more likely to be susceptible to smoking than those who scored 0. Even adolescents who scored 2 on the Index were twice as likely to be susceptible.34

Pierce et al.40 extended these findings in a longitudinal study design. A total of 1,752 of the adolescents who were not susceptible to smoking when first interviewed in 1993 were re-interviewed in 1996. In a measure of receptivity to tobacco marketing similar to that used by Evans et al,34 Pierce et al. defined receptivity as minimal if the respondent did not name a brand when asked to identify the brand advertised the most on billboards or in magazines recently seen. If respondents also had a favorite advertisement, they would be considered to have moderate receptivity. Respondents who said that they had bought or received a promotional item from a tobacco company, or that they would ever use a promotional item, were classified as highly receptive to advertising. Pierce and colleagues then investigated the progression toward smoking of the non-susceptible never-smokers.

In a logistic regression analysis of predictors of which adolescents progressed toward smoking, Pierce et al. found that

“The baseline receptivity (in 1993) to tobacco industry promotional activities was strongly related to which adolescents progressed toward smoking. Among those who were assessed as having a minimal level of receptivity, 37.7% progressed toward smoking. Compared with this group, those who had a favorite advertisement but who were not willing to use a promotional item (the moderate level) were 82% more likely to progress toward smoking, which is a statistically significant increase compared with those at the minimal level. Those with a high level of receptivity (at least willing to use a promotional item) were almost 3 times more likely to progress toward smoking, which was highly statistically significant.”40

The authors estimated that 34% of all smoking experimentation in California between 1993 and 1996 can be attributed to tobacco promotional activities, translating to experimentation by 700,000 adolescents nationally.40

In summary, the evidence from these two longitudinal studies39, 40 extends the findings from many cross-sectional studies, and confirms that awareness and approval of tobacco advertising and promotion, and “receptivity” to tobacco marketing, are causal factors in smoking initiation among youth.

3. Relationship between cigarette advertising and brand preference among youth

Another line of evidence indicating the effect of tobacco advertising and promotion on youth is the relationship between cigarette advertising and brand preference among youth. In a study of students in two junior high schools in the Chicago area, seventh- and eighth-grade children who smoked were asked to view a series of cigarette advertisements and to rate how much they “liked” each ad. The investigators found that the students’ cigarette buying preferences closely paralleled the perceived appeal of the cigarette advertisements.41

Particularly compelling evidence is the huge increase in teenage use of Camel cigarettes coinciding with R.J. Reynolds’ youth-oriented “Joe Camel” advertising campaign.13, 42 – 44 Furthermore, studies have shown that youth find Joe Camel to be appealing.13, 41 Similarly, tobacco advertising campaigns targeting women beginning in the late 1960s (i.e., Virginia Slims) were associated with a major increase in smoking initiation among adolescent girls.45 In general, the brand choices of adolescent smokers reflect the brands with the largest advertising budgets.43, 44 Especially noteworthy is the finding by Pollay and colleagues that the relationship between brand choices and brand advertising is about three times stronger among teenagers than among adults.46 Based on this area of research, the FDA came to the following conclusion:

“… these studies are evidence that, when considered together, form a coherent pattern that establishes the role that advertising plays in young people’s smoking behavior.”47

4. Other evidence

King et al. showed that cigarette brands popular among adolescent smokers are more likely than “adult brands” to be advertised in magazines with high youth readerships.48 This suggests that exposure to advertising affects smoking behavior and cigarette brand preference among youth.

The evidence summarized in this section (V. B), taken as a whole, makes a persuasive case that tobacco advertising and promotion increase tobacco use among children and adolescents.

VI. Billboards represent a particularly effective and intrusive medium for advertising in general, and for promotion of cigarettes in particular (especially to children)

There are a number of reasons why tobacco billboards warrant special concern with respect to their impact on youth:

1. billboards are a favorite medium for tobacco advertising;
2. billboards are intrusive and cannot be avoided;
3. billboards are in people’s neighborhoods and are constantly exposing youth and adults to unsolicited messages; and
4. billboards in urban, inner-city environments are more likely to carry tobacco and alcohol advertisements, often targeted to racial and ethnic minorities.

A. Billboards are a favorite medium for tobacco advertising.

There are two ways in which we can look at expenditures for tobacco advertising on billboards. The first is the proportion of total tobacco marketing expenditures devoted to billboards. This gives us a measure of how important billboards are in tobacco company marketing efforts. The second is the proportion of total advertising in various media devoted to tobacco. This gives us a measure of the extent to which tobacco advertising dominates those media.

According to data submitted by tobacco companies to the Federal Trade Commission, the companies have used outdoor media heavily through the years in comparison to other print media. In 1996, the last year for which data are available, cigarette companies spent $292 million on advertising in outdoor media in the United States (5.7% of total cigarette advertising and promotional expenditures for that year), compared to $253 million (4.9%) for advertising at the point of sale, $243 million (4.8%) in magazines, $28.9 million (0.6%) in transit media, and $14.1 million in newspapers (0.3%).27 In other words, billboards continue to be a preferred medium for print advertising of cigarettes.

If we consider total advertising expenditures for different media, we see that tobacco advertising has dominated outdoor media to a far greater extent than it has other print media. My own research showed that in 1985, cigarette advertising expenditures accounted for more than one-fifth (22.3%) of all advertising in outdoor media ($210.8 million out of a total of $945 million), compared to 7.1% for magazines ($367.1 million out of a total of $5.155 billion) and 0.8% for newspapers ($199.8 million out of a total of $25.17 billion). In 1984, the figures were 21.1%, 8.4%, and 1.0%, respectively. In 1985, cigarettes were the most heavily advertised product or service in outdoor media, the second most heavily advertised in magazines (after passenger cars), and the third most heavily advertised in newspapers (after passenger cars and airlines). Of the seven companies with the largest advertising expenditures in outdoor media in 1985, six were cigarette companies. Also in that year, tobacco advertising expenditures for “eight-sheet” (5 by 11 feet) billboards were $7.8 million — about half the total expenditures for that medium ($15.6 million).49

A subsequent analysis for the year 1988 showed that cigarettes remained the most heavily advertised product or service in outdoor media, compared to a ranking of second in magazines (after passenger cars) and sixth in newspapers. In 1988, cigarette advertising expenditures accounted for 16.9%, 5.7%, and 0.4% of total advertising expenditures in outdoor media, magazines, and newspapers, respectively.50 As these figures show, billboards remained a favorite medium for cigarette advertising, even though the tobacco industry was gradually shifting its marketing dollars from traditional forms of print advertising into promotional activities such as distribution of free samples and coupons, sponsorship of sporting and entertainment events, value-added offers (e.g., buy one, get one “free”).49, 50

B. Billboards are intrusive and cannot be avoided.

In Packer Corp v State of Utah,51 the U.S. Supreme Court upheld legislation in the state of Utah that prohibited all tobacco advertising in outdoor media and at the point of sale, against a challenge based on the 14th Amendment Equal Protection Clause. In its opinion, the Court approvingly cited a passage from the Utah Supreme Court’s decision upholding that law,51 (page 110) which speaks to the intrusiveness of billboards:

“Billboards, street car signs, and placards and such are in a class by themselves…. Advertisements of this sort are constantly before the eyes of observers on the streets and in street cars to be seen without the exercise of choice or volition on their part…. Other forms of advertising are ordinarily seen as a matter of choice on the part of the observer. The young people as well as the adults have the message of the billboard thrust upon them by all the arts and devices that skill can produce. In the case of newspapers and magazines, there must be some seeking by the one who is to see and read the advertisement. The radio can be turned off, but not so the billboard or street car placard. These distinctions clearly place this kind of advertisement in a position to be classified so that regulations or prohibitions may be imposed upon all within the class.”

The billboard industry’s own marketing material emphasizes the intrusive nature of the medium:

“Outdoor: … You can’t zap it. You can’t ignore it…. It asks little time, but leaves a long impression…. Outdoor is right up there. Day and night. Lurking. Waiting for another ambush.”52

Materials from the outdoor advertising industry in Chicago make similar, albeit less colorful, claims. The Eller Media Company notes that its “bulletins” assure “dominance in selected area(s),” and are “positioned on highly visible traffic locations such as expressways, primary arteries, and major intersections.” “Rotary bulletins” provide “full market coverage … to ensure total saturation of the market.” The company’s “Wallscape” sign on the sides of buildings “towers above the streets, creating a spectacular landmark … [and provides] dominance in key market (sic).” Eller’s 30-sheet posters “are located on primary and secondary streets where traffic volumes are high, … [provide] complete and instantaneous coverage of the market, … deliver exposures to both residents as well as commuter traffic, … [create] rapid consumer top-of-mind awareness, … [and provide] continuous presence, up to 18 hours every day.” “In Chicago,” Eller notes, “it takes a combination of 164 poster panels to achieve a daily circulation (number of impressions) equal to fifty percent of Chicago’s population. Showings can be specialized to reach various ‘niches’ within the overall market.”

Noticeably absent from Eller’s materials is any mention of avoiding youth exposure to advertising for age-restricted products such as tobacco and alcohol. On the contrary, the materials note that “Outdoor advertising displays are giant, dramatic and visible … their presence in the market ensures nearly everyone will be exposed to them … [they] generate massive awareness of an advertising message…. Outdoor reaches a highly mobile audience … where people live, work and socialize.” (Emphasis added.)

C. Billboards are in people’s neighborhoods and are constantly exposing youth and adults to unsolicited messages.

As Judge Hargrove noted in Penn Advertising of Baltimore Inc v Mayor of Baltimore,53

“A billboard is a constant fixture in a neighborhood. It looms over children every day while they walk to school, and every time they play in their neighborhood, thus forming an inescapable part of their daily life.”

“Eight-sheet” (5 by 11 feet) billboards are particularly effective in encroaching on people in their neighborhood, because they are smaller than the typical highway billboards, are low to the ground, and are close to the street (and thus, to sidewalks, cars, and school buses). As noted above, in 1985 tobacco advertising expenditures for eight-sheet billboards were $7.8 million — about half the total expenditures for that medium ($15.6 million).49

Voluntary codes by the billboard industry have been ineffective in preventing youth exposure to tobacco billboards (e.g., the code of the Outdoor Advertising Agencies of America, which recommends that its member companies not advertise tobacco and alcohol within 500 feet of schools and other areas where underage youth congregate).54 Evidence presented to the Lansing, Michigan city council, which recently banned tobacco billboards in that city, showed a substantial overlap between tobacco billboards and school bus routes. A similar problem has been reported from the United Kingdom, where many tobacco billboards are found near schools, in violation of a voluntary agreement on cigarette advertising between the government and cigarette manufacturers.55

In the Roper Starch study conducted for R.J. Reynolds Tobacco Company (mentioned above),12 children (10-17 years old) who said they knew Joe Camel were asked “Please tell me the ways that you might have seen or heard about this character.” The largest proportion (51%) said the information came from a billboard advertisement, followed by an advertisement in a magazine (45%), an advertisement in a store (32%), or from a T-shirt (22%). On the other hand, for other cartoon characters in advertisements — e.g., the Energizer Bunny, Ronald McDonald, and the Keebler Elves — recognition based on billboard exposure was between 6% and 13%.12

Further evidence that tobacco billboards are reaching (and probably influencing) youth comes from a survey conducted for the trade publication Advertising Age. It showed that 46% of children 8-13 years old said they most often saw cigarette advertising on billboards. Moreover, 34% of those 14-18 years of age cited billboards as the predominant advertising medium for tobacco products.56

D. Billboards in urban, inner-city environments are more likely to carry tobacco and alcohol advertisements, often targeted to racial and ethnic minorities.

A number of studies have shown that billboards in urban, inner-city environments are more likely to carry tobacco and alcohol advertisements, often targeted to racial and ethnic minorities. A survey in Baltimore, before that city banned tobacco and alcohol billboards, showed that of 2,015 billboards in the city, 75% were located in predominantly poor, African American neighborhoods; 75% of those billboards carried tobacco or alcohol ads, compared to 20% in white neighborhoods.57

The Detroit Planning Commission conducted a study of the 4,144 billboards in the city in 1989. It found that advertisements for tobacco and alcohol products accounted for 55% to 58% of all billboards in lower income Detroit, compared to 34% to 43% in higher income areas. The two billboards found to be the tallest and largest both advertised tobacco.58

A Chicago Lung Association survey found 27% more billboards in predominantly African American wards in Chicago than in white wards.59 In Washington, D.C., few alcohol and tobacco billboards were found in ward 3, which is predominantly white; however, 78% of billboards advertised alcohol or tobacco in wards 7 and 8, which are heavily African American.60 A similar pattern of targeting ethnic and poor neighborhoods was found in St. Louis, Atlanta, and San Francisco.61

Based on the evidence cited elsewhere in this report, it is reasonable to assume that the higher density of tobacco billboards in poor, ethnic neighborhoods is responsible for smoking by large numbers of young people in racial and ethnic populations in urban areas. This is a matter of great concern given the recent report that smoking prevalence increased substantially from 1991 to 1997 among African American high school students (from 12.6% to 22.7%) and among Hispanic students (from 25.3% to 34.0%).62

VII. Conclusions

A. Conclusions of the 1994 Surgeon General’s report

Based on much of the evidence cited above, the 1994 Surgeon General’s report “Preventing Tobacco Use Among Young People”2 reached the following conclusions about tobacco advertising and promotion:

1. Young people continue to be a strategically important market for the tobacco industry.
2. Young people are currently exposed to cigarette messages through print media (including outdoor billboards) and through promotional activities….
3. Cigarette advertising uses images rather than information to portray the attractiveness and function of smoking. Human models and cartoon characters in cigarette advertising convey independence, healthfulness, adventure-seeking, and youthful activities — themes correlated with psychosocial factors that appeal to young people.
4. Cigarette advertisements capitalize on the disparity between an ideal and actual self-image and imply that smoking may close the gap.
5. Cigarette advertising appears to affect young people’s perceptions of the pervasiveness, image, and function of smoking. Since misperceptions in these areas constitute psychosocial risk factors for the initiation of smoking, cigarette advertising appears to increase young people’s risk of smoking.”

B. Conclusions of the Food and Drug Administration

The Food and Drug Administration, having reviewed the same body of evidence discussed in this report, has come to the following conclusion:

“FDA recognizes that advertising may not be the most important factor in a child’s decision to smoke; however, the studies cited by the agency establish that it is a substantial, contributing, and therefore material, factor…. The proper question is not, ‘Is advertising the most important cause of youth initiation?’ but rather, ‘does FDA have a solid body of evidence establishing that advertising encourages young people’s tobacco use such that FDA could rationally restrict that advertising?’ The answer to this question is ‘yes.’” (emphasis in original)63

C. My own conclusions

My own conclusions are similar to those of the 1994 Surgeon General’s report and the Food and Drug Administration. The evidence reviewed in this report clearly indicates that tobacco advertising and promotion increase aggregate tobacco consumption, in part through a material effect on smoking by youth. The several lines of evidence that lead to these conclusions include:

o Time-series studies from several countries showing a relationship between tobacco consumption and tobacco advertising expenditures at the national level;
o Studies showing that countries with tobacco advertising bans have lower tobacco consumption (or slower increases in consumption) than those without bans;
o Studies showing that tobacco advertising and promotion reach children and adolescents;
o Numerous cross-sectional studies showing that smoking status and smoking initiation are correlated with awareness, recognition, and approval of tobacco advertisements and promotions; exposure to tobacco advertisements and promotions; “receptivity” to tobacco advertising and promotion; receipt or ownership of tobacco promotional items; and a feeling that cigarette ads make them want to smoke a cigarette;
o Two longitudinal studies showing that approval of cigarette advertising and “receptivity” to tobacco marketing predict the likelihood of taking up smoking or moving through the process of smoking initiation; and
o Studies showing relationships between cigarette brand preference among youth and the following variables: a) cigarette advertising expenditures for certain brands, b) the use of youth-oriented imagery in certain advertising (e.g., Joe Camel), and c) the degree to which teenagers “like” different ads.

Billboards are a special source of concern because: 1) they are a favorite medium for tobacco advertising; 2) they are intrusive and cannot be avoided; 3) they are in people’s neighborhoods and are constantly exposing youth and adults to unsolicited messages; and 4) billboards in urban, inner-city environments are more likely to carry tobacco and alcohol advertisements, often targeted to racial and ethnic minorities.

Because legislation prohibits the sale of tobacco to minors, because tobacco advertising and promotion encourage minors to buy and use tobacco products, and because tobacco billboards are a prime medium through which advertising and promotion accomplish these effects, I believe that implementation of legislation banning or limiting tobacco billboards in the City of Chicago will have a direct and material benefit on the welfare of the city and its children and adolescents.

VIII. References

1. U.S. Department of Health and Human Services. Reducing the health consequences of smoking: 25 years of progress. A report of the Surgeon General. Rockville, Maryland: Public Health Service, Centers for Disease Control, Office on Smoking and Health, 1989. (DHHS Publication No. (CDC) 89-8411)
2. U.S. Department of Health and Human Services. Preventing tobacco use among young people. A report of the Surgeon General. Atlanta, Georgia: Public Health Service, Centers for Disease Control and Prevention, Office on Smoking and Health, 1994. (U.S. Government Printing Office document #S/N 017-001-00491-0)
3. U.S. Food and Drug Administration. Regulations restricting the sale and distribution of cigarettes and smokeless tobacco products to protect children and adolescents; Proposed rule analysis regarding FDA’s jurisdiction over nicotine-containing cigarettes and smokeless tobacco products; Notice. Federal Register 1995 (August 11);60(155):41314-41787.
4. U.S. Food and Drug Administration. Regulations restricting the sale and distribution of cigarettes and smokeless tobacco to protect children and adolescents; Final rule. Federal Register 1996 (August 28);61(168):44396-45318.
5. U.K. Department of Health. Effect of tobacco advertising on tobacco consumption: A discussion document reviewing the evidence. London: Economics and Operational Research Division, Department of Health, October 1992.
6. Andrews RL, Franke GR. The determinants of cigarette consumption: a meta-analysis. J Public Policy & Marketing 1991;10:81-100.
7. Toxic Substances Board. Health OR tobacco: An end to tobacco advertising and promotion. Wellington, New Zealand: Department of Health, May 1989.
8. Laugesen M, Meads C. Tobacco advertising restrictions, price, income and tobacco consumption in OECD countries, 1960-1986. Brit J Addiction 1991;86:1343-54.
9. U.S. Food and Drug Administration. Regulations restricting the sale and distribution of cigarettes and smokeless tobacco to protect children and adolescents. Federal Register 1996 (August 28);61(168):44493.
10. Fischer PM, Schwartz MP, Richards JW, et al. Brand logo recognition by children aged 3 to 6 years: Mickey Mouse and Old Joe the Camel. JAMA 1991;266:3145-8.
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Appendix — Biographical Sketch for Ronald M. Davis, M.D.

Ronald M. Davis, M.D., became the director of the Center for Health Promotion and Disease Prevention of the Henry Ford Health System in September 1995. He was appointed Associate Medical Director of Health Alliance Plan of Michigan in September 1996. From 1991 to 1995, he served as Chief Medical Officer in the Michigan Department of Public Health. From 1987 to April 1991, Dr. Davis served as the director of the U.S. Centers for Disease Control’s Office on Smoking and Health. He completed the Epidemic Intelligence Service program and the preventive medicine residency program at CDC; received his M.D. and Master of Arts degree in Public Policy Studies from the University of Chicago; and a Bachelor of Science degree from the University of Michigan. Dr. Davis was elected as the first resident physician member of the American Medical Association’s Board of Trustees, and served in that capacity from 1984 through 1987. He was elected to the AMA Council on Scientific Affairs in June 1993, and became chair of the Council in June 1997.

Dr. Davis has published widely in peer-reviewed journals, and has received many award and honors, including the Surgeon General’s Medallion and the American Public Health Association’s Jay S. Drotman Memorial Award. He is a member of the World Health Organization’s Technical Advisory Group on Tobacco or Health; and is the editor of Tobacco Control: An International Journal, which was launched by the British Medical Association in March 1992.(PinoyPress)

Probe Sought Vs Philip Morris for ‘Organizing’ Eraserheads Concert

August 17, 2008

Devious.

That’s how tobacco control advocates today described the ploy of Philip Morris Incorporated (PMI) in sponsoring the upcoming Eraserheads Reunion Concert even as they call on the band to sacrifice for the sake of their multitude of non-smoking fans.

“Like millions of Filipinos, we want to watch the reunion concert. But when we look for ways to get the tickets, we are redirected to http://www.marlboro.ph. This is clearly tantamount to advertising,” said Dr. Maricar Limpin, executive director of the Framework Convention on Tobacco Control Alliance Philippines (FCAP).

Amid this, FCAP asked the Inter-Agency Committee-Tobacco (IAC-T) to immediately investigate the tobacco company’s “devious advertising tactics.”

Following Philip Morris’ denial of any violation of Republic Act (RA) 9211, Limpin wrote IAC-T to investigate the cigarette manufacturer for undermining the law’s provisions against advertising its brand and promoting cigarette smoking through the Eraserheads concert.

“Philip Morris sought to gloss over any likely illegality, which may arise from its sponsorship of the event by calling the reunion a promotional event not open to the general public but restricted to trade partners and adult smokers who have to ‘obtain’ an invitation by ‘registering’ in Marlboro’s website,” she said.

Philip Morris Philippines has denied it is violating the law by pointing out a difference in the definition of “sponsorship” and “promotion” under RA 9211 or the Tobacco Regulation Act of 2003. But FCAP described Philip Morris’ statement as “mere play of words, a marketing ploy that circumvents the law.”

RA 9211 prohibits “cigarette and tobacco companies from sponsoring any sport, concert, cultural or art event, as well as individual and team athletes, artists or performers where such sponsorship shall require or involve the advertisement or promotion of any cigarette or tobacco company, tobacco product or tobacco use.”

Philip Morris claims that it is not sponsoring the concert—by contributing a sum of money to a third party—but is organizing the event on its own as part of its promotional activity.

Limpin, however, pointed out that a violation of the ban on sponsorship occurs when: (1) the tobacco company sponsors, among others, any concert or performer; and (2) such sponsorship requires or involves the advertisement or promotion of any tobacco company, tobacco product or tobacco use, logo and trademark, among others.

Limpin said that even if Philip Morris does not give money to a third party to hold the concert, it is a fact that the event is closely tied to Marlboro, which constitutes an act of promoting and advertising the cigarette brand.

“Advertisement is likewise prevalent in the manner by which Philip Morris has aggressively used viral marketing to induce Eraserheads fans to register on its Marlboro website to obtain invitations to the event,” she noted.

Advertisement is defined under the law as “any visual and/or audible message disseminated to the public about or on a particular product that promote and give publicity by words, design, images or any other means through ….electronic … form of mass media.”

“The manner by which PMI has utilized the electronic media to stir interest and create hype about this event, lure both smokers and non-smokers alike to its website with the expectation of obtaining an invitation—thereby creating much publicity and getting electronic media mileage about Marlboro, its product name—is nothing but plain and simple, out-and-out advertisement,” Limpin said in her letter to I-ACT.

She said that even though the Marlboro website effectively limits the registration only to adults, these adult registrants are and will become part of the tobacco company’s database, easily accessible to its other forms of advertisements through the electronic media.

RA 9211 imposes a total ban on tobacco advertising in mass media, including through the Internet, starting July 1, 2008. The law defines advertising as “the business of conceptualizing, presenting, making available and communicating to the public, through any form of mass media, any fact, data or information about the attributes, features, quality or availability of consumer products, services or credit.”

“The act alone of making the concert accessible and free only to smokers, Philip Morris is actually promoting smoking,” Limpin said. “The concert is like a carrot at the end of the stick, the price for smoking,” she added.

To protect the health of Filipinos—young and old—FCAP is urging the IAC-T to convene, investigate and take the necessary action to ensure that the provisions of the Tobacco Regulatory Act are complied with.

The group also renewed its call for Eraserheads members to be good role models of Filipino youth and to disassociate themselves from a company that has done nothing but cause health problems to millions of people worldwide.

Meanwhile, Limpin dismissed speculations about FCAP’s “sudden hostility” toward Philip Morris.

She pointed out that FCAP has long been lobbying for tobacco control and its promotion by Philip Morris or any tobacco company. (30)(PinoyPress)

Eraserheads Reunion Concert: US Anti-Tobacco Group Slams Philip Morris’s ‘Devious’ Ploy

August 17, 2008

Company Urged to End Role in Eraserheads Concert as It Did with Alicia Keys Concert in Indonesia

Washington, D.C. – For the second time in recent weeks, international tobacco control advocates are calling on Philip Morris International to withdraw its sponsorship and promotion of a major concert, this time in the Philippines where the company’s activities appear to violate national law.

Last month, Philip Morris International withdrew its sponsorship of singer Alicia Keys’ concert in Jakarta, Indonesia, after the company was criticized for engaging in cigarette marketing that appealed to children and after Ms. Keys called for the sponsorship to be withdrawn.

Now health advocates are urging Philip Morris International to end its involvement in an August 30 reunion concert by the popular Filipino band Eraserheads, which has been called the “Beatles of the Philippines.” Those seeking tickets to the concert are being directed to http://www.marlboro.ph, a web site run by Philip Morris International’s Philippine subsidiary. To receive tickets and information, visitors to the web site must provide personal contact information that would allow Philip Morris International to send them promotional materials for cigarettes.

The reunion concert also has generated enormous Internet buzz that often mentions the Marlboro web site and brand name, resulting in positive publicity for Philip Morris International and its best-selling Marlboro cigarette brand.

Last week, the Philippines Department of Health warned Philip Morris International that it was violating the country’s tobacco regulation law. As of July 1, 2008, the law prohibits all forms of tobacco advertising in mass media including the Internet, places strict restrictions on other tobacco promotional activities (for example, allowing promotional displays only at point-of-sale of adult only facilities), and bans tobacco company sponsorship of concerts and other events. Philip Morris International’s involvement in the Eraserheads concert appears to violate different aspects of the law.

Health advocates are calling on Philip Morris International and Eraserheads to terminate any tobacco industry involvement in the concert and calling on Philippines government authorities to take action against any violation of the tobacco regulation law.

“Eraserheads members should not allow themselves to be deceived by Philip Morris and should protect their fans from this devious marketing ploy. Considered one of the most influential bands in the Philippines, Eraserheads has become a role model for our youth. I hope they will rise to the challenge and help young Filipinos lead healthy, tobacco-free lives by finding other sponsorship for the concert,” said Dr. Maricar Limpin, Executive Director of the Framework Convention on Tobacco Control Alliance Philippines, a leading tobacco control organization in the Philippines. She called on Eraserheads to follow the example of Alicia Keys and end tobacco industry involvement in the band’s concert.

“Once again, Philip Morris International has been caught engaging in cigarette marketing that appeals to children in a developing country and that would not be tolerated in the United States and other wealthier nations,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “The issue isn’t just whether Philip Morris International has violated Philippine law, but whether tobacco companies should be engaged in such youth-oriented marketing anywhere. Philip Morris International should immediately cease all such sponsorships and promotions in all countries.”

In the United States, Philip Morris USA and other major tobacco companies are prohibited from engaging in brand name sponsorships of concerts under a 1998 legal settlement with the states. However, in developing countries, tobacco companies continue to sponsor concerts by famous musicians, which health advocates have condemned as a means to market cigarettes to children and to circumvent restrictions on more traditional tobacco advertising.

The World Health Organization’s international tobacco control treaty, the Framework Convention on Tobacco Control, requires ratifying nations to ban all tobacco advertising promotions and sponsorships. To date, 157 countries including the Philippines have ratified the treaty.

Health advocates dismissed Philip Morris International’s excuses for its involvement in the Eraserheads concert. The company has argued that access to the concert and its web site is restricted to adults. However, the extensive Internet publicity regarding the concert, which links Eraserheads and Marlboro, has been accessible to all ages. A Philip Morris International spokesman also told Philippines media, “We’re not sponsoring the event. We organized it ourselves.” This statement indicates an effort to circumvent the sponsorship ban and does not address other possible violations of the Philippines’ tobacco regulation law.

Currently, over 17 percent of Philippine youth (age 13-15) and 34.7 percent of adults smoke. According to the Philippines Department of Health, 87,600 Filipinos die each year from smoking-related diseases. (source: http://www.tobaccofreekids.org)(PinoyPress)

1 in 20 patients acquires infection in hospitals

August 16, 2008

By Sheila Crisostomo
Saturday, August 16, 2008

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Health experts have warned that one out of 20 patients confined in a hospital or health care unit acquires infection during admission.

Dr. Mario Panaligan, former president of the Philippine Hospital Infection Control Society, said hospital-acquired infection or nosocomial infection are contracted by patients from treatment in a hospital or health care service unit.

“The infections are secondary or not related to the patient’s original condition,” said Panaligan who is currently an officer of the Philippine Society of Microbiology and Infectious Diseases.

Patients are susceptible to microorganisms that can cause infection because their immune system is often at their weakest state.

He claimed that pathogens are transmitted through direct contact in patient-care activities, and indirect contact through contaminated instruments or other paraphernalia, airborne particles from droplets launched by coughing, sneezing or talking.

Dr. Victor Rosenthal, of the World Health Organization’s Infection Control Guidelines External Reviewer, said that in most developing countries 15 out of 100 patients confined in the intensive care unit are at risk of acquiring hospital-related infection.

Rosenthal added that with “vigilance and proper enforcement of infection control initiatives, hospitals can successfully curb the incidence of infections.”

The two experts have recommended five-point strategies to prevent hospital-acquired infections.

Panaligan said that washing hands thoroughly is a simple procedure but it lessens the chance of transmitting pathogens after contact with blood, skin cells, secretions, bodily fluids, and contaminated articles and equipment.

They proposed the adoption of a “closed infusion system” in which a fully collapsible intravenous bag that does not require any external vent to empty the solution is used, thus preventing any bacteria from entering the system.

The experts want patients with communicable diseases to be isolated and proper ventilation should be installed in hospital rooms to prevent the airborne transmission of diseases.

Needles and sharp instruments like scalpels and surgical scissors must also be properly handled to stop the spread of blood borne pathogens.

Panaligan said proper sterilization and disposal should also be observed and it is imperative that contaminated items should not be left in patient care areas to avoid contact with food or common waste receptacles.

“Economics is one of the factors that can contribute to hospital infections, but shouldn’t necessarily be related. Even public hospitals and low-cost healthcare facilities can prevent hospital infections through simple initiatives,” he said.

He cited the importance of re-educating doctors and health workers as the aggressiveness of intervention in healthcare facilities will determine their success in infection control.(PhilippineStar)

Natural family planning (Unang bahagi)

August 10, 2008

MAY kasabihan sa Inggles na “the more, the merrier.” Ganito ang tradisyunal na pananaw ng mga Pilipino pagdating sa pamilya. Kaya nga hindi lang kuya at ate ang tawagan ng magkakapatid. Mayroon pang diko, ditse, sangko, sanse, siko at bunso.

Sa susunod na buwan, madaragdagan ang pamilya ni Sally. Magiging dalawa na ang anak niya. Halong ligaya at kaba ang nararamdaman niya. Ligaya, dahil magkakaroon na rin siya ng anak na lalaki. At kaba, dahil may kakambal itong panibagong gastusin. Sa taas ng presyo ng mga bilihin, hindi na sapat ang kinikita ng kanilang sari-sari store para sa pangangailangan ng kanyang pamilya. “Kung ako ang masusunod, hanggang dalawang anak lang. Ang hirap lang tumanggi sa mister ko ’pag nag-aaya siya (na makipagtalik).”

Gaya ng karamihang mga Pilipino, madalas marinig ni Sally ang terminong NFP (natural family planning). Pero hindi malinaw sa kanya kung ano ang ibig sabihin nito.

Ano ba ang NFP?

Ang NFP ay ang paraan kung paano mabuntis o umiwas sa pagbubuntis batay sa kaalaman sa menstrual cycle ng babae. At dahil natural ito, hindi ito gumagamit ng birth control devices tulad ng condom at pills. Ito’y medically safe, mabuti sa kalusugan, epektibo at hindi magastos.

NFP at reproduction

Para mas maunawaan ang NFP, mahalagang malaman ang proseso ng reproduction. May dalawang ovary na matatagpuan sa kaliwa’t kanan ng uterus ng babae. Bawat buwan, nagpapakawala ito ng egg sa fallopian tube. Ovulation ang tawag dito. Nangyayari ito 12-14 na araw bago magsimula ang menstrual period.

Maaaring mabuntis ang babae kung makikipagtalik siya sa panahong ito. Dadaan ang sperm ng lalake sa cervix papasok sa fallopian tube. Pag may naabutan itong egg, magkakaroon ng fertilization o ang pagsasama ng sperm at egg. Mapupunta ang fertilized egg sa uterus, at dito ito magiging fetus.

Sa NFP, matutulungan ang mga mag-asawang matukoy ang mga araw sa menstrual cycle kung kailan fertile at maaaring mabuntis ang babae. Para sa karamihan ng kababaihan, nagpapakawala ng egg ang ovary dalawang linggo bago ang kasunod na menstrual period. 24 oras itong mananatiling fertile matapos itong mapakawalan. Kung nais ng mag-asawang umiwas sa di-inaasahang pagbubuntis, hindi sila dapat magtalik sa panahong ito.

(May karugtong)(Pinoy Weekly)

Makabago at simpleng paraan ng natural family planning

August 10, 2008

Standard Days Method

Ang Standard Days Method ay nakabatay sa kaalamang ang menstrual cycle ay binubuo ng fertile phase na sinusundan ng mga araw na infertile. Tumatagal ng 26 hanggang 32 na araw ang regular na menstrual cycle ng babae. Maaaring siyang mabuntis sa ikawalo hanggang ika-19 na araw. Sa 12 araw na ito, isinaaalang-alang ang maaaring pagbabago sa timing ng ovulation at ang haba ng buhay ng sperm habang nasa loob ito ng reproductive tract ng babae.

Gumagabay ang color-coded beads na tinatawag na cycle beads para matukoy ang araw na fertile at infertile sa cycle ng babae.

Two Day Method

Cervical secretions ang batayan ng fertility sa Two Day Method. Kailangan i-monitor ng babae kung may bakas ng secretion para malaman kung maaari siyang mabuntis.

Bawat araw may dalawang tanong ang gumagamit ng Two day Method :

  • May napansin ba akong secretion ngayon?

  • May napansin ba akong secretion kahapon?

Kung may mapansin siyang secretion ngayon o kahapon, masasabing fertile siya ngayon, at hindi siya dapat makipagtalik para umiwas sa pagbubuntis. Kung wala siyang napansing secretion ngayon at kahapon (dalawang magkasunod na tuyong araw), napakaliit ng posibilidad na mabubuntis siya.

Iba pang paraan ng natural family planning:

Ovulation Method

Ang Ovulation Method na tinatawag ding Cervical Mucus Method, ay nakabatay sa pagbabago ng cervical secretion sa leeg ng uterus o cervix. Sa panahong pinaka-fertile, nagiging clear ang secretions, stretchy, madulas at basa.

Kung umiiwas pagbubuntis, hindi dapat makipagtalik sa panahong ito. Dapat hintayin ang ikatlong araw matapos ang huling fertile-type secretion.

Basal Body Temperature (BBT)

Temperatura ng katawan sa umaga, bago ang kahit anong aktibidad, ang basehan ng BBT. Mas mababa ang temperature ng katawan bago ang ovulation, at bahagyang tumataas ng .2 degrees Celsius o .4 degrees Farenheit matapos ang ovulation.

Kung umiiwas sa pagbubuntis, dapat hintayin ang ikatlong araw matapos tumaas ang basal body temperature ng .2 degrees Celsius o .4 degrees Fahrenheit, na senyales ng katapusan ng fertile phase.

Symptothermal Method

Ang Symptothermal Method ay ang pag-oobserba sa mga pagbabago sa cervical secretions, kasama rin dito ang mga pagbabago sa basal body temperature, at ang posisyon at pakiramdam ng bukana ng cervix. Ang ilan pang senyales gaya ng mid-cycle pain o pagdudugo ay maaaring sumabay sa ovulation.

Fertility indicators ang mga ito. At hindi dapat makipagtalik sa panahong ito kung umiiwas sa pagbubuntis.

Lactational Amenorrhea Method (LAM)

Ang LAM ay nakabatay sa siyentipikong ebidensiya na hindi fertile ang isang babae at maliit ang tsansang mabubuntis siya sa panahon ng full lactation o exclusive breastfeeding. Tinutukoy ng full lactation ang pagpapasuso sa bata sa panahong walang regular na supplemental feeding (kahit na tubig).

Nagbibigay ng proteksiyon ang LAM kapag:

  • Hindi pa uli nagkakaroon ng menstruation

  • Hindi pa binibigyan ng bottle feeds at regular na mga food supplement ang sanggol

  • Wala pang anim na buwan ang edad ng bata

Gaano kaepektibo ang natural family planning?

Kung maingat na susundan ng kababaihan ang mga direksyon nito (ang pagtutukoy kung kailan siya may ovulation para malaman kung kailan siya makikipagtalik), 91% hanggang 98% na magiging epektibo ito. Pero dahil bihira ang perpektong pagsasagawa nito, tinatantiyang nasa 76% ang pagka-epektibo nito. Ibig sabihin sa 100 na babaing gumagamit ng natural family planning para umiwas sa pagbubuntis, 24 sa kanilang ang nabubuntis kada taon.

Ang pagkakaroon ng di-regular na period ang karaniwang dahilan ng pagkabigo ng natural family planning.(PinoyWeekly)

Eraserheads Concert: Who’s Wagging the Dog?

August 9, 2008

Dave Gomez, the public affairs and communications manager of Philip Morris, was quoted in this report as saying that the Eraserheads reunion concert will push through. He revealed that Philip Morris is not sponsoring the event — in fact, he said, the tobacco company is organizing it.

“We’re not sponsoring the event. We organized it ourselves,” Gomez was quoted as saying. “The event is free for our valued customers. This is a little something we do for them to show them our appreciation for their continued patronage of our products.”

Gomez emphasized this because of a legal point that would seem to clear Philip Morris of accusations that it violated Republic Act 9211 (the Tobacco Regulation Act). Apparently, under this law, tobacco companies can organize events but they cannot sponsor it. Go figure.

(A bit of an aside: Gomez said he was surprised why anti-tobacco advocates are complaining against a tobacco-backed concert when, according to him, they had done this sort of thing in the past with other bands. Newsflash: The ban on sponsorship took effect only last July 1.)

We grant for a moment that the company’s ass is covered, legally speaking. And, moreover, it’s probably not its fault if this law seemed defective (although big companies are notorious for lobbying legislators to either kill a proposed law or water it down — just look at what they’re doing lobbying hard against a law that would mandate picture-based warnings on cigarette packs).

But where does corporate responsibility come in for Philip Morris?

Surely, they must know that the intent of the law is to protect the public, particularly teenagers, from smoking and that governments around the world have passed legislation banning or restricting the advertising and promotion of tobacco. Yet, here comes Philip Morris and it finds an apparent loophole in our law and then exploits it — disregarding completely the intent of the law. And for what? To be able to sell their products to teenagers and young adults, a market that tobacco companies have been targeting in order to replenish their ranks of smokers.

Isn’t the profit from existing smokers not enough, so that they had to lure more smokers, younger smokers? Is their any hope that Philip Morris would be decent enough to exercise some amount of responsibility?

Aside from finding loopholes in the law, regardless of its clear intent, Philip Morris, as I’ve pointed out in a previous post, has likewise been exploiting the viral-marketing potentials of the Internet. That can only be expected, of course, from a company that peddles a toxic product. What I find disturbing is Philip Morris’s ability to penetrate the mainstream press, the blogs and the mailing lists and apparently manipulate them. That, or there’s complicity on the part of these sectors in the mainstream press and the Internet, whether they knew it or not, to play the company’s game.

A bit of a background is needed here. News about the Eraserheads reunion concert was first reported publicly by Philippine Star entertainment columnist Ricky Lo. In his column, Lo did not name Philip Morris as the one organizing the event. But the column was enough to heighten the buzz.

Pretty soon, Philmusic, a music site whose owner, Jim Ayson, also moderates the largest Eraserheads mailing list (with more than 5,000 members), reported that it had learned from a source that, indeed, Philip Morris/Marlboro is behind the concert. As far as I could tell, philmusic and Ayson’s mailing list is the ground zero of the buzz. It was also there, again as far as I could tell, where people were directed to a website where one can join the “Red List” in order to get tickets to the concert.

In other words, if I were Philip Morris, philmusic and Ayson’s mailing list would be my logical target for planting information or tips that would generate the buzz. Now I’m not suggesting anything improper or unethical on Ayson’s or philmusic’s part. Anybody, after all, can join or post anything on the mailing list or that, knowing Ayson’s clout in the local music scene, it wouldn’t be a stretch to say that he has sources knowledgeable about the planned concert. In fact, it’s very likely that, it being an extraordinary piece of news and buzz, philmusic just reported what it learned, not knowing perhaps that it was being manipulated by Philip Morris in what was turning out to be a terrific viral marketing campaign.

My point is that, tobacco companies will do anything to sell their products. The Internet, because of its freewheeling nature and its enormous audience composed of precisely the demographic tobacco companies have been targeting, holds huge potentials for the marketing of tobacco. If anything, the buzz that Philip Morris generated for the Eraserheads reunion concert only validated this. (Carlos H. Conde/pinoypress.net)

Improve people’s access to health services to fight leptospirosis, health group says

August 6, 2008

DAVAO CITY – A non government health organization said improved sanitation facilities and better access to health services among the people will reduce the risk of leptospirosis once heavy rains set in again.

Dr. Lynn Redoble, executive director of the Community Based Health Services Incorporated (CBHS), said efficient sewerage and garbage collection system would greatly decrease cases of leptospirosis while better access to health care and sanitation could mean early detection of the disease.

Leptospirosis is defined as a bacterial disease caused by the contact of broken skin with water contaminated with the urine or tissue of infected animals, which may include cattle, pigs, horses, dogs, rodents, and wild animals, according to the United States Center for Disease Control.

The Department of Health (DoH) monitored 21 cases of leptospirosis in the city in the first half of the year, which more than double the 10 recorded cases in the entire year of 2007. Dr. Rogelio Peñera, a DoH medical specialist, confirmed one death caused by leptospirosis although he said that deaths from leptospirosis are very rare.

Patients who are sick of the disease usually die from complications, such as renal failure, he explained.

He also said that health authorities can only count few cases that reach the hospitals. City hospitals are required to report a patient diagnosed with leptospirosis within a week.

Peñera said more than half of the cases of leptospirosis in the region were reported to have come from Davao city. He explained though, that six of the 10 hospitals that DoH monitors are in the city, which might have accounted for the high number of cases here.

Redoble said the poor are most vulnerable to the disease. “Slum areas are frequently flooded because there is no proper garbage collection,” she said. “Sewers are usually clogged and the residents are forced to wade in flood waters.”

”When the poor get sick, they cannot afford to go to the doctor for check up,” she said. She also said the poor will be worse off if the planned privatization of the Davao Medical Center, the region’s largest public hospital, will push through.

Only laboratory tests can accurately tell if a patient has contracted the disease or not. But the poor could not afford more medical procedures, so, oftentimes these are not detected, Redoble said.

Leptospirosis has a wide array of symptoms which make it possible for most people to dismiss it as flu. DoH said the symptoms for leptospirosis and flue are similar–high fever, chills, vomiting, calf pains and muscle aches.

Redoble said children have an increased risk for the disease because they like to play in the mud and murky flood waters.

Advanced symptoms of leptospirosis include jaundice and renal failure, or inability to urinate. Redoble said that at its advanced stage, the disease could easily lead to the collapse of major organs such as kidney liver and lungs and eventually, death. (CJ Kuizon/ davaotoday.com)

US Group Urges Probe of Marlboro’s ‘Sponsorship’ of Eraserheads Concert

July 30, 2008

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids:

WASHINGTON, D.C.– U.S. singing star Alicia Keys has set a positive example that should be followed by musicians and entertainers worldwide by demanding the withdrawal of tobacco industry sponsorship of her July 31 concert in Jakarta, Indonesia.

We applaud Ms. Keys for taking quick action to disassociate herself from the tobacco industry and to prevent her name, image and talent from continuing to be used to market cigarettes to children.

It is critical that the tobacco company involved, Philip Morris International/Sampoerna, and concert promoters immediately end the sponsorship and all tobacco-related marketing and branding associated with the concert.

We call on all involved in the music and entertainment industry, including performers and promoters, to follow Alicia Keys’ example and adopt policies of rejecting all tobacco sponsorship and other tobacco promotions.

We also call on tobacco companies to immediately cease all such sponsorships and promotions.

The World Health Organization’s international tobacco control treaty, the Framework Convention on Tobacco Control, requires ratifying nations to ban all tobacco advertising, promotions and sponsorships. Nations should act quickly to implement this critical provision of the treaty. Even before they do, tobacco companies should immediately cease such sponsorships and promotions, including sporting as well as entertainment events.

In the United States, Philip Morris USA and other major tobacco companies are prohibited from engaging in brand name sponsorships of concerts under a 1998 legal settlement with the states.

However, in developing countries, tobacco companies continue to sponsor concerts by famous musicians as a means to market cigarettes to children and to circumvent restrictions on more traditional tobacco advertising.

Alicia Keys’ Jakarta concert had been sponsored and heavily advertised by Philip Morris International and its Indonesian subsidiary Sampoerna. According to giant billboards posted in Jakarta, the concert was billed as “A Mild Live Production”. “A Mild” is a cigarette brand produced by Sampoerna.

The billboards feature a large photo of Alicia Keys, the logo for “A Mild” cigarettes and a large health warning that states, “Smoking can cause cancer, heart attacks, impotence and harm pregnancy and fetal development.”

The Alicia Keys concert is not the only current example of Philip Morris International being involved in the sponsorship or promotion of concerts by well-known musicians.

In the Philippines, those seeking tickets to an August 30 reunion concert of the famous Filipino band Eraserheads are being directed to a http://www.marlboro.ph, a Web site run by Philip Morris International’s Philippines subsidiary.

The Eraserheads have been called the “Beatles of the Philippines” and the reunion concert has generated enormous online buzz that often mentions the Marlboro web site, generating positive publicity for the world’s best-selling cigarette brand. Philippines authorities should investigate whether marketing for this concert violates a national law that, as of July 1, 2008, bans tobacco sponsorships and all forms of tobacco advertising in mass media, including the Internet.

These concert sponsorships and promotions indicate that Philip Morris International continues to engage in cigarette marketing that attracts children, especially in developing countries where the company may think it can escape public scrutiny. We urge Philip Morris to immediately end all such sponsorships and promotions in all countries, not just when it is caught red-handed as it was in Indonesia.

Last week, international public health advocates called on Alicia Keys to withdraw tobacco industry sponsorship of the Jakarta concert and condemned Philip Morris International for sponsoring the concert as a way of marketing cigarettes to children. (http://www.tobaccofreecenter.org)

Public Health Providers Tired of GMA’s Promises

July 27, 2008

A meager P18.65 ($0.42) per day is the equivalent of the ten percent increase to Salary Grade I government employees, which includes health workers in public hospitals.

BY RONALYN V. OLEA
Bulatlat
Volume VIII, Number 25, July 27-August 2, 2008

Jamil Dionisio has been working as nursing attendant for 15 years at the Lung Center of the Philippines (LCP). His take home pay is only P3,000 ($67.827 at an exchange rate of $1=P44.23)a ) per month.

A big chunk of his salary is gobbled up by payments for Government Security and Insurance System (GSIS) and Pag-ibig loans, personal loans and taxes.

Even though his wife is working abroad, Dionisio still finds it hard to make both ends meet.

His three children have transferred from private to public schools due higher tuition and other fees. To cut expenses on transportation, he acquired a motorcycle and still pays for it on an installment basis.

Asked about the ten percent salary increase for government employees, he said, “Hindi namin naramdaman.” (We never felt it.)

Dionisio is one of the thousands of health workers nationwide who grapple with low salary and limited benefits.

According to the Alliance of Health Workers (AHW), the ten percent salary increase is only P18.65 ($0.42) per day for Salary Grade I workers.

Entry level for rank-and-file employees in hospitals categorized as government owned and controlled corporations (GOCCs) is Salary Grade IV with a P7,000 ($158.26) salary. Utility workers receive less, with Salary Grade III entry level receiving only a little more than P5,000 ($113.045) per month.

As of March 2008, the National Wages and Productivity Commission placed the daily cost of living for a family of six in the National Capital Region at P858 ($19.15). It means that to be able to live decently, a family needs to earn P25, 740 ($574.68) per month.

An insult

Emma Manuel, AHW chairperson warned Mrs. Gloria Macapagal-Arroyo against taking pride in the ten-percent salary increase for government employees.

Health ProvidersPagod na kami sa mga pangakong walang katotohanan,” (We are tired of empty promises.) Manuel said.

She said that Arroyo’s tarpaulins with the slogan “Ramdam ang Kaunlaran” (Progress is felt) is a big insult to government workers.

She described their condition, “Butas na ang bulsa, hikahos na.” (Pockets empty, struggling to survive). She added, “Our present take home pay even with the measly ten percent hike could not even take us home.”

Manuel also said that the long-awaited benefits accorded by law such as the subsistence allowance, cost of living allowance (COLA) backpay, increase in hazard pay “remain only as dreams” as these are subject to the availability of funds.

She also criticized Arroyo for not allocating funds for the implementation of the Nursing Law. The law mandates the increase of entry salary grade for nurses to Salary Grade 15 or P16,000 ($361.745) per month. Most nurses are classified under Salary Grade 10.

The AHW reiterated their demand for a P3,000 ($67.827) salary increase for government employees.

Doctors

Meanwhile, Dr. Julie Caguiat, executive director of the Community Medicine Development Foundation (COMMED) decried the Arroyo government’s neglect of doctors and health workers.

Caguiat said that while there are many well-meaning doctors who would want to serve the poor in rural areas, the economic conditions and lack of support from government compel them to work abroad. Caguiat said that 80 to 90 percent of municipal health officers in the country are taking up nursing.

The HEAD said that resident doctors in public hospitals receive only P18,000 ($406.96) per month.

“The conditions are not inviting,” Caguiat said. She deplored that those who go to far-flung areas are even branded as rebels.

“We ask Arroyo, where have the doctors gone? If we are losing our doctors, who will be the ones to look into the people’s health?”

Caguiat also called on the Arroyo government to address the plight of the poor. Caguiat said, “It is frustrating for us to treat them and then send them back to their abject conditions.” Bulatlat

People’s Health, Least in GMA’s Priorities

July 27, 2008

While Mrs. Gloria Macapagal-Arroyo has repeatedly claimed that health and other social services are her priorities, records show otherwise. The budget for health has been consistently meager, causing dire effects on the people’s conditions.

BY RONALYN V. OLEA
BULATLAT
Volume VIII, No. 25, July 27-August 2, 2008

In 2007, the United Nations ranked the Philippines 90th out of 177 countries for the Human Development Index (HDI). The HDI is a survey on the quality of life of citizens in UN member countries. It measures life expectancy, educational attainment, and GDP per capita. It was developed by the United Nations Development Program (UNDP) as a standard means of measuring human development, a concept, which according to the UNDP, refers to the process of widening the options of persons, giving them greater opportunities for education, health care, income, employment, etc.

Data from United Nations International Children Fund (UNICEF) reveals that in 2006, infant mortality rate in the Philippines is 24 per 1,000 live births.

At least 20 percent of infants born between 1999 and 2006 are with low birth weight. From 2000 to 2006, 28 percent of children under five are underweight.

According to the Health Alliance for Democracy (HEAD), ten mothers die daily of pregnancy-and child-related causes. The group also said that seven out of ten Filipinos die without medical attention.

Malnutrition and hunger remain perennial in the Philippines. UNICEF Representative in the Philippines Nicholas K. Alipui said in a statement in May 2006, “The malnutrition situation in the Philippines is devastating.”

The Philippines is among the ten countries severely affected by malnutrition, which is
considered a disease caused by inadequate or excessive intake of food. More than three million Filipino children are suffering from undernutrition, the worst form of malnutrition.

A recent survey by the Social Weather Station (SWS) showed that 14.5 million Filipinos experienced involuntary hunger or hunger due to lack of food between April and June this year.

The number accounts for 16.3 percent of families nationwide or approximately 2.9 million households. It must be noted that it is higher than the 10-year average hunger rate of 12.1 percent. Severe hunger also increased from 3.2 percent to 4.2 percent (760, 000 families or 3.8 million people)

Metro Manila has the highest hunger incidence, hitting a record high of 22 percent. This is equivalent to 530,000 families or 2.65 million people.

A survey by IBON Foundation in April this year showed that 75.3 percent of families could not buy enough food.

Undeniably, poverty has affected the health conditions of the Filipino people.

Based on the 2004 data of the Department of Health (DoH), most of the ten highest causes of morbidity remain to be communicable but preventable diseases such as dengue, diarrhea, bronchitis and tuberculosis.

Pittance

Amid these conditions, the Arroyo government has neglected the people’s health as data from the Department of Budget and Management (DBM) showed.

From 2001 to 2007, the annual average allocation for health is only P13 billion. ($293,918,155 at an exchange rate of $1=P44.23) The budget for 2007 was the lowest in seven years at P11.66 billion ($263,621,976). While the budget for 2008 has increased to P19.77 billion ($446,981,686), this is still a meager P219.66 ($4.966) per person health budget for the year considering that the country’s population is estimated at over 90 million. In addition, this meager budget is fast becoming nil because of run away inflation. The Bangko Sentral ng Pilipinas said the inflation rose to11.4 percent this June and could even reach 12 percent.

For this year, the allocation for disease prevention and control is only P4.91 billion ($111,010,626) while P120.13 million ($2,716,029) is allotted for monitoring and surveillance of diseases and outbreaks.

For this year, the 12 specialty government hospitals have a combined budget of P2.79 billion ($63,079,357). These include the Jose Reyes Memorial Medical Center, Rizal Medical Center, East Avenue Medical Center, Quirino Memorial Medical Center, Tondo Medical Center, Jose Fabella Memorial Hospital, National Children’s Hospital, National Center for Mental Health, Philippine Orthopedic Center, San Lazaro Hospital, Research Institute for Tropical Medicine, and Amang Rodriguez Medical Center.

Five of these hospitals have not received funds for capital outlay. Tondo Medical Center has the lowest budget of P102.44 million ($2,316,075) and the National Center for Mental Health is allotted P461.65 million ($10,437,485).

The budget for the Philippine General Hospital (PGH) for this year is P1.07 billion ($24,191,725), of which P810 million ($18,313,361) is allotted for personnel services and only P3 million ($67,827) for capital outlay.

In 2007, the PGH budget included a measly P15.5 million ($350,440) for medical and dental assistance, including hospitalization, for indigent patients. For this year, no such item is reflected in the PGH’s budget

Meanwhile, the Veterans Memorial Medical Center would receive P 629.33 million ($14,228,577) and the AFP Medical Center, P713.34 million ($16,127,967).

Subsidies for indigent patients for confinement in specialty hospitals and for the use of specialized equipment is only P6 million ($135,654). The overall subsidy for indigent patients is only P139 million ($3,142,663).

This is a pittance compared to allocations for defense and debt interest payments. From 2001 to 2008, the average allocation for debt interest payments is P257.10 billion ($5,812,796,744) and for defense, P43.58 billion ($985,304,092).

IBON Foundation revealed that debt service increased by 100 percent from 2001 to 2005. The independent think-tank estimated that during the same period, $48 billion had been paid for debt, equivalent to 11.8 percent of the country’s gross domestic product (GDP) each year.

Payments for the principal amortization of foreign and local debts in 2007 amounted to P303.83 billion ($6,869,319,466) and for this year, principal amortization is pegged at P328.34 billion ($7,423,468,234).

Year

Health

Debt Interest

Payments

Defense

2001

13.64 B

181.60 B

32.78 B

2002

14.49 B

185.86 B

38.91 B

2003

12.40 B

226.41 B

44.42 B

2004

12.88 B

271.53 B

43.85 B

2005

12.93 B

301.69 B

44.19 B

2007

11.66 B

318.18 B

49.34 B

2008

19.77 B

269.85 B

50.93 B

Ave. allocation per year

13.84 B

257.10 B

43.58 B

Source of basic data: Department of Budget and Management
The Congress re-enacted the 2005 budget for 2006.


Inaccessible

Due to the meager budget for health, government hospitals have imposed charges such as operating room deposits, emergency room fees and laboratory fees.

Based on a primer released by the Council for Health and Development (CHD), a national organization of community-based health programs (CBHPs), the PGH charges P1,500 ($33.91) for the use of its operating room and Jose Reyes Memorial Hospital charges P3,500 ($79.13) for the same item.

The CHD further revealed that patients at the National Kidney and Transplant Institute (NKTI) are suffering because of the hospital’s “no pay, no hook policy” referring to the hospital’s policy of not giving dialysis treatment to patients who cannot pay the treatment. One dialysis session at the NKTI costs P2,700 ($61.04). A patient with a serious kidney problem usually has to undergo dialysis treatment twice a week.

The health group also said that patients in public hospitals have to pay even for the cotton balls, syringe and gauze they consume.

Indeed, health services in government hospitals have become prohibitive for many of the country’s poor.

A survey conducted by the Kilos Bayan para sa Kalusugan (KBK or People’s Health Movement) in August 2007 revealed that 70 percent of patients paid P1,000 to P50,000 ($22.60 to $1,130) for hospital expenses and five percent spent P50,000 to one million pesos ($1,130 to $22,609). Only 15 percent were charged one peso to one thousand pesos ($0.02 to $22.60).

Sixty-one percent of the respondents of the survey are unemployed, 27 percent are low-income earners while the remaining 13 percent are low-income professionals. The survey results showed that 76 percent of the respondents have to borrow money from friends and relatives, sell their property or beg for mercy from charitable institutions to be able to pay the expenses they incurred while in the hospital.

The April 2008 survey by IBON Foundation also showed that 73.38 percent of families are having difficulty paying for medicines and treatment.

Even the Philippine Health Insurance Corporation (PhilHealth) cards prove to be insignificant, the CHD primer stated.

The PhilHealth claimed to cover 80 percent of the population.

According to Dr. Gene Nisperos, HEAD vice chairperson, the National Institute of Health maintained that the PhilHealth’s claim of coveragehealth sit is overestimated by at least 20 percent.

Nisperos noted that the PhilHealth coverage has been bloated to 80 percent during the election period in 2006. In the past years, the coverage is only 61 percent. He added that the PhilHealth does not include outpatient services.

Independent surveys conducted by the KBK also showed that in Metro Manila’s seven government hospitals, seven in every ten poor families are not members of PhilHealth.

Another study commissioned by the European Commission regarding PhilHealth coverage in Mindanao showed that only ten percent of the poor in Tawi-Tawi, 12 percent in Davao Oriental and 15 percent in Zamboanga del Norte and Maguindanao are covered by PhilHealth.

In a press conference, July 25, Dr. Eleanor Jara¸ CHD executive director, criticized the Botika ng Barangay program of the Arroyo government. She said, “There is no truth in government’s claim that the poor benefits from this program.”

Jara cited as an example the Botika ng Barangay in Payatas. She said that residents complained that the pharmacy is empty.

She also slammed the profiteering of the government from the said program. She revealed that while mefenamic acid costs P11 ($0.248) in some branches of the Botika ng Barangay, the actual cost of the said medicine, which is imported from India or Pakistan is only two pesos ($0.045).

Policies

The Arroyo government has continued the implementation of the Health Sector Reform Agenda (HSRA) through the Fourmula One Program. The HSRA was formulated in 1999 and ended in 2005.

The CHD maintained that the HSRA “laid down the conditions where the people have to foot for all their health needs and expenditures.”

The HSRA paved the way for the privatization of specialty hospitals. The CHD said, “In the guise of corporatization, the Philippine Heart Center, Lung Center of the Philippines, National Kidney and Transplant Institute at Philippine Children’s Medical Center, East Avenue Medical Center and the Quirino Memorial Medical Center were corporatized and provided autonomy in management and financial aspects.”

Mechanisms were implemented to collect and earn more revenues, including increasing the number of pay wards while reducing the number of beds for charity and allowing the DoH by virtue of Executive Order 197 to increase fees in public hospitals up to 20 percent.

The CHD further stressed, “The aspects of health reforms are characterized by increasing the people’s out-of-pocket spending for health and decreasing funds and responsibility of the government for people’s health.” Bulatlat

Gumanoy sisters’ mom maintains daughters were kidnapped

July 11, 2008

By Abigail Kwok
INQUIRER.net
First Posted 16:24:00 07/11/2008

MANILA, Philippines — The mother of two sisters allegedly abducted by the military maintained that her daughters were kidnapped and accused the military of “manipulating” her daughters to “cover up” the incident.

In a statement on Friday, Maria Gumanoy, mother of Rose Ann and Fatima and the wife of slain peasant leader Eduardo Gumanoy, said her daughters were only pressured by the military to deny the alleged abduction. Maria also accused the military of “drugging” her daughter Fatima, 17, who was confined at the AFP Medical Center in Quezon City.

“Fatima was lying in bed and was constantly guarded by the military. She could barely talk especially when the military was around. No doctor chosen by the family was allowed to see and check up Fatima,” Maria said.

Rosa Ann, 21, surfaced on Thursday at the Philippine Army Headquarters in Fort Bonfiacio to deny allegations that she and Fatima were abducted.

But their mother said Rose Ann’s appearance before media was only caused by her fear for her sister’s life.

“Rose Ann was threatened and was forced to cooperate with her abductors. I knew this would happen because my daughter feared the worst for her and her sister, Fatima,” said the mother.

Maria added that the military was “blackmailing” Rose Ann because they knew “she was very close to Fatima and I believed she could not bear to see her sister suffering what she had experienced in the hands of these perpetrators.”

Karapatan, the militant human rights group that accused the military of abducting the Gumanoy sisters, said the military was using the Gumanoy sisters to “clear their involvement in the death of Eduardo Gumanoy,” said secretary general Dorris Cuario.

“From the very beginning, we have already mentioned that the military will try to do everything to save again their neck for what they did to Rose Ann and Fatima. We are anticipating that the military will force the two to cooperate with them so that the military will be spared from further shame and damage,” she added.

“If the Philippine Army is serious in helping them, then the Gumanoy sisters must now be released to their family so that they can live free from fear,” Cuario said.

Diarrhea cases in province climb to 724

July 4, 2008

By NIÑA JANE A. SOURIBIO

ILOILO – Diarrhea cases in this province have now reached 724, reported the Provincial Health Office (PHO).

The figure could still rise, said Provincial Health Officer Patricia Grace Trabado, as municipalities grapple for potable water.

Respiratory and skin diseases are also being looked into by the PHO, said Trabado.
The town of Barotac Viejo, one of the municipalities devastated by Typhoon “Frank,” has the highest number of diarrhea cases with 43. It was followed by Miag-ao with 23.

Respiratory ailments like colds, on the other hand, reached 1,877 across the province.
There were 1,285 recorded cases of various skin diseases, PHO revealed.

“Health officers were dispatched to evacuation centers to prevent the outbreak of diseases,” Trabado said.

She had one simple advice to Ilonggos: boil their drinking water first.

Diarrhea cases have gone up to 724 cases from the previously 233 cases, respiratory tract infection to 1,077 from 1,029, headache to 1,140 from 628, injuries to 2,045 from 1,048, and skin infection to 1,425 from 448.

Trabado stressed, however, that the situation could not be considered alarming.

She advised people to seek early intervention if they are sick by going to the nearest barangay health stations, rural health units, and even submit to medical missions being conducted in their areas./PN

‘LEPTOS’ KILLS 2

July 4, 2008

City posts two more post-typhoon deaths

By DAVID ISRAEL SINAY

ILOILO City – Two died of infectious leptospirosis in this city, bringing to three the number of casualties since Typhoon “Frank” left.

Jose Militar, former village chief of Brgy. Banuyao, La Paz district, expired yesterday.

The other leptospirosis victim was 28-year-old Severo Villamucho, a resident of Brgy. San Roque, Nueva Valencia, Guimaras but worked and temporarily resided in Mandurriao district.

Villamucho had been hospitalized at the Western Visayas Medical Center since June 27. He died on Monday.

Leptospirosis is a water-borne disease usual in flooded areas. It is caused by the contamination of the flood water with animal urine. Infection begins when the contaminated water comes in contact with broken skin.

Friday last week, this city recorded its first post-typhoon casualty from a water-born disease. The 21-year old Florence Natalie Dagohoy of Brgy. Bolilao, Mandurriao was the first recorded casualty of diarrhea.

Yesterday, Mayor Jerry Treñas ordered the release of P20,000 for the procurement of antibiotics – like doxycycline and profilaxis – for the treatment of these diseases.

The medicines will be dispatched to various health centers in the metropolis.

City Health Office (CHO) chief Dr. Urminico Baronda said prone to infection are those with open wounds and treading on murky and contaminated waters.

Treñas urged residents to immediately see a doctor if they think they are sick.

But he admitted that the CHO lacks manpower – doctors, nurses, midwives, etc. – in health centers.

Still, Baronda remains confident that post-typhoon illnesses, especially gastrointestinal diseases, would be manageable.

His office has recorded some 50 cases of stomach problems.

CLEAN WATER
Treñas yesterday said water supplies being distributed by the city’s fire trucks and water tanks are potable drinking water and not other purposes.

Treñas said the local government resorted to water distribution as 75 percent of the city’s 418,000 population are without available drinking water.

The residents’ need for potable should be prioritized and attended to, the mayor stressed.
Thousands of bottled water being provided are not sufficient to the daily demands of city residents, the mayor admitted.

Several water treatment plants are now stationed in critical areas, where water sources and supplies are scarce.

The city has stationed three small water treatment plants from Ayala-Metro Waterworks and Sewerage System (MWSS) to the Metro Iloilo Water District (MIWD) compound.

MIWD presently provides free three to five gallons of water to city residents daily.
The water treatment plant the Spanish government donated will be stationed in Jaro district, Treñas said.

The Department of Health and the City Health Office had issued health advisories on water-borne diseases that may emerge – diarrhea, cholera, typhoid fever and leptospirosis, among others.

Typhoon “Frank” swamped almost half of the city’s land area with water and mud, contaminating almost all sources of potable water. Even some water refilling stations were not spared by the inundation.

The CHO advised residents to boil first their drinking water./PN

New AIDS threat emerging in India call centers (3 p.m.)

June 22, 2008

KUALA LUMPUR, Malaysia — A new AIDS threat is rising in India’s numerous call centers, where young staff are increasingly having unprotected sex with multiple partners in affairs developed during night shifts, a top AIDS expert has warned.

While India has made great strides in bringing down its HIV infection rate, the promiscuity among “call center Romeos” is a great concern, Dr. Suniti Solomon, who detected the first HIV case in India in 1986, told an international medical conference Saturday.

The United Nations, however, still estimates there are some 2.5 million Indians living with HIV and AIDS now.

“India has reached a plateau of the infections,” Solomon told the International Congress on Infectious Diseases, which ends Sunday.

Her concern now is the call centers, where many of the young staff work at night to correspond with the daytime working hours of their American and European clients.

“They have all the money. They huddle together in the night. They are young, they are sexually active, so naturally they start,” Solomon, who runs an AIDS center in the southern city of Chennai, told The Associated Press in a separate interview.

She said at least three or four call center workers visit her clinic every week to get tested for HIV because they are worried after having unprotected sex.

It is estimated that India’s call centers employ some 1.3 million people, mostly youths fresh out of school and colleges, earning a starting salary of 25,000 rupees (US$600) a month, more than a government doctor’s paycheck.

“You will see call center Romeos are a major high risk for HIV,” Solomon said.

There are no figures for how many call center workers are infected with HIV.

Citing confessions by the visitors to her center, Solomon said groups of young men and women rent apartments along the beach during the weekends and end up having multiple-partner sex.

“If they are having sex just among themselves, and all are non-infected it is fine. But if there is one person who has gone out of this group and brought in the virus, it will spread to everyone,” she said.

While the “call center Romeo” situation is a reflection of recent liberal values, India’s anti-AIDS fight is also hampered by society’s coexisting conservatism, Solomon told the conference.

She said this is evident in Hindu activists’ opposition to circumcision – which is proven to help inhibit HIV transmission – on the grounds that it is against tradition and religion of Hindu-majority India.

Solomon said she does not expect India to accept circumcision for preventing HIV infections. A recent government study to gauge the acceptance for circumcision triggered a massive backlash by Hindu fundamentalists, who called it “obnoxious” and “a conspiracy.”

“If you go out into the streets and say I will do this (circumcision) to reduce HIV, there will be a chaos,” she said. “Vaccines have failed. Microbicides have failed. This is one tool we have in hand but we can’t use it.” (AP)

Gov’t looking at possibility of rehabilitating BNPP – Reyes

June 8, 2008

Reviving its nuclear program remains as one of the options being considered by the government amid rising crude prices, Energy Secretary Angelo Reyes said yesterday.

Reyes said that with oil prices reaching more than $ 138 a barrel, the government is looking at the possibility of rehabilitating the mothballed Bataan Nuclear Power Plant (BNPP).

“I have taken the position that we have to revisit the nuclear option because we don’t want a situation where there will be power shortage. We are encouraging the development of alternative sources of energy, alternative ways of generating power,” Reyes said at the weekly news forum at Sulo Hotel in Quezon City.

The BNPP, whose construction began in 1976 and was completed in 1984 at a cost of $ 2.3 billion, was the response of the Marcos administration to the energy crisis of the late 1970s.

Then President Ferdinand Marcos saw nuclear power as the best way forward in terms of meeting the country’s future needs and reducing reliance on imported oil.

The 630-megawatt power plant cost the Filipino taxpayer a total of $ 460 million on a debt of $ 1.06 billion though it never produced a single watt of electricity.

In 1986, President Corazon Aquino mothballed the BNPP because of safety defects and sued its builder for overpricing and allegations of bribery.

In 2007, there were reports that the country made its final payment on the plant in April last year. Reyes said only three months ago, officials of International Atomic Energy Agency (IAEA) arrived in the country to evaluate the feasibility of commissioning the BNPP.

He said the tentative position of IAEA officials was that the country can rehabilitate the plant at a cost of 0 million for it to generate 630 megawatts of power.

Reyes said the rehabilitation may be expensive but the government is looking at what the plant can do the country in the long run.

“There’s no option that you will take that has no cost. If you’re looking at an option that has no cost, that option doesn’t exist,” he said.

He said before the rehabilitation, a complete feasibility study must be done and this will last for two years. The rehabilitation itself will take five years, he added.

The energy chief also said that rehabilitating BNPP would be faster than building a new plant, which may take one and a half decades.

“If you build a new plant, it would take 15 years to build it. Just looking for a site, the place where you locate the plant that will take a long time. You have to locate it in a place not vulnerable to earthquake and typhoons,” Reyes said. (Edmer F. Panesa)

“Take note of this, BNPP had survived earthquakes and typhoons,” he pointed out.

Besides nuclear power, Reyes said the government is looking at renewable sources of energy like wind, solar and geothermal, as well as alternative sources of fuel.

“We can’t have a situation where we do away with oil and coal. We will have blackouts then or we will have shortage in power supply,” he explained.

Without power, Reyes warned that investors would not come in and those who are already here will go away.(MB)

===============

My Take:

This is bullshit!

With the kind of government we have? We are not safe.  Yung mga advance countries na nga at mga disiplinadong tao pa na nagpapatakbo ng plantang nukleyar e nadaleng naaksidente, tayo pa kaya?

Baka sa pagpapatayo pa lang e panay mahinang klaseng materyal ang gawin dahil sa kikbak, komisyon at bukol.

tayo ang kawawa dito.  tutulan natin ito!

GMA signs Cheaper Medicine Law

June 7, 2008

By Marvin Sy
Saturday, June 7, 2008

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The long wait is over.

Filipinos can now expect more low-cost medicine in the market with the signing into law of the Universally Accessible, Cheaper and Quality Medicine Act of 2008.

The signing ceremony for Republic Act 9052 was held yesterday at the Laguna Provincial Hospital in Sta. Cruz, Laguna with the principal authors of the bill in the House of Representatives and the Senate joining President Arroyo.

Mrs. Arroyo said the existing generics law is an important piece of legislation that aims to bring down the cost of medicine in the country but it is “incomplete.”

“Now with the cheaper and quality medicine law, we have completed, I believe, our legislative reforms in bringing
affordable medicine to the people,” the President said.

RA 9052 allows the conduct of parallel importation of patented medicine from other countries where the prices are significantly lower than the prevailing price in the Philippines.

The government, through the Philippine International Trading Corp. (PITC), has been conducting parallel importation of medicine from countries such as Pakistan and India, selling these at state-run pharmacies aimed at the poor communities.

However, the PITC has faced strong resistance from the multinational pharmaceutical firms.

Sen. Manuel Roxas II, principal author of the bill in the Senate, said the PITC can now continue with its parallel importation with the signing of the new law.

Roxas said the PITC can now include more brands and types of medicine in its list of imports and it can also import higher volumes.

Apart from the PITC, Roxas said that even private groups or organizations can now import medicine directly from other countries provided that they register themselves with the Bureau of Food and Drugs (BFAD).

Under the law, the BFAD plays an important role as it is the agency tasked to ensure that all of the imported medicine is of high quality.

The law strengthens the BFAD by allowing it to retain its revenues for the upgrading of its facilities, equipment and human resources.

Roxas explained that by directly importing the medicine, the private entities would be able to save more since they no longer have to go through any middlemen.

The new law also provides for the use of the “early working principle” which allows local generic medicine manufacturers to test, produce and register their generic versions of patented drugs so that these could be sold immediately upon the expiration of the patents.

In order to prevent the owners of patented drugs from extending the term of their patents by declaring newly discovered uses for the components of their medicine, the law now prohibits the grant of new patents using this provision.

The law also allows the government to use patented drugs when the interest of the public is at stake.

Upon the recommendation of the Secretary of Health, the President has the power to impose price ceilings on various drugs, including those that are used for chronic illnesses, for the prevention of diseases and those in the Philippine National Drug Formulary Essential Drug list.

Drug outlets or pharmacies are now required to carry a variety of brands, including those brought in through parallel importation, in order to provide consumers with more choices.

The Generics Act was amended so that all generic drugs would now carry a label that has the statement of the BFAD about the therapeutic efficacy of the drug.

The Pharmacy Law was also amended to allow supermarkets, convenience stores and other retail establishments to sell over-the-counter medicine.

A congressional oversight committee would be created to monitor the implementation of the new law.

The Department of Health has been tasked to formulate the implementing rules and regulations for the new law within 120 days of its signing.

“We will not allow anything, not even a comma in the IRR, that would dilute the efficacy of this law. We will continue the fight, we will continue to monitor the implementation of the law in order to ensure that our people would have access to quality affordable medicine,” Roxas said.

“This new law will bring about competition. The prices of medicine will go down because of the increase in competition in the country,” Roxas said.

Healthier Philippines

Health Secretary Francisco Duque III yesterday gave assurances of a “healthier” Philippines as more Filipinos could now afford treatment for both common and potentially fatal diseases.

Duque said the DOH is set to launch very affordable treatment packs for common diseases and put 15,000 Botika ng Barangay (BnB) nationwide by 2010.

“DOH would make available treatment packs for common diseases at maximum prices of P100 for a one- to two-week treatment course,” Duque said.

The health chief explained that the country spends a total of P200 billion for health, half of which is spent on drugs and medicine.

“Since the cost of medicine in the country has been consistently and continuously prohibitive, the poor have limited access to these essential goods, bringing a perpetual cycle of impoverishment, deaths and diseases,” he pointed out.

“This law breathes new hope and life to all of us and gives a chance to the government to prove that health comes first before business interests,” Duque said.

Even labor unions are getting ready to import and sell medicine directly to workers with the new law.

Leaders of the Trade Union Congress of the Philippines, Federation of Free Workers, Alliance of Progressive Labor and others met with the representative of the PITC and Roxas recently to discuss how their groups could distribute medicine to their members and ensure that they would benefit from the lowering of prices of medicine.

TUCP secretary-general and former senator Ernesto Herrera said they had been waiting for this kind of measure for the sake of the laborers.

He expressed appreciation for the preparatory meetings with the PITC so that they could start immediately the importation of cheap medicine.

Herrera said laborers need maintenance medicine that are costly at present.

‘Fight not yet over’

The principal sponsor of the Cheaper Medicine Bill in the House, meantime, said the fight for low-cost drugs is not yet over.

“Proper implementation is the key to the measure’s promise of bringing down the prices of medicine,” said Palawan Rep. Antonio Alvarez, trade and commerce committee chairman.

“The next battleground for the law is in the drafting of its implementing rules and regulations (IRRs), where interest groups are expected to lobby for an interpretation of the provisions that will serve them,” Alvarez said.

“But the law cannot be tweaked or twisted because a House-Senate oversight committee that the law created will be looking over the shoulders of the agencies that will issue the IRRs,” he said.

An inter-agency panel composed of the DOH, Department of Trade and Industry, Intellectual Property Office, and BFAD will issue the implementing rules.

Alvarez said in addition to the rules, administrative measures are needed, including the strengthening of BFAD’s technical and manpower capabilities so it can properly evaluate pharmaceutical preparations. – With Mayen Jaymalin, Aurea Calica, Jess Diaz(PStar)

WHO Warns of ‘Tobacco Offensive’ Vs. Youths

May 31, 2008

MANILA, PHILIPPINES — The World Health Organization (WHO) today raised the alarm on the tobacco marketing net that targets half a billion young people in the Western Pacific Region, warning of the industry’s marketing ploys to hook youngsters into addiction at an early age.

In a statement to mark World No Tobacco Day on 31 May, WHO said the tobacco industry preys on the vulnerability of young people, knowing that they underestimate the risk of becoming addicted to nicotine. WHO called on policy-makers to support the ban on advertising, sponsorship and promotion called for in the WHO Framework Convention on Tobacco Control. WHO warned that:

* The more young people are exposed to tobacco advertising, the more likely they are to use tobacco.
* Widespread tobacco advertising makes tobacco use look normal and makes it difficult for young people to believe that smoking can kill.

“Youngsters are led to believe that certain types of cigarettes do not contain nicotine, when in fact they do,” said Dr Shigeru Omi, WHO Regional Director for the Western Pacific. “These tactics, along with the bombardment of messages through billboards, newspapers, magazines, radio and television ads, as well as sports and fashion sponsorships and other ploys, are meant to deceive young people into trying their first stick.”

WHO emphasized that research showed that only a total ban can break the tobacco marketing net. Partial bans merely allow companies to shift their vast resources from one promotional tactic to another, including falsely associating use of their products with desirable qualities such as glamour, energy and sex appeal, as well as exciting outdoor activities and adventure. Other than advertisements on billboards, in magazines, and on television, radio and the internet, the industry also ensures its products are highly visible in movies, in the world of fashion and in charity events. (WHO / pinoypress.net)

Tobacco companies sponsor sports and entertainment events, hand out branded items and advertise at point of sales to attract young people. Girls and young female adults are specially targeted. The rise in tobacco use in this group, the tobacco industry’s special focus, is a challenge that has to be dealt with urgently, Dr Omi said.

‘Philippine hospitals not good for health’–expert

May 27, 2008

By Jocelyn Uy
Philippine Daily Inquirer
First Posted 06:15:00 05/27/2008

MANILA, Philippines — Hospitals in the Philippines may not be good for your health, warned a UK-based scientist visiting the country.

Unknown to many, medical devices made from PVC (polyvinyl chloride) plastic such as IV bags and tubing, examination gloves, hospital flooring and plastic food wrap contain phthalates — chemicals that can damage the liver, kidneys and lungs and can also cause birth defects, especially among males.

This is according to Ruth Stringer, international science and policy coordinator for Health Care Without Harm.

Health Care Without Harm, says its website, is an international coalition of 473 organizations in more than 50 countries working to transform the health care sector so it is no longer a source of harm to people and the environment.

Stringer is also former deputy head of environmental group Greenpeace International’s science unit.

Stringer said medical devices made of flexible PVC can leach the phthalate DEHP (di-2-ethylhexyl phthalate) into patients.

Citing studies in Europe and the United States, exposure to DEHP has been linked to severe health problems, including infertility, immune system damage, impaired childhood development, hormone disruption and cancer.

Patients may be harmed when exposed to DEHP leaks from PVC medical devices, Stringer said in a press conference on Monday.

Animal studies, she noted, had documented that the developing male reproductive system was the most sensitive to DEHP exposure.

Stringer said that a recent study found a link between prenatal exposure to DEHP and reproductive changes in boys while another found that higher concentrations of phthalates in breast milk may decrease sex hormone concentrations in baby boys.

“Studies have shown that exposure to high levels of phthalates lower levels of sex hormones and they [target] the testicles,” said Stringer, who arrived in the country on 20 on a three-week study.

While medical establishments in the United States and Europe have started to take action against vinyl products — including the proper labeling of plastic products and resorting to other alternatives — doctors and health care experts in the Philippines have yet to become aware of its hazards, she said.

Last week, Stringer visited three hospitals in Metro Manila, where she found “many” PVC products that could “easily be replaced.”

She identified these hospitals as San Lazaro Hospital, Philippine Children’s Medical Center and Philippine Heart Center.

She said there were alternative plastic medical devices that hospitals could use such as those made from polyethylene, polypropylene, polyurethane, silicone, ethylene, vinyl acetate and multi-layer laminate plastics.

She also urged lawmakers to push for a bill making mandatory the labeling of plastic materials to properly guide consumers.

(PDI)

Fetal, Maternal Deaths in Philippines ‘Alarming’

May 26, 2008

MANILA, Philippines — The anti-poverty groups Global Call to Action Against Poverty (GCAP) and Womanhealth Philippines have raised alarm over the reported increase in fetal deaths due to short gestation and low birth weight as shown in the latest study of the National Statistics Office released this month.

“This report punctuates the problem on maternal health that remains a challenge to the government in meeting the United Nations’ Millenium Development Goals of reducing child mortality and improving maternal health towards completely eradicating poverty in the country,” said Joel Saracho, GCAP Philippines Coordinator.

In a paper that Mercedes Fabros of Womanhealth Philippines wrote, the Department of Health recommends all pregnant women to have at least four prenatal visits, with emphasis on receiving care as early as the first trimester. Prenatal care includes advice to expectant mothers on nutrition and health care, education on the symptoms of risk conditions, examination, screening, immunization and micronutrient supplementation.

“The proportion of women attended by skilled service providers has improved over the past years with almost three fourths or 70.4 percent of women having at least 4 prenatal visits. However, only a little more than half of them or 53 percent had their first visit during the first trimester that is the most critical stage,” said Fabros.

GCAP and Womenhealth Philippines have launched a campaign to address maternal and child mortality by weaving the stories of mothers in the communities in a tapestry of tales and help these women reclaim their right to maternal health as provided for in the UN Millenium Development Goals.

The sharing of stories started last Saturday in Barangay Bago Bantay in Quezon City. “We will bring this to other barangays in Metro Manila where maternal mortality and teenage pregnancy cases are high,” Saracho said.

According to the NSO study, the National Capital Region (NCR) posted the highest number of fetal deaths with 2,550 cases or 24.6 percent of the total in the country’s 17 regions. Regions IV-A and VII ranked second and third with 1,681 and 1,264, respectively.

“As alarming as fetal deaths is maternal mortality that contribute to 14 percent of the total deaths of women aged 15-49. Each day, 10 Filipino women die from pregnancy and childbirth-related complications. These are all preventable if poor women are given access to correct health services,” said Fabros.

Threat to life while giving birth

Freda Atienza knew giving birth to her second child will be difficult. Three months into her pregnancy, her husband left her and their eight year old daughter for another woman. She’s also been diagnosed as having a cyst in the right ovary. She’s been in and out the hospital for excessive bleeding. According to her, she has mastered the art of enduring and suppressing her pain.

On September 21, 2008 at around 11:30 in the evening, her water bag broke. Accompanied only by her eight year old daughter, she sought help from the Ramos General Hospital in Quezon City. She was told there was no bed for her. After three hours, she was referred to the nearby Sioson General Hospital.

Having had a previous caesarian operation, the 37-year old Freda was told that the hospital has no available anesthesiologist. The hospital also asked for P10,000 deposit but Freda said she does not have the full amount. The staff of Sioson Hospital then advised her to go the Quezon City General Hospital but to first go back to Ramos Hospital to ask a nurse to accompany her.

The pain has taken toll on Freda. At this point, she admitted that the staff of the two hospitals were virtually dealing with and giving instructions to her eight year old daughter.

Her daughter decided to go home to ask help from their landlady. She even climbed the terrace leading to the unit of their landlady’s house to wake her up.

Her landlady, Nelia Pagulayan, 42 accompanied her to Quezon City General Hospital, where they were told that it was a Sunday, and there is no available operating room for her. There were talks about her being sent to yet another hospital.

But Pagulayan insisted that she be treated in QCGH. Preda was bleeding profusely at that time and Pagulayan feared that she might die on arrival at the next, if there is indeed another available hospital without an excuse to treat her.

Still half-conscious at that time, Freda learned from conversations between the doctor and the staff who brought her to a delivery room that theirs is 40-60 chance.

One of them asks her to pray for a miracle.

“Misis, magdasal ka na kung marunong kang magdasal. Doktor lang kami. Diyos na ang may hawak sa buhay mo,” Freda recounted.

A few more minutes later, the doctors are almost ready to give up on her.

“Patay na ako para sa kanila. Pero sinabihan nila akong lumaban alang-alang sa baby ko. Dahil lumalaban siya,” Freda said.

At 4:45 am the following day, she gave birth to a boy. She would later learn that the doctors actually forced the baby out of her just to save him. They stayed for several more days in the hospital to ensure that both Freda and her child are now safe.

Child carrying a child

At the age of 13, Ellen (not her real name) is already carrying a child. When Ellen first sought prenatal check ups from a lying-in clinic in Quezon City, she was refused. The staff explained that their policies require them to give prenatal check up to expecting moms who are at least 20 years old.

She was able to get two check ups at the government-run Quezon City General Hospital.

Unlike Freda, Ellen went directly to the QCGH after experiencing pain. Unlike Freda, Ellen was with her husband, who was also a teenager. Fortunately, her parents are with them.

At the hospital, instead of immediately addressing her pain, the staff required her to first get a blood test and a urinalysis. Ellen was also given a list of medicines and things they would need in giving birth.

“Bilhin daw muna bago ako manganak,” she said.

Ellen’s companions were able to buy some of the things they need.

“Kulang pa daw sabi nila. Mabuti na lang naawa iyong isang doctor sa amin,” she recounted.

Ellen was told to stay in a labor room, which they later learned has to be paid for P200.

The doctor told Ellen that she needs to deliver by C-section, since as she is not yet fully developed as a woman who can give birth.

“Maliit daw ang sipit-sipitan ko. Hindi daw kakayanin ng normal,” Ellen said.

She gave birth to a boy.

The hospital however told them that both mother and child cannot leave the hospital until they settle all the bills. Aside from what they already bought, they were to pay the hospital P7,000 for the medicines and another P11,000 for her C-section delivery.

Fortunately, the Social Welfare Administration shouldered the payment for the C-section. Ellen’s family paid for the remainder of the bill.

A month after giving birth, Ellen’s teenage husband left her and their son.

“It is fortunate that Freda survived her sure death at that time. In her condition and accompanied only by a child, she should have been helped at the least by the two semi-private hospitals that refused her for various reasons,” Fabros explained.

Saracho said Ellen would not have suffered too much if QCGH staff exerted the better part of their time assisting her than worrying how to replenish their medical stock. There are more stories, probably worse than what happened to Preda and Ellen.

“We want to give the issue a face. We want our national government and local government units to listen. Something must be done to curb maternal and child mortality. No woman, no mother deserves to die while giving life,” said Saracho. (Global Call to Action Against Poverty / pinoypress.net)

UNILAB to assist biotech firms market natural ingredients

May 24, 2008

United Laboratories, Inc. (Unilab), one of the country’s biggest pharmacuetical firms, is interested in helping biotech companies extracting natural ingredients as source of compounds for the manufacture of medicines.

Jose Maria Echave, Unilab’s vice president for business development, said the company is encouraging scientists to bring their natural pharmaceutical products for possible development and collaboration in marketing the same.

Echave made the statement during the 4th Philippine Biotechnology Venture Summit held at the Ateneo School of Medicine and Public Health.

He noted the great potential of the natural ingredients industry. “If you have a very good natural product, we are willing to listen,” Echave said.

The Unilab official added the trend now in pharmaceuticals is to go biologicals. He added that the Philippines has the edge in this potentially huge market since the country has a strong natural ingredients industry.

“In the pharmaceuticals sector the way to go now is biologicals. The era of blockbuster synthetic drugs is about to end,” he said.

Unilab is also encouraging scientists to use biotechnology to develop vaccines. Right now, a Filipino company, Servac Philippines Corp. is developing an anti-rabies serum from the antibodies produced by horses. Servac hopes to make the vaccine commercially available by the end of the year.

Another area in which biotechnology can venture is the development of dengue diagnostic kits. “Anything portable, anything you can bring down to the lowest unit to the community will be very, very useful. It has to be at a good price point, ang tinitingnan namin is P5. If you can come up with drugs that is at P5, then we can do business,” Echave said.

He noted that natural ingredients must be backed up by clinical evidence to make a big splash in the world market.

“There are ways by which we can develop our resources but there has to be a good clinical evidence. Hindi puwedeng endorsement lang,” he said.

Data from the National Integrated Research Program on Medicinal Plants (NIRPROMP) showed the Philippines has over 1,500 identified medicinal plants. Some of these plants have been endorsed by the Department of Health (DoH).

These include bayabas, ba-wang, ampalaya, sambong, yerba buena, lagundi, akapulko, pansit-pansitan, tsaang-gubat and niyog-niyogan.

Pascual Laboratories, Inc., the second biggest Filipino pharmaceutical company, has succeeded in marketing phytomedicines (herbal medicines) with anti-cough medicine from lagundi popularly known as Ascof and a medicine from sambong to help prevent kidney stones, Re-Leaf.

Pascual Lab’s Dr. Eliseo Banaynal said the government can help the country’s natural ingredients industry venture deeper into pharmaceuticals industry.

Banaynal said government should help the industry by coming out with a geographical mapping of medicinal plants. – biolife news service(Malaya)

Editorial Cartoon: Coal is Cool.

May 23, 2008

Real cool!

Pia Cayetano on drugs bill: What’s taking Arroyo so long?

May 22, 2008

MANILA, Philippines — Senator Pia Cayetano called on President Gloria Macapagal-Arroyo Thursday to immediately sign into law a measure that seeks to lower the cost of medicines in the Philippines.

Cayetano said she found it unusual that the Universally Accessible Cheaper and Quality Medicines Act of 2008, certified as urgent by Arroyo, remains unsigned three weeks after Congress ratified it on April 29.

“I would like to think that the President will stand by her word that she is for this bill. It took Congress more than three years to have it passed. Now the fate of this landmark measure is in her hands,” said Cayetano, who chairs the Senate health committee.

She also belittled the pressure allegedly being exerted by US Lobby groups on the Philippine government to derail the bill’s enactment into law.

At the same time, she vowed to continue to work on several measures that will strengthen the bill, like boosting the capability of the Bureau of Food and Drugs to screen and monitor the quality of both branded and generic drugs in the market. Marilyn Baduria, contributor

Attempted rape, grave threat are only two of 4 cases against Ancheta

May 21, 2008

By Ines B. Tagacay

AS IF his murder case is not enough, controversial City Police Supt. Enrique Ancheta is facing four more cases filed against him on May 12 by the National Bureau of Investigation (NBI).

Investigation bureau Executive Officer Atty. Alex Cabornay said the new cases are “attempted rape, grave threat, violation of Republic Act 7438 or the Expanded Rights of the Accused Under Custodial Investigation and maltreatment of prisoner.”

Ancheta in police uniform with Vice-Mayor Lucillo R. Bayron of Puerto Princesa.

Cabornay said the NBI has reasons to believe that the cases are matters for the court to settle that’s why they were filed.

The cases stemmed from a complaint filed at the NBI by a certain Cirene Buezon, 24 years old, a resident of Tondo, Manila and currently a resident of Barangay San Manuel, and Barangay Manggahan chairman Gregorio Viguesilla.

“Aside from the murder that we filed against P/Supt. Ancheta, we filed four new cases against him at the Fiscal’s Office,” he said, stating three policemen and a policewoman are also included in the list of those who are going to be sued. The NBI chief did not name the policemen who are being accused.

A member of the Kilos Agad Action Center (KAAC), Janrex Lorilla, is also being sued for “unlawful arrest” by the NBI.

As of press time, Ancheta has a total of five cases to deal with. In an exchange of text messages with the Palawan Times, the beleaguered City PNP official denied all accusations against him, including mauling, beating and watching while the alleged victim is being forced to perform lewd acts on a naked policeman.

“All their accusations against me are not true, they’re all lies,” Ancheta said. He vowed that whoever is orchestrating the cases against him can expect that he will not buckle and will continue to arrest individuals who will break the law.

“My campaign against crime and lawlessness will continue and these people who are behind these cases will not make me go away. I will continue to protect the residents of Puerto Princesa,” Ancheta said.

Cabornay said Buezon was mistaken to be an “exhibitionist” that was why he was arrested by Lorilla of KAAC and was brought to the City PNP. At the police station, the suspect was brought inside the office of Ancheta.

“It was in the office of Ancheta where he said he was maltreated and beaten,” Cabornay narrated, adding Buezon was first brought to a doctor for medical examination before he was handled roughly.

On the attempted rape accusation, Ancheta was charged for being an accomplished. The victim allegedly told the NBI that the police chief was there when one of his men who went naked forced him to do a lewd act.

“We have a new law and it says rape also includes the male,” the NBI chief explained.

The new charges against Ancheta have already reached the knowledge of PNP Regional Director Chief Supt. Luisito Tinio Palmera, who immediately ordered the Palawan PNP Provincial Command to conduct a pre-charge evaluation.

He said this is “part of the due process” that any PNP official must go through when there are cases filed in court. Police Col. Dennis Peña would have to determine if there is probable cause for the filing of an administrative case against Ancheta.

As of this writing, Palmera is just waiting for the result of the pre-charge evaluation before he makes any decision.

“Regarding Ancheta’s cases, we have already required the Palawan PNP Provincial Command to submit a pre-charge evaluation report. We will have to wait for this to give him due process.

Davao’s tribute to Bob Marley helps to fight cancer

May 19, 2008

A TRIBUTE TO MARLEY. Raymond Aranjuez, front man of the local Ragged band, performs at the Taboan in Matina Town Square during the free Reggae Night concert on Sunday, May 11. The date happens to be the death anniversary of Nesta Robert “Bob” Marley, the British-African reggae musician who brought “mainstream cultural acceptance of reggae music outside of Africa.” (davaotoday.com photo by Barry Ohaylan)

REGGAE FESTIVAL. Audience are engrossed in great music during the Reggae Night. Various local bands perform at the free concert to celebrate cancer prevention month. A reggae festival is slated around the world this year to “confirm the universality of reggae,” according to Bob Marley’s website. (davaotoday.com photo by Barry Ohaylan)

HEALING WAILERS. Local reggae group, The Ragged band, performs for free during the celebration of the cancer prevention month. The band also pays tribute to reggae icon, Bob Marley who died 26 years ago of melanoma, a malignant skin cancer. (davaotoday.com photo by Barry Ohaylan)

Joan Soco, former Mutya ng Dabaw, encourages Davaoeños to support the local music talents. (davaotoday.com photo by Barry Ohaylan)

Victim in surgery video wants DOH excluded from probe

May 19, 2008

CEBU CITY, Philippines–The patient in the rectal surgery scandal at a government hospital here is now fighting for the exclusion of the Department of Health (DoH) in the administrative investigation of the doctors and nurses involved in his surgery.

The patient is also fighting for the protection of his identity after some local dailies and radio stations identified him.

The patient’s lawyer, Guiller Ceniza, said his client preferred that the investigation be done solely by the Visayas Ombudsman, as he believed the health department probe was biased in favor of the accused medical practitioners since only six of a dozen persons present during his surgery were facing administrative charges.

The surgery at the Vicente Sotto Memorial Medical Center (VSMMC) on Jan. 3 to remove a canister of spray-on perfume from the patient’s rectum became a scandal when the video of the operation—which showed the doctors and nurses crowding at the operating table laughing, cheering and making fun of the patient—was uploaded on YouTube.

Ceniza said they would ask the Ombudsman on Monday to order the DoH in Central Visayas to turn over to the Ombudsman the documents related to the administrative investigation.

He added that since his client has filed a complaint with the Ombudsman against the doctors and nurses involved in his surgery, they believed the Ombudsman could also direct media organizations to protect his client’s privacy and stop using the real name of his client.

DOH 7 regional director Susana Madarietta on Tuesday placed on a three-month preventive suspension lead surgeon Dr. Phillips Leo Arias, assisting surgeon Dr. Max Joseph Montecillo and circulating nurse Carminia Sapio after the hospital management filed an administrative case for misconduct before the DOH against six medical practitioners.

Health undersecretary Alexander Padilla earlier said the DoH would be willing to give way to the Ombudsman on the administrative investigation against the medical practitioners but DoH would continue its investigation until the Ombudsman’s ruling on the matter.(PDI)

Fr. Shay Cullen: What You Do to Them You Do to Me

May 18, 2008

A group of German visitors went with the staff of Preda Foundation last 5 and 6 of May, 2008 to visit the children at the Reception and Action Center (RAC) and the Manila Youth Reception Center (MYRC) to bring snacks and drinks and see the condition of the children detained as prisoners. In the Action center, the kids are 10 years old and below and lives in a bare and empty room. Since our list exposed on this, the children are now allowed to watch TV for a while in the dining room instead of looking at a bare wall all day. Still, they look down from barred windows on the second floor. But on our previous visit, we were shocked to see that two strangely half dressed young men with dyed hair and strange ways were allowed access to these little children. They were not social workers, not in uniform, no IDs and clearly not qualified to be there. (See photos at http://www.preda.org)

They seemed to be in charge with authority. The little kids were following their orders and were clearly frightened of them. The danger of abuse to the children was present and alarming. The council for the Welfare of Children ought to have professional social workers and psychologists visit the children and see the conditions and talk to them to know if any have been abused.

There must be something bad to hide if charity workers are forbidden to visit the children and bring them food. It’s what Jesus of Nazareth commanded us to do. This situation at the RAC and MYRC is harmful to children and youth. The sub-human conditions are a violation of RA 7610, PD 603 and RA 9344, and also the international conventions on the rights of the child. That’s why they don’t want us to visit. They are in violation of the law and harming the youth and children.

That’s one thing that Former Senator, now mayor of Manila Alfredo Lim, really abhors. He is a strict law and order mayor and his own son, recently arrested for drug offenses is to face the full wrath of the law. We expect him to investigate the sub-human conditions and the malnutrition of the inmates all suffering violations of their rights within a short walk of his office. He will see that this is a cruel and unusual punishment of children and youth and he will order it changed immediately. He is that kind of man.

We were also forbidden to visit the youth detained in the MYRC. But we know from previous visits, photographic evidence and the testimony of former inmates that it is a horrible dungeon and the kids are always hungry, deprived and lives worse than animals. The authorities have barred all outsiders from seeing the sub-human conditions. If there is nothing to hide, then why bar visits by charitable groups licensed and accredited by the DSWD such as Preda workers?

The MYRC authorities are acting like the Burmese Generals, they want us to leave the aid and relief supplies and go away. We will take care of it they say. There is no guarantee that the foods and donations will get to the needy and hungry children. They ought not to blame the staff of Mayor Lim for this. I advise the good mayor to lease out the entire compound for development into a ten story building with a commercial ground floor, a floor for the city offices, another for the courts and one for the social services. With the earnings from the rent and lease he can build a best practice and model children’s home on the city land in Marikina. END

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Contact Fr. Shay Cullen at the Preda Center, Upper Kalaklan, Olongapo City, Philippines.
e-mail: preda@info.com.ph
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PREDA Information Office
PREDA Foundation, Inc.
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http://www.preda.org

Mabinay has highest malnutrition rate

May 18, 2008

THE Integrated Provincial Health Office recent nutritional survey identified the town of Mabinay of having the highest malnutrition rate.

Based on the results, it was learned that Mabinay town has the highest recorded malnutrition rate while Dauin has the lowest rate.

The survey was part of the agency’s Operation Timbang conducted from January to March this year.

In a confirmatory meeting, the Provincial Nutrition Council revealed that of the towns, Mabinay ranked the highest malnutrition rate with 22.1 followed by Vallehermoso with 18.4, and Manjuyod with 18.1.

The town that recorded the lowest malnutrition rate is Dauin at a rate of 3.2.

As for cities, Canlaon received the highest malnutrition rate with 11.7, followed by Bayawan City with 10.3, and Tanjay City, 10.

Dumaguete City meanwhile ranked fourth with a malnutrition rate of 6.4 and Tanjay RHU 2 got the lowest rate with 4.2.

A total of 181, 182 children in the province aged zero to 71 months old were weighed during the Operation Timbang.

It is still currently ongoing with the results expected to be completed by June this year in time for the Nutrition Month celebration. (SunStarDumaguete)

Editorial Cartoon: Huwarang Ina Awardee

May 11, 2008

Huwad Na Ina

Who Is Afraid of Price Control for Medicines?

May 11, 2008

Who is afraid of drug price regulation?

Certainly not the patients, who stand to gain much if prices of much-needed medicine are immediately reduced to low, very inexpensive levels. Definitely not the doctors, who will finally see their patients able to comply and adhere to their medical treatment. And absolutely not the general public, who may yet enjoy a better life when even the most essential and life-saving drugs become affordable.

Who, then, is afraid of drug price regulation? The big pharmaceutical companies and their proxy representatives, who continue to raise the specter of “abuse”, “over-regulation”, “regulatory capture”, and other “complex problems” supposedly posed by price controls.

Health Alliance for Democracy (HEAD) today reiterated its calls for a strong drug price control and greater regulation of the entire drug industry as means to immediately reduce drug prices and provide any meaningful impact on the public. This is in reaction to reports that Congress has removed the provision on the drug price regulatory board in its consolidated version of the Cheaper Medicine Bill.

“Given the highly monopolized character of the industry, no genuine competition will prosper as it is the inherent nature of monopolies to suppress competition, as what happened with the Generics Law. Regulation at this juncture is therefore both a moral and political imperative.” said Dr. Gene Alzona Nisperos, HEAD secretary-general.

Because of the stifling stranglehold of big pharmas, the number of local Filipino drug manufacturers has been greatly reduced, from around 300 in the 1980s to only 27 today, 8 of which are up for sale. Many of these companies are manufacturing only specific drug lines and cannot yet provide genuine competition to big trans-national corporations (TNCs) or provide a backbone to a strong generics industry here.

In contrast, more than 70% of total drug sales are accounted for by pharmaceutical TNCs, earning some 58.5 billion pesos for the top 10 drug TNCs (excluding United Laboratories) in 2006. By July 2006, the pharmaceutical market grew by 7.4% in value but declined by 3% in volume, reflecting growth that is mainly driven by price.

“All talk about the so-called market forces coming into play is deceptive. These so-called market forces have been around for more than 20 years and have not affected any real change, which is why we are still faced with exorbitantly priced medicine.”

Added Dr. Nisperos, “If Congress is going to give the President the power to regulate drug prices, they are not just ensuring “regulatory capture”, they are promoting political expediency. Our legislators are expected to uphold the people’s interest and not exhibit their shameless mendicancy to the President.”

HEAD believes that the current status quo is unacceptable, especially when government line agencies like the Department of Health and the Bureau of Food and Drugs remain incapable of controlling the unscrupulous profiteering by big pharmaceutical companies.

“Filipino patients are dying or being maimed en masse because they cannot afford the medicine they need. If we truly have the interest of the Filipino patient at heart, then regulation is a requisite, not an option, in making medicine affordable in this country.” concluded Dr. Nisperos, “Anything less is a return to the status quo and an absolute betrayal of this interest.” ####

References:

Dr. Gene Alzona Nisperos

Secretary-General, 0916 214 5724

Dr. Geneve E. Rivera

Deputy Secretary-General, 0920 460 3712

PinoyPress

Editorial Cartoon: Light

May 10, 2008

And then there was light.

The Cure

April 29, 2008

eSKANDALO

April 24, 2008

Ang kumalat na bidyu hinggil sa isang lalaking inoperahan sa pwet sa Pagamutang Vicente Sotto ay lumikha ng ingay sa buong mundo.

Marami ang natawa sa aktwal na paghila ng isang perfume cannister na buong nakasuksok sa puwet ng naturang pasyente.

Ngunit marami rin ang nagalit. At least, ang mga nag-iisip, at nagpapahalaga sa karapatang pantao.

Marami na ang nagsalita. At maraming punto na ang narinig.

At sa pamamagitan ng kartung nakikita ninyo, nawa’y maihatid din namin ang isa pang mukha ng isyu: ang lahatang anti-gay na mensahe ng bidyu.