- 2 days ago
Join Mildred Galarpe as she talks with Dr. Christina Tan Bonghanoy, an Infectious Disease Specialist, about the rising risk of Leptospirosis in the wake of Typhoon Tino. They’ll discuss how to protect yourself from this disease, including symptoms, prevention, and treatment.
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00:00Good afternoon everyone and welcome to VitalScience, Sansar Cebu's health program in partnership with the Cebu Provincial Government.
00:28I'm Mildred Galarpe.
00:31Today we turn our attention to a timely and important issue, leptospirosis.
00:37In the wake of Typhoon Tino, many have been wading through floodwaters which increases the risk of conducting this dangerous disease.
00:45We'll be exploiting the symptoms, prevention and treatment of leptospirosis and discussing the steps we can take to protect ourselves during this flood season.
00:58We are joined today by Provincial Health Consultant Dr. Niki Catalan who is my co-host for today and with us as well is Dr. Christina Tan Bunghanoy, an infectious disease specialist.
01:12Dr. Bunghanoy earned her medical degree from the Cebu Institute of Medicine, completed her residency at Chongwa Hospital and trained in infectious disease at UPPGH.
01:24Dr. Bunghanoy, welcome to VitalScience and thank you for joining us for being my co-host this afternoon, Dr. Niki.
01:31Good afternoon, Dr.
01:32Hello, thank you. Thank you, Ma'am Mildred. Thank you, Dr. Niki, for inviting me on this very important and timely topic.
01:39Yes, very timely topic, no?
01:40Kay, ah, mo ito pagkita na ko sa pictures pitaw the day after and I've seen people really waiting sa baha.
01:48Oh my God, another disaster to happen if dili ma-addressed, if this is leptospirosis.
01:54But before we proceed, mas magiging sigurang magsugod kita sa very basic.
01:59What is leptospirosis? How does it spread?
02:02Okay. So, leptospirosis, infection ni siya, no? Gikan sa bacteria.
02:08O niya, makuha ni siya kung ma-contaminate ang tubig. O niya, ma-expose ta, mga tao.
02:16So, infection, basically, febrile, febrile siya nga illness, magsugod siya o ghilanat, sakit sa lawas, and then ang complications na dayon down the line.
02:27So, uso ni siya karong panahuna tungod sa pagbaha.
02:32So, again, ang contaminated water, nga daghan kayo na-expose karong nga sebuanos, at risk ka ayo tatanan, ani nga infection.
02:40Na-aikuan, anak, doc, ang mataptan daw ang leptospirosis is if naakay samad, sakto ba na siya or anybody ma-expose to the bacteria?
02:55Okay. So, to add the eye sa definition, kaning contamination, what I mean, ani, is contaminated ang water or soil sa hugaw kasagaran ka ng mga ilaga or rats.
03:07But, di liira na siya, limited to ilaga, pwede sad siya from pigs and even mga sheep, goats, even dogs.
03:16But, ang pinaka-common yod rats, that is why kung mustorya taong leptospirosis, rats yod ang iyahang ma-associate, no?
03:25And, anybody can be infected with leptospirosis, wala siya'y pili, bayi, laki, tigulang bata, with or without samad.
03:33But, mas dakuulang ugrisgo kung naay samad.
03:36Ang skin is a very important barrier against infection.
03:39And, once naasay samad, maski gamay lang, it will open a lot of possible organisms na makasulod sa lawas and will cause infection.
03:50Doknik, katong pagbaha, ang mga tao nga na-rescue, most of them naay samad.
03:56And, niwade ni sila sa baha.
03:59So, unso may, how is the data coming from the evacuation, how many evacuation centers to you?
04:05So, bayi, bayi sa tamang, Mildred, I don't have it at the top of my head.
04:08But, at one point, no, we had about 211,000 people in evacuation centers all over the Cebu province.
04:15Province data lang galini.
04:17So, dagang-nag-hundred sa dina, tao na exposed to katong floodwaters, tao directly.
04:24And then, for the responders that you've mentioned, we assume kitungod ng saum dyan sila dito, ng iguod dyan sila.
04:31So, makaingon dyan na, maka-assume dyan safely na, basig na iguod dyan sila by something bitaw that had a break in their skin integrity.
04:40So, as what Dok Tina mentioned, ang imuhang risk would be higher, especially kung naakay samad or naay masudlan bitaw inside sa...
04:47So, right now, Dok, with the symptoms of fever o panakit sa lawas,
04:52mo mo ni symptoms po, doog ka nang matrangkaso tatungod sa uwan, no?
04:56So, dili na ito, dapat i-ignore ang kanang...
05:00Dili, pwede nga magsalig lang taong...
05:02Ano sa'yo nang tambal? Parasetamol.
05:05Mas maigyod na if, you know, the second day nag-fever ka,
05:09ato na lang ito sa mga the nearest barangka health centers
05:13or ang atong, ku-an, atong mga...
05:15Napaman siguro gita yung responders in the evac centers currently.
05:19Currently.
05:20Or doctins, maybe you can also talk about itong...
05:23Sikat kayo ni Runo online, makabasa ang mga tao about doxycycline,
05:27ang kanang prevention for leptospirosis.
05:30I mean, the province has been quite aggressive, you're giving it out,
05:33but you're not umatagaan ta na at manag-seek, you're making a pass.
05:36But can you share a little bit, Dok, why it's important?
05:39Okay, so, after the baha, you know, ku-an kayo, sikat kayong doxycycline.
05:44It's a med.
05:45It's a medication capsule na siya that we can buy in the pharmacy.
05:49Dilisha, rare, very common siya, and it's used for many infections,
05:53including leptospirosis.
05:55And naamanggudtay, kitawag nga, marag golden period ba,
05:59after the exposure nga, within 24 to 72 hours,
06:04sa kanusaka na igo sa hugaw na tubig, kanusaka nilusong,
06:07kanusaka nakatulon, apil di ay ang pagtulon sa exposure, ha?
06:12Kung kanusaka na iguan na ang exposure,
06:15within three days, dapat nakainom ka sa doxycycline.
06:18So, moto ang baha, November 4, no?
06:21November 4, 5, 6, 7,
06:24nanamin na doon ganyan,
06:25naghurot-hurot na ang doxycycline.
06:27Kay people na ay awareness siguro po,
06:30kay daghan po nag-share sa social media,
06:33so, ngita sila ang doxycycline.
06:34And people, doctors, and healthcare centers, facilities,
06:38were giving it out for free.
06:40Kay ang important manggudt sa pag-control sa leptospirosis
06:43is not just treatment,
06:45di liira siya tambalan kung naana,
06:47but kung mahimu,
06:48kayaan yun siya before mahitabo.
06:51And kanang first three days,
06:5324 to 72 hours,
06:55mao ang pinaka-crucial nga time,
06:57so, mo dito ang mong giapas nga,
06:58mahatag, unta da yun ang doxycycline,
07:00ana nga time.
07:01Okay, di ha siya pwede malikayan pa.
07:04Okay, ang kanang very gold period of three days,
07:10if nakahatag taan na mo,
07:11mo less ang chances of,
07:14kung ano, kanang mo develop siya,
07:16if a person exposed,
07:18anang, kanang tubig,
07:20dili siya ka take in the next three days,
07:22nagmanifest na,
07:23what is the timeline
07:26for kaning bacteria to develop
07:28to be severely, ano?
07:30So, kani nga time,
07:32we will be discussing about
07:35incubation period na,
07:36kung kanun sa ang,
07:37it's the time between
07:39kanun sa ka na-exposed
07:40and kanun sa ka mo develop
07:41symptoms.
07:42And usually,
07:44sa literature,
07:45it's about five,
07:46five days to two weeks,
07:47and then it can also range
07:49as early as two days
07:50to one month.
07:51Karun, right,
07:52today,
07:52we are already on the 10th day
07:54from the exposure,
07:55katong November 4,
07:56sa mataron November 13.
07:57So, karun November 13,
08:0010th day of exposure,
08:01nag-expect na,
08:02naanay,
08:03leptospirosis,
08:04ng mga patients
08:05from the baha,
08:06mana-exposed.
08:08So, katong mga wala nakainom,
08:10naa sila,
08:10higher risk,
08:11gyud,
08:11madayunan,
08:13gyud,
08:13leptospirosis.
08:14Katong mga nakainom,
08:16lesser chance,
08:17way lesser chance,
08:18but,
08:18di ligya po siya,
08:19guarantee,
08:20di,
08:20yun sila mag-leptospirosis.
08:22So,
08:23kanyang,
08:24for example,
08:25na,
08:25did we,
08:26for the Cebu province,
08:28did we receive reports na
08:29of leptospirosis?
08:30So,
08:31we're constantly monitoring
08:33ma'amildred,
08:34mga so far,
08:35as of today,
08:35akong nabon upatra.
08:38Pero,
08:38saan nila pitadok?
08:39Na anak ko eh,
08:40I think,
08:41if I'm not mistaken,
08:42Balamban also,
08:43na nagmigawas na sa Balamban,
08:45ang uban places,
08:47amupananggi ipang monitor,
08:48but,
08:49just to backtrack a little bit,
08:51ma'am,
08:51magduk din,
08:52sa Cebu,
08:53whole this year,
08:55kuwanrata,
08:56na arata ay reported
08:57141 leptospirosis cases.
08:59This is from January.
09:01January to August.
09:02So,
09:02gamay ranasiya pa.
09:04So,
09:05kami po,
09:05we're also looking,
09:06so when the,
09:07when the typhoon happened,
09:09the first thing na we were looking at
09:11was unsay pinaka-disaster na pariho ani
09:13and what things can we mitigate.
09:15So,
09:16the closest one we were looking at
09:17was Undoy in Manila.
09:19Yes.
09:20Nukusukusugpod.
09:21And then,
09:21we were seeing studies,
09:23naghandag-hundred like,
09:24this is PGH data,
09:27katupag 2009,
09:29591 suspected cases had it,
09:32and then,
09:32they got 67 deaths from it.
09:35Nakuana.
09:36So,
09:36daku-daku pad ang number
09:37from this one hospital only.
09:40So,
09:41muntuh,
09:41we were quite worried.
09:43We called in the infectious diseases
09:45na experts,
09:46our nephro,
09:47to get input.
09:49So,
09:49the first phase really was to give out
09:51as much doxy as we can
09:52and inform na early,
09:54early detection
09:55na di sila mag-libog.
09:58So,
09:58sa Undoy sa dok,
09:59they mentioned na
10:00there was a triad
10:02ng uban.
10:03They had
10:03lepto,
10:05na abtan po,
10:05og typhoid
10:06because of the water,
10:07o dirty water,
10:09na intake,
10:10og,
10:11na iuban na dengy
10:12at the same time.
10:13So,
10:14these are the public health concerns.
10:15Ang katong nga mga sakit ba,
10:17all ka ng water-related ba,
10:19no?
10:19Water-related, yes.
10:20Ang typhoid
10:21because hugaw ang tubig,
10:23ang lepto,
10:23kaya hugaw gya po ng tubig.
10:25So,
10:26I noticed nga,
10:28ang province has been
10:29very aggressive
10:30distributing
10:30meds
10:32last week.
10:33So,
10:33was this part?
10:34It is definitely part of it,
10:36okay?
10:36We wanted to make sure na
10:38as much possible,
10:39di-drink na to maabot
10:40o severe.
10:42Kanamodoc can
10:43expound on it more,
10:44but for leptospirosis
10:46specifically,
10:46na ay mild,
10:47moderate,
10:48o severe na leptospirosis.
10:50The mild and moderate,
10:51you can handle
10:52inpatient
10:53or even outpatient,
10:54doc,
10:54no,
10:54for the mild.
10:55The severe would require
10:57dialysis na treatment,
10:59which we also had to check,
11:01do we have the capabilities
11:02of it kung magdungan ba na silatanan.
11:05So,
11:05muna na
11:05aggressive,
11:06may kikabawang ta
11:07na kuwang atong
11:08hemodialysis facilities
11:10as much possible.
11:11Today po,
11:12we did a webinar.
11:14Thank you to Dr. Brian Lim.
11:16He did a webinar
11:17with the municipal health officers
11:19na ito
11:19around the whole Cebu province
11:21and also sa
11:22Kuan Mildred
11:23sa itong mga
11:25province-run
11:26hospitals.
11:26Nag-appeal said sila
11:27there were about 75,
11:2974 doctors ganina
11:31from 3,
11:322 to 4 o'clock.
11:33Nag-refresher lang
11:34na what are the
11:35early ka ng signs
11:37and symptoms
11:37on sa aimong
11:38tier for management,
11:40I think,
11:40which Dr. Tina
11:41can share more
11:42about.
11:42Ka na siya,
11:43Doc,
11:43like,
11:44ka nang,
11:44okay,
11:45ni UG
11:46sa pagkaon pa,
11:48ni Bangil na sila daan
11:49pagpanghatag o meds.
11:51But,
11:52with,
11:52how many ito?
11:53200,000?
11:54200,000?
11:55200,000,
11:55which is a very
11:55conservative number
11:56na na-list sa
11:57itong evacuation centers.
11:58200,000 people
11:59in evac centers na,
12:01it was presumed na lang ta,
12:03na all of them
12:03na exposed to
12:04tubig.
12:07Maybe katong
12:08uban
12:08na nagipamatit
12:10pati-ignore.
12:11Kaya nalagi ka ng
12:12ang mindset
12:13bitaw na to nga,
12:13kung uwan-uwan,
12:14normal na nang
12:15hilang-tanta.
12:17So,
12:18ang second phase,
12:19katong,
12:20di ba,
12:20kung mo share,
12:22mo pakita na
12:22ang symptoms,
12:23unsa ang
12:24management po
12:26na niya doon?
12:27So,
12:28first phase,
12:29katang,
12:30may kitawag na
12:30acute phase lang sa
12:32hilang-nat,
12:32sakit sa lawas,
12:33mariragi pa maulan,
12:35unya,
12:35maulay na,
12:36magtuo ang mga tao nga,
12:37at rangkaso,
12:38rani,
12:38gikan,
12:38rani sa pag-alasan,
12:40nakusta ng mga gamit,
12:41gikan sa baha,
12:42unya,
12:42nauwanan lagi,
12:44so,
12:44hilang-nat,
12:45labad sa ulo,
12:46and anna.
12:47But,
12:47kasi garaan,
12:47anay nga time,
12:49kung mild lang ang
12:50infection,
12:51maayuan ni mga patients,
12:52walay kinahanglan nga,
12:54di ma-admit,
12:55antibiotic lang capsule,
12:56pero na'y uban patients,
12:58labi na itong mga
12:59magrabihan sa lepto,
13:01sa hypod,
13:02ilang immune system,
13:03dilinsat sama sa uban,
13:04medyo ubus,
13:05for whatever reason,
13:06like,
13:07at risk sila,
13:08diabetic,
13:08or unsaba,
13:09pwede sila mo proceed
13:10sa kanang
13:11severe phase,
13:13or the
13:13convalescent phase,
13:16unya,
13:16di rin na nga part ang
13:17kitawag nga,
13:20kanang,
13:20madialize ng patients,
13:21and then mo severe,
13:22mo yellow sila,
13:23and then,
13:24aside sa dialysis,
13:25pwede sila matubuhan po,
13:27mag-intubate,
13:29kaya,
13:30usas sa complications
13:31sa dialysis is,
13:32magdugo ang lungs,
13:33mag-hemorrhage,
13:34sa medical term pa,
13:35and kaya na,
13:36mag-acute kidney injury,
13:37hindi sila makaihi,
13:39so,
13:39mataas ang ilahang creatinine,
13:41kailangan sila,
13:42tauran o catheter sa lio
13:43para ma-dialize,
13:45and then,
13:46eventually,
13:46ang pinaka,
13:47worst yun makita po,
13:48is,
13:48mapildi yun,
13:49mupanaw.
13:50Ngayon,
13:52why ang kidney iya ay attack?
13:55Kana lang ang iyahan pathogenesis sa bakteriya,
13:57nga,
13:58add to siya mo attack,
13:59including sa lungs,
14:00and then,
14:01maunta nga,
14:01maayo,
14:02before ta maabot sa infection,
14:04malikayan yun,
14:04unta siya,
14:05with the prophylaxis,
14:07or,
14:08kung di mangani malikayan,
14:09kung maabta nagid sa infection,
14:11madakpan ug sayo.
14:12That is why,
14:13recognition is very important,
14:15early recognition yun,
14:16daily rabaliwalaon ang hilanat,
14:19sakit sa lawas,
14:20sakit sa tiyan,
14:22usa sa common sad niya symptoms,
14:24by the way,
14:24sakit sa lawas,
14:25especially sa batiis,
14:26bating bagtak,
14:27it's very,
14:28calf tenderness,
14:30walang kung na-expose sa ba,
14:31pero bitaw,
14:32mga igala,
14:33I think in any sakit,
14:36as long as ma-detect na to early,
14:38mas maayo,
14:38pero kani,
14:39ayaw kumpiyansa nga,
14:41pamaula ni,
14:42well,
14:43not endorsing any brand,
14:44mo yung nag-aalaksan ron eh,
14:46dili ka nang mas,
14:48I think na may mga government agencies karoon,
14:50nga manghatag,
14:51o libre nga service,
14:52atun na lang ta,
14:53walay mawaan na to,
14:55it's better to be so for,
14:57mam nag-iingo nila nga,
14:58pag-tino ko no,
15:01ka nang OA na ko no,
15:02kaya tapos preparation,
15:03talawa,
15:04di ba,
15:06sa atong ka-OA,
15:07huwag ito kasagangan,
15:08ikalit-lagsaka ang tubig,
15:10o wala pata nag-in-OA ato,
15:13pag-preparan na to,
15:14I think the damage could be more,
15:16so,
15:17ka nang,
15:18ayaw kumpiyansa sa hilang na to,
15:20sakit sa mga lawas ha,
15:22kung naging pamati,
15:23nakakaroon,
15:23dagan yun dahil yun,
15:24dagan sa ER,
15:25the nearest ER,
15:26or the nearest barangay ha,
15:28center na makahatag ninyo,
15:30o tabang right away,
15:31kaya,
15:32tinood na,
15:33ang problema na po na to,
15:34ang dialysis centers,
15:35kaya,
15:36dilita,
15:37dagahan o dialysis centers.
15:38Even now,
15:39sa atong,
15:40mga kidney patients,
15:41kalihunid,
15:42at kuwang na gali,
15:43siya karun.
15:44So,
15:44but,
15:45we're really here,
15:46I mean,
15:47the point being,
15:48talking to the people about this,
15:50di man pangadluk,
15:51it's never to scare,
15:52but,
15:52we think,
15:53manggud na,
15:54if,
15:54kaya bawang mo,
15:55unse pamatiun,
15:56unse bantayan,
15:57then,
15:58makasagang,
15:59tana,
15:59dilibito siya,
16:00mo progress.
16:01Pero,
16:01dok,
16:01bali na lang,
16:03ma,
16:03kanang,
16:03mahadluk ta,
16:04kaysa,
16:05magmahay ta,
16:06no?
16:06So,
16:07kanang,
16:07again,
16:08we cannot,
16:08kanang,
16:09akong mga,
16:09kauban din rin,
16:10ang mga doctors,
16:11diligid na mo,
16:12ma,
16:12overemphasize,
16:14ang need.
16:15If you're feeling not well today,
16:17it's best,
16:17you see a doctor,
16:19or you see the nearest,
16:20barangay health centers,
16:21kaya pasin ma,
16:23maibawanda yun,
16:24di ba?
16:24May nalagi,
16:25ad to ni mo,
16:25sakit man akong lawas,
16:26inigtes,
16:27everything,
16:27ay,
16:28hindi pa maulan rin kasi,
16:29okay na na,
16:30basta,
16:30at least,
16:31nakita na ka,
16:32nakonsulta na ka,
16:33o expert.
16:34Let's not be part of the numbers,
16:36nga,
16:37na,
16:37ninipanaw,
16:39sa kanang,
16:41sa bagyong tino,
16:42kay,
16:43kanang,
16:43after,
16:44kung an effect,
16:45after effect,
16:46di na tamo puno,
16:47mas may,
16:48na,
16:48kaya,
16:48tinto na tamang place,
16:49ay nagpa,
16:50ay nagpatasa,
16:51kanang,
16:52kaninga,
16:52kaninga mga casualties later,
16:54is,
16:54kung anong gundi,
16:55can be avoided,
16:56but,
16:56katong kang tino,
16:57di man to,
16:58can be avoided,
16:59so,
17:00kanang,
17:00don't ignore,
17:02these kind of symptoms,
17:03fever,
17:04kanang,
17:05panakit sa lawas,
17:06muragigid ba ni bisik,
17:07sa trangkaso,
17:08di ba?
17:09Yes,
17:09ang kanimang gong leptospirosis,
17:11di siya,
17:12pinakalit nga,
17:13mugrabi ba?
17:13Mwagi sa yun siyag mild,
17:15ilanat lang,
17:16lain ang lawas,
17:18dili siya ka ng two days lang,
17:19madialysis da yun ka,
17:21take pa yun siyag time,
17:22so,
17:22that's why,
17:23even to as long as a month,
17:25no,
17:25for some people.
17:26Kung naanak ay symptoms,
17:26a month pa mong manifest,
17:28ang pinaka-important yun nga,
17:30consider,
17:31important nga risk factor,
17:33nga among ipangita sa patients,
17:35kung maghuna-huna,
17:35mag leptospirosis,
17:37na ba siya exposure,
17:38na agi ba siyag baha,
17:39nakatunob ba siyag,
17:41di,
17:41tanan ba ha,
17:41kinahanglan ha,
17:42na iuban,
17:43ang among i-ask lang is,
17:44anong saman ka nang dagahan ba,
17:46puddle sa inyo ha,
17:47puddle of water ba,
17:48niyosahay,
17:48makatunob,
17:49na considered naman na siyay exposure,
17:51na iuban ka nang,
17:53outside the typhoon lang nga picture ha,
17:55na iuban mag,
17:57ansan ng water sport ka nang,
17:59river rafting,
18:00o,
18:01pwede kung contaminated ang river,
18:03pwede sila mag leptoana,
18:04there have been outbreaks about that,
18:06na iuban,
18:06makainom o tubig nga naiihi sa ilaga,
18:10o,
18:10kaya poor sanitation siguro,
18:12pwede sila mag leptoana,
18:14ang uubansad ka nang tiglimpyo lang sila,
18:16ang tangkal,
18:17pwede man ang baboy na i-leptospirosis,
18:20or yung sang hayop ilahanggi,
18:22alagaan,
18:23maigaw ilahang tiil,
18:24pwede na sila mag leptospirosis.
18:26So ang leptospirosis,
18:28pwede siya from mananap to humans.
18:32Oh,
18:32actually,
18:33leptospirosis,
18:33humans mag ito nga waste.
18:36Oh,
18:36zoonotic infection siya,
18:38so it's from animals,
18:39ang animals ang gadalaan ni,
18:41kung makaihi sila sa tubig or yuta,
18:45matumban sa tao,
18:47makasood sa lawas nila ang kagawa,
18:49common ang mga leptospirosis ang mga tao.
18:51So,
18:52dili siya,
18:52dili siya,
18:53ayag kumpiyansa ka,
18:54dili,
18:54limited to rats ang leptospirosis.
18:57Na-mention na to ni Doc ganina,
18:59huwag mantay ship ka,
19:00ayaw din he,
19:01arita sa goat,
19:02no,
19:02goat,
19:02even iro,
19:04ay kagkumpiyansa ka,
19:05naagya po niyong iro.
19:06So,
19:07kanang,
19:08bahala nagyug-OE,
19:10okay nagyug-OE,
19:11basta kay safe lang,
19:13diba?
19:13Kanang,
19:14asa man ka,
19:15OE,
19:15tawag kagka OE,
19:16and then Kenneth,
19:17kaysa,
19:18salamat,
19:18good net,
19:19nag-OE ka,
19:20tanawag ang ngisi ka ka ron.
19:22Okay,
19:23sa Manila,
19:24Manggood,
19:25ang mahitabo sa leptose season,
19:26ha,
19:27kanang,
19:27which is,
19:28magsugot ang leptospirosis season,
19:29by the way,
19:30kanating owan na,
19:31rainy season.
19:31So,
19:31mga bare months na ta.
19:33Mga bare months,
19:33masugot na na August,
19:34ang may tabo sa other hospitals,
19:36especially government hospitals ito,
19:38ang ilang mga gym,
19:39mahimo din siyang ward,
19:40mahimo siyang hospital.
19:41Kay,
19:42makuha nga din sila o bed,
19:43sood sa hospital,
19:44because of the surge in leptospirosis.
19:46So,
19:47kanaangi,
19:48so,
19:48why and yun na maglikay ka ron,
19:49mahitabo.
19:50Okay,
19:51daghan kay tag na sa evac centers,
19:52diba?
19:53Daghan kay itong,
19:54sa mga photos lang na ito,
19:56daghan kaayog din ang mga tao nga,
19:58na exposed sa tubig.
19:59So,
20:00ginuko.
20:01For the things that,
20:02ang timeline na gimention ni Doktina,
20:04mamildred,
20:05natay time,
20:07dindi siya,
20:07di bito siya,
20:08or insidua siya do,
20:09hinahinay,
20:10for di siya kalit ba.
20:11So,
20:12mo nang saba kita ron,
20:14grabi kita kung anke,
20:15hinaot atong ma,
20:17matakok ba?
20:18So,
20:19mo agrigid ko,
20:20ana ni mo karun,
20:21na magsaba,
20:21mahalag uwi-uwi,
20:22tagsaba-saba,
20:23kaysa magmahay na tayo.
20:25I mean,
20:26we will be facing,
20:28a more,
20:29kanang,
20:30complicated nga problem ba,
20:31ang kanang life-threatening na part na bitaw,
20:34kay short na ang period ni mo,
20:36kay severe na siya.
20:38So,
20:38mo na,
20:39my goodness.
20:40Anyway,
20:41kanidok,
20:42what are the current treatment options for leptospirosis,
20:46aside from kanang antibiotics given early?
20:50So,
20:50ang antibiotics lang,
20:51going back to the topic on antibiotics,
20:54naman ito yung doxycycline,
20:55nga capsule,
20:56which we give for prevention,
20:57katong immunon siya within three days,
21:00pwede sa siya ihatag sa katong nag-leptospirosis na gyud.
21:03And then,
21:04kung ma-admit gyud,
21:05sa hygiene na pwede nga capsule,
21:07kay,
21:08pasakiton na kayo sila,
21:09injection na taana.
21:11And then,
21:12tungod sa complications sa leptospirosis,
21:14ma-appel ang kidney and lungs,
21:16so,
21:17na-agid na ang pag-hydrate with the dextrose,
21:20and then,
21:21ang worst case scenario,
21:22kanalagi,
21:22matubuhan sila,
21:23kaya di na sila kaginhawa.
21:25O sa sa simptoma sa grabing ang leptospirosis,
21:27kaya na maglisod na ginhawa,
21:29o mag-uboog dugo.
21:30Oo,
21:31dugo na gilang nang maluwa.
21:32It's because kaya giigo man sa niya ang lungs.
21:34Yes.
21:35O niya,
21:35mag-yellow sila,
21:36kaya igo po ang atay.
21:38And then,
21:39Vietal organs,
21:39kaya di ang igun.
21:40Yes.
21:41Systemic ginsya,
21:43nga symptom or manifestations,
21:45ang mapangatnian sa patient.
21:47And then,
21:48kanal siya,
21:49admission yud ang uban kinahanglan.
21:52Kanisya kang dokniki,
21:53how equip our provincial hospitals,
21:56our rural health units,
21:58in managing these kind of cases?
22:00So,
22:00that's what we did,
22:01the refresher,
22:02Ma'am Mildred,
22:03na amunggi,
22:04refresh atong mga doctors,
22:05but offer early management and treatment.
22:08And apart from that,
22:10actually,
22:10nagpa-send out na tagletters.
22:12So,
22:12the office of the governor
22:13has sent out letters
22:14to the private hospital
22:16ng medical directors
22:17na dapat na na sila
22:18prepositioned na medication,
22:21prepared na silang
22:22leptopathway,
22:24o kaning naanatay med.
22:25So,
22:25kami po,
22:26on our end,
22:27sa provincial health office,
22:29nag-emergency purchase na lang
22:31for certain kinds of medications
22:33na mayansi ni Doctina,
22:35kato mga IV meds,
22:36o kuhana,
22:37para hina-outi,
22:38judta makapugnan,
22:39jud na to sad.
22:40There is a north,
22:42from Consulacion
22:44all the way to Danau,
22:46naatay district hospital din,
22:47ha?
22:47Yes,
22:48we have
22:48CPH Danau,
22:52which sadly,
22:53badly hit
22:55Sagayu.
22:56So,
22:56whole first floor
22:58was flooded.
22:59I went to
23:00see the place
23:01and did an assessment.
23:02They padded me
23:03fully operational
23:04ito.
23:05They're occupying
23:06the second and third floor,
23:07but they're only
23:08taking new patients.
23:10So,
23:10if we were going,
23:11if natay mga cases
23:12na kinahalan
23:13o ag-admission,
23:14like for example,
23:15in Compostela,
23:16in Liloan,
23:16they have to be brought
23:17into the city.
23:18The DOH hospital,
23:19so naamantay ka itong
23:20Cebu South,
23:21in Talisay.
23:23And,
23:23is Eversley?
23:25Eversley said,
23:27and Soto.
23:27So,
23:28I also,
23:29we had this conversation
23:30with R.D. Brillantes.
23:31I wanted to bring him
23:33over on that,
23:33but he's busy.
23:35So,
23:35he's well aware of this.
23:36Emergency purchases
23:37at Satsasi
23:37on meds
23:39para ato delay.
23:40So,
23:40we're high alert
23:40yutang tanan.
23:41So,
23:42we've been talking
23:42about this
23:43since last week
23:43non-stop.
23:44Saan yun na ito
23:45pagkoan ki.
23:47But,
23:47preparing for the worst,
23:48hoping for the best,
23:49Judo na.
23:51Bahala na lagi,
23:52later on,
23:53manubra ng
23:54tambal din ha.
23:54Mas may nang
23:55wa gigamit
23:56kaysa
23:57na gamit na ito.
23:59And,
23:59you know,
24:00late na po
24:00ang intervention
24:03to the public.
24:07So,
24:08ang Danaw,
24:10we're not
24:11100% operational.
24:12Not yet.
24:13We're trying our best
24:14na mabalik.
24:15I mean,
24:16slowly ilang.
24:16I think electricity
24:17is okay na.
24:18Nanay-connectivity
24:19did ito.
24:20On the first few days,
24:21I was trying
24:22to get patients
24:23out of there
24:24para ma-decongress
24:26lang nga ito.
24:27Bahaw,
24:27unsa-unsa kadako
24:28ang hospital.
24:29Two floors?
24:30Three.
24:31Three floors.
24:32Nabuckwit in Townsville.
24:33Dato sila sa taas.
24:34I assume more than
24:35three.
24:35But they had
24:36143 patients
24:38when I visited
24:38a day after.
24:40So,
24:40the gun guy.
24:41Sige,
24:42hawa na na na na.
24:43Para balhin sa
24:45Picas.
24:45But it was a challenge
24:46to bring ambulances
24:48in and out.
24:49Kaya,
24:49hindi mo matawagad.
24:50Kaya,
24:50mahilin niya,
24:51no?
24:51Ladrid.
24:52Yeah,
24:53tinod na.
24:53Naman sadmi,
24:54kauban dini.
24:54Nga,
24:55ba-bother ka ba?
24:56Dinin mo ma-account
24:57ang tanan ni mong kauban.
24:59So,
24:59mga,
25:00tunso ba,
25:00kinitabua to?
25:01Sus,
25:02mo,
25:02to pagka,
25:03pagka,
25:03the time na nakakonek na sa,
25:05gispam sa adminia,
25:07o,
25:07gdagan ka yung pictures,
25:08it's what happens sa iyang,
25:09yung,
25:09yung,
25:09huw,
25:10undang na na,
25:11yung sanan ba ni Kadagan.
25:12So,
25:12nakakitag connection ba?
25:14So,
25:14kanang,
25:15aside from Danau in the north,
25:18ang severely affected,
25:20ang tamaraman sa Danau.
25:22You also have the West Saimong Balamban,
25:24Asturias.
25:25But a good thing,
25:26our Balamban,
25:27I was there the other day,
25:29okay kaya sila.
25:30They already had,
25:31when I went there,
25:32morg na na sila isa Batuka patient
25:34na naleptospirosis gimantayan,
25:36but,
25:36morg,
25:37moderate na to,
25:38ha.
25:38But fully operational sila dito.
25:42So,
25:42okay,
25:43ra.
25:43What's this,
25:44amung concern,
25:45dok,
25:45ba,
25:45let's say,
25:46na sa Danau,
25:47ang may patients sa Danau,
25:49amung concern,
25:50like,
25:50diri sa Cebu City nga,
25:52doctors ba,
25:52mas siguro ni muad to sila sa bantayan
25:55para magpatambal?
25:56One,
25:57mas siguro sila sa siyad.
25:57City dito.
25:58What if ba,
25:59mga,
26:00macongest na gyudta sa patients,
26:02catering to people from the south,
26:04and sa Mandawi,
26:05which is also heavily affected sa flood,
26:08ka naalagi basig mapunok kayo taog patients.
26:12But,
26:13ah,
26:13so,
26:13motocritical ang
26:15municipal health officers,
26:17dok,
26:17ang modod silang gi-empower,
26:19like,
26:19dok,
26:20Brian was talking to them this afternoon,
26:21na,
26:22di na tamawit,
26:23if na nagi kay risk factor,
26:25immediately na na,
26:26di na tamag huat huat,
26:28di na tamag huat,
26:29di na tamag huat.
26:29Ang sana to be,
26:29di na tamag huat,
26:31di na tamag huat,
26:34ayaw na,
26:35ay nakabasing mo purple na na,
26:36ipadanan na diretsyo diretsyo sa city,
26:40well,
26:40ka na mati man pa ba,
26:42nalang mabakanti ang bed,
26:44next,
26:44kung naamang ganit,
26:45ang modod na.
26:46And then,
26:46the clinical eye po,
26:47dok,
26:48si dok,
26:48Brian was also reminding our,
26:50MHOs na kanang,
26:52ang diagnostic test,
26:54by,
26:54for this,
26:54di,
26:54but toing,
26:55like,
26:55dengue has that,
26:56katong kit,
26:57or koan,
26:58kanay,
26:58first few days,
26:59it could be anything,
27:00it looks like,
27:01any other,
27:02flu-like,
27:03dok,
27:03na,
27:04na,
27:04symptoms,
27:04but,
27:05mo itong gi-empower,
27:06dun sa na,
27:06na,
27:07di maglangay-langay,
27:08and,
27:08and,
27:09koan,
27:09treat right away,
27:11as if it's leptospirous,
27:12especially,
27:12if ka nang,
27:13tino na,
27:14na,
27:14victim.
27:15Murabag,
27:16gilanat ka,
27:17check,
27:18niagig kagbaha,
27:18check,
27:19awa,
27:19sakit sa lawas,
27:21labi na sa bagtak,
27:22check,
27:23na,
27:23so,
27:24ang utod,
27:25no,
27:25kaya,
27:25di siya pareha sa,
27:26dengue,
27:27or any sakit,
27:28nga,
27:28kung i-blood test lang ka,
27:31or nanay ka to markers,
27:32na,
27:32markers,
27:32na,
27:33dengue na,
27:34yun.
27:34Ang lepto,
27:35although na,
27:36atay test available,
27:37but,
27:37di likay siya,
27:38makasulti nga,
27:40naaka,
27:41or wala,
27:41kay,
27:42ang,
27:43best test,
27:44wala ka sa Cebu City,
27:44padala pa sa Manila,
27:47yun,
27:47di na takahuhat ka na,
27:48and it takes too long,
27:49ang,
27:50ang naanatong nga test,
27:51we do have it,
27:52few lang diri sa Cebu City,
27:53but it's not,
27:54it's not,
27:55di siya,
27:56pasabot nga,
27:57kung negative siya,
27:58wala kay leptospirosis,
27:59pwede siya,
27:59masayop na test,
28:01so,
28:02kanagid siya,
28:02kanag,
28:02clinical aidid siya,
28:04dapat naadid siya sa emong ulo,
28:06ang consideration ng leptospirosis,
28:09how about,
28:11dialysis machines,
28:12doc,
28:13si,
28:14kani,
28:14nainangutanan na ito,
28:16doc,
28:16Nick,
28:16sufficient traba,
28:18atong mga government hospitals?
28:20So,
28:20sadly,
28:21that's why,
28:22we were,
28:23koan,
28:23emily,
28:24nangy-discussed since last week,
28:25no,
28:26because,
28:26for example,
28:27atong Danao Hospital,
28:28na,
28:28diisod sila fully operational,
28:30and even then,
28:32ang current state,
28:33na to,
28:33kulang nagita for our renal patients,
28:36renal patients pa lang,
28:37alone pa ni,
28:38so,
28:38na ka nang hunid ka ng regular dialysis,
28:41so,
28:41moto,
28:42we were exploring,
28:43sad with,
28:43naaman naasay,
28:44peritoneal dialysis,
28:46doc,
28:46mo,
28:46it's another way to,
28:48andy-andy sa,
28:49tiyanya,
28:50I think my dad,
28:51ni Agya,
28:52na,
28:52siya,
28:53diabetis nga,
28:54nag-complicate sa kitnes,
28:55siya,
28:56so,
28:56but longer ang peritoneal,
28:59di ba?
28:59it's a,
28:59it's more high-risk product,
29:01no?
29:01kailangan sadtag-trained,
29:03yes,
29:04personnel,
29:04to do that,
29:05di man kay siya,
29:06common ginabuhan,
29:07very good,
29:07yeah,
29:08and we were talking to the suppliers,
29:10na,
29:10nailay,
29:11na san yung,
29:11naistorya,
29:12nangita,
29:13nakasare namin sa suppliers,
29:15we need,
29:15itong trained,
29:16gamayra kaina sila,
29:18na trained PD nurses,
29:20very few,
29:22ah,
29:22to sa mga hemodialis machines,
29:24in the government,
29:25in the hospital school,
29:26and even then,
29:27if mo tap ka sa private,
29:29lahi isa nang storya,
29:30lahi isa nang storya,
29:31lahi isa nang storya,
29:32actually,
29:33lahi isa na siya nga charge,
29:34yes,
29:35yes,
29:36lahi isa na siya nga charge,
29:37so,
29:38mo tuiyahang pangutan na doc,
29:40if,
29:40so,
29:40we don't have enough,
29:43that is why,
29:43ayag huwat,
29:44na maabot ka sa level,
29:45na mag dialysis na ka,
29:47di ba?
29:48so,
29:48ayag huwat,
29:48na may yellow town ka,
29:49ha?
29:50ka nang,
29:50wak naihi,
29:51wak naihi,
29:52ka nang,
29:53ka nang,
29:53ba halang nag-uay lagi,
29:55ba halang,
29:57ang imong hilana,
29:57at is darag yun sa panahon,
29:59at least,
30:01dili,
30:01happy ka,
30:02ta leptospirosis,
30:03but mas may nang magpacheck yun,
30:05right away,
30:06ayaw ang kumpiansa niya,
30:08ka nang,
30:09over the counter ba na ang doxy,
30:11oh no,
30:12ayaw,
30:12tugat-tugat,
30:13kita rao ba kay,
30:14ka nang narabasad tay,
30:15ang ka uihan na to,
30:16sometimes,
30:17ato,
30:17imbes mo,
30:17sulta na doktor,
30:18ato,
30:19ito,
30:19mong sultang,
30:20doktor gugol,
30:21oh,
30:21yes,
30:22pa-aid ka na,
30:24mag-consultat ang,
30:25Dr. Google,
30:26Dr. Chat Chipiti,
30:27awa,
30:28tagyutaan na,
30:29so,
30:30ah,
30:31doc,
30:31how effective,
30:32are public awareness campaigns,
30:34in controlling,
30:35lactospirosis,
30:36like,
30:37like,
30:37you know,
30:37what we're doing now,
30:39awareness,
30:40yun siya,
30:41nga maabot yun siya sa layman,
30:43and katong,
30:43especially,
30:44katong kinsagyud,
30:45ang exposed,
30:46kay,
30:47usahay,
30:47wa,
30:47sila'y,
30:48ah,
30:49capacity to consult,
30:50with the doctor,
30:51but because,
30:51makakita sila sa,
30:52stories,
30:54nga,
30:54inani di ayang simptomas,
30:56nga sila ma-prompt ba,
30:57ay,
30:57kailangan na day kong magpatanaw,
30:59ang doctor,
31:00oh,
31:00and then,
31:00also,
31:01kanang,
31:01na ay mga posters,
31:03nga ipang deliver sa healthcare centers,
31:05or even medical missions,
31:07ah,
31:07appeal sa siya,
31:08mamaka-aware sa mga tao.
31:10Nga amantay mga art cards,
31:11on lip to spirosis,
31:12no,
31:13ato na ibalik-balik,
31:14net,
31:14kay,
31:14base niya,
31:15wala ni gawa sa ilang feed,
31:17ato ibalik,
31:17ato na ibalik sa ilang feed,
31:19mo share sa mga.
31:20I can't wait to see it,
31:21and I think,
31:22we're also planning on a hotline,
31:24na matawag,
31:25so we're just,
31:26on the operations,
31:27and amulang ihanay,
31:28but,
31:29ah,
31:29smart,
31:30thankfully,
31:30gave us a hotline number,
31:32so i-activate na to na mo soon,
31:34where people can ask,
31:35can ask,
31:36or can just text,
31:37ang mga tawar barun,
31:38di nang pa ito glood,
31:39ka nang data na,
31:40internet na,
31:42ato na gid sa,
31:43sa messenger ba,
31:44so,
31:45mo pita to pagbaha,
31:46daku ka ayaw ang,
31:48problema sa mga tao,
31:49katung grabe ka dependent,
31:51nagdepression,
31:52nagdepression,
31:52di tungod sa bagbaha,
31:54nagdepression kay,
31:55why internet,
31:56lack of connectivity,
31:57lack of coverage area,
31:59disconnected to the world,
32:01sus,
32:02nagin ko yung nakita nga,
32:04nagpost ba nga,
32:05ka nang,
32:06this is,
32:07Tino,
32:07you are so mean,
32:08kay,
32:09ka nang,
32:10I think,
32:11high school pa,
32:12sigur,
32:12to nga,
32:12bata nga,
32:13na,
32:13na,
32:13na,
32:14na,
32:14na,
32:15lost ya,
32:16of what is happening to the world,
32:17wa siya naguwan,
32:18na,
32:18siya's evac center,
32:21ay,
32:21yung,
32:21gikagulan nga,
32:22wa siya na connected,
32:23sa world,
32:23well,
32:23lainlain,
32:24magid ang tao,
32:25pero,
32:25I just hope,
32:26safe rakaging,
32:27so,
32:29I think,
32:30na,
32:30na,
32:30mention to na to,
32:31atong lessons,
32:32we learn from Undoy,
32:33that's why,
32:34ah,
32:35grabe ka ayaw,
32:36atong,
32:37perhaps,
32:37pagpalit sa,
32:40from the next phase,
32:41no,
32:42do we have,
32:42for now,
32:43do we have enough meds for,
32:45so far,
32:46so far,
32:47okay,
32:47but,
32:47a lot of prayers,
32:48with my mildred,
32:50nag,
32:50kung anjun mi doc,
32:51na,
32:52na,
32:52hopefully,
32:52it won't be really that bad,
32:54but so far,
32:55dapat manggawas na na sila karun,
32:57yes,
32:57but the good thing is,
32:58ah,
32:59I also spoke to doc Brian,
33:00this morning,
33:01daghan nagpakonsulta na,
33:02agsugod,
33:03and it's a good sign,
33:04yes,
33:04it's a very good sign,
33:06we're happy about that,
33:07umbulbot,
33:08kumbulibo,
33:08so,
33:09oh good na,
33:10no,
33:10I think,
33:11best good is,
33:12dita magsalig ni Dr. Google,
33:13let's,
33:14ah,
33:15go to the nearest hospitals,
33:17if we feel,
33:18mga,
33:18kaninga mga simptomas,
33:20kay,
33:21mo,
33:21lagi na,
33:21let's not add the number,
33:23kay,
33:23prevented,
33:23ma-prevented man,
33:25git siya,
33:25kung,
33:25kung,
33:26mo respond lang siya,
33:27magpakabana lang siya,
33:28ba nga,
33:29kanang,
33:30sobrang daginot,
33:32no,
33:32what na no,
33:32ay nainot.
33:33To add sa prevention,
33:34di ay,
33:35dagang pamantag mga brothers and sisters,
33:37karoon nga,
33:38nagsigipaglimpyo sa ilang mga balay,
33:40no,
33:40so,
33:41sige pag sila tunog sa lapok,
33:43so,
33:43kana siya nga exposure,
33:46di ba,
33:46akong gimensyon earlier,
33:47kay first three days mo ino,
33:49pero kaning mga tao nga,
33:51magsigipagka-expose,
33:52sige paglimpyo,
33:53they are supposed to continue taking doxycycline once a week,
33:57once a week,
33:58mga ayaw lang sila grisita sa ilahang doctor,
34:00o sa ilang health center,
34:02kanin siya doc,
34:03daghan,
34:04huwa na tood ang baha,
34:05pero napaman ang lapok,
34:07parehan ni Juvie,
34:08nga padayo nagbutas,
34:09pala pa noon sa opisina,
34:11because of the lapok,
34:12I think wala,
34:12wala pamanggid siya na,
34:14wala pamanggid siya na,
34:15tang-tangbaga,
34:16manggid kayo ang lapok,
34:17so,
34:18we continue,
34:19mungad to lang taani sa itong nearest na barangay,
34:22RHUs,
34:23RHUs,
34:24very healthy units,
34:25nasa yung mga med missions,
34:27and we're trying to get as much outside,
34:29and then,
34:29Doc Tina also mentioned something very good,
34:32which is boots,
34:33boots,
34:34oh,
34:34it helps protect man,
34:35your skin integrity,
34:37imungkoan,
34:38ang boots,
34:38the eye,
34:39kay,
34:39kanang,
34:39naman sa dame,
34:40ang nahita bo,
34:41kanang,
34:42messengers,
34:42ramagid ang media,
34:44no,
34:44so,
34:44we put out a,
34:46kanang,
34:47form ba,
34:47where people can,
34:49kidagam kaya reklamo,
34:50what's like,
34:51quarantine,
34:51what's like,
34:52too big,
34:52clearing operations,
34:53so,
34:53kanina three,
34:54amunggi prioritize,
34:55now,
34:56I think,
34:56for power connections,
34:58a thousand plus,
34:59people,
35:00nga nag-send,
35:00ang clearing,
35:01almost a thousand,
35:03ang tubig yun,
35:04kay,
35:04five thousand,
35:05kabuok,
35:06nireklamo,
35:06nga,
35:07wa sila,
35:07tubig,
35:08but,
35:08ang tubig,
35:09is not limited to,
35:11Metro Cebu,
35:12so,
35:12okay,
35:13related baka ni,
35:14sa Tino,
35:15or Dili,
35:15so,
35:16muna siya,
35:16ang usap,
35:17but,
35:18naaguy,
35:20I think,
35:20it was in Talisa,
35:21iningunggit siya,
35:22kung naamoy,
35:23mga boots,
35:24kaya nga,
35:24yung man may og,
35:25kaning operation,
35:27bayanihan ni mo,
35:27where,
35:28send us,
35:29in yung,
35:30sinina nga,
35:31masulob,
35:31sinina nga,
35:32masulob,
35:34kay,
35:35lain po kaayo nga,
35:36ang dit ni mo ganahan,
35:37imunan noong ipasulob sa uban,
35:39so,
35:39kanang magamit pag yun,
35:40so,
35:41nangang magamit mga clothings,
35:43ready to eat food,
35:43kaya I think,
35:44until today,
35:45it's really very dependent,
35:46pag yun sila,
35:48dependent pag yun ang mga victims,
35:49kaya,
35:50how can you,
35:51move on,
35:52when you lost everything,
35:54di ba,
35:54so,
35:54dependent pag yun sila,
35:55so,
35:56manawagan na sag ko,
35:57kinahangla na nga itong mga,
35:59kay,
35:59suunan nga,
36:00nasa evac centers,
36:01ready to eat food,
36:02unsam ng ready to eat food,
36:03kanang easy to open cans,
36:05ba kay,
36:05asa man ilang abridor,
36:07na dadid to,
36:08so,
36:08kanang,
36:09kanang,
36:10there's a lot of,
36:11there's a lot of non-government,
36:13or just simple citizens,
36:15mga tag sila,
36:15o kanang,
36:16mga sopas,
36:17so,
36:18kanang,
36:18init pa ba,
36:19iluto dito,
36:20mag-careful sa ta,
36:21katos ang mga manghatag,
36:22o ready to eat food,
36:23careful po ta sa preparation,
36:25kaya basin o niya,
36:26o mag-poisoning punta,
36:27mas tako na itong problema,
36:29so,
36:30kanang siya,
36:30and then,
36:31kanang,
36:31nanginhalan sila,
36:32trapal,
36:33boots,
36:34kaya,
36:34because of the,
36:35mga buta nga nasa gawas,
36:38ang ilang problema,
36:39matunok,
36:39matunok,
36:40matunok sa,
36:41mga alambri,
36:42katong mga debris,
36:43matunok sila,
36:44dapat magpaangita sila,
36:46o,
36:46gatang,
36:46injection,
36:47for tetanus,
36:49no,
36:49so,
36:51kanasya,
36:51nangita sila,
36:52o,
36:52boots ka roon,
36:53yan,
36:53mo,
36:53ato sa,
36:53sa mga tindahan,
36:55na hurot-hurot sa lang,
36:56boots,
36:56so,
36:56fashion statement,
36:58na ang boots,
36:58roon,
36:59palit kong pink,
37:00aw,
37:01no,
37:01so,
37:02kanasya,
37:02ang boots can help,
37:04para ka nang,
37:05dili ka ma easily,
37:06o,
37:06endure kay,
37:07especially,
37:08o,
37:08ingo ni Juve nga,
37:09lapok pa tao ni Agian,
37:10everyday,
37:11until today,
37:12so,
37:13ah,
37:14kanisya,
37:15doc,
37:16unsa man ka,
37:17ang best practices,
37:19can local governments adopt,
37:21in managing leptospirosis?
37:24well,
37:24number one,
37:25accessible nga,
37:27consultation,
37:27good health care,
37:28manaasili kaduulan ba nga,
37:30free,
37:31kitaghan manani sa itong patient,
37:32ang usasailahang hindrance,
37:35or makapugong nila mo,
37:36consulta sa clinics,
37:37kainay,
37:38bayad,
37:38no,
37:39usan na siya,
37:40and then,
37:40ah,
37:40sa pagkakaroon,
37:41kainay atong mga,
37:42medical mission yung ipang buha,
37:43taghatag-tag free medications,
37:46and,
37:46ah,
37:47kanat,
37:47raising awareness,
37:48and then,
37:49um,
37:49kanat,
37:50unsay kinahanglan nila,
37:51labi na karoon nga,
37:52sige pa sila,
37:53clearing ka na,
37:53mga PPE,
37:54which is,
37:55included na na ang boots,
37:56kay,
37:57um,
37:57dili man leptospirosis,
37:58yung ato ang kontrakaroon good,
38:00pill na ng injuries,
38:01and then,
38:02infections from injuries,
38:03like,
38:04infected wounds,
38:05anya ka na,
38:05tatanuspod,
38:06I think the wounds will,
38:08dakukayo ang risk of,
38:10kanang mo complicate kay,
38:12tungod sa palibot ni mo,
38:13no?
38:13Yes,
38:14like,
38:14after gira tong baha,
38:16kay,
38:16sa hospital,
38:17naagyo,
38:18busy kayong surgery service,
38:20naagyo yung mga,
38:21naputlan tiil,
38:23kay,
38:23tungod sa injuries,
38:24caused by the,
38:25oh,
38:25sa paglusong sa baha,
38:26na,
38:27oh my God.
38:28anyway,
38:30kanang mo ragmakasahad man to eh,
38:31but,
38:31sige lang,
38:32mga igala,
38:33ang mga Cebuano are known to be very resilient,
38:36na igota,
38:36mor tag na double,
38:38double,
38:38na igota o glinog,
38:40makafeel pa ganita sa aftershocks,
38:43but yet,
38:44iigo na ta ni Tino,
38:45but,
38:46you know,
38:47isug,
38:48isug ang mga Cebuano,
38:49you know,
38:49we can,
38:50we can surpass this,
38:52let's just work together,
38:54ah,
38:55but di ta makalimot nga,
38:57the things nga nai tabo sa mga pagbaha,
39:01is,
39:02ah,
39:04there should be people be account,
39:05be held accountable for that,
39:06that's another day for discussion,
39:08but let's focus on the very immediate needs karoon sa atong nasa evakuist,
39:13which is ang atong mga,
39:14buckwheat nga nanginahanglan pa sa mga,
39:17kanang,
39:18mga,
39:18kanang donations,
39:20ang mga relief items na kinahanglan nila,
39:22aside sa mga tambal,
39:24kanil yung tambal,
39:25dili lang tambal sa leptospirosis,
39:27but even taning tambal for,
39:29maintenance,
39:30maintenance,
39:31kay katugyong nai ni Padana,
39:33mag-message,
39:33mom,
39:34asa na akong,
39:35pang kami nangita,
39:35asa na akong iyang mama,
39:37time sa asa man yung mama,
39:38sa kot-kot de ay sila,
39:40in one of the village,
39:41in siya,
39:42problema kay diabetic iyang mom,
39:44and then,
39:45nagunitan ang,
39:46gidada ang insulin,
39:47ba't nabuhihan,
39:48so,
39:49kanang,
39:50wat naman siya nito ba,
39:51kung na-rescue ba ang mom,
39:53or not,
39:54but,
39:54pagka November 4,
39:57grabe kay ang,
39:58ang call for people,
40:00asa,
40:01kanang,
40:02kanang,
40:02nana-bay update,
40:03but it was very difficult
40:04to reach Liloan at that time,
40:06kami na zero,
40:08give me,
40:09what me,
40:10I want me information
40:11of what is happening
40:12in Liloan,
40:13but,
40:14kindigtumanggid ang daghan
40:15kayong inquiries
40:16about kanang,
40:17injuries and highly populated,
40:19et cetera,
40:20so,
40:21kanang,
40:21I hope,
40:21katong na-rescue ra,
40:23narain yung mga ginikanan,
40:25yung maigsuon,
40:25so,
40:26now,
40:27it's time na,
40:28we start moving forward,
40:29kanang,
40:30padung na pasko,
40:31I hope,
40:32ang atong,
40:33the warmth,
40:34and the brightness of our homes,
40:35atong ma-share sa,
40:36atong mga igsuon nga,
40:38na sa evac centers,
40:39nga,
40:40na sila sangit-ngit,
40:41kay limited,
40:41ang suga sa evac centers,
40:43no,
40:43niya,
40:43they're sleeping on the floor,
40:46so,
40:46na muy extra banig,
40:48extra nga,
40:48mga habol,
40:49I think,
40:49are,
40:50and children's toys,
40:51ang children's toys,
40:52kaya,
40:53treatment for the trauma
40:54that they went through,
40:55no,
40:55so,
40:56murag,
40:57parehas sa di,
40:58sa katong bugupod ba,
41:00no,
41:00nga,
41:01kanang,
41:01nalipay na in taong sila,
41:02na swimming pool dito,
41:03ilaghin,
41:04katonginin mong ako,
41:05so,
41:05just to divert their attention
41:07from what happened,
41:09anyway,
41:10this is a very enriching discussion
41:12with Doc Tina,
41:13and,
41:14of course,
41:15my beautiful co-host this afternoon,
41:17si Doc Nikki,
41:18so,
41:19thank you,
41:19Doc Tin,
41:20thank you,
41:20Doc Nikki,
41:21for joining us,
41:23tonight,
41:24na net,
41:25tonight,
41:25tonight,
41:26na net,
41:26and thank you,
41:28for viewers,
41:29for tuning in,
41:29see you again next week,
41:30for another insightful discussion,
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