By S. S. Suarez
Mang Ambo (not his real name), 51 years old, has been working as a stevedore in Manila North Harbor. He has been doing the same back-breaking job for 25 years. Under extreme heat and sometimes harsh rains, Mang Ambo would still work his way to complete his task to earn his daily wage. “No work, no pay” is a common practice in stevedoring operations in North Harbor.
Mang Ambo was only eighteen years old when he left Leyte island in the Visayas to try his luck in in Manila. Taking different jobs, he finally settled down in a nearby slum in North Harbor. The one-bedroom makeshift house is hot during summer and damp after the rains. It’s a harsh living condition. Cramp and filth are breeding grounds for diseases. Poor sanitation is a perennial problem in this kind of living environment. Eventually, Mang Ambo and two of his children, age four and six, contracted Pulmonary Tuberculosis (PTB). His wife is also manifesting TB-like symptoms because of persistent productive cough. Because of the infection, Mang Ambo’s employer terminated his services until he got the proper treatment. Pity Mang Ambo, a daily wage earner and a father of four. Jobless and sick, who will now bring food on the table for his family?
The story of Mang Ambo is just one of the many TB incidences in the country today. TB remains a major public health problem in the country. Despite availability of drugs, TB continues to kill 68 Filipinos daily. According to the Department of Health (DOH). TB incidence is the highest among the productive age group (21-59 yrs old).
Contrary to popular belief, TB infection occurs when a susceptible person inhales droplet nuclei containing the bacteria and becomes established in the body. Hence, TB is airborne and could not be contracted from using utensils used by a TB patient.
There are various symptoms that may indicate exposure to TB. These include: lethargy, weakness, fatigue, fever, weight loss, persistent productive cough, coughing up blood, loss of appetite, and night sweats. The Mantoux tuberculin skin test is used to detect TB infection. Positive result indicates TB infection. Other tests are needed to confirm TB disease. TB is largely a preventable disease. Several drugs are used to treat TB. The most common drugs are isoniazid (INH) and rifampin.
Many confirmed cases involve workers and the Department of Labor and Employment (DOLE) is certainly aware of the threat of this health problem to workers and workplace productivity. Thus, DOLE issued Department Order 73-05 mandating companies with 10 or more employees to implement a TB prevention program in the workplace.
I was a TB educator myself. In my previous role as Health and Safety Department Head, we partnered with the Philippine Business for Social Progress (PBSP), a non-stock, non-profit non-government organization to implement a TB Prevention in the Workplace Program in our company. PBSP transferred their knowledge and technology to our team without asking for any fees.
PBSP taught us how to set up the policy and procedures for early detection, treatment and prevention of TB in the workplace that adhere to current guidelines established by the Comprehensive and Unified Policy for Tuberculosis Control (CUP). CUP has standardized the prevention and control in both public and private sectors directly through its implementing guidelines, and indirectly through compliance with SSS, ECC,and PHIC policies.
To ensure the success of the program, we adopted DOTS as the strategy of choice. DOTS stands for Directly Observed Treatment Short Course which adopt the Direct Sputum Smear Examination (DSSE) as the primary diagnostic tool for TB and not X-ray results.
Before commencing treatment, TB patient must identify his/her home-treatment partner. Our company conducted TB counseling sessions/TB orientation for the employee-patient and the treatment partners identified. We also ensured that the complete drug regimen is available. The company nurse dispenses TB drugs every two weeks to the treatment partner. Daily supervision of treatment (drug intake) is taken by the designated home-treatment partner
Without waiting for six months, the employee is allowed to return to work upon issuance of a medical clearance, supported by a duly accomplished treatment card. The company nurse will be the treatment partner when TB patient returns to work. The company nurse shall assign another HR staff member as treatment partner in case he/she will be on leave to ensure continuity of treatment.
The law is very clear that we should not discriminate against TB patients in the workplace. They have their rights too. So when you detect someone with TB, don’t discriminate and terminate the TB patient from his job. You must show compassion. The company must maintain an open door policy for qualified applicants diagnosed with TB who are willing to undergo treatment following the DOTS strategy.
