CHAPTER I

The Problem and Its Background

1.1 Introduction

The medicine in the Philippines discusses the folk medicinal practices and

the medical applications used in Philippine society. It was started from the

prehistoric times before the Spaniards were able to set a firm foothold on the

islands of the Philippines for over 300 years, to the transition from Spanish rule to

fifty-year American colonial embrace of the Philippines, and up to the

establishment of the Philippine Republic of the present.

In the past few years our country has been developing as a successful

tourist destination of choice for health and vacation because of our world class

physicians, availability of state-of-the-art facilities, and our uniquely Filipino brand

of caring and compassion at great values for money with only a fraction of the cost

in developed countries. We are home to some of the best medical schools and

stand-alone specialty clinics in the world, offering world-class expertise, advanced

facilities, topped with the distinct warmth of the famous Filipino hospitality.

Of over 200 different known cancers that afflict human, 90-95% of cases

are attributed to environment factors and 5-10% due to genetics. Common

environmental factors that contribute to cancer death include tobacco, diet and

obesity, infections, radiation, stress, lack of physical activity and environmental

pollutants.

CHAPTER I | THE PROBLEM AND ITS STATEMENT 1

 According to the United States National Cancer Institute Cancer statistics, a

new case of cancer is diagnosed every 30 seconds and one person dies every

minute. Twenty-two point eight percent (22.8%) of the total deaths is due to

cancer. Whereas globally, according to World Health Organization (WHO) cancer

statistics, worldwide deaths due to cancer is projected increased to nine (9) million

in 2015 and as high as 12 million in 2030. Thus, an increase of one (1) million

deaths every 5 years is evidenced.

Indeed, cancer has reputation as a deadly disease, usually treated with

chemotherapy, radiation therapy and surgery. The chances of surviving the

disease vary greatly by the type and location of the tumor and the extent of

disease at the start of treatment. Cancer rates are expected to increase with

ageing off populations and changes in lifestyle associated with economic

development.

Medical knowledge is the body of information about diseases, mechanisms

and pathogenesis, therapies and interactions, and interpretation of lab tests, which

is broadly applicable to decisions about multiple patients and public health

policies, in contrast to patient-specific data. Medical knowledge should, where

possible, be based on sound evidence from clinical and epidemiological studies,

using valid and reliable methods.

As a matter of fact, sunlight and darkness trigger the release of hormones

in your brain. Exposure to sunlight is thought to increase the brain’s release of a

CHAPTER I | THE PROBLEM AND ITS STATEMENT 2

hormone called serotonin. Serotonin is associated with boosting mood and helping

a person feel calm and focused. At night, darker lighting triggers the brain to make

another hormone called melatonin. This hormone is responsible for helping you

sleep.

The most natural way to get vitamin D is by exposing your bare skin to

sunlight (ultraviolet B rays). This can happen very quickly, particularly in the

summer. You don’t need to tan or burn your skin to get vitamin D. You only need

to expose your skin for around half the time it takes for your skin to begin to burn.

The amount of vitamin D produced from sunlight depends on the time of day,

where you live in the world and the color of your skin. The more skin you expose

the more vitamin D is produced.

Planting a beautiful garden can be a great way to relieve stress. Whether

you have a small patio to decorate or a vast amount of space to tend, the act of

making your particular stretch of nature into a haven can be a stress reliever in

itself, and the garden that you create can bring you even more peace. In one

study, subjects were asked to perform a stressful task and then asked to either

perform 30 minutes of gardening in their allotment gardens or 30 minutes of

reading. While both groups experienced a decrease in stress, the gardeners

experienced a significantly greater decline in stress (as measured by salivary

cortisol, a stress hormone), as well as a full restoration of positive mood; the

readers actually experienced a further decline in mood.

CHAPTER I | THE PROBLEM AND ITS STATEMENT 3

 In the Philippines cancer victim cases grow higher due to the fact that there

are lacks of public hospitals in NCR. The Proposed Disaster Resilient General

Hospital for National Capital Region with Cancer Institute is a great solution to

solve the problem in cancer cases in the Philippines. This proposal will help the

general public in Metro Manila to give them hope for an accessible health

institution that is affordable and will provide them general health care and cancer

care. One of the aim of this proposal is to eliminate the depression specially felt by

cancer patient due to their illness that are only small possibilities to survive the

said illness. The proposed institution will help the patient to feel safer while being

treated to the highest state as well as promotion of good heath to all the

city/provinces in NCR. This proposal is considered to cater all the needs of people

in the area.

1.2 Background of the Study

The National Capital Region (NCR), also recognized as Metropolitan Manila

is the country’s political, economic, and educational center. The NCR is the

smallest Region in the Philippines, while it’s also the second populous and the

most densely populated region of the Philippines. It is also the 12th of the most

populous metropolitan area in Asia and the 14th of the most populous urban area

in the world. It is a home to over 12 million Filipinos. It has sixteen (16) highly

urbanized cities composed of Manila, Quezon City, Caloocan, Las Piñas, Makati,

CHAPTER I | THE PROBLEM AND ITS STATEMENT 4

Malabon, Mandaluyong, Marikina, Muntinlupa, Navotas, Parañaque, Pasay, Pasig,

San Juan, Taguig, and Valenzuela, all broken down into 1,705 barangays.

The Philippines is in need of 45,000 additional hospital beds and more

public health physicians to provide medical services to 105 million Filipinos across

the country. DOH admitted that the shortage of beds remains a challenge in

government hospitals, as 800 people struggle for one hospital bed with a ratio of

1:800 in Metro Manila alone.

The WHO recognizes depression as one of the most burdensome diseases

in the world. Among patients with cancer, depression can be a major source of

distress and may have a profound impact on disease progression. Clinically

significant depression in patients with cancer is estimated to be 11–30%, a rate

two to five times greater than in the general population.

In the country, cancer rank as the third leading cause of mortality claiming

103 lives a day or four persons every hour wherein the estimated morbidity rate is

189 persons per 100,000 Filipinos. And according to the Philippine Statistical

Authority, one (1) in every ten (10) registered deaths in the country is attributable

to cancer.

Additionally, cancer can occur at any age. About seventy-five percent (75%)

of cancer patients in the Philippines are 50 years old and above while three point

two percent (3.2%) belong to the pediatric age bracket of 0-4 year old. Nine out of

ten smoker die of lung cancer while non-smoker who are most likely double the

CHAPTER I | THE PROBLEM AND ITS STATEMENT 5

smoking population have increased risk of a acquiring the disease. Sixteen

percent (16%) of a total of 50,000 reported cases of breast cancer in 2010 resulted

to death. Twelve (12) Filipino women die of cervical cancer each day with 6,000

new cases being diagnosed each year while almost twenty percent (20%) in every

100,000 Filipino men develop prostate cancer. Ninety-five (95) out of 100 liver

cancer patients have a high change of dying. While the most prevalent cases

affecting the Filipinos are the lungs, breast, colon, cervical, liver and prostate

cancer.

The number of Filipinos covered by the Philippine Health Insurance

Corporation (PhilHealth) has increased but the public has yet to enjoy the full

benefits of the government health care program for lack of facilities and equipment

in government hospitals. Citing data from the Department of Health (DoH), Metro

Manila have met the ideal number of population to hospital bed ratio of 1/800. The

public hospitals in Metro Manila cannot provide enough beds for patients and the

current bed to population ratio is 1:1,121.

1.3 Theoretical Framework

“Architecture is the learned game correct and magnificent of forms

assembled in the light”.

– Le Corbusier

CHAPTER I | THE PROBLEM AND ITS STATEMENT 6

 “Architecture is a visual art and the buildings speak for themselves”.

– Julia Morgan

Architecture is the art of defining space. It gives birth to the meaning of

what every single inch of an area would be, in harmony with the aesthetic; it gives

beauty to the creation. Architecture is the master of manipulating space to fit to the

people’s needs. Taking many factors on design, the most important is the need of

the people. Why the space should be defined? Why there is a need of developing

it? Architects always take the users’ purpose as the first consideration on

designing a space. Fusing it with art and meeting its space function is architecture

itself.

This study is committed to come up with a design solution in line with this

working proposition. It ensures that none of the laws is not to be considered in the

progress of this study especially in the formulation of solutions that will provide

holistic elements of health through hospital projects development. It guarantees

that users, patients and staff, are not deprived of the chance to obey these laws

while in stay of the proposed hospital but give them the best possible way to

exercise them.

CHAPTER I | THE PROBLEM AND ITS STATEMENT 7

Conceptual Framework

Problems Encountered Principles of Green Buildings

Major Problems: Site and its surroundings

Design Approach
Availability of modern
hospital equipments and
facilities in the country.
Geographical profile and
occurrence of natural
calamities in Metro Manila.
Minor Problems:
Innovative design solution
Efficient space planning
Amenities Needed
Energy Efficiency
Water Efficiency
Material Efficiency
Indoor Air Quality
Waste Reduction
Low maintenance costs
A Proposed Disaster
Design Solution and Resilient General
Concept Hospital for NCR with
Cancer Institute

Input Process Output

Figure 1.0 Conceptual Paradigm

The design of every single part of the structure of the medical institution will

be placed in the core of this project. It will be known as a public of sustainability,

feasibility and security of modern development.

1.4 Statement of the Problem

The ability of this study to maintain sustainability at a certain rate of level

that would prevail and stand by the test of time is one of the main goals of the

project.

CHAPTER I | THE PROBLEM AND ITS STATEMENT 8

1.4.1 Major Problems

1.4.1.1 What approach should be considered to make the user experience a

healing environment despite that the hospital is at the center of highly

urbanized area?

1.4.1.2 How to establish a project that will catch the attention of the community

and how it will help in providing the growing needs of the community?

1.4.1.3 How to develop a unique structure that will promote Metro Manila to be

a famous structure that will help in promoting the medical institution of

Metro Manila?

1.4.1.4 What would be the appropriate structural technique and innovation to

create a disaster resilient facility but are most economical?

1.4.2 Minor Problems

1.4.2.1 What are the existing problems in the site?

1.4.2.2 The competition of the development with its neighboring city is greatly

affecting the proposed project. How will the proposed project stand out

from the rest?

1.4.2.3 What are the facilities and amenities needed for the development of the

medical institution?

1.4.2.4 How can disaster resiliency technology be secured yet not

compromising the beauty of aesthetics and architectural approach to the

facility?

CHAPTER I | THE PROBLEM AND ITS STATEMENT 9

1.4.2.5 How can a patient feel comfortable and feel that he is in his own home

despite of hospitalization especially in cancer patients?

1.5 Significance of the Study

This study is of vital importance and provides general significance to the

following:

To the people of Metro Manila, this study will give them hope for an

accessible health institution that is affordable and will provide them general health

care and cancer care.

To the doctors and nurses, this study will be beneficial to them as working

in their desired work spaces and practicing their profession in a well-managed

environment in which they can exert their maximum potential as health providers.

To the medical staffs, by using new and advanced modern facilities, they

can fully help medical professionals to save lives and provide fast and reliable

medical care.

To the students and faculty of CEAFA, this will provide them basis or

reference for further studies, architectural designs and engineering concepts

regarding hospitals and similar structures.

CHAPTER I | THE PROBLEM AND ITS STATEMENT 10

1.6 Objectives of the Study

The project aims to meet the needs in health care facilities, to design and

establish a new hospital that will be safe in times of calamities or disaster.

1.6.1 Project Objectives

The goal of the study is to have general public to give them hope for an

accessible health institution that is affordable and will provide them general health

care and eliminate the depression specially felt by the cancer patient due to their

illness that there are only small possibilities to survive the said illness. The

technical aim of the facilities is to provide good environment which is healthy for

both the patient and family/companion of the patient which is the healing garden.

Healing garden is a physical setting that supports patients and families through the

stresses that develop as a result of illness, hospitalization, medical visits, the

healing process or bereavement.

This study is to promote the opportunity of the community to have their own

city having a hospital which provides the medical staffs using new and advanced

modern facilities, future researchers to give them background for their on-going

future medical improvements, and for the doctors and nurses. This study will be

beneficial to them as working in their desired work spaces and practicing their

profession in a well-managed environment in which they can exert the maximum

potential as health providers.

CHAPTER I | THE PROBLEM AND ITS STATEMENT 11

 1.6.2 Design Objectives

1.6.2.1 To design the building that incorporates healing architecture

through functionalism without compromising integrity of the

institution.

1.6.2.2 To formulate and design complete and fully functional plans

with the good standards of facilities, amenities and equipment.

1.6.2.3 To construct a medical facility that can withstand to any kind

of natural calamities which occur in NCR such as

earthquakes, storms and flash floods?

1.6.2.4 To design an environment with proper ventilation and sunlight

that promotes good health.

1.7 Scope and Limitation

The study focuses on the proposal which includes physical, environmental,

social and economic aspect of the project.

This study comprises the following:

1. Architectural Planning and Design

2. Site Planning

3. Economic Feasibility Study of Development

4. Project Cost

CHAPTER I | THE PROBLEM AND ITS STATEMENT 12

 The scopes of the development of the project are the following:

1. General Hospital

2. General Administration

3. Cancer Center

4. Rehabilitation Center

5. Museum for Cancer patients

6. Research Center

7. Training Center

8. Service Facilities

9. Gardens

1.8 Definition of Terms

The findings of this study were applied in a practical manner as a guide for

designing the proposal. Prior to a review of the literature relevant to the research

and design project, definitions are provided for several key terms that are used

throughout this study. The following terms are conceptually or operationally

defined to enhance the understanding of the readers of this study.

Altered. Made different in some way.

Ability. It is a general word for power, native or acquired, enabling one to do

things well.

CHAPTER I | THE PROBLEM AND ITS STATEMENT 13

Aesthetic. This is a branch of philosophy that explores the nature of art, beauty,

and taste, with the creation and appreciation of beauty.

Afflict. To cause pain or suffering t, to distress so severely as to cause persistent

suffering or anguish.

Cancer. Caused by cells that are not normal and that can spread to one or many

parts of the body.

Densely. Having parts that are close together.

Depression. A serious medical condition in which a person feels very sad,

hopeless, and unimportant and often is unable to live in a normal way.

Development. It is the carrying out of building, engineering, mining or other

operations in, on, over or under land, or the making of any material change

of use of any buildings or land.

Diseases. It is a disorder of structure or function in a human, animal, or plant,

especially one that produces specific signs or symptoms or that affects a specific

location and is not simply a direct result of physical injury.

Disaster Resilient. The ability of individuals, communities, organizations and

states to adapt to and recover from hazards, shocks or stresses without

compromising long-term prospects for development.

Environment. The condition that surround someone or something.

Facilities. These are buildings, pieces of equipment, or services that are provided

for a particular purpose.

CHAPTER I | THE PROBLEM AND ITS STATEMENT 14
Foothold. A position that makes it possible to begin an activity of effort.

Health. It is the level of functional and metabolic efficiency of a living organism.

Healing Garden. green spaces in hospitals and other healthcare facilities that

specifically aim to improve health outcomes.

Medical knowledge. The body of information about diseases, mechanisms and

pathogenesis, therapies and interactions, and interpretation of lab tests,

which is broadly applicable to decisions about multiple patients and public

health policies, in contrast to patient-specific data.

Medicine. A substance that is used in treating disease or relieving pain and that

is usually in the form of a pill or a liquid.

Patio. A flat area of ground that is covered with a hard material (such as bricks or

concrete), is usually behind the house, and is used for sitting and relaxing.

State-of-the-art. The level of development (as of a device, procedure, process,

technique, or science) reached at any particular time usually as a result of

modern methods.

Ventilation. Circulation of air.

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1.9 Acronyms

WHO. World Health Organization

DOH. Department of Health

PhilHealth. Philippine Health Insurance Corporation

NCR. National Capital Region

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