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

1
 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

2
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

3
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 ninety-two percent (92%) of these detainees’ cases are due to drug-

related crimes. Other cases (8%) include robbery, murder, arson, estafa, illegal

possession of firearms and explosives, and child abuse.

4
 Chief BJMP

Deputy Chief for Chief Directorial Directorate for

Administration Staff Operation

Regional Director
Asst. Regional Asst. Regional
Director for Regional Chief Staff Director for
Admin Operations
Officer-in-Charge

C, Admin/SOD/ C, IWD/C, HSU/SOD Custodial/ALS In-

Searcher/Driver Charge/ Intelligence
JNCO
Admin JNCO/C, Mess Officer
Personnel & Finance C, Security &
Record Coordinator Control/UESJO/ Asst.
Interfaith In-Charge/
Female Searcher
Warden/ C, Custodial

Releasing and
C, Escort
Receiving JNCO/ Custodial/ALS In-
Investigation Officer Charge
Custodial
Paralegal/Escort/
Subpoena JNCO/ Human Escort/HSU JNCO Custodial/ Operations
Rights Desk Officer
JNCO
Custodial/IWD JNCO
Escort/NIMS In- Female Searcher
Charge/ Paralegal Custodial/Alternate
Paralegal Officer Male Searcher/
Escort/Sports & Driver/ Logistic
Recreation In-Charge/ JNCO/ USAO
Commissary In-Charge

Custodial/ Asst. Unit

Budget/Custodial/ Investigator
Finance JNCO

Custodial/ Asst.
Custodial/ CRS Commissary &
JNCO Livelihood In-Charge

Figure 1.2 Bureau of Jail Management and Penology Davao City Female Jail Directory

5
 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.

6
 Table 2.1. Demographic Characteristics

Frequency Percent
Demographic Characteristics
Distribution Distribution
18-25 34 13.9%
26-35 93 38.0%
36-45 67 27.3%
Age
46-55 28 11.4%
>56 16 6.5%
No response 7 2.9%
Single 83 33.9%
Married 76 31.0%
Marital Status Separated 24 9.8%
Widowed 23 9.4%
Partnered 39 15.9%
Primary 49 20%
Secondary 137 56%
Educational
College 39 16%
Attainment
Postgraduate 1 1%
Vocational 17 20%

Table 2.1 shows the distribution of respondents in terms of age, marital

status and educational attainment.

Those who filled out the age profile, the majority of the respondents belong

to the 26-35 years old age group with a total of 93 (38.0%) respondents. There are

67 (27.3%) respondents within the age range of 36-45years, 34 (13.9%) respondents

within the age range of 18-25 years, 28 (11.4%) respondents within the age range

of 46-55 years and the age range having the least number or respondents are those

from ages 56 and above years with a total of 16 (6.5%).

Under the marital status profile, the majority of the respondents are single

with a total of 83 (33.9%) respondents. There are 76 (31.0%) respondents who are

married, 39 (15.9%) respondents who are partnered of, 24 (9.8%) respondents who

7
are separated and the category having the least respondents are those who are

widowed with a total of 23 (9.4%) respondents.

Under the educational attainment, majority of the respondents have a

secondary level of education with a total of 137 (56.4%) respondents. There are 49

(20.2%) respondents who have a primary level of education and 39 (16.0%)

respondents who are either college undergraduates or have attained a college

degree, 17 (7.0%) respondents who have a vocational education, and 1 (0.4%)

respondent who has a postgraduate education.

8
B. Social Status

Table 2.2. Social Status Profile

Frequency Percent
Social Status Characteristics
Distribution Distribution
Davao del Sur 28 11.4%
Davao del Norte 15 6.1%
Davao City 81 33.1%
Residence
Davao Oriental 10 4.1%
Others 67 27.3%
No response 44 18.0%
Roman Catholic 142 58.0%
Non-catholic 20 8.2%
Religion
Islam 68 27.8%
No response 15 6.1%
Maranao 8 2.9%
Tagalog 61 21.9%
Bisaya 173 62.0%
Language Tausug 14 5.0%
Maguindanaon 20 7.2%
Others 3 1.1%
Bilingual 37 15.1%

Table 2.2. shows the distribution of respondents in terms of residence,

religion and language spoken.

A total of 81 (33.1%), which is the majority of the respondents, are residents

of Davao City. 67 (27.3%) respondents 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. A total of 28 (11.4%)

respondents are from Davao del Sur, 15 (6.1%) from Davao del Norte, and 10

(4.1%) are from Davao Oriental.

9
 A total of 142 (58%) of the respondents are Roman Catholics, which is the

majority of the population, 68 (27.8%) of the respondents’ religion is Islam, and 20

(8.2%) 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.

There is a total of 173 (62.0%) of the respondents primary spoken language

is Visayan, which is majority of the population, 61 (21.9%) of the respondents

primary spoken language is Tagalog, 20 (7.2%) respondents primary spoken

language is Maguindanaoan, 14 (5.0%) is Tausug, 8 (2.9%) is Maranao, and 3

(1.1%) are other languages including Waray and Ilocano.

10
C. Economic Status

Table 2.3.Economic Status

Frequency Percent
Economic Status Characteristics
Distribution Distribution
Self-employed 91 32.2%
Source of Employed 76 26.9%
Income of Housewife 49 17.3%
Respondents Family Support 41 14.5%
Prior to Drug trade 15 5.3%
Detention Benefits/Pension 8 2.8%
Sex Worker 3 1.1%
P 0 – 1,000 17 6.9%
1,000 – 5,000 67 27.3%
P 5,000 – 10,000 56 22.9%
Monthly P 10,000 – 15,000 30 12.2%
Family Income P 15,000 – 20,000 21 8.6%
Prior to P 20,000 – 30,000 14 5.7%
Detention P 30,000 – 50,000 9 3.7%
P 60,000 – 70,000 2 0.8%
P 50,000 – 60,000 1 0.4%
No Response 28 11.4%
Income Sufficient 86 35.1%
Sufficiency Insufficient 159 64.9%

Table 2.3. shows the distribution of respondents in terms of source of

income, amount of monthly family income and income sufficiency as perceived by

the respondents.

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

before their incarceration with a total of 91 respondents (32.2%). There were 76

(26.9%) respondents who were employed, 49 (17.3%) respondents who were

housewives, 41 (14.5%) respondents who were supported by their respective

families, 15 (5.3%) respondents who were involved in drug trade, 8 (2.8%)

respondents who was receiving different types of pension, and 3 (1.1%)

11
respondents who were sex workers. A number of the respondents had multiple

sources of income.

A total of 67 (27.3%) 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.

A total of 159 (64.9%) of the respondents perceived that their income prior

to detention was insufficient for their daily needs while only 86 (35.1%) of the

respondent perceived it to be sufficient.

12
D. Prison History

Prison Time

80

70

60

50

40
73
65 61
30

20

10 23
18
2
0

Months 2-3 yrs Less than 2 4-5 yrs >6 year weeks

Figure 2.1. 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.

13
Type of Crime

Table 1.4 Reason for Imprisonment of Respondents

Frequency Percent
Crime
Distribution Distribution
Drug Trade 128 52.2%
Drug Use 92 37.6%
Murder 2 0.8%
Robbery 5 2.0%
Kidnapping 1 0.4%
Prostitution 2 0.8%
Estafa/Fraud 2 0.8%
Gambling 1 0.4%
Human trafficking 1 0.4%
Liquor ban 1 0.4%
VAWC 2 0.8%
Others 2 0.8%
No response 6 2.4%

Majority of the total respondents have drug-related cases, with 128 (52.2%)

of the respondents arrested due to drug trade and thirty-eight percent (37.6%) due

to drug use. A total of 19 (7.8%) of the cases are related to murder, robbery

kidnapping, prostitution, estafa/fraud, gambling, human trafficking, violation of

liquor ban, VAWC, and others.

History of Imprisonment

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.

14
 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.

15
Sleeping Area

17

49

169

0 20 40 60 80 100 120 140 160 180

Mattress Carton No response Rubber Mat Floor

Figure 3.1. Sleeping Area of Respondents

Majority of the respondents sleeps on the floor (69.0 %), while the

remaining respondents sleeps on the floor with covered rubber mats (20.0 %),

cardboards (3.3%), and a proper mattress (0.8 %).

16
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.

17
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.

18
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.

19
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.

20
 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 Percent

Distribution Distribution
Colds 117 31.6%
Cough 106 28.6%
Fever 89 24.1%
Diarrhea 38 10.3%
Vomiting 10 2.7%
Urinary tract
5 1.4%
infection
Abdominal Pain 2 0.5%
Allergy 1 0.3%
Dizziness 1 0.3%
Toothache 1 0.3%

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

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

21
 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 Percent

Distribution Distribution
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.

22
C. OB-GYN Illnesses

Table 4.3 Number of Respondents with Existing OB/GYN Illnesses

OB/GYN Illness Frequency Percent

Distribution Distribution
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 Rice and law-oy
gulay
Monday Rice and odong Rice and adobong batong Rice and paksiw
Tuesday Rice and Rice and tawge Rice and pansit
scrambled 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

23
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
One
35
36 Two

30 32 Three
Four
25
25 Five
24
20 Six
Seven
15
16 eight
14
10 Nine
10
8 ten
5 7
3 2 1 Eleven
0

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.

24
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.

25
F. Gynecologic History

Menarche

110

112

0 20 40 60 80 100 120
<10 y.o. 10-13 >14

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.

26
Menstrual Interval

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

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

Coitarche

120

100 107

80
79
60

40

20
3
0
<18y.o. 18-25y.o. >26y.o.

Figure 4.4 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.

27
G. Substance Abuse

Types of Substance Used

23%
34%

43%

Smoking Illicit Drug Use Alcoholic Drinking

Figure 4.5 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.

28
 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

31

100

0 20 40 60 80 100 120
Cocaine Ecstasy Rugby Marijuana Shabu

Figure 4.6 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%.

29
H. Treatment Seeking Priority

20%

42%

38%

Home remedies Self-medication Hospital

Figure 4.7 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.

30
I. Health Benefits

Table 4.5 Health Benefits from the Government Received by the Respondents

Health Benefit Frequency Percent

Distribution Distribution
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.

31
J. Perceived Problems

Perceived Health Needs

Table 4.6 Perceived Health Needs of the Respondents

Health Need Frequency Percent

Distribution Distribution
Lack of medicine and vitamins 77 69
Lack of OB/GYN health care services 18 16
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 Percent

Distribution Distribution
Minimal food variety 34 65%
Lack of adequate ventilation 8 15%
Strict schedule and visiting rules 6 12%
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.

32
 Chapter 5

THE PROBLEM

A. Problem Identification

1. Three 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 3 PDLs with MDR Tuberculosis in the facility, two 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.

2. 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.

33
3. Uncontrolled 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 16 female PDLs diagnosed with diabetes in the facility,

three of which have Multi Drug Resistant Tuberculosis.

4. 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.

5. 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

34
 viand being provided. During the interview, the head health aid verbalized that

PDLs have increased rice consumption.

6. 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.

7. 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.

8. 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.

9. 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.

35
 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.

10. 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, Increased Prevalence of Hypertension,

Uncontrolled Diabetes Mellitus and Three Multi Drug Resistant Cases were the

topmost cited problems respectively. The following problems are summarized in Table

5.1.

36
 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 Impact Urgency
Policies
Three MDR
Tuberculosis 10 8 10 5 3 10 46 3rd
Cases
Increased
Prevalence of 9 9 9 10 10 8 55 1st
Hypertension
Uncontrolled
Diabetes 7 10 8 8 9 9 51 2nd
Mellitus
Lack of
Medicine 6 7 6 9 6 7 41 4th
Supply
Limited
Nutritious 8 6 5 2 8 6 35 5th
Food Variety
Inadequate
Medical 5 4 4 6 7 5 31 6th
Check-up
Four Pregnant
PDLs with
Lack of
2 5 7 7 4 4 29 7th
Birthing and
Nursing Care
Facility
Lack of
Medical
Supplies for 4 3 3 4 2 2 18 8th
Monitoring
and First Aid
Lack of
Trained 3 2 1 3 1 1 11 10th
Health Aides
Increased
Incidence of
Reincarceratio
1 1 2 1 5 3 13 9th
n due to Drug-
Related
Activities

Although increased prevalence of hypertension ranks first among the problems

prioritized above, the hypertensive PDLs are already under maintenance medication

provided by the facility and their blood pressures are being monitored twice daily by the

health aids.. The next problem we can address is the uncontrolled diabetes mellitus. Two

of the diabetic PDLs are currently diagnosed with MDR Tuberculosis and one diabetic

37
PDL with Pneumonia. Considering the living conditions of the PDLs, these communicable

diseases poses a health threat to the residents of the community.

C. Problem Tree Analysis

Decreased Increased Risk

EFFECT Decreased Quality of to Developing Increased
S Productivity Daily Complications Mortality
Living

CORE Uncontrolled Diabetes Mellitus

PROBLE
M

Limited Decreased Non- Poor Delay of

Nutritio Physical Compliance Monitoring/ Treatment
us Food Follow Up
Activity to
Check Up
Variety Medication

Poor Health Seeking

Behavior

CAUSE Minimal Cottage Inadequate Knowledge on Diabetes Mellitus

S Food Containment
Allowance

Figure 5.1 Problem Tree Analysis

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

The population affected is now sixteen with three of these diabetic patients having

Multi-Drug Resistant Tuberculosis and one with Pneumonia. This may be due to

increased carbohydrate intake along with limited nutritious food variety of the daily

38
 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. Adding to these factors is the inadequacy of knowledge on Diabetes Mellitus

causing non-compliance to medication and poor health seeking behavior which leads

to poor follow up check-up and delay of treatment.

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 Physical Activity Limited Nutritious Food Variety

Inadequate Knowledge on Diabetes
Minimal Food Allowance
Mellitus
Cottage Containment

39
 Table 5.3 Causes That Can Be Addressed by the Health Sector

Short Term Long term

Inadequate Knowledge on Diabetes
Decreased Physical Activity
Mellitus

E. Objective Tree

Increased Decreased Risk to

EXPECTED Increased Quality of Developing Decreased
OUTCOMES Productivity Daily Living Complications Mortality

OBJECTIVES Controlled Diabetes Mellitus

Limited Increased Good Good Prompt

Nutritious Physical Compliance Monitoring/ Treatment
Food Follow Up
Activity to Medication
Check Up
Variety

Good Health Seeking Behavior

PROBLEMS Minimal Cottage Adequate Knowledge on Diabetes Mellitus

Food Containment
Allowance

Figure 5.2 Objective Tree

40
 Chapter 6

HEALTH ACTION PLAN

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

B. Problem: Uncontrolled 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.

41
D. General Objective:

To control 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 diagnosed with Diabetes

Mellitus will have increased physical activity and have adequate knowledge on the

importance and advantages of regular exercise in the management of Diabetes.

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

Leaders, PDLs diagnosed with Diabetes Mellitus will have adequate knowledge on

the causes, complications, treatment and prevention of Diabetes Mellitus through

lectures.

3. By the end of April 7, 2019, all diabetic BJMP female PDLs will have good

compliance to medication through a lecture about effects of hypoglycemic

medications.

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

good follow-up check-up through adequate medical consultation.

42
F. Activity Matrix

Table 6.1 Health Action Plan Activity Matrix

Causes of Objectives Activities Materials Time Persons Objectively

Core Needed Frame Responsible Verifiable
Problem Indicator
1. Decreased By the end of Lectures on PowerPoint March Medical Full
Physical April 7, 2019, Diabetic diet presentation 2019 Clerks attendance
Activity all the BJMP modification of all cottage
female PDLs and daily LCD projector Infirmary health aids,
diagnosed exercise Personnel infirmary
with Diabetes program of Informational personnel,
Mellitus will at least 30 pictures and Cottage and PDLs
have increased minutes a videos Health with DM
physical day Aides
activity and Pamphlets Participate
have adequate PDLs and answer
knowledge on diagnosed questions
the importance with DM after lecture
and
advantages of Able to
regular participate in
exercise in the daily
management exercise
of Diabetes program

Detainees
with diabetes
mellitus
were able to
modify their
diet
accordingly

43
 Causes of Objectives Activities Materials Time Persons Objectively
Core Needed Frame Responsible Verifiable
Problem Indicator
2.Inadequate By the end of Lectures: PowerPoint March Medical Full
Knowledge April 7, 2019, presentation 2019 Clerks attendance
on Diabetes all the BJMP Causes of all cottage
Mellitus female PDL LCD projector Infirmary health aids,
Infirmary Complicatio Personnel infirmary
Personnel, ns Informational personnel,
Cottage pictures Cottage and PDLs
Leaders, PDLs Treatment Health with DM
diagnosed options Pamphlet Aides
with Diabetes about the topic Participate
Mellitus will Preventions PDLs and answer
have adequate diagnosed questions
knowledge on with DM after lecture
the causes,
complications,
treatment and
prevention of
Diabetes
Mellitus
through
lecture

3. Poor By the end of Lecture: Power Point March Medical Full

Compliance April 7, 2019, Common presentation 2019 Clerks attendance
to all diabetic Hypoglycem of all cottage
Medication BJMP female ic LCD projector Infirmary health aids,
PDLs will Medications: Personnel infirmary
have good Indications Informational personnel,
compliance to and Effects pictures Cottage and PDLs
medication Health with DM
through a Pamphlet Aides
lecture about about the topic Participate
effects of PDLs and answer
hypoglycemic diagnosed questions
medications with DM after lecture
4. Poor By the end of Conduct Medical Kits March Medical To cater all
Monitoring/ April 7, 2019, Free 2019 clerks female PDLs
Follow Up all diabetic Medical Medications with medical
Check-Up BJMP female Check-Up Invited concerns
PDLs will FBS Glucometer medical
have good screening doctors Provide
follow-up proper health
check-up management
through by providing
adequate free
medical medications
consultation

44
 Chapter 7

ACCOMPLISHMENT REPORT

Table 7.1 Accomplishment Report

Activities Target Accomplishment

Lectures on Full attendance of all cottage All cottage leaders, infirmary
Diabetic diet health aids, infirmary personnel, personnel, and detainees with
modification and PDLs with DM diabetes mellitus attended the
and daily lecture.
exercise Participate and answer questions The attendees were able to
program of at after lecture participate and answer questions
least 30 related to the lecture.
minutes a day Detainees with diabetes mellitus Detainees with diabetes mellitus
were able to modify their diet were able to modify their diet
accordingly accordingly

Able to participate in daily Detainees with diabetes mellitus

exercise program participated in the daily exercise
program
Lectures on Full attendance of all cottage All cottage leaders and infirmary
Diabetes health aids, infirmary personnel, personnel attended the lecture.
mellitus and PDLs with DM
Causes
Complications Participate and answer questions The attendees were able to
Treatment after lecture participate and answer questions
options and related to the lecture.
preventive
measures
Lecture: Full attendance of all cottage All infirmary personnel and
Common health aids, infirmary personnel, selected detainees were able to
Hypoglycemic and PDLs with DM attend for the activity planning.
Medications:
Indications Participate and answer questions The attendees were able to
and Effects after lecture participate and answer questions
related to the lecture.

45
 Activities Target Accomplishment
Medical All female detainees of BJMP, Detainees with health complaints
Consultation, Detainees with existing medical were examined and interviewed at
FBS conditions and complaints, and the multipurpose hall.
screening, and BJMP personnel
discussion of
health Participate in FBS screening FBS screening done on detainees.
concerns
among female
detainees.

46
 Chapter 8

RECOMMENDATIONS

The proponents of this community diagnosis paper would like to recommend the

proper monitoring of the female detainees who have been diagnosed with diabetes mellitus

as well as conduct further confirmatory tests on the female detainees with prediabetic

(fasting blood sugar of 101-125mg/dL) blood glucose levels. Confirmatory tests done

would be key to early detection of the disease entity leading to timely management and

prevention of disease complication.

Secondly, the proponents recommend strict compliance to medications, diet

modification and increased in daily physical activities to all detainee’s diabetes mellitus

and detainees with prediabetic levels of blood sugar. All these would help in the prevention

of the development of the many complications associated with uncontrolled diabetes.

Finally, we recommend the continuation of the provision of health knowledge to

the female detainees for improvement of health literacy which may result to better health

outcomes.

47