This study examines the convergence and divergence of traditional and professional health systems among the B’laan communities in the municipality of Sarangani in the context of their child health care services. The B’laan is an indigenous tribe living in the southern island of Mindanao, in the Philippines.
Background of the Study
The Alma Ata Declaration in 1978 enunciated health as a basic human right. This reserves the right of individuals to access the highest attainable standard of health through the provision of basic health and social services. Specifically, the principle has defi ned access to health care as the affordability, accessibility, availability, and cultural acceptability of health care services amongst peoples across cultures. It also identifi ed the roles of governments, non-government organizations (NGOs), and international institutions in providing the health care needs to achieve a better health for all. This international pact also identified the basic elements of health that are vital to the management and provision of services to the people.
Showing posts with label Health Alert. Show all posts
Showing posts with label Health Alert. Show all posts
Thursday, June 18, 2009
Child Labor
Child labor is actual manpower coming from people below the age of 18. It is work that exceeds a minimum number of hours, depending on the age of a child and on the type of work. For children aged fi ve to 11, beyond one hour of economic work or 28 hours of domestic work per week already constitutes child labor. The hours increase as the child becomes older. For children 12 to 14 years old, 14 hours of economic work or 28 hours of domestic work per week is considered child labor. For minors 15 to 17, the minimum is 43 hours of economic or domestic work per week.
It comes in different forms. Children can work as household help or as workers in farming and fishing industries. Some are given work in quarries, mines, brick kilns and construction sites. On an even more dangerous note, children are increasingly becoming more involved in the drug trade or serve as providers of sex services. It is reported that children living in the poorest households are most likely to be involved in child labor, especially those in the rural areas.
It comes in different forms. Children can work as household help or as workers in farming and fishing industries. Some are given work in quarries, mines, brick kilns and construction sites. On an even more dangerous note, children are increasingly becoming more involved in the drug trade or serve as providers of sex services. It is reported that children living in the poorest households are most likely to be involved in child labor, especially those in the rural areas.
Wednesday, June 10, 2009
Domestic Violence in Vietnam: Situations and Challenges
Though national level statistics on gender-based violence do not exist, existing research shows that domestic violence is a problem in North Vietnam. A number of
recent studies in North Vietnam suggest that about one third of women experience domestic violence, and one in every three abused women suffer more than one kind of violence.
Social norms and cultural attitudes pose a challenge in program intervention. Violence against women is a socially acceptable behavior amongst Vietnamese men; it is seen as a punishment for their wives when they transgress the traditional roles. In addition, Vietnamese women are expected to quietly endure the hardships and protect the harmony and reputation of the family. Many abused women, therefore, do not seek support.
Multisectoral action against domestic violence Vietnam has made many efforts in response to this issue. In 2007, the government issued a Law on Domestic Violence Prevention and Control, which clearly defined domestic violence as “any intentional action by a family member to cause damage or potentially cause damage in terms of physical, spiritual, and economic damages to another family member” and provides a legal framework for the intervention and prevention of domestic violence.
recent studies in North Vietnam suggest that about one third of women experience domestic violence, and one in every three abused women suffer more than one kind of violence.
Social norms and cultural attitudes pose a challenge in program intervention. Violence against women is a socially acceptable behavior amongst Vietnamese men; it is seen as a punishment for their wives when they transgress the traditional roles. In addition, Vietnamese women are expected to quietly endure the hardships and protect the harmony and reputation of the family. Many abused women, therefore, do not seek support.
Multisectoral action against domestic violence Vietnam has made many efforts in response to this issue. In 2007, the government issued a Law on Domestic Violence Prevention and Control, which clearly defined domestic violence as “any intentional action by a family member to cause damage or potentially cause damage in terms of physical, spiritual, and economic damages to another family member” and provides a legal framework for the intervention and prevention of domestic violence.
Tuesday, June 09, 2009
The ties that bind: untangling the socio-political context of Maternal and Child Health
Maternal and child health (MCH) is not an entirely new concern, but its inclusion in the Millennium Development Goals (MDG) gave its attainment priority status. Goal 4 calls for the reduction of under-fi ve mortality by two-thirds by 2015, while Goal 5 aims to reduce maternal mortality rate by three-quarters.
Barely six years before the deadline, the global community still has a lot of catching up to do. At best, efforts to reduce maternal and child mortality ratios produce patchy results, with some countries attaining a level of success, while
others further slide down the ladder.
Maternal health
According to The Millennium Development Goals Report 2007, while child mortality
is on the decline, more than half a million women worldwide still die of pregnancy and/or childbirthrelated complications every year. In the Asia-Pacific region, South Asia posted the highest maternal mortality ratio of 546 deaths per 100,000 live births in 2000. East Asia, on the other hand, had the lowest ratio of 55 per 100,000 live births. From 1997 – 2002, 31 percent of maternal deaths in Asia was due to hemorrhage.
Barely six years before the deadline, the global community still has a lot of catching up to do. At best, efforts to reduce maternal and child mortality ratios produce patchy results, with some countries attaining a level of success, while
others further slide down the ladder.
Maternal health
According to The Millennium Development Goals Report 2007, while child mortality
is on the decline, more than half a million women worldwide still die of pregnancy and/or childbirthrelated complications every year. In the Asia-Pacific region, South Asia posted the highest maternal mortality ratio of 546 deaths per 100,000 live births in 2000. East Asia, on the other hand, had the lowest ratio of 55 per 100,000 live births. From 1997 – 2002, 31 percent of maternal deaths in Asia was due to hemorrhage.
Maternal & Child Health: the unpleasant truth
Mother and child has been a recurring theme in arts, owing mainly to the powerful images it evokes - that of the mother as a life-giving and caring creature, and that of the child as a personifi cation of purity and innocence. But the adage of art
imitating life certainly does not apply to this particular theme, for the truth about maternal and child health (MCH) situation is far from pleasant.
The latest issue of Health Alert Asia Pacific newsletter, provides untangles the sociopolitical context of Maternal and Child Health (MCH), providing an overview of the scope of the problem -- high incidences of maternal and child deaths, and mother to child transmission of HIV-- making MCH one of the pressing health concerns worldwide. This also features domestic violence situation in Vietnam which details the learnings of a Vietnamese organization in handling a gender-sensitivity and anti-violence against women program. The article also provides a few insights on how other organizations can help eliminate gender inequality and violence against women in their respective areas. Another article provides comprehensive look at the global burden of child labor including using children as child-warriors. Another article entitled, “Similarities and Differences of Traditional and Professional Health Care System in B’laan Communities,” explores the divergence and convergence between Western medicine and the traditional beliefs and practices of the B’laan tribe, an indigenous peoples living in the Philippine island of Mindanao. This issue of Health Alert also focuses on adolescent reproductive health and how the lack of information and services makes the youth more vulnerable to sexually transmitted infections and early pregnancy.
To request for copies of the newsletter, please write to hain@hain.org.
Monday, December 15, 2008
Drop of Life
A person can live without food for three weeks, but only three days without water.
Water is vital to the metabolic process, aiding in the digestion, absorption, and transportation of nutrients in the body. The recommended daily water intake is eight
glasses of water or about two liters. This, however, is just the minimum. Depending on the activity, location, and temperature in the area, a person may actually need more than that.
Unfortunately, water scarcity affects four in ten people and the World Health Organization predicts that the number of affected people may rise given the growing global population. While much of the earth is surrounded with water, only three percent are considered freshwater; the rest are too saline for human consumption.
Agricultural demand for water
There are varied factors for the depletion of water sources, including climate change and environmental degradation, but a major culprit was agriculture. With about 70 percent of the world’s water supply consumed by the agriculture sector, it is easy to see why. In the Asia-Pacific region alone, 81.3 percent of freshwater is utilized for agricultural purposes.
While potable drinking water is a key element in nutrition, the paradox is that huge amount of it is required by the agricultural industry to produce food items. Increased agricultural output has been at the forefront of the global fi ght against food insecurity. As the demand for food rises, so is the demand for water needed to
produce these items. While the daily water requirement for each individual is just about two to four liters, the amount of water needed to produce a person’s daily food
requirement ranges from 2,000 to 5,000 liters.
The solution to this problem is not to limit agricultural output, but rather the adoption of sustainable farming practices, as well as a change in food consumption pattern.
When it comes to food consumption pattern, there is a global shift to a meat-based diet, which means more water is needed to produce meat product. As a comparison, producing a kilo of wheat requires about 1000 liters of water. A kilo of meat, on the other hand, requires fi ve to ten times more water to produce.
The next conflict point?
In Tajikistan, people in the town of Taboshar are leaving the community due to acute water shortage, with the local water agency hardly able to meet even just 15 percent of the town’s water needs.
There are two confl icting views on whether water may be the next fl ash points for geo-political confl icts. The US Central Intelligence Agency is but one of the groups
predicting that this might very well be the case; after all, the UNESCO said that one-third of 262 international river basins are shared by two or more countries.
In the Middle East, five countries are sharing the Jordan River basin: Israel, Palestine, Jordan, Lebanon, and Syria. In 2001, tension erupted between Lebanon and Israel when the former attempted to build a pipeline on the Wassani River, which contributes 150 cubic meter of water to the Jordan River. Only the timely intervention of the international community prevented the tension from escalating.
Although there is no major war fought over the control of a water source, there have been periodic clashes, which tend to be localized. In 2000, Chinese police and farmers in Shandong province clashed over the planned diversion of irrigation water to cities and industries.
The other view is more circumspect; water is so vital that nations would benefit more from cooperation in the management of a water source, rather than fi ghting a war for its absolute control.
Prof. Asit Bikwas, a 2006 Stockholm Water Prize awardee, argued that the main issue is not really water scarcity but “bad water management.” He is not alone in this assessment. In the book “Water, a shared responsibility,” the UNESCO – World Water Assessment Programme, acknowledges that “the problem we face today is largely one of governance: equitably sharing this water while ensuring the sustainability of natural ecosystems. At this point in time, we have not yet achieved this balance.”
Addressing the threat of a global water shortage does provide a glimmer of hope, with countries willing to sit down and come up with a compromise on how to better
share a water source. However, it also highlights once more the vulnerability of the poor.
Indeed, when it comes to water allocation, the poor, as always, are left holding an empty jerry can.
Source: Health Alert Asia Pacific, Issue 13, 2008
Wednesday, December 10, 2008
Obesity in the Asia-Pacific Region
With much of the focus resting on under-nutrition and micronutrients defi ciency, it is easy to dismiss obesity as nothing but a disease peculiar to affl uent nations. However, experts warned that obesity is reaching an epidemic proportion, and should thus be treated as a valid health concern.
Consider these statistics: in 2005, 1.6 billion adults over the age of 15 are overweight and at least 400 million of this number is obese. By 2015, the World Health Organization calculates the number of overweight adults to increase to 2.3 billion, with 700 million of them clinically obese. Each year at least 2.6 million people die from health complications resulting from all the excessive weight.
Sunday, December 07, 2008
A wake-up call for a return to nutrition basics
More than 800 million people, or about 13 percent of the global population, are classifi ed as undernourished. The defi ciency in essential nutrients is said to be the underlying cause of an estimated 3.5 million deaths each year, mostly in young children and pregnant women. Under-nutrition among pregnant women in developing
countries is reported to lead to one out of six infants born with low birth weight.
In Malaysia, diabetes has reached very alarming proportions. In the first National
Health and Morbidity Survey (NHMS)carried out in 1986, the prevalence of diabetes was 6.3 percent. Just ten years later this figure increased to 8.3 percent. Now, based on the latest NHMS III, conducted in 2006, diabetes prevalence has increased to 14.9 percent.
Diabetes Type II is strongly linked to high sugar consumption and obesity.
Nutrition can be defi ned as the process of taking in the substances needed to nourish and support life and growth. Access to nutritious food is a key element in
achieving a well-balanced nutrition. But as the world becomes more dependent on artifi cially processed food, balanced nutrition is compromised, resulting in chronic
health problems. Worsening the problem is the addition of toxic chemicals on essential food products.
Tainted milk
The recent scandal where four children in China died following the consumption of baby formula milk contaminated with the toxic chemical known as melamine should serve as a wake-up call.
Melamine, used as an ingredient in the manufacture of some plastics and fertilizers, has found its way into food products such as infant formula and confectionaries. It
is abhorrent that melamine has been deliberately added to milk to give the false
impression of higher levels of protein than actually exists.
Authorities try to allay the fears of the public by announcing that the levels of melamine in certain foods are within “permissible levels”. This term should be questioned.
Melamine is a synthetic chemical. It does not occur naturally in food. Should permissible levels be set for substances that are not naturally occurring in food?
By law, there should be a zero tolerance for melamine, as well as other synthetic toxic chemicals in food, rather than waiting for all the evidence to come in, which might be too late – when harm has already been done.
There is the danger of the cumulative doses or ingestions that enhance the harm posed by such chemicals. Furthermore, the full effects of chemicals not meant for humans may not have been studied fully, and for over a suffi ciently long period of time. It is not ethical to conduct such tests on people. In cases such as these, the *Precautionary Principle should be applied and the consumption of this chemical should be fully avoided.
In the case of infants, breast milk is the safest and healthiest choice – fully for the fi rst six months, and thereafter as a complement to solid foods right up to at
least two years. Governments and the community as a whole would need to make a commitment to move in this direction and create a supportive environment.
Buyers beware
Overall, the Consumer Association of Penang (CAP) believes that it is timely for people to move away from eating so much artifi cially-processed foods, and instead
move towards natural healthy produce and home-cooked meals. There are countless additives included in many of the highly-processed foods in the market. Foods are altered so far from their original state. We did not require all these artificial additives at one time. If really needed, there are numerous natural substances such as natural colours or flavours that can be used for food. We do not see that it is possible for the public to take any realistic precautions themselves when it comes to
products on the shelves as it is impossible for people to know which foods contain dangerous chemicals. At the very least, food manufacturers should be required
to list the common names of all additives, such as preservatives, coloring, fl avors, flavor enhancers, antioxidants and conditioners, on the food labels and outer
packaging - as opposed to using numerical or alphabet codes or merely using phrases such as “Permitted Coloring” or “Permitted Conditioners” under the ingredients list. Information on the concentrations of these additives should also be provided.
The excuse sometimes given is that there is not enough space on the food label. We ask - should there be so many additives in a product that the information cannot even fit on a label, and should this be permitted by the authorities?
In view of the rise of critical chronic diseases such as heart disease, diabetes, obesity and high blood pressure, the information on salt, sugar, saturated fats and trans fats should be listed on current food labels. These particular components should be separated out from the general “Nutrition facts” or “Nutritional Labelling” so that the public is not lulled into a false sense of security. Rather, the attention of consumers can be immediately drawn towards taking special note of these ingredients that are linked to adverse health outcomes.
In view of our country’s alarming diabetic rates, which are only expected to worsen over the coming years, CAP believes that much more needs to be done, and with greater sense of urgency. Firm action needs to be taken against the numerous sweets and confectionaries that have fl ooded the market. These products that are being marketed to children are not conducive to health. They contain basically nothing more than sugar, coloring and other additives, which are not even labeled on the
packaging. Children received no nutritional benefit from consuming these products.
Sugary soft drinks, either carbonated or non-carbonated, used to be more of a luxury in the past and they were consumed as a treat. Nowadays, these drinks are sold in abundance everywhere. Vending machines proffering these drinks are also found at many locations, including airports, hospitals and schools. It is also becoming
increasingly common to see these drinks being offered in “jumbo” portions at various restaurants and food joints.
S.M. Mohamed Idris is the president of the Consumers’ Association of Penang (CAP). The organization may be contacted at Tel. No. 60-4-8299511, or through its website at www.en.cap.org.my. Graphics from Consumer Association of Penang.
This article appeared in the Health Alert Asia Pacific newsletter, Issue 13 2008. For copies of the newsletter, please write to hain@hain.org
Nutrition in Asia and the Pacific: An Ugly Portrait
Food and nutrition are human rights. International caucuses such as the 1989 Convention on the Rights of the Child enshrine these and thus deem governments as duty-bound in ensuring that the right to food and nutrition, as part of the overall well-being of a person, is achieved by all of its citizens.
Much as food and nutrition are regarded as basic human rights, the problem of malnutrition persists in many Asian countries. In fact, the concentration of malnutrition in Asia is greatest compared to anywhere else in the world.
The Asian Development Bank reports that one in three preschool children is stunted,
rising to one out of every two children in the countries of South Asia such as India,
Bangladesh, and Nepal.
The most painful subject with regard to under nutrition is the human cost. In 1999 alone, an estimated 2.8 million child deaths in nine low-income Asian countries, or 51 percent of child deaths were associated with malnutrition. (The countries included are Bangladesh, Cambodia, PRC, India, Lao PDR, Nepal, Pakistan, Sri Lanka, and Vietnam).
Different economic, political, and cultural characteristics in the region portray different faces of malnutrition. In many countries of the Asia-Pacifi c Region, under
nutrition is the most common. In some areas however, there are also incidences of over nutrition.
Much as food and nutrition are regarded as basic human rights, the problem of malnutrition persists in many Asian countries. In fact, the concentration of malnutrition in Asia is greatest compared to anywhere else in the world.
The Asian Development Bank reports that one in three preschool children is stunted,
rising to one out of every two children in the countries of South Asia such as India,
Bangladesh, and Nepal.
The most painful subject with regard to under nutrition is the human cost. In 1999 alone, an estimated 2.8 million child deaths in nine low-income Asian countries, or 51 percent of child deaths were associated with malnutrition. (The countries included are Bangladesh, Cambodia, PRC, India, Lao PDR, Nepal, Pakistan, Sri Lanka, and Vietnam).
Different economic, political, and cultural characteristics in the region portray different faces of malnutrition. In many countries of the Asia-Pacifi c Region, under
nutrition is the most common. In some areas however, there are also incidences of over nutrition.
Sunday, November 11, 2007
Simply, Mamita
I was waiting for a flight when I got the news that Dr. Mita Pardo de Tavera had passed away last week. I thought of writing an obituary, but postponed it, not wanting to write while I was still overwhelmed by grief. Mamita was a second mother to me; my parents referred to her in Chinese as my “hua lang bu” [Spanish mother] and said that with great pride. I still mourn her passing, but write now, hoping to capture the way she lived, vibrantly and so full of celebration.
I had graduated from college just a year earlier and was working with the Catholic Church’s community-based health programs, when a Maryknoll sister suggested that I apply for work with a new non-government organization. It was called AKAP, an abbreviation of the kilometric name Alay Kapwa Kilusang Pangkalusugan [Caring for Others Health Movement], specializing in tuberculosis control and headed by Dr. Mita Pardo de Tavera.
Dr. Tavera? The name of an old wealthy Spanish family alone was intimidating, yet I can’t remember the job interview to have been grueling in any sense. What I recall is how she introduced herself, and she insisted that she be called, simply, Mamita.
Article by Michael L. Tan. Pinoy Kasi column, Philippine Daily Inquirer, November 2, 2007
Read more...
I had graduated from college just a year earlier and was working with the Catholic Church’s community-based health programs, when a Maryknoll sister suggested that I apply for work with a new non-government organization. It was called AKAP, an abbreviation of the kilometric name Alay Kapwa Kilusang Pangkalusugan [Caring for Others Health Movement], specializing in tuberculosis control and headed by Dr. Mita Pardo de Tavera.
Dr. Tavera? The name of an old wealthy Spanish family alone was intimidating, yet I can’t remember the job interview to have been grueling in any sense. What I recall is how she introduced herself, and she insisted that she be called, simply, Mamita.
Article by Michael L. Tan. Pinoy Kasi column, Philippine Daily Inquirer, November 2, 2007
Read more...
Tuesday, May 08, 2007
Medherbal Pharmacy in Drug Retail
There is politics and economics in every pill. In the Philippines, branded medicines cost almost twice as generics. Media hype often dictates the drug consumption, no matter how unfounded some of the claims and portrayals in commercial ads.
Still with the exorbitant prices of drugs, it has become impossible for most patients to properly complete their medication. Medherbal Pharmacy (MHP) is trying to change that.
MHP is a community-oriented pharmacy promoting quality and affordable generic and herbal medicine. It also gives training on herbal medicine preparation.
The pharmacy was initially a project of the Council for Health and Development (CHD) with the mandate of providing generic medicines for the use of communitybased health programs (CBHP). It also provided affordable but effective medicines to members of organized communities.
When it started to achieve sustainability, the CHD Board of Trustees has decided to transform the project into an enterprise so it could reach more clients. Now it is slowly gaining ground into a wider market with its expansion around Metro Manila.
In line with its mission to provide affordable medicines to the poor, its three branches are located near urban poor communities.
A different business philosophy MHP may be a business entity, but its approach is different from commercial pharmacies.
Unlike other pharmacies that place as much as 30 percent profit of margin per item, MHP’s profit of margin is low; just enough to cover the operational expenses and post a small profit.
The pharmacy also carries generic medicines and herbal medicines. The herbal medicines are sourced from CBHPs to help them support community projects as well as their own programs. MHP buys its herbal soaps from CBHP-Isabela, herbal teas from San Benito SIPAG-KO in Bicol, and ampalaya (bitter gourd) capsules from the Tuazon Community Center Foundation. To ensure the products’ qualities, MHP regularly conducts trainings on syrup making and sterilization.
MHP also assists in the setting up of community-based pharmacies by conducting rainings on herbal medicine and pharmacy management. Organizations who have finished the trainings are then provided with initial stocks of medicines. So far, six community pharmacies have already been established: three in Paranaque, south of Manila; one in Tala; and two in the province of Nueva Ecija. MHP is planning to set up five more community pharmacies before the year ends.
Another thing that differentiates MHP from other pharmacies is its advocacy on Rational Drug Use. Since most of their customers have virtually zero knowledge on RDU, staff actually takes the time to educate them.
Advocacy at work
MHP often encounters some people who still think of amoxicilin as vitamins. “People need to know the right medicines to take, the right dosage, at the right time” says
Socoro Torres, Medherbal’s chief executive officer.
Drug consumption remains a big challenge because of the lack of knowledge about rational drug use as well as proper appreciation of generic drugs. Often people buy medicines inappropriate to their sickness. A majority of the Filipinos still buy drugs based on hearsay from what family members or neighbors say. Most of the time, they tend to buy drugs from what they hear or see on television or simply buy prescriptions given to them some years ago.
Often, lacking proper diagnosis from physicians, their illnesses take a turn for the worse.
Torres explains that cultural factors remain an issue, relating to how multinational drug companies have controlled or overwhelmed popular media with ads. Such example is that of the world boxing champion, Manny Pacquiao. In his endorsement of ibuprofen, he says that he has been using it for 11 years. However, a scientific finding concluded that prolonged use of ibrufropen can likely makes a person’s bones brittle, entirely belying the high profile ad.
Here still lies most of the challenges for MHP, but here is where it has also made significant gains. From an offshoot of CHD’s drug procurement unit then only serving orgnized communities, now it is reaching out to larger crowd that is mostly unfamiliar to the concepts of RDU. The MHP staff are proud to say that they have been somehow successful in slowly influencing some people to follow prescriptions, take a full course of medication or go for herbal or generic versions rather than known brands.
Torres admits that economic issues hinder the promotion of RDU. She says other patients could not afford to buy full dosage of medicines. “There are those who buy one or two tablets of amoxicillin. We tell them the minimum dosage for antibiotics is 15 tablets. We try to lower prices so they could buy the full dosage.” It is unfortunate however, that even if people know about the proper intake of medicines, they have not enough money to buy them.
Even with the enactment of the Generics Act of 1988, she underscores the failure of the government to support local drug manufacturers as well as its failure to regulate the production of medicines.
Due to monopoly pricing, the cost of drugs in the Philippines is one of the highest in the world, second in Asia next to Japan. Branded medicines still dominate the market, accounting for 97 percent of sales.
The Philippines now heavily imports drugs from India through the government’s parallel importation program. If indeed the government really wants to end monopoly and significantly reduce prices, Torres insists that it should instead promote local pharmaceutical companies by increasing subsidy and lowering taxes.
To demonstrate the ill-effects of such problematic trade, experts believe that the rise in number of cases of multi-drug resistant TB is a result of the failure to comply with prescribed medication.
The irony remains starkingly real. Great advances have been made regarding treatment and cure of many ailments, but who can afford them? All these gives MHP more reasons to continue its work.
By Philip Paraan Council for Health and Development (chdmancom@yahoo.com)
Published at Health Alert Asia Pacific (www.hain.org)
Still with the exorbitant prices of drugs, it has become impossible for most patients to properly complete their medication. Medherbal Pharmacy (MHP) is trying to change that.
MHP is a community-oriented pharmacy promoting quality and affordable generic and herbal medicine. It also gives training on herbal medicine preparation.
The pharmacy was initially a project of the Council for Health and Development (CHD) with the mandate of providing generic medicines for the use of communitybased health programs (CBHP). It also provided affordable but effective medicines to members of organized communities.
When it started to achieve sustainability, the CHD Board of Trustees has decided to transform the project into an enterprise so it could reach more clients. Now it is slowly gaining ground into a wider market with its expansion around Metro Manila.
In line with its mission to provide affordable medicines to the poor, its three branches are located near urban poor communities.
A different business philosophy MHP may be a business entity, but its approach is different from commercial pharmacies.
Unlike other pharmacies that place as much as 30 percent profit of margin per item, MHP’s profit of margin is low; just enough to cover the operational expenses and post a small profit.
The pharmacy also carries generic medicines and herbal medicines. The herbal medicines are sourced from CBHPs to help them support community projects as well as their own programs. MHP buys its herbal soaps from CBHP-Isabela, herbal teas from San Benito SIPAG-KO in Bicol, and ampalaya (bitter gourd) capsules from the Tuazon Community Center Foundation. To ensure the products’ qualities, MHP regularly conducts trainings on syrup making and sterilization.
MHP also assists in the setting up of community-based pharmacies by conducting rainings on herbal medicine and pharmacy management. Organizations who have finished the trainings are then provided with initial stocks of medicines. So far, six community pharmacies have already been established: three in Paranaque, south of Manila; one in Tala; and two in the province of Nueva Ecija. MHP is planning to set up five more community pharmacies before the year ends.
Another thing that differentiates MHP from other pharmacies is its advocacy on Rational Drug Use. Since most of their customers have virtually zero knowledge on RDU, staff actually takes the time to educate them.
Advocacy at work
MHP often encounters some people who still think of amoxicilin as vitamins. “People need to know the right medicines to take, the right dosage, at the right time” says
Socoro Torres, Medherbal’s chief executive officer.
Drug consumption remains a big challenge because of the lack of knowledge about rational drug use as well as proper appreciation of generic drugs. Often people buy medicines inappropriate to their sickness. A majority of the Filipinos still buy drugs based on hearsay from what family members or neighbors say. Most of the time, they tend to buy drugs from what they hear or see on television or simply buy prescriptions given to them some years ago.
Often, lacking proper diagnosis from physicians, their illnesses take a turn for the worse.
Torres explains that cultural factors remain an issue, relating to how multinational drug companies have controlled or overwhelmed popular media with ads. Such example is that of the world boxing champion, Manny Pacquiao. In his endorsement of ibuprofen, he says that he has been using it for 11 years. However, a scientific finding concluded that prolonged use of ibrufropen can likely makes a person’s bones brittle, entirely belying the high profile ad.
Here still lies most of the challenges for MHP, but here is where it has also made significant gains. From an offshoot of CHD’s drug procurement unit then only serving orgnized communities, now it is reaching out to larger crowd that is mostly unfamiliar to the concepts of RDU. The MHP staff are proud to say that they have been somehow successful in slowly influencing some people to follow prescriptions, take a full course of medication or go for herbal or generic versions rather than known brands.
Torres admits that economic issues hinder the promotion of RDU. She says other patients could not afford to buy full dosage of medicines. “There are those who buy one or two tablets of amoxicillin. We tell them the minimum dosage for antibiotics is 15 tablets. We try to lower prices so they could buy the full dosage.” It is unfortunate however, that even if people know about the proper intake of medicines, they have not enough money to buy them.
Even with the enactment of the Generics Act of 1988, she underscores the failure of the government to support local drug manufacturers as well as its failure to regulate the production of medicines.
Due to monopoly pricing, the cost of drugs in the Philippines is one of the highest in the world, second in Asia next to Japan. Branded medicines still dominate the market, accounting for 97 percent of sales.
The Philippines now heavily imports drugs from India through the government’s parallel importation program. If indeed the government really wants to end monopoly and significantly reduce prices, Torres insists that it should instead promote local pharmaceutical companies by increasing subsidy and lowering taxes.
To demonstrate the ill-effects of such problematic trade, experts believe that the rise in number of cases of multi-drug resistant TB is a result of the failure to comply with prescribed medication.
The irony remains starkingly real. Great advances have been made regarding treatment and cure of many ailments, but who can afford them? All these gives MHP more reasons to continue its work.
By Philip Paraan Council for Health and Development (chdmancom@yahoo.com)
Published at Health Alert Asia Pacific (www.hain.org)