Childhope Asia Philippines, Inc.

Health Advisory for Volunteers

Dear Volunteer,

Thank you for choosing Childhope Asia Philippines! The time and effort you selflessly offer our
organization will benefit the street children of Metro Manila in countless ways.

As our volunteer, we want to ensure your health and safety during your stay with us. To this end,
kindly take time to read this Health Advisory for you to have a fruitful experience of learning and
service with our organization.

Sincerely,

Dr. Josefina Pamela O. Carpio

Common Diseases in Metro Manila

As you join the Mobile Education Van and Mobile Health Clinic in CHAP’s different areas of operation
around Metro Manila, you may be exposed to various infectious diseases.

Dengue Fever and Chikungunya Fever are two viral infections transmitted by Aedes egypti
mosquitos, which are known to bite mostly during the day.

While the benign Chikungunya Fever is characterized initially by flu-like symptoms, the muscle and
joint pains that follow may inhibit you from joining work-related and leisurely activities for a week or two.
Furthermore, the joint and muscle pains may recur within a period of six months. At present, there is no
vaccine and no known effective anti-viral medication for Chikungunya infection, and medical treatment
merely addresses the patient’s symptoms as our own immune system fights the disease. Fortunately,
Chikungunya Fever is not life-threatening and does not cause any permanent disability.

Dengue Fever, on the other hand, is a potentially serious infection that begins with a sudden onset of
fever and headache that may be accompanied by other flu-like symptoms. Body temperature initially
decrease after 2 to 3 days of high grade fever, then rises again after 3 to 5 days but to a lesser degree.
The initial reduction in fever should be taken with a grain of salt, since this coincides with the signs and
symptoms characteristic of this disease: rash, dehydration, and risk or actual bleeding and hemorrhage
(due to a drop in platelet count). Vaccines for Dengue virus are still undergoing trials, and there is still no
anti-viral drug that targets the infection. As in the previous infection, outpatient and hospital treatment for
this potentially life-threatening infection addresses the patient’s symptoms as our own immune system
fights the disease.

Tuberculosis is a serious bacterial infection that involves mostly the lungs, but may also affect any part
of the body. This infection can be passed on from an infected individual through respiratory droplets or
secretions. Active Pulmonary Tuberculosis is characterized predominantly by chronic cough, fever, and
unexplained weight loss, whereas tuberculosis outside the lungs mimics other illnesses depending on what
organ is affected. Diagnosing this infection requires several tests, and although it is curable, treatment
requires taking at least 3 drugs for a minimum of 6 months.

Leptospirosis is another serious infection acquired through an exposure to rat urine, or contaminated
water and soil. In Metro Manila, it is often due to exposure to flood waters. Headache and fever appears 2
to 20 days after exposure, and is followed by calf muscle pains and yellowish color of the eyes and skin.
Multiple organs, including the heart, liver and kidneys, may then be involved in 1/3 of cases. Medical
management for this infection involves antibiotic drugs and symptom-directed treatment at an out-patient
setting. Hospitalization is warranted for more severe cases needing close monitoring and treatment of
complications. Owing to the potentially life-threatening complications of this infection, prophylaxis is
routinely given to persons exposed to flood waters.

Rabies is a viral infection that targets the central nervous system. It infects mammals, and is passed on
through their bites, or through open wounds exposed to saliva from an infected animal or person. In the
Philippines, rabies is mostly acquired from dog bites. It has no cure and is almost 100% fatal, which is why
post-exposure vaccination is warranted, especially if the bite is from a stray dog or from one with unknown
vaccination status.

Infectious Diarrhea, Enteric Fever (Typhoid and Paratyphoid Fever), and

Hepatitis A are all transmitted through ingestion of contaminated food and drinks, so adventurous eaters
beware!

Infectious Diarrhea may be viral, bacterial, or parasitic in nature, causing frequent and/or increased
amount of stool. Depending on the cause, diarrhea may be accompanied by fever, abdominal pain, and
vomiting. It is of utmost importance to prevent dehydration by pharmacologic and non-pharmacologic
modalities, and further treatment would depend on the cause of infection.

Enteric Fever is a bacterial infection that results in high grade fever that lasts for more than 5 days,
headache, and abdominal pain. This infection is often misdiagnosed as Dengue Fever, and vice versa,
underscoring the importance of medical assessment. Antibiotics and symptom-directed treatment are the
cornerstones in treating Enteric Fever.

Contaminated food and drinks may also give you Hepatitis A, a viral infection that targets the liver.
Jaundice, or yellow-tinged skin and eyes, is accompanied by flu-like symptoms, abdominal pain, diarrhea,
dark-colored urine, and chalk-colored stool. Symptom-directed medical treatment, nutritional support, and
 close monitoring are the standards for treating this infection, while anti-viral drugs are given with variable
efficacy. Fortunately, 99% percent of patients recover without complications and with lifelong immunity to
the disease. Furthermore, you may have your Hepatitis A vaccine, which is usually combined with Hepatitis
B vaccine, from your Primary Care Physician.

Respiratory Tract Infections and Influenza are very common among the street children you
will come in contact with, especially during the cold and rainy months of July to December. Since most are
viral infections, a strong immune system will easily fight it, and improvement will follow within a week or
two. Bacterial respiratory infections, on the other, are treated with a week’s course of antibiotics. Increasing
fluid intake and rest will hasten your recovery.

Several street children also have Scabies and Other Skin Infections of bacterial, fungal or
parasitic origin. Although skin infections cause a gamut of unpleasant signs and symptoms, including
itchiness, pain, an unsightly skin lesions, these are almost never serious and life-threatening. Treatment
entails at least a week or 2 of topical and/or oral medication.

Disease Prevention
We encourage you to follow the recommendations from the CDC or Centers for Disease Control
and Prevention to help ensure a disease-free stay with our organization.

Eat and Drink Safely:

 Avoid cooked food served at room temperature.
 Avoid raw food, including raw vegetables unless they can be washed thoroughly.
 Drink only beverages from sealed bottles or cans.
 Water is safe if it has been boiled or chemically treated.
 Avoid ice unless made from bottled/disinfected water.

Prevent Bug Bites:

 Use appropriate clothing to cover as much skin as possible.
 Use an appropriate insect repellent.
 Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents).
 Stay and sleep in air-conditioned or screened rooms.
 Use a bed net if sleeping area is exposed to the outdoors.

Keep Away from Animals

 Travelers should avoid touching, petting, handling, or feeding animals, including pets.
 Arthropods such as spiders and scorpions can pose a stinging risk, and travelers should exercise
care in environments where these creatures are likely to be present.
 Stress the urgency of treating suspected and probable rabies infection by washing the wound
immediately with soap and clean water and seeking medical attention as soon as possible.

Source: http://wwwnc.cdc.gov/travel/destinations/clinician/mission_disaster/philippines
In addition to these, we highly encourage you to practice the following:
 Hand Hygiene – Wash your hands with soap and water, or use 70% isopropyl or ethyl alcohol or
other hand sanitizers, before and after meals, after visiting the toilet, before handling food, and after
interacting with sick individuals
 Bathing – Regular/daily bathing, especially after every area visit

Lastly, it is worth stating the obvious - People who are ill should not travel.

Health and Medical Services

Pre-existing Medical Conditions

Kindly inform our organization about any pre-existing medical conditions, including allergies and disabilities,
that you may have. Rest assured that we will treat any information you provide us with utmost confidentiality.
Also, please ensure that you have with you an ample supply of maintenance and special emergency
medications for your illness, or else carry with you written prescriptions that can be filled at local pharmacies
at your own expense.

Medical Prophylaxis and Vaccinations

Medical prophylaxis for Leptospirosis may be provided by our organization in the event of exposure to
floodwaters.

Although the organization may assist in identifying and accessing health facilities and services, pre-exposure
vaccinations (such as those for Influenza and Hepatitis A) and post-exposure vaccinations (for Rabies and
Tetanus) are the responsibility of each volunteer.

Outpatient Medical Treatment and Hospitalization

The organization may provide management of simple infections, other illnesses, or minor injuries that can be
treated at an outpatient setting. However, if treatment in a hospital or private clinic is desired, the organization
will only assist in identifying and accessing medical services while all expenses will be shouldered by the
volunteer. The same goes for medical conditions that warrant referrals to medical specialists or hospitalization.
As such, it is highly advisable that each volunteer should have an international health insurance policy that is
valid throughout one’s stay with the organization, and throughout the stay in the Philippines for that matter.

Questions and Comments

For any concerns, please feel free to get in touch with us at the following:

Telephone Numbers : 63-2-25617118 and 63-2-5634647

E-mail Address : childhope@hope.org.ph
Website : www.childhope.hope.org.ph