Wednesday, September 30, 2009

FLOODS in MANILA

Where does the rain come from? Waters from the seas, oceans, rivers, lakes, clothesline, etc are dried up by the sun in a process called evaporation and become clouds and when cooled off, fall as rain. Trees are called rain trees because they absorb water that evaporates again and falls down as rain. So trees bring about rain but prevent flood and drought. So, we need forests and trees in large parks in our cities.

Third world colonial cities are characterized by cancerous growth we call the urban blight. Even before the “Ondoy” floods, Marikina valley, Cainta, Pasig and most of Metro Manila are all blighted urban centers that are very evident when diagnostically viewed with our naked eyes from a higher ground and analyzed with an urban planning lens. Therefore, we should put a limit to the size of our cities and put a stop to building megacities. Cities should be small and beautiful.

I lived in Manila for seven years in the pursuit of studies and work that paved the way for my career track. Manila as the financial and political center of the Philippines has a way of trapping us. I hope our students go home after university studies and serve in the provinces where they are more needed. Manila as a large metropolis has really deteriorated over the years. Its carrying capacity for humanity has overflowed to the brim many times over. Father Ben Nebres, sums it up when he said: “ When one has to wake up in Manila at 4:00 a.m. to be in the office at 8:00 a.m. is not development.”

Although, the magnitude of the “Ondoy” flood is an all time worst since 40 years ago, floods per se in Manila is a regular fare since time immemorial.
Which is why, knee deep waters flooding areas near Quaipo and Espana in Manila did not get attention anymore in the light of the severity of the situation in Cainta, Pasig and Marikina where the waters reached the roof of homes. Yet, everyone was really caught unprepared for these kind of disasters that visit us with frequent regularity as if on schedule.

The electronic gadgets like email, cell phones and social networking were so handy over the weekend in connecting us with friends, relatives and fellow Filipinos at large. The television brought the horror of the floods to our living room. The little boy crying because his notebooks and school things were destroyed by the flood really broke our hearts.

I hope we really resolve to learn the lessons of this “perfect flood.”
Many areas of Davao City such as Bangkal and Bajada and even our central business district have been flooded in the recent past. During a flash flood last year or the other year, I was trapped in an office for hours because the roads were full of vehicles stranded by impassable roads due to knee deep flood waters.

We must flood our urbanization planning with thoughts of preventing floods because Davao City should be beautiful and safe befitting our reputation as one of the most livable cities in the world.

Monday, September 28, 2009

Elections Reimagined

When we conduct electoral campaign and voters' education, we usually start with a discussion of the national and local situation. Then, it is followed by a discussion of our vision of our ideal society, concepts of good governance and democratic politics and then finally by a discussion or a commitment to lead or contribute to the attainment of short and long term strategies to reach the vision. At some point, voters also need to be introduced to the new automated election computerized technology. As the Commission on Elections (Comelec) has warned, the poll automation would not totally prevent cheating and therefore we have to organize ourselves around creative ways of safeguarding our votes.

The change politics movement is feeling confident about its ability to promote clean and free elections towards good governance and genuine development. The current hurdles or barriers to achieving these are not really that insurmountable. For it is not difficult to outbid a corrupt way of governance. We used to think that to be able to join the elected bureaucracy, one has no choice but to dip in bad politics first because this is the only way of winning. This kind of thinking undermines the voter or takes advantage of the hungry voter. How is the hungry voter taken advantaged of? The many ways are not unknown : the politician takes advantage of existing local government structures like the barangay leaders as the purveyor of patronage and largesse. The roads, the water system, and other programs like health, housing, education or Philhealth insurance which are actually part of governmental function are communicated and marketed as part of patronage. This is the theme of the current television infomercial of government officials. A variation of the theme is how the person (who is planning to run for a government position) is best able to have feelings of empathy with the poor and thus will work for the poor because one came from the ranks of the poor. We need to ask ourselves whether we are contented with our current condition of poverty with such government officials for decades now. Urgent cash donations just before the elections have been a practice for the longest time now and that is why they say candidates need so much funds to win. What is pathetic is for everyone to say that this is a reality that is difficult to change. The voters are rounded up to a place after the voting for confirmation or extraction of proof that the voting was indeed according to the terms of the vote buying transaction. As the “dagdag bawas” victims have sworn, the cheating is also found in the canvassing of ballots at different levels. With automation, the mechanism of cheating will take on a different form as the computerized counting is cumulatively straightforward and at once.

Half of the entire Filipino population are poor due to failed policies and corrupt governance. As citizens, we have been so used to traditional feudal patronage politics and this has hampered development and good governance. To re-imagine development is to change corrupt patronage politics towards a more democratic and participative politics involving communities. One important strategy is peoples’ policy agenda building : drafting of a peoples’ policy & legislative agenda towards meaningful poverty reduction programs such as asset reform and food security. This agenda can be presented to candidates and citizens can be organized around monitoring government compliance of these election promises.

Friday, September 11, 2009

The Sociology of Sickness


I spent my weekend in the hospital taking care of my mother –in-law who has been experiencing chest pains and difficulty of breathing.
The sociology of illness is related to the organizations managing health care, the professions giving health care and the attitude and behavior of people around illness or health care in general.


In first world countries, rich and poor people rely on public health care. In short, public health care is very accessible. 
In our country, tertiary hospitals are found in cities only as though only people in the cities get sick of ailments requiring highly specialized health care such as major surgical operations requiring state- of -the - art facilities.

In many rural areas, if you need emergency tertiary health care between midnight and dawn, you are at risk of dying because there is no public transportation at these hours to bring you to tertiary hospitals in cities. 

The health profession, especially the medical profession is now very specialized that one wonders whether, at all, the doctors remember that there is a value added to examining the entire body as the sum of all the body parts.
Doctors feel constrained to be the MD of record of a patient if the ailment is not their specialization - even if MDs studied medicine for decades. 
This kind of medical ethics and tradition need to be revisited. 

Today, in doctors’ offices, we find medical secretaries getting the medical history of a patient when the tale of a patient is crucial to the diagnosis of an ailment.
In effect, what the doctor gets in terms of history is hearsay.
Indeed, perhaps, this is part of the medical transcription age.

In emergency rooms, resident doctors spend more time preparing their report for their mentors rather than physically examining the patient who has come for emergency treatment.

In another third world country, I actually witnessed resident doctors neglecting to pay attention to a patient who was having a heart attack because they were more focused on writing their report to an incoming mentor consultant doctor.
Perhaps, the patient could have lived if they had focused their attention to the patient instead of writing their report.
I mean, there should be a time for writing the report later when the patient has emerged from the emergency condition.  Instead of studiously hearing the symptoms as felt by the patient and religiously performing a physical examination, the knee jerk reaction is to order a battery of  laboratory procedures ( expensive for a majority of patients ) as a data gathering procedure in aid of diagnosis.
Needless to say, some of these procedures are unnecessary for some good doctors.

The emergency rooms of our public hospitals are another sordid tale.

All these observations are related to how public health care is financed in this country which is also related to budgets and government revenues from  taxation.
In other first world countries, the ordinary citizen is mostly taxed thirty five per cent ( 35%) of  gross income.
Just after the second world war, rich British citizens were charged ninety five per cent ( 95%) from income.
We need this kind of taxation provided public funds are really used for public expenditures but this is another topic altogether. 


                            

Demystifying The Flu: 
A ( H1N1)  Virus

                                    
The flu that we know as children was so ordinary.
Doctors call it a self limiting disease as one gets healed rapidly even in the absence of treatment. All right, granted, one gets over the counter drugs but for the symptoms only.  But, this influenza A ( H1N1) virus is something.  Doctors go to school for years or decades and that is why we always think that health knowledge is a monopoly of health professionals. But, with this pandemic, the tendency is to “ google “ and read to know this ailment. Some of us are still skeptical about this swine virus. Why? Because, health care is an industry.  It can spell the difference between  rich  first world manufacturing drugs and third world  consuming drugs.

As young activists, we were socialized and educated to understand that  treating a sick patient is as important as working for a society where there is no poverty and  where health care is affordable and accessible. Someone asked me, “ what is the gender perspective to the swine virus pandemic? “  I said, women are poorer, and that  in reality, when someone gets sick in the family, it is always the mother or wife who takes care of the children or who  gets to be absent from work.  Ideally, of course, health should be a social concern with state funds for health care services. 
  
Just before this swine virus, there was an Ebola virus. Then, they said, that animal to human transmission is not possible. So, some of us said, maybe bird flu, but swine flu, as in pigs flying?

Nobody wants to be infected with this swine virus and so let us see what we already  know so far. The mode of transmission is droplet inhalation. It is not transmitted through the air per se. School briefings have advised that the masks are for the infected only. 

WHO experts have said that the H1N1 virus is not so severe and that most of those infected have made a rapid recovery often in the absence of treatment and that the number of deaths are small.  In the Philippines, the cases for the virus have reached 193 cases.   Despite the pandemic level, with 30,000 confirmed cases in 74 countries, the World Health Organization said, “ it continues to put  NO  restrictions on travel.’’  Of course.  To restrict travel, would be a violation of liberty.

So, why the media hype?  Dr. Kenneth  Balanay- Antonio, my surgeon cousin says, that what  is  precarious is the potential for an “ exponential  transmission from person to person. 
 Imagine, if you will, a passenger in a crowded international airport waiting for a flight  to wherever   for about an hour, coughing and smearing  secretions all over the place that        is then easily picked up by even a fraction of those within his / her immediate         vicinity, who  will also have destinations to other  points abroad.  Then, the             danger  that the virus will mutate  is always there; the more it gets           propagated globally the greater the chance of it developing into an instantly   fatal or really virulent strain that would be a public health nightmare.
While,  there is also media  hype abroad as  updates or news are released   to inform     the public, these are not as scary or panic-laden as our news releases here.   Someone emailed me that  Australia has the highest number of A(H1N1)         cases per capita in the world but nowhere were  the kind of measures being       taken in the Phil.  In Melbourne alone there are over 1,000+ cases and         Melbourne has a small population of under a million.  The screenings were     done in airports only but there is  no  temperature taking in schools. As most      everyone agrees, dengue is an even more scary as an  epidemic or pandemic           as it can be fatal within a few days.
Death from swine flu will be  due to             neglected symptoms of pneumonia, dehydration and general debility brought      about by the infection usually in very old or very young or very health-           compromised patients. The swine flu...like any other flu...is very debilitating             especially for  the very young and the very old and the very immuno-     compromised. Otherwise,  it is just like any other flu…  maybe a bit more    debilitating compared to the run-of-the-mill types of flu. So, when flu     symptoms do come about...do not ignore...have a consultation  WITH A  COMPETENT AND TRUSTED MEDICAL PRACTITIONER.”

Health & pharmaceutical industry are already making big money in the sale of pharmaceutical gadgets and drugs. So, expect the market to be flooded with the vaccine soon. This needs to be monitored and we ask the question: Who benefits? Who loses?















Senator NoyNoy Aquino & the presidency *

What kind of a leader does the Philippines need after the Gloria Arroyo administration? Will Noynoy Aquino be equal to the big task of addressing the seemingly intractable ailments that beset our nation? Our nation is desperately needing a leader who can journey with us towards our national goals that still need to be crystallized and articulated as agendas or policies that will generate mass based support. For the long term, the next presidency should not only be a knee- jerk reaction nor a symptomatic treatment of the pathologies of the moment but one that governs towards being a great nation : more wealth that is shared, good governance, justice and human rights prevailing and with good social institutions ( family, schools, health system, mass media, religion, etc) that will nurture all our resources for the current and future generation.

Noynoy has charisma and credibility and the burgeoning massive support which should translate into campaign funds and ultimately votes will be enough for him to win the presidency. Already, some political party turncoats have expressed to join the Liberal Party of NoyNoy Aquino and Mar Roxas. But, the Liberal Party has announced that it will be discriminating in their choice of local standard bearers. One presidential wannabe said that our clamor for Noynoy is part of the so called “ politics of personality” which is traditional politics. Some say that Noynoy did not really dazzle us with landmark legislations while he was at the 11th & 12th & 13th Congress and even now in his post as Senator of our Republic.

But, his accomplishment as a legislator is impressive enough. One would conclude that he is both a fiscalizer and an institution builder. He was deputy speaker of the 13th House of Congress. Currently in the Senate, he is chair of the Committee on Local Government and therefore he is privy to the state of the art of our local bureaucracy. He is a member of various congress committees because after all legislation in both houses of Congress is collective work. For this reason, it is crucial that legislators who will be elected will champion and support the people’s agenda because legislation requires the so called needed numbers for the passage of proposed bills into law.

Similarly, the seat of the Presidency is a plural agency with the support of hundreds of line agencies all over the country. Every cabinet member who is the alter ego of the President implements hundreds of millions worth of programs. In this sense, sans corruption, a cabinet member who is the head of a national line agency can really make a difference in the lives of millions of our people. While the budget is ultimately appropriated and legislated by our legislature, the budget originates from the Office of the President. That is why the post of the President is the center of power especially if the President has the support of the legislature. Equally important in this electronically wired world is the support of the community of nations in our global village.

Many government well entrenched existing programs need reforms and many bureaucratic processes have not been working according to the current requirements of our changing economic landscape. But, every now and then, we are able to recruit to our civil service well meaning, competent and honest bureaucrats or technocrats who will take on the role of public servants seriously and as well look up for guidance and inspiration from a good leader sitting at the Office of the President of the Philippines.

* from my column at the Mindanao Times/ Opinion Page/ WomenWise Sept 9, 2009

Thursday, September 3, 2009

To The 2010 Candidates *

( * For this piece I have adopted the framework from my conversations with Ms Carol Gamiao, a long time friend who advises me at turning points in my life. )


I am a grandchild of politicians. I was born at a time when there were only two political parties and when local politics were literally about guns, goons and gold. At a time when I felt adventurous, I joined the national election campaign of Raul Roco for Philippine president and Inday Santiago for Vice President and as such we were traveling all over the Philippines. In Davao City, I chaired Abanse Pinay, a women’s political movement that sent our Representative Patricia Sarenas to serve two terms in the Philippine House of Congress. And we have lost in elections as well.

Launching a political campaign is like applying for a job by convincing electorates that one is qualified and will be the best person for the job. Winners in elections have mostly been the well entrenched politician from a dynasty or the entertainer or someone popular who can afford media exposure. Which is why, there are now various calls and movements exhorting citizens to be participants of a different campaign : Change Politics Movement (CPM) , Moral Force Movements ( MFM), Ako ang Simula, TindigNation, etc.

Some of the tested formula for winning elections are the usual 2 Ms : machinery and money. Money is the basic material resource to achieve the goal of winning. The money is not for buying votes but logistics for moving around to meet with electorates, for campaign materials and meetings. Candidates must have a machinery and support base. Having dialogues and exploring with a few leaders out there to feel the pulse are important. A platform, a policy agenda or proposed program of governance and some targeted projects that a candidate can deliver can first be discussed with supporters.

The Barack Obama campaign was so integrated with the internet - that I think can be done in the national campaign since our burgeoning youth population have internet connection in such a massive scale. But, at the barangay level, community meetings and consultation will work out fine once a candidate has a program of action. Jobs are needed. Women vote. Students vote. Telephone, internet, will be needed to sell a city or town product. Economic growth and investments are important for the development of a city. Developing a base of support in business is crucial, too. There are some good partners that can provide jobs that are compatible with projects such as agricultural modernization or ecotourism and other appropriate developments for the city or town.

I think that entering politics is exciting, actually. We have been urging women to enter politics because a career in politics, for the longest time now, has been the preserve of men. So, to women out there, we are encouraging you to run. Probably, the intellectual who wants to be independent from the center of power and influence will want to have nothing to do with politics but politics can be an academic exercise as well or a laboratory for social theories and applications. But, spending a fortune to buy votes is so passé by today’s progressive and liberal standards.

My favorite sociologist Randy David said that politics is a mechanism of forging consensus and which is the very essence of democracy. Conrado de Quiros, a newspaper columnist said that we must entrust power to those who least covet it. My wish is for reluctant candidates to muster enough inspiration to launch their next campaign in life to enter politics.