HISTORY OF PUBLIC HEALTH  Epidemic of bubonic plague

 Caused by the bacterium Yersinia pestis.

I. Ancient civilization
Before 2000 BCE
 Evidence of sewage disposal and written medical
prescriptions.
 Taboos against defecation within the tribal
communal area or near the source of drinking
water.
 Rites associated with burial of the dead.
 Use of herbs for the prevention and curing of
diseases and communal assistance with child birth.
Around 1900 BCE
 The earliest written record of public health was the
Code of Hammurabi- included laws for physicians
and health practices.
Around 1500 BCE
 Bible’s Book of Leviticus written- includes
guidelines for personal cleanliness and sanitation.
 Sacrifice to be sanctified.
 5th and 6th Centuries BCE
 Evidence that Greek men participated in games of
strength and skill and swam in public facilities.
 Greek was involved in practice of community
sanitation; involved in obtaining water from
sources far away and not just local wells. (Cleaner
water)
 Christians created hospitals benevolent charitable
organizations
476 CE
 Roman Empire fell and most public health activities
ceased.
 Romans were community minded.
- Improved on community sanitation of Greeks
- Built aqueducts to transport water from miles
away
- Built sewer systems
 Created regulation for building construction, refuse
removal, and street cleaning and repair
 Created hospitals as infirmaries for slaves
 Circulates among wild rodents where they live in
great number and density (plague focus” or “plague
reservoir)
 Common signs:
-Blackening and death of tissue in your extremities,
most common are fingertips, toes, nose, etc.
 Killed 25 million; half of population London lost
and in some parts of France only 1 in 10 survived
 Originated in Asia, spread by armies of Genghis
Khan, world pandemic kills 60 million in fourteenth
century, 1/3 to 1/2 of the population of Europe.
III. Reinassance
 Belief that disease was caused by environmental,
not spiritual factors;
Example: Malaria (bad air), is a direct reference to
humid or swampy air. - Caused by Plasmodium spp
 Observation of ill led to more accurate descriptions
of symptoms and outcomes of diseases;
observations led to whooping cough (Bordatella
pertussis)
1662
 John Graunt published the “Observations on the
Bills of Mortality”, which was the beginning of
vital statistics.
1665
 Epidemics (e.g. small pox, malaria, and plague) still
rampant; plague epidemic killed 68,596 (15% of
the population) in London in.
 Explorers, conquerors and merchants and their
crews spread disease to colonists and indigenous
people throughout the New World
1789
 Marine Hospital Service (forerunner to U.S. Public
Health Service) was formed.
 Archeological findings reveal community and
public health practices of the past.
1790
 First U.S. census.

II. Middle age 1793

 Yellow fever epidemic in Philadelphia.
500-1000 CE (Dark Ages)
 Health problems were considered to have both 1796
spiritual causes and spiritual solutions, a time
 Dr. Edward Jenner successfully demonstrated
referred to as the spiritual era of public health.
smallpox vaccination.
 Destruction of Roman society and the rise of
Christianity; 1799
- Sickness as punishment for sin
 Several of America’s largest cities including Boston,
- Mortification of the flesh (An act by which an
Philadelphia, New York, and Baltimore, had
individual or group seeks to mortify, or put to
municipal boards of health.
death, their sinful nature, as a part of the
process of sanctification.)
- Prayer, fasting, and faith as therapy
- Poor nutrition and hygiene pandemics
- Anti-science
- Care of the sick as religious duty
 Failure to take into account the role of the physical
and biological environment in the causation of
communicable diseases resulted in many
unrelenting epidemics in which millions suffered
and died.
 Deadliest epidemics were from plague (Black
Death); occurred in 543 CE and 1348 CE

IV. Eighteenth Century

Black Death
 -Was characterized by industrial growth.
-Despite the beginnings of recognition of the nature
of disease, living conditions were hardly conducive
to good health.
-Cities were overcrowded, and water supplies were
inadequate and often unsanitary.
-Streets were usually unpaved, filthy, and heaped
with trash and garbage.
-Many homes have unsanitary dirt floors.
-Workplaces were unsafe and unhealthy – portion
of the workforce was made up of the poor; which
included children, who were forced to work long
hours as servants.
-Many of these jobs were unsafe or involved
working in unhealthy environments, such as textile
factories and coal mines.
-There were still problems of industrialization, but
agricultural development led to improvements in
nutrition.
V. Nineteenth Century
 Period of health resources development
-1900-1960
 Social engineering- 1960-1973
 Health promotion (Primary Health Care), and
market period- 1985 and beyond
Challenges are:
 Reducing the burden of excess morbidity (rate of
people who are sick) and mortality (rate of
deaths/destined to die) among the poor
 Counter reacting the threats of economic crisis
 Unhealthy environment and lifestyle
 Developing more effective health system and
investing in expanding knowledge base
HISTORY OF PUBLIC HEALTH IN THE PHILIPPINES
Before Pre-Spanish era:
-Discovered that there was far more to life than
such mysticism and superstition.
-Chroniclers recorded the communities that lived
together according to a set of rules of laws, ruled by
Rajas or Datus as chieftains
-History of health care dates back in 15th century.
Prior to the arrival of the Spaniards, life, and thus
health care, revolved around the animate and
inanimate worlds
-The way of life of our ancestors was in the form of
believing in two (2) worlds’
o PHYSICAL AND SPIRITUAL
-Believed the ailments were caused by lack of
harmony with the spiritual world and
restoring health meant appeasing the gods
with incantations, dances, and ritual offering
ranging from food to clothing to blood
sacrifice.
Pre- Spanish Era
-Like most indigenous people, our ancestors put
faith in nature not only for physical but also for
spiritual sustenance.
-Belief in the power of both the animate and
inanimate world was central to their way of life
-Growth in extensive knowledge and discoveries
about medicinal plants made public health start to
develop.
 Folk medicine- traditional health knowledge and
healing practices that mirrors the indigenous
beliefs about body physiology and health
preservations.
Examples of traditional medicinal herbs:
 Sambong - treat kidney stones, rheumatism,
coughs, colds, hypertension, and diarrhea
 Anonas leaves - treat indigestion
 Betel or areca - treat injuries.
 Leaves of tangan-tangan - rub on the
forehead to relieved headaches.
 Seeds of balconag - rub on the scalp to kill
lice.
 Roots of the panda kaki- when boiled, it used
as a pain reliever.
 Leaves of the balabgon - treat to wounds.
 Igasud - used as an antidote for poison
Babaylans
-one of the mythical healers and well-versed herb lore
during the Pre-Spanish Era.
-Harnessing unlimited powers of nature is their forte.
-Serve as mediator between physical and spiritual world
Spanish Colonial Period (1565-1898)
-The San Lazaro Church and Hospital represents
early medical healthcare in the Spanish era.
-As the Spanish era were not accustomed to the climate,
food, and other challenges of living in the Philippines,
Spanish soldiers succumbed to a number of diseases
and were treated in hospitals specially created for their
welfare.
-Babaylans were replaced by Spanish friars
-Leading Filipinos in rituals of the catholic faiths
influence of Spanish clergy went beyond religion
-Establishment and administration of some of the first
health institutions in the country were also
accomplished by the men of the cloth (Friars)
 Hospital real
-Very 1st hospital in the Philippines
-Cebu, 1565 and relocated in Manila
-catered to Spanish army and navy.
-There was a constant need for doctors, nurses, and
chaplains.
-Food and other supplies were always lacking
-Continued its operations through the next centuries
until the earthquake of 1863 which demolished almost
all of the stone buildings in Manila.
1582
-Miguel de Loarca reported that inhabitants of Cebu
were afflicted by itchy lesions and a certain "bubas.”
 “Bubas”- came from Bohol when raiders
infected the natives.
1690
-An important development in public health
administration during the Spanish regime was the
introduction of safe water supply
 Fray Juan Clemente
 -54-year-old botanist and lay brother, designed
the Hospital de Naturales.
-regularly made medicine for the many people who
begged outside the convent, until the monastery's
capacity was reached Under Clemente's
supervision
The Hospital de los Indios Naturales, or
Hospital de Naturales
-The hospital also provided free medical products
such as oils, herbs, and ointments. It also provided
medical supplies to other clinics and hospitals.
-As a result of King Philip II's favor, the Hospital De
Naturales obtained government funding. Their
safety was likewise guaranteed by the governor-
general.
-After 20 years of service, he died and a few years
later, the hospital was once again destroyed by fire.
-The rehabilitation of the hospital resulted in the
creation of the Hospital de San Lazaro.
 Hospital de San Lazaro
- Located on Rizal Avenue
-one of the oldest medical institutions in the count
-it continues to develop as time passes and the
hospital was renamed after Japanese Emperor
Iemitsu sent 150 lepers to the hospital, which was
previously known as the Hospital de Naturales
-The lepers were cared for by the hospital, the
clergy, and the community.
- As a result, the Naturales Hospital was
renamed the Hospital de San Lazaro, in honor of
lepers' patron saint.
 Hospital De La Misericordia
1603
-After the fire, the original location of the Hospital
de Naturales was donated to the Brotherhood of
Santa Misericordia.
-The brothers were well-liked in the community for
their compassionate treatment of the disabled,
injured, abandoned, and underprivileged.
1599
-Philippines were struck by a plague, the
Brotherhood provided food and medicine, as well
as attending the wakes and graves of those who
perished as a result of the pandemic
 Hospital of San Gabriel
- In 1587, Dominicans arrived in the country at the
invitation of Manila Bishop Domingo de Salazar.
The Dominicans helped Chinese, many of whom
became ill, perished in poverty, and abandonment
-The priests built a small structure behind the
monastery named the Hospital de San Pedro Martir
to handle the growing number of sick people.
During the 400 years of colonization
-Spaniards erected further medical facilities.
-Another military hospital was built in the Presidio de
Zamboanga, in addition to the one in Manila. The Order
of San Juan de Dios founded the Hospital of San Jose in
Cavite in 1591 for the welfare of sailors.
1871
-The sisters of Charity opened a new facility in Caacao,
which they supervised. The Basilan Hospital, which was
created as a naval hospital, was unique in the Orient
because it was entirely built on water.
1574
 Bolotong- smallpox; became the first recorded
outbreak in the country’s history
1760s
- it spread to areas as far as Cagayan, Samar, and Leyte,
killing over 30,000 Filipinos 1789 - Chinese ship
sailing to the Ilocos region was suspected of being the
source of an epidemic that quickly spread to Manila and
the surrounding provinces.
-In response to the problem, King Carlos IV of Spain
ordered the smallpox vaccine to be introduced into
Spanish possessions, including the Philippines, via
expedition led by Dr. Francisco de Balmis that began
on April 15, 1805
- Approximately 6,000 to 7,000 adults and children
were vaccinated in Manila, Tondo, and Cavite in 1805
-The Superior Government also mandated that
physicians, practicantes, mediquillos, and sangradores
be educated on vaccination protocols throughout the
country.
THE PUBLIC HEALTH AFTER THE PRE-SPANISH AND
SPANISH ERA
-Health issues gained much importance in the
Philippines throughout the last few decades. The
country has put in place multiple phases of reform have
been implemented to enhance the nation's public health
system.
- The history of Philippine medicine is organized along
an evolutionary developmental path that advances from
primitive medical thinking as Philippine history
progressed, folk physicians, training and deployment of
genuine medical practitioners evolved and the darkness
and shadows of superstitious beliefs to light purpose
and the victory of biomedical science as marked by the
empiric period
 Bureau of Public Health was founded as part
of General Emilio Aguinaldo's revolutionary
administration
 The Americans gained control of the
government, eventually forming the Board of
Health for the Philippine Islands on July 1,
1901
American Period (1899-1933)
 American period = hygiene
-The Americans provided for better healthcare by
building more hospitals and implementing measures to
prevent the spread of diseases.
-American medicos imagined themselves producing
germ-free Filipino citizens, hence, William Cameron
Forbes, an American who served as Governor-General in
the Philippines from 1909 to 1913 believed that one of
the greatest things in life was sanitation.
-Thus, Since the defeat of Spanish forces in the
archipelago in 1898, the American colonial authorities
had eagerly taken up the burden of cleansing their
newly acquired part of the Orient, attempting to purify
not only its spaces, water, and food, but also the bodies
and conduct of the inhabitants.
-American military and civil health officers thus
dedicated themselves to registering and refashioning
the Filipino Philippine barrio. Hygiene reform in this
particular fallen world was intrinsic to a "civilizing
bodies and social life, to forging an improved sanitary
race out of the raw material found in the process," which
was also an uneven and shallow process of
Americanization.
- During the first years of the twentieth century,
Filipinos emerged as a foolish, immature, contaminating
type, but also a potentially reformable one. In imagining
their new colony as a laboratory of hygiene and
modernity, challenges also rose
CHRONOLOGICAL DEVELOPMENT OF PUBLIC
HEALTH DURING THE AMERICAN PERIOD
-After the end of Spanish rule, the Filipino
Revolutionary Government was established, including
a Bureau of Public Health
-Under General Wesley Merritt, a Board of Health for
supervising public health was established on
September 29, 1898.
-American major general who served in the cavalry of
the United States Army. Following the latter war, he
became the first American Military Governor of the
Philippines.
 July 1, 1901
-The Board of Health for the Philippine
Islands was established. The Board soon
became the Insular Board of Health as
provincial and municipal boards were created.
 The Insular Board of Health- was
given the power to draft legislation for
sanitary and medical practices in the
Philippines. They were tasked with studying
diseases and prevention methods, as well as
overseeing public health.
 Importance to public health was the
establishment of the Bureau of Science in
1905. Working in close
collaboration with the Philippine General
Hospital and the University of the Philippines,
it became an active center for scientific
instruction and research and made valuable
contributions to public health.
1902-1906
 Leprosy and Cholera- when American forces
landed in the Philippines, leprosy was rampant
—thousand cases were developing each year.
 October 17, 1902 - American forces then
decided to establish Culion Leper Colony
under the supervision of Director of Health
Victor Heiser.
 May 27, 1906, did the first 370 patients from
Cebu land on Culion.
 A vessel carrying cholera from Hongkong
arrived in Manila in March 1902 causing a
commotion between the Americans and
Filipinos.
 American officials resorted to lockdowns and
even burning the houses of cholera victims. As
a response, Filipinos with sick family members
went hiding, and some, because of their fear,
massacred white people.
 Heavy rains came in 1903, and washed away
the cholera-infected sewage; dates the end of
the epidemic as February 1904 with 109,
461 casualties.
1912-1919
- Campaign against hookworm was launched
-Anti-dysentery vaccine as first tried locally
 Bubonic plague and Influenza- It was spread
by rats and fleas on them. To contain the
disease, the main entry point, the port, was
controlled. Americans told the Filipinos to
protect themselves from rats, so ratcatchers
like cats, even pythons were utilized at the
time. The American sanitation officials also
paid people five centavos for every rat caught
or killed.
 The 1918 influenza pandemic was one of the
most virulent epidemics ever to hit the
American occupied Philippines. Areas hit by
the first wave of infections in the middle of
1918 had fewer deaths during the more
virulent episode at the end of the year.
-Regions “that were mostly open to global
commerce” outside of Manila were hit hard
during the second wave later in the year. And it
was said that the Philippines surpassed the
epidemic and concluded that the epidemic
was short-lived and would be blown away by a
well-timed typhoon.
1916
-A Committee was appointed to study the
cause and prevalence of typhoid fever. Jones
Law, after Francis Burton has been appointed.
Harrison's tenure as Governor-General
resulted in the implementation of the Jones
Law, which encouraged more Filipinozation.
1913-1934
-The composition, value and vitamin
distribution of many Philippine foods were
studied.
- This is part of the drive for better nutrition.
1917
- The Board of Health’s biggest challenge was
smallpox, which they battled by standardizing
vaccine production and campaigning for
vaccination.
-When the US mandated a mass smallpox
vaccination program in the Philippines in
1917, about 25 million shots were given to
Filipinos.
-An estimated 163,000 Filipinos came down
with the disease after the vaccination, and
75,339 of them died from it.
1919
-Schick test was first used on a large scale to
determine the susceptibility of Filipino
children to diphtheria.
1921
-The Rockefeller Foundation expanded its
collaboration. Government and Rockefeller
fellows were dispatched overseas to train a
corps of qualified 4 public health men capable
of taking on leadership responsibilities.
 Dr. Jacobo Fajardo
-Director of Health
 Dr. Jose Fabella
- first Secretary of Health and
Welfare, were among them.
1922-1923
-Role of seafood in transmission of cholera and of
pollution of the fishing sector to typhoid were studied.
1923
-First training course for sanitary inspector Sewage of
Manila purified by hypochlorite
1924-1926
-Mechanism of transmission through Aedes Aegypti of
dengue fever was studied successfully.
-Construction of Novaliches dam started and there
was the success of the first rapid sand treatment to
purify water of a swimming pool constructed at state
university.
-Legislation was passed for the establishment of the
School of Hygiene and Public Health with support from
the Rockefeller Foundation.
1927
-The National Research Council of the Philippines
was founded and officially established in 1934 to
encourage comprehensive research programs in the
basic sciences, with a focus on health and medical
research.
1928
-Bachelor of Science in Education, major in health
education was offered in University of the Philippines
1929-1930
-Compulsory notification and inoculation for reportable
disease was affected
-Law was enacted to establish a civil registry
-The Tuberculosis Commission was created
1932
-Free Emergency Medical Treatment for Laborers was
offered.
-Industrial Hygiene and Sanitation were initiated.
- The Philippine Public Health Association was
organized
- Building of School Hygiene and Public Health
(Donation of Rockefeller Foundation) was constructed
and the first Child Health Day observed.
1933 Reorganization Act - consolidating public health
and welfare activities under the Commission of Health
and Welfare was promulgated.
Conclusion: In a glimpse, the contributions of the
Americans during this period towards the development
of Public Health here in the Philippines were focused
mainly on establishing the concept of sanitation,
addressing the contemporary pandemics and other
major crises like Cholera, Influenza, Smallpox, and
surprisingly the deadliest plague on the world’s history,
the Bubonic plague. Bureaus, foundations, and councils
were organized for a single purpose to establish the
good quality of life and health of the general public.
Within the creation of these institutions came the
promulgation of laws and acts consolidating public
health. All of these are the developments in the Public
Health of the Philippines during the American Period
Japanese Era (1942-1945)
-The gains of the Commonwealth, however, were soon
crushed by the onslaught of the conquering Japanese
Imperial Forces.
 December 7, 1941 (Ph time) - the Japanese
bombed Pearl Harbor in Hawaii. After this, the
United States of America officially announced
a war between the Japanese.
 December 8, 1941 - The Philippines, as an
American ally, found itself at war. 10-hours
after the attack on Pearl Harbor, Japanese
troops landed on Manila port.
 January 30, 1942 - President Quezon’s
Executive Secretary Jorge Vargas became the
Chairman of the Philippine Executive
Commission which replaced the
Commonwealth government.
 Jorge Vargas - Instituted by the Japanese
Imperial Forces, he issued Executive Order
No.1, which placed the Bureau of Health
including the Quarantine Service, under the
newly formed Department of Health and
Public Welfare.
 March 11, 1942 - After struggling against
great odds to save the Philippines from
Japanese conquest, U.S. General Douglas
MacArthur escaped the fortress under the
order given by President Franklin Roosevelt.
 Claro M. Recto - He served as Commissioner
of Education, Health, and Public Welfare, with
Dr. Eusebio Aguilar as Director of Health from
1942-1943.
 Dr. Mariano Icasiano - Much of the badly
needed services during the war were carried
out by the city’s Health Service Branch, under
Dr. Mariano Icasiano. Despite of the lack of
resources, he continuously provided health
services to ill and injured patients during the
war
 September 2, 1945 - the Japanese Empire
formally surrendered.
 1945 - The Commonwealth was re-established
upon the liberation of Manila. President Sergio
Osmena with General Douglas MacArthur and
Secretary of Interior Jose Zulueta restored the
Department of Health and Public Welfare,
which had stopped operations when the
government was in exile
PUBLIC HEALTH CONDITION DURING THE JAPANESE
OCCUPATION
-The Japanese Occupation was relatively brief, lasting
from 1942 to 1945. But for the Filipinos who lived in
fear and deprivation, those years were a long, horrible
nightmare. Condition of the country’s health during
Japanese occupation:
o Food and medicine were scarce
o Rampant malnutrition and unsanitary
conditions on the metropolis.
o Diseases like malaria and tuberculosis raged
over the country.
o Over 5,000 previously segregated lepers
escaped in search of food.
o The spread of infectious diseases was
uncontrollable as no hygienic standard could
be used
- A smattering of health directives regarding the
operation of sanitary markets, the distribution of milk,
and submission of reports concerning outbreaks of
diseases were issued between 1942 and 1943.
In the following years, 3 Health Institutions were
created:
1. Philippine Malaria Relief Association
2. Board of Nutritional Research
3. Medicinal Plant Committee
 The Asociacion Feminista Filipina
-Built a milk station, Gota de Leche (“Drop of
Milk”). GOTA DE LECHE
-This facility took care of children suffering from
beriberi and malnutrition. It was used for milk
rationing, providing milk for babies whose mothers
were unable to breastfeed and serving as a
puericulture center during the war
PUBLIC HEALTH CONDITIONS IN THE POST-WAR
PHILIPPINES:
-Cases of infectious diseases were high
-malnutrition and beriberi were widespread
-public sanitation was in a horrible state
-Destruction of health infrastructure posed new
threats of cholera, plague, and other epidemics.
Conclusion:
 the Japanese period grappled with the healthcare
system of the Philippines. It was severely affected
due to the onslaught of war, and many died because
of the lack of resources that are needed on a daily
life basis.
 We can also see that when the public health system
is neglected, the nation will suffer from epidemics,
widespread diseases, and inadequate access to
medical services.
 A nation cannot survive without a proper public
health system as it caters to the citizens' wellbeing,
prevents the spread of infectious diseases, and
provides accessible and quality healthcare
regardless of the status or disparity in society.
 This also provides an avenue for prolonging life
and promoting health, preventive measures, and
efficiency. With this, it improves the life expectancy
and overall wellness of diverse populations
PHILIPPINE PUBLIC HEALTH DURING POST-WORLD
WAR II
-Public Health infrastructures need to reflect that is
an interdisciplinary pursuit with a commitment to
equality. Public participation, sustainable
development and freedom war. As such it is part of
a global commitment and strategy
-Destruction of health infrastructure posed new
threats of cholera, plague, smallpox, and other
epidemics. War had indeed left the nation in a
weakened state. But with the end of the
Commonwealth period in sight, nothing deterred
the nation further from achieving the dream of
independence.
1940’s
- Post-war survey of public health condition
- Emergency measure passed by U.S Congress
through the Philippine Rehabilitation Act of 1946
-Joint cooperative agreement between U.S.P.H.S and
the Philippines Secretary of Health and Welfare
-Separation of the country’s health and public
welfare office through Executive Order No. 94
1960’s
 1965
-The Family Planning Association of the
Philippines was organized while the Family
Relation Center served as the nucleus for the
Planned Parenthood Movement of the Phil.
- Medicare and Medicaid were established.
 August 4, 1969- President Ferdinand E. Marcos
signed the Philippine Medical Care Act, more
popularly known as “Medicare.”
 Launched in 1963, the MARIA project ran for
seven years, extending health services to rural
areas in the Philippines deemed “doctorless.”
The same period saw the creation of several offices:
 The Dental Health Services (1963)
 Malaria Education Services (1966)
 Disease Intelligence Center (1961)
 Division of Nutrition (1960)
 Food and Drug Administration (1963)
 National Schistosomiasis Control Commission,
National Nutrition Program (1968)
1970’s
-By the early 70's improved biologicals were
produced and widely used which proved as a
breakthrough in public health in the prevention
and control of communicable diseases.
 May 15 1970- the Commission on
Population was created an intersectoral body
 Aug 16 1971
- R.A. No. 6365 approved the Population Act
of the Philippines.
- Many foreign assistants came in:
 USAID
 IPPF
 Pop. Council of New Work
 Pathfinder Fund
 Ford foundation
 WHO
 UNDP
 Rockefeller Foundation
 Church World Service
Sept. 21, 1972- At the height of all these developments
in public health came the declaration of the Martial law
-In Spite of the political change, the Ministry of Health
continued to function in accordance with the public
health structure previously laid. Acted as Ministers of
Health during this period were Drs. Clemente
Gatmaitan, Enrique Garcia and Azurin
Conclusion:
 Indeed, the post-World War 2 is unbelievable
and left a mark that makes the Philippines in a
weakened state. Filipinos lived in fear, hunger,
and deprivation. Our nation had experienced a
huge deal of death and spreading disease that
had no cure that can also cause farewell.
 An estimated 1 million of Filipinos were killed
in the war. Manila was severely damaged; the
one was selected as headquarters for the WHO.
And also, the lack of several things in terms of
health, such as medical materials. Lack of
medicine and vaccinations. Activities and
programs of public health did not continue
because of war. Doctors are still researching
several undiscovered cases of infectious
diseases.
 And different kinds of acts and laws that
provide in terms of health. Despite what the
nation and people have been through, they
keep moving forward, vision the near future,
and look at the bigger picture because
whatever happens there's a reason behind it.
And challenges are a part of life. I must say the
war is tough but we are tougher.
FACTORS AFFECTING PUBLIC HEALTH:
1. Biological – Age distribution, gender distribution,
genetic makeup distribution, immunity status
2. Behavioral – prevalence of healthy behaviors,
prevalence of unhealthy behaviors
3. Social – economic conditions, occupational
distribution, politicals milieu
4. Cultural - Religion, racial and ethnic profile
5. Organization – Ways and extents of organization
within the community, healthcare, housing,
education
6. Environmental – Quality of air, environmental
sanitation, quality of water supply, quality of food.

CURRENT CHALLENGES:
 Providing effective interventions for chronic
disease prevention
 Developing tools and methods for dealing with
infectious diseases
 Strengthening mental health problems and
services including violence prevention
 Strengthening local and state health departments
 Adequate training of community and public health
professionals
 Achieving universal health care coverage
 Protecting environmental health
 Being prepared to deal with terrorist activities,
including bioterrorism
 Combating health disparities
 Used of health technology (iHEALTH, telemedicine)
 Reducing use of alcohol, tobacco and other drugs
 Accurately communicating health risk
 Prevention of disabilities and providing effective
rehabilitation for the disabled
 Designing child and elder abuse prevention
programs
 Working toward global health.

HAND WASHING

 Hand Hygiene
- single most important measure to avoid the
transmission of harmful germs and microorganisms
and/or disease-causing pathogens/microbes prevent
health care-associated infections.
-the most important measure to avoid the transmission
of harmful germs and prevent health care-associated
infections

 Hands- are the main pathways of germ
transmission during health care.
 Hand Washing
-Washing hands with plain or antimicrobial soap.
With the use of Soap (Bar or Liquid), Lavatory with
faucet and running water, and Paper Towel/Tissue
Paper.
 Hand Rub
-Rubbing hands with an alcohol-containing
preparation (liquid, gel or foam) designed to
inactivate microorganisms and/or temporarily
suppress their growth. With the use of 70%
Alcohol.
 Soap
-Antimicrobial (medicated) soap
-containing an antiseptic agent at a concentration
sufficient to inactivate microorganisms and/or
temporarily suppress their growth.
 Soap (detergent) - dislodge transient
microorganisms or other contaminants from the
skin to facilitate their subsequent removal by water.
effective in protecting your skin from potential
contamination.
 Masks are worn to protect against inhalation of
droplets containing microorganisms from infective
patients.
 Masks and goggles are worn to protect the
mucous membranes of the mouth, nose, and eyes
from splashing of body substances.
 Face shields also protect the mucous membranes
from splashes.
 Respirators- may be required when collecting
blood from patients who have airborne diseases,
such as tuberculosis.
-With the increased incidents of antibiotic-resistant
tuberculosis and the appearance of new strains of
influenza viruses, respirators have become more
routinely used.

 Alcohol -65 – 95% Alcohols have excellent in vitro

germicidal activity against gram-positive and gram-
negative vegetative bacteria

 (PPE) Personal Protective Equipment

- specialized clothing or equipment worn by an
employee for protection against infectious
materials and patients.
-The most important in preventing transmission of
the microorganisms not only in treatment centers
and hospitals but also in various activities, e.g.
cleaning, waste management, and community care
related to the outbreak.

 Gowns- are worn to protect the clothing and skin

of health-care workers from contamination by
patient body substances and to prevent the transfer
of microorganisms out of patient rooms.
 Fluid-resistant gowns- should be worn when the
possibility of encountering splashes or large
amounts of body fluids is anticipated.
 Gowns tie in the back at the neck and the waist
and have tightfitting cuffs. They should be large
enough to provide full body coverage, including
closing completely at the back.

 Disposable Gloves- it is crucial to use them when

handling hazardous materials, including body
tissues. These tissues are potentially hazardous due
to the presence of bloodborne pathogens and other
infectious agents.

 Gloves and coats

-do not fully protect against needlestick accidents,
but they can prevent the transfer of hazardous
materials to your skin. This includes any cuts or
abrasions you may have on your skin, which can be
infected if exposed to contaminants.

-Always replace gloves immediately if they are torn

or punctured. This ensures that the gloves remain