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Dona Pazzibugan
Philippine Daily Inquirer

MANILA, Philippines—One out of every five adult Filipinos is diabetic, according to the latest national survey on the prevalence of the disease.

And compared to a decade ago, more Filipino children may now be at risk of contracting diabetes due to the growing cases of childhood obesity, among other factors, according to a panel of doctors who presented the findings Tuesday.

The survey, conducted last year by the Philippine Cardiovascular Outcome Study on Diabetes Mellitus, also found that as many as three out of five adults may already be diabetic or on the verge of becoming one unless they change their lifestyle.

Dr. Rody Sy, former president of the Philippine College of Physicians and current head of the Cardiovascular Institute at the Cardinal Santos Medical Center, said 82 percent of the respondents in a diabetes survey in 1998 were interviewed again last year.
The 1998 survey showed 3.9 percent of the adult population, or persons aged 30 and above, to be diabetic. The figure rose sharply to 20.6 percent in the 2007 study.

“That means one out of every five adults is diabetic. That is quite high,” Sy said in a press conference.

Sy said the prevalence of diabetes could be higher based on the glucose tolerance tests conducted on the respondents. The study found that 26.2 percent of the sample had “impaired fasting glucose” levels and 23 percent had “impaired glucose tolerance” levels.

“The tests mean that if they are not careful, they can become diabetic,” Sy explained. “Given some overlapping, it appears that three out of five of the adult population are diabetic or pre-diabetic. That’s the bottom line.”

A diabetes survey among Filipino children has yet to be conducted. But giving an estimate, Dr. Lorna Abad, president of the Philippine Society of Pediatric Metabolism and Endocrinology, said around 8 percent of the country’s child population may be diabetic.

“That’s high,” Abad said, noting that 10 years ago the estimate was only 2 to 3 percent.

Abad said she receives as many as eight new diabetic patients a year in her clinic at the state-run Philippine General Hospital, and six to eight more new patients a year in her private practice. “That’s a lot,” she said.

Her youngest patient so far had been a month-old baby, Abad recalled.

Dr. Yolanda Olivares, director of the Department of Health’s National Center for Disease Prevention and Control, described the latest findings on adult diabetics as “a cause for alarm” and “a big challenge for all of us.”

But like Abad, she observed that “more and more children are succumbing to diabetes.”

Olivares cited 2003 data showing that 2.6 percent of Filipino children under 5 years old, as well as 5 percent of children aged 6 to 12 years old, to be overweight—or having one of the risk factors for diabetes.

In 1998, Olivares said, only 1 percent of Filipino children were considered obese.

Olivares warned that unless people start changing their diet and lifestyle, deaths from diabetes among Filipinos may increase by 17 percent within 10 years.

She said the public should start demanding “healthier food”—products containing less sugar and salt—from restaurants and fast-food joints. Smokers should quit, she stressed.

Olivares also cited the importance of breastfeeding, saying formula-fed babies are more prone to developing chronic diseases like diabetes in adult life. Also, diabetes among children is often misdiagnosed as flu, which has similar symptoms, or sometimes not detected at all, she noted.

Dr. Tommy Ty Willing, president of Diabetes Philippines, said Type 2 diabetes generally afflicts adults “but more and more of this kind are (being diagnosed in) children.” He cited cases of high school students already found with Type 2 diabetes.

If diabetes goes undetected in early childhood, it can either prove fatal or result in serious brain damage, Willing said.

The United Nations in 2006 declared Nov. 14 as World Diabetes Day, the first time that a non-communicable disease was recognized as a global problem. The Philippine observance this year focuses on diabetic children and adolescents.

Diabetes is a metabolic disease in which the body is unable to produce or properly use insulin, a hormone needed to convert sugar into energy. This leads to an increase in the sugar level in the blood. Complications include blindness, kidney failure, stroke, heart attack, wounds that would not heal, and impotence.

Diabetes has several warning signs—frequent urination, excessive thirst, and unexplained weight loss. Children of diabetics are at risk of diabetes, and so are people suffering from obesity, hypertension, and high cholesterol levels. Lack of exercise, or living a sedentary lifestyle, has also been found to play a role in causing this disease.

Philippine Star

With the growing global demand for physicians and other health workers, medical doctors in the country continue to dwindle in number and are fast becoming a rare breed.

In fact, seven out of 10 sick Filipinos die untreated due to the acute lack of doctors in the country, former health secretary Jaime Galvez-Tan disclosed yesterday.

Tan said the country’s health care delivery system is now nearing collapse as the shortage of doctors has persisted for decades.

“Our health care system is collapsing and in some areas, particularly in urban communities, has collapsed,” Tan told The STAR.

He noted that 21 municipalities and seven government hospitals in Western Samar as well as all the five municipalities of Sulu have no doctors.

“There are 120 municipalities nationwide at this time without doctors. The figure was down from the 271 doctorless municipalities but just the same that’s 120 municipalities and many people are living there,” he pointed out.

In 1992, Tan said the Department of Health (DOH) launched the “Doctors to the Barrio” program in an effort to fill up the 271 municipalities.

Sixteen years later, Tan said, the DOH’s program hardly succeeded in deploying health care professionals to the country’s doctorless municipalities.

He admitted that the widening demand for doctors in various developed countries is further worsening the doctors’ shortage.

“Foreign countries like Finland and France that were not recruiting doctors before are now offering $6,000 salaries for physicians and we cannot match that,” Tan said.

A growing number of Filipino doctors are also studying again to become nurses so they could easily go abroad.

Citing data from the Professional Regulatory Commission (PRC), Tan said that 10,000 doctors have become nurses and 99 percent passed the licensure examination.

“Of the 10,000 doctors who became nurses, 6,000 have already left for abroad,” he said.

To further compound the situation, Tan said that fewer young Filipinos are now taking up medicine due to high cost of education.

“From 30,000 two years ago, the number of medical students are now down to 1,500. So we could just imagine how many will remain by 2012,” he said.

According to Tan, many Filipino would actually choose to stay in the country over the lure of high-paying jobs but the lack of support from the government drives them away.

“They would want to stay and treat people here, but government hospitals do not have the necessary facilities and it’s very frustrating for them,” he explained.

For this year, Tan said, the government allocated 50 centavos for every Filipino’s health care, which is not even enough to buy a tablet of painkiller.

He urged the government to come out with appropriate measures that would require Filipino doctors to stay in the country.

“While other countries are in need of doctors, the Philippines should not suffer for it. Thus, if developed countries would hire Filipino doctors, they should replenish them by providing training to those who are here,” Tan said.

He added that medical graduates of state universities should also be required to serve in the country before going abroad.

“Starting next year, those who are entering medical course at the University of the Philippines and are set to graduate in 2018 are required to stay and serve here for three years,” Tan said.

He also expressed confidence that with programs honoring the few patriotic doctors, more medical experts would opt to stay and serve in remote areas.

To celebrate its 75th foundation year, UP’s Phi Kappa Mu Fraternity is mounting the first search for hero doctors.

Dubbed “Diamonds in the Rough,” the national search for young doctors in community setting aims to highlight the heroism of Filipino doctors amid the lure of overseas employment and recent scandals that tainted the medical sector.

Speaking before the launching of the Search, Sen. Richard Gordon doctors serving in far-flung communities must be given recognition.

“There are less and less doctors in the field and they have become a rare breed,” Gordon said, adding that as mayor he had difficulty filling up vacancies in government hospitals.

He also pledged to work on a proposed measure that would provide higher financial benefits and bring doctors back in communities.   Fraternity alumni association president Dr. Manuel Chiaco said that with the project they hope to give exemplary model for today’s youth.

“On our 75th year, we felt not just celebrating, but also honor those who are working in distant communities that are so remote that their works are practically unheard of,” Chiaco said.

With Philippine STAR as one of the partners, Phi Kappa Mu superior exemplar Vincent Varilla said the search would have three major award categories – Luzon, Visayas and Mindanao.

Qualified to join are licensed doctors below 40 years who have actively served the community for five years and have not been recognized by other award giving bodies.

A screening committee will select nine finalists from all the nominees and elevate them to the final evaluation committee, who will select winners from Luzon, Visayas and Mindanao.

The three winners will receive P100,000 worth of prizes to be given during the awarding rites in December.

– Mayen Jaymalin

Ruby de Vera
Philippine Daily Inquirer

Last updated 04:33pm (Mla time) 08/04/2008

MANILA, Philippines—Did you know:

13.4 percent of young adults have thought of committing suicide

25 percent have attempted to commit suicide
The average age of first suicide attempt is 16

9.6 percent felt really hopeless about the future and 9.9 percent felt depressed about life in general.

*From the 2002 Young Adult Fertility and Sexuality Study (YAFS) 3.

What causes depression

While depression can be genetic, it can also be triggered by one or several external and environment factors such as separation or death in the family, difficult relationships, moving to a different place, and any unwelcome change in life.

How to spot it

According to Zsa Zsa Briones, psychologist for PsychConsult Inc., suicidal tendency is only one of the symptoms of clinical depression. It also includes behavioral changes such as change in routine, extreme deviation from the usual sleeping and eating habits, and withdrawal from social contacts and interaction.

As soon as someone verbalizes thoughts about taking their own life, take it seriously. They may or may not be just seeking attention, but even joking about might be a silent cry for help of people who might be falling into the black hole of depression.

They become irritable and would leave instructions to their family and friends what to do with their belongings in case they’re “gone.” Sometimes they would even detail the method and paraphernalia they will use.

What to do

If someone you know suddenly exhibits the symptoms mentioned above, Briones suggests that in the case of parents, they should make time to talk to their children. Being sensitive to them makes a big difference in making a turnaround in their situation. These people are constantly looking for that light at the end of the tunnel, because they feel that their options have narrowed.

If it’s a friend, don’t leave him or her on their own. If possible, take turns sleeping with him so he’s never alone. They need your constant company and support so they won’t feel so hopeless.

If you yourself feel that your sad spell is getting longer and more serious, seek help. Reach out to people. If your friends and parents are not available, go to an adult you trust. It can be a close relative, or it can also be your teacher, coach, or parish priest.

Mental health awareness

In the country, seeking professional help on psychological problems still carries with it a stigma. Mental problems might not be acknowledged as physical diseases, but they are as important. To get to a mental health professional, people either ask for referrals from their family doctors or friends.

A strong support group is important for people who are susceptible to depression. Families and friends play a major role in getting us out of the blues. It’s okay to reach out and talk to people. It’s okay that we can’t please everybody, and there would always be someone whose world will crumble when we’re gone.

PsychConsult. Inc. is at Unit 227 Regalia Park Towers, P. Tuazon Ave., Cubao. You may call them at 421-2469 or 357-6427.

Credits are also given to Christine Gervacio of the Foundation for Adolescent Development (http://teenfad.ph) and Jerome Daclison of Philippine Business for Social Progress (http://pbsp.org.ph).

Marvin Sy
Philippine Star

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

Marvin Sy
Philippine Star

The Philippines is ranked first among 55 developing countries in terms of providing basic health care to children, according to the United States-based organization Save the Children.

In its annual State of the World’s Mothers report, the organization placed the Philippines on top of its basic health care report card after seeing good progress in the country’s efforts to improve health care for children.

However, while the overall ranking of the country was high, Save the Children noted a wide disparity between rich and poor children as recipients of health care.

Save the Children defines basic health care as a package of lifesaving interventions that includes prenatal care, skilled care at childbirth, immunizations and treatment for diarrhea and pneumonia.

“The Philippines is making good progress in improving health care for children and has achieved a 48 percent reduction in its under-5 death rate since 1990,” the report said.

In terms of newborn mortality rates, the Philippines has one of the lowest in the developing world with an average of 15 out of 1,000 live births.

“Sixty percent of births in the Philippines are assisted by trained personnel, but the disparity between rich and poor is wide, with 92 percent of births among the wealthiest assisted by skilled health professionals, compared to 25 percent among the poorest,” the report stated.

It noted that nearly half or 46 percent of the poorest children under 5 in the Philippines do not get health care when they need it and that a poor child is 3.2 times more likely than a rich child to die before reaching age 5.

“The Philippines could save many more children’s lives by targeting health care to the poor,” according to Save the Children.

The report said that if all children survived at the same rate as the wealthiest children, 35 percent of the Philippines’ under-5 deaths could be averted.

“That means 26,000 Philippine children would be saved each year,” the organization said.

The Philippines was followed by Peru, South Africa and Indonesia/ Turkmenistan (tied).

Ethiopia was at the bottom of the list with 84 percent of its children having these basic health needs unmet. Also at the bottom were Lao People’s Democratic Republic, Yemen, Chad and Somalia.

The report said that more than 200 million under age 5 do not get basic health care when they need it.

The 55 countries included in the report card account for nearly 60 percent of the world’s under-5 population and 83 percent of all child deaths worldwide.

Save the Children also ranked 146 countries for how good they are for mothers and children. Sweden, Norway, Iceland, New Zealand and Denmark topped the list. Niger was last. The United States placed 27th, one spot below last year’s ranking.

- With AP

Helen Flores
Philippine Star

The government has allocated some P750 million to sustain the implementation of the supplemental feeding program this year, the Department of Social Welfare and Development (DSWD) said yesterday.

Social Welfare Secretary Esperanza Cabral said the budget was allocated in the 2007 General Appropriations Act so the program can be continuously implemented for school year 2007-2008.

Cabral said the Day Care Students Parents Groups (DCSPGs) in the target municipalities in Regions I, IV-A to VIII as well as in the Cordillera Administrative Region, CARAGA and National Capital Region have already received their respective fund allocation and have started implementing the supplemental feeding program.

The DSWD has also sub-allotted P256 million to these regional offices, which came from the supplemental budget of 2006.

“In Regions I, IV-A, IV-B, V, VI, VIII, X, CAR, CARAGA and NCR, the feeding program started in many areas during the opening of classes on June 4, while some local government units (LGUs) started their feeding program on June 18,” Cabral said.

The program involves providing milk and hot meals for children in day care centers in 370 municipalities in 15 regions on regular school days and even during the summer vacation.

Cabral also commended the municipalities of Jovellar in Albay, Milagros in Masbate, Quartero, Dao and Sapian in Capiz, Region VI, and Sta. Marcela in Kalinga, Apayao, CAR for being the first local government units to implement the feeding program.

Some 5,000 pupils from the 166 day care centers in these areas are now receiving milk and hot meals daily, the DSWD said.

In Metro Manila, 123,311 children in 17 cities and municipalities   are benefiting from the program. The children are given milk and hot meals using available indigenous food materials that will provide at least one-third of the recommended daily energy and nutrient intake of children three to five years old.

At the start of the feeding program, the children went through a deworming process in health centers and their baseline height and weight were taken. At the end of the feeding program, the children’s height and weight will be taken again to determine how the feeding program has improved their nutritional status.

DSWD started its feeding program in November 2005, initially covering 11 regions. In 2006, the program was expanded to cover 15 regions, including NCR and Region IV-A, to serve 282,023 day care children nationwide. The children were given one kilo of rice per day that they attended the day care session.

This year, the DSWD will implement a milk and hot meal feeding program for the entire school year.

Officials of the DSWD and the Department of Education earlier said the supplemental feeding program has increased school attendance and improved schoolchildren’s health.

“Children in the program are already manifesting the social benefits of proper feeding. They are friendlier and more interactive and attend day care sessions more regularly. The children also learn the value of sharing food with other kids,” Cabral stressed.

The parents, on the other hand, learn about proper nutrition for their children, especially for those aged six months to six years, through participation in nutrition education sessions provided by a municipal nutritionist. The parents also enhance their parenting skills through sessions in Parent Effectiveness Service (PES).

“Likewise, day care parents demonstrate the value of volunteerism by participating in the program, since they are the ones who cook and supervise the feeding of their children,” Cabral said.