CHAPTER I: INTRODUCTION As the first man and woman made the first family in this world, families are

continuously multiplying and spreading their ancestry. As time goes by, a big group of families are formed, thus creating a community. Community characteristics is of therefore goals defined and as a group of people with common wit hin a

shared

interest

living

together

g e o g r a p h i c a l b o u n d a r y , h a s a p o p u l a t i o n and environmental resources. In every community, different problems can be found especially healths problems that are usually caused by environmental factors. To prevent this kind of chaos, every individual in the community must be part of the process of improving their community into something better through the help of a health sector in a community by using a Community Organizing articipatory Action !esearch "CO A!#. Community Organizing articipatory Action !esearch "CO A!# is a continuous and a

sustained process of educating the people, working with people, and mobilizing with people. The process and structure through which members of a community are$or become organized for participation in health care and community development activities. As second year nursing students, we conducted CO which aims to help organize the people and help them identify and solve their problem in Canucutan, asonanca %m&,

'amboanga City. At our first entry in the community, we conducted an ocular survey in the said barangay. (e gathered information for the Initial )atabase on *+ families at Canucutan to gather information and to confirm the initial identified ma,or problem which is incidence of unvaccinated and stray dogs. Two other ma,or problems which are cough and colds and hypertension were also identified by the people of the barangay.

After the ma,or problems in the community were identified by the residents, we conducted our CO general assembly where in CO officers were elected. (e also educate them about !abies, its definition, signs and symptoms, treatment and prevention, and we also educate them how to be a responsible pet owners.

-.- !ationale This study has been conducted and undertaken to prepare us, a future health workers through e.posure to different kinds of health problems in the community. This study was also initiated for us to carry out community assessment, and help the community identify their own problems. 1

-.* urpose This research has been also performed to organize as well as to mobilize the people in the chosen community. This will help the people stand on their own, in preventing and solving the community/s ma,or problem which is the incidence of unvaccinated and stray dogs. The study has been conducted in order to gather databases of the community for further use of other health workers and community profiling. This has also been conducted to evaluate their health status after the assessment and diagnosis has been carried out through proper education and health promotion.

-.0 1tatement of the Ob,ectives The Ateneo de 'amboanga 2niversity College of 3ursing 4evel II, 5roup 6, aims to help the residents identify the ma,or community problems at Canucutan, 6arangay asonanca ,%m&,

'amboanga City, and to organize the people in the community, as well as to give them knowledge for them to be independent and cope with the community problem on their own. 1pecific Ob,ectives7 -. To be able to decrease the number of dog bites and the prevention of rabies at Canucutan ,6arangay asonanca through health teachings. 2. To be able to impart knowledge on the prevention and treatment of cough and colds. 3. To be able to educate the people on the management of hypertension.

-.8 9ethodology In our Community Organizing, we were assisted by the 6arangay Captain, :figenio :. ;ulian ;r. and by the ublic <ealth 3urse, 9rs. ;osephine =. Aringo, !3. (e were able to select a community and its ma,or problem which was identified by the people in the community. (e had our Initial )ata 6ase from the *+ families. (e also gave health teachings about the community/s problem. )uring our pre>entry phase we started our community organizing with an ocular survey with the help of the public health nurse to select a potential community. The :ntry phase. After the public health nurse helped us choose a community which is the Canucutan, a potential area for community organizing because of apparent problems that they are facing, we started collecting information from the community for the initial data base compilation. The community identified ma,or problems that they are encountering and among the problems, they chose incidence of unvaccinated and stray dogs as their ma,or problem. 2

Organizational>building hase. They elected a set of officers that will take charge of the community, specifically to organize, support and supervise in the implementation of health initiatives by the people. After the election of officers, we gave health teachings about prevention and treatment of rabies. (e also educate them on how to be a responsible pet owner. -.? 4imitation of the 1tudy This study is intended for the benefit of the residents in Canucutan, 6arangay asonanca %m&, 'amboanga City. The main focus of this community assessment is concerned with the development and empowerment of the people of the said barangay. The study presents data based on the study conducted by the students. It includes house to house interview, survey specifically about incidence of unvaccinated and stray dog and ocular survey. The respondents included were *+ families in Canucutan. This research focuses on the assessment and planning to identify the health problems present in the said community and arrive in an appropriate action plan for the empowerment of the people. Target respondents are those head of each household as well as the family members present.

CHAPTER II: TARGET COMMUNITY PROFILE *.- 5eographical 9odifiers *.-.- <istorical 6ackground 6arangay hectares. asonanca is about ?.-@ km from the city proper. Its area size is -,-8A

asonanca is known for its beautiful park. It is one of the most visited parks in the

hilippines. One of the boy/s scout training center can also be found in this barangay. A public pools are also located in this place, which is ideal for people during summer. asonanca became a barangay upon the enactment of Commonwealth Act 3o. 0B, s. -B0&.There are numerous tales about the mystery or origin of the name asonanca. One such story tells of a group of people discovering a kind of plant growing abundantly in the hills and bearing a very sweet fruit. 1o they planted the plant in a CpasoC or big vase. It was years later that they discovered the plantDs name > CnangkaC. The name asonanca was thus coined and

given to the place where the trees are growing. Others say that the name C asonancaC is a contraction of three words > paso de nanca, which means C ass of ;ackfruitC. It is bounded by 1ta. 9aria on the 1outh, 1an !oEue on the (est, 4unzuran on the 3orth and Tumaga on the :ast. It is composed of & puroks and & sitios, namely7 Abong>Abong, 4uyahan, 1hanty Town, 4antawan, 6usay, 9uruk, 1abana Coco and Canucutan. It is the biggest barangay in land coverage, ?+F of which is plain, *?F hilly and *?F mountainous. 3

2pper

asonanca, which is situated in the northernmost part, used to be a virgin forest

with e.tensive collection of wildlife, trees and rich soil. It was also an agricultural area because of the abundant resources like coconuts, mango trees, bananas and other agricultural products. 9t. ulong 6ato, the legendary home of !a,al 1argan, the CtimuayC of 1ubanen, completes the pretty background of this picturesEue barangay. asonanca is a beautiful place befitting its popularity as a tourist destination. It has attracted a lot of people because it boasts both the asonanca and Abong>Abong =reedom

arks. Often hailed as the C4ittle 6aguio of the 1outhC due to its cool ambience, its terrain is hilly to mountainous. It has a natural swimming pool, the only one in the country.

*.-.* Organizational Chart of 6arangay Officials Efegenio E. Julian Jr. "6arangay Chairman# 1ecretary7 Conception !. !amoya Treasurer7 Cecilia A. )e ;esus "6arangay %agawads# Nel on A. La!a "e an"o E#ralin C. La!a "e an"o P$ili% &. Jone '(e" &. Ar)ui(a Pe#ro P. Lanu(a Jr. Le"i!ia M. Mili"an"e Jer on M. Mon"e*er#e Joanna Mari D. Ma "1.% Chairman# Elnier Ana "a!io Dar+l An#i!o I*an Co ,e Lea Gue*arra R$ina La!a "e an"o &a,-&a, ,o )ue#a JC Tan!io "1% %agawads# *.-.0 Organizational Chart of the <ealth Center ersonnel

Dr. Rodelyn Agbulos

City Health Officer

Dr. Ma. Lourdes Carol Carabaa

Assistant City Health Officer

Dra. Teresita L. Chiong

Medical Officer IV

Doreta M. 4 Cortes
District Nurse

Josephine F. Aringo
Nurse II

Reynaldo M. Bue
Sanitary Inspector

Arsenia B. Bello
TBA, BHW

!enaida A. Frangolin
BHW

"liceria A. #are$a
BHW

Mercedita B. Alvare
BHW

Rose C. "arcia
BHS

*.-.8 CO A! Officer of Canucutan The election of officers for the community organizing was conducted during the first CO A! assembly held on ;anuary -+, *+-*, Tuesday at the stage near the river at Canucutan. A number of the resident attended and were actively participating during the election of the set of officer. =our among the residents were chosen to fill the spots. The newly elected officers were responsible, cooperative, open>minded, and trustworthy. They helped us make their community a better one by organizing and supervising the people.

:lected Officers7 resident7 Gice resident7 1ecretary7 Treasurer7 9rs. Carmencita 4. 6atiun 9rs. 'enaida 6antug 9rs. !osibel Tolentino 9rs. ;osephina 6ello

*.-.A 1pot 9ap of asonanca

Chap C A N U C U T A N 5

CHAPTER III: DEMOGRAPHIC DATA 0.- Total opulation7 0-, *?B 0.* opulation )ensity =ormula7 )HTotal no. of population I -+++ Total no. of sEuare meters H "0-, *?B# "-,+++# --, 8A+,+++sEm* H *.&*&AA-8 or *.&0

0.0 Total of =amilies 1urveyed (e have surveyed *+ families. 0.8 Total 3umber of <ousehold 1urveyed (e have surveyed -?& household.

0.?

)ialect 1poken

Out of *+ families, -8 are using Chavacano as their dialect spoken, A are using 6isaya, and none of them is using Tausug

0.A Transportation

In barangay asonanca %m&, @?F of the community is using ,eepney as a means of transportation , and -?F is using motorcycle.

CHAPTER I.: /OCIO-DEMOGRAPHIC DATA 8.* Age )istribution

The graph shows that 8BF of the population in asonanca km &, are -?>8B years old, *-F are &>-8 years old, --F of them are ->8years old and ?+>A8 years old, 8F are ?>A years old, 0F are A? years old and above, and -F are +>--months.

8.0 5ender )istribution

There are *+ surveyed familiesJ there are more female family members than male. There are &A males and @- females. 8.8 =amily 1tructure

Out of *+ families, the graph shows that -- of the surveyed families are having patriarchal family structure, & families for matriarchal, - family for nuclear, and * families are e.tended.

CHAPTER .: /OCIO-ECONOMIC AND CULTURAL DATA

Out of -?& family members of the *+ families, in terms of highest educational attainment, B@ individuals reached grade school, -B of them have reached high school, -0 of them have reached college, and *& don/t go to school yet.

Occupation

6ased on the graph, out of -?& individuals, there are A construction worker, B farmers, 8 ,anitors, * vendors, * tricycle drivers, - housemaid, - saleslady, and * government employees.

10

6ased on the graph, out of *+ families, A of them are earning monthly salary and also A of them are earning ?+++ * families are earning

-+++>*+++ as their 0+++>

A+++> @+++, 8families are earning

-++++> *++++, - family is earning

@+++> -++++ and - family

also earns *?+++> 0?+++ monthly.

6ased on the graph, all of the *+ families who were surveyed were !oman Catholics.

CHAPTER .I: EN.IRONMENTAL FACTOR/

11

6ased on the graph, all of the *+ families, who were surveyed, own their houses.

The graph shows that out of *+ families, who were surveyed, * families have strong housing structure, @ families have light housing structure, and -+ families have mi.ed housing structure.

12

Lighting Facilities Other# 0!

"ero#ene 15!

E lectricit 85!

The graph shows that out of *+ families, who were surveyed, -& families are using electricity and 0 families are using kerosene.

6ased on the graph, out of the *+ families, who were surveyed, -+ families are using private water supply, and -+ families are using public water supply " such as deep well#.

13

6ased on the graph, out of the *+ families, who were surveyed, -- families use ,ar with faucet, ? families are using ,ar without faucet, and 8 families don/t have water storage because they get water directly from the pipe.

6ased on the graph, out of the *+ families, who were surveyed, * families are using electric stove, 8 families are using gas stove, and -8 families are using charcoal$firewood.

14

6ased on the graph, out of the *+ families, who were surveyed, the graph reveals that A+F have open drainage, and 8+F have no drainage.

The graph reveals that -++F of the families were using the method of open burning for their waste disposal. All of the *+ families, who were surveyed, are following open burning method of disposal.

15

6ased on the graph, out of *+ families, who were surveyed, 0 families are using Closed

it

rivy, A families are using ail 1ystem, -+ families are using (ater>1ealed 4atrine, and - family is using the =lushed type.

DomesticAnimals
Chic"en 5!

Cat 34!

$o% 51!

&i% 10!

The most numbered domestic animal is dog, followed by chicken, pig, and then cat. Out of ?B domestic animals owned by the *+ families, there were 0+ dogs, A pigs, *+ chickens, and 0 cats.

16

6ased on the graph, all of the *+ families/ houses were not congested.

CHAPTER .II: HEALTH PROFILE

6ased on the health status graph of the *+ families, consist of -?& family members, --& of them have no present illness, -& of them have cough and colds, -- of them are hypertensive, A of them have diabetes mellitus, - of them has T6, one of them has T6, one of them has cancer, and 8 of them are asthmatic.

17

The *+ families are -++F completely vaccinated.

CHAPTER .III: ANALY/I/ OF DATA @.- Identified roblem In the chosen community, barangay asonanca, Canucutan, the residents together

with the student were able to identify different community problems that are prevalent in the place. These problems were prioritized, and were able to come up with three ma,or problems in Canucutan. <ealth problem is a state in which an individual is unable to function normally. These problems in the community were identified according to the statement of the people in the community and can be proven through the data sources such as the I)6 and the survey as well as through observation during the ocular survey. The following are the ma,or problems that were identified. -. 2nvaccinated and 1tray dogs The people in the community have agreed that Incidence of 2nvaccinated and 1tray dogs is one of the ma,or problems that they are facing in their community. 3ot ,ust because they will attack or chase people especially children, which could cause in,uries but also this could lead to death because of rabies. !abies is a fatal disease which can 18

be transmitted to humans. Although all warm>blooded animals can get and transmit rabies, dogs are the most common carrier

*. Cough and colds According to the people of Canucutan, cough and colds is freEuently e.perience by them especially the young ones. It was observed in the I)6 that almost every family has a member who is e.periencing cough and colds. 9ost coughs and colds are caused by viruses. 9any different viruses can infect the nose and throat. They are passed by droplets or by coughing and sneezing, thus the virus is being transferred.

0. <ypertension As stated by the people in the community and also according to the information gathered, hypertension is also among the different health problem in

Canucutan,6rangay

asonanca. <igh blood pressure, sometimes called as arterial

hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated. This reEuires the heart to work harder than normal to circulate blood through the blood vessels.

roblem Tree

19

2nvaccinated and 1tray )og

<ypertension

Cough and Colds

@.* rioritize the roblems Unvaccinated and Stray dogs

Criteria 3ature of the problem

Computation 0$0 . -

Actual 1core

;ustification The problem health deficit

is

a and

20

reEuires

more

immediate 9odifiability problem * of the *$*. * intervention The problem is easily modifiable vaccination of since the

dogs is provided by reventive otential 0$0 . the health sector. 1usceptibility of other complications infections prevented can if and be the

number of stray dog without 1alience roblem of the *$* . vaccination the

can be decrease The family or

community as a whole recognizes problem. it as a

Total =5

Cough and Colds Criteria 3ature of the problem Computation 0$0 . Actual 1core ;ustification The problem health reEuires immediate 9odifiability problem of the -$* . * intervention Though the resources and interventions deficit is a

and more

needed to solve the problem are available to the family, is the

problem 21

greatly

affected reventive otential 0$0 . -

by

the

change in weather. Transferability of cough and colds to other member of the family is reduced or elimited if the problem is managed as soon

1alience roblem

of

the

-$* . -

as possible The recognize -$* it

families as a

problem. <owever, it is not seen as a

problem that needs immediate action.

TotalH 0 -$*

Hypertension Criteria 3ature the problem of Computatio n 0$0 . Actual 1core The problem is a health deficit and reEuires more immediate intervention ;ustification

9odifiability of problem the

-$ * . *

The problem is not easily modified since having maintenance for hypertension cause money. -

22

reventive otential

0$0 . -

The possibility of having a heart condition will be prevented if hypertension is properly managed. -

1alience of the roblem

*$* . -

The family recognize it as a problem

Total H8

Appendi. A Action lan of Community Assembly COPAR ACTI.ITIE/ 1ignificant dates of CO A! activity )ate )ecember -*, *+-Activity$Activities >On this day, it was our first duty at asonanca km& <ealth Center. (e were oriented with the health center/s organizational charts and its physical set>up, the different programs of the community were also discussed. On the same day, we made a courtesy call to the barangay hall. That activity was done for us to ask permission to the barangay officials and to let them know the purpose of our presence in their community. The barangay chairman was the one who welcomed us, and gave some background information about our target area, )ecember -0, *+-which is the Canucutan. >=or the first time we visited our target area, Canucutan, ;anuary B,*+-* asonanca to conduct an occular

survey for our Community Organizing "CO#. (e gather information through Initial )ata 23

6ase or I)6 and we also distributed some survey Euestions about dog bites as what the main problem of the community is facing. To inform the community that we will have an assembly about forming set of officers and will having some health teachings about their problem on their community, we distributed some of the invitations.

;anuary -+, *+-*

>(e gave letter to the barangay captain, telling that we are going to conduct a generally assembly for election of officers at Canucutan and educate the residents about !abies.

;anuary --,*+-*

(e conducted our Community Organizing 5eneral Assembly. The members of the community elected their officers. )uring the assembly, we discussed about !abies,

specifically its definition, signs and symptoms, prevention, treatment, and the harm that it can bring to the community. eople participated

well in the discussions and they also shared their e.periences about dog bites and also raised some Euestions. (e also gave some health teachings to the community on what they will do if a dog bites them, like, observe first if the dog will die after how many days, cleaning and closing the wound, drink

antibiotics as prescribed by the veterinarian.

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Appendi. 6 Invitation for the Community Assembly

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Appendi. C Attendance )uring the 5eneral Community Assembly

:3)II )

1ample of the 1urvey Kuestion Ateneo de 'amboanga 2niversity 6achelor of 1cience in 3ursing 4evel II> 5roup 6

Community Organizing rogram 1urvey Kuestions about stray and unvaccinated dogs in the Community -. <ow many dogs do you haveL a. a. Caged a. Nes a. Nes b. * b. tied up b. 3o b. 3o c. othersJ specify MMMMMMMMMMMM c. roaming around *. Are your dogs caged, tied up or roaming aroundL 0. Are your dogs vaccinatedL 8. <ad your dogs bitten anyone in the communityL ?. If yes, how many timesL 1pecify MMMMMMMMMMMMMM A. Is someone looking after your dogsL a. Nes b. 3o &. Are you aware that if your dog has bitten someone, you will be held responsible for the medical e.pensesL a. Nes a. Nes a. Nes b. 3o b. 3o b. 3o 26 @. )o you see unvaccinated and stray dog a problemL B. If your dog has bitten someone, do you know what to doL

-+. If the barangay initiate a responsible ownership program, will you attendL a. Nes b. No

:3)II :

<ealth Teachings 1ample !abies "from 4atin7 rabies, Omadness, rage, fury.P Also known as O $+#ro%$o0iaP# is a zoonotic disease "a disease that is tr ansmitted to humans from animals# that is caused by a rod or bullet>shaped virus "from the !habdoviridae family#. It is gray when seen under an electron microscope. The virus is sensitive to sunlight, ultra>violet light, ether, formalin, mercury and nitric acid. It is resistant to merthiolate and other common anti>bacterial agents. !abies infects warm>blooded domestic and wild animals, and is spread to people through close contact with infected saliva "via bites, scratches or licks on open wounds#. Cases have also been reported in which the virus penetrated the body through moist tissues such as the eyes or lips or the transplantation of infected tissues. Cases of person>to>person transmission through dispersion of saliva droplets in the air have been recorded. The rabies virus has a strong affinity for the Central 3ervous 1ystem "which is made up of the brain and the spinal cord#. It makes its way to the brain by following the peripheral nerves "the nerves that run throughout the body#.

The virus goes through the following stages7 -. Attachment7 The rabies virus attaches itself to a healthy nerve cell. *. enetration7 The virus is taken in by the cell.

0. !eplication7 Inside the cell, the virus multiplies rapidly. 8. 6udding7 The new rabies virus leaves the host cell. It attaches to other nerve cells. The virus then spreads from the brain to the rest of the body by the nerves. The incubation period of the disease depends on various factors like how far the virus must travel to reach the central nervous system. In rabies, the incubation period refers to the period from the animal bite incidence to the time when signs begin to appear. =actors that may affect incubation include7 e.tensiveness of the bite, specie of the animal, richness of the nerve supply in the affected area, and resistance of the host. It usually takes one week to seven and a half months in animals and ten days to fifteen years in humans. The disease is

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communicable from three to five days before onset of symptoms until the entire course of illness. /ign an# /+,%"o, : Rabies in Humans

Once the signs and symptoms of rabies infection appear in humans, the situation becomes irreversible and death is almost always inevitable. This is why it is very important to go to the nearest animal bite center if you have been bitten, scratched or licked by an animal that might be rabid. :arly symptoms of rabies include fever, headache, sore throat, fatigue, loss of appetite, nausea, vomiting and diarrhea. The disease, later, progresses to involve the respiratory, gastro>intestinal and$or central nervous systems. As the virus gets to the brain, the person may act nervous, confused, upset and violent. Other symptoms of rabies in humans include7 -. pain or tingling at the site of the bite *. dilated or irregular pupils 0. e.cessive sweating especially at the head part 8. increased tears, low blood pressure and increase in blood sugar level ?. sensitivity to air, to touch, to loud noises and bright lights A. hallucinations "for e.ample, seeing things that are not really there# &. hydrophobia "Cfear of waterC due to painful spasms in the throat# despite e.treme thirst @. drooling "e.cessive flow of foam>like saliva# B. paralysis "unable to move parts of the body# As the disease advances to the fatal stage, the person gets dehydrated, enters into a coma and dies. Rabies in Animals

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Animals with rabies may e.hibit notable changes in behavior. They become either aggressive or withdrawn. A pet that is usually friendly may suddenly snap at you and try to bite. !abies is transmitted to other animals through contact with virus>laden saliva by biting or licking of open wounds by a rabid animal. There are two common types of rabies. One type is CfuriousC rabies. Animals with this type are hostile, may bite at ob,ects, and e.hibit e.cessive salivation. The second and more common form is known as paralytic or CdumbC rabies. An animal with CdumbC rabies is timid and shy, refuses to eat and suffers from paralysis of the lower ,aw and muscles. In the hilippines, the most common source of infection are dogs, followed by cats. In the 2nited 1tates, rabies is much more common in wild animals like raccoons, skunks, fo.es and bats than in pets like cats or dogs. /ign of Canine Ra0ie There are two forms of rabies7 A. -. FURIOU/ TYPE Change from friendly disposition into wild vicious behaviorJ restlessnessJ runs around aimlessly *. 0. 8. ?. &. -. *. 0. 8. ?. A. (hining > as if in painJ =oaming of the mouthJ If on leash, bites anyone or anything within its reach, if caged, bites even the cageJ )ifficulty in eating and drinkingJ 1naps at imaginary ob,ects. DUM& TYPE 6ecomes lethargic and depressed. <ides in dark, Euiet places, sluggish or sleepy !efuses to eatJ difficulty in swallowing, drinking and breathing Appears to be staring at a distant ob,ect "far>away look# The lower ,aw drops, the tongue hangs, and the dog salivates continuously 4ameness )ies suddenly without any signs

1$a" "o Do in Ca e of Ani,al &i"e2/!ra"!$2Li!3 on an O%en 1oun# -. (hen e.posed to or bitten by an animal "rabid or not#, wash Q flush the wound thoroughly with soap and water for at least five minutes. *. Gisit the nearest Animal 6ite Center for wound care or possible post> e.posure vaccination. 0. !estrain the dog with a leash or confine in a cage.

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8.

)o not kill the animal.. (ait to see what happens within -8 days of the incidence to confirm if it is rabid or not. A rabid animal usually dies within the -8>day observation period. If it dies within -8 days, call a veterinarian for proper submission of sample to the nearest Animal)isease )iagnostic 4aboratory.

Re,in#er re: La0ora"or+ Confir,a"ion of /u %e!"e# Ra0i# Ani,al : -. The head of animals for laboratory testing should be placed in a leak>proof double plastic bag. This, in turn, should be placed in a bigger container with liberal amounts of ice. If the animal can be brought to the laboratory within -* hours of death, ice is not needed. *. 0. 8. )o not put chemical disinfectants or preservatives such as formalin, alcohol, etc. Animals for testing should be brought to the nearest rabies diagnostic laboratory. :nsure proper care and protection when attempting to detach the head of the animal. (ear protective gear "e.g. gloves, mask, and goggles# and disinfect all materials used after carrying out the procedure. !eferences7 http7$$www.cdc.gov$ncidod$dvrd$rabies http7$$www.who.int$mediacentre$factsheets$fs+BB$en$inde..html http7$$www.who.int$rabies$epidemiology$en$

:3)II = )ocumentation

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