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Chapter 1

BACKGROUND AND SETTING OF THE COMMUNITY

A. Historical Background

Pursuant to Republic Act 6975, also known as the Department of the Interior

and Local Government Act of 1990, The Bureau of Jail Management and Penology

(BJMP) was created on January 2, 1991. As one of the five pillars of the Criminal

Justice System, BJMP was created to address growing concerns of jail management

and penology problem. Primarily, its clients are detainees accused before a court who

are temporarily confined in such jails while undergoing investigation, waiting for final

judgment and those who are serving sentence promulgated by the court 3 years and

below. As provided for under R.A. No. 6975, the Jail Bureau is mandated to take

operational and administrative control over all city, district and municipal jails.

With the expansion of BJMP facilities in the country made way to the creation

of a female friendly facility supported by the Women Development Code of Davao

City, also known as the City Ordinance 5004 and Executive Order No. 24, Section 68.

The Davao City female jail was a proposed facility on May 2004 as a project of

Mayor Rodrigo R. Duterte, with the Local Government of Davao City. Three million

pesos was allotted for the perimeter and secondary fences construction for the proposed

facility. On March 2005, a Memorandum of Agreement between the BJMP and Gawad

Kalinga was signed to strengthen the partnership between them. Through the help of
generous partners who funded the said project, the New City Commercial Center Cares

Foundation (NCCC Cares Foundation) and Metro Davao Sports Association (MEDSA)

with the partnership of Gawad Kalinga, the Ray of Hope Village materialized.

On March 2008, the Phase 1 of the village, which consisted of 5 duplex houses

was inaugurated and turned-over to the BJMP personnel. The 10 cottages were

constructed and each was built with comfort rooms. The houses were painted; windows

had decorative steel grills which gave a home-like ambience of the inmates. Although

it is still a jail, it is considered a home at its heart. It carries the GK character and spirit,

thus the name ‘Ray of Hope Village’. On August 2008, the GK-Ray of Hope Village

Phase 2, funded by the MEDSA was turned-over to BJMP through the initiative of

Mayor Rodrigo R. Duterte.

B. Physical Description of the Area

The GK-Ray of Hope Village is a 5,400 square-meter jail compound that used

to be an idle lot within the compound of Davao City Jail located at the Telecom

Reservation Area, Purok 25, Barangay Ma-a, Davao City. The location is

approximately 4 kilometers from Davao City proper or around 10 minutes of

convenient access to the City Hall and the Hall of Justice. It holds the 20 bungalows

and each cell or cottage is 20.25 sqm with a floor area of 405 sqm and has a capacity

of 15 detainees per cottage. There is a main gate with a visible guard post that separates

the facility from the public, a parking area for the official vehicles divides the entrance

between the female and male sections of the jail. A second gate on the left side of the

compound is where the entrance to the female section is located. Another guard post is
situated here for inspection of visitors. A third gate is placed prior to finally entering

GK-Ray of Hope Village. Upon entering the village, a basketball court is located on

the right side and a gazebo, a playground and an Interfaith Building is placed on the

left. There are 5 duplex houses (a total of 20 cottages) situated on the either side of the

village’s Activity Hall. The Activity Hall is found at the heart of the village where

morning meetings, visitations, and other activities are being held. A third guard post is

situated in front of the multipurpose function hall. Behind the Activity Hall is where

the Canteen, the Bakery, a small Clinic and the Sewing Area is found. At the back

portion of the village is where the Kitchen and Laundry area is located.

Figure 1.1 Davao City Female Jail, Ma-a, Davao City

C. Organizational Structure

There are a total of 31 Jail Officers rotating on a 24 hour shift. Twenty-six of

which are female and Five are male. These jail officers supervise the activities inside
the village. A warden oversees and manages all the operations and activities inside the

village. She is stationed at the office along with two other administration officers. There

are also three senior officers of the day, seven escorts, and eighteen custodial officers.

Each one of them plays a specific role and does specific tasks, but all for the purpose

of peace and order inside the village.

The total jail population as of February 2019 is at 411 female inmates.

Approximately eighty-eight percent (90%) of these detainees’ cases are due to drug-

related crimes. Other cases (10%) include robbery, murder, arson, estafa, illegal

possession of firearms and explosives, and child abuse.


Figure 1.2 BJMP Davao City Female Jail Directory
Chapter 2

DEMOGRAPHIC PROFILE

A. Population Size and Composition

Population Size

At present, the total population of female PDLs in Gawad Kalinga Ray of

Hope Village is currently at 411. There are 20 duplex cottages available in the area

with an ideal capacity of 5 PDLs, but because of the large population of detainees,

the cottages have occupants ranging from 12 to 30 PDLs. The researchers were able

to gather data from 245 detainees. The respondents were chosen through random

sampling, with 12-13 respondents for each cottage.

Age

100 93
90

80

70 67

60

50

40 34
28
30

20 16

10

18-25 y.o. 26-35 y.o. 36-45 y.o. 46-55 y.o. 56 y.o. and above
Figure 2.1 Age Profile of Respondents
The majority of the respondents belong to the 26-35 years age group with

a total of 94 respondents. There are 67 respondents within the age range of 36-

45years, 34 respondents within the age range of 18-25 years, 28 respondents within

the age range of 46-55 years, 16 respondents within the age range of 56 and above

years

Civil Status

16%

34%
Single
9% Married
Separated
Widowed
10%
Partnered

31%

Figure 1.2 Marital Status of Respondents

The majority of the respondents are single with a total of 83 (34%)

respondents. There are 76 (31%) respondents who are married, 39 (16%)


respondents who are partnered, 24 (10%) respondents who are separated, and 23

(10%) respondents who are widowed.

Educational Attainment

1%
7%
20%

16%
Primary
Secondary
College
Postgraduate
Vocational

56%

Figure 2.2 Educational Attainment of Respondents

Majority of the respondents have a secondary level of education with a total

of 137 (56%) respondents. There are 49 (20%) respondents who have a primary

level of education and 39 (16%) respondents who are either college undergraduates

or have attained a college degree, 17 (7%) respondents who have a vocational

education, and 1 (1%) respondent who has a postgraduate education.


B. Social Status

Residence

14%

33%
8%
Davao del Sur
Davao del Norte
Davao City
Davao Oriental
Others

5%

40%

Figure 2.4 Residence of Respondents

Forty percent (40%), which is the majority of the respondents, are residents

of Davao City. Thirty-three percent (33%) are from other different nearby

provinces and cities including Marawi City, Lanao Del Sur, Lanao Del Norte,

Maguindanao, Cotabato, Bukidnon, Compostella Valley, Southern Leyte, Marawi,

Digos, Zamboanga, Samal City, Saranggani, Cebu, Butuan, General Santos, Bohol,

Surigao del norte, Surigao del sur, Iloilo City, Agusan del sur, Misamis Occidental,
Leyte, Cagayan de Oro City, Ozamiz City and Pasig City. Fourteen percent (14%)

are from Davao del Sur, eight percent (8%) from Davao del Norte, and five percent

(5%) are from Davao Oriental.

Religion

29%

Roman Catholic
Non-catholic
Islam
62%
9%

Figure 2.5 Religion of Respondents

Sixty-two percent (62%) of the respondents are Roman Catholics, which is

the majority of the population. Twenty-nine percent (29%) of the respondents’

religion is Islam, and nine percent (9%) of the respondents’ religion is comprised

of non-Catholics including Protestants, UCCP, Born Again, Evangelical,

Pentecostal, Adventist, Jehovah’s' Witness, Iglesia ni Cristo, Baptist and Seventh

Day Adventist.
Language

1%
3%
7%

5%

22%

Maranao
Tagalog
Bisaya
Tausug
Maguindanaon
Others

62%

Figure 2.6 Spoken Language of Respondents

Sixty-two percent (62%) of the respondents primary spoken language is

Visayan, which is majority of the population. Twenty-two percent (22%) of the

respondents primary spoken language is Tagalog, seven percent (7%) is


Maguindanaoan, five percent (5%) is Tausug, three percent (3%) is Maranao, and

one percent (1%) are other languages including Waray and Ilocano.

C. Economic Status

Source of Income

1%

3%
5%

15% 32% Self-employed


Employed
Housewife
Family Support
Drug trade
Benefits/Pension
17%
Sex Worker

27%

Figure 2.7 Source of Income of Respondents Before Detention

Most of the respondents’ source of income came from self-employment

before their incarceration with a total of 91 respondents (32%). There were 76

(27%) respondents who were employed, 49 (17%) respondents who were


housewives, 41 (15%) respondents who were supported by their respective

families, 15 (5%) respondents who were involved in drug trade, 8 (3%) respondents

who was receiving different types of pension, and 3 (1%) respondents who were

sex workers. A number of the respondents had multiple sources of income.

Family Income

P 50,000 – 60,000 1

P 60,000 – 70,000 2

P 30,000 – 50,000 9

P 20,000 – 30,000 14

P 0 – 1,000 17

P 15,000 – 20,000 21

P 10,000 – 15,000 30

P 5,000 – 10,000 56

1,000 – 5,000 67

0 10 20 30 40 50 60 70 80

Figure 2.8 Monthly Household Income of Respondents Prior to Detention

A total of 67 respondents have a family income ranging from 1,00 – 5,000

pesos monthly having the most of the participants out of the 245. The Philippine

Statistics Authority (PSA) currently pegs the poverty threshold at Php9,063.75 a

month for a family of five, or Php60.43 per day per person. The data acquired
reveals that majority of the respondents prior being detained are living below the

poverty threshold.

Income Sufficiency

55% Sufficient
45%

Figure 2.9 Income Sufficiency Perception of Respondents


Fifty-five percent (55%) of the respondents perceived that their income

prior to detention was insufficient for their daily needs while only forty-three

percent (43%) of the respondent perceived it to be sufficient.

D. Prison History

Prison Time

1%

25%
30%
Less than 2
2-3 yrs
4-5 yrs
>6 year
Months
weeks
7%
27%
10%
Figure 2.10 Prison Time of Respondents

Majority of the respondents have been detained in the facility for less than

one year with a total of 73 (30%) respondents. 65 (27%) respondents have been in

detention for 2-3 years, 61 (25%) respondents have been in detention for less than

2 years, 23 (10%) respondents have been in detention for 4-5 years, 18 (7%)

respondents have been in detention for 6 years or more, and 2 (1%) respondents

have been in detention for only a couple of weeks.

Type of Crime

Table 1.1 Reason for Imprisonment of Respondents

Crime No. of Respondents


Drug trade 128
Murder 2
Robbery 5
Drug Use 92
Kidnapping 1
Prostitution 2
Estafa/Fraud 2
Gambling 1
Human trafficking 1
Liquor ban 1
VAWC 2
Political detainee 1
Illegal detention 1

Majority of the total respondents have drug-related cases, with fifty-three

percent (53%) of the respondents arrested due to drug trade and thirty-eight percent

(38%) due to drug use. Eight percent of the cases are related to murder, robbery
kidnapping, prostitution, Estafa/fraud, gambling, human trafficking, violation of

liquor ban, VAWC, political detainee and illegal detention.

History of Imprisonment

17%

Yes
No

83%
Figure 2.11 History of Previous Arrest of Respondents

Majority of our respondents have never been imprisoned before, a total of

188 (83%) respondents. Only 39 (17%) of the respondents had a history of prior

arrest. Majority of cause of prior arrest is the selling of illicit drugs.

Chapter 3

LIVING ENVIRONMENT

A. Physical Environment

Cottages
The facility has twenty low-cost type duplex cottages with concrete floors and

walls, galvanized iron roofing and large windows which provides adequate ventilation.

One cottage houses 12-30 detainees.

Water Supply and Sanitation


The detainees provide their own water storage. The two water sources of the

facility are Davao Water District and a jetmatic pump connected to a deep well. The

tap water from Davao Water District is used for drinking, bathing, and laundry while

the water from jetmatic pump was used for watering the plants and cleaning purposes.

Each cottage has a comfort room for the use of all the residing detainees.

Waste Management

Waste management is strictly implemented inside the community. A clean

surrounding is a must and is a part of discipline training. Large trash bins are provided

for proper waste segregation. The canals are also cleaned regularly. These wastes are

then collected twice a week by the Community Environment and National Resource

Office (CENRO) for proper disposal.

Sleeping Area
4% 1%

21%

74%

Floor Rubber Mat Carton Mattress

Figure 3.1. Sleeping Area of Respondents

Majority of the respondents sleeps on the floor (74 %), while the remaining

respondents sleeps on the floor with covered rubber mats (21 %), cardboards (4%),

and a proper mattress (1 %).


B. Biological Environment

Animal Pests

4%
12%
27%

11%

46%

Cockroaches Rats Mosquitoes Flies None

Figure 3.2. Animal Pests In the Area

Majority of the respondents were concerned with pests in their area. Most

of the respondents complained about rats (49%) in the area. This was followed by

cockroaches (27%), flies (12 %), and lastly mosquitoes (11 %). A small number of

respondents (4%) did not have any complain against these pests.
C. Psychosocial Environment

The detainees of Gawad Kalinga-Ray of Hope Village are uniquely named

as “Bakasyonistas”. The village shows of a community filled with plants, artistic

handmade decorations, colored cottages, sports and recreation area and a beautiful

garden. Different organizations come to visit every week to hone the detainees’

philosophies and attitudes towards life. The facility offers different programs fully

implemented to manage the detainees’ behavioral, psychological, emotional,

intellectual and spiritual aspects of life.

Sports and Recreation

The community is busy most of the time participating in different set of

program activities created to hone their talents and skills in sports, arts and

craftsmanship. They always look forward to Sportsfests, Variety shows, Film

Viewing, Zumba gatherings, and the like. They have a covered court and stage

where all in doors activities are held decorated with colorful and designs and a

basketball court where all outdoor activities are held. The detainees always have

their morning exercise at 5-6 AM every day and are allowed to use the basketball

court from 9-11 AM every Mondays and Fridays for sports and recreation activities.

They also engage in painting, twine bags making, crochet and baking and make

them their hobbies, at the same time, source of income.

Education

A College Education Program and Alternative Learning System (ALS) is

offered in the facility as well as a mini library that allows the female detainees to

educate themselves. Nine detainees are in college and are studying in the newly
built two story building of College Education Behind Bars of Social

Entrepreneurship Institute Technology and Business Institute Incorporated

(SETBIFI). About 56 detainees are under the ALS program using 3 cottages as their

lecture rooms from 1:00 p.m. to 5:00 p.m. under the supervision of their professors

hired by the government. Examinations are conducted from time to time.

Livelihood

Equipped with baking/bread making, sewing/dress making, painting and

twine bags making from their skills training program in partnership with TESDA

RO-XI, they managed to uphold themselves, bring out their talents, become

independent and earn money. Their durable and affordable products and gorgeous

paintings are being sold internationally. Other services are also offered like laundry,

massage, hair cutting, and manicure/pedicure and make-up services.

Transport

The facility has its own ambulance used for medical emergencies. High

security vehicles are also used for transport of detainees upon approval of a court

order.

Community Organization

Discipline is strictly implemented along with peace and order within the

community. To maintain these, the facility has established a well-organized system

of BJMP staffs and their chosen qualified cottage leaders. Cottages have their own

leader and other officers who discipline them and listen to everyone’s concerns

inside the community. The detainees also have their overall team president. In cases
of serious problems, the BJMP staff handle the issue and intervene once

disagreements are present.


Chapter 4

HEALTH PROFILE

A. Acute Medical Conditions

The following are the existing acute medical conditions identified in our

respondents, assessed or diagnosed prior to and during imprisonment by appointed

health personnel from February 2016 to February 2017:

Table 4.1 Number of Respondents with Existing Acute Medical Conditions

Condition Frequency %
Colds 117
Cough 106
Fever 89
Diarrhea 38
Vomiting 10
Urinary tract infection 5
Abdominal Pain 2
Allergy 1
Dizziness 1
Toothache 1

The respiratory problems, colds and cough, are the leading acute medical

conditions among the respondents over the past year. These are followed by fever,

diarrhea and vomiting. Most of the acute medical conditions are treated using over-the-

counter medications provided by the infirmary.


B. Chronic Medical Conditions

Table 4.2 Number of Respondents with Existing Chronic Medical Conditions

Condition Frequency %
Hypertension 46 26.9
Bronchial Asthma 27 15.8
Diabetes Mellitus 21 12.3
Arthritis (Gout) 16 9.3
Allergic Rhinitis 14 8.2
Goiter 11 6.4
Cardiac Disease 7 4
Skin Disease 6 3.5
Stroke 5 2.9
Mental Illness 4 2.3
Kidney Disease 3 1.7
Epilepsy 3 1.7
Cancer 2 1.2
Tuberculosis 2 1.2
Breast Mass 1 0.5
Chronic Pneumonia 1 0.5
Hepatitis B 1 0.5
Hypercholesterolemia 1 0.5

Of the 245 respondents, 171 claimed to have chronic medical conditions

diagnosed before detention. The most common chronic medical condition is

hypertension, followed by bronchial asthma, diabetes mellitus and gouty arthritis.

These respondents are given with maintenance medications such as antihypertensives

and hypoglycemics, which are provided by the infirmary.


C. OB-GYN Illnesses

Table 4.3 Number of Respondents with Existing OB/GYN Illnesses

OB/GYN Illness Frequency %


Ovarian cyst 1 33.33
Uterine myoma 1 33.33
Ovarian cancer 1 33.33

Among the 245 respondents, there were only 3 who claimed to have OB/GYN-

related conditions diagnosed prior to and during detention. These cases are ovarian

cyst, uterine myoma and ovarian cancer.

D. Diet and Nutrition

Table 4.4 Sample 1-Week Menu for the PDLs

Day Breakfast Lunch Dinner


Sunday Rice and dilis Rice and guisadong gulay Rice and law-oy
Monday Rice and odong Rice and adobong batong Rice and paksiw
Tuesday Rice and scrambled Rice and tawge Rice and pansit
egg
Wednesday Rice and bulad Rice and ginataang Rice and tinolang
monggo manok

Thursday Rice and sopas Rice and dinengdeng Rice and bas-oy
Friday Rice and beef loaf Rice and salad talong Rice and bam-i
Saturday Rice and ginisang Rice and pinakbet Rice and chicken
tinapa afritada

The respondents eat three meals a day consisting of rice and a viand. Their food

is prepared by 10 trusted detainees assigned in the kitchen. These personnel have health

cards for food handling. The female PDLs can also buy other food items for sale by
their co-detainees. They have a bakery inside the facility manned by trusted detainees

who trained under Technical Education and Skills Development Authority (TESDA)

and who also have health cards.

E. Obstetrical History

Number of Pregnancies

40
36
None
35
32
1
30 2
25 3
25 24
4

20 5
16 6
15 14
7
10 8
10 8
7 9
5 3 10
2
1
11
0
None 1 2 3 4 5 6 7 8 9 10 11

Figure 4.1 Number of Pregnancies of the Respondents

Of the 245 respondents, 14 (8%) are nulligravid, 164 (92%) have had pregnancies.

Of the respondents who had pregnancies, 32 (18%) are primigravid and 132 (74%) are

multigravid. 1 respondent has the highest number of pregnancies, which is 11.


Pregnancy Outcomes

23%

Full Term

5% Preterm
Abortion/FDIU

72%

Figure 4.2 Pregnancy Outcomes of the Respondents

Among the 164 respondents who have had pregnancies, 163 (72%) had full term

pregnancies, 11 (5%) had preterm and 51 (23%) had previous abortions/fetal death in utero.
F. Gynecologic History

Menarche

120
110 112

100

80

<10 y.o
60
10-13 y.o
>14 y.o
40

20

2
0
<10 y.o 10-13 y.o >14 y.o

Figure 4.3 Menarche of the Respondents

According to the National Demographic and Health Survey (2013), the mean

age at menarche among women ages 15 to 49 is 13.1 years old. Over one in ten women

had her first menstruation before age 12, while more than half of women had menarche

between ages 12 or 13 and 18 percent began menstruating at age 15 or older.

Among the 245 respondents, 2 (1%) had their menarche between ages 8-9 years

old, 110 (49%) between ages 10-13 years old, and 112 (50%) had their menarche

between ages 14-17 years old.


Menstrual Interval

250

197
200

150

Regular
Irregular
100

50
32

0
Regular Irregular

Figure 4.4 Menstrual Interval of Respondents

Among the 245 respondents, 197 (86%) had regular menstrual intervals of

average 28 days, while 32 (14%) had irregular menstrual intervals.


Coitarche

120
107

100

79
80

<18 y/o
60
18-25 y/o
>25 y/o
40

20

3
0
<18 y/o 18-25 y/o >25 y/o

Figure 4.5 Coitarche of Respondents

Median age at first sexual intercourse of women ages 25-49 is 21.5 years old.

Different coitarche between urban and rural areas by one year were noted (National

Demographic and Health Survey, 2013).

Among the 245respondents, 107 (57%) had their coitarche at age less than 18

years old, 79 (42%) between ages 18-25 years old, 3 (2%) at more than 25 years old.
G. Substance Abuse

Types of Substance Used

23%

34%

Smoking
Illicit Drug Use
Alcoholic Drinking

43%

Figure 4.6 Types of Substance Used by the Respondents

Based on the Philippines’ Global Adult Tobacco Survey (2009), 28.3% of

Filipino adults ages 15 years and older were currently smoking, representing 17.8

million Filipinos.

According to the WHO (2015), Philippines’ total population is 93, 444, 000.

Among the population aged 15 years and older, 65% lived in urban areas and 49% in

lower middle income group have recorded alcohol consumption.

Philippines has 1.8 million current drug users (Dangerous Drug Board Survey,

2016). The survey estimated 4.8 million Filpinos aged 10-69 years old used illegal

drugs at least once in their lives.


Among the 245 respondents, 88 (34%) claimed to be smokers, 61 (23%)

claimed to be alcoholic beverage drinkers, and 112 (43%) claimed to be illicit drug

users.

Types of Drugs Used

120

100
100

80
Shabu
Marijuana
60
Rugby
Ecstasy
40 Cocaine
31

20

3 3 2
0
Shabu Marijuana Rugby Ecstasy Cocaine

Figure 4.7 Types of Drug Used by the Respondents

Shabu (72%) shows to be the leading type of drug used by the respondents. This

is followed by marijuana (22%), and rugby, ecstasy and cocaine at 2%.


H. Treatment Seeking Priority

20%

42%
Home remedies
Self-medication
Hospital

38%

Figure 4.8 Treatment Seeking Priority of Respondents for the last year

In a study conducted by Geissier, P.W., et al. (2000), there is an increasing trend

in self-medication practices especially to economically-deprived countries wherein

most of the illnesses are treated through these practices. The establishment of Botika

ng Barangay in the different communities as a program of the Department of Health

that sells BFAD approved over the counter medicines is a significant evidence for the

approval World Self Medication Industry (WSMI) advocacy in the Philippines (Worku,

S. et al., 2006). Among the 245 respondents, 40 (20%) had home remedies as their

treatment seeking priority for their illnesses for the past year, 76 (38%) self-medicated

and 82 (41%) went to the hospital.


I. Health Benefits

Table 4.5 Health Benefits from the Government Received by the Respondents

Health Benefit Frequency %


Philhealth Card 88 45
"Lingap Sa Mahirap" 55 28
CCT/4Ps Program 28 14
DSWD Medical Support 11 6
911 Ambulance Service 7 4
PCSO Medical Support 6 3

As of December 31, 2016, a total of 41, 231, 849 Philhealth member

representing 40% of the estimated total Philippine population (Philhealth Stats &

Charts, 2016).

Among the 245 respondents, the Philhealth card shows to be the most common

health benefit from the government, followed by “Lingap sa Mahirap” program and

CCT/4Ps, which they benefitted before detention.


J. Perceived Problems

Perceived Health Needs

Table 4.6 Perceived Health Needs of the Respondents

Health Need Frequency %


Lack of medicine and vitamins 77 69
Lack of OB/GYN health care 18 16
services
Lack of regular health assessment 13 11
Lack of trained health aides 2 2
Lack of health monitoring supplies 2 2

Among the 245 respondents, 77 (69%) perceived lack of medicine and vitamins,

18 (16%) lack of OB-Gyne health care services, 13 (12%) lack of regular health

assessment, and lack of trained health aides and health monitoring supplies both at 2%

during their stay in the facility.

Perceived Non-Health Needs

Table 4.7 Perceived Non-health Needs of the Respondents

Health Need Frequency %


Minimal food variety 34 65
Lack of adequate 8 15
ventilation
Strict schedule and visiting 6 12
rules
Lack of facilities 4 8

Among the 245 respondents, 34 (65%) perceived they have minimal food

variety, 8 (15%) perceived there is lack of adequate ventilation, 6 (12%) perceived they

have strict schedule and visiting rules, and 4 (8%) perceived there is lack of facilities

in BJMP.
Chapter 5

THE PROBLEM

A. Problem Identification

I. Two MDR Tuberculosis Cases

Tuberculosis is a major cause of death worldwide. This disease most often

affects the lungs, although other organs are involved in up to one-third of cases.

If properly treated, TB cause by drug-susceptible strains is curable in the vast

majority of cases. If untreated, the disease may be fatal within 5 years in 50-

65% of cases. Transmission usually takes place through the airborne spread of

droplet nuclei produced by patients with infectious pulmonary TB.

Currently there are 2 PDLs with MDR Tuberculosis in the facility, both of

which have diabetes mellitus as a comorbidity. These PDLs are undergoing

treatment and are supposedly isolated, but due to the lack of free cottages or

sick bay, some healthy PDL’s are detained together with the other two.

II. Increased Prevalence of Hypertension

Hypertension, one of the most common medical disorders, is associated

with an increased incidence of all-cause and cardiovascular disease (CVD)

mortality, stroke, coronary heart disease, heart failure, peripheral arterial

disease, and renal insufficiency. As of February 2019, there are a total of 46

female PDLs diagnosed with hypertension in the facility.


III. Increased Prevalence of Diabetes Mellitus

The worldwide prevalence of Diabetes Mellitus has risen dramatically over

the past two decades. Diabetes is a major cause of mortality, but several studies

indicate that diabetes is likely underreported as a cause of death. Diabetes-

related complications affect many organ systems and are responsible for the

majority of the morbidity and mortality associated with the disease.

Complications include retinopathy, neuropathy, nephropathy, coronary heart

disease, peripheral arterial disease, cerebrovascular disease, etc. As of February

2019, there are a total of 21 female PDLs diagnosed with diabetes in the facility,

two of which have Multi Drug Resistant Tuberculosis.

IV. Lack of Medicine Supply

A small room near the sewing area is designated as the clinic for the village.

A trustee runs the clinic wherein over the counter medicines and the inmate’s

health records are being stored. However, the available medicine in the clinic is

not enough for the increase demands of the inmates. The head of the infirmary

claims that medicines and vitamins of the facility are sent only every 4 months

and in limited amount.

V. Limited Nutritious Food Variety

Each PDL is given an allowance of 50 pesos per day for all three meals. The

three meals are given in a timely and orderly manner, however, they are only

given one type of viand for each meal in measured amounts. Although they can

ask for seconds but this cannot compensate with the nutrient value of the sole
viand being provided. During the interview, the head health aid verbalized that

PDLs have increased rice consumption.

VI. Inadequate Medical Check-up

The institution does not have regular monthly medical check-ups and it was

known that the PDLs who are prioritized in such check-ups are those who have

been diagnosed already leaving the seemingly healthy unnoticed.

VII. Four Pregnant PDLs with Lack of Birthing and Nursing Care Facility

Currently, there are 4 pregnant PDLs in the facility who are nearing their

due date of delivery. They are having their regular prenatal check-ups at

SPMC where they will also be having their future delivery escorted with jail

personnel. However, infirmary of the village is not equipped with maternal

health care paraphernalia to monitor and cater to maternal and fetal needs.

VIII. Lack of Medical Supplies for Monitoring and First Aid

As mentioned by the head of the infirmary the medical supplies are

restocked only every 4 months in limited amount. Currently there are only 4

stethoscopes in good condition and 2 functional sphygmomanometers. All

their thermometers no longer work and they have run out of glucometer strips.

Their infirmary easily runs out of gauze pads, alcohol and the like.

IX. Lack of Trained Health Aides

There is no designated doctor or even a nurse in this facility. Although there

are police officers who are registered nurses, but there role and function in this

facility is to keep the security. Trustee detainees are tasked to monitor the

wellbeing of sick inmates, however, these people are not medically inclined.
This becomes a problem because some chronically ill inmates cannot be readily

seen by professional healthcare providers and for them to receive the proper

medical attention, a court order must be issued which can be a lengthy process

which delays the delivery of the much need medical care.

X. Increased Incidence of Reincarceration due to Drug-Related Activities

Ninety percent of the cases of the PDLs are drug-related either in trade or

use. Although the facility has many programs addressing the problem on

drugs including drug awareness lectures there is an increased incidence of

PDLs who come back in the facility just after a few months of being released

due to similar drug-related activities.

B. Problem Prioritization
The problem identified were ranked according to the following four variables:

magnitude of the problem, vulnerability to change, presence of existing health policies

and social concern. It was ranked from 1 to 10 with 1 being the lowest and 10 being

the highest. The scores given were added and the problems were ranked according to

the largest and smallest total score. The problem ranked first is considered as the core

problem of the community. Upon prioritization, Diabetes Mellitus, MDR-Tuberculosis

Cases and Hypertension were the topmost cited problems respectively. Among the

three, the acute upper respiratory tract infection is the one that can be addressed and

remedied by the health sector. The following problems are summarized in Table 5.1.
Table 5.1 Problem Prioritization among Detainees in the GK-Ray of Hope
Village

Existing
Vulnerability Social
Problem Magnitude Health Total Rank
to Change Concern
Policies
Two MDR
Tuberculosis 7 9 10 7 33 2nd
Cases
Increased
Prevalence of 6 8 8 9 31 3rd
Hypertension
Increased
Prevalence of
8 10 9 8 35 1st
Diabetes
Mellitus
Lack of
Medicine 5 2 3 10 20 6th
Supply
Limited
Nutritious 1 1 5 6 13 9th
Food Variety
Inadequate
Medical 4 5 1 5 15 8th
Check-up
Four Pregnant
PDLs with
Lack of
9 4 6 3 22 5th
Birthing and
Nursing Care
Facility
Lack of
Medical
Supplies for 2 3 2 2 9 10th
Monitoring
and First Aid
Lack of
Trained Health 3 7 4 4 18 7th
Aides
Increased
4th
Incidence of 10 6 7 1 24
Reincarceratio
n due to Drug-
Related
Activities

C. Problem Tree Analysis

Decreased Increased Risk to


EFFECTS Decreased Quality of Increased Developing
Productivity Daily Living Mortality Complications

CORE Increased Prevalence of Diabetes Mellitus


PROBLEM

Delay of Lack of Health


Limited Sedentary Treatment Education
Nutritious Lifestyle
Food
Variety
Lack of Medicine
Supply

CAUSES Minimal Decreased Family Insufficient Inadequate Lack of


Food Exercise History Funds Allocated Medical Trained
Allowance for Medicine Check-up Health Aids

Figure 5.1 Problem Tree Analysis

Diabetes Mellitus is a growing burden among the female inmates. The

population affected is now eighteen with two of these diabetic patients having Multi-

Drug Resistant Tuberculosis`. This may be due to increased carbohydrate intake along

with limited nutritious food variety of the daily meals prepared by the institution’s
kitchen due to minimal budgeted food allowance of the PDLs. Although the PDLs have

programs that involve exercise, not all of the PDLs participate in such activities. Their

decrease in activity and being locked in their cottages the whole day lead to a sedentary

lifestyle which increases the risk of having Diabetes. A strong risk factor in acquiring

the disease entity is the presence of Diabetes Mellitus among immediate family

members of the PDLs. Another reason would be the insufficient funds allocated for

medicine causing the lack of medicine supply because the delivery of medical supplies

come only every 4 months resulting to delay of treatment among diagnosed diabetics.

Adding to these factors is the inadequacy of medical checkups and the lack of trained

health aids leading to lack of health education. Health education, which is an important

part of the disease management, is also affected hence the delay of appropriate and

timely therapy.

Diabetes mellitus is a chronic disease which consists of an array of dysfunctions

characterized by hyperglycemia cause by an inherited and/or acquired deficiency in

production of insulin by the pancreas or by the ineffectiveness of the insulin produced

causing damage to the body’s blood vessels and nerves. If untreated, it can lead to

complications such as retinopathy, neuropathy, nephropathy, coronary heart disease,

peripheral arterial disease and cerebrovascular disease. If the complications mentioned

develop, the effect towards the female inmates may be reversible or irreversible. The

effects of increased prevalence of diabetes mellitus include decreased productivity,

decreased quality of daily living, and increased mortality.

D. Analysis of Causes
Table 5.2 Causes That Can Be Acted Upon by Health and Other Sectors
Can be Acted Upon by Health Sector Can be Acted Upon by Other Sectors

Decreased Exercise Limited Nutritious Food Variety


Sedentary Lifestyle Minimal Food Allowance
Lack of Medicine Supply Delay of Treatment
Inadequate Medical Check Up Lack of Medicine Supply
Lack of Health Education Insufficient Funds Allocated for Medicine
Lack of Trained Health Aids Lack of Trained Health Aids

Table 5.3 Causes That Can Be Addressed by the Health Sector

Short Term Long term

Lack of Medicine Supply Decreased Exercise


Inadequate Medical Check Up Sedentary Lifestyle
Lack of Health Education
Lack of Trained Health Aids
E. Objective Tree

Increased Decreased Risk to


Increased Quality of Decreased Developing
EFFECTS
Productivity Daily Living Mortality Complications

CORE Controlled Diabetes Mellitus


PROBLEM

Educate on Educate on Disease


Limited Promote Alternative Medicine Surveillance and
Nutritious Regular Management of
Food Variety Daily Complications
Exercise
Lack of Medicine
Supply

CAUSES Minimal Decreased Family Insufficient Inadequate Lack of


Food Exercise History Funds Allocated Medical Trained
Allowance for Medicine Check-up Health Aids

Figure 5.2 Objective Tree

Chapter 6

HEALTH ACTION PLAN

A. Title: “Kalawasan Alagaan Alang Sa Kalampusan sa Diabetes”

B. Problem: Increased Prevalence of Diabetes Mellitus


C. Rationale:

There is an escalating prevalence of diabetes in the Philippines with over six

million Filipinos diagnosed to have diabetes. It is the sixth leading cause of death in

both male and female Filipinos. It is a chronic disease characterized by high levels of

sugar in the blood because of inadequate production and/or action of insulin, the

hormone that regulates blood sugar levels. Uncontrolled diabetes leads to serious

complications such as stroke, heart attack, end-stage kidney disease and diabetic

retinopathy among others. Lack of proper education about the disease such as the

causes, risk factors, treatment, and complications can deter the affected PDLs from

having quality of life while inside the facility. Lack of treatment and medication can

aggravate the PDLs conditions. Intensive education regarding the disease will give the

health aides and affected PDLs an edge to fight against complications and increase the

quality of life. Knowledge and use of the different herbal medicines will also allow the

community to have an alternative when medical supplies are low. These are simple

strategies that can help diabetics avoid the dire, costlier complication of their affliction.

D. General Objective:

To reduce the incidence of diabetes mellitus among female Persons Deprived of

Liberty at Gawad Kalinga - Ray of Hope Village, Bureau of Jail Management and

Penology, Ma-a, Davao City.

E. Specific Objectives:
1. By the end of April 7, 2019, all the BJMP female PDLs will be well-informed on

the importance and advantages of regular exercise in the diabetes mellitus

prevention.

2. By the end of April 7, 2019, all the BJMP female PDL Infirmary Personnel, Cottage

Leaders, PDLs diagnosed with Diabetes Mellitus and selected PDLs skilled with

planting will be educated about alternative and cost-effective methods of treating

and preventing diabetes mellitus through the use of approved herbal medicinal

plants.

3. By the end of April 7, 2019, all BJMP female PDL Infirmary Personnel, Cottage

Leaders and PDLs diagnosed with Diabetes Mellitus will be educated about the

causes, complications, treatment and prevention of Diabetes mellitus through

lectures.

4. By the end of April 7, 2019, BJMP female PDLs who have medical concerns will

have adequate medical consultation.

F. Activity Matrix

Table 6. Health Action Plan Activity Matrix

Causes of Objectives Activities Materials Time Persons Objectively


Core Needed Frame Responsible Verifiable
Problem Indicator
Decreased To discuss Daily exercise PowerPoint March Medical Full
Exercise about the program of at presentation 2019 Clerks attendance
importance least 1-2 hours of all cottage
and the a day LCD projector All cottage leaders,
advantages leaders infirmary
of regular Informational personnel,
exercise in pictures and Infirmary and
DM videos Personnel detainees
prevention with DM
Pamphlets PDLs
diagnosed Participate
with DM and answer
questions
after lecture

Able to
participate in
morning
Zumba
activity
everyday
Lack of To discuss Lectures on PowerPoint March Medical Full
Medicine about ampalaya presentation 2019 clerks attendance
Supply alternative preparation of all
methods of LCD All cottage cottage
treating and Planting of projector leaders leaders and
preventing ampalaya infirmary
diabetes within the Instructional Infirmary personnel
mellitus with facility videos Personnel
the use of Participate
ampalaya Ampalaya PDLs and answer
plant diagnosed questions
To with DM after the
demonstrate lecture
how to make Selected
ampalaya female PDLs Able to plant
preparations skilled for ampalaya
for diabetes planting and to make
mellitus in a medicinal
cost preparations
effective
way

To plant
ampalaya for
its
availability
within the
facility
Lack of To discuss Lectures: PowerPoint March Medical Full
Health about the presentation 2019 clerks attendance
Education causes, Causes of all cottage
on DM and complication LCD projector All cottage leaders and
Lack of s, treatment Complications leaders infirmary
Trained and Informational personnel
Health Aids prevention Treatment pictures Infirmary
of Diabetes options Personnel Participate
mellitus Pamphlet and answer
through Preventions about the topic PDLs questions
lectures. diagnosed after lecture
with DM
Inadequate To address Conduct Free Medical Kits April Medical To cater all
Medical medical Medical 2019 clerks female PDLs
Check-Up concerns Check-Up Medications with medical
through Invited concerns
conducting medical
consultation doctors Provide
proper
health
management
by providing
free
medications