Environmental health and sanitation PCM reflection paper

Harold Ismael Nkume 01/01/13 Section A

Every person deserves the opportunity to maintain good health and attain the likelihood of any happiness that results from it. It goes without saying therefore that we all try to make life a little more bearable for ourselves in many different ways. We may try to lavish our garages with luxurious automobiles or partake in a fte champtre. Even in the event that we succumb to illness, we attempt to gain immediate relief from the best possible sources, all done in efforts to appeal to our very basic need for comfort. There are many causes of illness that should be brought to our attention if we are to maintain good health. I for one decided to look into the current situation of environmental sanitation according to my own observations in the Philippines, mostly in reference to Cebu city where I have had the utmost pleasure of residing for the past 3 years. Of course many of us are not in control of most things that contribute causally to the poor state of our health whether these things are genetic, psychological and more commonly environmental and financial in nature, as seems to be the case in developing countries. Nevertheless one must stop to observe and ponder. Are we really not in control of our health? Is there nothing I can do to keep myself from falling sick all the time? In light of all this I have learned to accept that there are some enshrouded threats to our wellbeing a lot of which may be ablated or spiflicated, but through ignorance remain concealed to the general public. I pertain to the fact that Environmental Sanitation is still a major health problem in the Philippines and that diarrheal diseases in particular can be controlled by simple prevention methods such as health education about spread of infection and good personal and food hygiene to mention a few. (WHO, 2009) On that note I must commend the efforts made by the late Dr. Mariano Icasiano, the late Dr. Amadeo Cruz and Dr. Clemente S. Gamaitan and the various establishments of governments that helped them finally publish The code on sanitation. Their endeavours make one consider taking more responsibility for health and environment alike. This brings me to some experiences on which I will share my views regarding what I have observed lately. The set of standards established and enforced by the Philippine

Environmental health and sanitation PCM reflection paper

Harold Ismael Nkume 01/01/13 Section A

government for health requirements, are not complete until we, as individuals, play a part in fulfilling these requirements.

Section 3c of the code on functions of the department of health describes how the Department of Health responsible for coordinating activities and services and programs which are aimed at educating the general public on health and sanitation. I have often noticed street vendors, taxi drivers and all sorts of commuters, taking a break to urinate in public before getting right back to work. I am not implying in any way that it is wrong to relieve oneself from time to time. I merely wish to illustrate the practical aspects of certain unsanitary behaviours in relation to the impact they might have on health. At first glance we would conclude that the Department of health has failed to reach or educate us in proper hygiene. Most of the time, we ignore this when we see it happening on the streets. Public urination is slowly becoming a norm in the society. However, if one were to become curious or inquisitive enough, they may take note that the culprit will in some cases, imprudently continue about their business without washing or so much as disinfecting their hands in any way. We can get into talking about the food or goods the vendor will handle, the change the taxi driver will pass to his passenger or the next person the commuter may greet, all with the same unwashed hands they used to relieve themselves, but it is the wrong approach in trying to address the main issues at hand. There are 2.5 billion people worldwide who lack basic sanitation. (WHO, 2009) this however does not justify what I observed in this particular case because countless adverts in the media, and on posters and bill boards constantly advise us the general public on various health issues. Companies such as the manufacturers of the soap BIODERM have placed toilets in some locations around Cebu city and to my disappointment it is these same areas where I see people urinating by the wall, next to telephone poles and even right on the pedestrian sidewalks. This is proof that approaches through hardware subsidies have been ineffective. (Chambers, 2009) In my opinion, for this particular scenario, lack of public toilets or education on hygiene is not as important in the cause of avoidable illness as individual arrogance seems to be. I

Environmental health and sanitation PCM reflection paper

Harold Ismael Nkume 01/01/13 Section A

agree with the goals and methods of a program described by Chambers who wrote about how programs that are based on Community-Led Total Sanitation are instrumental in dealing with this problem as they engage communities directly. Communities are facilitated to conduct their own appraisal and analysis of open defecation and take their own action to become open defecation free. (Chambers, 2009) This idea can be applied to public urination as well. I am glad to see that similar efforts are being made by our barangays at a community level, involving monthly clearing of clogged drainage systems and enforcing rules on each home for trash organization. Almost everywhere nowadays I see posters with the weeks schedule for trash collection including the BALAOD SA REPUBLIC ACT 9003, UG CITY ORDINCE 1361 UG 2031 provision. So our communities have also taken part in trying to maintain good health and a formidable environment. What then of cases which are a little harder to control? As I mentioned earlier there are things we can easily do to prevent infection like hand washing. But sometimes there are scenarios in which current situation renders us unable to comply with even the most basic methods of preventing illness. I came across such a case when I visited Mactan Island and noticed crowded shack houses located on dark smelly clearly unsafe water. My first thought was doesnt the government try to improve living conditions for these urban dwellers? Indeed it does. In fact there is a provision in Section 3a in which one of the functions of The Department of Health is to undertake the promotion and preservation of health of the people and raise the health standards of individuals and communities throughout the Philippines, but as is with most other developing country, the government cannot reach everyone in cases such as this. This observation is the typical mode of living of some of the less financially stable urban dwellers, who cannot afford the land needed for which to build their homes upon. A lot of the families living on this water have gone through ordeals of earthquakes, volcanoes and typhoons. These events have largely displaced them from their normal habitats and we can t really claim that it is their fault that they live under such conditions. For example, the November 2006 eruption of Mayon Volcano was followed by Typhoon Durian shortly after, leading

Environmental health and sanitation PCM reflection paper

Harold Ismael Nkume 01/01/13 Section A

to floods that created mayhem in surrounding settlements and took many lives. Mudslides of volcanic ash and boulders from Mayon Volcano killed hundreds and covered a large portion of the village of Padang (an outer suburb of Legazpi City) in mud up to roof level. The death toll was estimated at 1000, which is either equal to or surpasses the death toll from the major 1814 Mayon Volcano eruption. (d'Cruz, 2006) It goes without saying however that the risks of illness due to such crowded living conditions on the very water that is a main source of spread of infection of many diarrheal and other diseases, remain remarkably high. According to WHO, diarrheal disease are the second most common cause of morbidity and mortality in the Philippines. Every year there are about two billion cases of diarrheal disease worldwide. In 2004 diarrheal disease was the third leading cause of death in developing countries, causing 6.9% deaths overall. WHO reported that water is a main source of diarrheal disease, and other causes such as person to person spread, are aggravated by poor hygiene. Although my opinions are merely minor unproven assumptions based on my own observations, I still believe we can improve general health and wellbeing by practicing simple proper hygiene. Given that many organizations such as Slum/Shack Dwellers International, an umbrella organization formed by 15 national slum/shack/homeless peoples federations are already contributing to improving sanitation and general standards of living for people, the least we can do (for those of us who are able) is join their efforts by living a clean personal life.

Refrences: Celine dcruz (2006) Leadership in Philippines' Urban Areas The Global Network of the Urban Poor, Slum/Shack Dwellers International, http://www.sdinet.org/blog/categories/philippines/ Robert Chambers (2009) Going to Scale with Community-led Total Sanitation: Reflections on Experience, Issues and Ways Forward

Environmental health and sanitation PCM reflection paper

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WHO (2009) Diarrhoeal disease Fact sheet N330, August 2009 http://www.who.int/mediacentre/factsheets/fs330/en/index.html The Code on Sanitation Philippines, Presidential decree No. 856, THE DEPARTMENT OF HEALTH, Manila, Philippines 1976