VICTORIA B.

LIONG ASSIGNMENT CHD 203

AUG. 24, 2013

SOMETHING TO PONDER Let us take a look at a paradise island of Cuyo, Palawan away from the ever busy city where traditions, cultures and customs are highlights of the haven. In their eyes they see things uniquely from what others may say. Elders and head tribes are highly respected and their opinions are valued and honoured. Though the place seems to be a paradise for tourists who explore the place, it seems different when asking a Cuyo like in medicine. As time pass by inventions and innovations now also invades the world of medicine. The face of it changes so fast that some are left behind, or maybe they have chosen to stay behind. A patient with a complaint of stomach pain came with a rope tied tight around his abdomen and herbal leaves were placed on top of it. The young physician ask the patient to remove the rope and the leaves but the senior resident whisper to the young physician not remove anything that is placed by an albularyo a traditional medicine man, because you will be responsible to patients death when it happens. They find out that it was dengue that made him sick, he was given the medications and the care needed for him to get well. = narrated to me by the young physician who is now a consultant in our department.

SHYNESS I dont know why but Im shy, I cant bring myself to the doctors and tell them my problems, that is what she said. Yeah its a typical Filipina reaction when they feel something is wrong within them. But they think that they may be exploited during the process of medical procedures, so let us wait and see if it continues then see a doctor if not then never mind. Keeping a positive perspective that its nothing serious that a doctor should examine, defending it and considering other factors like maybe its just because you stayed up late from the past few days, or simply stress. When the pain reached her limit she decided to have a consultation. It took her more than a year to pull herself together and have the courage to finally ask a professional opinion regarding her condition. During diagnostic work up, they found out that her breast mass was already large, and that it has been staying in her for quite a while. Now ifs are coming back, if only I had the courage that time if only, then maybe its not that worst now. There are times when it is right to keep quite on the other hand speaking might be the right option. = story of a breast cancer patient undergoing radiation therapy.

GO WITH THE FLOW (CANAO) Instead of continuing with her medications advised by her doctor, she followed what the ethnic group head says. Through the mambunongs or spirit medium the dead ancestors says that family must conduct a canao since her illness is caused by some unknown creatures, or maybe they just forgot to gave there ancestor something that they ask. With this celebration, the family spends a lot of money providing the necessary offering to the ancestors until they are satisfied, it may take a week or longer. Believing that she will be healed by with the help spirit of the ancestors if followed everything that was asked from them. The patient then stays there and didnt follow instructions of the doctors for her to continue her medication. She never returned to them and they never heard about her in return. story of diagnosed cervical cancer patient with liver metastases as narrated by a Post Graduate Intern

EXEMPTIONS Meningococcemia, when a patient dies from this disease the department of health says that it must be buried immediately in order not to spread the disease to other people. In some places here in the cordilleras, the dead ones are not being placed inside a coffin and treated like it is alive and just sleeping. They clean the dead from time to time, and it is exposed to all the people sharing their sympathy to the bereaved family. Unknowingly the cause of the patient death was Meningococcemia. Another individual who have visited the dead also contacted the disease thus a chain reaction. The preventive measures of the health department means to break the tradition of the ethnic group in which they belong and that has been a practice for them for a very long time. The old folks might get angry at them and the people around them may see them as acting rebellious, or may say that they will be punished by their ancestor spirit for not continuing the practice. They think that they are being selfish and didnt want to share the last moment of the dead one. The health department was being cautious about public health and never wanted to bring dilemma to them. The health department stood firm that if the cause of death is the stated disease the dead must be buried immediately. In not sure if this is true but its been buzzed upon during the time that there were several people who have had contacted Meningococcemia here in the Cordilleras.

DECISIONS Low oxygen level low chances of radiation therapy success, a patient having a very low haemoglobin level when bombarded with radiation doesnt make much difference, unlike with patients with normal level of haemoglobin. Blood transfusion was suggested to increase the haemoglobin level of the patient but since they are devoted Jehovahs Witness they refuse to take it due to scriptural reasons and asked for alternative ways in which to increase her blood level. During that time hematopoietic drug that increases blood level and other alternatives are not yet available. The patient then decided not to continue with the radiation therapy sessions since it no use, instead she chose to stand firm in her decisions. The patient died after several weeks. - story of one patient undergoing radiation therapy