Hilera residents stigmatized by swine flu
CABANATUAN CITY, Philippines -- The farming village of Hilera (pop: 1,622), about six kilometers north of the Jaen town proper in Nueva Ecija, is one of the last places one would expect to find or catch the Influenza A (H1N1) virus.
It is seldom visited by out-of-towners in cars or even jeepneys and tricycles, and, some residents say, no "balikbayan" has visited the village, some residents said. Of the 198 pupils in the village's public elementary school, only one was reported to have left the village in recent weeks, for a visit to a Bulacan town a week before the opening of classes.
"We didn't expect that Hilera would have H1N1 cases," said Dr. Milgrace Santos, town health officer, in a telephone interview. "But there is no panic… because the victims were reported to be doing well now."
Hilera is the first community in the country where H1N1 infections have been confirmed. Its residents have started to feel the stigma, following confirmation from health officials that 11 cases of swine flu have turned up in the village.
Despite this, many have remained cooperative with health authorities.
"There's no panic among them but some residents say parang iniiwasan sila pag nalamang galing sila sa Hilera (it seems they are being avoided when people learn they live in Hilera). Some do feel stigmatized but many are very cooperative," Dr. Rio Magpantay, director of the Department of Health in Central Luzon, replied when asked how villagers were reacting to the DOH's interventions in the place.
Jaen Mayor Santiago Austria confirmed the information from Magpantay.
"Pakiramdam nila parang nandidiri sa kanila (They feel that some people shrink away from them)," Austria told the Inquirer in a telephone interview on Saturday.
This, he said, is a reaction of people overly concerned about their health.
Trying to counter the feeling of stigma or fear of coming out and seeking treatment, Austria said he has been staying in Barangay Hilera to reassure villagers there.
"Ang sinasabi ko po ay, 'Halikayo at magtiwala kayo.' Binabago po natin ang pagtingin nila (I tell them, 'Come and trust me.' We want to change how they treat this situation)," he said.
Austria said he has also joined the DOH-led teams of health workers who visit houses in the municipality to identify those showing symptoms of swine flu.
Others go straight to the DOH command post at the Hilera Elementary School to submit to a medical checkup, Magpantay said.
Mercy Gatus, 48, a resident who has a Grade 5 daughter in the village school, said they go on with their usual activities despite the disease.
"I observed that many of the children here appeared to be well and were always playing," she said in Filipino.
Gatus said the one good thing that happened to their village is that there are many health personnel going around and they get free consultation and free medicine.
Eight of the 11 children confirmed infected with H1N1 have been recovering well, meaning they don't have fever anymore, he said. The other three children still have cough and runny noses.
The 11 children belonged to the first batch tested last Sunday. Ten of them are students of the Hilera Elementary School. The 11th child is four years old.
The DOH has not yet received the results of tests done on the second batch of 19 students and adult residents, said Magpantay.
The expanded surveillance started on Friday in Hilera's neighboring villages of Kalabasa, Pitak, Pakul and Lambakin.
As of 4 p.m. on Saturday, the DOH had documented 43 cases in Lambakin and more than 20 others in Pakul, he said. Most of them were children aged 11 to 12.
The number of people with influenza-like illnesses in Lambakin and Pakul are slightly higher than those in Hilera, which counted 57 on Thursday.
Magpantay said the DOH would only do throat swabbing on residents of Lambakin and Pakul if their symptoms -- fever, coughing, diarrhea and vomiting -- turned from mild to worse.
"What we're doing now is early detection and treatment," he said of the DOH approaches in Jaen.
Aside from the 30 health personnel working on shifts in Hilera, barangay health workers have also been mobilized for house visits.
Magpantay said he has recommended the resumption of classes at the Hilera Elementary School and in the four nearby villages on Monday.
"The 11 cases we have [in Hilera] are mild and they've responded well to the medication. While we have influenza-like illnesses in other villages, they are also mild. We don't have a community-level outbreak. The virus appeared to have come from one source," he said.
Dr. Mario Ramirez, regional director of the Department of Education, has not confirmed if he has agreed to the reopening of classes in Hilera.
Magpantay said his "closest theory" on the source of the infection was the exposure of the children and some adult residents to a team of doctors and nurses that conducted a medical mission in Hilera on May 31. Residents from nearby villages also availed themselves of medical services there.