You are currently browsing the tag archive for the 'community development' tag.
Erle Frayne Argonza
From Lima beans to Lima community-based XDR-TB treatment, Lima got it! The exciting news about lessons that we can cull from Lima’s health teachings is that the components of the community-based approach are comprehensive and not just “let me inoculate you Patient so you won’t be vector to your household members and neighbors” sort of dinosaur treatment.
Below is the news about the special TB treatment that Lima shares to us all.
[28 August 2008, Quezon City, MetroManila. Thanks to SciDev database news.]
We can learn from XDR-TB treatment in Lima
Source: New England Journal of Medicine
11 August 2008 | EN | ES
A nurse prepares TB drugs in Peru
World Lung Foundation
A new report from Lima, Peru, offers hope for tackling extensively drug-resistant tuberculosis (XDR-TB) in the developing world, says Mario C. Raviglione in the New England Journal of Medicine.
The report shows that with “aggressive and appropriate” management, XDR-TB can be cured in most cases.
Raviglione highlights some of the factors that may have contributed to Peru’s success in treating the disease. All patients were given systematic drug-susceptibility tests and were treated with powerful second-line drugs, including a fluoroquinolone and an injectable drug. Where necessary, treatment regimens were reinforced with known effective drugs.
Strict community-based supervision was enforced, comprising psychological support, nutritional support and financial incentives. Additionally, intense bacteriological and clinical monitoring allowed for readjustments where necessary.
Raviglione believes that applying such an approach on a more global scale would help minimise, and effectively manage, drug resistance.
“In 2008, scaling up is indeed the major challenge faced by most complex health interventions worldwide … Effectiveness of a complex intervention depends on coordinated work among all forces.”
Erle Frayne Argonza
Who says that male circumcision does not have any positive health value at all, that it is more of an esthetic practice than a medical one?
In the Philippines, ‘libreng tuli’ (free circumcision) is among the health services offered by NGOs and social service groups to community members. As President of the KAKAMMPI in 89-93, I led the conduct of this free service for the adolescent boys of Anakbayan in Paco district, (Old) Manila, and in Tondo district, (Old) Manila. Not only were the surgical operations simple and well accepted, they also somehow ensured my group’s relevance among urban poor residents of the beneficiary communities.
But there is the lingering question raised about the true health value of circumcision. With a recent development in HIV research, it seems that the issue is coming to a close finally. Circumcision could very well be very cost effective a way to prevent HIV, and Africa itself could save as much as billions of dollars of prospective medications via male circumcision.
See the exciting news below.
[28 August 2008, Quezon City, MetroManila. Thanks to SciDev database news… The Kakammpi is a national organization of dependents of overseas workers, largely concerned with advocacy and community organizing. As its president, I was involved in the drafting of a proposed law for migrants that was passed later, as the Omnibus Law for Overseas Workers.]
Circumcision for HIV prevention ‘cost effective’
Mohammed Yahia
11 August 2008 | EN | 中文
Photoshare
[MEXICO CITY] In addition to decreasing the transmission of HIV, circumcision is cost effective and can reduce the risk of human papillomavirus (HPV) infection, researchers have announced.
Researchers presented a mathematical model at the International AIDS Conference in Mexico City last week (6 August) that showed that male circumcision programmes are economically feasible in Sub-Saharan Africa.
While they may cost more than US$900 million dollars to initiate, the budget for antiretroviral therapies would be cut considerably with the reduction in new infections.
“Calculations suggest that, over a 20-year period, two billion dollars would be saved,” said Bertran Auvert, professor of public health at France’s national biomedical institute INSERM.
Auvert also announced that HPV infection can be cut by around 40 per cent in men, as well as circumcision reducing HIV infections by 60 per cent.
“Circumcision could therefore be an indirect way of limiting the risk of genital cancers caused by HPV in women,” said Auvert.
According to Alvaro Bermejo, executive director of the International HIV/AIDS Alliance, studies in South Africa show a high level of acceptance of male circumcision. “We’ve seen high uptake and there are lengthy waiting lists right now,” he said.
But expansion of the practice in Africa has proved slow. “If it were a traditional biomedical product, like a pill, I think we would see roll-out much more quickly,” said Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition. “But you are dealing with a deeply cultural and social issue.”
For example, the elders of the Luo tribe, a large community in Kenya, have refused to endorse male circumcision as it is against their culture and they are not convinced it will decrease the rate of new infections.
And in Indonesia, Christians have been reluctant to get circumcised because the practice is associated with the coming of age for young Muslim boys, explained Karen Houston Smith, deputy director of Family Health International, Indonesia. “They feel this casts some doubt on the validity of their Christianity.”
Bermejo stressed that dialogue and information will be essential for any global strategies to roll out male circumcision.
And the messages need to be clear. “We need to be sure we are not putting women at risk. We need to be sure that men who do get circumcised don’t think that they can now stop using condoms” said Warren.
“But that doesn’t mean we should not be scaling up in a strategic and smart fashion that is addressing all of these other factors.”
Erle Frayne Argonza
Tuberculosis could be a way to contract HIV, and cases encountered in the field are replete with this route to the dreaded disease.
From Cape Town comes a welcome news about a wonder drug that is most effective for treating patients who become sick of HIV precisely thru the TB way.
The good news is contained below.
[28 August 2008, Quezon City, MetroManila]
Scientists reveal ‘most effective’ drug for HIV/TB patients
Carol Campbell
15 August 2008 | EN | 中文
Efavirenz capsules
Flickr/MikeBlyth
[CAPE TOWN] The antiretroviral drug efavirenz has been recommended for tuberculosis patients who then contract HIV.
Researchers compared the effectiveness of the antiretroviral drugs efavirenz and nevirapine in 4,000 South African HIV patients. Some already had tuberculosis (TB) and were taking rifampicin.
Nevirapine — the cheaper of the two drugs — was found to be less effective in patients with existing TB, with higher HIV loads in their blood than those on efavirenz.
HIV-infected patients who were already on antiretroviral drugs when they subsequently developed TB were unaffected, highlighting the complexity of treating concurrent HIV and TB infections.
Researchers from the Western Cape provincial health department, Médecins Sans Frontières and the University of Cape Town (UCT) published their findings in the Journal of the American Medical Association (6 August).
Study leader Andrew Boulle warns that the research is not a rejection of nevirapine, which is popular in the developing world because of its low cost, simplicity of use and its safety for pregnant HIV-infected women.
“Four out of five of our patients in the study continued to do well on nevirapine,” said Boulle, a public health specialist from the School of Public Health and Family Medicine at UCT.
The long-standing anti-TB drug rifampicin slows down the liver’s ability to process nevirapine, making the anti-HIV drug less effective and causing an increase in virus levels.
Efavirenz is only slightly affected by rifampicin, said Katherine Hildebrand, another UCT researcher. But it costs twice the price of nevirapine. “We need to get the price of efavirenz down in places with high HIV/TB co-infection,” she told SciDev.Net.
The research also disproves earlier assumptions that people with both TB and HIV may need increased doses of efavirenz. Researchers found that efavirenz in normal doses was ideal for HIV patients regardless of whether they had TB or not.
“Efavirenz should be used unless there are compelling reasons not to use it. Unfortunately many developing countries do not have access to efavirenz which is more expensive,” said Gary Maartens from UCT medical school’s clinical pharmacology division. Botswana and South Africa both use efavirenz extensively.
Link to abstract in Journal of the American Medical Association
Erle Frayne Argonza
Who says that community-based health care systems won’t work? In the Philippines this has been an on-going effort, with the University of the Philippines leading. Couples of communities were adopted by the U.P. Manila in other regions precisely to study the effects of intervention via community organization.
Below is a news caption about a study that shows the effectiveness of community-based health care. Community-based health care has already been revolutionizing access to health care by many poor folks in the south.
Enjoy your read!
[02 August 2008, Quezon City, MetroManila. Thanks to SciDev database news.]
Community-directed healthcare ‘effective’, finds study
Abiose Adelaja
23 June 2008 | EN
In the strategy, family members help deliver drugs and administer treatment, instead of patients visiting a clinic
Flickr/CharlesFred
Community-administered healthcare is effective in combating a range of illnesses including river blindness and malaria as well as micronutrient deficiencies, according to a study of over two million people in three African countries.
The researchers say restrictive health department policies on who can administer medications should be altered so that other illnesses can be tackled in a similar fashion.
Community-directed drug intervention (CDI) has proved successful in delivering the drug Ivermectin to treat river blindness, also known as onchocerciasis. In the strategy, family members help deliver drugs and administer treatment, instead of patients visiting a clinic.
The study looked at the effectiveness of CDI in strategies to fight river blindness, later pairing it with treatments against malaria, tuberculosis and micronutrient deficiencies, in Cameroon, Nigeria and Uganda. Community dispensing of drugs, vitamin A supplements and insecticide-treated mosquito nets was compared with conventional delivery strategies over three years.
Researchers found that the number of feverish children receiving the right antimalarial treatment doubled, exceeding the 60 per cent target set by the Roll Back Malaria campaign. The use of insecticide-treated bednets also doubled.
Vitamin A supplementation coverage was also significantly higher in districts using CDI compared with those that did not. But community-directed interventions for tuberculosis proved only as effective as treatment from clinics.
Samuel Wanji, a researcher at the University of Buéa who conducted the southwest Cameroon part of the study, says the African Programme for Onchocerciasis Control — linked to the WHO and with 19 health ministers on the board — has given the go-ahead to extend the use of CDI for river blindness in countries that have lower, but still significant, levels of the disease.
The expanded programme will investigate whether CDI works as well in places where disease infection is less intense, and is scheduled to begin before the end of the year. Dispensing of other medications will be added as the programme progresses.
“The study’s approach is very useful for increasing access to health and will reduce the burden on health facilities,” says Hans Remme of the WHO Special Programme for Research and Training in Tropical Disease.
But a shortage of drugs and other materials remains a drawback, according to a WHO report of the study.
Erle Frayne D. Argonza
[Writ 12 April 2008, Quezon City, MetroManila. The author was former community development assistant at the Ministry of Human Settlements, Region II, in early 1981.]
If Bob Marley were alive today and visited Mayoyao in Ifugao, Cordillera region, he might achieve euphoria even without having to smoke pot. And his cause for Dionysiac wonderment would be: a fishpond atop a mountain. And he’d declare wide-eyed, with nary a 2nd thought, that “the Ifugaos are a free people! Hail Ifugaos!”
Free indeed is this sturdy ethnicity of highlanders, who used to be ferocious head-hunters and were dreaded by the Americans. They have since become tame, no longer do head-hunting, and have instead hunted for tons of bright ideas to multiply their survival chances up in the boondocks.
I was then a newly hired program staff for the Ministry of Human Settlements’ Regional Liaison Office in Region II or RLO-2. We covered the whole of Cagayan Valley and the Cordillera provinces of Ifugao, Kalinga and Apayao. As soon as I had a couple of days of briefing as a new staff, I immediately buzzed off for field work to monitor our community services at the town levels where we have deployed community organizers who were dubbed the HSOs (Human Settlements Officers).
Over 250 kilometeres south of Tuguegarao, the location of our liaison office (we were an adjunct of the central office in the region), was Ifugao which had to be traversed via Nueva Vizcaya. Armed with my monitoring sheets, itinerary, cassette recorder with The Police and Sex Pistols playing, and an escort of truly-armed Philippine Constabulary (our regional supervisor was Gen. Olivas of PC Region II), I visited couples of HSOs in Vizcaya for a day first, after which I proceeded to Mayoyao.
Well, the road to Ifugao was narrow, winding and gravel-rough, and only single-lane. And down below was crevice, hard rock, or some cursed dangerous vertical wall that King Kong would hate to scale. And my balls (excuse me) quickly moved from down loin up to past my head, as the goose bumps overwhelmed my being till we reached Mayoyao 40 kilometers from Banawe.
The recompense for the rough and hazardous ride was the beautiful scenery, so grand and beautiful beyond words. The best-looking rice terraces are found here, not in Banawe that is merely the entry point. And, without doubt, the fish pond built atop a mountain whose peak was leveled for the purpose.
How many places on Earth could one find fishponds that are not only impossible to build but also costly? And this one was built from concrete. Rectangular in shape, around it was classy cobble-like stone and cement aisle. Below is the pond, around two (2) meters deep, with the fingerlings just seeded. Covering around one (1) hectare in size or so, it was actually more of an experimental prototype, though the town residents thought of producing at commercial levels. Tilapia was the experimental species, to recall.
The Cordillerans are truly a wonderful people in terms of innovativeness in thriving. They’ve already chiseled out the mountains into productive rice lands. Now they followed through with fish farming, and of all places, atop a mountain.
The project, installed by cooperating agencies (mayor’s office, MHS, Bureau of Fisheries & Aquatic Resources or BFAR), was a success for the duration of my stay then in the MHS (I stayed till 1983). And there were no reputable enterprise financing programs for these types then. They funded it themselves, via local funds and private donors.
So for those who are interested to know the success story, please visit Mayoyao in Ifugao. Enjoy the ride up there. For relaxation, you can choose between bottles of gin or local rice wine (tapoy). And better quaff them, because whether hot or cold days, it is always cold up there. Ride the wave of the moment!
Bro. Erle Frayne D. Argonza
[Writ 12 April 2008, Quezon City, MetroManila. The author was former community development assistant at the Ministry of Human Settlements, Region II, in early 1981.]
If Bob Marley were alive today and visited Mayoyao in Ifugao, Cordillera region, he might achieve euphoria even without having to smoke pot. And his cause for Dionysiac wonderment would be: a fishpond atop a mountain. And he’d declare wide-eyed, with nary a 2nd thought, that “the Ifugaos are a free people! Hail Ifugaos!”
Free indeed is this sturdy ethnicity of highlanders, who used to be ferocious head-hunters and were dreaded by the Americans. They have since become tame, no longer do head-hunting, and have instead hunted for tons of bright ideas to multiply their survival chances up in the boondocks.
I was then a newly hired program staff for the Ministry of Human Settlements’ Regional Liaison Office in Region II or RLO-2. We covered the whole of Cagayan Valley and the Cordillera provinces of Ifugao, Kalinga and Apayao. As soon as I had a couple of days of briefing as a new staff, I immediately buzzed off for field work to monitor our community services at the town levels where we have deployed community organizers who were dubbed the HSOs (Human Settlements Officers).
Over 250 kilometeres south of Tuguegarao, the location of our liaison office (we were an adjunct of the central office in the region), was Ifugao which had to be traversed via Nueva Vizcaya. Armed with my monitoring sheets, itinerary, cassette recorder with The Police and Sex Pistols playing, and an escort of truly-armed Philippine Constabulary (our regional supervisor was Gen. Olivas of PC Region II), I visited couples of HSOs in Vizcaya for a day first, after which I proceeded to Mayoyao.
Well, the road to Ifugao was narrow, winding and gravel-rough, and only single-lane. And down below was crevice, hard rock, or some cursed dangerous vertical wall that King Kong would hate to scale. And my balls (excuse me) quickly moved from down loin up to past my head, as the goose bumps overwhelmed my being till we reached Mayoyao 40 kilometers from Banawe.
The recompense for the rough and hazardous ride was the beautiful scenery, so grand and beautiful beyond words. The best-looking rice terraces are found here, not in Banawe that is merely the entry point. And, without doubt, the fish pond built atop a mountain whose peak was leveled for the purpose.
How many places on Earth could one find fishponds that are not only impossible to build but also costly? And this one was built from concrete. Rectangular in shape, around it was classy cobble-like stone and cement aisle. Below is the pond, around two (2) meters deep, with the fingerlings just seeded. Covering around one (1) hectare in size or so, it was actually more of an experimental prototype, though the town residents thought of producing at commercial levels. Tilapia was the experimental species, to recall.
The Cordillerans are truly a wonderful people in terms of innovativeness in thriving. They’ve already chiseled out the mountains into productive rice lands. Now they followed through with fish farming, and of all places, atop a mountain.
The project, installed by cooperating agencies (mayor’s office, MHS, Bureau of Fisheries & Aquatic Resources or BFAR), was a success for the duration of my stay then in the MHS (I stayed till 1983). And there were no reputable enterprise financing programs for these types then. They funded it themselves, via local funds and private donors.
So for those who are interested to know the success story, please visit Mayoyao in Ifugao. Enjoy the ride up there. For relaxation, you can choose between bottles of gin or local rice wine (tapoy). And better quaff them, because whether hot or cold days, it is always cold up there. Ride the wave of the moment!

Recent Comments