Published on March 14, 2014
Concept Note Sa Pagbangon kay Yolanda: Paano ibabangon ang mga Programang Pangkalusugan? An Online Conference Organized by: eHealth Philippines in partnership with SARILAYA and HealthJustice Rationale It has been more than two months since SuperTyphoon Yolanda hit the Visayas badly. According to authorities, they were prepared. However, the devastation and death toll were just so enormous for a small developing country like the Philippines. Within months, we became witnesses to the biggest mobilization of relief efforts and influx of domestic and foreign aid that even the entire United Nations put the situation into a Category 3 in their protocol. Now, going on its fourth month, efforts at relief and early recovery are slowly phasing out while rehabilitation and reconstruction are just picking-up. However initial observations among stakeholders, specifically civil society organizations, felt that their blind as to where the plans at reconstruction is heading. What development framework is to be used in this phase? What does the principle of “building back better” means? Most importantly, where are the people in the plans of the government? The only thing clear at this point is the government’s pronouncements of private sector participation based on the Reconstruction Assistance Yolanda (RAY) and Presidential Assistant for Rehabilitation and Reconstruction (PARR) plans. It is at this time of rehabilitation and reconstruction that we need a clear development framework from the people, by the people and for the people especially when it comes to healthcare. Taking-off from the assumption that all Yolanda-affected communities are starting from zero at this point, health advocates would like to ensure that a framework on preventive healthcare is integrated in the “building back better” policy direction of the government. Preventive Healthcare would mean more stress on ensuring the communities’ over-all health more than just the provision of medical assistance when people are already sick. While there is a need to rebuild health infrastructures such as barangay health stations, rural health units and provincial hospitals, emphasis should also be given to the promotion of programs on preventing illnesses (e.g. nutrition-based healthcare, physical activities, tobacco and alcohol control and public road safety). In addition, SuperTyphoon Haiyan, which many believe to have been contributed by climate change, is the biggest global health threat in the 21st century according to the 2009 UCL-Lancet Commission. Certainly, climate resiliency should be integrated in the healthcare system to be rebuilt and reconstructed. It cannot be just getting back to normal, it should even be, “building back better and safer”. Business as usual (BAU) will no longer hold this time. We should have learned our lesson well!
Poor status of health affects the people’s adaptive capacity and resiliency. Therefore, the reconstruction/rebuilding efforts should first and foremost assess this status, upgrade if necessary and make health a cross-cutting priority in the long-term through facilities and programs to be set-up. Health needs and assessment in Yolanda-affected communities Earlier this year, in an article published by the Philippine Star, the Department of Health said that 432 health facilities in Mimaropa, Western Visayas, Central Visayas and Eastern Samar were either destroyed or damaged by Yolanda. The damage on these facilities was estimated at PhP1.17 billion. In addition, around PhP1.4 billion is needed to prevent the spread of diseases and provide affected residents with medicines for hypertension, heart ailments and diabetes. In the recently released Health Cluster Bulletin No. 15 (February 28, 2014) by the United Nations Office for the Coordination of Humanitarian Affairs (UN-OCHA) Health Cluster, the following is a list of the progress made at ground zero, responses and what still needs to be done: SHELTER. Around 1,455 family-survivors of Yolanda have been transferred to 60 bunkhouses built by the government in Eastern Visayas (224 families are in the Motocross Bunkhouse in Tacloban City; 81 families in Palo, Leyte; 429 families in Ormoc City; 50 families in Basey, Samar; and, 673 families in Eastern Samar. Seven (7) schools in Tacloban are still being used as evacuation centers for 556 Yolanda-displaced families with 2,347 people. HEALTH FACILITIES. There was already a groundbreaking of the new Eastern Visayas Regional Medical Center in Bgy. Cabalawan, Tacloban City. Dialogue and coordination on the rehabilitation of health facilities continue and many partners have already committed to support. However, significant gaps still remain. Therefore, the DOH thought of coming up with a photobook to support the rehabilitation, “Rising Anew- Health at the heart of healing.” The document will present 31 out of the 96 damaged Community Health Centers (CHCs) in Region VIII. HEALTH RESOURCES (FOREIGN). Twelve (12) foreign medical teams are still in the area to provide services in Regions VI, VII and VIII. Seven (7) are providing basic outpatient care (Type I) while three teams provide more advanced health services including surgeries (Type II). Two teams provide mobile health clinics and mental health and psychosocial support. DISEASE CONTROL (MEASLES, DENGUE, TB). Forty-one (41) health facilities in Region VI and VIII reported 8,697 total consultations through Surveillance Post Extreme Emergencies and Disasters (SPEED). Acute Respiratory Infection accounted for 37% of total consultations and still the leading cause of consultation amongst SPEED conditions. MEASLES. Suspect measles cases continue to be reported from Region VIII with 180 cases and two deaths. To address this, a measles immunization campaign has been conducted in the region targeting children aged under 5 years. The door-to-door mop up immunization will be strengthened while Vitamin A were given to government hospitals in AMDMH in Balangiga, Quinapondan Community Hospital, Oras District Hospital to help manage suspected measles cases. Cold Chain plan has been finalized; equipment and training on this will be provided. DENGUE. There are 470 suspected cases of dengue fever including two deaths were reported. Vector measures like fumigation have been intensified in Region VIII. Community campaign on self-protection methods is also ongoing. In Eastern Samar, spraying has been conducted giving priority to barangays with clustering. A Larval survey too is also being conducted now. TB. DOH plans to install eight additional units providing diagnostic services for suspected TB and MDR-TB through rapid, fully-automated molecular techniques (Xpert). The National TB Reference Laboratory in collaboration with the World Health Organization (WHO) has supported the training on Xpert testing of 22 medical technologists the affected areas.
MENTAL AND PSYCHOSOCIAL SUPPORT (MHPSS). In Tacloban and Ormoc, trainings on Mental Health Global Action Program (mhGAP) for primary health care doctors and nurses were conducted. This training is focus on increasing non-specialist care, including primary healthcare, to address the unmet mental health needs of people. The specific working group also developed key messages on MHPSS that are translated into different local languages for dissemination. REPRODUCTIVE HEALTH. A Comprehensive inventory of the available maternal and child health services, facilities and human resources in the area (e.g. BEmONC and CEmONC) is now being conducted by a WHO expert. An estimated 3.5 million women of child-bearing age require special needs and protection in the affected areas. More than 250,000 women are pregnant and about 170,000 are breastfeeding mothers with babies up to six months of age. A total of 4 RH Medical missions were conducted in Region VIII attending 650 pregnant and lactating women (PLWs) and 550 non-PLWs. A total of 17 women friendly spaces (WFS) breast-feeding spaces were established in different evacuation centers in the affected areas and more than 3,000 dignity and hygiene kits were distributed. A youth friendly space was set-up at Balyuan Tower, Magsaysay blvd. Thirty youth volunteers were trained in peer education on adolescent reproductive health by Save the Children. WHO is currently using geography and Geographic Information System (GIS) to integrate different sources of information to provide a comprehensive picture of accessibility to Emergency Obstetric and Neonatal Care (EmONC) in Region VIII. WATER, SANITATION AND HYGIENE (WASH) AND ENVIRONMENTAL HEALTH. Training workshop on water quality monitoring for local government units (LGUs) was conducted. As a result, participants were able to prepare an action plan. Assessment of the capacities of LGUs is being conducted including their capacity in health care waste management in Region VI. Assessment of public health needs of Motocross Bunk Houses (290 families) in Tacloban was conducted and revealed WASH including drainage and stagnant waters as concerns. They have identified the need for strengthening health promotion and sanitation. NUTRITION. A total of 87,517 (77%) children from the age of 6-59 months have been screened. Among the 14,476 children screened, 13 new cases of severe acute malnutrition (SAM) and 73 cases of moderate acute malnutrition (MAM) were identified. All SAM cases were admitted to a treatment program. An new inpatient treatment facility is now operational in Ormoc supported by International Medical Corps. In Region VIII, the implementation of the Community Nutrition Response Strategy is underway. Municipal nutrition action officers and community nutrition/health workers are currently being trained in Tacloban and in Eastern Samar. Infant and young child feeding activities and screening of boys, girls and PLWs will increase in the next coming weeks as community works scale up implementation activities. The current numbers of the affected are: 16,078,181 persons; 4,095,280 displaced; 28,626 injured; and, 1,785 missing. In the action plan of the UN-OCHA, around 52% of which are already funded for the health sector. However, it is not clear yet in these data how much of government efforts are addressed and funded. While health facilities are being rehabilitated, the status of primary health care programs (especially preventive health care) in the communities is unclear. More than facilities and immunization packages, health advocates have yet to see a comprehensive plan for a new healthcare system in the affected areas. Health advocates don’t just want to see a sense of normalcy in the aspect of health but a new and improve healthcare system that gives emphasis to building back better and safer and in the context of climate change: From Dirty and Harmful to Renewable Energies. Some coal-fired power plants (CFPP) are going to be built in the Visayas. What Environmental Health programs can the DOH with the LGUs develop?
From the usual health facilities to Greener Hospitals. Secretary Ona said in one speech that hospitals should be the last standing ground to be hit in disaster like SuperTyphoon Haiyan. What is the current plan of the department with the LGUs on building back better and safer health facilities? From the usual immunization packages to a strong nutrition-based prevention of diseases. Apart from immunization, do the DOH and LGUs have plans of conducting massive health education programs to prevent diseases and/or manage its control through the use nutrition? From the civil society groups working at ground zero, health-related services offered were: relief, gender work through the setting-up of women and children-friendly spaces, feeding and nutrition programs, building of earth villages/windship (through permaculture aid) and organic farming. In addition, many have been doing advocacy and organizing work in the areas and in the national. Again, what kind of development framework do we want to follow is a fundamental question here. Objective/s While the country is nearing and/or starting its rehabilitation and reconstruction phase, a follow-up on “Health and Disaster Work in Complex Emergencies” discussion is needed. Last year, eHealth.PH focused more on the relief phase. This time, the community forum will discuss on health and disaster work during rehabilitation and reconstruction phase using the principle “building back better”. Thus, the online conference on: “Sa Pagbangon kay Yolanda: Ibabangon ang mga Programang Pangkalusugan?” Resource persons to be invited are: organizations and experts, who participated in the first discussion and in a webinar last December on Health Information Systems and Disaster Management; and, CSOs working in and for Yolanda-affected areas, With the assumption that everything starts from zero in the Yolanda-affected communities, health advocates, if given the go, would like to make these areas a haven of good health and climate resiliency. The online conference would like to serve as a painting canvass/drawing board for a people-centered, pro-poor health care system, appropriate for the context of the region but with a big consideration given to environmental health. At the end of the discussion, the participants and organizers should have a clearer view as to what kind of health programs or system that the group could eventually propose to participatory processes of the people and the CSOs (People’s Platform Development) and/or health institutions, which could help in the validation at the ground level. A caveat though, this process does not necessarily mean that the group should come up with a complete program. It may only be a starting point. The output could be general principles of a health system and/or concrete examples of possible health programs. The online conference could also be a start of a collaboration and partnership with other CSOs and health agencies (non-government/government). Partner Organizations Kasarian-Kalayaan or SARILAYA is a 20-year old women’s organization committed to promote women’s empowerment and gender equality. Its mission is to mainstream gender and development in every member’s workplace, community and the broader movement for social change. SARILAYA promotes a development agenda that focuses on: integrative healthcare and development, sustainable agriculture and ecological care, livelihood and enterprise, liberating education and capacity-building and good governance.
HealthJustice Philippines is a non-governmental organization founded in 2009 that aims to bridge the gap between public health and law in the country to enable Filipinos to make informed and empowered health choices. The organization is committed to be the leading resource in research and capacity-building for priority public health policies. It envisions a population that is free from health risks and has equal access to health. Resource Persons Dr. Yvonne Entico and Dr. Tess Galang, Medical Action Group (MAG) Dr. Dennis Batangan, eHealth Philippines SARILAYA and HealthJustice Philippines Doctors to the Barrios in Eastern Samar (TBC) Date of the Online Conference: March 17, 2014 (Monday) Groups who can participate: Health, Environment, Safe Food Advocates and Organizations working in related areas Agencies and experts on related field (certain DOH units are into environmental health) ***End of Concept Note***
“Sa Pagbangon kay Yolanda: Paanong Ibabangon ang mga Programang Pangkalusugan?” Guideline for Participants Online Conference Schedule: 17 March 2014, 9am-5pm Objectives: To discuss health and disaster work during rehabilitation and reconstruction phase in Yolanda-stricken Visayas, using the principle “building back better”. Moderator: The online discussion will be moderated by two moderators, a global moderator who will moderate and oversee the complete forum and a moderator assigned to moderate specific sub forums. Participants: A regular (registered) forum user can join the discussion thread on maternal and child health (e.g. ask questions to a specific resource person, share their ideas or comments) at whatever time they want within the day (17 March 2014). They shall be asked to visit the forum site and input their comments or answer queries from their fellow participants at least thrice a day (depending on their availability within the day). Day 0: Registration (11 March-17 March 2014) -Participants are asked to register and create their eHealth profile on the eHealth website. Please go to http://www.ehealth.ph to register. Please wait for the eHealth administrator to send a confirmation email to your registered email account. Please be advised against registering on the day of the online discussion itself, as the site may be slow and busy that day. Participants are encouraged to post their picture, contact information, and signature. -Please test the forum functionalities to familiarize one’s self with the platform and avoid confusion on the forum day itself. -Participants are encouraged to invite their volunteers and supporters, and share the online event to other people and communities who may be interested in the online discussion topic. -Please feel free to contact us through email@example.com and through SMS 09266232038 for further inquiries or technical difficulties. Day 1: 17 March 2014(9am to 5pm) -Resource speakers shall be asked to give their opening message (9am to 12nn) after the moderators introduce them. After their opening messages, the moderators shall officially open the forum by giving the welcome remarks of Dr. Dennis B. Batangan, Institute of Philippine Culture Research Associate and eHealth PH Project Director.
-The moderators shall determine the emerging sub-topics and shall redirect the resource speakers to their respective sub-forum sites to avoid cluttering of ideas. Please feel free to ask the administrators for links of redirected sub-topics. -At that point, participants can join the discussion. They are free to join and input their ideas in any of the discussion threads on emerging health issues and the candidates’ health agendas. -There will be an assigned moderator that will summarize the discussion points twice (12:00nn-1:00pm, 5:00pm- 6:00pm). The synthesis of the said discussion will be posted by 6pm. Some reminders: 1. Once a comment (from a participant, moderator, or other resource speaker) is posted on the discussion thread, an email alert from the eHealth administrator shall be sent to the email addresses of all the forum users. Hence, email accounts of users may be flooded by eHealth email alerts on 17 March 2014. 2. Refreshing of the forum site is necessary from time to time to see if someone had input their comments. 3. Technically, the participants and resource speakers may opt to join the discussion wherever and whenever they want so long as they have internet access. However, all are asked to go online on the early part of the discussion from 9am to 12nn for the official opening. Thank you and we are looking forward to a fruitful discussion with you!
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