Journal articles on the topic 'Gabriela (Organization : Manila, Philippines)'

Young adults in the Philippines face a demographic and economic situation that, when coupled with cultural expectations, compels many to consider entry into the global labor force as part and parcel of their obligation to improve their family’s livelihood. Drawing on ethnographic fieldwork conducted between 2006 and 2007 in Metro Manila and the province of Laguna, this study examines the partnership of an educational training center and a nongovernmental organization to provide services to young Filipinos transitioning to adulthood. Utilizing a cognitive map exercise given at an orientation seminar for young male migrants, the study charts their financial and family goals and traces not only the source of the intergenerational transfers of material and social assistance back to a set of cultural values but also reveals how their gendered behaviors and practices can effectively delay other markers of the transition to adulthood, such as courtship, marriage, and parenthood.

The Philippines has a rapidly growing HIV epidemic, with men who have sex with men (MSM) accounting for a majority of known cases. Currently, there is little understanding about MSM's experiences of HIV–related stigma in the Philippines and how they influence behavior and quality of life. Twenty-one interviews with MSM living with HIV and with communitybased organization workers were conducted in Manila from June to August 2017. MSM participants were affected by the intersection of HIV–related stigma and stigma toward homosexuality that are rooted in connotations of morality, “dirtiness,” and sin. We identified specific patterns by which MSM living with HIV experienced enacted, felt, and internalized stigma and discuss implications of stigma for mental health, delays in HIV testing, and avoidance of HIV health services. Findings support the development of public health strategies in the Philippines that address stigma at societal and individual levels to reduce stigma-related harms.

Background: Continuous efforts in the implementation of the National Patient Safety Goals (PSG) as a framework to guide the service providers have been made. However,there are reported incidents of untoward patient outcomes due to wrong medication administration, wrong site of surgical operation, acquisition of healthcare-associated infections, adverse reactions, and incidence of fall.Purpose: This study aimed to evaluate the PSGs’ level of attainment in selected tertiary hospitals in Metro Manila, Philippines. Methods: This study employed a field, descriptive and historical research survey conducted in three tertiary hospitals in Metro Manila. The participants were nurses having at least one year of experience in their current workplace (n=214). The sets of questionnaires used to get the data include the demographic profile and PSGs indicators adapted from the National Patient Safety Goals (NPSGs). Data responses were analyzed with descriptive statistics and One-Way ANOVA. Results: Based on the findings, the PSGs level of attainment obtained high extent with overall mean average: PSG 1 (M=4.35), PSG 2 (M=3.97), PSG 3 (M=4.07), PSG 4 (M=3.61), PSG 5 (M=3.89), PSG 6 (M=3.77) and PSG7 (M=4.20). Furthermore, there were significant differences on PSG 3 and PSG 4 with p-values of 0.00 and 0.02 respectively, which were tested at 0.05 level of significance. Others PSGs showed no significant differences. Conclusion: The results indicate that the selected hospitals in Metropolitan Manila, Philippines have a high level of attainment for patient safety goals and remains at the core of health service delivery in each organization. It is recommended that the hospital further enhance the knowledge, skills, and attitudes towards a sustained patient safety culture through continuing education programs, benchmarking, institutionalization, and accreditation.

Contextual factors, such as cultures of collectivism versus individualism, shape HIV coping strategies; despite this, little research regarding collective coping strategies applied to HIV exists. This may be important for the growing HIV epidemic in the Philippines, which has a collectivistic culture and where men who have sex with men (MSM) account for a majority of the cases. Fifteen semistructured, in-depth interviews with HIV-positive MSM and 6 interviews with community-based organization workers were conducted between June and August 2017. Data were analyzed using thematic framework analysis. Three strategies were identified: peer support, spirituality, and support from existing relationships. Each form of collective coping had unique mechanisms and benefits for dealing with HIV. Overall, helping MSM with HIV find a collective identity after an HIV diagnosis enables management of HIV-related challenges. Policies and research interventions that improve access to collective identities for MSM with HIV may improve management of HIV-related challenges.

Policy makers in the Philippines are focusing on the gaps between the knowledge and skills provided by higher educational institutions and the job opportunities available in the labor market. Graduates are often faced with challenges in looking for jobs right after graduation, thus, schools play a crucial role in ensuring that students are equipped with knowledge and competency skills. This study examines the level of employability and competence skills of the 309 graduating students taking up different degree programs of The Fisher Valley College located in Taguig City, Metro Manila. About 17.8% of the respondents are currently working and 21.7% wanted to work in the service sector. More than half of the total respondents wanted to work in the government. Most of the respondents will look for a job immediately after graduation. Communication skills are the most important of skills in order for them to get hired in their first job applications. The most important factor identified when selecting an organization or company for work is when it provides ample opportunities for them for career advancement. Among work-related values, respondents considered love for God and perseverance and hard work as the most important. Five components of employability skills were identified: (1) problem-solving and analytic; (2) learning; (3) personal organization and time management; (4) creativity, innovation, and change; and (5) personal strengths. Overall, students assessed that these skills are very important in employment. However, they reported lower competency levels on these skills particularly on solving problems, identifying essential components of the problem, sorting out the relevant data to solve the problem, and contributing to group problem solving. It is very important for all sectors, i.e., schools, government, and industry, to prepare the students acquire the necessary skills and provide them with opportunities as they enter the labor market.

Core values are critical to an organization’s identity, mission, strategy, and success. Harmonizing personal values and the core values espoused by the organization addresses congruence gaps and ensures that the actions of employees are consistent and aligned with organizational strategies. This study aims to identify the HR management practices of a University in Manila, Philippines that promote the congruence between the personal values of employees and the core values of the organization. The qualitative research methodology was utilized to identify practices in the areas of Recruitment and Selection, Performance Management System, and Training and Development that promote congruence of values. Semi-structured interviews of key University officials were conducted using open-ended questions. A review of relevant and pertinent documents was also undertaken. The three identified HR functional areas are highlighted because these are critical in the selection, motivation, and retention of high-quality employees. Leveraging HR management practices to promote congruence entails that the values of the organization are well-defined. Employees must understand how these are translated into workplace behaviors and actions. It must be clearly laid down how these relate to their performance and the impact these have on the achievement of the overall goals of the organization.

Many nation-states have increasingly found themselves in a situation where they are unable to sort out their domestic conflicts without third party mediation. This is particularly true for a country like the Government of the Philippines (GPH) who has been fighting violent protracted internal conflicts for many decades against Bangsamoro revolutionary groups. Therefore, with respect to the above, the purpose of this article is to compare peacebuilding models of third party mediation to the Bangsamoro conflicts with particular focus between Malaysia and the Organization of Islamic Conference, presently Cooperation (OIC). Its approach is primarily an eclectic, by concentrating on the strengths and weaknesses of the peacebuilding models of the third party mediation as employed by both Malaysia and OIC. The article is divided into two major parts. The first part discussed both Malaysia and OIC’s diplomatic approaches in dealing with the Bangsamoro conflict, while the second part explained inclusivity versus exclusivity of both Malaysia and the OIC respectively. The study found that Malaysia’s model is more durable and successful when compared to OIC’s. In fact, Malaysia’s quiet diplomacy and less confrontational approach with greater inclusivity were more effective compared to elitist and confrontational approach of the OIC’s mediation to the Bangsamoro conflicts. Indeed, the Government of the Philippines and Moro Islamic Liberation Front (GPH-MILF) peace process is one of the most inclusive peace processes in the world. It may have some who were left out in the peace process, but they were all consulted by both Manila and the Moro Islamic Liberation Front (MILF) as opposed to OIC mediated Government of the Republic of the Philippines and the Moro National Liberation Front (GRP-MNLF) peace negotiations. Therefore, it is pertinent to conclude that there is nothing that resembles the inclusivity of the GPH-MILF peace process that characterized the exclusivity of the GRP-MNLF peace process.

Objectives:Although health technology assessment (HTA) has been well established in all developed countries, it has not found a firm footing in many developing countries. This is especially true of the Asia Pacific region, which has much of the world population.Methods:The beginnings of HTA in this region go back to the work of Dr. David Banta in China and the establishment of the Asian HTA Network. The Network embarked on increasing awareness and building capacity among personnel from the region. Attempts were made to introduce HTA in countries where it did not exist, as well as to strengthen existing HTA programs. The Network had regular meetings, and also carried out a study on the diffusion and utilization of magnetic resonance imaging in the region. In an attempt to boost the efforts of the Network, the author spearheaded the organization of the Asian Regional HTA Conferences in Kuala Lumpur in 2000 and 2003, and in Manila, Philippines, in 2004. In addition, the author carried out a survey on HTA in the region. There are two broad categories of countries in the region: Australia, Malaysia, Singapore, New Zealand, China, Philippines, Korea, Thailand, and Taiwan, which have formal HTA programs, and others for which informal mechanisms or related activities exist, which include Bangladesh, Bhutan, Brunei, Cambodia, India, Indonesia, Laos, Maldives, Mongolia, Nepal, Pakistan, Sri Lanka, and Vietnam.Results:It is important that once HTA is established, it is used effectively. Perseverance and dedication is needed to ensure the success of an HTA program.Conclusion:Some countries in the region have effective HTA programs, whereas in some, efforts are being made to establish HTA, or HTA-related activities are being carried out in the absence of a formal HTA program.

This article introduces the Praxis for Accelerated Improvement in Research (PAIR) as a transformative research management paradigm drawn from the participatory action research program focused on research production and publication in a private higher education institution in Manila, Philippines. PAIR mentoring scheme upholds establishing a committed and caring relationship between the mentor and the mentee, thereby developing a shared vision towards research. PAIR mentoring further underscores the need to institute a university research infrastructure to support its research programs and initiatives. This participatory and transformative approach to research management tendered significant (and accelerated) improvement in the Scopus® metrics of the university. Reflecting from the researchers’ and research participants’ journey in implementing and embracing change and improvement in the university research programs, this article argues that researchers need to advance connectedness, conviviality, optimism, shared vision, and prudence in all aspects of research. This article thereby recommends learning and researching within the lens of participatory and transformative paradigm. The authors further recommend to higher education institutions establishment of a sustained mentoring program where mentors and mentees mutually agree and commit to advance the research vision of the university collectively. Finally, this article reasons in favor of an institutional research infrastructure that nurtures not just the knowledge and skills in research, but also the attitude and values of its research stakeholders towards research and the overall research program of the organization.

Policy makers in the Philippines are focusing on the gaps between the knowledge and skills provided by higher educational institutions and the job opportunities available in the labor market. Graduates are often faced with challenges in looking for jobs right after graduation, thus, schools play a crucial role in ensuring that students are equipped with knowledge and competency skills. This study examines the level of employability and competence skills of the 309 graduating students taking up different degree programs of The Fisher Valley College located in Taguig City, Metro Manila. About 17.8% of the respondents are currently working and 21.7% wanted to work in the service sector. More than half of the total respondents wanted to work in the government. Most of the respondents will look for a job immediately after graduation. Communication skills are the most important of skills in order for them to get hired in their first job applications. The most important factor identified when selecting an organization or company for work is when it provides ample opportunities for them for career advancement. Among work-related values, respondents considered love for God and perseverance and hard work as the most important. Five components of employability skills were identified: (1) problem-solving and analytic; (2) learning; (3) personal organization and time management; (4) creativity, innovation, and change; and (5) personal strengths. Overall, students assessed that these skills are very important in employment. However, they reported lower competency levels on these skills particularly on solving problems, identifying essential components of the problem, sorting out the relevant data to solve the problem, and contributing to group problem solving. It is very important for all sectors, i.e., schools, government, and industry, to prepare the students acquire the necessary skills and provide them with opportunities as they enter the labor market.

In February of this year, I was fortunate to attend Bodies in/and Asian Theatres, a regional conference of the International Federation for Theatre Research (IFTR, the scholarly organization with which this journal is affiliated). It was held at the University of the Philippines Diliman under the aegis of the IFTR Asian Theatre working group. Toward the end of a plenary panel on contemporary South East Asian dance on the final day, a debate arose over the work of one of the speakers, Eisa Jocson. A dancer and choreographer, Jocson's work explores the aesthetics of local and transnational performative labour, and is often based on forms she learns from Filipinos working in the entertainment industry. For example, Macho Dancer (2013) is based on a distinctive style of erotic male nightclub performance, Host (2015) on the work of Filipinas in Japanese hostess clubs, and the HAPPYLAND series (2017) on the high number of Filipinos employed at the Hong Kong Disneyland. In response to her presentation on these and other works, some scholars from the Philippines asked Jocson, who mainly performs in Manila and on the international contemporary performance circuit, why she did not tour nationally. After all, they reasoned, since Jocson's performances are inspired by the work of entertainers who often come from regional cities and rural areas, is it not right to present the work ‘back’ to such a workforce and their communities? Such questions are, of course, complex and loaded. In so far as Jocson's performances address the exploitation of Filipino entertainers’ affective labour, is there any risk that Jocson compounds that exploitation for her own benefit? And in so far as those performances explore the choreographies of entertainment capital and commodified desire, should Filipino audiences not be informed and perhaps educated about such things? Jocson countered that while wider local exposure for her work was desirable, it was wrong to presume that it could readily be presented in such circumstances. She makes her work within a specific critical and discursive context, she explained, and as part of a long-term thematic and aesthetic enquiry. To present it outside such contexts would benefit neither the audience, nor the artist, nor the work. If anything, she seemed to be suggesting, the work is not made for the producers of such performance forms, but for their consumers, and those who elsewhere participate in and benefit from such economies. She recounted making the ‘mistake’ of asking the owners of a ‘macho dancer’ nightclub if she could perform Macho Dancer there, as part of their regular line-up, late at night. They offered her an early slot, so as not to disrupt business as usual.

The World Health Organization Constitution “enshrines the highest attainable standard of health as a fundamental right of every human being. The right to health includes access to timely, acceptable, and affordable health care of appropriate quality … as well as the underlying determinants of health, such as … access to health-related education and information.”1 On the other hand, “social determinants of health can themselves pose barriers to education … and ‘damaged brains and bodies’ cannot learn optimally.”2 While there are no clear-cut solutions to such multifactorial issues involving complex-systems, the sustainable developmental goals of the United Nations development agenda beyond 2015 address both health and education.3 Health research fundamentally underpins the key aspiration of the sustainable development goals to realize universal health coverage.3 It is the responsibility of researchers and publishers to make this research available and accessible to all those who need it, in order to assist policymakers and practitioners to progressively realize the right to health of every global citizen. It would seem that the speed and reach of present-day information and communication technology would have facilitated the dissemination of health information. “However, despite the promises of the information revolution, and some successful initiatives, there is little if any evidence that the majority of health professionals in the developing world are any better informed than they were 10 years ago.”4 This observation made over a decade ago still holds true today. How can we advance access to health information and publication in our current “glocal” situation? How can the health information produced by research conducted by our students, residents and fellows, be shared with all those who may need and use the information? The Philipp J Otolaryngol Head Neck Surg has been actively pursuing multiple means of ensuring the availability of our research and innovation through traditional means, including indexing on various Index Medici and databases. While our visibility has increased dramatically in the 10 years of my editorship, we need to explore new paradigms, trends and innovations, especially with regard the social media. This includes using Facebook, Twitter, LinkedIn and RSS feeds, to name a few. It also calls us to consider the transition to a full open access model and adopting Creative Commons licenses. It is timely that the Asia Pacific Association of Medical Journal Editors (APAME) will explore this very theme of shifting paradigms, trends and innovations in advancing access to health information and publication in the forthcoming APAME2015 Annual Convention and Joint Meeting with the Western Pacific Region Index Medicus at the Sofitel Philippine Plaza and WHO Western Pacific Region Office from August 24-26 (http://apame2015.healthresearch.ph) in conjunction with the Global Health Forum 2015 at the Philippine International Convention Center (http://www.forum2015.org). Close to a thousand editors, reviewers, authors, researchers, librarians, and publishers of medical journals from Asia Pacific states, local delegates representing various institutions and organizations, including the Department of Science and Technology - Philippine Council for Health Research and Development (PCHRD), Department of Health, University of the Philippines Manila, Medical and Health Librarians Association of the Philippines (MAHLAP), the Philippine Medical Association, the Philippine Nursing Association, the Philippine Dental Association and others will exchange ideas in three days of meetings, scientific sessions and workshops. At the same time, the over 70 conjoint Forum 2015 sessions across 2 tracks covering 6 themes will provide “a platform where several other thousand key global actors in health gather to learn, debate and shape the global agenda on research and innovation for health, to arrive at new solutions that are driving health equity and socio-economic development.” Whether you are a beginning researcher or a seasoned scientist, a novice trainee or senior subspecialist, a community-based health worker or health policy-maker, there will be something for you to learn and share at these meetings that recognize “people (are) at the center of health research and innovation.” Medical and health professions students, ORL-HNS residents and consultants of all training and academic institutions are particularly enjoined to participate in this rare opportunity that will benefit us as well as the people we serve. Meet me at the Forum!

In the sprawling megalopolis of Metro Manila, the failure or inability of centralized public and privatized water service utilities to connect outlying and poor communities within their service areas led to the emergence of community-owned water providers run by cooperatives and neighborhood associations, often led and initiated by women. Born out of necessity and daily struggles to provide water for their households, communities organize themselves as water service cooperatives or associative water systems that assume the traditional role of the state as duty-bearers in ensuring universal access and human rights to water. Employing long-term ethnographic fieldwork, participant observation, key informant interviews and literature review, this paper critically examines urban poor communities’ experimentations of water service provisioning whereby women have taken on the cudgels to effectively deliver water to their own people and in the process, practice self-governance and autonomy. Using neo-institutionalist (Ostrom and Cox, 2010) and critical socio-institutionalist frameworks (Cleaver, 2002), we critically interrogate the praxes of women-led associative water systems, a model whereby water consumers both control and own the service in their capacity as consumers, using the cases of Bagong Silang and Recomville Two water service cooperatives located in Caloocan City. By illustrating on-the-ground experiences, we stress the crucial role that waterless citizens and communities play in bridging the gap in the country’s water service provision, thereby expanding the private/public dichotomies that often dominate water governance debates. Through these case studies, we argue that associative water systems were borne out of collective desire to have safe, clean, and affordable water to flow to waterless communities. As Metro Manila remains under a privatized water set up, these community-owned initiatives are legitimate expressions of social transformation. We problematize how these women-led associative water systems progress in the face of neoliberal governance marked by hegemonic power of private and public actors. We also investigate how democracy is exercised —or not— within these systems as well as surface the various contestations they face. This paper therefore scrutinizes the principles and pitfalls of, the ups and downs and lessons learnt from associative water systems in providing piped connections to waterless communities. Our aim is to shed light on the reconstruction of public services anchored on collective action. We find that the political possibility for collective self-organization and bottom-up social governance are facilitated or constrained by a combination of political, socioeconomic factors such as access to technical inputs and financing, social acceptability and legitimacy of the cooperative, sustained social organizing, and understanding of micro-politics and power in the community. Afterall, community-led initiatives operate in a highly contentious local politics marked by clientelism and heterogeneity. We posit that the successes of associative water systems lie on their ability to practice democracy, transparency, and accountability as well as mobilize social capital, trust, and cooperation. However, the experiences of urban poor communities in Caloocan City reveal a more complicated picture in which water service cooperatives are plagued by multiple governance issues, internal corruption, power struggles, and affordability issues. The process of building cooperatives is tension-laden, revealing the challenges of creating the commons through sociopolitical and institutional arrangements on the ground. The paper further reveals how state and market institutions successfully managed to define the terms of engagement with the urban poor communities that constrain the latter’s capability to expand water service in their areas, on one hand. On the other, private and public actors have distanced themselves from the people and obscured their objectives and economic interests from the communities they are supposed to serve. This generated a situation where dissatisfaction and capitalistic exploitation are directed toward cooperatives, instead, further redefining social relations within communities (Cheng, 2014; Chng, 2008). The paper is organized into six sections. The first parts provide a short introduction of the topic as well as a brief overview of the history and socio-political underpinnings of Metro Manila’s water privatization and neoliberal undercurrents that gave way to the rise of associative water systems. The second section outlines methodological considerations that detail our general approach in gathering empirical material. The third part offers a conceptual and literature review of associative water systems in theory and practice, outlining the positive and promising principles as well as the pitfalls of the model as commons or bottom-up social governance. Examples from Bolivia and the Philippines are mentioned that offered inspiration for urban poor communities in Caloocan City to embark on their own cooperative-building and water service provisioning. The fourth part narrates the dynamics, history, and experiences of Bagong Silang and Recomville Two water service cooperatives, underlining the similarities in the contexts where they operate as well as the various tensions and challenges they faced in the process of creating cooperatives and delivering quality and safe water to the urban poor households. We pay special attention to the role of women as leaders and changemakers amid a generally masculinized culture. The part played by two NGOs as wayfinders and supporters that accompanied the cooperatives accentuate the importance of having allies and partners in the process. We also detail how the uneven and inequitable relationship between Maynilad and the cooperatives produced a culture of payment for water which partially contributed to strained social relationships in the community. This culture restructured the roles and responsibilities among community, state, and market actors. The fifth part sketches the lessons learnt from these experiences, underlining the communities’ struggle for self-governance and autonomy to remake public services through collective action and participation in water service provision and stressing the crucial role that women played in the process. This section also identifies three challenges around issues of non-participation, power, and outcomes/impacts, underscoring the dangers of fetishizing communities (Cleaver, 2002) as homogenous, idealized forms or sources of social innovation. Divided along the lines of gender and class, women empowerment facilitated by the cooperative through trainings and skills enhancement did not sit well with some men in the communities. Further, the capacity to pay for water of the urban poor that is greatly tied to precarity of work and informality affects the operations and management of the system. We conclude by reiterating the pivotal role played by communities in enabling water to flow to their homes. But associative water systems are far from perfect. As on-going works-in-progress, the urban poor’s desired water services can only be discovered and constructed through daily —democratic— political struggles, collective action, and contestations. The praxes of associative water systems accentuate what Dahl and Soss (2012, as mentioned in McDonald, 2016) argue that “democratic conceptions of the common good will always be partial and provisional, never universal or static” (p. 4).

AbstractWhat occupies us in this volume is how women at all social levels devise their own coping mechanisms to deal with the impact of externally imposed pressures. Their stories reflect the creative solutions with which they have come to terms with some of the resulting problems, but always in a very personal way and without recourse to any form of collective action or organization. With a few exceptions, most of these women are still committed to traditional roles and the perception of obligations, even if the content of the role has changed. At least these "core" roles seem ideologically more resistant to change, such that there is a considerable lag between changing social conditions and the values underpinning them (cf. Goody, 1984). Apparently, it is only when women have become exposed, either through education, overseas travel or scholarly professions, that outside ("Western") notions of feminism and gender equality emerge. It is the highly unique and privileged upper middle class who agitate and raise the consciousness of their "deprived" sisters, and who also initiate women's organizations and support centres. If an awareness of womanhood for itself, a gender-as-class type of feminism has yet to surface in most of the societies of Southeast Asia, it is still legitimate to pursue the question of situation of women as a group-in-itself, as a potential action group. If we focus on the kinship system, as we have seen above, there is little in the ideology, distribution of resources and male-female relationships in traditional Southeast Asian practice (the immigrant Chinese here being something of an exception), to suggest an undue exploitation or oppression of women as a whole. In the domestic arrangements of most of them, a modus vivendi had been struck, an acceptance of role complementarily whether labelled the "myth of male dominance" (Rogers, 1975; Hirschon, 1984), or the false consciousness so readily perceived by many outsiders. Operating from the domestic core, women devise all manner of individual strategies to pursue their interests, influence their kin and turn events towards their chosen direction. Whether within or outside the household, such strategies are in the broadest sense political and can have substantial impact upon the male world (Collier, 1974). Commonly, women act or achieve their goals indirectly through men, particularly by the manipulation of husbands, brothers and sons, so that even the Chinese woman may eventually come into her own as a mother-in-law. In this collection of stories, Chat is the supreme example of this kind of successful manipulator. Satisfaction may even be had vicariously, as in Tok Nyam's pleasure in seeing her husband and sons make the pilgrimage to Mecca ahead of her. All of these women have managed to make, within their own small worlds, a choice of action between two or more options: Maimunah and Ah Ling opted for a non-traditional life of their own in the city, while Zainab chose to retreat from it and ease her family into compliance with her choice. The Singapore women's solutions to their working situation constantly result in a creative tension and some changes in the original Chinese family organization. For all the poverty of her family, even Yurni has been bold enough to spurn employment with and dependence on Ibu Ica, whom she dislikes, taking up alternative sharecropping and embroidery jobs instead. Rufina left Manila to marry the man of her own choosing, and in the most desperate of circumstances, devises a constant series of strategies of survival, while she and Tia Lilia are both victims of a system of rural proletarianization endemic in the Philippines. The deprivations of the latter two women stem, not from their position in a kinship, domestic or male-dominated system, but rather from the inequities of the wider society beyond them. In the case of the Muslim women in particular, some "interference" or even conflict emerges between the ideologies of their religion and kinship customs. In matrilineal Minangkabau society, Islam's main impact on Yurni has been in diverting the girls to an inferior or less modern type of education in favour of preparing the boys for a profession or other career. Islam moulded the sequence of Tok Nyam's divorce, remarriage and such important events in her life as the pilgrimage, but in no way prevented her from enjoying an active community life and the profits of her pandanus mat trade. Zainab happened to be growing up at a time when Islam was on the upswing in her social set and the immediate pressures of her social environment undoubtedly provided some coercive effect. Yet the final choice was still her own: Maimunah, living in the same time and place, charted a different path for herself. In the final analysis, it is probably to the world beyond the kin and family group that we must turn to seek the locus of the real inequities and the sources of oppression as they affect women, both in Southeast Asia and elsewhere. As noted above, the origins of most of the problems of the disadvantaged women of our collection lie in their overall class position, or in the political situation of their country. Rufina and Tia Lilia are the most dramatic examples here, and to a lesser degree, Yurni. In these cases, it must be recognized that the men, alongside the women, are also in positions of dependence and deprivation lacking the means to take control of their own lives and condition. It is a fallacy to assume that women represent an undifferentiated common interest group on the basis of their gender alone, for factors more powerful emerge on the backs of such distinctions as wealth, status, class, ethnicity and religion. Even the "advantages" of involvement in modern economic development, employment and education institutions are dependent upon these same distinctions, such that, for example, elite women may benefit more than those of lower status, as shown by Ibu Ica and Yurni, or women of one ethnic origin may be eligible for certain employment opportunities less available to those of other backgrounds for political reasons, as the urban careers of Maimunah, Zainab and Ah Ling illustrate. In the Philippines, it is to the destructive process of increasing rural proletarianization and poverty affecting the country as a whole that Rufina and Tia Lilia owe their pitiful existence, of which their menfolk are equally victims. Women in their own daily lives take cognisance of these various roles in devising strategies of action and charting paths to particular goals. None of this is quantifiable in any reliable way and to attempt to do so is to reduce the women actors to the anonymous shadow, dependent role occupants that most feminists would strenuously avoid. The alternative pursued here is the biographical method which allows us to present more of the individual richness of the situations of a small sample of selected women, as seen through their own eyes. In this exercise, the observer/biographers have deliberately refrained from passing judgment of a cultural, feminist or other variety, instead using the opportunity for interaction with their subjects to gain insights into both cultures through a process of defamiliarization and refamiliarization simultaneously.

In 2013, multiple articles reporting the clinical trial of valsartan, an antihypertensive drug of more than US$ 1 billion annual sales from Novartis, were retracted due to data falsification.1,2 These included the Kyoto Heart Study presented by Dr. Hiroaki Matsubara at the European Society of Cardiology 2009 Congress and subsequently published in the European Heart Journal (EHJ).3,4 Aside from retraction of this article by EHJ, the American Heart Association (AHA) also retracted five papers published in three of its journals -- Circulation, Circulation Research, and Hypertension.4 Novartis employees were involved in the conduct and analysis of the Kyoto Heart Study and a second investigator-initiated trial, the Jikei Heart Study,5 although their participation was not acknowledged in publications and presentations of the data, while a Novartis employee who allegedly manipulated statistical data was listed as one of the academic authors, without disclosing the relation with the company.4,6 This scandal has severely damaged scientific integrity in Japan and set the stage for the “Tokyo Declaration on Research Integrity and Ethical Publication in Science and Medicine in the Asia Pacific Region” adopted at the 2013 Convention of the Asia Pacific Association of Medi­cal Journal Editors (APAME) held in Tokyo from 2 to 4 August 2013, and co-published by Journals linked to APAME and listed in the Index Medicus for the South East Asian Region (IMSEAR) and the Western Pacific Region Index Medicus (WPRIM), including the Philippine Journal of Otolaryngology Head and Neck Surgery, with a Special Announcement in this issue.7 At the core of research integrity and ethical publication is responsible and accountable authorship. The ICMJE "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" has been replaced by the “Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals.”8 An important change under these new guidelines is an additional criterion for authorship, totaling four (4) instead of three (3) criteria. The ICMJE recommends that authorship be based on the following 4 criteria:8 Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND Drafting the work or revising it critically for important intellectual content; AND Final approval of the version to be published; AND Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. In addition to being accountable for the parts of the work he or she has done, an author should be able to identify which co-authors are responsible for specific other parts of the work. In addition, authors should have confidence in the integrity of the contributions of their co-authors. One cannot be listed as a co-author for the credit it brings, without being equally accountable in case of discredit. For example, consultant advisers and seniors who would consider adding their names as co-authors of a junior resident, are equally accountable for research misconduct (such as data fabrication, falsification, plagiarism), and cannot lay the blame on one (usually junior) author. While all those designated as authors should meet all four criteria for authorship, and all who meet the four criteria should be identified as authors, those who do not meet all four criteria should be acknowledged. Hence, it is more appropriate for consultant advisers and seniors who do not meet all four criteria for authorship to be acknowledged in this manner. Our journal seeks to maintain the highest standards of biomedical publication, and fully supports the APAME Tokyo Declaration on Research Integrity and Ethical Publication in Science and Medicine in the Asia – Pacific Region as well as the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals. Multiple accreditations and indexing are testimony to these standards. It was surprising therefore, that a letter from the Commission on Higher Education Journal Accreditation System dated 26 April 2013, which we received 26 May 2013, informed us of our reaccreditation under Category B based on the “recommendation of the panel of evaluators” who “pointed out the need to improve the journal’s refereeing system, regularity of publication/circulation and timeliness.”9 I respectfully responded to these remarks10 stating that: the Philipp J Otolaryngol Head Neck Surg is one of the few consistently compliant journals accredited by the National Journal Selection Committee of the Philippine Council for Health Research and Development, Department of Science and Technology. Our journal has a reputable loco-regional stature evidenced by international contributions from the USA, Japan, Turkey, Malaysia, India and Brunei, and has consistently been recognized as a benchmark journal by the Philippine Association of Medical Journal Editors and Asia Pacific Association of Medical Journal Editors. It functions as the de facto ASEAN Journal in the field of Otolaryngology Head and Neck Surgery. It is always regularly published on time, and indexed in the Health Research and Development Network (HERDIN-NeON) supported by the PCHRD-DOST; Philippine Journals On Line (PhilJOL) and Asia Journals On Line (AsiaJOL) supported by the International Network for the Availability of Scientific Publications (INASP); the Western Pacific Region Index Medicus (WPRIM) of the World Health Organization (WHO), APAMED Central and the Index Copernicus™ Journals Master List. It has always met the accreditation criteria of these services. The journal’s online peer review system is used as an example for other local journals, including in National Medical Writing and Reviewing Workshops organized by the PCHRD (2012 Cebu and Davao, 2013 Baguio and Iloilo), in the Philippine National Health Research System Week (2011 Bacolod, 2012 Manila, 2013 Laoag) as well as for regional journals in Medical Writing and Review Workshops held in Brunei, Singapore, Malaysia, Vietnam and Cambodia. Several local and regional journals have been thus assisted by us in their editing and peer review systems. As a Category A Accredited Research Journal (Batch 1) for 2009 – 2012 per Commission on Higher Education (CHED) Memorandum Order No. 09 s. 2010 and Resolution No. 477-2009, effective December 9, 2009 (signed May 26, 2010), our journal has faithfully complied with all the terms of the JAS, including “acknowledgement in the published journal that the publication thereof was a product of the Journal Accreditation Service project of the Commission on Higher Education” in the inside front cover of every issue. Moreover, we have gone beyond the dissemination requirement by providing a complimentary copy of each issue to every Medical School Library in the Philippines. I ended by reiterating that our journal “has more than complied with the requirements of the Journal Accreditation Service of the Commission on Higher Education for reaccreditation as a Category A Accredited Research Journal, and beg(ged) the honorable review panel to reconsider its recommendation.”10 It turned out that previously-submitted copies of our journal had been inadvertently misplaced, leading to our downgrade from Category A to B. Expecting full reinstatement, I was surprised to receive a response dated 23 July 2013 on 23 August 2013, informing us that: “the Technical Evaluators decided to classify the said journal as ‘conditional category A’ pending submission of enhanced volumes with sober and serious formats to project scientific/scholarly image. While refereed journals often contain many graphs and charts, these do not normally include glossy pages (e.g. advertisements) or exciting pictures (e.g. captoons) which noticeably appeared in the issues that you submitted.”11 I again respectfully responded to these remarks by citing12 the International Committee of Medical Journal Editors Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals (ICMJE Recommendations) updated August 2013, cited 29 August 2013 available at http://www.icmje.org/urm_main.html8 The recommendations have clear guidelines on advertising, and do not forbid exciting pictures and cartoons. Nowhere do they constrain scholarly medical journals to maintain “sober and serious formats to project scientific/scholarly image.” The Philippine Journal of Otolaryngology Head and Neck Surgery is listed among the Journals Following ICMJE Recommendations http://www.icmje.org/journals.html13 The top-tier journals in medicine (BMJ, JAMA, Lancet and NEJM) as well as Science and Nature all have advertising in glossy pages and exciting pictures and cartoons, even on their covers. The same is true for our major journals in the field of Otolaryngology Head and Neck Surgery. I provided the technical panel with copies of the Instructions to Authors of these journals, as well as photographs of actual caricatures from their covers and inside pages. Finally, I also attached an excerpt from: Bennett HJ. Humor in Medicine. South Med J. 2003;96(12)14 for the perusal of the honourable Technical Panel. As of press time, we have not received a reply from the Technical Panel, but have received advise from the Office of Policy, Planning, Research and Information of the Commission on Higher Education to withhold, in the meantime, our inside front cover acknowledgement that the publication of this issue “was a product of the Journal Accreditation Service project of the Commission on Higher Education.” However, we shall continue to provide a complimentary copy of this issue to every Medical School Library in the Philippines as a valuable service of our Society and Journal as we await the resolution of this situation.

The Volunteer Youth Leaders for Health - Philippines (VYLHPhilippines) is a national youth network established in 2009 as a model of how to organize young women and men into a national force that promotes self-learning, independence, personal growth and sustained positive public health change from the grassroots level and up. Formed under the aegis of the University of the Philippines Manila and the Department of Health, the VYLH-Philippines has focused its activities in the past eight years on helping reduce mortality and disability from congenital disorders through awareness programs and support for policy development. This paper describes in detail the organization and extraordinary accomplishments of the VYLHPhilippines to date.

Introduction. In the Philippines, data on road traffic injuries show that road injury is the 11th leading cause of premature deaths in the Philippines. The World Health Organization estimates that 1.24 million die globally due to road traffic crashes. Objectives. This study aimed to show the trend of the road crash situation in Metro Manila, Philippines, over eleven years (2005–2015) and to analyze human error and other associated hazard factors for road crashes. Methods. This study is a secondary analysis of an 11-year database culled from 2005–2015, for Metro Manila, Philippines. The variables included road crash classification, incidence over months and time of the day, road crash disaggregated by location, region, and city, and type of vehicle. Descriptive statistics were used to describe the incidence of a road crash, road crash fatalities, and risk factors associated with a road crash in Metro Manila. Results. The incidence of road crashes in Metro Manila has increased from 65,111 in 2005 to 95,615 in 2015. Fatalities also increased from 348 to 536. The most predominant type of vehicle involved in road crashes were cars from 46% to 67%, followed by jeepneys, vans, and motorcycles. The most commonly reported human errors were speeding, inattentive and bad turning. The reported percentage of speeding from 2005–2010 ranged between 32% and 58%. In 2014, speeding (96%) was the most reported human error among the other reported errors; such as inattentiveness (range, 28 to 41%) and bad turning (0.6% and 33%). Fatigue and traffic violation made up 0.02% to 0.45% of the reported human factors of road crash-related hospitalization cases in Metro Manila for the period. Suspected alcohol use accounted for 0.04% to 4.57% of the human errors reported. For non-fatal and fatal crashes, the associated human errors were suspected alcohol use, inattentiveness, and speeding. The highest adjusted residual for both fatal and non-fatal (injurious) crashes was for inattentiveness. Human error was associated with years, suggesting that for some years, the number of crashes caused by human errors is significantly higher than expected. Alcohol-suspected crashes are significantly higher than expected for 2005 and 2011, with 2011 having the highest adjusted residual. Inattentiveness-caused crashes were significantly higher than expected for years 2005 to 2010, with 2007 having the highest adjusted residual. Bad turning was significantly higher from 2005 to 2007; while disobedience was significantly higher for 2005 to 2008. Speeding was significantly higher than expected from 2005 to 2010. Conclusion. There is a need to address the public health concern posed by road crashes in Metro Manila, as well as to rectify the ergonomically related risk factors and human error components in a road crash.

Introduction: World Health Organization recognizes online game addiction as a mental health condition. The rise of excessive online gaming is emerging in the Philippines, with 29.9 million gamers recorded in the country. The incidence of depression is also increasing in the country. The current correlational analysis evaluated the association between online game addiction and depression in Filipino adolescents. Methods: A paper-and-pencil self-administered questionnaire assessing depression and online game addiction was distributed from August to November, 2018. The questionnaire included socio-demographic profiles of the respondents, and the 14-item Video Game Addiction Test (VAT) (Cronbach's α=0.91) and the Patient Health Questionnaire-9 (Cronbach's α=0.88) to determine levels of online game addiction and depression, respectively. Multiple regression analyses were used to test the association between depression and online game addiction. Results: Three hundred adolescents (59% males, 41% females) participated in the study. Fifty-three out of 300 respondents (12.0% males, 5.7% females) had high level of online game addiction as reflected in their high VAT scores. In this study, 37 respondents (6.7% males, 5.7% females) had moderately severe depression and 6 (2.0%) females had severe depression. Online game addiction was positively correlated with depression in this study (r=0.31; p<0.001). When multiple regression analysis was computed, depression was found to be a predictor of online game addiction (Coefficient=0.0121; 95% CI-8.1924 - 0.0242; p=0.05). Conclusion: Depression, as associated with online game addiction, is a serious threat that needs to be addressed. High level of online game addiction, as positively correlated to the rate of depression among adolescents in Manila, could potentially be attributed to the booming internet industry and lack of suffiicent mental health interventions in the country. Recommended interventions include strengthening depression management among adolescents and improving mental health services for this vulnerable population groups in schools and within the communities.

Fish is the staple viand for Filipinos. Unsurprisingly, fish processing becomes a livelihood in the Philippines. Lead, cadmium and chromium contamination in fish may result to adverse health effects. This study aimed to determine such heavy metals in processed fish (dried and smoked) in both head and meat sold in the markets of Metro Manila, Philippines. The levels were compared with each other. The levels of heavy metals obtained were also compared with standard limits set by the Food and Agriculture Organization, World Health Organization, and the US Environmental Protection Agency. The samples were analyzed using Flame Atomic Absorption Spectrophotometry. All processed fish smoked and dried fish samples contained lead, cadmium and chromium. Smoked Bisugo (Nemipterus japonicus) head had lead that went beyond the allowed limit. All dried fish samples contained cadmium beyond the acceptable limit. Smoked Galunggong (Decapterus macrosoma) meat went beyond the acceptable cadmium limit. Chromium in all samples went beyond the acceptable limit. Using Student’s t-test, the levels of lead and cadmium (head, meat) in processed fish showed statistically insignificant difference similar to chromium in smoked but not for dried fish. Hence, all processed fish samples contain lead, cadmium and chromium. The species and body parts with heavy metals beyond the acceptable limits vary. Keywords - Environmental toxicology, acid digestion, fl ame atomic absorption spectroscopy, lead, cadmium, chromium, experimental design, Philippines

According to the World Health Organization (WHO), almost 98% of low and middle-income countries’ air fail to meet the United Nations (UN) body’s standards. Data from the Department of Environment and Natural Resources’ Environmental Management Bureau (DENR-EMB) revealed the Total Suspended Particles (TSP) in Metro Manila during the first quarter of 2015 reached 130 micrograms per normal cubic meter (ug/Ncm). The maximum safe level is 90 ug/Ncm. Since 80% of pollution load is contributed by vehicles, the study determined the amount of carbon monoxide (CO) and hydrocarbons (HC) during the smoke emission testing of motorcycles in Metro Dumaguete, Negros Oriental, Philippines. Random sampling and simple average formula were utilized in the study. Using the smoke test results from January to February 2015, it was found out that the average amount of CO is 1.45 µg/cm which is very low compared to DENR standard exposure value of 35 ug/cm for one hour and 10 µg/cm for 8-hour exposure. Also, the average amount of HC is 600.26 ppm which is low compared to DENR’s maximum set value of 4500ppm to 6500 ppm. Current findings indicate that the amount of CO of motorcycle emissions is insignificant while HC is low as compared to the standard value.

The UP Manila Health Policy Development Hub recognizes the invaluable contribution of the participants in theseries of roundtable discussions listed below: RTD: Beyond Hospital Beds: Equity,quality, and service1. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, UP Manila2. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, UP Manila3. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, UP Manila4. Hilton Y. Lam, MHA, PhD, Chair, UP Manila HealthPolicy Development Hub; Director, Institute of HealthPolicy and Development Studies, University of thePhilippines Manila5. Irma L. Asuncion, MHA, CESO III, Director IV,Bureau of Local Health Systems Development,Department of Health6. Renely Pangilinan-Tungol, MD, CFP, MPM-HSD,Municipal Health Officer, San Fernando, Pampanga7. Salome F. Arinduque, MD, Galing-Pook AwardeeRepresentative, Municipal Health Officer, San Felipe,Zambales8. Carmelita C. Canila, MD, MPH, Faculty, College ofPublic Health, University of the Philippines Manila9. Lester M. Tan, MD, MPH, Division Chief, Bureau ofLocal Health System Development, Department ofHealth10. Anthony Rosendo G. Faraon, MD, Vice President,Zuellig Family Foundation (ZFF)11. Albert Francis E. Domingo, MD, Consultant, HealthSystem strengthening through Public Policy andRegulation, World Health Organization12. Jesus Randy O. Cañal, MD, FPSO-HNS, AssociateDirector, Medical and Regulatory Affairs, AsianHospital and Medical Center13. Christian Edward L. Nuevo, Health Policy and SystemsResearch Fellow, Health Policy Development andPlanning Bureau, Department of Health14. Paolo Victor N. Medina, MD, Assistant Professor 4,College of Medicine, University of the PhilippinesManila15. Jose Rafael A. Marfori, MD, Special Assistant to theDirector, Philippine General Hospital16. Maria Teresa U. Bagaman, Committee Chair, PhilippineSociety for Quality, Inc.17. Maria Theresa G. Vera, MSc, MHA, CESO III, DirectorIV, Health Facility Development Bureau, Departmentof Health18. Ana Melissa F. Hilvano-Cabungcal, MD, AssistantAssociate Dean for Planning & Development, Collegeof Medicine, University of the Philippines Manila19. Fevi Rose C. Paro, Faculty, Department of Communityand Environmental Resource Planning, University ofthe Philippines Los Baños20. Maria Rosa C. Abad, MD, Medical Specialist III,Standard Development Division, Health Facilities andServices Regulation21. Yolanda R. Robles, RPh, PhD, Faculty, College ofPharmacy, University of the Philippines Manila22. Jaya P. Ebuen, RN, Development Manager Officer,CHDMM, Department of Health23. Josephine E. Cariaso, MA, RN, Assistant Professor,College of Nursing, University of the Philippines Manila24. Diana Van Daele, Programme Manager, CooperationSection, European Union25. Maria Paz de Sagun, Project Management Specialist,USAID26. Christopher Muñoz, Member, Yellow Warriors SocietyPhilippinesRTD: Health services and financingroles: Population based- andindividual-based1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, University of thePhilippines Manila3. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, University of thePhilippines Manila4. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, University of the PhilippinesManila5. Mario C. Villaverde, Undersecretary, Health Policyand Development Systems and Development Team,Department of Health6. Jaime Z. Galvez Tan, MD, Former Secretary, Department of Health7. Marvin C. Galvez, MD, OIC Division Chief, BenefitsDevelopment and Research Department, PhilippineHealth Insurance Corporation8. Alvin B. Caballes, MD, MPE, MPP, Faculty, Collegeof Medicine, University of the Philippines Manila9. Carlos D. Da Silva, Executive Director, Association ofMunicipal Health Maintenance Organization of thePhilippines, Inc.10. Anthony Rosendo G. Faraon, MD, Vice President,Zuellig Family Foundation (ZFF) 11. Albert Francis E. Domingo, MD, Consultant, HealthSystem strengthening through Public Policy andRegulation, World Health Organization12. Salome F. Arinduque, MD, Galing-Pook AwardeeRepresentative, Municipal Health Officer, San Felipe,Zambales13. Michael Ralph M. Abrigo, PhD, Research Fellow,Philippine Institute for Developmental Studies14. Oscar D. Tinio, MD, Committee Chair, Legislation,Philippine Medical Association15. Rogelio V. Dazo, Jr., MD, FPCOM, Legislation,Philippine Medical Association16. Ligaya V. Catadman, MM, Officer-in-charge, HealthPolicy Development and Planning Bureau, Department of Health17. Maria Fatima Garcia-Lorenzo, President, PhilippineAlliance of Patients Organization18. Tomasito P. Javate, Jr, Supervising Economic DevelopmentSpecialist, Health Nutrition and Population Division,National Economic and Development Authority19. Josefina Isidro-Lapena, MD, National Board ofDirector, Philippine Academy of Family Physicians20. Maria Eliza Ruiz-Aguila, MPhty, PhD, Dean, Collegeof Allied Medical Professions, University of thePhilippines Manila21. Ana Melissa F. Hilvano-Cabungcal, MD, AssistantAssociate Dean for Planning & Development, College ofMedicine, University of the Philippines Manila22. Maria Paz P. Corrales, MD, MHA, MPA, Director III,Department of Health-National Capital Region23. Karin Estepa Garcia, MD, Executive Secretary, PhilippineAcademy of Family Physicians24. Adeline A. Mesina, MD, Medical Specialist III,Philippine Health Insurance Corporation25. Glorey Ann P. Alde, RN, MPH, Research Fellow,Department of HealthRTD: Moving towards provincelevel integration throughUniversal Health Care Act1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, University of thePhilippines Manila3. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, University of thePhilippines Manila4. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, University of the PhilippinesManila5. Mario C. Villaverde, Undersecretary of Health, HealthPolicy and Development Systems and DevelopmentTeam, Department of Health6. Ferdinand A. Pecson, Undersecretary and ExecutiveDirector, Public Private Partnership Center7. Rosanna M. Buccahan, MD, Provincial Health Officer,Bataan Provincial Office8. Lester M. Tan, MD, Division Chief, Bureau of LocalHealth System Development, Department of Health9. Ernesto O. Domingo, MD, FPCP, FPSF, FormerChancellor, University of the Philippines Manila10. Albert Francis E. Domingo, MD, Consultant, HealthSystem strengthening through Public Policy andRegulation, World Health Organization11. Leslie Ann L. Luces, MD, Provincial Health Officer,Aklan12. Rene C. Catan, MD, Provincial Health Officer, Cebu13. Anthony Rosendo G. Faraon, MD, Vice President,Zuellig Family Foundation14. Jose Rafael A. Marfori, MD, Special Assistant to theDirector, Philippine General Hospital15. Jesus Randy O. Cañal, MD, FPSO-HNS, Consultant,Asian Hospital and Medical Center16. Ramon Paterno, MD, Member, Universal Health CareStudy Group, University of the Philippines Manila17. Mayor Eunice U. Babalcon, Mayor, Paranas, Samar18. Zorayda E. Leopando, MD, Former President,Philippine Academy of Family Physicians19. Madeleine de Rosas-Valera, MD, MScIH, SeniorTechnical Consultant, World Bank20. Arlene C. Sebastian, MD, Municipal Health Officer,Sta. Monica, Siargao Island, Mindanao21. Rizza Majella L. Herrera, MD, Acting Senior Manager,Accreditation Department, Philippine Health InsuranceCorporation22. Alvin B. Caballes, MD, MPE, MPP, Faculty, Collegeof Medicine, University of the Philippines Manila23. Pres. Policarpio B. Joves, MD, MPH, MOH, FPAFP,President, Philippine Academy of Family Physicians24. Leilanie A. Nicodemus, MD, Board of Director,Philippine Academy of Family Physicians25. Maria Paz P. Corrales, MD, MHA, MPA, Director III,National Capital Region Office, Department of Health26. Dir. Irma L. Asuncion, MD, MHA, CESO III, DirectorIV, Bureau of Local Health Systems Development,Department of Health27. Bernard B. Argamosa, MD, Mental Health Representative, National Center for Mental Health28. Flerida Chan, Chief, Poverty Reduction Section, JapanInternational Cooperation Agency29. Raul R. Alamis, Chief Health Program Officer, ServiceDelivery Network, Department of Health30. Mary Anne Milliscent B. Castro, Supervising HealthProgram Officer, Department of Health 31. Marikris Florenz N. Garcia, Project Manager, PublicPrivate Partnership Center32. Mary Grace G. Darunday, Supervising Budget andManagement Specialist, Budget and Management Bureaufor the Human Development Sector, Department ofBudget and Management33. Belinda Cater, Senior Budget and Management Specialist,Department of Budget and Management34. Sheryl N. Macalipay, LGU Officer IV, Bureau of LocalGovernment and Development, Department of Interiorand Local Government35. Kristel Faye M. Roderos, OTRP, Representative,College of Allied Medical Professions, University ofthe Philippines Manila36. Jeffrey I. Manalo, Director III, Policy Formulation,Project Evaluation and Monitoring Service, PublicPrivate Partnership Center37. Atty. Phebean Belle A. Ramos-Lacuna, Division Chief,Policy Formulation Division, Public Private PartnershipCenter38. Ricardo Benjamin D. Osorio, Planning Officer, PolicyFormulation, Project Evaluation and MonitoringService, Public Private Partnership Center39. Gladys Rabacal, Program Officer, Japan InternationalCooperation Agency40. Michael Angelo Baluyot, Nurse, Bataan Provincial Office41. Jonna Jane Javier Austria, Nurse, Bataan Provincial Office42. Heidee Buenaventura, MD, Associate Director, ZuelligFamily Foundation43. Dominique L. Monido, Policy Associate, Zuellig FamilyFoundation44. Rosa Nene De Lima-Estellana, RN, MD, Medical OfficerIII, Department of Interior and Local Government45. Ma Lourdes Sangalang-Yap, MD, FPCR, Medical OfficerIV, Department of Interior and Local Government46. Ana Melissa F. Hilvano-Cabungcal, MD, AssistantAssociate Dean for Planning & Development, College ofMedicine, University of the Philippines Manila47. Colleen T. Francisco, Representative, Department ofBudget and Management48. Kristine Galamgam, Representative, Department ofHealth49. Fides S. Basco, Officer-in-charge, Chief Budget andManagement Specialist, Development of Budget andManagementRTD: Health financing: Co-paymentsand Personnel1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, University of thePhilippines Manila3. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, University of thePhilippines Manila4. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, University of the Philippines Manila5. Ernesto O. Domingo, MD, Professor Emeritus,University of the Philippines Manila6. Irma L. Asuncion, MHA, CESO III, Director IV,Bureau of Local Health Systems Development,Department of Health7. Lester M. Tan, MD, MPH, Division Chief, Bureau ofLocal Health System Development, Department ofHealth8. Marvin C. Galvez, MD, OIC Division Chief, BenefitsDevelopment and Research Department, PhilippineHealth Insurance Corporation9. Adeline A. Mesina, MD, Medical Specialist III, BenefitsDepartment and Research Department, PhilippineHealth Insurance Corporation10. Carlos D. Da Silva, Executive Director, Association ofHealth Maintenance Organization of the Philippines,Inc.11. Ma. Margarita Lat-Luna, MD, Deputy Director, FiscalServices, Philippine General Hospital12. Waldemar V. Galindo, MD, Chief of Clinics, Ospital ngMaynila13. Albert Francis E. Domingo, MD, Consultant, HealthSystem strengthening through Public Policy andRegulation, World Health Organization14. Rogelio V. Dazo, Jr., MD, Member, Commission onLegislation, Philippine Medical Association15. Aileen R. Espina, MD, Board Member, PhilippineAcademy of Family Physicians16. Anthony R. Faraon, MD, Vice President, Zuellig FamilyFoundation17. Jesus Randy O. Cañal, Associate Director, Medical andRegulatory Affairs, Asian Hospital and Medical Center18. Jared Martin Clarianes, Technical Officer, Union of LocalAuthorities of the Philippines19. Leslie Ann L. Luces, MD, Provincial Health Officer,Aklan20. Rosa Nene De Lima-Estellana, MD, Medical OfficerIII, Department of the Interior and Local Government21. Ma. Lourdes Sangalang-Yap, MD, Medical Officer V,Department of the Interior and Local Government 22. Dominique L. Monido, Policy Associate, Zuellig FamilyFoundation23. Krisch Trine D. Ramos, MD, Medical Officer, PhilippineCharity Sweepstakes Office24. Larry R. Cedro, MD, Assistant General Manager, CharitySector, Philippine Charity Sweepstakes Office25. Margarita V. Hing, Officer in Charge, ManagementDivision, Financial Management Service Sector,Department of Health26. Dr. Carlo Irwin Panelo, Associate Professor, College ofMedicine, University of the Philippines Manila27. Dr. Angelita V. Larin, Faculty, College of Public Health,University of the Philippines Manila28. Dr. Abdel Jeffri A. Abdulla, Chair, RegionalizationProgram, University of the Philippines Manila29. Christopher S. Muñoz, Member, Philippine Alliance ofPatients Organization30. Gemma R. Macatangay, LGOO V, Department ofInterior and Local Government – Bureau of LocalGovernment Development31. Dr. Narisa Portia J. Sugay, Acting Vice President, QualityAssurance Group, Philippine Health InsuranceCorporation32. Maria Eliza R. Aguila, Dean, College of Allied MedicalProfessions, University of the Philippines Manila33. Angeli A. Comia, Manager, Zuellig Family Foundation34. Leo Alcantara, Union of Local Authorities of thePhilippines35. Dr. Zorayda E. Leopando, Former President, PhilippineAcademy of Family Physicians36. Dr. Emerito Jose Faraon, Faculty, College of PublicHealth, University of the Philippines Manila37. Dr. Carmelita C. Canila, Faculty, College of PublicHealth, University of the Philippines ManilaRTD: Moving towards third partyaccreditation for health facilities1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, University of thePhilippines Manila3. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, University of thePhilippines Manila4. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, University of the PhilippinesManila5. Rizza Majella L. Herrera, MD, Acting SeniorManager, Accreditation Department, Philippine HealthInsurance Corporation6. Bernadette C. Hogar-Manlapat, MD, FPBA, FPSA,FPSQua, MMPA, President and Board of Trustee,Philippine Society for Quality in Healthcare, Inc.7. Waldemar V. Galindo, MD, Chief of Clinics, Ospital ngMaynila8. Amor. F. Lahoz, Division Chief, Promotion andDocumentation Division, Department of Trade andIndustry – Philippine Accreditation Bureau9. Jenebert P. Opinion, Development Specialist, Department of Trade and Industry – Philippine AccreditationBureau10. Maria Linda G. Buhat, President, Association ofNursing Service Administrators of the Philippines, Inc.11. Bernardino A. Vicente, MD, FPPA, MHA, CESOIV, President, Philippine Tripartite Accreditation forHealth Facilities, Inc.12. Atty. Bu C. Castro, MD, Board Member, PhilippineHospital Association13. Cristina Lagao-Caalim, RN, MAN, MHA, ImmediatePast President and Board of Trustee, Philippine Societyfor Quality in Healthcare, Inc.14. Manuel E. Villegas Jr., MD, Vice Treasurer and Board ofTrustee, Philippine Society for Quality in Healthcare,Inc.15. Michelle A. Arban, Treasurer and Board of Trustee,Philippine Society for Quality in Healthcare, Inc.16. Joselito R. Chavez, MD, FPCP, FPCCP, FACCP,CESE, Deputy Executive Director, Medical Services,National Kidney and Transplant Institute17. Blesilda A. Gutierrez, CPA, MBA, Deputy ExecutiveDirector, Administrative Services, National Kidney andTransplant Institute18. Eulalia C. Magpusao, MD, Associate Director, Qualityand Patient Safety, St. Luke’s Medical Centre GlobalCity19. Clemencia D. Bondoc, MD, Auditor, Association ofMunicipal Health Officers of the Philippines20. Jesus Randy O. Cañal, MD, FPSO-HNS, AssociateDirector, Medical and Regulatory Affairs, Asian Hospitaland Medical Center21. Maria Fatima Garcia-Lorenzo, President, PhilippineAlliance of Patient Organizations22. Leilanie A. Nicodemus, MD, Board of Directors,Philippine Academy of Family Physicians23. Policarpio B. Joves Jr., MD, President, PhilippineAcademy of Family Physicians24. Kristel Faye Roderos, Faculty, College of Allied MedicalProfessions, University of the Philippines Manila25. Ana Melissa Hilvano-Cabungcal, MD, AssistantAssociate Dean, College of Medicine, University of thePhilippines Manila26. Christopher Malorre Calaquian, MD, Faculty, Collegeof Medicine, University of the Philippines Manila27. Emerito Jose C. Faraon, MD, Faculty, College ofPublic Health, University of the Philippines Manila 28. Carmelita Canila, Faculty, College of Public Health,University of the Philippines Manila29. Oscar D. Tinio, MD, Representative, Philippine MedicalAssociation30. Farrah Rocamora, Member, Philippine Society forQuality in Healthcare, IncRTD: RA 11036 (Mental Health Act):Addressing Mental Health Needs ofOverseas Filipino Workers1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Leonardo R. Estacio, Jr., MCD, MPH, PhD, UPManila Health Policy Development Hub; College ofArts and Sciences, UP Manila3. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD, UPManila Health Policy Development Hub; College ofPublic Health, UP Manila4. Michael Antonio F. Mendoza, DDM, UP ManilaHealth Policy Development Hub; College of Dentistry,UP Manila5. Frances Prescilla L. Cuevas, RN, MAN, Director,Essential Non-Communicable Diseases Division,Department of Health6. Maria Teresa D. De los Santos, Workers Education andMonitoring Division, Philippine Overseas EmploymentAdministration7. Andrelyn R. Gregorio, Policy Program and Development Office,Overseas Workers Welfare Administration8. Sally D. Bongalonta, MA, Institute of Family Life &Children Studies, Philippine Women’s University9. Consul Ferdinand P. Flores, Department of ForeignAffairs10. Jerome Alcantara, BLAS OPLE Policy Center andTraining Institute11. Andrea Luisa C. Anolin, Commission on FilipinoOverseas12. Bernard B. Argamosa, MD, DSBPP, National Centerfor Mental Health13. Agnes Joy L. Casino, MD, DSBPP, National Centerfor Mental Health14. Ryan Roberto E. Delos Reyes, Employment Promotionand Workers Welfare Division, Department of Laborand Employment15. Sheralee Bondad, Legal and International AffairsCluster, Department of Labor and Employment16. Rhodora A. Abano, Center for Migrant Advocacy17. Nina Evita Q. Guzman, Ugnayan at Tulong para saMaralitang Pamilya (UGAT) Foundation, Inc.18. Katrina S. Ching, Ugnayan at Tulong para sa MaralitangPamilya (UGAT) Foundation, Inc.RTD: (Bitter) Sweet Smile of Filipinos1. Dr. Hilton Y. Lam, Institute of Health Policy andDevelopment Studies, NIH2. Dr. Leonardo R. Estacio, Jr., College of Arts andSciences, UP Manila3. Dr. Ma. Esmeralda C. Silva, College of Public Health,UP Manila4. Dr. Michael Antonio F. Mendoza, College of Dentistry,UP Manila5. Dr. Ma. Susan T. Yanga-Mabunga, Department ofHealth Policy & Administration, UP Manila6. Dr. Danilo L. Magtanong, College of Dentistry, UPManila7. Dr. Alvin Munoz Laxamana, Philippine DentalAssociation8. Dr. Fina Lopez, Philippine Pediatric Dental Society, Inc9. Dr. Artemio Licos, Jr.,Department of Health NationalAssociation of Dentists10. Dr. Maria Jona D. Godoy, Professional RegulationCommission11. Ms. Anna Liza De Leon, Philippine Health InsuranceCorporation12. Ms. Nicole Sigmuend, GIZ Fit for School13. Ms. Lita Orbillo, Disease Prevention and Control Bureau14. Mr. Raymond Oxcena Akap sa Bata Philippines15. Dr. Jessica Rebueno-Santos, Department of CommunityDentistry, UP Manila16. Ms. Maria Olivine M. Contreras, Bureau of LocalGovernment Supervision, DILG17. Ms. Janel Christine Mendoza, Philippine DentalStudents Association18. Mr. Eric Raymund Yu, UP College of DentistryStudent Council19. Dr. Joy Memorando, Philippine Pediatric Society20. Dr. Sharon Alvarez, Philippine Association of DentalColleges

Objectives. This study aims to determine demographics, job suitability, job satisfaction and perception among the administrative staff and research, extension and professional staff (REPS) of the University of the Philippines Manila College of Medicine. Methods. This is a descriptive study. A questionnaire was developed and administered to 71 administrative employees and Research, Extension and Professional Staff (REPS) to assess job profile, actual duties and responsibilities of the official job position/title during a period of five years from January 1, 2010 to December 31, 2014. Results. There are 71 employees of the University of the Philippines College of Medicine (UPCM), 61 administrative staff and 10 REPS. A majority (62%) have been with the UPCM for more than 15 years. Sixty-two employees had complete information and among these, 45 (72.6%) were hired for jobs related to their educational backgrounds. All employees underwent some form of training as part of staff development (2.56 courses/employee/year) and the staff recognized that these courses enhanced their ability to do their jobs (95.3%). However, the staff also feel that they attend many other courses (66.4% of courses attended) that are not directly related to their jobs, with only 33.6% of these courses having any bearing on the performance of their specific jobs. Survey results showed that job satisfaction and perception of the value of their work is generally high. However, sources of dissatisfaction include being assigned tasks by people other than their immediate supervisor, not enough time to do their jobs and duties assigned that are not within their job description. Conclusion. Most employees of the UPCM have a high level of satisfaction with their jobs. Cited factors for this include job suitability, continued staff development, a sense that what they do is essential to the organization as a whole. Some areas are seen to be sources of dissatisfaction. These include mismatch between training and actual duties, work assigned by people other than their supervisors, too little time allotted for the work assigned, and tasks expected of them that are not within their job descriptions.

There are several problems that continue to plague the Philippine health care system. The cost of branded drugs in the Philippines is 22 times more than international reference prices while generic drugs are 4 times more.1 Despite price reductions due to legislations such as the Cheaper Medicines Act of 2008, as well as the Generics Act of 1988, those in the lower-income brackets still cannot afford maintenance medicines for hypertension and diabetes as well as antibiotics.2 Access to medicines and care from physicians and other healthcare professionals is especially challenging for geographically isolated and disadvantaged areas wherein the people are physically or economically inaccessible. Filipino traditional medicine, of which herbal medicine plays a large role has been around for centuries and is wellaccepted in the rural areas. Validating the use of these traditional medicinal plants through research is essential in order to have an evidence-based practice of herbal medicine. The main areas of research can be defined as (1) herbal medicine quality and standardization, (2) preclinical pharmacological assessments and action mechanisms, and (3) clinical efficacy and safety assessments.3 These types of researches aimed at developing safe and efficacious, as well as low-cost Philippine herbal medicines, may well be a long-term solution to the obstacles to a healthy population cited above. Our Philippine medicinal plants are a valuable but often underappreciated resource with innumerable applications for non-communicable and communicable disease indications. Limited research in this field had long been ongoing in the Philippines. Support for this movement came with the passage of the Traditional and Alternative Medicine Act of 1997 which affirmed the commitment of the government towards the support and development of traditional medicine including herbal medicine.4 Another boost was the endorsement of the Department of Health of the Sampung Halamang Gamot in the 1990s.5 The World Health Organization has advocated the integration of Traditional Medicine within national health care systems and has urged governments to develop and implement national traditional medicine policies and programs especially with Universal Health Coverage.6 It was the National Integrated Research Program of the Philippines (NIRPROMP) who was at the forefront of this field and conducted the initial studies of these Ten Medicinal Plants.7 Many of them have been developed into modern formulations. These include Lagundi (Vitex negundo) tablet and syrup for cough and asthma, Sambong (Blumea balsamifera) tablet as a diuretic and treatment of urolithiasis, Tsaang gubat (Ehretia microphylla) tablet for gastrointestinal and biliary colic, Akapulco (Senna alata) lotion for cutaneous fungal infections, Yerba Buena (Mentha villosa) tablet as an analgesic, Ulasimang bato (Peperomia pellucida) tablet for the treatment of gout and hyperuricemia. Ampalaya (Momordica charantia) tablet was also developed as a glucose-lowering agent, but it is presently undergoing researches on the reformulated tablet.8 Several of the articles in this issue present evidence for the use of some of the mentioned medicinal plants. The NIRPROMP was the forerunner and is still an integral part of the Institute of Herbal Medicine. Lagundi and Sambong have been integrated into the clinical practice of physicians in the Philippines, even by specialists. They have both been scientific and commercial successes.9 Their production has contributed to the revenue and growth of the Philippine Pharmaceutical Industry, as well as improved the economic status of farmers cultivating these crops. Developing more herbal medicines needed for primary health care would decrease our dependence on the importation of medicines, and increase the accessibility of drugs even in geographically isolated areas. Bringing back the herbal medicine gardens to the barangays in the rural communities will also assist in empowering the population. The integration of herbal medicines into mainstream clinical practice will only be possible if the researches performed, both non-clinical and clinical, are as robust as those for synthetic medicine. Cecilia C. Maramba-Lazarte, MD Director Institute of Herbal Medicine National Institutes of Health University of the Philippines Manila REFERENCES 1. Paris J. Pharma Companies Offer to Cut Drug Prices [Internet] Rappler. 2019 25 October [cited 2020 Jan 15]. Available from https://www. rappler.com/nation/243372-pharmaceutical-companies-offer-cut-drug-prices. 2. Clarete RL, Llanto GM. 2017. Access to medicines in the Philippines: Overcoming the barriers [Internet]. Philippine Institute for Development Studies. 2017 [cited 2020 Jan 14]. Available from http://hdl.handle.net/11540/7967. 3. Zhang AL, Xue CC, Fong HH. Integration of Herbal Medicine into Evidence-Based Clinical Practice Current Status and Issues. In: Benzie IFF, Wachtel-Galor S, eds. Herbal Medicine: Biomolecular and Clinical Aspects, 2nd ed. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. 4. Traditional and Alternative Medicine Act (TAMA) of 1997, Republic Act No. 8423, Approved: December 9, 1997. 5. World Health Organization. Report of the Working Group on Herbal Medicines Meeting, March 1997. 6. World Health Organization. WHO Traditional Medicine Strategy: 2014-2023. 7. Eusebio JE, Umali BE. Inventory, documentation and status of medicinal plants research in Philippines. In: Batugal PA, Kanniah J, Young LS, Oliver JT, editors. Medicinal plants research in Asia, Volume 1: The framework and project workplans. Selangor DE, Malaysia: International Plant Genetic Resource Institute-Regional office for Asia, the Pacific and Oceania (IPGRI-APO), Serdang; 2004. 8. Purificacion J, Maramba N. Research Proposal Phase 1 Clinical Trial: Safety and Efficacy of Lyophilized Momordica charantia (Ampalaya) leaf tablet among Normal Volunteer Subjects (2018 version). 9. From Herbal Folklore to Modern Medicine [Internet]. World Intellectual Property Organization. 2013 [cited 2020 Jan 14]. Available from https://www.wipo.int/ipadvantage/en/details.jsp?id=3661.

Abstract Focus and outcomes for participants Neglected tropical diseases (NTDs) are a group of communicable diseases caused by a variety of infectious agents including virus, bacteria and parasites. They are prevalent in 149 countries in the tropics and affect more than one billion people living in disadvantaged communities, further limiting their social and economic development. For several NTDs, including the ones that are the focus of this symposium, the main strategy for control consists of preventive chemotherapy: the large-scale administration of drugs to entire communities or specific population groups, without prior individual diagnosis. In this symposium we will present the progress made in several countries in the Asia-Pacific region towards the control of 5 NTDs (lymphatic filariasis, scabies, schistosomiasis, soil-transmitted helminths and trachoma) largely through the scale-up of preventive chemotherapy. We will also describe the contribution of operational research to optimise control and elimination of these infections. At the end of the symposium, participants will be able to: Rationale for the symposium, including for its inclusion in the In 2012 the World Health Organization endorsed ambitious targets towards control and elimination of NTDs. to be reached by the end of 2020. Although not all of those targets will be reached there was remarkable progress in coverage of preventive chemotherapy worldwide with millions of doses of medications such as albendazole, ivermectin and ddiethylcarbamazine distributed annually or bi-annually to populations at risk. In early 2020 WHO released the new roadmap for NTDs, that sets new targets to achieve by 2030. Developed with extensive stakeholder consultation this roadmap aims to build on the momentum created since 2012 to further advance the progress made against NTDs. This symposium will review the current burden of NTDs in the region, summarise the successes achieved and present evidence from operational research that is contributing to the achievement of the WHO targets. Presentation program Names of presenters Associate Professor Susana Vaz Nery, The Kirby Institute – University of New South Wales Professor John Kaldor, The Kirby Institute – University of New South Wales Associate Professor Colleen Lau, Research School of Population Health – Australian National University Professor Andrew Steer, Murdoch Children's Research Institute Professor Vicente J Belizario, College of Public Health, University of the Philippines Manila Names of facilitator or chair Associate Professor Susana Vaz Nery

When the coronavirus 2019 (COVID-19) pandemic struck during the first quarter of 2020, global attention trained in on the city of Wuhan, the capital of Hubei province in China, where the first cases were reported in December 2019. With its exponential spread to other countries over a short span of time, infecting millions of people and exacting a global death toll of over half a million during the first six months of its discovery,1 interest in the little-known yet devastating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus splurged. As quickly as the virus spread across the globe did the scientific publications on the subject go into circulation, a phenomenon unequalled compared to other pandemics, with an estimated rate of 181 articles published per day.2 The scientific community churned as much data as the disease was evolving, covering the range from the epidemiology and clinical symptomatology to treatment and disease prevention. The significant number of deaths occurring among healthcare workers further hit home as the Philippines experienced its share of mortalities, especially of prominent personalities in the medical world. With the scientific literature growing phenomenally, the stage for a global research database on COVID-19 had invariably set in.3 The various scientific communities in the Philippines did not also lose time in pursuing research endeavors to bridge the knowledge gaps as these relate to the local setting. Teams from medicine, sociology, mathematics, and other disciplines came together to answer the queries within and across their fields of expertise.4,5 The Philippine General Hospital (PGH) as an institution encouraged the pursuit of new knowledge on COVID-19 among its constituents. Support from no less than its Hospital Director, Dr. Gerardo D. Legaspi, came through an allocation of funds in the amount of four million Philippine Pesos solely for COVID-related research. This Acta Medica Philippina Special Issue is dedicated to the initial researches conducted in the PGH on COVID-19. It chronicles the issues and concerns of the PGH as a COVID Referral Center as it responds to the medical needs of COVID patients while ensuring the safety and protection of its invaluable hospital personnel. The clinical profile and outcomes of patients presenting at the emergency room as well as those admitted to the various units of the hospital such as the intensive care, maternal, and neonatal units are carefully described in four papers. The initial observations on the patient profile as these relate to clinical outcomes are similar to those reported in literature with a poorer prognosis noted among the elderly, those requiring ventilatory support, and those developing complications such as acute kidney injury, stroke, and sepsis. The maternal and neonatal outcomes as documented in this issue have been favorable for the mother-infant dyad with no evidence of vertical transmission of the disease. While children are less likely to be infected by SARS-CoV-2 virus, the local experience in the hospitalized pediatric population during the early phase of the pandemic has highlighted cough and dyspnea as the most common respiratory symptoms. The attempt at determining the correlates for mortality in the included paper was inconclusive, which challenges future researchers to pursue the endeavor in a prospective manner. In the continual thrust for expanding the methods of diagnosing COVID-19 beyond the standard nasopharyngeal swab reverse transcriptase-polymerase chain reaction (RT-PCR) test, the validation of the snort-spit saliva RT-PCR test in the local setting presents a welcome alternative to the standard manner of specimen collection. With vaccination as an important strategy in the control of COVID-19 infections, up-to-date recommendations on the efficacy and safety of the vaccines are essential in providing guidance and one such living recommendation is available in this issue. Faced with a highly transmissible disease that can easily wreak havoc to any healthcare system, a review of healthcare delivery processes and the development of more suitable operational guidelines are in order. This issue shares the experience from the UP Health Service and the Department of Obstetrics and Gynecology during the pandemic as they constantly create ways of addressing the new normal. The Department of Surgery on the other hand offers some ethical and operational guidelines to streamline the healthcare delivery system to achieve efficiency. Such operational measures especially for the elective surgical cases could proactively minimize the deleterious outcomes brought about by delays in the management of non-COVID cases, which is underscored in the paper on the treatment of patients with osteosarcoma. Operational guidelines for aerosol generating procedures such as gastrointestinal endoscopy have been advanced in many centers abroad and one paper in this issue integrates the current local and international guidelines for use in resource-limited endoscopy units in the country. Amid the challenges that the COVID-19 pandemic has wrought on the healthcare system, opportunities to creatively manage the health concerns of the patients have surfaced, one of which is telemedicine. Telemedicine has long been utilized in the country before the pandemic in the geographically isolated and disadvantaged areas where there is a dearth of practicing specialists. Using the Community Health Information Tracking System (CHITS) and the RxBox Telehealth Device developed by the University of the Philippines (UP) National Telehealth Center in collaboration with the UP Diliman College of Engineering, selected rural health centers in the Philippines have been accorded the support for assisted individualized case management.6 With the physical restrictions for face-to-face consultations, compounded further by the protracted nature of the pandemic, telemedicine may yet be an essential strategy in bridging the gaps in the current healthcare delivery system. Described in this Special COVID issue are two articles on the relevance of telemedicine in the local setting, one that appertains to the general health services among healthcare personnel in the hospital setting and the other on the care of cancer patients served by the hospital. New process flows need to be meticulously mapped out to ensure service efficiency and patient satisfaction. As the COVID-19 crisis lays open numerous uncertainties to the world at large, one cannot but take confidence on what Albert Einstein once said, “In the midst of every crisis, lies great opportunity.” Juliet Sio Aguilar, MD, MSc Former Professor and Past Chair Department of Pediatrics Philippine General Hospital University of the Philippines Manila REFERENCESPP PitlikSD COVID-19 compared to other pandemic diseases. Rambam Maimonides Med J. 2020 Jul; 11(3):e0027. Lui A. Letter to the Editor: Exponential increase in COVID-19 related publications compared to other pandemic diseases. Rambam Maimonides Med J. 2021 Jan; 12(1):e0009. Worldd Health Organization [Internet]. Global research on coronavirus disease (COVID-19). [cited 2021 Apr]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov Aguilarr FV. Preparedness, Agility, and the Philippine Response to the Covid-19 Pandemic: The Early Phase in Comparative Southeast Asian Perspective. Philippine Studies: Historical and Ethnographic Viewpoints. 2020; 68 (3-4): 373-421. Davidd G, Rye RS, Agbulos MP. COVID-19 Forecasts in the Philippines: Insights for Policy Making [Internet]. [cited 2021 Apr]. Available from: https://up.edu.ph/covid-19-forecasts-in-the-philippines-insights-for-policy-making-updated-as-of-april-22-2020/ Departmentt of Science and Technology Region X [Internet]. Roll-out of 1000 RxBox Telehealth Device in Selected Rural Health Centers in the Philippines. [cited 2021 Apr]. Available from: https://region10.dost.gov.ph/101-roll-out-of-1000-rxbox-telehealth-device-in-selected-rural-health-centers-in-the-philippines

My message is this in regard to SMS messages and swarming crowds; this is ludicrous behaviour; it is unAustralian. We all share this wonderful country. (NSW Police Assistant Commissioners Mark Goodwin, quoted in Kennedy) The cops hate and fear the swarming packs of Lebanese who respond when some of their numbers are confronted, mobilising quickly via mobile phones and showing open contempt for Australian law. All this is the real world, as distinct from the world preferred by ideological academics who talk about “moral panic” and the oppression of Muslims. They will see only Australian racism as the problem. (Sheehan) The Politics of Transmission On 11 December 2005, as Sydney was settling into early summer haze, there was a race riot on the popular Cronulla beach in the city’s southern suburbs. Hundreds of people, young men especially, gathered for a weekend protest. Their target and pretext were visitors from the culturally diverse suburbs to the west, and the need to defend their women and beaches in the face of such unwelcome incursions and behaviours. In the ensuing days, there were violent raids and assaults criss-crossing back and forth across Sydney’s beaches and suburbs, involving almost farcical yet deadly earnest efforts to identify, respectively, people of “anglo” or “Middle Eastern” appearance (often specifically “Lebanese”) and to threaten or bash them. At the very heart of this state of siege and the fear, outrage, and sadness that gripped those living in Sydney were the politics of transmission. The spark that set off this conflagration was widely believed to have been caused by the transmission of racist and violent “calls to arms” via mobile text messages. Predictably perhaps media outlets sought out experts on text messaging and cell phone culture for commentary, including myself and most mainstream media appeared interested in portraying a fascination for texting and reinforcing its pivotal role in the riots. In participating in media interviews, I found myself torn between wishing to attest to the significance and importance of cell phone culture and texting, on the one hand (or thumb perhaps), while being extremely sceptical about its alleged power in shaping these unfolding events, on the other — not to mention being disturbed about the ethical implications of what had unfolded. In this article, I wish to discuss the subject of transmission and the power of mobile texting culture, something that attracted much attention elsewhere — and to which the Sydney riots offer a fascinating and instructive lesson. My argument runs like this. Mobile phone culture, especially texting, has emerged over the past decade, and has played a central role in communicative and cultural practice in many countries and contexts as scholars have shown (Glotz and Bertschi; Harper, Palen and Taylor). Among other features, texting often plays a significant, if not decisive, role in co-ordinated as well as spontaneous social and political organization and networks, if not, on occasion, in revolution. However, it is important not to over-play the role, significance and force of such texting culture in the exercise of power, or the formation of collective action and identities (whether mobs, crowds, masses, movements, or multitudes). I think texting has been figured in such a hyperbolic and technological determinist way, especially, and ironically, through how it has been represented in other media (print, television, radio, and online). The difficulty then is to identify the precise contribution of mobile texting in organized and disorganized social networks, without the antimonies conferred alternatively by dystopian treatments (such as moral panic) or utopian ones (such as the technological sublime) — something which I shall try to elucidate in what follows. On the Beach Again Largely caught unawares and initially slow to respond, the New South Wales state government responded with a massive show of force and repression. 2005 had been marked by the state and Federal enactment of draconian terror laws. Now here was an opportunity for the government to demonstrate the worth of the instruments and rationales for suppression of liberties, to secure public order against threats of a more (un)civil than martial order. Outflanking the opposition party on law-and-order rhetoric once again, the government immediately formulated new laws to curtail accused and offender’s rights (Brown). The police “locked” down whole suburbs — first Cronulla, then others — and made a show of policing all beaches north and south (Sydney Morning Herald). The race riots were widely reported in the international press, and, not for the first time (especially since the recent Redfern and Macquarie Fields), the city’s self-image of a cosmopolitan, multicultural nation (or in Australian Prime Minister John Howard’s prim and loaded terms, a nation “relaxed and comfortable”) looked like a mirage. Debate raged on why the riots occurred, how harmony could be restored and what the events signified for questions of race and identity — the latter most narrowly construed in the Prime Minister’s insistence that the riots did not reflect underlying racism in Australia (Dodson, Timms and Creagh). There were suggestions that the unrest was rather at base about the contradictions and violence of masculinity, some two-odd decades after Puberty Blues — the famous account of teenage girls growing up on the (Cronulla) Shire beaches. Journalists agonized about whether the media amounted to reporter or amplifier of tensions. In the lead-up to the riots, at their height, and in their wake, there was much emphasis on the role mobile text messages played in creating the riots and sustaining the subsequent atmosphere of violence and racial tension (The Australian; Overington and Warne-Smith). Not only were text messages circulating in the Sydney area, but in other states as well (Daily Telegraph). The volume of such text messages and emails also increased in the wake of the riot (certainly I received one personally from a phone number I did not recognise). New messages were sent to exhort Lebanese-Australians and others to fight back. Those decrying racism, such as the organizers of a rally, pointedly circulated text messages, hoping to spread peace. Media commentators, police, government officials, and many others held such text messages directly and centrally responsible for organizing the riot and for the violent scuffles that followed: The text message hate mail that inspired 5000 people to attend the rally at Cronulla 10 days ago demonstrated to the police the power of the medium. The retaliation that followed, when gangs marauded through Maroubra and Cronulla, was also co-ordinated by text messaging (Davies). It is rioting for a tech-savvy generation. Mobile phones are providing the call to arms for the tribes in the race war dividing Sydney. More than 5000 people turn up to Cronulla on Sunday … many were drawn to the rally, which turned into a mob, by text messages on their mobiles (Hayes and Kearney). Such accounts were crucial to the international framing of the events as this report from The Times in London illustrates: In the days leading up to the riot racist text messages had apparently been circulating calling upon concerned “white” Australians to rally at Cronulla to defend their beach and women. Following the attacks on the volunteer lifeguards, a mobile telephone text campaign started, backed up by frenzied discussions on weblogs, calling on Cronulla locals to rally to protect their beach. In response, a text campaign urged youths from western Sydney to be at Cronulla on Sunday to protect their friends (Maynard). There were calls upon the mobile companies to intercept and ban such messages, with industry spokespeople pointing out text messages were usually only held for twenty-four hours and were in many ways more difficult to intercept than it was to tap phone calls (Burke and Cubby). Mobs and Messages I think there are many reasons to suggest that the transmission of text messages did constitute a moral panic (what I’ve called elsewhere a “mobile panic”; see Goggin), pace columnist Paul Sheehan. Notably the wayward texting drew a direct and immediate response from the state government, with legislative changes that included provisions allowing the confiscation of cell phones and outlawing sending, receipt or keeping of racist or inflammatory text messages. For some days police proceeded to stop cars and board buses and demand to inspect mobiles, checking and reading text messages, arresting at least one person for being responsible for transmitting banned text messages. However, there is another important set of ideas adduced by commentators to explain how people came together to riot in Sydney, taking their cue from Howard Rheingold’s 2002 book Smart Mobs, a widely discussed and prophetic text on social revolution and new technologies. Rheingold sees text messaging as the harbinger of such new, powerful forms of collectivity, studying emergent uses around the world. A prime example he uses to illustrate the “power of the mobile many” is the celebrated overthrow of President Joseph Estrada of the Philippines in January 2001: President Joseph Estrada of the Philippines became the first head of state in history to lose power to a smart mob. More than 1 million Manila residents, mobilized and coordinated by waves of text messages, assembled … Estrada fell. The legend of “Generation Txt” was born (Rheingold 157-58). Rheingold is careful to emphasize the social as much as technical nature of this revolution, yet still sees such developments leading to “smart mobs”. As with his earlier, prescient book Virtual Community (Rheingold 1993) did for the Internet, so has Smart Mobs compellingly fused and circulated a set of ideas about cell phones and the pervasive, wearable and mobile technologies that are their successors. The received view of the overthrow of the Estrada government is summed up in a remark attributed to Estrada himself: “I was ousted by a coup d’text” (Pertierra et al. ch. 6). The text-toppling of Estrada is typically attributed to “Generation Txt”, underlining the power of text messaging and the new social category which marks it, and has now passed into myth. What is less well-known is that the overriding role of the cell phone in the Estrada overthrow has been challenged. In the most detailed study of text messaging and subjectivity in the Philippines, which reviewed accounts of the events of the Estrada overthrow, as well as conducting interviews with participants, Pertierra et al. discern in EDSA2 a “utopian vision of the mobile phone that is characteristic of ‘discourses of sublime technology’”: It focuses squarely on the mobile phone, and ignores the people who used it … the technology is said to possess a mysterious force, called “Text Power” ... it is the technology that does things — makes things happen — not the people who use it. (Pertierra et al. ch. 6) Given the recrudescence of the technological sublime in digital media (on which see Mosco) the detailed examination of precise details and forms of agency and coordination using cell phones is most instructive. Pertierra et al. confirm that the cell phone did play an important role in EDSA2 (the term given to the events surrounding the downfall of Estrada). That role, however, was not the one for which it has usually been praised in the media since the event — namely, that of crowd-drawer par excellence … less than half of our survey respondents who took part in People Power 2 noted that text messaging influenced them to go. If people did attend, it was because they were persuaded to by an ensemble of other reasons … (2002: ch. 6) Instead, they argue, the significance of the cell phone lay firstly, in the way it helped join people who disapproved of Pres. Estrada in a network of complex connectivity … Secondly, the mobile phone was instrumental as an organizational device … In the hands of activists and powerbrokers from politics, the military, business groups and civil society, the mobile phone becomes a “potent communications tool” … (Pertierra et al. 2002: ch. 6) What this revisionist account of the Estrada coup underscores is that careful research and analysis is required to understand how SMS is used and what it signifies. Indeed it is worth going further to step back from either the celebratory or minatory discourses on the cell phone and its powerful effects, and reframe this set of events as very much to do with the mutual construction of society and technology, in which culture is intimately involved. This involves placing both the technology of text messaging and the social and political forces manifested in this uprising in a much wider setting. For instance, in his account of the Estrada crisis Vicente L. Rafael terms the tropes of text messaging and activism evident in the discourses surrounding it as: a set of telecommunicative fantasies among middle-class Filipinos … [that] reveal certain pervasive beliefs of the middle classes … in the power of communication technologies to transmit messages at a distance and in their own ability to possess that power (Rafael 399). For Rafael, rather than possessing instrinsic politics in its own right, text messaging here is about a “media politics (understood in both senses of the phrase: the politics of media systems, but also the inescapable mediation of the political) [that] reveal the unstable workings of Filipino middle-class sentiments” (400). “Little Square of Light” Doubtless there are emergent cultural and social forms created in conjunction with new technologies, which unfreeze and open up (for a time) social relations. As my discussion of the Estrada “coup d’text” shows, however, the dynamics of media, politics and technology in any revolution or riot need to be carefully traced. A full discussion of mobile media and the Sydney uprising will need to wait for another occasion. However, it is worth noting that the text messages in question to which the initial riot had been attributed, were actually read out on one of the country’s highest-rating and most influential talk-radio programs. The contents of such messages had also been detailed in print media, especially tabloids, and been widely discussed (McLellan, Marr). What remains unknown and unclear, however, is the actual use of text messages and cell phones in the conceiving, co-ordination, and improvisational dynamics of the riots, and affective, cultural processing of what occurred. Little retrospective interpretation at all has emerged in the months since the riots, but it certainly felt as if the police and state’s over-reaction, and the arrival of the traditionally hot and lethargic Christmas — combined with the underlying structures of power and feeling to achieve the reinstitution of calm, or rather perhaps the habitual, much less invisible, expression of whiteness as usual. The policing of the crisis had certainly been fuelled by the mobile panic, but setting law enforcement the task of bringing those text messages to book was much like asking them to catch the wind. For analysts, as well as police, the novel and salience appearance of texting also has a certain lure. Yet in concentrating on the deadly power of the cell phone to conjure up a howling or smart mob, or in the fascination with the new modes of transmission of mobile devices, it is important to give credit to the formidable, implacable role of media and cultural representations more generally, in all this, as they are transmitted, received, interpreted and circulated through old as well as new modes, channels and technologies. References The Australian. “SMS Message Goes Out: Let’s March for Racial Tolerance.” The Australian. 17 September, 2005. 6. Brown, M. “Powers Tested in the Text”. Sydney Morning Herald. 20 December, 2005. 7. Burke, K. and Cubby, B. “Police Track Text Message Senders”. Sydney Morning Herald, 23-25 December, 2005. 7. Daily Telegraph. “Police Intercept Interstate Riot SMS — Race Riot: Flames of Fear.” Daily Telegraph. 15 December, 2005. 5. Davis, A. “Flying Bats Rang Alarm”. Sydney Morning Herald. 21 December, 2005. 1, 5. Dodson, L., Timms, A. and Creagh, S. “Tourism Starts Counting the Cost of Race Riots”, Sydney Morning Herald. 21 December, 2005. 1. Goggin, G. Cell Phone Culture: Mobile Technology in Everyday Life. London: Routledge, 2006. In press. Glotz, P., and Bertschi, S. (ed.) Thumb Culture: Social Trends and Mobile Phone Use, Bielefeld: Transcript Verlag. Harper, R., Palen, L. and Taylor, A. (ed.)_ _The Inside Text: Social, Cultural and Design Perspectives on SMS. Dordrecht: Springer. Hayes, S. and Kearney, S. “Call to Arms Transmitted by Text”. Sydney Morning Herald. 13 December, 2005. 4. Kennedy, L. “Police Act Swiftly to Curb Attacks”. Sydney Morning Herald. 13 December, 2005. 6. Maynard, R. “Battle on Beach as Mob Vows to Defend ‘Aussie Way of Life.’ ” The Times. 12 December 2005. 29. Marr, D. “One-Way Radio Plays by Its Own Rules.” Sydney Morning Herald. 13 December, 2005. 6. McLellan, A. “Solid Reportage or Fanning the Flames?” The Australian. 15 December, 2005. 16. Mosco, V. The Digital Sublime: Myth, Power, and Cyberspace. Cambridge, MA: MIT Press, 2004. Overington, C. and Warne-Smith, D. “Countdown to Conflict”. The Australian. 17 December, 2005. 17, 20. Pertierra, R., E.F. Ugarte, A. Pingol, J. Hernandez, and N.L. Dacanay, N.L. Txt-ing Selves: Cellphones and Philippine Modernity. Manila: De La Salle University Press, 2002. 1 January 2006 http://www.finlandembassy.ph/texting1.htm>. Rafael, V. L. “The Cell Phone and the Crowd: Messianic Politics in the Contemporary Philippines.” Public Culture 15 (2003): 399-425. Rheingold, H. Smart Mobs: The Next Social Revolution. Cambridge, MA: Perseus, 2002. Sheehan, P. “Nasty Reality Surfs In as Ugly Tribes Collide”. Sydney Morning Herald. 12 December, 2005. 13. Sydney Morning Herald. “Beach Wars 1: After Lockdown”. Editorial. Sydney Morning Herald. 20 December, 2005. 12. Citation reference for this article MLA Style Goggin, Gerard. "SMS Riot: Transmitting Race on a Sydney Beach, December 2005." M/C Journal 9.1 (2006). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0603/02-goggin.php>. APA Style Goggin, G. (Mar. 2006) "SMS Riot: Transmitting Race on a Sydney Beach, December 2005," M/C Journal, 9(1). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0603/02-goggin.php>.

Borders seem to be dropping all around us. Interdisciplinary university curricula, international free trade, wireless broadband technologies—these and many other phenomena suggest a steady decline in the rigidity and quantity of borders delimiting social interactions. In response to this apparent loss of borders, critical scholars might point out that university hiring practices remain discipline-bound, international tariffs are widespread, and technological access is uneven. But even as this critical response points out the limited extent of border-loss, it still affirms the weakening of these borders. Since the 9/11 tragedy, the world has witnessed much fortification of national and cultural borders through essentializing discourses (epitomized by America’s “us versus them” response to terror). But can critical scholars, as affirmative as they are of the dissolution and the crossing of borders, also support the building of exclusionary national and cultural borders? More importantly, can this reasoning responsibly emerge from a postmodern or postcolonial perspective that both favors marginalized voices and recognizes the routinely violent excesses of nationalism? By considering the practice of hybridity within the context of international capitalism, I will argue that maintaining the “conditions of possibility” for hybridity, and thus, maintaining the possibility of resistance to essentializing discourses, requires the strategic reinforcement of national and cultural borders. Border-Crossing as Hybrid Practice The most critical aspect of hybridity in relation to culture is the hybrid’s position as border-crosser. Postmodern theory typically affirms individual instances of border-crossing, but its overall project in regards to boundaries is more comprehensive. Henri Giroux writes: …postmodernism constitutes a general attempt to transgress the borders sealed by modernism, to proclaim the arbitrariness of all boundaries, and to call attention to the sphere of culture as a shifting social and historical construction. (Border 55) The figure of the hybrid emerges in postcolonial discourses as the embodiment of this postmodern critique of borders. Hybrid identities such as Gloria Anzaldua’s “mestiza consciousness”—a hybrid of white, Indian, and Mexican identities—creates the possibility of resisting oppression because such multiplicity disavows the reductive and essentializing binaries that colonizers employ to maintain power (Anzaldua 892). By embracing these hybrid identities, colonized people thus affirm cultural differences in ways that resist essentialism and which conceive of these differences in ways that “are not identified with backwardness” (Martín-Barbero 352). In studying the border-crossing work of critical intellectual Paulo Freire, Giroux claims that border-crossing offers the hybrid the “opportunity for new subject positions, identities, and social relations that can produce resistance to and relief from the structures of domination and oppression” (“Paulo” 18). Prior to these claims, postcolonial theorist Homi Bhabha wrote that the “third space” of hybridity surfaces as an “ambivalence” toward colonial authority and as a “strategic reversal of the process of domination through disavowal” (34). But what if we take seriously Michael Hardt and Antonio Negri’s claim in their book, Empire, that postcolonial theory, with its acclaim of the subversive potential of the hybrid, is “entirely insufficient for theorizing contemporary global power”? Or what if we admit that, unfortunately, the postcolonial hybrid is nowhere near as successful or as efficient a border-crosser as corporations have become, corporations which have made their own successful ‘runs for the borders’ by colonizing the markets of nations across the globe? In what forms can the ambivalence and disavowal identified by Bhabha emerge when cultures are now being colonized, not by other cultures, but by the influence of corporations? In the context of this new state of empire, Hardt and Negri warn that traditional hybridity becomes “an empty gesture … or worse, these gestures risk reinforcing imperial power rather than challenging it” (216–17). But in a world where “the freedom of self-fashioning is often indistinguishable from the powers of an all-encompassing control,” how can scholars approve a program of aggressive national self-fashioning (Hardt 216)? Stanley Fish suggests one answer. In Professional Correctness, Fish states that only enterprises “bent on suicide” would fail to establish their “distinctiveness.” He writes: An enterprise acquires an identity by winning a space at the table of enterprises …. Within the space that has been secured, all questions, including questions on basic concepts, remain open. Nor are the boundaries between enterprises fixed and impermeable; negotiations on the borders go on continually, and at times border skirmishes can turn into large-scale territorial disputes (19) If we substitute the word “nations” or “cultures” here for “enterprises,” Fish’s text reminds us that the building of national and cultural borders is always at best a temporary event, and that ‘openness’ is only available within a “space that has [previously] been secured.” Although nations may risk many things when they resist colonization, cultural fixity is not one of them. Cultures can thus maintain distinctiveness from other cultures without giving up their aspirations to hybridity. Pragmatically, Fish might say, one needs to secure a space at the table before one can negotiate. Essentialist border-building is just such a pragmatic effort. Building Borders That Disavow Cultural turf and national turf are inseparable. In the idealistic American view of culture as a “melting pot,” cultural identity relinquishes its substance to a greater national identity. Especially in the wake of 9/11, nationalistic maintenance of identity has prompted a host of culturally-focused turf disputes ranging from the bombing of mosques to the deliberate dumping of French champagne. Such disputes reveal cultural antagonisms that emerge from essentializing discourses. In his speech to the United Nations only two months after the September 11th attack, President George W. Bush explicitly connected the willingness of countries to form a coalition against terror (and thus to accept the essentializing “us versus them” mentality) with the ability to maintain secure borders by stating “Some nations want to play their part in the fight against terror, but tell us they lack the means to enforce their laws and control their borders” (n.pag.). Clear and manageable borders are presented here as stabilizing influences that enable the war against terror. By maintaining Western economic and political interests, these borders appear to delimit a space most unlike the subversive hybrid space that Bhabha imagines. Although essentializing discourses naturally seem to threaten the space of hybridity, it is important here to recall Bhabha’s definition of hybridity as a “strategic reversal of the process of domination” (emphasis added). Gayatri Spivak reminds us that “it’s the idea of strategy that has been forgotten” in current critiques of essentialism (5). In fact, essentialism, properly situated, can be used as a strategy against essentialism. While Spivak warns that a “strategic use of essentialism can turn into an alibi for proselytizing academic essentialisms,” she more forcefully claims that the “strategic use of a positivist essentialism in a scrupulously visible political interest” is “something one cannot not use”; a strategy that is “unavoidably useful” (4, 5). For Spivak, the critical qualities of a strategic essentialism are its “self-conscious” use (i.e. its “scrupulously visible political interest”) and its ongoing “critique of the ‘fetish-character’” of its own master terms (3–4). Three short examples will serve to highlight this strategic use of border-building in service of “scrupulously visible political interests.” While Russians may have the distinction of being the first to turn a candy bar’s name (“Snickers”) into a swear word, there have been no more visible borders that disavow multinational capitalism than those in France. Predictably, the key sites of struggle are the traditional repositories of French high culture: art, language, and food. One highly visible effort in this struggle is the ten per cent cinema tax (which, based on American dominance in the industry, affects mainly American films), the revenue from which is used to subsidize French filmmaking. Also, the controversial 1997 Toubon Law built borders by establishing fines and even prison sentences for refusal to use French language in venues such as advertising; as did the 1999 “dismantling” of a McDonald’s restaurant by José Bové, a French sheep farmer protesting U.S. sanctions, the WTO, and “Americanization” in general (Gordon 23, 35). Two nations that erected “borders of disavowal” in regards to the war on terror are Turkey and the Philippines. In March of 2003, even after being offered $6 billion in aid from the U.S., Turkey refused to allow 62,000 U.S. troops to be deployed in Turkey to facilitate the war in Iraq (Lee). While Turkey did allow the U.S. the use of airbases for certain purposes, the refusal to allow U.S. troops to cross the Turkey-Iraq border marked a significant site of cultural resistance. Even after the Philippines accepted a $78 billion increase in military aid from the U.S. to fight terrorism, public outcry there forced the U.S. to remove its “active” military presence since it violated a portion of the Philippines’s constitution that banned combat by foreign soldiers on its soil. (Klein). Also significant here is the degree to which the negotiation of national and cultural borders is primarily a negotiation of capital. As The Nation reported: For [Philippine President Arroyo], the global antiterrorist campaign is first and foremost a business proposition, and she made this very clear when she emerged from her meeting with President Bush in Washington in November and boasted to Filipino reporters that "it's $4.6 billion, and counting.” (Bello) All of these examples reinforce cultural and national borders in order to resist domination by capital. In French Foreign Minister Védrine’s words, the “desire to preserve cultural diversity in the world is in no way a sign of anti-Americanism but of antihegemonism, a refusal of impoverishment” (qtd. in Gordon 30). This “refusal of impoverishment” is the accomplishment of identities that refuse to supplant culture with capital. As these examples show, borders need not simply reinforce existing power relations, but are sites of resistance as well. But Is This Turf Really Cultural? Can one legitimately refer to the examples of Turkey and the Philippines, as well as the web of forces that structure the interactions of all nations in a system of multinational capitalism, as being “cultural”? If the subtitle of Fredric Jameson’s book, Postmodernism: Or, the Cultural Logic of Late Capitalism, does not suggest strongly enough the particularly cultural turf of these systems, Jameson makes this explicit when he states that we have witnessed . . . a prodigious expansion of culture throughout the social realm, to the point at which everything in our social life—from economic value and state power to practices and to the very structure of the psyche itself—can be said to have become ”cultural.” (48). One of Jameson’s basic arguments in his second chapter is that “every position on postmodernism in culture . . . is also at one and the same time, and necessarily, an implicitly or explicitly political stance on the nature of multinational capitalism today” (3). I would like to transpose this statement somewhat by asserting that every position on culture in postmodernism is necessarily a political stance on the nature of multinational capitalism. Therefore, actions that negotiate cultural turf and modify national identities can be methods of influencing the contours of multinational capitalism. In other words, strategic border-building maintains the space of hybridity because it seeks to disavow the dominance of cultural turf by capital. Without such protectionist and essentializing efforts, the conditions of possibility for hybrid identities would be at the mercy of market forces. The pragmatic use of essentialism as a mode of resistance is a move one can imagine Fish would approve of, and that Hardt and Negri hint at the necessity of when they state: The creative forces that sustain Empire are also capable of autonomously constructing a counter-Empire, an alternative political organization of global flows and exchanges. The struggles to contest and subvert Empire, as well as those to construct a real alternative, will thus take place on the imperial terrain itself. (xv) Essentialism is admittedly one of the “creative forces that sustain Empire.” The dangers of struggling “on the imperial terrain itself” lie in not retaining the critical self-consciousness of one’s own strategies that Spivak argues for, and in not remaining mindful of the histories of genocide and tyranny that have accompanied much modern nationalism. In constructing a “counter-Empire,” cultures can resist both the seductions of aggressive nationalism and the homogenizing forces of multinational capitalism. The turf of hybridity provides a space from which to launch this counter-Empire, but this space may only exist between cultural identities, not between multiple versions of a homogenized consumer identity maintained by corporate influence. Nations should neither be afraid to rebuild self-consciously their cultural borders nor to act strategically to maintain their distinctiveness, despite postmodern theory’s acclamation of the dissolution of borders and political appeals for global solidarity against the terrorist ‘Other.’ In order to establish resistance in the context of international capitalism, the strategic disavowal necessary to hybridity may need to emerge as a disavowal of hybridity itself. Works Cited Anzaldua, Gloria. “Borderlands/La Frontera.” Literary Theory, An Anthology. Ed. Julie Rivkin and Michael Ryan. Malden: Blackwell, 2001. 887–902. Bello, Waldo. “A ‘Second Front’ in the Philippines.” The Nation 18 Mar. 2002. 16 Feb. 2004. <http://www.thenation.com/doc.mhtml?i=20020318&s=bello>. Bhabha, Homi. K. “Signs Taken for Wonders: Questions of Ambivalence and Authority Under a Tree Outside Delhi, May 1817.” The Postcolonial Studies Reader. Ed. Bill Ashcroft, et al. New York: Routledge, 1995. 29–35. Bush, George W. “President Bush Speaks to United Nations.” The White House. 11 Jan. 2004. <http://www.whitehouse.gov/news/releases/2001/11/20011110-3.php>. Fish, Stanley. Professional Correctness: Literary Studies and Political Change. Oxford: Clarendon Press, 1995. Giroux, Henry. Border Crossings: Cultural Workers and the Politics of Education. New York: Routledge, 1992. ---. “Paulo Freire and the Politics of Postcolonialism.” JAC 12.1 (1992): 15–26. Gordon, Philip H., and Sophie Meunier. “Globalization and French Cultural Identity.”French Politics, Culture, and Society 19.1 (2001): 22–41. Hardt, Michael, and Antonio Negri. Empire. Cambridge: Harvard UP, 2000. Jameson, Fredric. Postmodernism: Or, the Cultural Logic of Late Capitalism. Durham: Duke UP, 1991. Klein, Naomi. “Mutiny in Manila.” The Nation 1 Sep. 2003. 16 Feb. 2004. <http://www.thenation.com/doc.mhtml?i=20030901&s=klein>. Lee, Matthew. “Turkey’s Refusal Stuns U.S.” Common Dreams News Center. 1 Mar. 2003. 12 Jan. 2004. <http://www.commondreams.org/headlines03/0301-10.htm>. Martín-Barbero, Jésus. “The Processes: From Nationalisms to Transnationals.” Media and Cultural Studies: Keyworks. Ed. Meenakshi Gigi Durham and Douglas M. Kellner. Oxford: Blackwell, 2001. 351–84. Spivak, Gayatri Chakravorty. Outside in the Teaching Machine. New York: Routledge, 1993. Citation reference for this article MLA Style Mason's, Eric D. "Border-Building" M/C: A Journal of Media and Culture <http://www.media-culture.org.au/0403/03-border-building.php>. APA Style Mason's, E. (2004, Mar17). Border-Building. M/C: A Journal of Media and Culture, 7, <http://www.media-culture.org.au/0403/03-border-building.php>