Lapu-Lapu Times: Public Safety

RETURN OF THE SHRIKE (TIBAS)

2006-09-23T14:28:00.000-07:00

This week marks the beginning of the Philippine leg of oriental shrike (locally known as tibas) migration. I have been observing the birds since Monday (6 days ago) when first I heard one eeekkk-eeekkk-eeekkkk.

By this time, it should be early-morning cacophony of shrikes screaming all around.

Bird flu??

ULTRA STAMPEDE AND MONDAY-MORNING QUARTERBACKING - AN EMAIL FROM CHARLESTON, WV, USA

2006-02-16T17:28:00.000-08:00

[This is a response to the post below - Mactanman]

Right on....You should cc the city and provincial gov'ts.

PENIS ENLARGEMENT - THE HARD FACTS

2006-02-15T01:36:00.000-08:00

A local television show last night had a long segment on penis enlargement. The procedure is now an established practice (illegal and nonmedical) done by injecting silicone into the penis to enlarge the organ.

Shock of all shocks! This is being done in the kitchen of some typical poor person's household, under local anesthetics, using toothbrush handle for dissection, and injection of hardware-grade silicone grease through a syringe-and-rubber tube contraption.

Predictably, infections are already happening.

In my practice, I already have come across patients who lost their nose, breasts and buttocks from these practices.

I often lecture in hospital grand rounds and in major medical conventions. One of the topics that never get old is competency issues in platic surgery. I point out over and over again that anytime one violates the skin, that is already a medical practice under the existing law of the land (Philippine Medical Act of 1959). And only licensed physicians are allowed to practice medicine.

Yet, we see these businesses everyday all over. In the malls. Advertised on TV. Clearly all medical practices by non-physicians, yet they go on and on with their illegal practices without fear of prosecution.

In the Penis Enlargement TV program last night, an officer from CIDG (Criminal Intelligence and Detection Group, the Philippine National Police) said that these practicioners cannot be prosecuted because there are no complainants.

Well, duh! Who is going to go to a police station and complain that his penis fell off!?

ULTRA STAMPEDE AND MONDAY-MORNING QUARTERBACKING

2006-02-14T19:01:00.000-08:00

First, for the benefit of those outside the Philippines, Ultra stampede happened 10 days ago on a Saturday, when poverty-stricken people rushed to enter a game show venue, each one carrying the hope of getting out of poverty by getting lucky on the show. People were lining up and holding their position for up to a week before the show!

Second, for the benefit of those outside the USA, Monday-morning quaterbacking is "knowing" what and what not to do in situations that already happened. The term is derived from the popular American football (NFL) which is played during the season mainly on Sundays. The quaterback is the offensive leader of the team - he is the one who "knows" what and what not to do.

The Ultra stampede killed 76 people. More than 600 were injured. Less than 24 hours after the tragedy media savvy people parked themselves in front of the TV cameras and embarked on Monday-morning quaterbacking that still happens today, 10 days after. Points and counterpoints often throw in the term "Monday-morning quaterbacking".

So, I hope that this blog enlightens the confused Filipinos when the TV anchors and reporters and spin doctors utter the word.

Oh! By the way, there are disasters waiting to happen in and around Mactan. Please refer to this blog. When any of these happen and it turns out disaster response is inept, we're not Monday-morning quaterbacking.

HOLIDAY SEASON 2005

2005-12-24T01:47:00.000-08:00

Lapu-Lapu Times wishes you
Happy Holidays!

GOOD IDEA!

2005-11-25T11:31:00.000-08:00

DILG Secretary Angelo Reyes during a pep talk to the TMG people after the infamous Ortigas shoot out: "Habulin ang mga kriminal! Bring them to justice!"

Good idea!

ANARCHY IN THE STREETS

2005-11-22T20:12:00.000-08:00

Last week, Automobile Association of the Philippines (AAP) reported that between January and October of 2005, there were 51,439 road accidents. I do not know if this is Metro Manila alone or the whole Philippines. At any rate, this is the highest incidence of vehicular accidents in Asia (maybe the whole world?). The representative from AAP was babbling about the many causes.

Well, duh! There is only one cause, the drivers do not know the rules of the road. Specifically, they do not know what right-of-way means. Why? In some places, fixers will take care of one acquiring a license. There are no manuals distributed nor sold to the driver applicants. Places without fixers...written test? The answers are given to the applicants without them reading the questions at all (The test is in English; I do not know what percentage of the applicants can even comprehend the questions). Practical test? I do not know if it is ever given at all.

A common scenario: Truck A is cruising on a two-way street , comes to a blind curve , and suddenly faces Multicab B right in the middle of his lane, passing Multicab C. Then, smack! Head on collision. Driver of Multicab B dies; driver of Truck A goes to jail.

Why does driver of Truck A go to jail? When you ask the arresting officer, "homicide through reckless imprudence". Who is reckless? Who is imprudent? They should put the body in jail instead of the driver of Truck A, who was in his lane, has the right of way, and absolutely has nothing that he could do to avoid the demise of the Multicab B driver.

A host of other scenarios happen every day. Again, either one or both drivers did not know what right-of-way means.

"HAPPY AS A TORNADO IN A TRAILER PARK"

2005-11-08T12:27:00.000-08:00

The title is a metaphorical statement expressing a state of wanton satisfaction, a uniquely American expression due to a confluence of two things: prevalence of tornados especially in the central and midwest regions of USA; and the presence of trailer parks, lower-end communities where instead of traditional houses, people just park their trailers (literally houses that people pull behind on their vehicles) side by side with other trailers. Depending upon the size of the park, these can number into the tens, hundreds or thousands.

Tornados are very opportunistic forces of nature. Somehow, they don't bother to hit cities and communities with houses and buildings built on solid foundation. When they hit (with their 250 kph winds), they usually hit the trailer parks where there are no basements to hide in. They just wantonly throw the foundation-less trailers around like match boxes in a wind tunnel.

Thus, the headline on the news wires in the last couple of days: "22 Killed in a Tornado in the US". Twenty-two is a pittance compared to what could have been had the US not have the warning and disaster response systems that operate in all 50 states.

You can analyze the different calamities that hit all over the world recently - the Indian Ocean tsunami, hurricanes Katrina and Wilma, and South Asia earthquake that hit Pakistan and India. Disaster preparadeness plays a very important role in limiting the casualties.

We in Lapu-Lapu City can look at these disasters with merely a passing interest. Or, should we? Is the city prepared to handle any of these mass disasters?

A 747 with 250 passengers on board crashes on approach and hit a Basak neighborhood. Impossible? A similar accident happened in the late 60's when a Fokker plane crashed on approach.
A 747 on an emergency landing overshoots the runway and breaks apart off Ibo coastline and goes down under 10 meters of water. Impossible? A similar accident happened at Washington National Airport where a commercial plane fell into the Potomac River.
A 747 crashes after take-off into Camotes Sea at 60 meters deep. Impossible? There has been a literal rash of take-off crashes lately.
A passenger ship overloaded with passengers (like always) is blown up by terrorists at the Gilutongan Channel and a fire on board happens (over 80% of interisland and international boat traffic goes through Gilutongan Channel now since Mactan Channel was closed to traffic except for the small boats). Impossible? Recall the Superferry incident.
A passenger ship overloaded with passengers is caught in a typhoon in Gilutongan Channel. Impossible? I've seen two ships struggle to keep their position in the middle of Gilutongan Channel in a minor typhoon four years ago.

What is the city to do under any of these circumstances? I remember when I was in Kansas City during my training days in Plastic Surgery, we used to have regular mass disaster drills where everything is in place except for the real victims. The scenario is much more far-fetched than any of the above, like a bus fell off a bridge, full of kids on their way to the hemophiliac convention. I remember in my practice in Charleston, West Virginia we devote one day a year in mass disaster drills. The scenario is more real here - a major chemical leak at the Union Carbide plant just outside the city. Recall Bhopal, India.

In my 5 years here, I have not seen any disaster drills. Salig lang ta gihapon sa Birhen sa Regla? Any of the above can still happen...despite!

UNAFFORDABLE PRICE OF MEDICINES

2005-11-02T12:33:00.000-08:00

A few days ago, I caught a forum on cable TV titled: " Lowering Prices of Medicine in RP". This was in preparation to a major pharmaceutical convention in Manila held last week. As always, we look to a foreigner as the resource person in looking for the solution, a fellow by the name of James Love, Director of Washington Project on Technology (Washington, DC).

The forum talked about:

The current exorbitant prices of medicines in RP
Lack of R & D (Research and Development)
Pharmaceutical business in the age of globalization
Smuggling and piracy

Consider the current scenario: Nowadays, more than 65% of health care pesos in the Philippines is spent on diseases related to atherosclerosis (hardening of the arteries). So, we need medicines for high cholesterol, high blood pressure, the heart, and for diabetes. Typically, these will cost around P200 per day, more or less. I don't think even 50% of the population can afford this. If you follow the dynamics of R & D and production of pharmaceuticals, I don't think that this price can be lowered any further.

So, we resort to smuggling and piracy. With the high price of R & D, I think this is one of the few ways that the Philippine society can manage to keep a reasonable percentage of the population treated.

One last hope is breaking the mutual relationship between physicians and the pharmaceutical companies. Financial favors and favors-in-kind from the pharmaceutical companies to the physicians must be stopped, or else the generic law will never work.

If nothing else, we can keep relying on the arbularyos, and snake charmers selling herbs and medical potions (and their high-tech variations that you see operating in malls and other public places).

STROKES AND HEART ATTACKS - LESSONS AT THE "BILAR"

2005-10-30T20:30:00.000-08:00

Quite appropriately, at the bilars (traditional nightly wake for the dearly departed) that I go to, the discussion invariably drifts down to strokes and heart attacks. And, invariably the whole discussion seem to be eye-openers for most. So, here are the salient points:

Strokes and heart attacks are all caused by hardening of the arteries (the blood vessels that deliver blood to the rest of the body from the heart).
With animal fat and arguably, coconut oil flavoring most of the Filipino food, each and everyone are doomed to have a certain degree of hardening of the arteries. At childhood and adolescence, our arteries are soft as rubber. By the time we reach forty, some areas of our arterial systems are hard as rocks. These are your typical cholesterol deposits, known as plaques.
While in the hard state, the disease is fairly tolerated. Then, softening of the plaque occurs (quite possibly from infection with Chlamydia Pneumoniae, a bacteria) and it ruptures into the cavity of the artery, known as lumen.
When the lumen wall is violated, the natural body mechanism is to form a clot to plug the hole in the lumen. Then 2 things happen: a) the clot is so stable and efficient that it totally takes care of the rupture, or b) the clot is unstable so that by the next heart beat, the clot floats away.
When the clot floats away two things can happen: a) blood at the high pressure flows throw the hole and inside the wall of the artery, ripping off the lining of the artery all the way from the heart, up to the brain and down to the extremities...and into the body organs including the pancreas (erroneously diagnosed by the medical community as Urom, hemorrhagic pancreatitis); or, b) the clot flows backward into the coronaries causing sudden heart attack, or to the brain causing stroke.

So, what to do? Avoid hardening of the arteries. Limit intake of known cholesterol hazards like animal fat (lechon, humba, pochero, balbacua, inasal manok). Avoid obesity. Excess fat eventually breaks down to cholesterol, among other things. By the way, obesity happens not because of not eating low-fat food. Rather, excessively positive balance between calorie in and calorie out. Translation: too much sweets such as cakes, sopas, snacks, ice cream, etc.

What if you are already above 40 and you already have hardening of the arteries? Answer: a) continue to cut down on your cholesterol by dieting and cholesterol-lowering pills if you can afford it; b) exercise regularly - you do not have to belong to gym nor buy a thread mill or exercise bicycle, walk and do not take a tricycle or multicab when you go some place within reasonable distance; c) drink wine (especially red) in moderation; and d) take 5 grains of Aspirin twice a day forever, so when the big one hits, circulation to whatever is left of your heart or brain is maximized.

Simbako! doesn't work here. So, take heed.

PRETTY BIRDS/DEADLY VIRUS

2005-10-06T10:30:00.000-07:00

Lately, there have been lots of action on the news wires and the internet (Reuters AlertNet)regarding bird flu. Translate...possible influenza pandemic killing 100's of million people (not birds). Presumably, this will be brought about by the combination of the bird flu virus that has been percolating in Asia in the last few years, and the human influenza virus.
Dreadful possibilities for Mactan and surrounding areas:

Like clockwork, oriental shrike (locally known as tibas) arrived a few days ago. You can hear their loud distinctive shreek (eekeekeekeekeekeek!) at sunrise and sundown, and their pretty chirps at midday.

WHERE HAVE THESE BIRDS BEEN TO?
I remember growing up in Mactan Island when we look forward to October-December so we could go slingshot hunting tibas. SHOULD THE CITY HEALTH DEPARTMENT ISSUE A WARNING?
Apparently, the mode of transition from avian to human disease is spread from wild birds to domesticated birds, combination with human flu virus transforming it into a human pathogen. SHOULD THERE BE AN ADVISORY FROM THE CITY HEALTH DEPARTMENT FOR RESIDENTS TO WATCH ANY SIGNS OF AN EPIDEMIC IN CHICKENS AND OTHER HOUSE FOWL (in the old days, locally referred to as atay)?

The Olango Bird Sanctuary. Very soon, activity at the sanctuary will skyrocket due to the arrival of the shore birds.

WHAT PRECAUTIONS SHOULD BE TAKEN AT THE SANCTUARY? SHOULD THERE BE A MORATORIUM ON TOURS TO THE SANCTUARY?
I don't know if people still do it. But, believe it or not, people used to catch birds at the sanctuary for food using koskos(cyanide)-laced fish baits. SHOULD THE CITY HEALTH DEPARTMENT LOOK INTO THIS?

Better safe than sorry.

Soy and Thyroid Disease

2005-10-05T16:15:00.000-07:00

Item on Hoy Gising! on cable TV today, Health Tip: Avoid thyroid disease by limiting consumption of soy.
Presumably, the isoflavones (the active ingredient that makes soy so popular today) blocks production of thyroid hormones.
This reminds me of my presentation at the Mactan Doctor's Hospital Community Medicine Annual Convention two years ago. Of all things, I was tasked to talk on the status of the coastal environment in and around Mactan Island. For me, it was truly a lucky occasion since the Directors of all six Community Medicine Training Programs in Metro Cebu were there. I pounced on the opportunity of challenging the Directors in doing a joint study to support my hypothesis that the main cause of goiter in our area is the indiscriminate use of cyanide (koskos) in fishing. Koskos has long been the preferred method of catching fish especially in the aquarium fish trade. And, we have been squirting cyanide into our coral reefs since 1960.
Cyanide is non-biodegradable and continues to accumulate in the environment. IT IS THE STRONGEST THYROID HORMONE BLOCKER KNOWN TO MAN. With chronic low dose cyanide poisoning, the body continues to send messages to the thyroid gland about there being no hormone reaching the endorgans, so therefore the thyroid activity goes into high gear, creating the typical goiter. Goiter is so prevalent now, that thyroidectomy is the #1 general surgical procedure that we do during our medical missions.
Has the medical community done anything about this. None, so far. What about the government? None, so far. If we spent our efforts on passing the ASIN law into stopping Koskos, it would have served us...and the environment better. Koskos remains the #1 killer of our coral reefs to this day.

LAUNCHING OF LAPU-LAPU TIMES

2005-10-02T22:03:00.000-07:00

Greetings, everyone!
For a modern crowded city of more than 265,000 souls, Lapu-Lapu's lack of a newspaper truly stands out. Other than the usual LOOSE gossip, nobody really knows what the actual day-to-day pulse of the city is. True, we have a section dedicated in one or two regional Cebu newspapers, but the items are inadequate and mostly deal with killings, drugs, robbery and rape.
We in Lapu-Lapu City ought to know more! So, let's try this venue.
Everybody is free to send comments ("news", opinion, etc.) on this blog, ON ANYTHING AND EVERYTHING THAT PERTAIN TO PUBLIC SAFETY (CRIME, DISASTERS, ETC) IN LAPU-LAPU CITY. I will post them, subject to my privilege as editor.