Another village in the Philippines has declared a diarrhea outbreak.
 |
| https://www.pna.gov.ph/articles/1147405 |
Sto. Tomas, Davao del Norte Mayor Ernesto Evangelista declared a diarrhea outbreak in Barangay Tulalian on Friday.
In a statement on Saturday, the Municipal Information Office (MIO) said the declaration was due to the death of a resident while 47 others were confined in various public and private hospitals.
As of Saturday, the Municipal Health Office said the fatality is a 58-year-old male resident who experienced loose bowel movement, stomach pain, and vomiting.
“The 47 residents were rushed to both private and public hospitals; some are still recovering while others were discharged,” the MIO said.
Charlemagne Fernandez, MHO administrator, said the local government unit (LGU) and the MHO began their investigation to determine the cause of the outbreak.
“But the Environment Sanitation Report from the MHO revealed that the water system source in the area was possibly contaminated because of the water’s poor quality due to poor chlorine disinfection. Such finding was based on the ocular inspection conducted by the Sanitation Team and random interviews with the Tulalian Water Association (TUWASA) personnel,” the MIO said.
Lapiña said the Sto. Tomas LGU provided potable water, installed a makeshift treatment facility in Barangay Tulalian covered court, meals, and other medical support to patients complaining of severe diarrhea.
The town also provided new water containers and water-purification chemicals to the affected areas while residents have been briefed about cleaning their surroundings and maintaining proper sanitation to prevent another outbreak.
“We will continue to monitor the patients to make sure they were all safe,” Lapiña said.
To avoid future outbreaks, Lapiña urged the officials of Barangay Tulalian to sit down with TUWASA to discuss how to improve the water supply in the barangay.
She added that the town is available to guide and improve water services delivery in the area.
How many diarrhea outbreaks is that this year so far? If the government thinks shutting down the entire economy and forcing people to follow burdensome and unscientific health protocols like wearing face shields and face masks because of a virus with an official survival rate of 97% is acceptable then why not do the same for the diarrhea pandemic which has been gripping this nation for decades?
Just how serious is the diarrhea pandemic? To assess that we will have to review the available statistics. Oddly enough the statistics compiled by the DOH and PSA do not agree with one another.
First, let's look at the available stats for 2016, 2017, 2018, and 2019. These statistics are whats available on the DOH's official website.
2016:
 |
| 2016 |
14,487 cases with 52 deaths.
2017:
 |
| 2017 |
 |
| 2018 |
17,906 cases with 20 deaths.
2019:
 |
| 2019 |
11,594 cases with 14 deaths.
Perhaps you cannot tell but this data is not complete. What is being recorded here is not all diarrhea cases and deaths but only those related to Acute Bloody Diarrhea which is not the same as regular or Acute Watery diarrhea. The DOH has a different publication which gives the details for both types of diarrhea. The stats for 2018 do not match the above stats from 2018.
The total number of Acute bloody diarrhea cases for 2018 is 30,886.
 |
| pg. 366 |
For acute watery diarrhea the number is much higher.
 |
| pg.391 |
The would bring the total number of diarrhea cases in the Philippines for 2018 to 164,446 which is much higher than in the DOH's other official figures. What accounts for this discrepancy?
It is not so easy to find hard data on the diarrhea situation in the Philippines. For instance, in 2008 the WHO and UNICEF released a report noting that 10,000 children in the Philippines die each year from diarrhea.
 |
| https://www.gmanetwork.com/news/news/nation/119921/diarrhea-kills-10-000-pinoy-kids-every-year-who/story/ |
Over 70,000 Filipino children have died of diarrhea in span of seven years, the World Health Organization (WHO) said in a study released Friday. In its study which it co-conducted with the Department of Health and United Nations Children Emergency Fund (UNICEF), WHO said this figure makes diarrhea the fourth leading cause of deaths among children less than five years old and the third leading cause of illness among the children. The study showed that if the trend continues, it is expected to cause 10,000 deaths every year.
Try as I might I cannot find this study. It appears WHO and UNICEF deleted it from the web. Perhaps if this news article had given the name of the study and a link I could manage to find something. The only official reference I can find is on the web archive.
 |
| http://web.archive.org/web/20100430085500/https://www.unicef.org/philippines/mediacentre_10168.html |
In the country, diarrhea is the 3rd leading cause of child illness and the 4th leading cause of deaths among children less than 5 years. It is estimated to cause 12% or almost 10,000 deaths a year. A 2004 UNICEF assisted study on the prevalence of soil transmitted helminthes, estimates that almost 70% of pre schoolchildren are host to at least one type of intestinal helminth infection and that 7 out of 10 children (aged 3-12) suffer from intestinal worms.
I had to find this on the web archive because otherwise it is now a dead link. Strangely enough this dead linked article is cited in a textbook about the Philippines.
Diarrhea causes the death of about 10,000 Filipino children every year. It is the third leading came of illness among the children. The ratio of diarrhea cases in the Philippines is almost double the figure for other Southeast Asian countries such as Vietnam, Malaysia, Laos or Cambodia. 10-20%—or 1.5 million children—under the age of five suffer from diarrhea. A 2004 UNICEF study shows that 70% of children aged 3-12 suffer from intestinal worms.
The source for that paragraph is the UNICEF article quoted above and not the actual studies from 2004 or 2008. It is pretty odd that a text book would quote a press release as an authoritative source rather than an official study because in the context of the book there are many surveys cited to confirm what the author has written.
Let's take another look at official statistics on diarrhea deaths from the PSA. The most current report is from 2017.
 |
| pg. 50 |
2016:
 |
| pg. 51 |
4,801 deaths
The statistics from 2006-2015 are all laid out in one convenient table put together by the PSA. Diarrhea is the 18th cause of death in this time period.
 |
| pg. 1 |
We are given separate totals for both male and female deaths but I will only give the totals for each year.
2006: 4,390
2007: 3,989
2008: 4,306
2009: 4,572
2010: 3,708
2011: 4,199
2012: 3,970
2013: 3,273
2014: 3,313
2015: 3,675
That is 39,395 deaths from diarrhea over a ten year period.
Let's go back a little further and see all the statistics since the year 2000.
Going back 21 years to 2000 the annual death rate was not much different.
 |
| pg. 212 |
4,015 dead from diarrhea in the year 2000.
4,200 dead in 2001. Pg. 116 of the report.
3,684 dead in 2002. Pg. 116 of the report.
3,135 dead in 2003. Pg. 123 of the report.
3,538 dead in 2004. Pg. 132 of the report.
3,982 dead in 2005. Pg. 133 of the report.
According to the PSA from 2000-2017 there were 66,589 deaths which is an average of 3,699 dead every year from diarrhea.
So, what can be done to fight the diarrhea pandemic? The government has many solutions laid on the table. Making sure everyone has proper toilets is a big goal.
 |
| https://www.unicef.org/philippines/press-releases/department-health-100-toilet-coverage-possible-2022 |
“Our target is 100 percent coverage by 2022. Let us not wait till 2022. Nothing is stopping us to achieve this earlier than planned,” Duque said, citing his agency’s National Sustainable Sanitation Plan.
According to the Joint Monitoring Programme for Water Supply, Sanitation and Hygiene of the World Health Organization and the United Nations Children’s Fund (UNICEF), approximately six percent of Filipinos, mostly in rural areas, still do not have sanitary toilets, as of 2015.
“When people living in our communities defecate in the open, in fields and waterways, our children will more likely experience frequent bouts of diarrhea, have worm infections, and grow up stunted and undernourished,” said UNICEF Philippines country representative Lotta Sylwander.
Eliminating open defecation by 2022 is one of the goals of the Philippine Health Agenda. “But giving away toilets alone will not solve our problem,” said Duque.
To address this, the Department of Health (DOH) is implementing the Zero Open Defecation Program (ZODP). The ZODP utilizes the approaches and strategies of Community-Led Total Sanitation (CLTS). CLTS is under the umbrella concept of total sanitation that includes a range of behaviours such as stopping open defecation practices; ensuring that everyone uses a sanitary toilet, washes hands properly, handles food and water in a hygienic manner; and disposing animal and domestic waste safely to create a clean and safe environment.
“Achieving zero open defecation is not easy. Households and communities need to be aware and prepared. We cannot just give toilets for free. All our efforts will be for naught if families are not willing to invest their time and resources in building and maintaining their own toilet facilities,” said Duque.
According to DOH, eradicating open defecation and setting up the safe management of sanitation requires a shift in the use of approaches. This shift will include collective behavior change, strong supply chains and improved public services. Across these steps is a need for public regulation of behavior compliance, improvement of infrastructure and services of individuals, collectives and corporations.
 |
| https://www.pna.gov.ph/articles/1130632 |
In its disease surveillance report, DOH data showed that from Jan. 1-30, influenza-like cases dropped to 69 as compared to the 678 -- a 130 percent decrease -- recorded in the same period last year; typhoid and paratyphoid cases with 29 cases from 266; and dengue with 35 cases from 251.
The three illnesses logged the highest number of cases last year.
Other illnesses, including viral hepatitis B and C, bacterial meningitis, non-neonatal tetanus, leptospirosis, and acute bloody diarrhea also logged decreases in cases during the first month of this year.
Only one measles case was recorded in January as compared to the 106 in the same month last year.
Dr. Ruby Constantino, DOH regional director, attributed the decrease in the number of illnesses to the observance of health protocols.
“The practice to prevent getting infected with Covid-19 applies to other diseases. Iwas lamok, paglilinis ng paligid at ng katawan (avoid being bitten by mosquitos, cleaning of the environment and our bodies) is also protecting us from acquiring other diseases,” Constantino said.
Washing ones hands and keeping their environment clean is an obvious way to prevent disease but not everyone knows this. Just as important as proper toilets and sanitation are to preventing diarrhea outbreaks is having clean water. But what can people do when the water supply controlled by the city is tainted?
 |
| https://www.pna.gov.ph/articles/1147931 |
The Sto. Tomas Municipal Health Office (MHO), in a statement, said they found E. coli bacteria in the village's water system which is run by the Tulalian Water Association (TUWASA), a private water service provider in the said village.
E. coli or coliform is bacteria that can be found in human or animal waste and causes diarrhea/bloody diarrhea, vomiting and stomach pains, and cramps.
“For now, we discouraged the residents from drinking water if it is not purified or boiled for about 20 minutes in order for the bacteria to die,” Lim said. As of July 21, the MHO recorded another 27 diarrhea cases.
In the Philippines it is better to never drink water from the tap.
There is no single solution to this problem. The eradication of diarrhea as a cause of death in the Philippines will take a multifaceted approach involving both the public and the government. Seeing as the problem has persisted for decades there is likely no ending this pandemic anytime soon.
But sir, I was told "It's more fun in the Philippines" shitting yourself to death doesn't sound like fun at all...
ReplyDelete