Qualitative Research and Respondents Essay

1.1. Introduction Leptospirosis is one of the deadliest bacterial infection that I commonly acquired in tropical countries. you can get the disease when you were exposed to soils and waters that is contaminated by leptospira bacteria. Rodents such as rats are the primary carriers of the leptospirosis bacteria. It is important to identify the signs of rodent infestation at home. If you regularly see rodent droppings around food packages, in drawers, cupboards, under the sink, then your house is infested. Whenever you see such droppings or boxes of food, or wirings that has rodent bites, you must take an action. Symptoms can take 2 – 26 days (average 10 days) to develop this may include: dry cough, fever, headache, muscle pain, nausea, vomiting, and diarrhea, shaking chills, less common symptoms include: abdominal pain, abnormal lung sounds, bone pain, conjunctivitis, enlarged lymph glands, enlarged spleen or liver, joint aches, muscle rigidity, muscle tenderness, skin rash and sore throat. (Dugdale III, 2010) Test to be done to find if you contract leptospirosis are the following: CBC (Complete blood count), creatine kinase, urinalysis. Medications are given to the patient but complicated cases however are life-threatening if not treated promptly. The fatality rate of the disease is 5-40. (Dugdale III, 2010) Here in the Philippines one of the most common cause of leptospirosis is flood water. Leptospirosis cases goes up in the rainy period. In Metro Manila, improper disposal of our wastes such as plastics, domestic wastes, and others blocks the water pass on the sink or to the drainage system. This causes floods even in just a small amount of rain. And garbage attracts rodents that carry a letpospira bacteria and it contaminates the flood water that leads to acquiring the leptospirosis. 1.2. Background of the study Flash floods are common throughout the Philippine archipelago during the monsoon seasons, which runs from the June to December. They are particularly common in Manila, the country’s sprawling capital and home of 14 million Filipino’s. The awareness of the people is very much important especially when flash floods or typhoons occur. Leptospirosis is a bacterial disease which could be contracted by humans when exposed to flood waters containing urine infected animals like rats, dog, and pigs. The leptospirosis cases was caused by the widespread flooding caused by the typhoons that affected the Luzon areas. In Quezon City one barangay, barangay Gulod, has encountered many cases of leptospirosis. Barangay Gulod is located near the Tullahan River and Kaybuktot Creek. The barangay itself is along the Quirino Highway. The barangay is big but because of poor urban development program the drainage system is still a problem during the rainy seasons they have the most number of incidents of leptospirosis cases in the past 3 years. In 2009 the disease, according to the record of Department of Health (DOH) has afflicted more people in Metro Manila, attributing the â€Å"Outbreak† to large numbers of people wading in flood waters carrying the bacteria. The DOH had recorded 1,027 leptospirosis patients, wherein 89 died. There were 122 cases in Quezon City alone with 14 cases in Barangay Gulod. (Quezon City Health Department [QCHD], 2011) In 2010, leptospirosis was noted as the fourth on the list of the top disease outbreaks in the Philippines. The DOH has recorded over 400 leptospirosis cases in the first half of the year (Department of Health [DOH], 2010), which includes 26 deaths with 1 case in Barangay Gulod. (QCHD, 2010) Recently, the Department of Health released an announcement that casualties from leptospirosis has increased 247% in 10 months (January-October) in Metro Manila with number of 131 cases of Leptospirosis in Quezon City with 5 cases in barangay Gulod. It usually takes two weeks after the infection to manifest flu-like symptoms. If not diagnosed early enough, it can lead to more severe symptom and may cause death. Mild infections can be treated by antibiotics like doxycyline, but for severe infections generally, they require Intravenous Penicillin which is still dangerous because the patient might encounter the Jarisch-Hexheimer reaction. This disease needs prompt medication upon its contraction. (Uy, 2011) 1.3. Theoretical Framework Systems design approach is interconnected, interdependent and interacting problems that seeks to create an action to take the entity as a whole. It implies that we take the responsibility of the whole thing to be able to create future better by understanding the nature and saving the environment by fulfilling its requirement on saving it. (Laszlo & Krippner, 1998). Living in this planet, there are things we need to maintain. The Systems Design is said that it is interconnected and interacting problems. Meaning every problem we do, creates another one and relates to another, everything is a chain from small to the biggest. Just like what is happening here in the Philippines right now the people who throws their trash everywhere creates a bigger problem. Systems Design is participatory by nature (Bethany, 1996), meaning everyone from the society can make a change on how the problem will be solved by making small steps on providing a remedy on their problems. They can engage themselves by becoming an active participant on change and they can be more resourceful. Bela Bethany (1996), a Systems Theorist characterized the systems design focusing the humanities to be, experience oriented, rational, neutral, and it has concerns on future generations . (Banathy, 1996, pp. 34-35.) Here in the Philippines we believe that systems design by being participatory makes people move on their own on the time of calamities. Disasters are made by simple forms of action. Nowadays when it rained a little it floods the city and that would make people alarmed and take actions. And by that they will learn from their mistakes and try to solve their problem as a â€Å"system† and functioning as one. Because being in a societal systems human beings actively apply their skills to the analysis of the design of socially and ecologically sustainable systems by becoming active participants of their community on shaping their future. (Laszlo & Krippner, 1998) 1.4. Conceptual Framework This part of the paper will serve as a guide to study systems approach of the input-process-output devised by Stoner, Freeman and Gilbert Jr. (1995). The system has flows of information, materials and energy, including human energy that enter as an inputs then transform the processes on the system and exit as an output. A feedback is considered as a key to systems controls . Leptospirosis prevention on barangays are being followed in the subject matter. The following protocols followed by the local government is preventing leptospirosis: â€Å"Policy-Making† it refers to the concept of operation and the tasks for execution of the organization’s programs by the respective staffs and officers, ths directs the functions and responsibilities of the personnel to strict guidance and compliance. (Leveriza, 1983) â€Å"Access† it is the portal of each citizen to the city government on the services of the city government. On every projects and information about the services they need. This would let them have the power to know and accumulate certain information. (Dr. Cruz, Personal Communication, 2011) â€Å"Social Participation† is the extent of the participation of the people in both formal or informal group activities. (Leveriza, 1983) These inputs undergo the process of assessment to determine whether the existing policy and procedures being implemented by each of the subject government institutions are sufficient to protect the network resources from any unlawful acts, as well as identify problems in relation the said review of the prevention of leptospirosis cases on the barangays. (Stoner et al., 1995) The dynamic process in the framework shall contribute, as output, to a significant improvement of the review of leptospirosis cases, including the measures that should be adopted by each respondent government agency. Given the foregoing system’s model, the research paradigm of the study id presented in Figure below for a clearer understanding and appreciation.   Selected Government Institutions.City Health Government-Policy procedures-Access-Society Awareness| | Analysis of-Leptospirosis cases in Barangay Gulod, Quezon City. | | A significant review of Leptospirosis prevention on the barangays.| FEEDBACK Research paradigm As shown in paradigm, the input variables include the profile of the network of subject government institution. It is the city health department of the Quezon city is the department of the city from which the programs and developments are made while encountering this leptospirosis cases. 1.5. Scope and Limitations This study would focus more of Leptospirosis cases in Barangay Gulod, Quezon City from the year 2009 – 2011 who had recorded the most of the cases of the said disease for the past 3 years. This would include the citizens of the barangay in all age groups. We would also investigate the programs (if any) implemented to prevent the Leptospirosis cases in the Barangay before, during and after the floods, and the projects aimed at eliminating the floods and rats that caused the disease. 1.6. Statement of the Problem This study would like to the answer the following problems about the strategies of the City Government towards the leptospirosis cases encountered in Barangay Gulod Q.C.: 1. What are the efforts made by the City Government before, during and after the typhoon? 2. Are the efforts effective enough? 3. What are the programs and projects implemented on the said Barangay? Does the programs and projects help the citizens of the Barangay? 4. What are the steps of the City Government to empower its people on the time of floods and rains? This study would like to help the barangays and the Quezon City on preventing the leptospirosis cases during the time of typhoons and floods. 1.7. Importance of the Study This study is important to the following: Quezon City Government – to help them on implementing: rules, programs and projects to prevent Leptospirosis on the barangays that is said to have a large scale of Leptospirosis cases. This hopefully would help them on the ideas of the other barangays and cities to prevent and hopefully stop the spread of the disease. Barangay officials – to give them knowledge on the status of the leptospirosis on their barangay. Barangay Citizens – to help them and their families on contracting the disease. 1.8. Definition of Terms 1. Afflicted – being troubled with pains. 2. Ceftriaxone Injection- injection used to treat certain infections caused by gonorrhea (a sexually transmitted disease) and infections of lungs, ears, skin, urinary tract, blood, bones joints and abdomen. It is also given to some types of surgery to prevent the development of another disease after the operation. 3. Chemoprohylaxis – use of a chemical agent to prevent a development of disease. 4. Creatine Kinase – The mitochondrial creatine kinase (CKm) is present in the mitochondrial intermembrane space, where it produces phosphocreatine (PCr) from mitochondrially-generated ATP and creatine (Cr) imported from the cytosol. 5. Disease – disturbed or abnormal structure or physiological action in the living organism as awhole or in any of its parts. 6. Dopamine – an important neurotransmitter in the brain. 7. Doxycyline – this is used to treat a wide variety of bacterial infections or to treat the trave ler’s diarrhea. It acts by inhibiting the growth of bacteria 8. Fatality – a state of how bad the disease is 9. Flashflood – an event caused by heavy rain   10. Furosemide- this is used to treat high blood pressure. Furosemide reduces fluid accumulation by increasing the elimination of sodium and water through the kidneys. 11. IgM ELISA – is a fast test for a qualitative detection of IgM anti Bodies. 12. IgM leptospira Dipstickâ„ ¢ – is a fast test for a qualitative detection of IgM anti Bodies against Leptospirosis. It is used to determine the leptospirosis cases in Yucatan, Mexico. 13. Input – something put into a system or device as energy into a machine, food into the body, data into a computer, etc. 14. Jarisch-Herxheimer reaction – reaction caused by organisms (bacteria) dying off and releasing toxins into the body faster than the body may comfortably handle it. 15. Meningitis – an inflammation of the meninge, the membranes that covers the brain and spinal cord. 16. Microscopic Agglutination Test (MAT) – a test to determine if you are infected by leptospirosis. 17. Outbreak – a sudden and violent breaking forth; said of passion or of disease affecting large numbers of people. 18. Output – the quantity put out or produced in a specified time 19. Sanitation – making something sterile or clean. 20. Seropositivity – showing positive reaction to a serological or test on blood serum for a disease. 21. Serovars Manilae – sample Vaccines used for Leptospirosis 22. Spirochetes – any of a genus of typically saprophytic bacteria commonly found in water and sewage and characterized by spiral flexible filaments with apparently rotary movements. 23. Thrombocytopenic – relative decrease of platelets in blood. 24. Urinalysis – also known as Routine and Microscopy (R&M), is an array of tests performed on urine, and one of the most common methods of medical diagnosis. 25. Vasodilatation – dilation of blood vessel, as by the action of a nerve drug. 26. Vax-SPIRAL ® – Trivalent AntiLeptospirosis Vaccine for Human use. 27. Zoonotic – a developed individual of a compound animal or of a simple egg CHAPTER 2 REVIEW OF RELATED LITERATURES AND STUDIES This portion of the research gives some additional information that have been made both local and foreign researchers which are in one way of the other related in the research under taken in this study. 2.1. FOREIGN LITERATURES According to www.Leptospirosis.org (2010) a reference archive on the internet for Leptospirosis information, the Leptospirosis bacteria can’t live on saltwater. We cannot get Leptospirosis by taking a bath on a beach. Contaminated fresh waters and flood waters are usually the bacteria carrier. They also said that you can get Leptospirosis by swallowing, swimming with open wounds on contaminated water. It is never air borne. It also said that the bacteria can’t survived by acid, heat, disinfectants, and alkali’s. Thus cooked foods are safe. Everything in your house should be clean most especially if your house is infested by rodents. Doxycycline offers some protection against severe illness and is the best and normal medication to be given in these situations, but it cannot guarantee protection and a mild illness may still occur. Therefore, protection is all we need. We should be aware that the disease is existing and might cause death. According to an Indian heath portal www.aarogya.com gave some guidelines on how to prevent the Leptospirosis infection. The first step is sanitation, of course cleanliness is the first step. Then protect your self with gloves, masks, boots, when going to a water area that might be contaminated by the Leptospirosis. (S. Pallavi, 2008) You should also keep your open wounds from the contaminated water, and also wash your hands after touching an animal. Do not touch rats. Prevention is better than cure. Therefore, we should educate people from the disease, do not let them swim on a possible contaminated fresh water. Get rid of rats and throw your waste properly. Waste management repels rats. The Medicenet.com states some implications or symptoms of the Leptospirosis, he said that at the first phase the patient would experience some flu like symptoms like fever, headaches, muscle pains, cough and colds. Then the redness of the eye would develop on the ninth day. Then it will develop some aching with stiffness of the nerves then some inflammations. This disease is somewhat connected to liver and kidney disease. That would take the disease to another implications. (Cunha, 2009) That is why whenever you experience the first types of symptoms then you should do something about it right away before it’s too late. Vaccines are developed already which are given to some explorers but it is not that advisable for some research are not yet done about the vaccine. According to www.nlm.nih.gov there the procedures to cure Leptospirosis, this would include the intakes of medicine, such as Ampicillin, Ceftriaxone, Doxycyclne, and Penicillin. He said that complicated cases need to be taken care in ICU (intensive care unit). Leptospirosis is curable, but serious and complicated cases maybe life-threatening. There are also other complications that the patient can get in Leptospirosis. There is the Jarisch-Herxheimer reaction is a reaction of the body when the is an intake of Penicillin, there is also Meningitis, and severe bleeding. Therefore, although the Leptospirosis is life threatening there are still hopes that is coming out, there is a vaccine developed in Europe and in Asia that might not stop but at least freeze the Leptospirosis spread. Still prevention is better than the cure. We must manage our surroundings to stop the infestation of the rodents on on our households. And we should learn to clean our environment to stop the flooding. (Dugd ale III, 2010) 2.2. LOCAL LITERATURES Sison, (2009) said that â€Å"the Philippines is facing a serious problem of Leptospirosis. Poor sanitation and the increase of the urban slums along with frequent typhoons and expansion of flooding areas in the country have exacerbated the risk of infection. Leptospires are said the cause of the Weil’s disease in Japan, where it was common in coal miners. Leptospirosis can affect many species of of wild and domestic animals, including marine mammals. Prompt scientific treatment is essential, and aggressive support care with strict attention to fluid and electrolyte is a must. Some severely ill patients may require dialysis.† So with a clean surroundings, and a better prevention of the disease is a Leptospirosis free community even those people in the slum area, if know how to clean and sanitize their belongings they can’t get leptospirosis. So whenever there are contaminations in the place they should be alert. Cause prevention is better than cure. (Sison, 2009) (Medenilla et al., 2009) Leptospirosis is a disease caused by a bacterial infection when humans get contact in flood waters contaminated by animal urines from dogs, cats, pigs and specially rats. It takes 5 days t o 2 weeks before you can see the symptoms. During that time the leptospirosis cases hits a large amount of cases in Luzon with 1,027 cases with 89 fatalities. Sec. Duque said that the widespread cases were caused by the two tropical storms that hit the country. The Government warned the public to avoid flood water to prevent getting infected by the bacteria. The government that time prepared P 4-million pesos for the leptospirosis victims. Phrophylaxis, a drug which cures leptospirosis. This medicine is given immediately to those admitted cases of Leptospirosis. However, Prophylaxis is not suitable for children and pregnant women. The PCP (Philippine College of Physicians) and PMA (Philippine Medical Center) released a guidelines on an antibiotic â€Å"Prophylaxis† to people in leptospirosis-affected communities. They said that Prophylaxis is not recommended to those individuals unless they confirmed that they have visited a leptospirosis contaminated area. Ii is said that to prevent this disease, sanitation and protection is the best. Flood water is one of the risk factors that would infect you a leptospirosis. By just wearing boots, goggles, overalls, gloves and others. 2 capsules of Doxycycline is given once weekly for those who were exposed and should be continued through out the end of the exposure period. Then, the use of Prophylaxis is not 100% effective. It is said that it would depend on the quality of the drug and the timing of the intake. (Manongdo, 2009) If the rat’s urine was mixed in the flood waters, what comes next is the Leptospirosis. There lots of rats in metro manila, Rats are the largest group of mammal in the world. Their population is even greater than humans. The dirtier the place the more they would get in to your households. (Editorial: Pilipino Star Ngayon; 2009) For the past epidemiological research the Leptospirosis cases in the Metro manila especially in the Quezon City, were reported to have a high case of Leptospirosis. One of the reasons of this disease is the improper waste management. Many of Filipinos are not disciplined enough to throw their waste properly, some were just throwing their garbage on the river. And some doesn’t separate the biodegradable and the non biodegradable. So by keeping the discipline everywhere and not just throwing waste every where we can at least refrain the floods that brings the Leptospirosis.