The Philippines is getting healthier

Title

Creator

Agayo, Marcos

Language

English

Source

The Republic Volume I (Issue No.22) 1-31 December 1976

Subject

Health -- Philippines

Rights

In Copyright - Educational Use Permitted

Abstract

[This article presents the population’s state of health in the Philippines. It discusses topics on the country's disease problems, communicable disease traits, and health services.]

Fulltext

-31 December 1976 7 PROGRESS REPORT □ Marcos Agayo The Philippines is getting healthier HOW healthy is the Philippines? There are no known exact gauges of a population’s state of health. However, the indicators in current use are: the nature and extent of disease in the popu lation and the occurrence of vital events (births and deaths). Using these, the Department of Health (DOH) says that the state of health of the Philippines today is “satisfactory and continually improving.” Nature of disease problems. Communicable diseases have always been the major disease problem of the Philippines. Fortunately, the impact of these diseases on our population has been significantly reduced over the years. In 1923, when the problem for the first time could be well defined statistically, communicable diseases accounted for 75.6 percent of all deaths. In 1956 the proportion was reduced to 54.7 percent; and in 1974, further cut down to only 42 percent Deaths caused by communicable diseases has been declining more than the relative rate of incidence. According to the latest (1974) statistics, five of the ten leading causes of death in the Philip pines are communicable diseases; namely, pneumonia, tuberculosis, gastro-enteritis, bronchitis and tetanus. These ranked, in 1974, first, second, fourth, ninth, and tenth, respectively. The other leading causes of death in 1974 were diseases of The state of health of the Philippines is satisjaciury «„u ^^uiuuuy improving. the heart (third), diseases of the vascular system (fifth), avitaminosis and other nutritional deficiency diseases (sixth), malignant neoplasms or tumors (seventh). At present, communicable disease problems come from three distinct di sease groups; namely, respiratory disea ses, gastro-intestinal diseases, and viral diseases. Respiratory diseases. These account ed in 1974, for 22.2 percent of all deaths, for 52.6 percent of all communi cable disease deaths, and for the illnesses of 0.3 percent of the total Philippine population. Of this group, respiratory tuberculosis had been the leading killer of Filipinos until about 20 years ago. Lately, pneumonia (all forms) has been responsible for more deaths than any other disease, causing 16.2 percent of all deaths and 72.3 percent of all in fants’ deaths. Gastro-intestinal diseases. These were responsible, in 1974, for 6.0 per cent of all deaths, for 14.2 percent of all communicable disease deaths, and for the illnesses of about 67 persons per 1,000 of the population. The incidence of gastro-intestinal disease group rises during the rainy sea son, especially during the months of July and August. Slight rises of “summer diarrheas” of infants and young children may occur during the hot months. These diseases are closely tied up with poor environmental conditions. Outbreaks of ten occur in rural areas where food and water sanitation is lacking. Viral diseases. The m$or members of this group are influenza, measles, rabies, poliomyelitis, varicella and he morrhagic fever. They have accounted for 2.5 percent of all deaths and 6.0 per cent of all communicable disease deaths in the country. The major impact of this disease group occurs in morbidity; it ac counted for the illnesses of 7.8 persons per 1000 population. Of these viral diseases, influenza leads in morbidity and mortality. It caused about 1.0 percent of all deaths and 2.5 percent of all communicable di sease deaths in 1974. Viral diseases are mainly childhood diseases; and while in fluenza attacks all ages, deaths are con centrated among the young. Communicable disease traits. Two relatively new diseases of which there have been recent outbreaks de monstrate some basic facts about com municable diseases. One—Philippine he morrhagic fever-illustrates, according to Director J.J. Dizon of the Bureau of Health Services and Disease Control, “the trend of viruses to multiply and develop into more types and strains and to increase in pathogenicity (capability of causing diseases) possibly through mu tations.” The other “new” disease, cho lera el tor, has shown that “complete eradication of communicable diseases is quite difficult to attain-that while a di sease may be absent for some time, the introduction of a force that would trigger off into action the many other factors of disease causation would result in its reappearance.” Hemorrhagic fever first occurred in the Philippines in 1954 sporadically, then in localized outbreaks; the disease has become endemic (prevalent in a particular locality or people) with a ten dency to break out into an epidemic (rapid spread of a disease) every five years. Preliminary investigations point to the household mosquito as the carrier of hemorrhagic fever virus. Cholera el tor broke into the Phil ippines despite the application of all known preventive and quarantine mea sures. It was originally confined in the South Celebes. It then spread to South and Southeast Asia before it came here. Director Dizon notes that: “Cholera el tor is basically a poor man’s disease inti mately related with poor environmen tal conditions.” The problem of communicable di seases, as Dizon sums up, is that: “Com municable diseases are diseases of a young population and of a poor environ ment As that population tends to grow older as shown by an increasing life ex pectancy, and as the environment tends to improve, then the problem corres pondingly becomes less and less. This principle has been excellently illustrated in our country, as shown by the close correlation between the increasing aver age life span of Filipinos and the im provement of environmental sanitation on one hand with the decline of the main impact of communicable diseases on the other. Declining Death Rates. Indicating an improvement in health services, espe cially among newborn babies and mo thers giving birth, the death rate declined by 61.6 percent, from what it was 50 years ago to 6.8 per 1000 in 1974. The decline is particularly notable among newborn babes and mothers giving birth. During the last 25 years, the crude death rate declined by about 38.7 percent while the infant mortality rate declined by about 58.3 percent and the maternal mortality rate, by about 56.8 percent A young population. The declining death rate has resulted in an enlarged youth population. The Philippine popu lation in 1974 was estimated to be about 41.5 million. And it has been noted that the population is essentially young; 45 percent are under 15 years of age and are equally distributed between the sexes. While Malthusian nightmares are engendered by this expanded youth population, it shows how far the battle against disease has progressed. SPREADING HEALTH SERVICES. Since most of the population cannot afford private medical care, the task of providing health services to the majority has fallen upon the DOH. The public health system consists mainly of Rural Health Units (RHUs) and city health department clinics. Cases needing hospi talization are referred to city or provin cial or town hospitals. Cases needing more specialized care are referred to a regional hospital or to Metro Manila. Keeping up with a geometrically expanding population provides a con stant strain on the capacity of govern ment services. For their part, health planners have had to minimize the cost of medical services while increasing popu lation coverage and making maximum use of technology and resources. There are now 762 government and private hospitals and 1,605 Rural Health Units in the country. Health manpower con sists of 52,783 or an average of one phy sician per 3,222 persons. Metropolitan areas enjoy a better ratio of services while the ratio for rural areas falls “far below the average”. To help orient the Philippine medi cal curriculum to rural indigenous needs, the following, among others, have been proposed: locating undergraduate medi cal training facilities in predominantly rural areas and granting “preferential fis cal treatment” to medical schools ac cording to how many of their graduates practice in the Philippines. To be able to provide adequate health services to the rural population, the DOH has formulated a program for upgrading and expanding its rural health infrastructure. This program includes: 1) the establishment of health stations in barrios or districts remote from the local RHU which is usually located in the town proper; 2) the construction of new RHUs and renovation of existing ones; and 3) the provision of jeeps for transportation of RHU personnel. The present accent of health services is preventive rather than curative. The DOH, consequently, is carrying out an expanded immunization program, for mulating more environmental sanitation programs, and accelerating its part in the government’s nutrition program. Immunization. The priorities are directed to mass immunization of infants 3-14 months old and to primary grade school entrants, against tetanus, diptheria, pertussis, and tuberculosis. The pro gram will soon include immunization against other preventable diseases as soon as technical and operational cons traints will allow. Most of the vaccines used in immu nization programs were either donated by other agencies or imported. Efforts in the way of research, experiments, and appropriate allocations are being done to produce serums locally. Eventually, self-sufficiency in vaccines will be at tained via accelerated production by the Alabang Laboratories of the government. Immunization teams visit each of the 40,000 primary schools in the coun try twice a year. The first visit is made in June or July when schools open. The second visit is made in January or Feb ruary, after an interval of six months from the first round. Each immunization round, lasting for about four weeks, en sures that the vaccines used retain their potency despite lack of refrigeration facilities in most rural areas. An information campaign precedes every immunization round to motivate parents to submit their children for im munization. To ensure sufficient cover age, moreover, basic immunization was declared compulsory for all children eight years of age or younger. Environmental Sanitation. Only about 39 percent of the population has access to potable water and about 32 percent, to sanitary toilet facilities. Since it will take some years before proper municipal water and sewerage systems reach the minority of the population, most will still have to make do with un connected systems. The DOH’s Division of Environmental Sanitation is respon sible for inspecting water and sewage or toilet systems and for educating the public about environmental health. Plans have been made to increase the budget of this agency and thus give better atten tion to preventive measures. Nutrition Education. The Philippine campaign against malnutrition has been praised by the United Nations University as “the most comprehensive program of applied nutrition at the village level yet undertaken by any country.” The report further notes that the government pro gram has “contributed in three years to an improvement of nutrition and health in the Philippines.” The government’s nutrition policy is focused on the prevention and cure of malnutrition among infants, preschool children, and pregnant or lactating wo men. These persons are the ones who suffer most from the effects of malnutri tion. Specifically, the first six months in the life of an infant are the most cru cial period in his mental development. A vital factor in providing for good infant nutrition is making the mothers aware of good nutrition practices. In the rural areas, mothers usually learn about the nutritional needs of their children through the Mothercraft Centers of the DOH’s National Nutrition Service. These centers also provide supplemental feed ing to pregnant and lactating women, as well as to infants and children from needy families. □

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