MEDINA, Miguel Andrei C.

2016-00448
FCH 250.2 Community Health Management Output
A. Table 1. Biopsychosocial analysis of a specific health condition/issue of the urban poor
Health Issue: Rudy was exposed to a COVID19
positive patient

[1] Describe the pathophysiology or biologic  COVID-19 is caused by the SARS-CoV-2

determinants of the virus, and it is mainly spread through
health condition that can cause COVID19 disease in respiratory droplets or via direct or indirect
Rudy contact with secretions
 Common reported symptoms of COVID-19
include cough, fever and chills, shortness of
breath, new onset loss of taste or smell, sore
throat, vomiting or diarrhea, and fatigue or
muscle pains; it is more severe in older
persons
 A person can spread COVID-19 as early as 2
days before symptom onset (at which time a
person is most infectious) with the
infectiousness declining as time goes on
 Symptoms may appear 2-14 days after
exposure to the SARS-CoV-2
Psycho-emotional determinants of the health condition:  Anxiety over Rudy, the main breadwinner of
[2] How do the family, becoming critically ill (children and
you think the Rudy (and his family) feel about or would wife are dependents)
react to the  Anxiety over Rudy spreading the disease to
health issue? his family members and to his sister Elvie and
her family
 Anxiety over the lack of health support from
the golf club despite Rudy having been
working there for the past 25 years
 Anxiety over how to deal with the pandemic
and sustain their lives moving forward
because Rudy could possibly lose his job
[3] Psycho-emotional aspects of the disease have  Anxiety over Rudy becoming critically ill could
biological basis; be increased because COVID-19 is known to
describe this. be more dangerous in the older populations
 COVID-19 has been known to spread even
when a patient is asymptomatic, contributing
to the anxiety that the disease could have
spread to other family members without them
knowing
 It would be known from the news the horror
stories involved in managing COVID-19
patients: the need for hospitalization,
intubation, isolation, etc. This would contribute
to the worry caused by the lack of health
support because Rudy and his family would be
worrying how they would be able to afford
these interventions
 COVID-19 is known to spread in the
community and thus the government has
implemented infection control measures – but
these are hard to implement in practice,
especially for the urban poor who may not be
able to afford PPEs or who may not be able to
just “stay at home” without working,
contributing to anxiety on the future
 [4] What are social determinants of the health condition
that can
make Rudy be at higher risk to succumb to the disease
[5] What are social determinants of the health condition
that can
make him able to combat/ get well if succumbs to the
disease?
 Unsanitary conditions (lives near estero)
 Overcrowding (lives with his family and his
sister’s family)
 Irregular employment with no benefits,
dependent on tips (not stable)
 Stress and Anxiety over the pandemic and
being exposed to COVID-19 (mental health)
 Community engagement – his volunteerism
with the SHaCC may help him if ever he
succumbs to the disease
 Health insurance – his diligence in paying the
premiums for PhilHealth would help subsidize
costs should Rudy develop COVID-19
 Health coverage – Rudy visits Malibay Health
Center once a month and it seems that this
Health Center is well-equipped, which would
help Rudy combat COVID-19
 Housing – through the help of SHaCC, Rudy
and his family now owns the land and home in
which they live in, plus it is a three-storey living
space, which would help if ever the need to
quarantine arises

B. Analysis of “The Village and the Lions”

1.
The village is competent enough to solve its problems. Commitment is exemplified by
the village because the villagers recognize that they themselves and the decisions that they
make have a direct and significant effect to the community as a whole; their lives are literally at
stake because of the lions! They themselves can make a difference and they are committed to
finding a lasting, final solution to the lions. Clarity of situational definitions and self-other
awareness is also evident because the villagers do not have any hidden agendas and are
honest about their common problem. The problem of the lions is clearly articulated to other
members of the community through discussion and clear communication. There are no conflicts
known in the community: they are united in their goal to fend off the lions. The villagers all
participate in trying to brainstorm for solutions and in also putting their plans into actions, and
there is a dedicated place for the village council to achieve consensus and make decisions. All
of these traits are essential conditions for a community to be considered competent according to
Cottrell.
In the same way, SHaCC exemplifies commitment to their partner barangays, and their
own unique problems, especially to the underserved. They have adequate avenues for
communication with its members and key members of the barangay, and are able to clear any
misperceptions others may have about their role in the healthcare system. They are able to
participate with their partners in the barangay to implement programs which have been deemed
important by leaders in SHEC-covered barangays, showing that participation both from the
SHaCC (an FBO) and the barangays they are covering is adequate.
2.
Intersectoral collaboration
 “The prompt action by the nurse was able to save the life, and the leg, of the boy.”
 “[A]nd that very same day a strong high fence made of thick branches began to slowly
appear around the village.”  construction workers
  “Eventually, an old hunter rose offered this advice, “There is a saying that my
grandfather taught me …”
The above quoted lines from the story show that various sectors were tapped in trying to solve
the main problem of the lions.
Public or community participation
 “Urgently the village chief called a meeting of the village council.”
 the villagers were directed by their village leaders to construct a small thatched hut
to accommodate a dispensary.
 “However, a few people were troubled …”
 “Eventually during a meeting of the village council one of the concerned villagers
complained, …”
 “the rest of the villagers were convinced by their leaders that while hunting lions
would be dangerous hard work, it was necessary.”
The above quoted lines from the story show that the community was actively participating in
finding a solution to the problem of the lions. There was a village council which was mandated
to finalize decisions, however this did not hamper the opinion of its constituents; the regular
village members still had an avenue to voice out their opinion and have a role in decision-
making. The leaders also did not just decide on anything without making sure that all its
constituents were on the same page as them, as shown by the last quote.
Accessibility
 “The dispensary began treating lion victims from neighboring villages.”
 “Our hospital tends our wounded, and our fence protects us if we stay in the village, but
neither has struck at the heart of the problem.”
The first quote above shows that health was made accessible to all individuals, even those from
neighboring villages, because they were also suffering from the same problem of the lions. The
second quote shows that while certain solutions only catered to certain groups (i.e. the wounded
or the ones who only had to stay within the village), the village strived to find solutions which
was accommodating and accessible for all sectors, including the villagers who had to go out.
Appropriate use of technology
 “Eventually, on the advice of their nurse, the village enlarged the dispensary by adding
a lab, pharmacy and a few beds. One thing followed another until eventually the growing
complex was almost a hospital with operating room, laboratory and rehabilitation center.”
 “a strong high fence made of thick branches”
 “So the lion hunt began!”
The above quotes show that technology was appropriately used in a way that was feasible and
culturally acceptable to the members of the village. The dispensary was enlarged out of the
advice of the nurse, one of the members of the community, increasing the capacity of the village
to respond to other diseases. A fence was constructed made out of thick branches, a feasible
and also moderately effective technology given the villager’s geographical location around
towering trees. When the fence technology proved to be lacking, a lion hunt was initiated, and it
is implied that appropriate technologies related to the hunting of the lions were developed and
adequately provided, which eventually led to the village solving their lion problem.
Health Promotion
 The story teller would always conclude with this advice, “The life of our village has been
forever changed by the lions. […] Let us use this new knowledge wisely to protect
and maintain the health of our village and of the generations to come.”
The principles of health and the story of the village’s struggles with the lions, along with the
lessons learned about how the perfect solution must be accessible to all and borne out of
participation of the villagers, shows that the village is promoting health in all its aspects.
C. Planning Matrix for one of the solutions given in the story
Table 2. Planning Matrix for the Final Solution to the Lions
General objective: Eliminate the threat of the lions within the next five years and thus decrease
incidence of lion attacks
Specific Methodology/Intervention Resources Objectively Means of
Objectives Human Materials verifiable verification
indicators
Complete - Assign people to go Village N/A Concrete By the end of one
census for the door-to-door and ask council biodata month, a suitable
village to for number of family Census- and set of hunters
identify members and takers breakdown should have been
number of respective ages of villagers identified
willing - Village council should in the
working-age brainstorm a list of village
villagers exceptions that would
suitable for identify suitable
hunting lions hunters and exempt
by the end of certain persons from
the first month joining the hunt
Hold a town hall
meeting in order to
ensure that people do
not feel obligated to go
to something they do
not agree with
Produce an - Assign Craftsmen Wood Number of The village council
adequate craftsmen/craftswomen Craftswomen Copper/Iron/Bronze weapons should inspect the
number of to create wooden Miners Plant materials created quality of the
quality spears and bows from Smithers after four weapons and look
weapons to the dense forest Fletchers months for any flaws in its
arm at least surrounding the village Farmers design. Each
80% of the - Assign miners to mine Weavers Quality of weapon should be
identified metals for use in the tested for its
hunters within weapons weapons sharpness as
the next four - Assign people to smith shown by its ability
months tips for the spears and to pierce wood.
arrowtips for the bows
- Have fletchers create
adequate arrow shafts
for use with the bows
- Have the farmers
collect plant materials
to be spun into
bowstrings by
designated weavers
-
Train the - The old hunter rose Old Hunter Adequate food and By the end Certification from
identified mentioned in the story water for trainee of the next the training head
hunters in should be asked to Drafted hunters during their 3 months, that the trainee
basic combat volunteer as the trainee training we should hunters are
skills such that training head (despite hunters have a prepared for
they are battle being old, he would be confident combat against the
ready within 3 knowledgeable and be fighting lions
 months of able to instruct trainees force
them being on the proper methods capable of
drafted as of hunting) fighting the
hunters - Lesson planning for the lions.
appointed training
head, with bi-weekly
training sessions
during the afternoons
- As weapon production
is not expected to be
completed by this time,
rotation among
trainees is encouraged,
as is making do with
makeshift materials
and weapons
Once the - Topnotchers from Trained Weapons (would Population By the end of five
hunters have training would be hunters have already been of lions and years, the
been trained, promoted to lead produced by this frequency population of lions
there would hunting expeditions Assigned point) of attacks in the village should
be bi-weekly - Drafted hunters would hunter- have dwindled, and
hunting trips rotate in a bi-weekly leaders Food and water for the
to slowly basis to hunt during hunting expeditions frequency/incidence
eliminate the ideal times of the day, of attacks should
population of the non-decked have dropped to
the lions, for hunters would stay none.
the rest of the behind to defend in the
five years event of an attack
from the onset - This would be
of this plan continued for the rest
of the five years from
the onset of this plan
- Injuries would be dealt
with in the village
hospital
Generate - Collect tax from the Traders N/A Net profit Net profit per month
adequate villagers as the threat per month should be sufficient
funding and of lions is something for all the workers
compensation that affects all of them in production and
for workers - Possibly engage in the hunters without
and hunters trade with other any complaints
throughout villagers, enter into
this five-year bounty hunting
plan contracts with other
villages threatened by
lions as extermination
of lions will benefit all

As mentioned in the study guide, the lions can be an allegory for a health concern such as
flooding. As shown in the planning matrix, the final “health service delivery” is the hunting
expeditions to be carried out by drafted hunter-villagers, a suitable “health workforce.” The
weapons created, being the tools used to combat the lions, could stand for the “access to
essential medicines” which are needed in a health system. The “health service” of hunting would
be financed by entering into bounty hunting contracts and by collecting tax – much like a well-
functioning state health insurance. The census and final verification of outcome at the end of
five years would constitute our “health information system.” Finally, leadership and governance
is present as shown by the village council’s unique role in ensuring quality of weapons, the old
hunter’s role in ensuring quality of hunters, and of course, in the council’s final assessment that
the lion population has dwindled and lion attacks are scarce/eliminated.
 References
https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-how-is-it-transmitted
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
https://www.kff.org/racial-equity-and-health-policy/issue-brief/beyond-health-care-the-role-of-
social-determinants-in-promoting-health-and-health-equity/
Cottrell, The Competent Community
Rifkin’s Process Indicators of Community Participation
Partnership Matters: A Decade of Community-University Partnership in Community
Development Chapters 1, 5, 7
https://www.von.ca/en/principles-primary-health-care