The magic begins when we step out of our comfort zones. This phrase may be much of a cliche to all of us but yet, it is true. Community medicine never failed to make us want to become bigger than what we have been, to widen our perspective, and become more courageous. 

One of the most rewarding aspects of being in barangay Motibot is being able to journey with the people in the quest for a better and healthier community. This can be achieved by beginning with building a sense of trust and transparency. Our good relationship with the community people would never have been as flourishing as it is without the help of our barangay health workers.

Being with people, knowing their struggles, relating to them by spending time with them, sharing stories of perseverance and success, joining them in laughters paved the way to understanding our new home. 

Motibot is our home away from home.

Apple Rose B. Calud
ADZU SOM, Level 1

Non-Achieving Status of the National Tuberculosis Control Program

 Community Health Problem #6  

            A potentially serious infectious disease that mainly affects the lungs, the bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.

            According to the DOH, around 1 million Filipinos are estimated to have tuberculosis, and may or may not even know it. And around 760,000 Filipinos aged ≥15 years are estimated to have PTB. It remains a major public health concern, with the infectious disease among the top killers of Filipinos for almost a decade now.

            According to the gathered data at Sindangan Rural Health Unit, the disease is included in the top leading causes of mortality in barangay Motibot 2014-2019.During the house-to-house surveys, it has come to the attention of the researchers that there are 7 residents of Motibot that had Pulmonary Tuberculosis and some are currently undergoing TB DOTS from 2014-2019.There was also 1 reported mortality in 2019.

            The sudden discontinuation of the NTCP in barangay Motibot enables the problem. The residents are unaware of the risks, signs and symptoms, complications and management of the disease. A few number of households have about 12 members that live together which makes Pulmonary Tuberculosis a threat because of the crowding index. The number of reported cases may be few, but it still counts as a threat because of the nature of the disease and how it is easily transmitted through air.

            Together with the community, the group came up with strategies to address the problem. The strategies include formation of TB program core group (Team moTBot), conduction of lectures on  detection of PTB and proper referral system, conduction of training on proper specimen collection and transport, procurement and endorsement of collection kits, PPE, and biohazard bins identification of cases, and health education. Scheduling of specimen collection every 2 weeks will also be proposed. The people that will be manning these programs will include the researchers, the barangay health nurse, barangay health workers and volunteers.


Improper Solid Waste Management

 Community Health Problem #5  

            Waste management is defined as the activities and actions required to manage waste from its inception to its final disposal. This includes the collection, transport, treatment and disposal of waste, together with monitoring and regulation of the waste management process.Improper disposal of barangay solid waste can create unsanitary conditions, and these conditions in turn can lead to pollution of the environment and to outbreaks of vector-borne disease—that is, diseases spread by rodents and insects.

            Data gathered during the house-to-house survey shows that out of 508 households surveyed in barangay Motibot,72 (14.17%) householdsstill practice incineration of waste, only 460 (90.56%) households practice waste segregation, only 245 (48.23%) households practice composting, and only 26 (5.12%) households practice recycling. In line with this,incineration of waste productsproduces emissions that are detrimental to healthand are polluting the air as emphasized in Republic Act No. 8749 otherwise known as the Philippine Clean Air Act. Waste segregation, on the other hand, promotes reduction of waste that reaches landfills and occupies space. Air and water pollution rates are considerably reduced thus will make it easier to apply different processes – composting, recycling and incineration can be applied to different kinds of waste. Lastly, in terms of composting and recycling, if we exploited every available opportunity to recycle the plastic, metal, glass, rubber and other non-organic waste that gets discarded, and if we composted as much of our excess organic matter as we conceivably could anduse them to enrich soil in sustainable agriculture systems, we could cut our garbage production dramatically.

            Together with the keypersons of barangay Motibot, headed by the barangay captain Hon. Evangeline Murro, the group was able to come up with strategies to improve the overall solid waste practices of the community. The first strategy is to increase community knowledge on solid waste management through education and information disseminationby conducting lecturesand placement of materials in key locations in the barangay. Next strategy is to establish a tailor fitted SWM scheme for the barangay so as to increase the number of households practicing proper waste segregation, composting and recycling via construction of a barangay Small-Scale Vermicomposting Facility, launching of the “Shoot-that-Bottle Campaign”, and creation of the Lantern-and-Christmas-Tree-making contest made of recyclable materials. All of these activities aregeared towards the primary goal ofincreasing the number of households practicing solid waste management in Barangay Motibot, Sindangan, Zamboanga Del Norte by year 2022.


Lack of Responsible Pet Ownership

 Community Health Problem #4 

As defined by the Department of Head (DOH)
a.         Vaccinating pet dogs against rabies at 3 months of age and every year thereafter
b.         Providing clean, comfortable and proper shelter
c.         Providing enough exercise
d.         Providing enough care and proper nutrition
e.         Keeping them within our own backyard, where they are free from contact with infected dogs. Keeping them on leash when we take them for walks or daily exercise
f.          Bringing the pet for regular health consultation with the veterinarian

            Thus it brings fort the well being of the dogs, that are free from disease such as rabies, which if transmitted to a human through a bite from an infected dog surely brings about the demise of the patient.

            It can be seen that rabies is not the current leading cause of morbidity or mortality in barangay Motibot, however, it can’t be ignored that there is a high number of unvaccinated dogs (69.6% of 480 dogs) and most of them are left untied or unconfined within the perimeters of their owners houses (418 dogs) which were identified\seen during our survey. Moreover, the entire Philippines is experiencing shortage of FREE human vaccines for rabies which can cause thousands of pesos if bought out of pocket by the victims. Therefore, it is wise to have the dog vaccinated, good health by proper diet and exercise,and keeping them contained to limit contact with other dogs to decrease transmission of rabies and other canine diseases and as well as decreasing the risk of having a stranger bitten. Rabies is 100% fatal but 100% preventable if measures are taken.

            The goal of the group is to increase the responsible pet ownership of the barangay. This can be achieve through 4 specific objectives which are patterned from the 2007 anti rabies act of the Philippines (RA 9482) and from the Community health plans of previous batches from the ateneo de Zamboanga university school of medicine. Firstly, is to increase the awareness of rabies and responsible pet ownership, majority of pet owners are aware of rabies, it’s consequences and the free vaccination for their pet dogs, however a not all pet owners and the community know the proper management if a person is bitten by dogs. Secondly, to increase the vaccinated dogs to 80%. Because according to RA 9482 in order to achieve the herd immunity against rabies is to ensure the percentage of dog vaccination at least 70%. This can be achieved by tapping to Department of Agriculture and other non-government offices in order to assure the number of vaccines and manpower needed for vaccination of Pet dogs well as vaccination and  castration of stray dogs. Thirdly, In order to monitor the progress of vaccinations as well as the number of canines and cats, it is therefore necessary to have a central registry of the pet owners and their pets. Lastly, establishing of a core group of MOtibot REsponsible Pet Ownership Club (MOREPOC) to ensure an active participation of the community especially the pet owners during activities such as vaccination, registration, and field control of dogs through the years to come.

            Majority of dogs in motibot are unvaccinated and are not contained in the houses of their masters, thus it is important for the WHOLE community of Barangay Motibot and not just the pet owners and the government to work hand in hand in order to be a responsible pet owners.


Inadequate Improved Toilet Facilities

 Community Health Problem #3  

One of the goals of the WHO is that every person in the world has access to toilets that safely contain excreta. This is essential to protect the health of individuals, communities and the environment from disease such as diarrhea.

Diarrhea is the top 2 cause of morbidity in Barangay Motibot since 2014.  The department of health already stressed out that basic toilet facilities should be a necessity for every Filipino household more than having mobile phones. However, in the Barangay only 359 (70.6%) out of 508 have an improved sanitation facilities; 134 (26.4%) of the household have limited sanitation, 41 households have unimproved sanitation facilities and 12 have no sanitation services at all.

During the house to house survey, people from the uplands, sectors 6 and 7, have been pointing out their lack of toilet facilities, aside from it’s too far from lowland, it is also due to their lack of finances. Toilet facilities were one of the top 10 perceived problems of the community. Hence, during the assembly the barangay key persons prioritized inadequate toilet facilities as their number one problem together with hypertension. Both parties then agreed to have the intervention with this problem. The goal of this project is to achieve one improved sanitary toilet per one household in Barangay Motibot.

One of the reasons for the lack of improved toilet facility among the residence of Barangay Motibot includes the lack of knowledge regarding the importance of having a toilet facility, financial instability and the poor implementation of the Philippine ordinance for toilet facilities and sanitation. The goal of this group is to deliver health teaching in order for the people to know the significance of having toilet facilities. Another goal is to provide toilet facilities through the help of the barangay officials, municipality government and DSWD’s 4Ps. The group also had the idea to implement the existing law which mandates the LGU to establish and provide communal and hygienic toilet facility.

With that, the group’s primary goal is to increase number of household with improved toilet facilities from 71% to 90% in Barangay Motibot, Zamboanga del Norte by the year 2022.


Non-Functional Emergency Response System

 Community Health Problem #2  

            Cardiopulmonary Resuscitation is an emergency lifesaving procedure performed when the heart stops beating. Immediate CPR can double or triple chances of survival after cardiac arrest. This technique can be used when victims appear to be choking, drowning, unconscious or suffering from cardiac arrest. 

          During the survey that the team conducted, results revealed that the Emergency Response System in Barangay Motibot is non-functional. Residents verbalized that there is no consistent system that the Barangay follows when it comes to transport and management of emergencies considering that houses from sectors 5-7 are far from the main road. Even the officials admitted that they do not follow certain guidelines to address the emergency needs of the residents. Whereas, the officials themselves are aware that they have personal duties and jobs to attend to that disables them to attend to every emergency that occurs in the Barangay. Currently, whenever emergencies occur, no one is in charge in assuring the transport of the patient, thus, whoever is available and is willing to aid in transporting the patient does the job. Even with the presence of a vehicle for transport, still, no one mans the vehicle and does not serve the purpose of its existence. Also, the Barangay Health Workers who manage the health center does not have any training in saving lives – even basic life support.  

          This problem, the non-functional emergency response system, was included in the top 10 perceived problems of the people of Barangay Motibot. During the prioritization, it ranked 2nd among eight problems. 

          Our team aims to establish the Barangay Motibot Emergency Response System (BMERS) Program by year 2022 to address this problem. In this program, BMERS core team will be established where officers will be elected. Emergency Management Plan (EMP) will also be established to have an emergency response flowchart where team members’ job description will be specified. Of course, knowledge and skills on appropriate emergency  management of the BMERS Core Team and the community people as a whole will be supplemented through lectures and training. Information drive will also be conducted to disseminate hotline numbers and the BMERS EMP. Also, the group intends to partner with various organizations. Red Cross will be coordinated to conduct the lecture and training on Basic Life Support and other first aid measures. The group also intends to coordinate with other organizations for the provision of other medical equipment needed. The Barangay Motibot Council will be responsible with other matters especially with the sustainability of the BMERS Program after four years and beyond. 

          This particular community health problem is indeed not easy to address but is with utmost importance. A lot of effort will be needed to successfully establish the Barangay Motibot Emergency Response System (BMERS) Program. Whereas, we, the Team Motibot, are willing to do whatever it takes to make the people of Barangay Motibot live in a better, healthier, and safer Barangay. 



High Prevalence of Uncontrolled Blood Pressure

Community Health Problem #1

Hypertension, angay kontrolon ug taga’ag solusyon!

            Hypertension is the top leading cause of morbidity from 2014 to 2019 in Barangay Motibot. The Rural Health Unit recorded 14 mortalities due to hypertension-related complications. During the community assessment, there were 125 individuals diagnosed as hypertensive and among these, 48 have uncontrolled hypertension. During survey interviews, the problem on hypertension was recognized by the community people as their top problem and this was further supported by ranking first during the prioritization.In Motibot, 61% of the total households surveyed have members who smoke and only 43% exercise regularly.Smoking, high alcohol and sodium intake, and decreased physical activity all contribute to hypertension. Moreover, those who were prescribed with maintenance medications are not consistent in taking their medications due to financial hindrances.

 The predisposing factors of uncontrolled hypertension are the limited knowledge about the seriousness of uncontrolled hypertension, the signs and symptoms, particularly the risk factors, cost-of-care and medications, drug side effects, attitudes, and psychological barriers.

            This health plan aims to control the blood pressure of hypertensive individuals within level recommended by the JNC 8 guidelines by the year 2022. These are the following specific objectives:

  1.     . Increase knowledge and skills of BHWs and key personnel on the early detection of hypertension and proper referral system.
  2.     . Increase knowledge of entire community about hypertension.
  3.     . Increase adherence to pharmacologic and non-pharmacologic interventions
  4.     . Ensure sustainability of the program.

            In order to increase knowledge and skills of BHWs and key personnel, they will be given lectures and trainings. The knowledge of the community members will be fostered through the conduct of lectures and information caravan. There will be capacity building activities for hypertensive patients such as the celebration of Hypertension Awareness Month and launching of “ Sis and Brad Against highbLoodTeam ” (SALT) Peer Group, zumba, and weight loss competitions. To increase adherence to pharmacologic and non-pharmacologic interventions, the team will establish linkages with the local government unit, rural health unit, and DOH to ensure availability of maintenance medications at the barangay health center. Their adherence to maintenance medications and BP control will be monitored using booklets, establishment of Upper Motibot BP Hut for BP monitoring and dispensing of medicines, and conduct promotional activities for nonpharmacologic management of hypertensionsuch as weekly zumba and cost-effective dietary approaches. Lastly, there should be involvement of key stakeholders in the development of programs in order to ensure sustainability of programs and this will be achieved through formulation of ordinance on the celebration of hypertension awareness month, procurement of the apparatuses, and training of trainers of the barangay.

            Hypertension is a life-style related disease and it can bring a health crisis in the community. The good thing is, it is preventable. Complications brought by this disease can be addressed by consistent monitoring, adherence to pharmacologic and non-pharmacologic interventions, and changing behavioural and modifiable risk factors.

            Sustainability is the responsibility of everybody. With the strong involvement of each member of the community in the quest to address hypertension and its complications, #NaaySolusyonSaHypertension.