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Fighting back to end TB

It was my first time attending the 48th Union Conference, which is happening in the gorgeous city of Guadalajara, Mexico. The Union Conference’s long name is “World Conference on Lung Health” so it’s technically a conference about lung health, but #tuberculosis being one of the global pandemics, this conference is basically an International TB Conference. It’s apt, given that the R&D on TB and the investment to R&D has slowly moved, and while TB is generally treatable and preventable, the sessions at the Union are focused mostly on treatment — I am not saying that we should not, but I think there must be an equal footing between prevention and treatment, same with HIV.

IMG_3832In terms of HIV, what I observed at the Union Conference was how almost missing TB-affected communities are. Yes, you will see them walking here and there attending sessions, but there was no fire, no anger, no life. I could only count those who really will push and challenge people who develop these drugs to come out soon, and challenge National TB managers (NTPs) to do better. I cringe everytime I hear the word “patients” in the sessions I have attended, still putting people within that paradigm that the TB managers and the doctors are still in-charge of people’s lives, discounting the agency needed to push the TB response to include communities. Most importantly, TB-affected communities have not been the front and centre of the responses, and have only relied to NTPs and those who provide treatment. Nothing more.

I am not saying that it’s bad to establish partnership. In the SDG era, multisectoral approach to ending diseases has proven to be effective and the only way forward. But TB activism needs to learn from HIV activism a lot. Here are some of the few ways that we can do to change the tide and finally put an end to TB:

  1. Let’s stop being kind to each other. Patting each other at the back and circle jerks are good to some extent, but it will never address critical issues needed to push the TB response. TB-affected communities need to change the language that we are patients. We are not. We are people who live, who lived, affected, and has survived TB. To enable communities, we need to break the power dynamics between physicians and people and put people at the front and centre of the response.
  2. We need to learn more from the HIV activism. The reason why investments to new HIV treatments are high and quick was because people are angry because of decision makers’ and health programmers’ complacency. Complacency kills innovation. If we want new drugs for TB, we need to rally before pharma companies. If we want us to be involved in the TB response in the country, we need to demand that to our NTP managers. If we want TB stigma to end, we need to voice that out more.
  3. We need to involve more people who are affected by TB, including people living with HIV. I have heard at the Union Conference that the stigma that people with TB face is different from HIV. I beg to disagree. Stigma, in whatever form, is still stigma. People are discriminated because of inequality and prejudice, the rest are just qualifiers. But TB is an airborne disease, which means it can affect anyone, unlike HIV. However, I haven’t really seen affected populations participating in the activism. Why limit to those who have already have had TB, when we know that once a person who contracted with TB is treated, he or she is most likely not going to involve himself or herself due to the trauma of the treatment? So where are the miners? Where are the indigenous groups? Where are the people who use drugs? Where are the urban poor groups? TB must be and should be their concern too.

The Union Conference might be among the driest conference that I have been. It’s very scientific and exclusive. At the same time, it inspires me to push for better inclusion of people who have and are affected with TB in the TB response. It’s time to change the way we do activism in TB. Just like in HIV, it’s time to play kind. It’s time to fight back, and let’s bring that fight at the High Level Meeting on TB this September 2018.

 

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Philippine Games

Sa tatlong taon kong pagkawala sa Pilipinas ay na-culture shock ako sa maraming bagay na bumubuo sa Maynila. Mula sa dami nang taong parang mga ipis na nagsisitakbuhan kung saan-saan; sa ingay ng mga kalsada; at sa sobrang haggard ng byahe ay kinailangan kong matutunang muli ang iba't ibang skills upang mabuhay — at manatiling buhay — sa electric city na Metro Manila. Napagtanto ko na ang mga kasanayang ito pala ay itinuturo na sa atin habang bata palang tayo sa pamamaraan ng mga laro. Heto ang ilan sa mga laro noong bata pa tayo at kung bakit dapat natin itong isa-isip, isagawa, at kung hindi ay ipasa-Diyos na lang natin:

1. Patintero: isa sa mga napakahalagang skill ang matutunan kung paano umiwas sa mga taong mabagal maglakad dahil sa kung hindi nagfe-Facebook ay may kalandiang jowa na ginagawang Luneta ang kahabaan ng Cubao MRT station. Dapat ay mabilis rin ang iyong reaction time at senses sakaling may biglang lumitaw sa dinadaanan mong isang bulto ng mga pasaherong parang nagtatakbuhang mga elepante.

2. Luksong Baka: mahalagang malaman ang iba't ibang strategy upang maunahan ang magbabarkadang holding hands na nasa harap mo at kulang na lang ay mag-joint singing ng "If We Hold On Together". Sa Luksong Baka matututunan natin kung paano lumusot sa mga kakarampot na mga daanan sa pagitan ng mga estudyanteng magkakahawak at mabagal ang paglalakad na tila nagpoprotesta sa Mendiola.

3. Langit Lupa: sikat na sikat ang larong ito lalo na sa may bandang gutter sa labas ng eskwelahan. Pero napaka-importante ng mga matututunan sa larong ito lalo na sa panahon ng tag-ulan, kung saan ang pagiging nasa "lupa" ay hindi lamang ibig sabihin na pwede kang mataya; ibig ring sabihin nito ay mababasa ka ng sobrang pristine na baha, kasabay na ng mga lumalangoy na ipis, daga, at basurang tinapon mo kaninang umaga.

4. Agawan-Base: Napakasikat ng larong ito noong bata pa ako, dahil maaari itong laruin ng buong klase. Pero ngayong malaki ka na, hindi na lang mga kaklase ang kalaro mo: si kuyang naka-sleeveless na amoy pawis na kung magtaas ng mga kamay ay parang nasa patalastas ng fabric conditioner; si ate girl na may dalang bayong ng mga gulay; si kuya estudyante na may hawak na mahabang measuring stick, mga grupo ng mga lalaking nakajacket kahit na sobrang init na naghahanda sa susunod nilang target, at sina ate gurl na magkakahawak na akala mo'y nasa Top 3 ng Miss Universe. Ang base: ang aircon bus na walang masyadong laman na papuntang Monumento, alas-siyete ng gabi ng Biyernes.

5. Jackstone: Isa sa pinakapaborito kong laro noong bata pa ako ang Jackstone. Sa larong ito maeensayo mo ang mga daliri at kamay mo: ang tindi ng grip, ang pagsiguradong sa pagdakot mo ay marami kang makukuha. Sobrang halaga nito ngayong malaki ka na, lalo na sa pagbabantay ng iyong gamit. Hindi lang eye-hand coordination ang kailangan mo; maging ang pagsiguradong lahat ng mga zipper ay nakasara, at bawat daliri ay nakasukbit sa bawat zipper ng bag mo.

Marami pang mga larong nilalaro tayong mga bata noon pero dahil pang-General Patronage ang aking blog ay hindi ko na isasama ang Piko, Garter, at Tumbang Preso. Philippine Games skills on!

Perceiving is Learning

If there was one thing the last back-to-back-to-back-to-back meeting taught me, it’s the value of listening as an integral form of learning. As activists, we are always assumed and expected to register our points just to make sure that we “have arrived”, that we are participating, but sometimes, perceiving is the best form of participation.

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Perceiving comes in many forms. Those meetings taught me a lot about different issues beyond the usual field of advocacy that I am engaged in. It taught me to become more sensitive of how other people feel, of how other people perceives me, and of how everything turns and would turn out. The field of tuberculosis and the field of sustainability are two areas that I am very new in, but by listening what others have to say instead of debating and arguing with them, it made me become more conscious about other people and make them appreciate me even more. One particular instance I can recall was at this recently concluded global TB workshop, wherein a lot of people has a lot to say, which was good because everybody is making their voices count and their points registered, but sensing the room: understanding why one person is feeling this way, and showing people that you are open to understanding where they are coming from, was really humbling for me. I admit, that second to the last meeting on TB was what I can describe as ‘disastrous’ in terms of handling the sessions and the people in the room (with so many strong personalities) but overall, I did what I can and always get the sense of what people wants, of which, in the end, makes them own the process more than the facilitator. More than me.

As I go and think about it more, I was happy that it went as it was supposed to be. There may be rifts and misunderstandings and blaming on why it turned out that way, but I learned a lot as a facilitator. I tried to stand my ground when necessary; to make decisions when necessary; to let the process flow when nobody else was standing up and making it flow. As a result, there was a mutual respect between me and the participants, between us facilitators, and between us people.

My boss and I had a heart-to-heart talk after the last meeting about what happened. I did describe it to her as disastrous as a facilitator per se, but if there was something that I can take way out of that meeting, it was all the new things that I learned from her and from the rest of the people in the room. I opened my mind to new things, and I was happy with what I garnered in return.

Cleaning Ladies

Living in a condo unit is a privilege. With the big amount of money that I pay for my monthly rent, I get to enjoy the pool, the gym, I get to experience the clean corridors, that the garbage are taken care of, and that whenever there is a utility problem, I can always call someone to help me. But sometimes, I would notice the cleaning ladies who mop the floor quietly, or would pass by quietly at the pool area trying to make themselves as unnoticeable as possible, away from the residents. They usually look exhausted, possibly from cleaning the entire building daily. I also don’t see them resting, or if they do, they are not in places where residents can see them.

Early this afternoon, I saw one of the cleaning ladies who was about to go home preparing a bag full of plastic pet bottles. She was also sniffing what seemed to be her lunch meal if it was still okay. Maybe she was not able to eat it because of the work that she had to do for the day.

I know why she is keeping those bottles and where she is going to take them.

I was half-submerged in the pool when she passed. I was trying to get her attention but it seemed that she was trying as much as she can not to mind me. She came back a few minutes later and that was when she saw me looking at her. I smiled and said hello. She responded with a weak smile, and said that she forgot her umbrella. I waited for her to pass by again and said goodbye. She smiled again.

As she walked away, I realized that I have never seen the cleaning ladies enjoy the pool even for just a single day. Or get to enjoy the areas in the condo where they can hang out. Or be given a discount, if not a free room, in the building for doing a good job. While I enjoy the good location of where I live, these cleaning ladies would go home after 5PM and travel far and not in this building where others would call home, but they cannot.

Life can be unfair, and this is not due to people’s choices or capacity. There are complex systemic problems that need to be addressed. If these cleaning problems could have had a good access to education or job opportunities; if policies are kinder or fair; if hierarchies are not as rigid as they are, then maybe this old cleaning lady will be allowed to swim at the pool during her day off, or be rewarded a room after working for x number of years in this building. Maybe she does not need to keep the bottles and bring it with them to earn more.

Or maybe the reason why she is keeping the pet bottles is because she is more conscious towards the environment than those who live in this building. Myself included.

 

Spare Time

 

I woke up this Sunday morning thinking how fast yesterday has been, and as I try to recall what I did yesterday, I can’t help but plot out how my week will go — not just Monday, not until Tuesday, but for the entire week! Monday has not started yet but I am already dragging myself to another busy week.

Don’t get me wrong; I love keeping myself busy with work, probably watching a film or an episode of the series I am following, or scrolling through Facebook, Twitter, and Instagram feeds feeding myself with more information that I have to know. These things make me occupied, but at the same time, half of me feels like I am missing some aspects of the day, just breathing in the day and letting the day pass without any worry.

Is it because I am chained to time that I am feeling this way? With an almost 24-hour mode of work, a round-the-clock need to do things that is slowly becoming a routine: that by this hour I should be doing this, that by that hour I should be doing that, I feel agitated if I do not finish anything. If I did not meet my 20-lap average swim every other day, I feel irritated. I feel obliged to respond to my email immediately even on a weekend, even if it’s not urgent. I am being dragged to take part on something even if I know I can always say no.

baguio-2017A spare time feels like something that I need to spend because it’s a piece of time that I consider unused, an extra, and should be utilized for something useful. But doing nothing is making use of this spare time wisely.

When will I experience reading a book I so love to read for an entire day? When will I play Pokémon without any worry that I will be late for work? When will I be able to write more blogs without the need to rush myself?

To compete with time by spending every single minute of it towards something that I am obliged to do at the moment isn’t the good way to go. Rather, I must learn to make use of my spare time by not obliging myself to do something because I have to do it, but because I just want to, for myself.

Mental

 

I was about to get ready to sleep when I decided to listen to Jonas Blues’ Perfect Strangers and then it kicked in, along with my nightly medicine: this song could have been part of my playlist as I was getting ready for my next work/road trip north of Luzon one hot summer of April 2009. I was sitting at the office with my board shorts and light shirt copy-pasting music from my desktop, already imagining the sound of the waves, the dark, powdery sand, and the hot sun above me. I was 23, getting ready for my next monitoring trip to Santiago City-La Union-Baguio, and then after that, the endless partying at night with some random guy, getting drunk and wasted, and getting laid. Hoping that the guy I am hooking up with will be that someone who I can call my forever.

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Yeah, I have been there and done those, but even if I did not survive my early 20s well, I must say that I have enjoyed every piece of it. I just could not believe that I have been that young guy craving for parties and going out and spending hours with friends at wee hours, cruising as much as possible and literally being out there, even if I myself was hypocritical about it. But it seemed that those days were the days when I just wanted to tick that box and boast at the world and say, “ yeah, I have done that.”

That was eight years ago. Almost a decade ago.

In a few days, it will be 2017. My priorities have changed. Heck, I have a happy and stable relationship, and my priorities have changed. Even my daily chores and things to do have changed as well: I am more focused at work and in spending more with people that are dearest to me the most, not craving for having a big group of friends or that feeling of wanting to belong to a group. I can let go of things easily. Which is a good sign of maturity. But I have lived my life full during those years: no what ifs, no could haves.

Today is 31st December 2016, the last day of 2016. Have I lived 2016 fully? I believe so. But I also feel like I am becoming younger than my physical age. I still love playing Pokémon on my past time. I still daydream and my mind just flies whenever, thinking about taking out my wand to jinx someone. I am still that 15-year old boy who becomes giddy over a new toy, or that 21-year old emo who sings and dances alone at 2AM in the morning to the tunes of Whitney Houston. I still enjoy going to the beach and traveling like that 25-year old guy craving to explore the world. But there are new things that have changed (or improved): I started to think about settling down and of marriage, of investing for the future, of having my own family – things that a 32-year old guy would do.

My body may be frail and is getting older, but my mind still couldn’t figure out what age does he really is. Mental. It’s probably not that bad at all.

Extinction.png“Anthropocene”. I first encountered this term back in 2003 in my Geology and Biology class when we were discussing different epochs. Two words popped out of my mind upon hearing the word: human civilization, and climate change. Last night’s podcast could have possibly confirmed these two.

Anthropocene started when varieties of snails in Italy die, leaving only one species of snail to dominate the area. This was a sign of the rise of industrialization and humanity’s global impact, unbalancing global ecology. The term anthropocene was described in geologic nomenclature (as the term was first proposed to the Stratigraphy Commission of the Geologic Society of London to be adopted as a legitimate geologic division) as a period when humans have completely harnessed its influence in the world, controlling world’s resources. And we see it everyday: as more and more humans are born and human society’s become more established, as cities and megacities are built, we produce more waste, and exploit a lot of finite resources. Ergo, thousands of animal species become extinct every year, or around 3 species per day. Just last month, the last of Rabb’s fringed-limb tree frog died, wiping its entire species off the planet. When agriculture started in the US, 7,000 varieties of apple can be found, but since only 100 species are commercially grown for human consumption, the other 6,900 species will most likely to go extinct in the next 25 to 50 years.

It’s interesting and somewhat disturbing to think that as we engage passionately on human affairs, we devoid ourselves from doing something to save ourselves from an impending extinction. Many scientists are predicting another great extinction is at hand, but contrary to the mysterious extinction of the dinosaurs during the Cretaceous – Tertiary period, this next great extinction is certainly human-made. More than the increasing threat to a global nuclear war between Russia and the US, storms become more treacherous and natural calamities become far worse than ever. It is Nature finding its way to bring back its balance.

As the podcast ended, I wondered what would be the next epoch after Anthropocene, or whether we are still here to define that next epoch. It may probably be the end of the world in the next 100 years or so, I will never know.”There is too many of us,” as Jane Goodall would put it, suggesting that we should find a way to reduce the number of people in the world. It’s a scary thought, but it makes sense, unless we start figuring out how to balance this power that we have as humans with Nature. Governments must begin to plan way ahead, similar to how the Norwegian government is collecting seeds from around the world and keep it at the Svalbard Global Seed Vault. We need begin to mind the world we live in and live harmoniously as part of the global ecology.

We already are at the last few minutes before Earth’s time strikes 12. We don’t have much time left.