Tuesday, March 22, 2016

Too many tourists spoil the view

The crowd in Mt. Pulag as captured by Don Kevin Mariano in this selfie
by Gideon Lasco

Facebook nowadays is full of selfies taken all over the Philippines: from the summit of Mt. Pulag to the white sand beaches in many parts of our archipelago. With the availability of cheaper plane tickets, better roads, and travel blogs that tell you all you need to know, domestic tourism is growing - and this is welcome news. But as traveling around the country becomes a common pursuit for many Filipinos - and as the summer “peak season” draws near - it is important for us to reflect on our impact on our places we visit.

By impact, I mean two distinct but interrelated things: the impact on local communities, and impact on the environment. Both are serious matters that we have to address.

Traveling brings us into contact with communities whose shared values and ways of life may be at odds with what we are used to, and this can be the root of distress and conflict. Tracey Santiago of ICOMOS Philippines said it best: “Think also of how the community feels when more than a thousand tourists are disrupting their peaceful daily lives. Put yourself in their shoes. It’s not all about the money that tourists bring in to their community but mostly it’s about having a peaceful sleep, clean water to drink, food for the family, safety of their environment, and clear roads to walk on.” She was admonishing travelers to specifically avoid Sagada during the Holy Week, but her words can be said of many places.

Aside from the sheer presence of outsiders, tourism can also have unintended consequences. By fostering the establishment of guides, hostels, souvenir shops and so on, at a pace faster for regulatory measures to catch up, it alters the local economy, making it cash-based, and the society itself becomes commercialized. This, of course, is not bad in itself, but inasmuch as we’d like to think that tourism equates to jobs, we have to be mindful that it can also disrupt people’s lives.


Impact on the environment is another cause for grave concern. The United Nations Environment Programme identifies three main impact areas of tourism: Depletion of natural resources, polution, and sewage. All these are salient in the Philippines, given the precariousness of our island ecosystems.

The case of Boracay is emblematic. We take pride in its being one of the best beaches in the world, but as the peak season comes and as young people congregate for another “Laboracay”, we are left to ask whether the island can keep supporting the tourism juggernaut. The algal blooms that line the beach is just an ominous sign of deeper problems: Last year the DENR reported that coliform bacteria levels in one of the island's drainage outlets was 47 times more than the safe level.

Sitio Pungayan in Tuba, Benguet - now known as “Sitio La Presa” - is another insightful case. Once a quiet farming community at the outskirts of Baguio, its having been the filming location for the soap opera “Forevermore” quickly turned it into a tourist attraction with souvenir stalls and numerous vehicles appearing overnight. Fortunately, the Court of Appeals issued a writ of kalikasan in May 2015, averting an environmental disaster. “La Presa” is a sobering reminder of the impacts media - including social media - can have in the places they feature.

In nature spots like mountains and beaches, garbage left by tourists can can leach into the soil, affecting forest ecosystems, or end up in the oceans to affect marine life. Noise pollution can disrupt wildlife, and human waste can contaminate nearby water sources.

These examples are far from exhaustive, but what is important for us to realise is that even the simplest of acts can have an adverse effect. Once when I was in Mt. Bulusan in Sorsogon, one hiker approached a cuckoo-dove’s nest and used flash while taking a picture of it, causing the startled mother to flee. “She will never come back,” one of our companions, a birdwatcher, ruefully said. “And the eggs will be abandoned.”


Too many tourists spoil the view when you cannot even see what you want to see, because of so many people. The solemn procession of the sunrise atop Mt. Pulag can be interrupted by camera flashes - and instead of a quiet contemplation of the glories of a new day, you see other people making all kinds of funny poses.

But as I have discussed in this piece, tourists can also spoil the view by actually damaging the view itself, that is, by causing harm to the environment. Finally, ‘view’ can also mean the pananaw or perspectives of the locals about the people who visit them: they can end being resentful of tourists, and by extension, the outside world. Beyond that, tourism can have unintended consequences in their ways of life.

The government should take concrete steps to regulate tourism. For areas with fragile ecosystems like Mt. Pulag and Calaguas, carrying capacity should be determined and applied accordingly, limiting the number of visitors at any given time. Tourist magnets like Sagada and Boracay can be regulated by limiting the number of hotels being built and bus and plane routes being licensed. Finally, promoting alternatives can spread the impact of tourism, even as these alternatives must also be regulated from the very start to avoid the fate of their more popular counterparts.

As for people planning to travel this summer, you can help reduce the impact of tourism by being responsible travelers and visiting lesser-known - but no less fascinating - places. This is also for your own good: You can’t complain about the crowd if you’re part of it.

Saturday, March 12, 2016

Managing the epidemic of fear: Reflections on last year's National School Deworming Day

by Gideon Lasco, MD

Last year, the Department of Health launched the National School Deworming Day (NSDD) - a timely initiative that combined the need to actually treat children for intestinal parasitism and the need to educate public the importance of deworming in children’s health and nutrition.

Unfortunately, it was marred by reports of children being brought to hospitals after taking the deworming tablets, and rumors of more serious problems.

The most virulent rumor was that children actually died as a result of the deworming, amplified by the radio station in Pagadian City which actually reported it. DOH officials now suggest that this rumor was a major reason many parents actually brought their children to the hospitals. “They just wanted to be sure,” an Inquirer report cited a nurse as saying.

Then there were intrigues suggesting that the chewable Albendazole tablets given to the children were expired. DOH Secretary Janette Garin had to show the actual tablets used in the deworming to show that expiration is not until 2017.

What can explain the alarm? First, some of the children could be experiencing the body’s natural reaction to the drug. Upset stomach is one of the common side effects of Albendazole, and the process of deworming could be felt as a sign that the drug . Studies show that the more worms children have, the more they might experience drug-related reactions.

Second, some of the cases can be attributed to “mass hysteria” or “mass psychogenic illness”. My colleague Dr. Harvy Liwanag, who has worked in parasitology research, recounts a deworming activity in Negros Oriental where, there was suddenly a large number of schoolchildren complaining of the same symptoms. The exact mechanism of mass hysteria remains poorly understood by scientists.

The fear of having been poisoned by the drug could itself be a cause for the symptoms children experience, as when some parents in Zamboanga were reported to have given remedies like coconut milk and coconut oil that could very well cause upset stomach.

But the damage has been done. Some towns actually suspended the deworming activtiy as soon as the reports came in, and there were also reports of parents refusing to send their children to school. My medical colleagues say that some of their patients are already telling them that they will never allow their children to take deworming tablets again. Thus, while emphasizing that medical problems were dealt with, the DOH must now seek to manage the epidemic of fear that could greatly undermine deworming efforts in our country.


Misconceptions about diseases and their treatments can be as devastating the diseases themselves. The widely-discredited claim that measles, mumps, and rubella (MMR) vaccines can cause autism continues to be believed by many parents, and is directly responsible for the increased incidence of mumps and measles - as well as deaths from these otherwise-preventable viral infections.

In the Philippines, we have a similar example in the tetanus-infertility scare in the 1990s. Following a report that showed traces of a hCG, human hormone in tetanus vaccines, various groups quickly jumped to the conclusion that the anti-tetanus vaccine can cause infertility (the hCG levels were far too low to be significant). This too, has led to many people refusing tetanus shots, rendering themselves - including their babies - at risk of contracting an deadly infection.

These cases remind us that people do develop misconceptions about health interventions, even in the face of unequivocal scientific data. Enough people believe in the measles-autism link in the US that some politicians are even cowered into not taking a clear stand about it. The malignancy towards which these rumors can escalate should make the DOH redouble its efforts in conducting a thorough investigation and providing an explanation of this deworming incident in way that the public can easily understand.


Intestinal parasitism is one of the reasons why Filipino children are malnourished; why many children are stunted, and consequently, why many Filipinos are short. These truths must also be emphasized. One very recent study in the US showed that parents are more likely to vaccinate their children when informed of the risks of a certain disase, than assurances that the vaccine against it is safe and effective.

Rather than sensationalize the reports and intrigues, the media for their part should be mindful that they can be an accessory to the propagation of this epidemic of fear.  Even if we accept it as natural that the media will highlight the hundreds who were hospitalized over the millions who weren’t, there is no room for reporting based on rumors - as that radio broadcaster in Pagadian did.

Of course, anticipating adverse reactions and orienting everyone about what to expect are crucial parts of any health intervention. If, as Undersecrtary Dr. Vicente Belizario reminds us, the “chemical reactions are signs that the drug is working or showing its effectiveness,” then this should be relayed in advance to children, teachers, and parents. And if, as Dr. Eduardo Janairo of DOH MIMAROPA said, children should have eaten something before taking the medicine, then this too, should be (even more) emphasized.

As the National School Deworming Day - and deworming incident in Zamboanga demonstrates -  public health is not just about documenting health problems and coming up with programs to deal with them. It is also about successfully communicating these problems - and programs - to the people.

Tuesday, March 8, 2016

An open letter to the grammar police

An open letter to the grammar police
by Gideon Lasco

If, to attract your attention, I need to plant some grammatical errors in this piece, then so be it, but alas, I'm not sure how many of you would appreciate such a subtle and fanciful exercise. So I have instead taken the route of addressing you directly in the hope that I could indeed reach people who belong to an imagined community of “grammar Nazis” - whether you identify yourselves as such, or are in denial.

Let me preface my remarks by congratulating you for your work in recent years. You have spared no one, not even Vilma Santos, from your surveillance, and the poor actress had to humbly (and rather gracefully) explain herself for offending your sensibilities, after a grammatically-incorrect but well-intentioned Instagram post. More unfortunate is the case of Janina San Miguel, a teenager whose incorrect grammar and pronunciation during a Binibining Pilipinas Q&A went viral to your glee.

But you must ask yourself what else you have accomplished, aside from the humiliation of others - and the banishment of non-words like “irregardless” from the lexicon. In what follows, I will offer my assessment.

First, you have intimidated people from even trying to speak English. I have met college students who can speak English, but are too shy to do so, lest they get corrected or humiliated. They won’t even practice - which is sad because you won’t master a language unless you practice it. Such an unhealthy spirit, I argue, is because of people like you who focus on errors.

Second, you have exacerbated divisions within social media and society at large. The years-long bashing of the “jeje” (which has incidentally made jejemons out of the entire Spanish-speaking world) was the opening volley in a protracted civil war you have instigated between the “educated” and those whose knowledge of English is not as deep as yours. Like the divide between Spanish and Tagalog speakers in colonial times, or English and Taglish in more recent years, this language-based discrimination along lines of class is not contributory to national unity.

Third, you have opened yourself to judgement in your own terms. I am sure many of you will claim to be of a better mold, but some among you have made fun of yourselves by correcting something that is not really wrong - and in the process betray their own ignorance. Their greatest downfall are instances when there is more than one correct spelling - or more than one correct rule - such as advice vs. advise, or in the two ways to pronounce “route”. Correcting others, only to be corrected: that is most embarrassing.


It is tempting, in this age of automatic spelling-and-grammar checks performed by Microsoft Word and even Gmail - together with posts like “11 Common Grammatical Mistakes and How to Avoid Them” - to prognosticate your decline and extinction. But I do not see this happening at all in the recent future. You have a role in policing your own ranks and those who are in the business of writing (i.e. journalists, novelists). Certainly, this piece is within your jurisdiction - and if you find something wrong, I am guilty as charged.

But please spare the rest of the people from your gaze. Do not alienate those who are trying to practice their English, and those who do not even care about languages, but are simply communicating something to their friends. Let languages unite, not divide us. With all our diversity, and the already-lamentable educational and economic disparities between the rich and the poor, the last thing we need is an elitism based on the ability to speak a certain language in a certain way. Moreover, do not take our “poor mastery of English” against our nation: Many Americans - and English - don’t know how to speak English “properly”.

Instead of looking at individuals’ errors in grammar, spelling, and pronunciations, you should be channeling your criticism to the educational system. Surely, even a college graduate can be excused from not knowing the plural of hypothesis - or seraph. But subject-verb agreement is elementary, and the fact that many have not learned it should point to gaps in the way English is taught among our children, particularly in the public schools. If you are truly experts in English, we need your pens to articulate the case for improving language literary in our country. Make an article, submit it to a newspaper or a website! If it goes viral, well and good for the rest of us.

Finally, you should be mindful that it is the languages that are open to accept new words, and break its own rules, that have survived. There is a “playfulness” in the Filipino languages that have allowed us to “colonize” words and make them part of our own lexicon, such as “Mag-on” and “Mag-oonline”. There lies our strength - and the same can be said of English, which has borrowed heavily from French, Latin, Greek - even Tagalog (i.e. boondocks). If your rules were strictly followed, how can we have the unforgettable lines of Master Yoda? “Seenzoned” may yet become part of Merriam-Webster someday - just as the word “OK” - which started as a joke in Boston newspapers in the 1830s - is now part of our everyday speech.

Thus, my appeal to you is to become relevant by looking more broadly than the placement of apostrophes and hyphens in people’s posts on Facebook and Instagram. Because right now, you are holding back the growth of the very language you have sworn your allegiance to. What are the synonyms of impediment?

Heidelberg, Germany
March 8, 2016