The Ebola-Reston virus scare in the Philippines

Ebola Hemorrhagic Fever

There was panic and alarm when Ebola virus first emerged as a fatal bleeding disease in Congo (Zaire) in 1978. Similar outbreaks in neighboring countries in Africa occured. Transmitted mainly by body fluids, the acute infection (aka Ebola hemorrhagic fever, EHF) of the Filoviridae family of RNA viruses presented like a typical viral infection— fever, headache, joint and muscle pain, sore throat, and weakness after an incubation of 2 to 21 days. Some manifested with a skin rash, conjunctival injection, diarrhea, vomiting, stomach pain, internal and external bleeding.

There were those who survived and spontaneously recovered, but many with severe infections showed signs of hemorrhage, fluid loss, shock, and eventual death. EHF is feared because it is highly transmissible and carries a high mortality rate.

Reported cases of EHF have been zoonotic infections (animal borne.) A potential agent of bioterrorism, Ebola can present as a nosocomial infection, a disease contracted in hospitals and medical facilities during an outbreak. The exact origin, location, and natural habitat (known as the “natural reservoir”) of Ebola virus aren’t fully known. This makes containment of the infection difficult.

The first 4 of the 5 subtypes of Ebola is known to cause disease in humans: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo. The virulence and lethality of these viral strains are suggested by World Health Organizations’s (WHO) containment recommendations below. EHF has no known vaccine nor specific cure.

WHO’s containment of Ebola

•Suspected cases should be isolated from other patients and strict barrier nursing techniques implemented.
•Tracing and following up people who may have been exposed to Ebola through close contact with patients are essential.
•All hospital staff should be briefed on the nature of the disease and its transmission routes. Particular emphasis should be placed on ensuring that invasive procedures such as the placing of intravenous lines and the handling of blood, secretions, catheters and suction devices are carried out under strict barrier nursing conditions (biohazard.) Hospital staff should have individual gowns, gloves, masks and goggles. Non-disposable protective equipment must not be reused unless they have been properly disinfected.
•Infection may also spread through contact with the soiled clothing or bed linens from a patient with Ebola. Disinfection is therefore required before handling these items.
•Communities affected by Ebola should make efforts to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures, including burial of the deceased. People who have died from Ebola should be promptly and safely buried. — World Health Organization (WHO)

WHO’s therapy and treatment of Ebola

• Severe cases require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids or oral rehydration with solutions containing electrolytes.
• No specific treatment or vaccine is yet available for Ebola haemorrhagic fever. Several potential vaccines are being tested but it could be several years before any is available. A new drug therapy has shown some promise in laboratory studies and is currently being evaluated. But this too will take several years.
• Experimental studies using hyper-immune sera on animals have shown no protection against the disease. —World Health Organization (WHO)

Ebola Reston virus in the Philippines

“In 1989, Reston, an Ebola virus subtype, was isolated in quarantined laboratory cynomolgus monkeys (Macacca fascicularis) in Reston, Virginia, USA. From 1989 to 1996, several outbreaks caused by the Ebola Reston subtype occurred in monkeys imported from the Philippines to the USA (Reston in Virginia, Alice in Texas and Pennsylvania) and to Italy. Investigations traced the source of all Ebola Reston outbreaks to one export facility near Manila in the Philippines, but the mode of contamination of this facility was not determined. Several monkeys died, and at least four people were infected, although none of them suffered clinical illness.”—World Health Organization (WHO)

The Ebola-Reston (ERV,) the fifth subtype of the virus was first found in Philippine monkeys. It has caused disease in primates, but not in humans. Mainly because this that local health authorities seem to be “in control” over the simmering Ebola outbreak that has infected pigs in Pandi, Bulacan.

To make sure the ERV doesn’t spread to the general population, the Philippine government in coordination with the World Health Organization (WHO) is on the process of slaughtering 6,000 infected pigs. So far no person has been reported to have fallen ill of the disease, but there are 6 farm workers and butchers who turned positive for Ebola antibodies. This is surely a cause of concern.

In spite the Department of Health’s (DOH) effort to contain the disease, nobody knows the extent ERV has spread in the country at this time. It is unclear which other animal species harbor the disease agent and need isolation or killing. Philippine health authorities can only speak of what they know—that a number of pigs and some individuals were proven to be positive for antibodies— which means they encountered the virus without suffering signs of illness.

With the potential to mutate and acquire virulence, Ebola-Reston can be transmitted to susceptible hosts and become infective to more animals and humans. Though ERV doesn’t cause disease in healthy individuals, it’s unclear what happens if the virus infects people with weak immunity or those sick of debilitating illnesses. That’s why to avoid epidemics, isolation or euthanasia of infected animals (like in the Avian Flu infection) are high in the list of priorities.

Awareness of the disease is enhanced through step-up public health education. Cleanliness is important. There is heightened watch over the sale of “double-dead” meat that may carry the disease agent. As a precaution, testing for ERV is expanded and export of porcine meat to other countries has been halted.

The strategies to combat ERV is complex and tedious. Despite DOH’s monitoring and vigilance, medical workers have to deal with the challenges of a serious health threat whose outcome is just starting to unravel. The danger of Ebola doesn’t only rest on the Philippines, but on the entire world as well. It’s a global effort that this disease is nipped on the bud. (Photo Credit: [][][][][]/ http://www.bio.davidson.edu /KeeAun)=0=

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Medicine & Religion: Is confession a potent balm against major diseases in RP?

Dr. Francisco Duque III, the secretary of the Department of Health (DOH) reportedly said a staggering 80% of Filipinos are suffering from non-communicable diseases (NCDs) “due to unhealthy lifestyle.” The doctor goes on to say that to combat cardiovascular illnesses, cancers, and diabetes, people have to go to church and make regular “confession.” I find his religious recommendation oddly misleading. It needs clarification.

“Among those considered as NCDs are cardiovascular diseases, cancer, and diabetes. Duque said the three are now among the major health problems in the country. Duque said one way to address this problem is for the people to go on regular confession.” I suggest that they go to church to pray and confess their sins because its one way of managing”—-GMANewTV.net (02/16/09)

It isn’t unusual to blame stress as a cause of sickness. Though stress goes with almost all diseases, its role is often indirect, sometimes obscure, in many organic diseases. As far as science is concerned, most illnesses have underlying pathogenetic bases whose roles are generally far-reaching than the effects of stress.

Heart diseases are related to high fat diet, sedentary lifestyle, and smoking. Diabetes mellitus may have an autoimmune basis but can come with risk factors like obesity, lack of exercise, and genetics. Certain cancers are triggered by stepwise mutations (alterations in the DNA) that generate clones of abnormal cells that invade, metastasize, and eventually kill the body. In all these, stress plays a role, albeit less strongly than what is suggested by Dr. Duque.

The act of confession (reconciliation) taught by certain religions is not shared by all believers. Confessing sins to a priest by the Catholics has markedly dwindled in recent years. Dr. Duque may encounter criticism and opposition in recommending the holy sacrament to prevent non-communicable diseases. There are non-faith based treatments in medicine which are more predictable and efficacious.

Stress is part of the normal challenges of daily living. Not all people who go through significant emotionally disruptive situations get ill in the process. Sick and healthy individuals, suffer from harrowing conditions in varying degrees. As such the roles of stress in every illness are hard to quantify; their effects on the body aren’t uniformly the same.

I believe emotion plus the working of the mind, and the entire body equilibrium are influenced by stress more than it affects specific organs of the body. It is probably the reason why religion, spirituality, a belief in the supernatural, exercise, meditation, and relaxation regimens have some roles to play in disease management. The mechanisms behind their healing properties aren’t fully understood.

Yet, medical science offers credible explanations in disease causation and treatment. Illnesses can be attributed to causes like direct physical injuries, infections, cancers, immunologic conditions, hormonal swings, metabolic derangements, nutritional deficiencies, hereditary disorders, chemical, drug and radiation exposures, poisonings, among others.

Stress is only one among the long list. Therefore, “confession” as Dr. Duque suggested may help in being healthy, preventing sickness, and going through an illness and subsequent recuperation. But surely, we need to account for greater ways to fight diseases more than what have been recommended by the standard and complementary approaches of medicine. This is important in the holistic way of maintaining the health of the nation.(Photo Credits: denislpaul; sacerdotal) =0=

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Medicine & Religion: Is confession a potent balm against major diseases in RP?

Dr. Francisco Duque III, the secretary of the Department of Health (DOH) reportedly said a staggering 80% of Filipinos are suffering from non-communicable diseases (NCDs) “due to unhealthy lifestyle.” The doctor goes on to say that to combat cardiovascular illnesses, cancers, and diabetes, people have to go to church and make regular “confession.” I find his religious recommendation oddly misleading. It needs clarification.

“Among those considered as NCDs are cardiovascular diseases, cancer, and diabetes. Duque said the three are now among the major health problems in the country. Duque said one way to address this problem is for the people to go on regular confession.” I suggest that they go to church to pray and confess their sins because its one way of managing”—-GMANewTV.net (02/16/09)

It isn’t unusual to blame stress as a cause of sickness. Though stress goes with almost all diseases, its role is often indirect, sometimes obscure, in many organic diseases. As far as science is concerned, most illnesses have underlying pathogenetic bases whose roles are generally far-reaching than the effects of stress.

Heart diseases are related to high fat diet, sedentary lifestyle, and smoking. Diabetes mellitus may have an autoimmune basis but can come with risk factors like obesity, lack of exercise, and genetics. Certain cancers are triggered by stepwise mutations (alterations in the DNA) that generate clones of abnormal cells that invade, metastasize, and eventually kill the body. In all these, stress plays a role, albeit less strongly than what is suggested by Dr. Duque.

The act of confession (reconciliation) taught by certain religions is not shared by all believers. Confessing sins to a priest by the Catholics has markedly dwindled in recent years. Dr. Duque may encounter criticism and opposition in recommending the holy sacrament to prevent non-communicable diseases. There are non-faith based treatments in medicine which are more predictable and efficacious.

Stress is part of the normal challenges of daily living. Not all people who go through significant emotionally disruptive situations get ill in the process. Sick and healthy individuals, suffer from harrowing conditions in varying degrees. As such the roles of stress in every illness are hard to quantify; their effects on the body aren’t uniformly the same.

I believe emotion plus the working of the mind, and the entire body equilibrium are influenced by stress more than it affects specific organs of the body. It is probably the reason why religion, spirituality, a belief in the supernatural, exercise, meditation, and relaxation regimens have some roles to play in disease management. The mechanisms behind their healing properties aren’t fully understood.

Yet, medical science offers credible explanations in disease causation and treatment. Illnesses can be attributed to causes like direct physical injuries, infections, cancers, immunologic conditions, hormonal swings, metabolic derangements, nutritional deficiencies, hereditary disorders, chemical, drug and radiation exposures, poisonings, among others.

Stress is only one among the long list. Therefore, “confession” as Dr. Duque suggested may help in being healthy, preventing sickness, and going through an illness and subsequent recuperation. But surely, we need to account for greater ways to fight diseases more than what have been recommended by the standard and complementary approaches of medicine. This is important in the holistic way of maintaining the health of the nation.(Photo Credits: denislpaul; sacerdotal) =0=

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Nepalese MD’s to train and render service in Bicol Medical Center

As a result of the drop in the number of medical school graduates and the exodus of local doctors to foreign countries, the Bicol Medical Center (BMC) in Naga City has resorted to bringing in 40 doctors from Nepal. From the remote country close to Mount Everest, Nepalese foreign medical graduates will be in the city to train and render service.

“The Bicol Medical Center (BMC) in Concepcion Pequeña, Naga City is a 500-bed government tertiary hospital under the direct supervision of Department of Health Center for Health Development – Bicol, Legazpi City. It is a non-profit institution and one of the 13 medical centers under the National Government.” http://doh.gov.ph/bmc (Photo Credit: bmc)

The presence of imported healers in Naga is expected to beef up the medical personnel of the government hospital which has suffered the lack of MDs for the last 5 years. There have been fewer applicants to fill in the 28 doctor-vacancies in BMC. Therefore, the coming of the international physicians appears to be a boon to the hospital service in the city. But is it?

Without inciting any nativist sentiment against the foreign professionals, I think it is justified to ask if the Nepalese doctors’ schooling is comparable to those of the local physicians. The adherence to standard medical training (i.e. in the tradition of Western allopathic medicine) is important before they are allowed to handle patients. Their medical background must be adequate to meet the peculiar health needs of the community. To ascertain competency and avoid compromising the health of patients, they must be tested for basic communication and clinical skills.

Though the Department of Health (DOH) approves of these foreign doctors, does the government have guidelines that define the scope of medical duties and accountability? Are the professional regulations in place to protect the doctors, their patients and the hospitals where they work? Will the presence of these trainee-MDs not interfere with the training and oversight of local doctors, nurses, and other paramedical professionals? Are there enough senior MDs to supervise and teach them? Are they not in violation with the rules of the Professional Regulations Commission (PRC) which regulates physician licensure and practice? Has there been discussions on the effects of foreign doctors on the healthcare of the nation? Their presence may distract the government from pursuing the programs which will make local doctors stay and serve the community instead of going abroad.

In a blog I posted on August 27, 2008, I wrote:

According to Philippine Medical Association (PMA) president Reynaldo Santos, M.D. the arrival of these foreign medical trainees attests to the high quality of education in the country. But this is doubted in the wake of a sharp decline of the number of hospitals, a marked rise in patient load for doctors and nurses, a low passing rate of Filipinos in the United States Medical Licensure Examination (USMLE,) an over-crowding of patients and trainees, lack of budget, equipment upgrade, and medical facilities in many hospitals.

I hope Bicol Medical Center has ironed out the important issues cited above. Otherwise, sending in the Nepalese doctors will solve some of the current healthcare problems of Naga City, but it can also spawn fresh and bigger challenges that haven’t been given enough attention and consideration.=0=

RELATED BLOG: “RP’s 40% drop in med school enrollment & the foreign doctors” Posted by mesiamd at 8/27/2008

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DOH’s plan to spend P90 million for random drug testing

The Department of Health (DOH) plans to spend P90 million on random drug testing for high school and college students. Supposedly, the money is earmarked to develop manpower and laboratory resources for the test which is expected to give teeth to the fight against drugs in the country.

On the basis of trying to find out the prevalence of drug abuse the Commission of Higher Education (CHED,) DOH and its secretary Dr. Francisco Duque believe the testing is justified. They chorused it is needed in setting up strategies in controlling the problem as Pres. Gloria M. Arroyo steps up her campaign against illegal drugs.

According to Inquirer (01/29/09 Pazzibugan, D,) the test will be done in the next 7 to 9 months on 87,000 students from 8,750 high schools and 2,000 colleges nationwide. Based on past random drug testing, about 0.8% of 8,670 high school students and 0.5% of 7,499 college students tested positive for drugs. Notably, those who tested positive (majority use marijuana) aren’t a lot compared to many Filipinos who are sick and in need of urgent medical attention.

Does it mean that the government is willing to spend P1,034.48 for every student in order to track down about 696 students, the 0.8% who are expected to be positive in the test? If they find out who are positive, do the authorities have additional money to “treat & rehabilitate” them? Will the money for drug testing be better used for other serious health problems that involve a larger number of people who may need more medical attention—-i.e. tuberculosis, malaria, dengue? Or can funds be used to improve the facilities of schools?

Why is testing being planned for the teachers and not for other professionals? Why doesn’t the government directly run after the drug dealers? How come only the students and teachers are being singled out to undergo the test? Why can’t they not include the regular workers, unemployed, drivers, military personnel etc.? What are the safeguards that medical information culled from the testing will be handled confidentially and not be used or abused for other purpose? Isn’t privacy violated and civil liberties invaded when this testing is done?

The above questions may help in deciding if the controversial drug testing plan is worthwhile to pursue. At this time of economic crisis, wise spending can go a long way in helping the neediest. If a law on drug testing is to be applied fairly, it must cover the entire population and not single out a particular group. Organizations like the Alliance of Concerned Teachers (ACT) and the National Union of Students of the Philippines (NUSP) have valid reasons to oppose the rationale and legality of this plan. (Photo Credit: Mooosh; Suntoksabwan; Latin Snake) =0=

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Campaign against firecrackers and fireworks

A counter-move against the merry tradition of bidding a noisy ending of the year, young students in Manila staged rallies against firecrackers. In a gathering spearheaded by EcoWaste foundation, environment-conscious students in Malate, brought attention to the dangers and polluting effects of firecrackers during the holiday.

In Negros Occidental and Cadiz City, an estimated P300,000 and P100,000 worth of illegal pyrotechnic devices respectively were confiscated by authorities. Similar operations where conducted in various cities all over the country as the new year draws near.

Although the Department of Health (DOH) has made headway in discouraging the use of firecrackers with the use of explicit anti-firecracker ads, hospitals in the country are in “Code White Alert” in anticipation for more people who might need medical attention. More than a hundred injuries have been reported including at least three directly inflicted by gunfire.

The argument against the firecrackers and indiscriminate gunfire at this time is easy to understand, but annually, Filipinos needed to be reminded of the risks and perils. Students and concerned Filipinos standing against firecrackers are helpful in getting this message across. (Photo Credit: Malaya/ Philip Duquiatan) =0=

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Firecrackers to rid us of bad luck of the past year

There is urgency in the young man who works fast at a deadline. He is one of the fire-cracker makers in one of the busy pyrotechnics hub in Bulacan from where many fireworks on the streets come from. Dirtied by gunpowder and grime, the man rushes firecracker production in his make-shift factory during the Christmas holiday, oblivious of the risks it poses on his life and on his neighbor.

Revelers this Christmas and new year seek to buy fireworks for their rowdy celebration. By our tradition, the bang and bright display are ways to mark the coming year —the Filipino merry-making which doubles as an occasion to ward off bad luck.

According to our folk beliefs detonating firecrackers is needed to invite life’s good forces on the first day of the year. Whether this is true or not, we are thrilled by the spark and sound of firecrackers. A fast buck can be gained by trading watusi, bawang, “belt of judas, and lolo when the demand is there.

Body injuries and burns are some of fireworks’ drawbacks. Eardrums have been ruptured by the loud blasts. Explosive debris have pierced the eyes. Houses have been gutted down and many mutilations and deaths have been reported. Last year, the Department of Health (DOH,) has listed about 750 fire-cracker injuries. Public hospitals are now on alert in anticipation for those who may be brought to the emergency rooms.

As of December 21, 2008, it was reported that of the 119 holiday-related injuries documented, 115 were from firecrackers and fireworks,, 3 were gunshot wounds and 1 from ingestion of watusi.

There is obviously a need to regulate the use of pyrotechnics for the protection of the public. Shoddy manufacture of firecrackers brings problems of safety, giving a boost to the sale of the ones imported abroad. There’s little implementation of laws—even gunfires and pistol shots are recklessly substituted for fireworks at the height of celebration. Though most of us know the dangers, the relentless campaign for the safe use of fireworks during holidays remains a job in progress.(Photo Credits: _gem_s; Reuters/ Ranoco, Romeo; Reuters/Ranoco, Romeo; persesverando)=0=

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Ships hijacked by pirates, an earthquake in Indonesia and the decline of RP peso

7

Is the total number of ships hijacked by Somali pirates on since November 5, 2008 in the Aden Gulf. The latest hijacked ships are operated by the Islamic Republic of Iran and that of Saudi Arabia, a super oil tanker carrying $100 million worth of crude oil. In the past ransoms were paid to recover the ships, but nations are finding ways to foil piracy in the busiest sea lane of the world.

P49.96

At the close of business trading on November 18, 2008, the peso-dollar exchange has floundered close to P50/per dollar. The slide of the peso value is expected to continue as local and foreign effects of recession take its full effect.

7.5

Recorded in the Richter’s scale is strength of the quake that hit Indonesian island Sulawesi on November 17, 2008 which reportedly killed at least 6 persons, toppling houses and injuring scores of people. A tsunami warning from US officials in the area was raised within 1,000 kilometers (620 miles) from the quake’s origin, but was later lifted.

$1.2 billion

Bangko Sentral of the Philippines (BSP,) discloses this amount of deficit in the balance of payments (BOP) mainly attributed to capital flight, weak exports, and payment of maturing obligations. BOP is the record of the country’s transactions with the rest of the world and its deficit in October 2008 reduces this year’s surplus in a 10 month period to $345 million, down from $7.87 billion registered year-on-year.

77

Is the reported number of people who contracted typhoid fever in Quezon. Caused by Salmonella typhosa, the diarrheal disease with systemic manifestations is linked with contaminated water supply. The Department of Health (DOH,) advises boiling of water and frequent hand-washing to counter the spread of the disease. In a separate outbreak, 2 persons died of another diarrheal illness in Misamis Oriental. Reported on 11/18/08, about 1,000 people have sought treatment in the hospital for complaints which are suspicious of cholera. (Photo Credit: by Moody_fingers) =0=

The Death Clock and the Dangers of Smoking

In the last week of September 2008, Mar Arguelles wrote in Bicol Mail about a “death clock” which ticks for millions including Filipinos who use tobacco. In support of the anti-smoking initiative, I thought I must blog on smoking because it is truly a menace that is linked to a myriad of respiratory illnesses notably lung cancer, asthma, emphysema, pneumonia and other airway diseases. The adverse effects of smoking go beyond the lungs. The heart, blood vessels, gastrointestinal tract, the nervous and urinary systems are among the body organs that bear the brunt of continued exposure to the hazardous biochemical pollutants in cigarette smoke.

In Legazpi City, Philippines, the local government in coordination with the Department of Health (DOH,) multisectoral organizations and preventive medicine advocates introduced the “Death Clock,” a graphic count and warning system on the danger and lethality of smoking. It aims to discourage smoking and urge people to stop the habit. According the World Health Organization (WHO,) smokers in ASEAN countries account for 10% of the 1.25 billion smokers worldwide.

PHILIPPINES IS SECOND IN THE MOST NUMBER OF SMOKERS AMONG ASEAN NATIONS
Country/%/# of Smokers in Millions
Indonesia———-46.16%———–58.07
Philippines———16.62%———–20.91
Vietnam————14.11%———–17.75
Burma————–8.73%————10.98
Thailand————7.74%————-9.74
Malaysia————2.90%——– —-3.65
Cambodia———-2.07%————–2.60
Singapore———-0.04%————–0.05
Others————–1.63%————–2.05
ASEAN Countries–Total————- 125.8
Source: Southeast Asia Tobacco Control Alliance (SEATCA) Philstar (09/04/07, Crisostomo, S)

The “Death Clock” is a visual countdown on the number of smoking-related deaths since House bill 3364 or the Picture-Based Health Warning Bill was filed in December last year. The visual countdown indicated that 66,960 Filipinos have already died due to smoking-related diseases as of September 24, 2008. At least 1,680 are expected to die within the next seven days. DOH statistics showed that at least 240 Filipinos die every day, or 87,600 every year, due to smoking-related diseases.” Bicol Mail (09/25/08, Arguelles, M)

The smoking problem in the Philippines can be traced to the active promotion of cigarettes in the early 1960’s. As such it is a problem that can be solved by behavior modification—educational campaigns, designation of non-smoking areas in public places, tobacco warning labels, imposition of high cigarette taxes, regulation of tobacco advertising especially among minors, control of cigarette importation, disincentive to those who cultivate and sell tobacco, assistance to those who seek jobs away from the tobacco industry and prosecution of violators of anti-smoking laws.

A sharp drop in the smoking habit has been realized by wide anti-tobacco campaigns in developed countries, yet a sustained drive must be done to totally eradicate the dangerous habit. These approaches have applications in other health problems as well like alcoholism and obesity. (Photo Credits: CRDancer; FranklinParkLibrary.com; sunnyUK) =0=

Philippines’s Melamine Scare: 2 Million Kilos of Milk Imported From China This Year

It took nearly two weeks before Philippine authorities finally revealed that there had been 2 million kilos of milk imported from China from January to August this year. As the scare of melamine-contaminated milk exploded in the news, about 53,000 children, mostly from China, have been sickened by the adulterated milk which causes urinary malfunction and kidney stones. There are some reports of death.

Melamine, an industrial chemical used for the manufacture of plastics, has been added to milk to make it appear thick and proteinaceous. (see blog entitled “Import ban of 30+ generic drugs from India & melamine-contaminated milk from China” dated September 17, 2008.

The first reaction from the Philippines was to monitor the milk being sold in the market which is flooded with smuggled goods. The Department of Health (DOH) announced later that hospitals are being watched for sickened children that could be linked with melamine. Not until today, September 25, 2008, there was no mention by the Bureau of Customs that milk from China has in fact entered the country.

“In a memorandum circular issued to all Customs district and port collectors, Morales said that all existing licenses of Chinese milk and dairy product importers have been revoked and canceled following the Department of Health’s ban on the importation, distribution and sale of milk and dairy products from China.

“I issued the circular adopting the order of the DOH to ensure that there would be no more importations of milk and dairy products from China,”—Customs Commissioner Napoleon Morales PDI (09/25/08, Ortiz, M)

Here are some questions worth thinking about. Why is testing for melamine being done only now when the scare has been there for sometime? Until now why is there no laboratory result? How many of the milk comes from Sanlu, the main manufacturer of the melamine-tainted products from China? Have the authorities also tested smuggled milk that’s not part of the imports the government has identified? Has there been any report of children getting sick from ingestion of milk from China? Why did it take the government too long to inform the public of these milk imports? How can the government make dissemination of information faster? =0=