The whole village talked about how Mang Efren was cursed by the spirits who were disturbed and displeased by the continuous cutting of trees on his farm. He was the talk of the town, and no one could resist staring at his thick legs.
He is not alone. In another village, there was this woman whose large breasts stretched down to her waisline. The village folks believe she had also angered the spirits that lived in her backyard.
While many of their neighbors believe the unusual physical conditions of the two to be the result of buyag or kulam (superstitious beliefs), the more enlightened ones call the afflictions buyong or danlak. No matter how people regard this condition, it is actually an illness caused by microscopic worms transmitted to humans through mosquito bites.
“It is commonly described as malaking bayag na halos hanggang tuhod na (it is commonly described as enlarged scrotum that reaches down to the knees),” said Dr. Jaime Z. Galvez-Tan, chairperson of the Coalition For the Elimination of Lymphatic Filariasis in the Philippines.
Galvez-Tan said one of the most common symptoms of a person with lymphatic filariasis is elephantiasis. When the parasites feed on the lymphatic system, he said, it results in the thickening or swelling of the lower extremities and other parts of the body like the vulva, scrotum, arms, legs and even the breasts.
Filariasis is in fact the third in a triumvirate of mosquito-born diseases that are creating havoc in the health and the economies of poor countries like the Philippines. First there is dengue, with bouts of malaria in between. Unknown to everyone, they also have to contend with filariasis.
“Not too many people know about filariasis because it is not as common as dengue or malaria,” Galvez-Tan said. While it is not as deadly as dengue, filariasis can cause disability which is responsible for the unproductiveness of over half a million Filipinos, he added.
Mindanao situationer
Up to 25 million Filipinos are at risk daily of getting filariasis. “Ganito kadaming tao ang kinakagat ng lamok, minsan sobra pa (this is the number of people being bitten by mosquitos daily and sometimes even more).”
Department of Health assistant secretary Dr. Paulyn Jean Rosell-Ubial said out of the 43 provinces originally identified as endemic areas, seven have been declared free from lymphatic filariasis. Among these are Dinagat Island, Sorsogon, Bukidnon, Southern Leyte, Biliran, Romblon and Agusan del Sur.
Galvez-Tan said one of the hardest hit by filariasis is Cagayan de Oro. He said the whole of Davao region, including Davao City, has been identified as an area with high cases of filariasis because of the vast banana plantations and abaca.
While filariasis does not really kill, Galvez-Tan admitted that it has an adverse effect on the economy. Granting that the half a million Filipinos infected with filariasis earning a minimum daily wage of P300, he said, that would amount to almost P54 billion in losses.
At least 10 percent of the population in the Davao region are infected with lymphatic filariasis, which means the region is losing up to P10 billion annually in terms of lost income.
“The Davao region is highly susceptible to filariasis because there are lots of banana plantations and abaca here,” he said.
Prevention
Ubial said they are aiming for the declaration of a filariasis-free Philippines by 2014 To accomplish this, DOH and its partner organizations like CELF and Glaxo Smith Kline (GSK) have launched a campaign to encourage Filipinos two years old and above, to take anti-filariasis medicines.
GSK has donated $2 billion to eliminate filariasis worldwide. This donation has been matched by the Bill Gates Foundation to provide medicines and funding for the campaign.
“We are conducting a mass drug administration of all the population in the endemic areas,” DOH central office infectious diseases division chief Dr. Leda Hernandez said. The two anti-filariasis medicines are Diethylcarbamazine (DEC) and Albendazole, both of which should be taken in once a year for five years.
An Executive Order signed by former President Gloria Macapagal Arroyo has designated the month of November every year as Filarisis Mass Treatment month.
Aside from the common manifestations of filariasis, a person will only know he has the disease through a blood examination which will show that he is a carrier of millions of worms.
Ubial said lymphatic filariasis is one of the six diseases that can be eradicated with mass treatment to include leprosy, rabies, malaria and cystosomiasis. [Lovely A. Carillo]
Health workers are, however, faced with the challenge of getting 85 percent of the population to religiously take the medicines once a year for five years. Ubial admitted that others have wrong impressions about the medicine and their effects, so they are hesitant about taking the anti-filariasis medications.
Despite these challenges, the country’s health professionals are confident they can help eradicate lymphatic filariasis in the next four years, first by creating awareness about the disease, and then getting as many people in the endemic areas to take the medicines. And hopefully, the next time villagers see a person with swollen scrotum, breasts or legs, they would no longer attribute it to kulam or buyag.
