Salud Bikolnon Edition14

Salud Bikolnon I April - June 2016

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SaludBIKOLNON

DEPARTMENT OF HEALTH REGIONAL OFFICE V Health Promotion Unit Legazpi City, Albay Tel. No. : (052) 483-5656 loc. 551 Email: dohbicolhpu@gmail.com www.ro5.doh.gov.ph www.facebook.com/dohrov

The COVER THUMBS-UP. The Department of Health Regional Office V took a step further in attaining universal health care by distributing TSeKaP (Tamang Serbisyo para sa Kalusugan ng Pamilya) equipment packages to Rural Health Units, Urban Health Centers and Barangay Health Stations of the region. This aimed to equip Local Government Units with essential medical equipment for them to efficiently deliver basic health services especially to PhilHealth and Pantawid Pamilyang Pilipino Program (4Ps) beneficiaries.

Turn over ceremonies were graced by Health Secretary Janette Garin. “Distributing the TSeKap equipment packages to LGUs is granting ease of access to all Filipinos of their basic health needs”, she emphasized.

NEXT Issue . . .

EDITORIAL

Board & Staff

Chairman Napoleon L. Arevalo, MD, MPH

OIC - Director IV

Vice Chairman Ernie V. Vera, MD, MPH, CHA

Director III

Members

WAR ON DRUGS. As President Rodrigo Duterte launched the fight against illegal drugs, the Department of Health Regional Office V takes opportunity to solve the drug menace with an intensified program on drug rehabilitation.

Dr. Napoleon L. Arevalo, DOH RO V OIC - Director IV, said that the surge of drug surrenderees created an influx of demand for people to seek treatment. “Not all of the surrenderees need to be admitted in rehab centers. The DOH together with partner agencies devised a system in classifying them.”

Norberto A. Balane, Jr., CPA, MPA Arnulfo C. Carandang, MD, MPH Alan Lucañas, MD Ms. Noemi A. Bron, HEPO III Mr. Kenn S. Nuyda, HEPO II

Editor-in-Chief Ms. Noemi A. Bron, HEPO III Associate Editor Mr. Kenn S. Nuyda, HEPO II Writer & Layout Artist Danica D. Caballero Photographer / Sharon B. Besmonte Circulation-in-Charge Crisostomo Dado, Jr. Contributors Ma. Aura Ermina C. Tandog, RM, RN Niña Albie Dulay Jeric V. Gianan, RN Russel Joy. V. Pitajen, RN Joselle C. Magtagñob Princess Neah A.Talan Marie Gail V. Molina Ailene Bitancor Magdamit Bicol Medical Center ENTERED AS SECOND CLASS MAIL At Legazpi City Post Office , Albay Under Permit No. 2013-22 on 25 September 2013

IN THIS ISSUE

4 Be Ready this Rainy Season 5 BMC receives International Award Sanitarium launches Senior 6 Bicol Citizens’ Club

7 POPCOM-V Educates IP Teens and Teen Moms on Adolescent Health Development

12 HIV/AIDS: Advocacy thru the Stage 14 TSekaP Sets to Uplift Health Service 16 Give Extra Care to Your Kidneys 18 DOH Bicol rolls out RPRH Forum 20 GHW Law: Full Blast this November 23 What makes You a “Wina”?

Health Headlines

Be ready this

Rainy Season With the onset of the rainy season and La Niña, the Department of Health Regional Office V reminds the public of potential health risks.

According to the National Epidemiology Center (NEC), infectious diseases with the acronym WILD, (Water-borne infectious diseases, Influenza, Leptospirosis, and Dengue) will be common this season.

“We should be prepared and well informed of these health risks for us to prevent them,” Regional Director Dr. Napoleon L. Arevalo said. “WILD diseases are usually more prevalent during the wet season.

The public is advised to have enough rest, exercise, and maintain a healthy diet to boost the body’s resistance.”

RD Arevalo also stressed that proper waste disposal should be practiced especially during the rainy season to prevent waterborne disease which is a result of water contamination. Water-borne and foodborne diseases are transmitted by ingestion of contaminated food or water. This includes diarrheal diseases that are caused

by several species of the salmonella and shigella bacteria, cholera, hepatitis A, and typhoid fever.

“Parents should also make sure that their children are protected from rains and flashfloods by providing them rain gears like umbrella, boots and raincoat,” RD Arevalo added. “They should always be in tune with weather forecasts and be proactive.” Children and older adults are more susceptible to catch the flu this wet season.

Influenza or flu spreads from person to person by infectious droplets created by sneezing, coughing and talking. It is characterized by cold-like symptoms and headaches. It is a self-limiting illness in most instances, but a small percentage of patients develop life-threatening complications like pneumonia.

Other health risks this season are leptospirosis and dengue. We acquire leptospirosis when we get in contact with water or soil that has been contaminated with the urine of an infected animal like rats. Its symptoms include high fever, headache, muscle aches especially of the calf, abdominal pain, nausea and vomiting, red eyes, and chills. In its severe form, leptospirosis can cause kidney damage, liver and respiratory failure, and meningitis.

Dengue, which is expected to have a higher incidence rate this season, is a viral disease that is transmitted by the bite of the Aedes mosquito, which breeds in stagnant water. It is characterized by fever and body aches. It is often self-limiting and mild, but sometimes it complicates and leads to fatal bleeding and death.

“To prevent Dengue, we should practice 4S: (1) Search & destroy mosquito breeding places, (2) Self-protection measures, (3) Seek early consultation for fever lasting more than 2 days, and (4) Say yes to fogging when there is an impending outbreak”, RD Arevalo explains. “We can protect ourselves by wearing long sleeved shirt, pants and long socks, applying insect repellent lotion, or use mosquito nets when sleeping. More importantly, we should practice the habit of destroying possible breeding sites of mosquitoes”.

RD Arevalo reiterated that we should be vigilant and be ready should the WILD diseases affect our locality. “Remember, when symptoms manifest we should take the patient to the nearest health center or hospital for proper medical interventions”.

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Salud Bikolnon I April - June 2016

BMC receives International Award

by MBL64 Bicol Medical Center

In recognition of Bicol Medical Center’s best practices in blood collection and blood banking, the International Society of Blood Transfusion (ISBT) based in The Netherlands chose to award the ISBT Developing Country Award 2016 Certificate of Commendation to BMC Blood Bank and Transfusion Service which shall be awarded during the opening ceremony of ISBT congress in Dubai, UAE on September 4, 2016. This is truly a first in Bicol.

SHARE LIFE. (left) Participants during World Blood Donor Day celebration of BMC willingly donate their blood. (right) The simultaneous blood letting of BMC garnered 115 blood units from voluntary non-remunerated blood donors.

The award is a fruit of the endeavours that

diseases requiring blood transfusions. The

donation activities at the BMC Orthopedic

BMC upholds in the service to Bicolanos.

continued availability of safe blood is then

Ward and Naga City People’s Hall. A total of

The BMC Blood Bank takes seriously it

of utmost importance.

115 blood units were collected that day from

mission to achieve an average of forty five (45) Mass Blood Donation activities per month and on a regular basis.

It

enables BMC to collect and maintain the ideal daily stock levels needed by patients not only at BMC but also for private and other government hospitals in Camarines Sur, Camarines Norte and Albay. A total of 1500 to 2200 blood units are collected on a mothly basis.

A single unit of blood can be used to benefit several patients and save lives in instances of emergency like conflicts, natural disasters and childbirth as well as

BLOOD DONATION ADVOCACY Recently, BMC celebrated World Blood Donor day with the theme “Blood connects us all” which highlighted the common bond

voluntary non-remunerated blood donors: students, young professionals, doctors, health personnel, media practitioners and private individuals.

that all people share with their blood. The

Such endeavours bring BMC as one of the

slogan, “Share life, give blood” brought

top performing blood service facilities in the

attention to the role that the voluntary

region. The facility continuously strive for

donation system play in encouraging

excellence in the years to come.

people to care for one another and promote community cohesion.

Dr. Raymundo B. Ibarrientos , head of the BMC Blood Bank and Transfusion Service,

BMC as the lead blood service facility,

and Mr. Mario Chavez and Mr. Jose Miguel

spearheaded the celebration on June 14,

Bergonio, members of the team, hope to

2016 with simultaneous mobile blood

attend the awarding for the ISBT award on September.

Salud Bikolnon I April - June 2016

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Bicol Sanitarium launches

Senior Citizens’ Club

by Ma. Aura Ermina C. Tandog, RM, RN Bicol Sanitarium, HEPO II

In the coming years, there will be unprecedented demand for health services required by older adults.

They seek better quality of life in the later years. Quality of life has come to mean much more than just physical health or absence of disease. It includes a general sense of happiness and satisfaction, meaningful activity, and the ability to express culture, values, beliefs, and relationship.

BETTER HEALTH FOR SENIORS. (left) Seniors interact and laugh during the talk of Assistant Secretary Dr. Nestor F. Santiago, Jr. (right) Participants brightly smile when they found out of the benefits and programs.

In connection with the Geriatrics Program,

Dr.

Sophia

C.

Tanicala,

Geriatrician,

is to be a Geriatric Health Center Facility in

Bicol Sanitarium (BS) launched its Senior

remarked that the activity is an appropriate

Bicol Region to provide accessible, highest

Citizens’ Club last May 5, 2016. Around

step taken by BS for senior citizens. She

quality and affordable health care for senior

150 senior citizens attended the launching,

further adds, “Our institution is directed to

citizens that is provided by competent and

to which majority of them are officials of

lead a team that would develop a service

compassionate service providers”.He also

Federation of Senior Citizens Association

plan on the commitment to provide the

introduced the Senior Citizen handbook

(FSCA) from different municipalities of the

best possible service to older adults with

developed by BS which is composed of

1st District of Camarines Sur. The senior

strategic directions and goals”. The need

complete physical history and medications

citizens from Custodial and Palliative Care

of elderly population are broad and unique,

taken by an elderly client.

and relatives of Bicol Sanitarium employees

and so is the range of approaches to

also attended the said event.

meeting those needs.

Dr. Arevalo and Dr. Santiago gave

Prominent guests and keynote speakers

Dr. Edgardo R. Sarmiento, BS Chief of

congratulated the Bicol Sanitarium family for

were present at the event namely Dr.

Hospital II, in his speech said that “from a

successfully launching the Senior Citizens’

Nestor F. Santiago Jr., Assistant Secretary of

sanitaria and general services , BS is now

Club. Both stressed that BS promotes

Health, Office for Health Operations and Dr.

expanding its services to senior citizens”.

Primary Health Care programs emphasizing

Napoleon L. Arevalo, OIC-Director IV of the

He continues, “From providing Leprosy

health promotion and education activities.

Regional Office V.

Management in Southern Luzon, our vision

their messages to senior citizens and

turn to next page

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Salud Bikolnon I April - June 2016

POPCOM-V educates

IP teens and teen moms on

by NiĂąa Albie Dulay Commission on Population RO V

Adolescent Health Development Commission on Population-Regional Office V (POPCOM-V), in partnership with the National Commission on Indigenous Peoples (NCIP), reached out to the young Indigenous Peoples (IPs) by bringing the U4U Teen Trail to the Ilians of Iriga City and other indigenous groups from different parts of the region on April 14-15, 2016.

The activities were done with careful consideration of their culture, beliefs, perspectives, and behaviors. The teen trail experience had a positive impact on the young IPs who expressed gaining additional knowledge on adolescent sexuality and health issues. The peer facilitators who were trained committed to engage in health promotion in their communities. The NCIP and LGU-Iriga City provided counterpart funds for the conduct of said teen trail.

A modified U4U activity was also conducted for teen mothers, in collaboration with Legazpi City Health Office and Luzon A Legazpi CHO staff (left) facilitates the nutrition assessment of a participant of the U4U for Teen Moms event.

Health at Ysabelle’s Restaurant on May 6, 2016. In attendance were 68 young turn to next page

After the talks, the elderly were given free consultations and Pneumococcal and Flu vaccines.

Bicol Sanitarium serves as an instrument to provide for the special needs of senior citizens as well as guide them to prepare for old age.

At the end of the day the seniors were too happy to be part of this event.

BS has once again fulfilled its goal of providing

services

with

competent,

compassionate care to older people.

IMMUNIZATION. A health worker innoculates senior citizens with free pneumococcal and flu vaccines.

Salud Bikolnon I April - June 2016

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from page 7

pregnant women aged 15-19 from the

EAGER TO LEARN. Teen moms pay close attention to Ms. Sheryl Bulawan (not in the picture), PPO I, as she discuss the changes happening to the body of a pregnant woman.

different barangays in Legazpi City. The activity aimed to educate the teen mothers particularly on the importance of facilitybased delivery, pre and post-natal checkup, proper nutrition for infants and parental responsibilities.

The

activity

included

segments of #TeenMomExhibit, Let’s Talk About Responsible Parenthood (RP), and Family Planning (FP) Chat.

The demand for U4U is increasing since its launch in 2014. As of May 2016, POPCOM-V counts a total of 27 U4U teen trails conducted in 44 public schools and 11 private schools in the region, serving 2,353 teens with critical information on adolescent health and development. Local government units with trained U4U facilitators have been replicating the conduct of U4U to their respective communities.

U4U is the Philippine teen health resource portal, a youth hub initiative of the Commission on Population (POPCOM), supported by the UN Population Fund (UNFPA). It aims to help Filipino teens delay sexual debut, avoid teen pregnancy and reduce the spread of STI & HIV. This initiative has 4 platforms: 1. Online Portal (www.u4u.ph) - A dynamic and interactive website that allows teen users to learn about self-identity, friendship, life skills, and teen health advocacy 2. Social Media (Facebook, YouTube and Twitter) 3. Interactive Voice Response System (IVRS) - Automated mobile service that gives recorded information to teens who

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send a “U4U” text message to dedicated mobile phone numbers

entertaining teen caravan that can be set up easily in schools and communities and managed by teens themselves. It’s a 3-4 hour event that has 4 simultaneous

4. Teen Trail - An educational and

segments and 1 plenary closing segment.

Salud Bikolnon I April - June 2016

For details, contact: COMMISSION ON POPULATION Buraguis, Legazpi City Tel. No.: 480-5478 E-mail: popcomregion5@yahoo.com

RHU Virac and Religious sect conducts MBD

by Joselle C. Magtagñob RHU Virac, Catanduanes

A single drop of blood can help sustain and make a change to someone in need.

The Rural Health Unit of Virac in collaboration with the Ang Dating Daan, a religious sector in the community, conducted a Mobile Blood Donation activity last April 10, 2016 at the Ang Dating Daan Coordinating Center located at Barangay Salvacion, Virac, Catanduanes.

The half-day blood letting activity gathered 21 donors. This is now routinely done since it started last July 2015. Most of the donors are members of the sect. It has been their advocacy to help save lives through blood donation.

Dr. Elva M. Joson, Municipal Health Officer, and the Rural Health Unit Staff composed of the PHN’s, RHM’s, NDP’s and the Med Tech’s assisted during the event. Some of the Rural Health Physicians and Medical Technologists provided services.

ADVOCACY TO HELP. A member of Ang Dating Daan donates blood during the mobile blood donation.

www.facebook.com/OfficialDOHgov

Salud Bikolnon I April - June 2016

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A passage to

Manhood

by Jeric V. Gianan, RN Russel Joy. V. Pitajen, RN RHU Virac, Catanduanes

‘Tuli’ is a Filipino rite of male circumcision. It has a long historical tradition and considered a rite of passage to manhood.

Boys who have not undergone the ritual are labelled ‘supot’ and face ridicule from their peers. Nowadays, more affluent parents opt to have their children circumcised as neonates at a hospital, but majority still prefer their sons undergo the tradition at around 5-7 years of age. Boys of the same age group would either go to governmentsponsored missions, hospitals, or to local circumciser every summer.

At least 230 boys ages 9-17 availed the free circumcision as part of the annual program of the municipal government of Virac dubbed as “Summer Operation Tuli” at the Rural Health Unit of Virac, Catanduanes from April 5, 2016 to May 13, 2016 on Monday, Tuesday and Friday afternoons.

There would have been more boys circumcised, however, some had backed out from the queue, obviously due to fear

OF BEING A MAN. The RHU team conducts an operation during the free circumcision.

of pain. Others cried silently, some bit their lips in pain and still most of them covered their eyes with their shorts but had themselves circumcised just the same.

There were few who braved the pain and appeared relaxed.

Newly circumcised boys usually wore house dresses or loose skirts to help in the healing.

The swelling might occur during this period termed “pangangamatis” (literally “becoming like a tomato”, kamatis) owing to the reddish appearance of the penis.

Free medicines (antibiotics and pain reliever) were given to patients who went thru circumcision. They were advised on proper care of post-operation wound and how to take their medications. They were also scheduled for their follow-up checkups.

Circumcision is a matter of family tradition, personal hygiene, preventive health care and religion. The benefits of it outweigh the risks, include easier hygiene, decreased risk of urinary tract infections and sexually transmitted infections, prevention of penile problems and decreased risk of penile cancer.

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Salud Bikolnon I April - June 2016

Annual Buntis Congress to reduce maternal death

by Princess Neah A.Talan Marie Gail V. Molina RHU Virac, Catanduanes

While motherhood is often a positive experience, for many women it is associated with suffering, ill-health and even death. There is an increasing number of women dying from pregnancyrelated complications which the public and the government must give serious attention to.

On May 20, 2016, the Rural Health Unit of Virac in collaboration with the Local Government Unit held its 5th Buntis Congress at the Provincial Capitol Dome with the theme LIGTAS ANG MAY ALAM: “Si Nanay ay turuan upang komplikasyon ay maiwasan. Si Baby ay alagaan para kalusugan ay makamtan.”

The annual event seeks to reduce the number of maternal death, neonatal and infant mortality, teenage pregnancy, halt HIV/AIDS or sexually transmitted infection

Jocelyn Quinones, Municipal Nutrition Officer, explains the advantages of exclusive breastfeeding and proper nutrition for pregnant women.

and provide education to future moms. It highlighted the do’s and don’ts of pre and post pregnancy. Ninety pregnant mothers, mostly teen moms, first time moms, multigravida and high risk pregnancy, were present and benefitted from the activity.

RHU Public Health Nurse and MNCHN Coordinator Anne Torno graced the event with a stimulating message and acknowledgement of participants and guests, followed by a short film presentation on the different services offered by the RHU. After the program, participants went to different booths that cater different health services for the pregnant moms and their future child. These health booths were put up for: PhilHealth, newborn hearing and screening, free laboratory services (hemoglobin, blood typing and urine examination), dental health, micronutrient supplementation, nutrition, vaccination, OB-Gyne and family planning. Pregnant

Participants, mostly teens and first-time moms, are all ears during the opening program of the 5th Buntis Congress of Virac, Catanduanes.

participants were given health information

healthcare solutions to prevent or manage

by assigned rural health midwives and

complications are well known. It was a

nurses at every booth. A message from Dr.

fulfilling and rewarding occasion knowing

Elva M. Joson, the Municipal Health Officer

that by doing this annual event, lives can

of Virac marked the closing of the event.

be saved.

Most maternal deaths are avoidable, as the

Salud Bikolnon I April - June 2016

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Health Events

(top left) Red balloons released as a commemoration of those who died from AIDS. (top right) Actors of Sining Banwa, a local theatrical group, portray the life of being HIV positive. (bottom left) Regional Director Dr. Napoleon L. Arevalo explains the misconceptions and stigma of HIV. (bottom right) An officer of the Bureau of Jail Mangement and Penology clarifies how HIV is transmitted.

HIV/AIDS: Advocacy thru the Stage

“Gym Gurls”, a play staged by Sining Banwa, raised awareness on HIV prevention and removing stigma from People Living with Human Immunodeficiency Virus (PLHIV) during the celebration of the 33rd International AIDS Candlelight Memorial on May 19, 2016 at the Department of Health Regional Office V, Legazpi City.

The play depicted the lives PLHIV and gave light on the issues they faced. It also encouraged people at high risk of the infection to get tested and know their HIV status.

transfusion of infected blood, sharing of hypodermic needles and sexual contact. The virus is found in body fluids (blood, semen, vaginal fluid, and breast milk) of an infected individual.

In Bicol region, there are 408 HIV cases recorded from 1984 to March 2016.

By province, data showed that Camarines Sur has the highest number with 148 cases, Albay-124, Sorsogon-54, Masbate-38, Camarines Norte-28, Catanduanes-15, and one undisclosed case.

“A person is high risk of HIV when he/she is engaged in risky behaviors like unsafe sex, multiple partners, and drugs,” explained Lilian Rose Contessa Encisa, HIV coordinator.

HIV is a virus that gradually attacks the immune system. Advance cases lead to acquired immunodeficiency syndrome (AIDS) which makes a patient more vulnerable to infections and diseases.

HIV/AIDS is transmitted through blood

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Salud Bikolnon I April - June 2016

To prevent HIV, DOH advocates the ABCDE campaign. This is an acronym for abstinence, being faithful to your partner, correct and consistent use of condoms, don’t do drugs and early detection or treatment.

The theatrical play evolved on getting out of the “gym” – encouraging those with HIV to have courage and stop

hiding from society to go on with normal lives. “With early detection and effective anti-retroviral treatment, PLHIV can live a normal healthy life.

They only need to be cautious of their health and have healthy lifestyle,” Ms. Encisa said.

“We encourage those who engage in risky behaviors to know their HIV status. The testing is confidential and free,” said Regional Director Dr. Napoleon L. Arevalo. “Social hygiene clinics are available regionwide through municipal and city health offices.”

The play ends with a meaningful song and a message of ending stigma to PLHIV. “Kalinga, pagmamahal at sama-samang pagkilos ang kailangan sa pagsugpo sa HIV at AIDS.”/ddc

(top left) Lilian Rose Contessa Encisa, HIV coordinator, explains the transmission of HIV. (top center) Dr. Ong gives inputs on TB and its treatment (top right) A participant eagerly reads a pamphlet about TB. (bottom left) Assistant Regional Director Dr. Ernie V. Vera energizes the crowd with his opening message. (bottom center) The hataw team of DOH and Bicol Regional Training and Teaching Hospital leads the dance exercises to start the program. (bottom right) Windalyn Baluis, Healthy Lifestyle Coordinator, empowers the participants to have a healthy living.

DOH Brings TB Caravan to Rapu-Rapu Island

“Continuous medication and healthy lifestyle is the key to prevent tuberculosis,” explains Dr. Alberto Ong Jr., Area Facilitator of the IMPACT (Innovations and Multi-sectoral Partnerships to Achieve Control of TB) Project.

With the theme “Unite to end TB through Healthy lifestyle”, the Department of Health Regional Office V conducted the first TB caravan in the island of Rapu-Rapu, Albay on May 31, 2016.

Tuberculosis is a disease caused by a bacterium called Mycobacterium tuberculosis that is acquired by inhalation of infectious droplets produced by coughing, sneezing, and talking. In Bicol, there were 22,251 cases of TB in 2015 and 10,994 cases as of June 2016. There is an increase of 24% in TB cases in Rapu-Rapu with 61 cases in 2015 and 76 cases as of present.

“TB is not a problem in Rapu-Rapu because there is an allocation of medicines from DOH”, Mayor Ronald Galicia said. “The only problem is the discipline of the patients in finishing the six months to ten months medication.”

It was highlighted in the activity that TB patients should strictly follow the 6-month medication and healthy lifestyle for them to fully recover from the illness. Dr. Ong explained that incorrect use of antimicrobial drugs and treatment interruption can cause Multidrug-resistant TB (MDRTB). “MDR-TB does not respond to the commonly available anti-TB drugs which makes it difficult to treat,” said Dr. Ong. Healthy lifestyle as the key in preventing all sorts of ailment including TB was given emphasis by Windalyn Baluis, Nurse V, in her discussion.

Practicing it can significantly increase the effectiveness of the treatment for TB patients. “We all want to live a long happy life, but that will be hard to achieve if we are sick. So let’s eat right, don’t smoke, avoid drinking alcohol, be stress free and have a regular exercise to stay healthy and fit,” Baluis added.

The prevention of Human Immunodeficiency Virus (HIV) was also given priority in the discussion of Lilian Rose Contessa Encisa, HIV coordinator.

“The co-infection of TB and HIV is fatal,” Encisa explained. HIV infection has contributed to the increase in the worldwide incidence of TB. According to World Health Organization, TB is the most common opportunistic infection affecting people with HIV and it remains the most common cause of death in patients with Acquired Immunodeficiency Syndrome (AIDS).

TB is curable and the treatment of which is free. It is advised that once symptoms appear one should seek for treatment immediately. The symptoms of TB may include a cough that lasts 2 weeks or longer, coughing up blood or phlegm, weakness or feeling very tired, sudden weight loss, loss of appetite night sweats and low grade fever./ddc

Salud Bikolnon I April - June 2016

13

The Cover

TSeKaP sets to uplift

Health Service

EMPOWER. (left) Health Secretary Janette L. Garin empowers health workers with her message on the DOH effort in scaling up health services in the country. (right) Representatives of Del Gallego Rural Health Unit gladly receives the TSeKaP package as turned over by Regional Director Dr. Napoleon L. Arevalo .

A step closer to Universal Health Care (UHC). The distribution of TSeKaP (Tamang Serbisyo para sa Kalusugan ng Pamilya) equipment packages aimed to increase the efficiency and effectiveness of health service delivery in the region.

The Department of Health Regional

the country”.

Office V distributed a total of 1,224 TSeKaP equipment packages to Rural Health Units, Urban Health Centers and Barangay Health Stations of Bicol region.

This is through turn over

ceremonies across six provinces last April 21-22, 2016.

“Distributing the TSeKap equipment packages to LGUs is granting ease of access to all Filipinos of their basic

Pamilyang

“This will equip our frontliners in health who play a vital role in bringing health services down to our grassroots ”.

health needs,” Health Secretary Janette Garin stated during her message last April 21, 2016 at the Divine Word College Gymnasium, Legazpi City.

“This will help us in achieving UHC in

especially to PhilHealth and Pantawid Pilipino

Program

(4Ps)

beneficiaries. Secretary Garin also said that this will also help RHUs get accredited by PhilHealth.

The turn over activities were well attended and even exceeded their target number of participants. During the all

succession were

eager

of to

the

program,

receive

their

respective package which contained (2) non-contact thermometers, (1)

This endeavor shall equip LGUs with essential medical equipment for them to efficiently cater basic health services

stethoscope, (1) digital BP apparatus, (1) glucometer set (blood sugar monitor), (1) dressing set (for sterile wound care), and (2) nebulizers for turn to next page

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Salud Bikolnon I April - June 2016

TSeKap PACKAGE. (left) A group of nurses assist in checking the apparatus contained in each package. (right) Each set contains (2) non-contact thermometers, (1) stethoscope, (1) digital BP apparatus, (1) glucometer set, (1) dressing set and (2) nebulizers.

asthma relief.

With these new set

of apparatus, health workers will be able to monitor the health of their constituents and will enable them to respond to illnesses like diabetes, high blood and asthma at their level.

This initiative of DOH will help improve the health status in the region especially to those living in far-flung areas where health care is sometimes inaccessible.

“Providing equipment to RHUs down to the Barangay Health stations is a good strategy in improving our health service.”

DOH Regional Director Dr.

Napoleon L. Arevalo said during the

GLAD. Participants smile when RD Arevalo revealed the good news during the turn over ceremony at the Sorsogon Provincial Gymnasium, Sorsogon City.

turn over ceremony at the Sorsogon public health”.

Present during the activity were

“This will equip our frontliners in

Local chief executives and health

health, especially the Barangay Health

Barangay

workers acknowledged this endeavor

Workers

Nutrition

Kagawad for Healh, and Barangay

of DOH. “We are grateful that DOH

Scholars, who play a vital role in

Health

took this initiative, everyone will

bringing health services down to our

recipient. The six provinces received

benefit from this especially those who

grassroots”, RD Arevalo said. “Without

the following number of packages:

live in hard to reach areas. Now, they

the spirit of commitment and passion

Albay – 207 packages, Camarines

will be able to access health services

to public service of our health workers,

Sur – 378 packages, Camarines Norte

like monitoring their blood pressure or

our strategies will not be that efficient

– 132 packages, Catanduanes – 71

sugar level at their barangay health

and will not reach those who are in

packages, Masbate – 236 packages,

station,”

need.

and Sorsogon – 200 packages. /ddc

Provincial Health Officer of Albay, said

City Gymnasium last April 22, 2016.

and

Barangay

So we take this opportunity

to thank them for their dedication to

Dr.

Municipal/City Councilors for health,

Nathaniel

Rempillo,

Captain Worker

or

from

Barangay each

BHS

during a media interview.

Salud Bikolnon I April - June 2016

15

Give Extra Care to your

KIDNEYS

Filipinos love using condiments like soy sauce, “patis” and “bagoong” to add extra punch to their meal but, now, it’s time to limit that habit.

Health Secretary Janette Loreto-Garin stated in a press release that one way to prevent kidney-related diseases is by limiting salt intake. Part of the campaign for the National Kidney Month this June is to stress not only the curative side but also the importance of kidney care to prevent renal diseases which may lead to kidney failure.

The incidence of renal diseases has steadily gone up in the Philippines.

Around 14,000 Filipinos die of renal diseases yearly. In 2014, 15,983 Filipinos were registered on dialysis and 470 Filipinos had kidney transplant in 2015. In 2013, the prevalence rate of kidney disease in Bicol region is 365 per 100,000 and it recorded 787 deaths.

A participant shares her experience in dealing with chronic disease and asks about how family members and carers help a patient cope with the disease.

Congress on Renal Disease Control Program (REDCOP) on July 15-16, 2016 at Hotel Venezia, Legazpi City. It aimed at intensifying REDCOP in the

Chronic kidney diseases (CKD) can

region by educating medical and non-

be treated. With early diagnosis and

medical representatives of public and

treatment, it’s possible to slow or stop

private health units, hospitals, health

the progression of kidney disease but

workers and academe.

most of the diagnosed patients found out too late.

we

Prevention is better

Yaman at Buhay Ko”, the Department of Health Regional Office V through the Non-communicable Disease Prevention Control

conducted

the

Program 1st

practice

healthy

living”,

said

Regional Director Dr. Napoleon L.

With the theme, “Malusog na Bato,

and

“Kidney disease is preventable when

Public

(NCDPC) Health

Arevalo in an interview. “Despite of it being preventable, it is 9th among the top cause of death in the country and it ranked 6th in Bicol. This means there is a need for more extensive information drive for the public to understand the importance of their kidneys and how to

prevent renal diseases.”

The congress was divided into two batches with the first day focused on the basics of REDCOP for the nonmedical participants while the second day

imparted

topics

concerning

medical practitioners.

“The early stages of renal disease or what we call stage one has no symptoms.

By the time someone

experiences

fever,

swelling,

red

cloudy foul smelling urine, painful urination, abdominal pain, back pain and

frequent/infrequent

urination,

the disease is already progressive,” explains Dr. Susan Losaria-Jorge of the National Kidney Transplant Institute turn to next page

16

Salud Bikolnon I April - June 2016

(right) Participants from the academe and Barangay Health Workers listen attentively while taking notes from the lecture during the congress. (right) Ms. Windalyn Baluis, Nurse V and Healthy Lifestyle Program Coordinator, gives pointers on the prevention of kidney diseases by practicing healthy lifestyle.

(NKTI).

Dr. Jorge gave emphasis that we should watch what we eat and be health conscious.

load to the kidneys and heart disease.

the long run, this might lead to CKD

It is recommended to have regular

and eventually to End Stage Renal

urinalysis checkups.

Disease (ESRD) where the only means to survive is through regular dialysis or

“To prevent renal

“In preventing this disease, we should

diseases we should drink enough

have a total lifestyle modification. Once

water daily, eat healthily by avoiding

we are afflicted with renal disease, it

Other co-morbidities include arthritis,

too salty food and processed food,

will be irreversible. So, watch what

liver

exercise regularly, avoid smoking and

you eat,” added Balderama.

alcohol, and practice good hygiene,” she added.

Ms.

Socorro

Balderama,

NKTI

Nutritionist, gave advices on how to prevent kidney diseases.

“We

should always watch what we eat and consume a balanced and a variety of food to meet your daily nutritional requirements,” Balderama said.

It is advised to drink 8-10 glasses of water everyday and avoid excessive intake of protein, salt and high cholesterol foods.

We should also

avoid exposure to various chemicals as these can injure your kidney cells and be aware that prolonged use of certain drugs can be harmful to the kidneys too.

Large consumption of

alcohol may cause fatty liver, additional

kidney transplant.

problem,

heart

conditions,

turn to page 19

Co-morbid conditions A person is more at risk of kidney disease when he has a family history of diabetes and hypertension.

Dr.

Jorge in her discussion on the disease prevalence said, “Diabetes is the lead cause of chronic kidney disease (CKD) and renal failure followed by

Dr. Susan Jorge of NKTI highlights the prevention of renal diseases adding that once symptoms are present the disease is already progressive.

hypertension based on the Philippine Renal Disease Registry”.

Hypertension and diabetes disrupt the

functions

of

our

kidneys.

Prolonged high blood pressure causes a degeneration of the small artery in the kidneys.

Diabetes

impairs

efficiency

because

renal of

its

medication and blood sugar that adds load to the kidney. In

Salud Bikolnon I April - June 2016

17

DOH Bicol rolls out

RPRH Forum

The Department of Health Regional Office V concluded its series of dissemination forum on Responsible Parenthood and Reproductive Health (RPRH) across Bicol on April 6, 2016 in Naga City. The event aimed at strengthening the implementation of RPRH law and women’s health.

The forum was designed to provide information on the basics and elements of RPRH Act of 2012 or Republic Act 10354. It also gave light on the misconceptions of the law and intend to break the barriers to its full implementation.

“The DOH conducted these series of information drive to create more awareness and provide guidance to stakeholders, national and local government agencies, and other organizations providing reproductive health services with the provisions

of the law,” said Dr. Rita Mae Ang, Medical Officer IV. “RPRH mandates the universal provision of reproductive health services as a means to improve maternal health”.

Dave Isidore Plopinio, Nurse V, highligted the Family Planning Informed Choice and Volunteerism (FB-ICV) program of DOH to ensure the support of the participants by making them aware of the program.

“Clients are provided with complete and accurate information during counselling. They are the ones to

decide which FP method they will use”, he said.

Among the issues clarified during the forum was the involvement of other agencies on the full implementation of RPRH and adolescent health program.

“These programs needs multi-sectoral effort to fully establish its mandates,” said Ms. Tricia Barozo, Nurse V and Adolescent Health Program Coordinator. “The local government units, private organizations and national government agencies should work hand and hand with DOH for us to realize the benefits of the law.”

Dr. Ang further explained that conducting the forum intends to gain support from stakeholders and generate demand for RPRH services and commodities among the population. This will soon improve the quality of life of Bicolanos and eradicate maternal and child death in the region.

The DOH through the Family Health Cluster also conducted dissemination fora to the provinces of Albay, Catanduanes, Sorsogon, Masbate and Camarines Norte. Participants mainly composed of provincial health officers, municipal health officers, nurses, midwives, and media partners.

EMPOWER RPRH. (top) DOH Regional Director Dr. Napoleon L. Arevalo delivers his opening remarks during the forum in Sorsogon City. (above) Dr. Rita Mae Ang explains the basics of RPRH law to the participants in Naga City.

18

Salud Bikolnon I April - June 2016

In the Philippines, many mothers die due to pregnancy and childbirth primarily because of the inaccessibility of maternal health care services.

RPRH law guarantees the protection of maternal and child health and ensuring the reproductive health of Filipinos./ddc

from page 17

lung pathology, history of taking pain relievers, history of urinary tract infection, kidney stones and tuberculosis.

Dealing with CKD Unique to the congress was the discussion

of

Dr.

Angelli

Morico,

Psychiatrist Consultant of Bicol Regional Teaching and Training Hospital, on how to deal with the diagnosis of CKD. Dr. Morico stressed that there is no health without mental health. “Caring for the mental health of the patient and carers is as important as the caring for the physical state of the patient for there is a psychological unease of the diagnosis of CKD”, Dr. Morico emphasized.

Fear, anxiety and anger are common emotions

when

one

has

been

diagnosed with a chronic disease like CKD. “When we face these kinds of situation we should inject positive insights.

Everyone will soon face

death and so we should take this as an opportunity to journey back into our lives and see what we have been doing wrong. This is also an opportunity to make your life better by doing what you can still do and improve your life eventually,” added Dr. Morico.

Ms. Windalyn Baluis, DOH RO V Nurse V, highlighted the importance of integrating healthy lifestyle at the end of the congress. “We strongly advocate the practice of healthy lifestyle for us to prevent all these diseases. Healthy lifestyle is a choice. Let’s choose to be healthy,” Baluis said.

Now, when you are eating a hearty meal and you have that urge to reach for that “patis”, think again./ddc

Salud Bikolnon I April - June 2016

19

Health Advisory

GHW Law: FULL BLAST this NOVEMBER The Department of Health (DOH) together with the World Health Organization (WHO) and other antitobacco partners come together annually on the 31st of May to celebrate World No Tobacco Day while the whole month of June is observed as the National No Smoking Month for the country.

This year’s theme for World No

we will not waste that. Aside from the

recommend

Tobacco Day is “Getting ready for

Sin Tax Reform law, we believe the

implementing plain packaging. Since

plain packaging.” Plain (standardized)

Graphic Health Warning Law (GHW)

March this year, in line with the release

packaging of tobacco products refers

will be of great help especially in

of the Graphic Health Warnings (GHW)

to a measure that restricts the use

reminding Filipinos not to engage

implementing rules and regulations,

of logos, colors, brand images or

in smoking and to those who are

all tobacco products manufactured or

promotional information on packaging.

smoking, to eventually quit. This year,

imported for sale in the Philippines

Under plain packaging, health warnings

World No Tobacco Day reminds us to

are required to carry graphic health

would continue to appear, but the brand

go full blast in implementing GHW

warnings on the lower portion of a

portion of the package would have the

Law and that by November 4, 2016,

cigarette pack, in at least 50 percent of

same color for all brands. The brand

the public should see graphic health

both sides of the pack.

name would be allowed on packages,

warnings in all cigarette packs.” Health

but only in a standard location, color,

Secretary Janette P. Loreto-Garin said.

font style, and size.

parties

consider

On the other hand, National No Smoking Month is observed every June

Under the Framework Convention

as per Proclamation No. 183 s. 1993.

historical

on Tobacco Control, to which the

This year, DOH focuses to inform the

milestone from our strong efforts to

Philippines is a signatory, both the

youth on the ill effects of smoking

control tobacco use in the country and

Article 11 and the Article 13 guidelines

and discourage them from starting to

“We

have

achieved

a

smoke.

20

that

Salud Bikolnon I April - June 2016

turn to next page

“The problem is that youth today think that smoking is a cool hobby. They either see adults smoke or are pressured or influenced by their friends. If we cut the source or constantly emphasize to them the danger of smoking as we do in the GHW of cigarette packs, will not start smoking at all.” said Garin The health chief added that currently, there is an existing law

Republic

Act 9211 or the Tobacco Regulation Act of 2003 which provides that tobacco products could not be sold or distributed within 100 meters from the school perimeter, as well as near public playgrounds or any other facility that minors frequently go to. It is also good news for the the department that the incoming administration fully supports the total ban of smoking in the country as it would strengthen the implementation of the law and stop the youth of being tempted of starting the habit.

Based on the 2015 Global Youth Tobacco Survey, overall current smokers among students of age group 13-15 years increased to 12% from 8.0% in 2011.

Luzon has the highest proportion of smokers at 16.2% followed by Visayas at 12.9% and Mindanao at 11.5% among the youth population in the country. Furthermore, 73% of the respondents said they saw anyone smoking within school premises.

“Walang

maidudulot

na

mabuti

ang paninigarilyo. Una, alamin ang mga sakit na makukuha mula sa paninigarilyo. Ikalawa, unawain nating mabuti kung ano ang mga masasamang epekto nito sa ating katawan. At ang pinakamahalaga, bantayan na ang mga pakete ay may GHW sa November 4.” Garin concluded./Press Release

Salud Bikolnon I April - June 2016

21

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Salud Bikolnon I April - June 2016

What Makes You a

“Wina”?

By Ailene Bitancor Magdamit Provincial DOH Office Sorsogon

For someone who has been through a lot of adversities, she is definitely a winner.

“How are you?” she asked me. I responded

very optimistic. She may have a little

and eventually gave her the opportunity

with a smile.

‘shortcoming’ but it did not stop her from

to join a seminary school. Wina’s desire

doing the things she is passionate about.

for proper education was heard and given

It was a sunny Tuesday afternoon and Wina is busy cleaning up the dining area.

“Mama was sick that time so we would

Good thing, her busy schedule permits my

usually stay in the hospital. That is why I

interview. Her jet-black hair, that makes her

dreamed of becoming a doctor. I knew that

look younger than her age, shines perfectly

my parents can’t afford to send me to that

as she moves. She smiles a lot— radiating

course since it is costly. What I did was I

her inner jolly kid and vibrancy. She looks

studied really hard and I did not do things

very happy.

that will not be beneficial to my studies,”

Edwina “Wina” Berdin-Corañez, 53 years

After receiving honors

two (2), a wife to Alfredo S. Corañez, grew

in

up in Lipata, Bucalbucalan, in the humble

Elementary School,

province of Sorsogon. Having been blessed

young

with a height shorter than four (4) feet, she

needed to stretch

grew up the less superficial way.

up a bit and

I’m different because I was way shorter than them. I would cry because they would tell me that I will not be able to achieve my goals, but I told them that even though I

Bucalbucalan Wina

never an easy road for her. Facing all the bullies in school was a major challenge for Wina, not to mention the critics and foes in her community. But no, she stayed

turn to next page

SERVICE WITH A HEART. Edwina Corañes, Barangay Health Worker of Bucalbucalan, Sorsogon City for 36 years, devotedly performs her duty to her patient.

financial needs.

pursuit to

to check her condition. And yes, it was

(TESDA) for a vocational electronic course.

meet their

can never do.,” says Wina.

were not able to send her to a specialist

Education and Skills Develpoment Authority

her parents

W i n a ’ s

suffice for their essential needs, they

graduating, she enrolled herself to Technical

work to help

am just this short, I can do things that they

Because her parents’ earnings would only

After successfully

she said.

old, Barangay Health Worker, a mother of

“When I was little, they would tell me that

a justifiable reward.

study w

a

s

temporarily stopped.

She became active in church activities where she was offered to join their choir

Salud Bikolnon I April - June 2016

23

Years after, she involved herself in different community service activities as a volunteer worker. Little did she know that her dream to be in the service of healthcare for the community is about to unfold.

“We went to the Health Center for a checkup and then the midwife asked if I know a particular patient in our community. She asked me to go there and see how the patient is doing; I did not know that she was planning to train me. That’s is when it all started.”

After attending various trainings, seminars and workshops, Wina learned a lot. She finally found her first love; helping people (above) Wina’s simple house stands in Bucalbucalan, Sorsogon City.

She lives with her husband, Alfredo (left) , together with her daughter (right) and grandsons.

in terms of health and wellness and guiding them to live a better life. The lessons she acquired from those lectures made her more prepared in ensuring everyone in her community the proper knowledge about health and medications.

One thing which makes her one of the most loved Barangay Health Workers (BHW) is her sincerity to facilitate things for the people, even to the point that she would spend for their hospital bills. There were times when it would cost her extra sweat to serve, but she did not give up. Her time and energy were compromised but she did not mind for the sake of others who look up to her strength and courage.

“DOH has contributed a lot in my BHW experience. I am very dedicated most

Through years of dedicated service and

especially when I see my people get well

commitment to her craft, Wina’s sincere

and feel better. My constituents know that I

effort was recognized paving her way to

am here whenever they need me, I will do

multiple recognitions and awards from

my very best to help.”

prestigious award-giving bodies in the Department of Health (DOH). But above it all, the happiness that she gives to people and the emotional incentives that she receives are what she considers for keeps.

more than a wife, a mother, a BHW and a health servant, she’s beyond labels.

“Dae akong pinagsisishan ta maski ako saday sana, padaba ako kan kapwa ko.

Ini dahil bako sana ako nagtatrabaho para sa DOH pero isinasabuhay ko talaga ang

Sharing her healthcare knowledge since

mga pig-gigibo ko. Kaya dae ka matakot

1980, Wina has been a household name

kung pigmamaliit ka ninda ngunyan, basta

in her community. Serving the needy from

aram mong tama ang pig-gigibo mo, may

left to right, she never gets tired, yet she

papadumanan ka na ikakaogma ning

is becoming more motivated. Indeed, she’s turn to next page

24

Salud Bikolnon I April - June 2016

puso mo, ang sakuya ay ang pagsirbi sa kapwa sa pmamagitan kan DOH (I do not regret anything because even though I am undersized, the people loves me. This is because I do not just work for DOH but I live with what I do. So, do not be afraid if some people belittle you now, as long as you know that you are doing the right thing, there’s always something that awaits you—something that will make your heart genuinely happy. Mine is serving through DOH.)” She may be unsuccessful in her childhood dream of becoming a doctor; but still, she was given the opportunity to wear a DOH-BHW uniform. She may not have a Baccalaureate degree for now; still, she is able to serve the people.

Wina is a living testimony that height and/ or status could not stop one from dreaming and making those goals materialize. She never fails to inspire and amaze people.

Her accomplishments are indeed greater than her height. The goodness of her heart is extremely above 4 feet. She never runs out of ways to help and has limitless venues to spread cheer and tender care.

Her arms are extended enough to reach those in need. Her legs are long enough to lead. She’s tall enough to help but not high enough to ignore, and these traits are what makes her a champion in life.

Yes, indeed, her name is interchangeable to the noun ‘winner’ because for someone who has been through a lot of adversities, she is definitely one.

How about you, are you at par?

What makes you a “Wina” (winner)?

Salud Bikolnon I April - June 2016

25

Insights WHAT IS THE IMPACT OF TSeKaP?

We asked health workers on what they think is the impact of the TSEKAP (Tamang Serbisyo para sa Kalusugan ng Pamilya) equipment package distribution to the community.

“Ang magiging impact nito, lalo na sa mga barangay, mas mapapadali ang pagdiagnose sa mga taong may hypertension at diabetes. Alam naman natin na halos lahat ng na-oospital ay huli na nilang nalalaman na meron silang sakit. With this TSeKaP kit, sa barangay pa lang malalaman na kung meron silang ganoong sakit. Mapapadali pa nito ang implementation ng high impact five natin.”

Dr. Edgar Garcia Sorsogon Provincial Health Officer Sorsogon

“Para sa akin, mas mapapadali ang pag monitor natin sa ating kalusugan. Sa pamamagitan lang ng pagbisita sa barangay health station malalaman mong mataas ang blood sugar mo o di kaya’y hypertensive ka. Dito na rin papasok ang intervention ng DOH sa pagbibigay ng libreng gamot. Ito ang tinatawag natin na 4 molecules kung saan libreng makaka-avail ng gamot sa hypertension at diabetes sa rural health units.”

Donna Benitez Health Facility Enhancement Program Nurse DOH RO V

“Malaking tulong itong Tsekap package sa aming barangay lalo na sa mga hypertensive at diabetic. Doon sa amin, marami kaming activities na isinasagawa para sa health na mas nagiging informed ang aming kabarangay. Ang isang problema lang namin ay pag nauubusan na ng gamot.”

Nancy Jaromamay Barangay Health Worker Sorsogon City

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Salud Bikolnon I April - June 2016

“Mas mag-iimprove ang quality health care services sa ating Local Government Units at lalo na sa mga barangay. Mas magkakaroon ng access ang mga tao sa health care na eventually mag-iimprove ng quality of life.”

Darwin R. Enriola Nurse Deployment Program Sorsogon

Comedy Cure DISREGARDED

BUSINESS AS USUAL

PROMDI

Pumasok ang isang pasyente sa klinika.

JUAN: Ikaw na naman? 3 beses mo na kong naholdup ngayong taon ah!

Pumunta si Pedro sa Manila at nag check-in sa hotel.

PASYENTE: Dok, tulungan nyo po ako. Pakiramdam ko, binabalewala ako ng mga tao!

DOKTOR: Next!

KAMBAL DOCTOR: Misis, kambal ang anak mo, ang sister mo ang nagpangalan!

MARIA: Naku! Weirdo yun, ano po ipinangalan?

HOLDAPER: Ganun talaga business, inaalagaan ang good customer!

PIZZA Nag-order si Juan ng isang buong pizza.

CLERK: Sir, ilang slice po ang gagawin namin sa pizza nyo,6 or 8?

JUAN: 6 lang, baka hindi ko maubos ang 8!

ROOMBOY: Sir, nasa elevator pa lang tayo!

JOSE RIZAL TITSER: Mario, kilala mo ba si Jose Rizal?

MARIO: Hindi po, Mam.

DOCTOR: Sa girl, DENICE!

BIRTHDAY NG KAMBAL

MARIA: Ok yun, eh sa boy?

PEDRO: Pare,wag mong kalimutan na may handaan sa bahay bukas!

Birthday kasi ng inaanak mong KAMBAL!

DOC: DENEPHEW!

PEDRO: Promdi ako pero di ako tanga! Bakit ganito lang ang kwarto ko, maliit na nga, wala pang kama at bintana? Ang mahal pa ng binayad ko!

JUAN: Wow, talaga? kanilang dalawa?

Sino

sa

TITSER: Greg, kilala mo ba si Jose Rizal?

GREG: Hindi rin po, Mam. TITSER: Wala ba sa inyo ang nakakikilala kay Jose Rizal?

STUDENT: Mam, baka kabilang section siya.

nasa

Salud Bikolnon I April - June 2016

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Salud Bikolnon I April - June 2016

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