Researcher       JAKE N. FABIAN

INTRODUCTION

This study aimed to determine the health and sanitation problems and practices of selected pupils of Sto. Domingo Elementary School, Sto. Domingo, Bambang Nueva Vizcaya. Specifically, it sought to give answer to the profile of the pupils in the terms of age, gender, parent’s occupation, family background and family income. The health and sanitation practices were those in the terms of practices done in the school, in their homes in the community. Health problems were those common problems like   fever and chills, skin diseases, dental problems and malnutrition.

The descriptive-normative survey was used in this study with a questionnaire as its main gathering instrument. A total of 125 pupils chosen through random sampling were the pupil-respondents of the study. On the other hand, seven teacher-respondents were asked to fill up the health survey form to identify the percentage of school population found to suffer from health problems. The frequency, percentage and weighted mean were employed to treat the data.

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Researcher: Jake N. Fabian

INTRODUCTION

Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF) are endemic in the Philippines.  The biggest recorded epidemic in the Philippines occurred in 1996 in Metro Manila with a morbidity rate of 28 / 100,000 and a mortality rate of 0.7/100,000. DHF cases are increasing with the average 5 – year morbidity in 1979 to 1983. 1984 to 1988 and 1989 to 1993 were 1.54/100,000, 3.85/100,000 and 12.12/100,000, respectively. In 1998, nearly 32,000 cases and 500 deaths were reported from all regions, the over-all case fatality rate was 2%.

Dengue is the most important arthropod-borne viral disease of public health significance. Its geographic distribution includes more than 100 countries worldwide. The World Health Organization (WHO) estimates that more than 2.5 Billion people are at risk of dengue infection. As per estimate, over 50 million infections with about 400,000 cases of Dengue Hemorrhagic Fever (DHF) are reported annually which is a leading cause of childhood mortality in several Asian countries. Affecting mostly children, the case fatality rates range from less than 1% to 10%.

According to the National Epidemiology Center (NEC) – Department of Health (DOH), 3,771 cases of Dengue Fever has been reported since April 2005. The country has reached its epidemic threshold in January and February this year.

Since 1998, as part of the national government’s thrust to control Dengue epidemics, DOH has initiated Community clean-up operations. Public information campaigns have been launched. Most notable of the government’s aggressive campaign is the launching of the “Four o’clock Habit” which mobilizes the communities and schools to clean their environment every 4:00 PM.

But despite these initiatives by the Philippine government, Dengue remains to be an important cause of pediatric admission. Much needs to be done in finding effective strategies for behavior change of the community toward dengue. Since prevention and early recognition are important in decreasing morbidity and mortality, the knowledge, attitude and practices of parents are important factors to be evaluated.

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The WORLD HEALTH ORGANIZATION defines the term DISABILITY as a consequence of impairments, activity

limitations, participation restrictions, and environmental factors.

In relation to the article Pregnancy in Women with Physical Disability (Smeltzer, 2007), I would rather focus my concern sharing my ideas on women with physical disabilities as to their needs, problems and concerns not only during pregnancy but also during labor and delivery and also after childbirth or during puerperium/postpartum.

In general, women with physical disabilities are stereotyped, forgetting that the reproductive stage that they too are endowed with the capacity to be impregnated, able to carry the products of conception for the whole duration to full term, can go through the process of childbirth and can accept and perform the new roles and responsibilities of a mother beginning at puerperium/postpartum.

Health Care Providers who are not familiar with the health care needs of this group of women should take into consideration the important issues and experiences of these women.

Health care for women with disabilities related to pregnancy, childbearing and puerperium should start with effective and appropriate communication.  Communication addressed and care rendered to women with disabilities should be empowering, strengthens their abilities and should boost their morale for emotional stability.

As mentioned by Misra, Grasen, and Weisman (2000) “women with disabilities should receive preconception counseling to make sure that they are in the healthiest condition giving emphasis on nutritional status, weight control, cessation of smoking and alcohol use, and treatment of any active symptoms or secondary conditions related to disability.”

During the period of Pregnancy Cycle, Santiago (2002); and Nasek et. al., (1977) had identified some barriers which prevent women with disabilities from obtaining prenatal care suitable and appropriate for their condition.  Health Care Providers should take the efforts to improve rendered prenatal care amidst their disabilities so that these pregnant women with disabilities can receive care in a comfortable and dignified manner.  Negative attitudes of Health Care Providers and lack of physical access to equipment of the facility and environments ranked number one among the barriers; hence this serves as an awakening on the part of the Health Care Providers.

Like other women, those with disabilities are often anxious and concerned about the labor and delivery process they are about to experience.  Assessment and care rendered to these patients should not warrant the safety and well-being of a woman and her baby and evaluation and decisions of type of care based on the assessment obtained should be based on sound obstetric indications rather than the mere presence of a disability.

Necessary care during the puerperium/postpartum period rendered to women with disabilities may require longer period of stay in the hospital.  Easy access to her infant should be made possible as suggested by Carty (1998) and Madorsky (1995) for the purpose of establishing feelings of fulfillment on the part of the mother.  Other new roles and responsibilities should be well explained and words of encouragement should be given especially so with breastfeeding providing all the necessary assistance and guidance for these women with disabilities to gain independence in caring for their infants.

Smeltzer’s (2007) concludes that nurses aim to be holistic in their approach to the patients in their care.  Thus, women with disabilities who are pregnant or considering pregnancy should expect that the holistic approach be extended to them, and that clinicians will welcome their legitimate claim to be parents and provide them care and support through their pregnancies, during the labor and delivery processes and the postpartum period.#

By Mrs. Phoebe Bacayana

Director, Reproductive Health Care Center

Aldersgate College