Health (Tacloban): What is chikungunya?

March 2, 2014 (8:00 AM)

My cousin, Jenny (alias), 20, was diagnosed with chikungunya early this week.  I thought it was a made-up disease, so when she texted me about it, I replied with “What LOL (laugh-out-loud).” Unfortunately, there was nothing funny about chikungunya. As bizarre as the name sounded, the worldwide web confirmed that chikungunya was indeed a disease – one that afflicted Tacloban and some parts of Leyte these past two weeks.

The Tiger mosquito or forest mosquito, Aedes albopictus (Stegomyia albopicta), from the mosquito (Culicidae) family, is characterized by its black and white striped legs, and small black and white striped body. It is native to the tropical and subtropical areas of Southeast Asia; however, in the past couple of decades this species has invaded many countries throughout the world through the transport of goods and increasing international travel. - Wikipedia

The Tiger mosquito or forest mosquito, Aedes albopictus, from the mosquito family, is characterized by its black and white striped legs, and small black and white striped body. Wikipedia

According to the World Health Organization, chikungunya is a viral disease transmitted to humans by infected mosquitoes – Aedes aegypti and Aedes albopictus. A person bitten by an infected mosquito suffers from joint pain and swelling, which explains how the disease acquired its name. Chikungunya is a verb in Kamikonde language, which means “to become contorted” – an allusion to the patient’s “stooped” posture. The symptoms include high fever (40°C/ 104°F), joint pain, joint swelling, rash, headache, muscle pain, nausea, and fatigue. They appear 4-7 days after the person has been bitten by the infected mosquito, and last for 2-3 days. The virus remains in the human system for 5-7 days and mosquitoes feeding on an infected person during this period can also become infected. Because of similarity in manifestations, chikungunya is often mistaken for dengue fever.  

Huli ka na sa balita ate (You’re last to know),” Jenny answered when I asked her how long she has known about chikungunya. Reports of chikungunya has increased over the past two weeks such that chikungunya, a disease previously unknown to most residents, has become a household topic in Tacloban and nearby municipalities.

But am I the last to know? Since I do not have television at home, I rely on other people to prompt me when to hit the web for what news. I am usually not the first to hear about important updates, but seldom am I the last, especially when it comes to Tacloban/Leyte news. After my conversation with Jenny, I called up my Tacloban/Leyte-friends currently based in Manila and, like me, it was their first time to hear about it. We knew about the alarming rate of dengue fever and measles, but we did not know about chikungunya.

I checked the net for any published articles about chikungunya in Eastern Visayas, here are what I managed to pull out:

  • The Department of Health in Eastern Visayas through its Epidemiology Unit is closely monitoring chikungunya, along with two other infectious diseases, measles and dengue fever. Reports suggest that cases of both dengue and chikungunya have not reached an epidemic level. While the article provided statistics on dengue and measles, no number was mentioned to suggest the number of reported cases for chikungunya.  Philippine Information Agency (PIA) – Feb 22, 2014
  • Just like dengue, which is also a mosquito-borne disease, Chikugunya is best addressed when mosquito breeding sites in the household and immediate vicinity are eliminated. Other settings include schools, hospital, and workplaces. – World Health Organization

Is chikungunya fatal?

No, rarely is it fatal. But those who have it may suffer from acute arthritis for years even after they have recovered from the initial infection.

How is it different from dengue?

Both dengue manifest fever and rash, but what is unique to chikungunya are the joint pain and joint swelling. Most victims of chikungunya are adults whereas most dengue victims are children.

How many have been diagnosed with chikungunya in Eastern Visayas?

No data has been released by DOH, to-date.

Has there been any confirmation of an epidemic from the Department of Health (DOH)?

No. In an article released by PIA two weeks ago, the DOH acknowledges that chikungunya, along with dengue and measles, are the infectious diseases with most number of cases, but it also clearly states that reports have not yet reached epidemic levels. DOH has “intensified its vector control measures like fumigation in many areas and community campaigns on self-protection methods as well as measles immunization especially to children to prevent an outbreak.” - Read more.

How big is an outbreak when chikungunya is not addressed?

Other countries have reported confirmed cases ranging from 197 to 1,500,000.

2007: Migration of infected people introduced the infection in a coastal village in Italy. This outbreak (197 cases) confirmed that mosquito-borne outbreaks by Ae. albopictus are plausible in Europe.

2006: Outbreak in India, more than 1 500 000 cases of chikungunya were reported with Ae. aegypti implicated as the vector.

2005-2006: More than 272 000 people were infected during an outbreak of Chikungunya in the Indian Ocean islands of Réunion and Mauritius where Ae. albopictus was the presumed vector.

Chikungunya was first identified in Tanzania in the early 1952 and has caused periodic outbreaks in Asia and Africa since the 1960s.

How is chikungunya treated?

There is no specific treatment for the disease but analgesics and non-steroidal anti-inflammatory medication may be used to reduce the pain and swelling. Aspirin should be avoided.

What can be done for prevention and control?

There is no vaccine against this virus, so preventive measures depend entirely on avoiding mosquito bites which occur mainly during the daytime, and eliminating mosquito breeding sites.

Please click on the links below to visit WHO page: Environmental managementchemical controlbiological control.

Note from me: With no electricity, residents of Haiyan-hit Eastern Visayas still have little to no access to broadcast news. Residents are usually dependent on families located outside the region to prompt them about important news, ranging from politics, health, and resources for Haiyan-help. I am publishing this article with the intent of putting chikungunya on the reader’s radar. Let us encourage families in Eastern Visayas to put in place controls that would protect them from infected mosquitoes and actively remove mosquitoes breeding grounds in households.

You can leave a comment for helpful information and suggestions.

in the gutters

Tiffany:

Tacloban, two months after Nov 8, 2013.

Originally posted on A walk with my camera:

Rainy days used to be something I look forward to on weekends, but it has been raining like forever since December.  Water was leaking into my supposedly watertight shoes, dripping through the stitching of my umbrella and soaking my shirt under the heavy jacket which was already supersaturated with rain water.  I miss the sunshine.

Apparently, nobody can afford to wait forever, especially if it involves fun.  It sure feels good to forget about everything else but the current moment.  The adults can take care of themselves anyway.

Playing with another is better than playing alone, and this game doesn’t need to have a loser.  Our politicians have a lot to learn about cooperative play.  It’s more fun this way.

While some people feel the rain, others just don’t want to get wet.

A literal definition of chilling out (in the cold windy rain).

While the government has been dragging…

View original 187 more words

Haiyan videos: storm surge drowns houses, evacuees’ near-miss encounter…

January 12, 2014 (9:00 PM)

A compilation of Haiyan videos shared by netizens.

Video 1: Tsunami-like power of Yolanda’s storm surge (2:01) - A house is drowned by Haiyan.

 

Video 2: Evacuees’ near-miss encounter with the angry waves of Haiyan (1:57) – With their own eyes, more than two thousand evacuees witness  the tsunami-like waves of Haiyan. 

Note: Astrodome, located along the coastline of Cancabato Bay (see photo below), was directly within the storm surge zone. Had the infrastructure collapsed, everyone in Astrodome would have been powerless against the surge. Click here to view the footage.

astrodome

 

 

Video 3: Videographer films Typhoon Haiyan hitting Tacloban (1:59) – It wouldn’t have been wise to stay in a hotel located along the Cancabato Bay shoreline on the day of Haiyan’s landfall. But if the intention was to capture the storm surge on film, I would say the videgrapher made the right decision. I just hope he made it safe after he took the 1:59-long video.

Earlier:

Tacloban City: 30 days after the typhoon Yolanda

Tacloban, far from restoring normalcy (see photos)

Haiyan: if we are to play the blame game

Also read:

What shouldn’t go missing in the Philippines’ Haiyan rehabilitation plan

Yolanda, not our first category 5 super typhoon yet national/local governments were unprepared

Public health: How can private sector/NGOs help Yolanda survivors?

The burden of patriotism – AFP’s role in EV; how they perform in Yolanda relief efforts will make or break public image

Guiuan, Eastern Samar just as badly hit as Tacloban or worse, 100% damage on infrastructures says Mayor Gonzales

A song of hope and support for Tacloban, “Tindog Tacloban” by Rex Makabenta (listen to audio)

December 14, 2013 (7:30 AM)

Rex Makabenta, a local artist from Tacloban, writes a song for the survivors of Yolanda and their families.

The title of the song is Tindog Tacloban (English Translation: Rise Tacloban), a fitting song for Warays who survived the typhoon Yolanda. It talks about regaining hope, encouragement, and a promise of support and help from fellow people.

Thank you @Rex Makabenta for this beautiful piece.

Listen to the full song on Sound clound.

Tindog Tacloban, Tindog Tacloban (Rise Tacloban)
Ibalik an mga ngisi (Bring back the smiles)
Mga inup han kunabuhi (Dreams of humanity)
An paglaum di mawarawara (Hope is not lost)
Magkaurusa la kita (If we just unite)

Full lyrics and translation to follow.

Thanks.

Tap water in Tacloban and Leyte, unsafe

December 12, 2013 (7:00 AM)

Tap water in Tacloban is not yet potable.

From a report:

Water from faucets in Tacloban City and other parts of Leyte is not safe for drinking.

The Department of Health confirmed the presence of fecal coliform – a type of bacteria from animal and human excrement – in samples of tap water from some areas in Leyte including Tacloban City. Of the 45 water samples observed by DOH from Leyte, 29 contained the bacteria.

The bacteria causes diarrhea and other water-borne diseases that can be fatal, especially to children.

People in Tacloban and Leyte advised to boil water prior to use.

Earlier:

Tacloban City: 30 days after typhoon Yolanda

Politicking post-Haiyan, PH president vs. Tacloban mayor

Tacloban, far from restoring normalcy (see photos)

Why students shouldn’t be compelled by schools to return to Yolanda-hit Tacloban

Also read:

Haiyan: if we are to play the blame game

What shouldn’t go missing in the Philippines’ Haiyan rehabilitation plan

Yolanda, not our first category 5 super typhoon yet national/local governments were unprepared

Public health: How can private sector/NGOs help Yolanda survivors?

The burden of patriotism – AFP’s role in EV; how they perform in Yolanda relief efforts will make or break public image

Guiuan, Eastern Samar just as badly hit as Tacloban or worse, 100% damage on infrastructures says Mayor Gonzales

Tacloban City: 30 days after typhoon Yolanda

A post released by Jerry Uy, City Councilor of Tacloban City. Published on his facebook last December 8, 2013.

TACLOBAN CITY: 30 DAYS AFTER TYPHOON YOLANDA

It’s been a month since Super Typhoon Yolanda (International Codename: Haiyan) devastated the City of Tacloban. Killing almost 6,000 people, with more than 2,100 casualties who were residents of the city, destroying 90% of its residential, commercial and public infrastructures, and affecting about 58,000 families here, where most of the families had fled to nearby towns and cities in Eastern Visayas, and to Cebu or Manila, days after the super typhoon to seek refuge.

RESTORING POWER

The backbone transmission lines in Feeders 1, 2 and 3 are said to be completely restored, and partly in Feeders 4 and 5 of Tacloban City, with the help of the electric cooperatives from other parts of the country. However, the city still remain dark because the street lights have not been energized by the City Government for unknown reason, but a segment from Real Street (Fatima Area to Burayan, San Jose) is illuminated by An Waray Partylist, using its own generator set. While most of the electric consumers have to apply for reconnection of their electricity with Leyte Electric Cooperative II (Leyeco II).

A one-stop-shop has been created at the office of Leyeco II to speed up the processing of electrical connections; fees and charges being collected by the City Government have been waived after numerous complaints were aired, in support of the public clamor, the City Council passed a resolution waiving the fees and charges being collected by the local government unit. A professional electrical engineer had been reported to be collecting Php 500.00 pesos from each applicant for his signature in the reconnection process. But his signature was no longer required, after the anomaly was exposed.

RESTORING WATER SYSTEM

Water supply system from the Leyte Metropolitan Water District is sufficient, but in some areas there are reports that they are experiencing low water pressure, due to the fact that water pipes are intentionally sawed by residents to get an instant water supply. However, there is private water company in the city that is said to be offering free water connection, but its water source comes from the deep well, which is unsafe and unreliable.

(Read: Tap water in Tacloban and Leyte, unsafe)

RESTORING COMMUNICATION LINES

Smart Communications and Globe Telecom have restored their services in the City two days after the super typhoon. PLDT and Bayan Communications are restoring their systems.

RESTORING PEACE AND ORDER

To maintain peace and order in the city, the Philippine National Police and the Armed Forces of the Philippines were deployed by the national government to augment the local police in the city, a de facto curfew was imposed during the first two weeks after the super typhoon to suppress lawlessness, after looters carted goods from business establishments in downtown Tacloban and the Robinson’s Place and its nearby establishments in Marabaras.

With the clamor of the business community and the residents of Tacloban over their security, the City Council passed an Ordinance imposing curfew from 8 o’clock in the evening until 5 o’clock of the following morning.

Local residents and subdivision homeowners banded and armed themselves to form citizens’ brigade to patrol their respective vicinities against criminal element, to the extent that license gun owners volunteered to help secure their premises. Police checkpoints were established in strategic locations in the city.

RESTORING SHELTER

Since many residents remain homeless, and many families are staying at evacuation centers, shelter is a major concern. Public schools serve as evacuation centers during calamities. Each classroom is shared by at least four families.

While government has announced the establishment of bunkhouses and tent cities, majority of those who are homeless don’t have any idea on how to avail the shelter program of the government.

In a chance conversation with one of the evacuees staying at Rizal Central School, the evacuee said that she very much interested to avail of the housing program of the government, but has no idea on how to avail the same. She said that they have not been consulted nor informed on this matter. They are apprehensive that at any moment they might be transferred to another area because the school will be using the classrooms.

CLEAN UP AND CLEARING

With the assistance of Metro Manila Development Authority (MMDA), the Department of Works and Highways (DPWH), and later the Buddhist Tzu Chi Foundation, Inc., thru their cash for work program (temporary employment program, employing to a maximum of 34,000 persons and paid Php 500 pesos for a day’s work, the major streets in the city are now cleared of debris. However, due to the clean up of residents and commercial establishments their garbage are being piled up in the streets, and has to be collected by the city’s garbage trucks, being operated by local contractors.

Heavy equipment hired by Buddhist Tzu-Chi Foundations has also been transporting debris and garbage to the dumpsites.

Temporary dumpsites were established at the Balyu-an grounds along Magsaysay Boulevard, and at the property of Robinson’s Land Corporation, previously owned by the City Government, at the Abucay Bus Terminal.

CADAVER COLLECTION

The Bureau of Fire Protection, SOCO and NBI form part of Task Force Cadaver and is tasked to retrieve and process the cadavers. Likewise, Korean and Japanese Disaster Relief Teams assisted in the retrieval.

Up to this moment, there are still uncollected cadavers that are either submerged in flood water, washed ashore or covered by the piles of debris.

Cadavers that were collected are being process by the NBI and SOCO for future identification by their relatives.

Mass graves were established by the City Government at Basper Public Cemetery and at Barangay Suhi (San Isidro), beside the Barangay Health Center of said Barangay.

HEALTH

With the assistance of the different foreign medical missions from Korea, Australia, Canada, Japan, Germany, France, China and other countries, in collaboration with the local and private hospitals in the City, they have provided medical treatments to the victims of the super typhoon.

The Australian Government was among the first to set-up a field hospital, near the Tacloban City Airport, complete with medical facilities.

China sent a hospital ship known as Ark of Peace, a 300 bed floating hospital complete with medical equipment, which also provided surgical treatment to local residents here.

Water, sanitation, hygiene and protection services are reportedly needed in evacuation centers.

PUBLIC TRANSPORTATION

Philippine and United States military cargo aircrafts transported thousands of fleeing residents out of the city, during the first two weeks after the typhoon. Commercial flights were available three days after the super typhoon struck.

At present, there are only a few Public Utility Vehicles (PUJ) and Motorcycle for Hire (MCH) plying their regular routes within the city, charging their passengers with overpriced fare.

Buses and vans to other cities and municipalities in the Eastern Visayas Region (Leyte, Samar and Biliran Islands), and to Manila and Davao are now available.

Traffic jam is experienced in the some areas in the city due to uncollected debris and garbage.

RESTORING LOCAL ECONOMY

To restore normalcy, the National Disaster Risk Reduction and Management Council created Task Force Normalization.

They convinced gas station operators and owners to re-open. Assuring them that security issues will be addressed.

Bank managers were also called up to re-open their banks, as it was one of the concerns aired by gas stations operators and other local businessmen, who were willing to resume their business in the city, days after the calamity.

Next in line that opened their businesses were grocery stores, hardwares, repair shops, auto and motor parts, remittance centers and other vital establishments.

To date only about 3% of the total establishments in the city have resumed their operations. They are operating on a skeletal workforce basis and reduced store hours; some establishments only open a part of their premises, enough for a few customers to enter; while others don’t even open their business premises to customers, but sale transactions are made thru a small pigeon hole, enough to hand the item bought and receive payment.

While major business establishments remain closed in the business district of Tacloban. Street vendors, with makeshift stalls, mushroomed in Burgos Street, Torres and Tarcela Sts. selling vegetables, fish, food stuff, can goods, and even “looted items”, as claimed by other people. Prices of those items are almost double, and government regulatory agencies cannot do anything about it.

Salazar Street, Zamora Street and Rizal Avenue are now congested with vendors selling anything you need from foodstuff, clothing, shoes, flashlights, solar- driven gadgets, mobile phones and accessories, to kitchen wares.

The Tacloban Public Market was damaged and no action has been done by the local government to restore it, despite the call by the City Council, during one of their regular sessions.

Livelihood and employment opportunities remain a major concern among the local residents.

RESTORING EDUCATION

Severely damaged also by the super typhoon were school buildings, both private and publicly owned. Classes have to be suspended from the primary to the tertiary level. For the second semester, some affected pupils and students opted to enroll, in other cities not affected by the typhoon. Others will just have to wait until school reopens.

Last December 2, 2013, classes for elementary and high school re-opened. However, only few students went back to school. Classrooms in almost all public schools served as evacuation centers for typhoon victims. However, in the tertiary level, the Commission on Higher Education announced that the reopening of classes is on January 15, 2014.

Donations made by both local and foreign non-government organization are said to be pouring in to help rebuilt damaged school buildings. Tents will be installed as alternative learning centers.

THE ROAD AHEAD

Local residents in Tacloban are anxious on what lies ahead for the next six months- during the recovery period, when the distribution of relief goods and cash for work program are terminated, and with a perceived massive unemployment and no copra to be harvested by the coconut farmers.

They are also concern with their safety and security if ever the augmented police force will be pulled-out and return to their mother unit by the end of December 2013.

They hope that government programs such as the food for work, and cash for work would continue during the recovery period thus giving food and employment opportunity. They also hope that the police visibility will remain.

The business sector which is the backbone of the local economy, must be supported by both government and private financial institutions by granting concessionary loans with low interest rates, ranging from 2 to 3% interest per annum. A loan with a 6% interest per annum is unacceptable to them.

Many businessmen will start not only start from zero, but from a “negative capitalization”. According to members of the local Chamber of Commerce the reason why they are starting from a negative is that their business premises where damaged by the typhoon, after which their merchandize were looted, and they still have the credit obligation to pay their suppliers.

The homeless are expecting that the government’s shelter program will be implemented at the soonest possible time, coupled with livelihood and employment opportunities.

A rehabilitation czar has recently been appointed by the President of the Philippines, the implementation of the rehabilitation of Eastern Visayas will take time, considering that a well-studied master plan requires an in-depth assessment, consultation, planning, and study addressing various issues and concerns,. An economic recovery plan is envisioned, similar to the Marshall Plan implemented by the United States to assist with the recovery efforts for Western Europe, after World War II is needed.

Earlier:

Politicking post-Haiyan, PH president vs. Tacloban mayor

Tacloban, far from restoring normalcy (see photos)

Why students shouldn’t be compelled by schools to return to Yolanda-hit Tacloban

Also read:

Haiyan: if we are to play the blame game

What shouldn’t go missing in the Philippines’ Haiyan rehabilitation plan

Yolanda, not our first category 5 super typhoon yet national/local governments were unprepared

Public health: How can private sector/NGOs help Yolanda survivors?

The burden of patriotism – AFP’s role in EV; how they perform in Yolanda relief efforts will make or break public image

Guiuan, Eastern Samar just as badly hit as Tacloban or worse, 100% damage on infrastructures says Mayor Gonzales

Politicking post-Haiyan, PH president vs. Tacloban mayor

December 10, 2013 (4:00 PM)

Comparing Tacloban Mayor Alfred Romualdez and President Benigno Aquino

An act of paghuhugas ng kamay (washing of hands, a Filipino idiom), hinting at Tacloban’s unpreparedness on day 1 post-Haiyan, had earned President Benigno “Noynoy” S. Aquino criticisms on his leadership. To the Filipino people and the international community, it appeared that he was more concerned in finding a scapegoat rather than responding to the urgency of the situation in Eastern Visayas.

If his comment was a conscious effort to blame the Tacloban mayor, then I could say that his plan took a bad turn. Instead of exonerating himself, his comment, made him unpopular, even acquiring a new nickname “BS Aquino.” It did not help too when, a few days later, the national government announced the plan to investigate LGU handling of Haiyan, further establishing the perception that his priority was politicking more than saving lives.

With increased visibility on television, Warays could not avoid but compare the mayor Alfred Romualdez and Presidet NoyNoy Aquino. Both were the most powerful chief executive officer in their territory; both failed to prepare their constituents for Haiyan; both were overwhelmed by the damages seen after the typhoon; and, both were looked upon by their people for guidance post Haiyan… Here the similarities end.

After Haiyan, the mayor visibly helped the people and did everything in his capacity to bring aid to Tacloban – clearing of roads, transport of aid, call for help to the government and the people. People saw him drive trucks and lead recovery of corpses. Most people were willing to stand by his side despite criticisms from the president himself. Constituents who knew of his dedication post-Haiyan gave him a free pass from the rumor that he abandoned the city during and 2 days after Haiyan. Most Warays were also willing to accept “we were prepared but overwhelmed/did not expect magnitude” reasoning to explain insufficient preparation pre-Haiyan.

(Read: Haiyan: if we are to play the blame game)

In contrast, Noynoy did poorly post-Haiyan- he stormed out of a press conference, retorted “buhay ka pa naman diba? (but you didn’t die right right?) to a businessman’s plea for the declaration of a state of emergency; he turned an interview with CNN into a blaming spree and obtained criticisms from all over the world for his slow rescue and relief operations; later, he was accused of stifling help in Tacloban due to political rivalry between Romualdez/Marcos and Aquino families. As a result of all these negative publicity, post-Haiyan, he managed to alienate the  trust, confidence and the respect of many Filipinos.

After Haiyan, Romualdez had became more visible to national news. He spoke about his frustrations and obstacles as he sought help from the Aquino led administration. The patsy-underdog angle brought him sympathy from the people. On the other hand, Aquino has been a downward spiral since November 8. People who did not like him before he was president now has more reasons to dislike his leadership. People who voted for him question their choice, some even regretting it, and expressing shame for voting him to power.

In the Philippines, it seems when a crisis emerges, political drama follows. Talks about leadership and governance in the Philippines always lead to a discussion of power struggle between political clans  or parties. Let’s hope that in the coming days, Noynoy and Alfred, the national and local governments and their agencies, find a way to put their interests aside and focus on the more important issues. At the end of the day, what matters is rehabilitating the region and putting people back on their feet.

Earlier:

Haiyan: if we are to play the blame game

Tacloban City: 30 days after the typhoon Yolanda

Tacloban, far from restoring normalcy (see photos)

Why students shouldn’t be compelled by schools to return to Yolanda-hit Tacloban

Also read:

What shouldn’t go missing in the Philippines’ Haiyan rehabilitation plan

Yolanda, not our first category 5 super typhoon yet national/local governments were unprepared

Public health: How can private sector/NGOs help Yolanda survivors?

The burden of patriotism – AFP’s role in EV; how they perform in Yolanda relief efforts will make or break public image

Guiuan, Eastern Samar just as badly hit as Tacloban or worse, 100% damage on infrastructures says Mayor Gonzales