Parents' Presence on Social Media

The 3rd Healthcare and Social Media Summit was held in Marco Polo Hotel in Cebu City organized by the #HealthXPH in coordination with the DOST-PCHRD.

"The solution to pollution is dilution."  This was the message of keynote speaker Marie O'Conner, who encouraged healthcare professionals to have a presence on social media to support patients' need for proper medical information, considering that patients are now empowered to turn to the internet for support.

In the same manner that healthcare professionals are encouraged to be online because patients are online, parents are encouraged to also have a social media presence because their children are active on social media.  The youth tend to post online their feelings and emotions, and parents should be able to identify signs of depression to determine what help their children need.

There was a post being shared a few weeks back on facebook which read "if your mother has facebook and she doesn't comment in 15 minutes, she owes you PHP1,000..."  This message proves a point that some parents create facebook account to be able to follow their children and remain connected.  Not a bad idea.  In this day and age where everything comes and goes and life passes with dizzying speed, social media is a way to be connected.

Therefore, parents should be on social media because that is where your children are.

Watch out for the next posts on pearls of wisdom about the healthcare social media summit.

35th Anniversary of The Share A Child Movement Inc

First, I wish to thank everyone for joining us in this our celebration of thirty-five years working for the rights of children in communities.

Thirty-five years ago, my Lola Sising founded The Share A Child Movement Inc to solicit funds from friends and concerned Cebuano benefactors to help keep poor children in school.  Thirty-five years ago, I was only 4 years old.  I was fortunate enough to have a family that cherished me, and who provided me with my basic needs (food, shelter, clothes, a good education, and a little extra luxuries now and then). Unfortunately, not all children in the Philippines are as lucky as I am. Hence, it is the responsibility of those who have been abundantly blessed to share what they have and to do what they can to provide poor but deserving children with opportunities to rise above their beginnings to become morally upright and productive citizens of the world. 

The testimonies of beneficiaries and scholars of Share A Child are proof that thirty five years ago today, Share a Child was the meaningful and needed response to the needs of so many children in Cebu.  That we have changed the lives of thousands of children who have now become upright citizens of the world is a feather in the cap of our founders, and an inspiration for us to keep on doing the work that they began.

When I took over the Share a Child’s leadership three years ago, we were overcome with grief at the passing of Lola Sising, and shortly thereafter, Auntie Nina.  It was a loss that struck us at the very core of our being as an organization and which we continue to mourn today.  But there is a saying that pain refines the soul, and if we allow it to, it can make us stronger.

In a month’s time, we will be closing our ComBat project with CARITAS Switzerland.  Last Saturday, we visited the Community Based Child Protection Network (CBCPN) of San Roque in Talisay, and proudly heard the glowing reports of mothers, private citizens and barangay officials on how our interventions have changed the social landscape of their communities.  Where before there was fear and apathy, there is now vigilant awareness of the rights of children and communities working together to promote and defend it against predatory activity.

We visited the livelihood project in Sitio Panaghiusa, and heard about the neighbourhood group that produces detergents for the use of the local communities and provides retail services in procuring rice for the consumption of the neighbourhood.  With our nudging and support, our partners are going in the right direction here, providing services that will strengthen the bonds among neighbourhood groups and local communities, as well as supplementing the incomes of their members, even as we empower them with the capacity to participate in policy making of local government units.

On a shoestring budget, we accomplished our part in the Child Protect project and in fighting against Commercial Sexual Exploitation of Children (CSEC), a project funded by Terre des Homes. Community-based Child Protection Networks (CBCPNs) now initiate meaningful projects in their own barangays such as hair-cutting activities, advocacy and lobbying with their respecive local government units.

After almost twenty years, the Sugbuanong Pundok Aron Supuon ang Child Abuse (SUPACA) is going stronger than ever.  Organized in 1997, it earned an award as one the Ten Accomplished Youth Organizations (TAYO) of the Philippines in 2004.  Today, we have a presence not only in the schools of Cebu and neighboring cities, but also in the communities that we are serving. We have infused training and capacity building into the new leadership, and the members have been active with advocacy activities in their respective schools and communities.  They say that the youth is the promise of the motherland.  The SUPACA will be at the forefront of making things happen to make this land a kinder, gentler place for the next generation.

We have been through many daunting challenges in the last three years that threatened to wipe us out.  But we have managed to survive, and with strong determination, we will persevere and strive to grow stronger.

The current social environment show that the Share a Child has many more things that need to be done.  The dangers of cyber sex and cyber pornography continues, and will thrive as long as poverty drives families to reduce children to commodities. We have to rise to the challenge of protecting the children in our communities against the menace of drug addiction and the war of extermination being waged by the current administration.  We have to rise to the challenge of encapacitating the youth to participate in planning and policy making to reduce the impact of climate change.

As we face these challenges, Share a Child itself rises to the challenge of transforming itself to a self-sustaining institution, a valuable resource in the fight to protect and promote the rights of children in Cebu.  We have painstakingly reviewed our strategic plans and policy manual, and plan to institute governance improvements in the days to come.  We will strengthen the Board of Trustees by providing for representation of the SUPACA and the Community Based Child Protection Networks, as well as other sectors such as academe, the corporate sector, and civil society. 

And so, even as we face the uncertainties of the future, we remain undaunted, because we are fully assured that we are doing the right thing, and we rely first and foremost on the Providence of a loving Father in heaven, the prayers of our founder and first Executive Director who continue to smile on us from above, and the generous support of our benefactors and partners in this imperfect world of ours.

Allow me to acknowledge the leadership of Dr. Fe Necessario, who despite her advanced age, has stepped in to fill the gap left by Lola Sising.  At the helm of the Board of Trustees, she has steered us through difficult hurdles.  Thank you also to Marlon Mendoza, who as Board Secretary, representing the alumni has so generously, contributed his time and resources to Share a Child. To my uncle,  Francisco Valenzona for his deep insights and humor that often broke the ennui at board meetings. And to the other Board members, Maricel Madamba, and SPO3 Egmedio  Felisan Jr. for their service.

I wish to acknowledge the support of the staff that has persevered with us through this most trying of times.  Thank you all and we wish you a prosperous and productive year in 2017. My God bless us all!

Community-Based Recovery Program for Drug Dependents

I attended a youth forum in our community one day.  The attendees were asked to list down the relevant issues of children and youth in society today.  Different sharing of perspectives and disclosure of personal experiences narrowed the issues to violence and drug dependency leading to sexual abuse resulting to teenage pregnancy and HIV/AIDS.

I come from Cebu, an island in the middle of the Philippine archipelago.  Cebu faces the challenge of dual epidemics of drug abuse and HIV/AIDS.  Based on a recent surveillance study, Cebu City has one of the highest concentrated epidemics of HIV in the Philippines and the main mode of transmission is via intravenous drug use.  This gives us an idea of the burden of the drug problem in our communities.  

Over 7,000 suspected drug users and drug dealers have surrendered in Cebu province since President Rodrigo Duterte was elected on May 9.  President Duterte expressed that Cebu has the highest number of drug dependency rates in the Philippines. With the current war on drugs, thousands have voluntarily surrendered to the government for rehabilitation.  Existing rehabilitation centers can no longer accommodate patients who wish to avail treatment services in public facilities.  Hence, the government turns to the private sector, the civil society organizations and the barangays to create community-based drug rehabilitation and recovery programs which consider intensive phase, relapse prevention and skills training for alternative economic opportunities.

Drug rehabilitation is a complex program that many do not understand. Patients need to be treated holistically.  Healthcare providers can determine which patients would qualify for a community-based rehabilitation program.  With community support, healthcare providers can manage and follow up patients and de-load the need to institutionalize.  There would be a combination of psychological counselling, pharmacotherapy, family development, skills training, and increased advocacy campaigns to improve awareness on drug rehabilitation.  We therefore ask the question: what can we do in our own personal capacity to help rehabilitate and reintegrate these drug dependents into our community?

On June 2017, the Central Visayas Consortium for Health Research and Development will be having its innovation conference and one of the plenary lectures will be on community-based recovery programs, and we’d like to call for collaborators on researches that need to be done on this topic to find solutions to this multi-faceted emerging health issue.  We hope that we can discuss this topic academically to find solutions to this very relevant problem.

T1.  In your view, what is the impact of drug dependence on your community’s health?

T2. What would be the components of a successful community-based drug recovery program?

T3.  What is the role of social media in solving drug dependency problems?

Lowering the Minimum Age of Criminal Responsibility

I write this in reaction to the online survey of the House of Representatives 17th Congress on http://www.congress.gov.ph/ regarding public opinion on lowering the minimum age of criminal responsibility from fifteen (15) years to nine (9) years.

In the 1980s, my grandmother Atty Esperanza G. Valenzona ministered to the juvenile delinquents at the Cebu City Jail.  With her friends, they provided literacy classes, conducted feeding programs and instituted neighborhood scouting.  They believed that children deserve to be provided with opportunities for growth and development to become morally upright and productive citizens of the world.

She was part of the advocates who lobbied for the passing of Republic Act No. 9344 known as "Juvenile Justice and Welfare Act of 2006" which celebrated its 10th year recently.    This law recognizes the vital role of children and youth in nation building.  A child is defined as a person under the age of eighteen (18) years.  In Section 6, it states that a child fifteen (15) years or under at the time of the commission of the offense shall be exempt from criminal liability and be subjected to an intervention program.  Sections 12-17 mentions the roles of the family, the education system, mass media, local councils for the protection of children, the local social welfare and development workers and the Sangguniang Kabataan.  Hence, the protection of children in conflict with the law (CICL) is the responsibility of a whole community, and not just of a single agency or department.  It involves multi-sectoral cooperation of different government agencies and non-government organizations.

In Cebu, we have the Operation Second Chance which functions as the Bahay Pag-asa (House of Hope), which currently houses approximately 200 children.  Like many of Philippine laws which are very good and comprehensive on paper, there is much difficulty in implementation of the law, especially if the programs and services are not funded by government budget.  Hence, instead of changing the law, in my humble opinion as a child advocate, we must strive first to fully implement all the stipulations in this law before we consider it as a failure and lower the minimum age of criminal responsibility from 15 years old to nine (9) years old.  After all, the children and youth have a vital role to play in the community, and they have rights to survival, development, protection and participation.

A jail cell is no place for a child, so long as programs in jail do not offer true rehabilitation for the offender. It only becomes a school for crime.

I enjoin you to vote NO in this congress online survey.  Give the Filipino child a chance.  Children would not be in conflict with the law if they were given basic needs for survival and development.    Please do it now, it would take less than a minute.  Many things can wait, the child cannot.

Promoting a Research Environment in Medical Schools

The recent controversial issue on the dengue vaccination program in the Philippines has led me to research about such terms as “antibody-dependent enhancement” and clinical research phase studies.  Reading the news, I realize that the public will probably need a translator with all the technical terms used, but the issues boil down to questioning due diligence and social preparation, searching for evidence for safety of the vaccine, and need for further research on the proper precautions and procedures prior to administering the vaccine in a local mass vaccination program.  Not all medical doctors will understand the jargon of research and epidemiology, because not all doctors participate in research activities.  Most doctors and medical students actually tend to gravitate away from anything that sounds like research.  What would explain this common attitude?

It was Dr Ourlad Tantengco @drladstantengco who first asked the questions about the state of research and publication in UP Manila on his facebook page last December 12, 2016.  I realized when we were preparing for the PAASCU accreditation in our own medical school that there is a dirth of faculty members conducting research.  Hence, we ask the questions about strategies in promoting a research environment in our medical schools and how we can catch up with our counterparts in foreign universities where most research and publication come from medical/health colleges.

Join us on Saturday, December 17, 2016 at 9PM MLA / 9AM EST as we discuss how we can promote a research environment in medical schools.

T1. How can we promote an environment of research in medical schools?

T2. What aspects of research should be taught in medical school?

T3. In the age of evidence-based medicine, should all doctors be researchers? Why?

Independence at the Price of Depression due to Isolation

I just came from a month-long observership on HIV care in New York, USA.  I shadowed doctors, nurses, nutritionists, social workers and volunteers managing HIV-positive patients.  Many of the realizations I had were not necessarily healthcare-related.

INDEPENDENCE.  Many of the youth move out of their family home and live independently at an early age.  I am already a 38-year old professional, and I still live with my mom.  In the US, patients receive calls to remind them of their doctor’s appointments and they can come without any cash because their medical insurance would pay for the medical services and prescription medications.  In the Philippines, often doctors have to consider the cost of treatment because patients have to pay out of pocket.

ISOLATION.  Because children leave the homes early, many of the parents end up coming to appointments alone.  One taxi cab driver provided unsolicited advice that people should not build large houses because after a few years, you end up living alone anyway.  I also experienced isolation when I was housed in an expensive hotel room all by myself.

DEPRESSION.  There was a recurring commercial on television showing people telling a bald cancer patients things like “snap out of it…” or “you’re wearing me down…” or “stop with the pity part ok…” then ending with the conclusion “you don’t say this to a cancer patient, don’t say it to a person with depression.  Depression can kill…”  When people are isolated because it is the price of independence, then the ensuing depression is also a factor in the costs.  In the Philippines, you endure it when you get sad, mainly because there are a lot of people around you to talk things over with.  At one point, everyone is so snoopy they think your business is their business, hence the very active social media.  Is this better than a society that says loudly “mind your own business!” but relies heavily on professional (psychiatric) help when they feel sad or depressed?

This is also the plight of Filipinos who go abroad in search of financial independence for the sake of their families. People at risk of depression due to isolation would be overseas Filipino workers.

This is also the scenario of HIV patients who isolate themselves due to self-stigma to gain independence as a means of coping with their disease.  Often this also results in depression which necessitates additional support.

T1. How do we achieve the middle ground between independence and isolation?

T2. What strategies can be implemented to prevent depression due to isolation?

T3. How can healthcare service delivery help address mental health issues of isolation?

DOH Integrated Essential Maternal and Newborn Care

Training of Trainers on the Integrated Essential Maternal and Newborn Care (EMNC) and Lactation Management Training (LMT) for Health Care Providers in Hospitals

September 20-24, 2016

The Department of Health has a lot of programs, even for the same beneficiaries there are different programs.  For maternal and child health for example, we have the Essential Intrapartum and Newborn Care (EINC), the Kangaroo Mother Care (KMC), the Lactation Management Training (LMT) and even the Basic Emergency Obstetric and Newborn Care (BEmONC) training and Infant and Young Child Feeding (IYCF).  To make things simpler, we now have an integration of all these training programs into one broad training of trainors, much like a sampler of everything.  Hence, the Integrated Essential Maternal and Newborn Care and Lactation Management (EMNC-LM)!





As is also the norm since my three (3) years of working at the Vicente Sotto Memorial Medical Center, we are tapped by the DOH as trainers and facilitators.  Rising up to the challenge of a myriad of conflicting schedules, we managed to respond.

The first batch took place on June 13-18, 2016 at Bayview Park Hotel in Manila.  

The second batch was conducted at the Cebu Business Hotel in Cebu City. For the Cebu batch, participants include Far North Luzon General Hospital, Luis Hora Memorial Regional Hospital, Novaliches District Hospital, Batangas Medical Center, Eastern Visayas Regional Medical Center, Schistosoma Research and General Hospital, Amai Pakpak Medical Center, Mayor Hilario Ramiro Sr Regional Teaching and Training Hospital, CARAGA Regional Hospital, and Vicente Sotto Memorial Medical Center. 

Aside from introducing the laws to protect breastfeeding and the support system needed to ensure continuous successful feeding, it has to start long before labor and delivery, possibly during antenatal care. This sentiment was echoed during the last session on supportive supervision.

The programs on promoting breastfeeding should consider the hospital policies, the capabilities of the healthcare works, the health education and promotion classes, as well as support groups in the community.

This training seminar included also facilitation and communication skills, in addition to promotion of breastfeeding during pregnancy, through EINC especially during non-separation of mother and child during the entire hospital stay, practices that protect breastfeeding, as well as introducing Kangaroo Mother Care for preterm babies and low birth weight babies.

The participants visited the Vicente Sotto Memorial Medical Center to interact with the mothers and to experience for themselves how a busy overcrowded government hospital implements government programs despite the challenges of inadequate space maximizing 300-400% bed capacity, undermanned service areas and limited resources.  

It warms my heart to hear that the participants appreciated the presence of the Intensive Maternal Unit, which aims to separate pregnant patients with special concerns such as hypertension, preterm labor, infections during pregnancy and antenatal bleeding.

As a case in point, when we had to move temporarily to the Trauma Center for the duration of the construction of the Perinatal Care, we only had a labor room-delivery room complex with the neonatal intensive care unit attached to it.  We had no extra space.  We really had to request for a specific space for the Intensive Maternal Unit (IMU).  Patients with high risk pregnancies complicated by hypertension, antenatal hemorrhage, preterm labor, gestational diabetes mellitus, infections in pregnancy, and other co-morbidities are admitted at the Intensive Maternal Unit, which is under the supervision of maternal health specialists like the perinatologist and the infectious disease specialist.  With cohorting as a strategy, we noted that the conditions of these patients could not be managed while they were staying at the jampacked labor room.  Patients in labor have to take turns lying down on the bed because several of them have no choice but to share on bed.  Patients in labor understandably feel discomfort and intense pain due to childbirth.  These uncomfortable circumstances would not help control the blood pressure of a hypertensive, for example. Hopefully, all government hospitals would have an intensive maternal unit, supervised by a maternal-fetal medicine/perinatology specialist so as to reduce maternal and child morbidity and mortality.

In the end, what is important is the identification of champions for the program - whether in the community, in the hospital or in the head office of the Department of Health.  These are people who truly believe that by implementing these programs, our population of mother and children will be better fed, better nourished, better cared for and healthier.  Congratulations to the team of Dr Anthony Calibo and Ms Aya Escober!

Here is the video TV commercial by the Department of Health for the promotion of breastfeeding, All for Health towards Health for All!