1
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Lasco G, Yu VG. Pampalibog: chemsex, desire and pleasure in the Philippines. Cult Health Sex 2024; 26:143-158. [PMID: 37000038 DOI: 10.1080/13691058.2023.2192256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/14/2023] [Indexed: 04/01/2023]
Abstract
This article draws from qualitative interviews to provide the first in-depth exploration of reasons for engaging in chemsex in the Philippines. It articulates the many forms that drugs assume as pampalibog, or enhancers of libido, demonstrating the multidimensional pleasures of chemsex along overlapping sensorial and affective planes. By showing the inextricability of the corporeal to the affective, and of the emotional to the erotic, we contend that chemsex also involves the embodied and performed attainment of pleasure. As such, chemsex is both central to modern sexual scripts yet also a negotiable aspect of any sexual encounter. In constructing this rare account of drug use in settings of pleasure in the Philippines, we situate chemsex within a historical pattern of bodily tinkering and, more significantly, demystify people who use drugs by departing not only from global public health's pathologising approach to chemsex, but also from the scholarly tendency to locate drug use in the country within scenes of hardship and marginalisation.
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Affiliation(s)
- Gideon Lasco
- Development Studies Program, School of Social Sciences, Ateneo de Manila University, Quezon City, Philippines
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | - Vincen Gregory Yu
- Development Studies Program, School of Social Sciences, Ateneo de Manila University, Quezon City, Philippines
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2
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Feliciano EJG, Ho FDV, Yee K, Paguio JA, Eala MAB, Robredo JPG, Ng K, Lim J, Pyone KT, Peralta CA, Flores JA, Yao JS, Santos PMG, Ang CDU, Lasco G, Chan JSK, Tse G, Tangco ED, Kingham TP, Chitapanarux I, Bhoo-Pathy N, Legaspi GD, Dee EC. Cancer disparities in Southeast Asia: intersectionality and a call to action. Lancet Reg Health West Pac 2023; 41:100971. [PMID: 38053740 PMCID: PMC10694578 DOI: 10.1016/j.lanwpc.2023.100971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/27/2023] [Accepted: 11/05/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Erin Jay G. Feliciano
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
- Department of Medicine, NYC H+H/Elmhurst, Icahn School of Medicine at Mt. Sinai, Queens, NY, USA
| | | | - Kaisin Yee
- SingHealth Duke-NUS Global Health Institute, Singapore, Singapore
| | - Joseph A. Paguio
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Michelle Ann B. Eala
- University of the Philippines College of Medicine, Manila, Philippines
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Janine Patricia G. Robredo
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
| | - Kenrick Ng
- Department of Medical Oncology, St Bartholomew’s Hospital, Bart’s Health NHS Trust, London, UK
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khin Thuzar Pyone
- Radiation Oncology Department, Yangon General Hospital Yangon, Myanmar
| | | | | | - J. Seth Yao
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Patricia Mae G. Santos
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christian Daniel U. Ang
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | - Gideon Lasco
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | | | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
- Kent and Medway Medical School, Canterbury, UK
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Enrico D. Tangco
- Department of Radiation Oncology, The Medical City, Pasig City, Philippines
| | - T. Peter Kingham
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence Based Practice, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Gerardo D. Legaspi
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines Manila, Philippine General Hospital, Metro Manila, Philippines
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Lasco G. Not All Citations Are Equal: Reflections from Medical Anthropology in the Philippines. Med Anthropol Q 2023; 37:217-224. [PMID: 36996073 DOI: 10.1111/maq.12758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Long before recent calls to decolonize anthropology, practitioners of "national anthropologies"-such as local anthropologists from/in/of the Philippines-have sought to implement a more inclusive kind of scholarship, and this has been reflected in their citational practices. Indeed, a look at the scholarly output of Philippine anthropologists would show a diverse set of citations that feature local scholarship, including those written in Filipino. As I will show in this article, however, not all citations are equal. Theoretical and methodological citations are typically drawn from Euro-American scholars while scholarship from the Global South is typically invoked as illustrative examples, as parallels, and to set context. Such citational practices, I argue, are a consequence of particular disciplinary histories and divergent priorities. They reinforce the inequalities of power and academic capital within medical anthropology, raising the need for more reflexivity not just about whom medical anthropologists cite but for what reasons.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines, Quezon City, Philippines
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
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Yu VG, Lasco G, David CC, Baysic IS. 'Kontra-partido': Untangling oppositional local politics and health care devolution in the Philippines. Health Policy Plan 2023:czad039. [PMID: 37338203 DOI: 10.1093/heapol/czad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/17/2023] [Accepted: 06/19/2023] [Indexed: 06/21/2023] Open
Abstract
A long-recognized problem of health care devolution in many developing countries is its inextricability from the influences of local politics. This has been particularly self-evident in the Philippines, where, since the adoption of the Local Government Code of 1991, the devolution of health governance, planning, administration, and service delivery has placed the health system largely under the control of individual provinces, cities, municipalities, and villages or barangays. In this article, we utilize the notion of 'kontra-partido' (the Filipino term connoting 'oppositional politics') to concretize local, oppositional politics as a lived experience of health workers, government officials, and ordinary citizens in in the country. Through multi-sited qualitative fieldwork, we demonstrate how 'kontra-partido' politics ultimately worsens health outcomes in any locality. We show how such politics figures in the relational dynamics of health governance, often resulting in petty infighting and strained relationships among local health authorities; how it leads to the politicization of appointments and prevents the local workforce, especially those at the grassroots, from doing their jobs efficiently amid environments rife with hostile patronage; and how it impedes service delivery as politicians prioritize 'visible' projects (over sustainable ones) and selectively deliver health care to their known supporters. In turn, health workers and ordinary citizens alike have been actively negotiating their roles within this political milieu, either by joining the so-called political frontlines or engaging in the transactional relationships that develop between politicians and their constituents during perennial election seasons. We conclude with a reflection on the vulnerability of health to politicization and the visceral consequences of 'kontra-partido' politics to health workers, as well as an identification of possible areas of intervention for future policy reform, given the deepening political polarization in the country and the upcoming implementation of the recently passed Universal Health Care Law.
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Affiliation(s)
- Vincen Gregory Yu
- School of Government, Ateneo de Manila University, Quezon City, Philippines
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
| | - Gideon Lasco
- School of Government, Ateneo de Manila University, Quezon City, Philippines
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | - Clarissa C David
- School of Government, Ateneo de Manila University, Quezon City, Philippines
| | - Ivyrose S Baysic
- School of Government, Ateneo de Manila University, Quezon City, Philippines
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Lasco G, Yu VG. Taking Flight: Narratives, Logistics, and Risks of Chemsex Scenes in the Philippines. J Sex Res 2023:1-12. [PMID: 37042837 DOI: 10.1080/00224499.2023.2197426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Chemsex - the use of specific, illicit substances to facilitate and enhance sexual encounters - has been documented extensively across the Global North using qualitative methodologies. Elsewhere, however, little is known about the phenomenon. Our article addresses this gap in the scholarly literature by exploring how chemsex encounters transpire in the Philippines. Through semi-structured interviews, we demonstrate the spatiotemporal nature of chemsex scenes, showing how people move between physical and virtual domains across time as they find sexual partners, procure drugs, and organize and attend the actual encounter. Consequently, the risks faced by chemsex practitioners - to health and to security - are also spatiotemporally plotted within intersecting physical and virtual risk environments, and best mitigated by a form of experiential expertise that is likewise temporally determined. Ultimately, chemsex scenes in the Philippines are distinguished from the rest of the world by the state-led "war on drugs." We consider our findings in the context of this war, showing how its very real and often fatal threats have shaped the way people navigate chemsex scenes and mitigate the risks through "counterpublic health" measures, and how its prominent ideologies and discourses are reflected in the ways by which people make sense of their drug use.
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Affiliation(s)
- Gideon Lasco
- Development Studies Program, Ateneo de Manila University
- Department of Anthropology, University of the Philippines Diliman
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Lasco G. Drug testing in Philippine schools: Historical overview and implications for drug policy. Int J Drug Policy 2023; 113:103961. [PMID: 36758336 DOI: 10.1016/j.drugpo.2023.103961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 02/11/2023]
Abstract
With the stated aims of promoting "drug-free" campuses and "instilling in the minds of students" that drugs are harmful, drug testing in schools has been a feature of the Philippines' punitive drug regime for two decades, gaining prominence during the Duterte administration's war on drugs (2016-2022). Drawing on key informant interviews and a desk review of news articles and official documents, this paper presents a historical overview of this policy as well as its impacts on students, educational institutions, and Philippine society. The paper finds that the group most affected by drug testing in schools are the students themselves, who are placed at risk of discrimination and alienation. Schools are also affected by the policy, as it requires expending their human and financial resources. More broadly, the policy perpetuates longstanding popular notions on drugs, children, and the overall idea that individuals carry the "burden of proof" to demonstrate their worthiness for societal inclusion. Drug testing in Philippine schools is ineffective and misguided in its objectives, but it has received widespread support because of its social and political efficacies.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, Room No. 1317 Pavilion 1, 3/F Palma Hall, University of the Philippines Diliman, Quezon City 1101, Philippines; Development Studies Program, Ateneo de Manila University, Quezon City 1106, Philippines.
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Gonçalves JF, Lasco G. Anthropology, Democracy, and Authoritarianism. Current Anthropology 2023. [DOI: 10.1086/723300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Lasco G, Tan ML, Yu VG. 'Loob' and 'labas': Spatial constructions of safety and risk amid the COVID-19 pandemic in the Philippines. Health Place 2023; 79:102929. [PMID: 36542918 PMCID: PMC9676171 DOI: 10.1016/j.healthplace.2022.102929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 11/22/2022]
Abstract
This article argues that local constructions of risky and safe spaces, as articulated by the notions 'loob' (inside) and 'labas' (outside), informed popular and political responses to the COVID-19 pandemic in the Philippines, leading to an overemphasis on staying at home and, conversely, a general avoidance or fear of outdoor spaces that was at times reinforced by public health authorities. Practices and policies related to the pandemic response rendered this binary opposition between 'loob' and 'labas' visible, from regulations concerning the use of personal protective equipment to restrictions of access to outdoor spaces. While this emergent form of bodily proxemics was contested and negotiated over time, its tenacity throughout the pandemic underscores the importance of understanding how people spatialize risk in times of health crises.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Philippines,Development Studies Program, Ateneo de Manila University, Philippines
| | - Michael L. Tan
- Department of Anthropology, University of the Philippines Diliman, Philippines
| | - Vincen Gregory Yu
- Development Studies Program, Ateneo de Manila University, Philippines; Social Medicine Unit, College of Medicine, University of the Philippines Manila, Philippines.
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Abubakar I, Gram L, Lasoye S, Achiume ET, Becares L, Bola GK, Dhairyawan R, Lasco G, McKee M, Paradies Y, Sabharwal NS, Selvarajah S, Shannon G, Devakumar D. Confronting the consequences of racism, xenophobia, and discrimination on health and health-care systems. Lancet 2022; 400:2137-2146. [PMID: 36502851 DOI: 10.1016/s0140-6736(22)01989-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 12/13/2022]
Abstract
Racism, xenophobia, and discrimination are key determinants of health and equity and must be addressed for improved health outcomes. We conclude that far broader, deeper, transformative action is needed compared with current measures to tackle adverse effects of racism on health. To challenge the structural drivers of racism and xenophobia, anti-racist action and other wider measures that target determinants should implement an intersectional approach to effectively address the causes and consequences of racism within a population. Structurally, legal instruments and human rights law provide a robust framework to challenge the pervasive drivers of disadvantage linked to caste, ethnicity, Indigeneity, migratory status, race, religion, and skin colour. Actions need to consider the historical, economic, and political contexts in which the effects of racism, xenophobia, and discrimination affect health. We propose several specific actions: a commission that explores how we action the approaches laid out in this paper; building a conversation and a series of events with international multilateral agency stakeholders to raise the issue and profile of racism, xenophobia, and discrimination within health; and using our multiple platforms to build coalitions, expand knowledge, highlight inequities, and advocate for change across the world.
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Affiliation(s)
- Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK.
| | - Lu Gram
- Institute for Global Health, University College London, London, UK
| | - Sarah Lasoye
- Institute for Global Health, University College London, London, UK
| | | | - Laia Becares
- Department of Social Work and Social Care, University of Sussex, Brighton, UK
| | | | | | - Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | - Martin McKee
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne, VIC, Australia
| | - Nidhi S Sabharwal
- Centre for Policy Research in Higher Education, National Institute of Educational Planning and Administration, New Delhi, India
| | | | - Geordan Shannon
- Institute for Global Health, University College London, London, UK
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
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Seguin M, Mendoza J, Lasco G, Palileo-Villanueva LM, Palafox B, Renedo A, McKee M, Balabanova D. Strong structuration analysis of patterns of adherence to hypertension medication. SSM Qual Res Health 2022; 2:None. [PMID: 36531298 PMCID: PMC9748305 DOI: 10.1016/j.ssmqr.2022.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/29/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
Achieving blood pressure control is among the highest priorities for reducing the burden of cardiovascular diseases globally. Control is poor in the Philippines, especially in socioeconomically marginalised communities. This paper explores long-term adherence to anti-hypertensive medication in these communities, identifying 4 distinct medication adherence patterns. We draw on Strong Structuration Theory to explore motivations of action for those who are consistently adherent, consistently non-adherent, and those who became more or less adherent over time. We employ longitudinal qualitative methods comprising repeat interviews and digital diaries collected over 12 months by 34 participants. Twelve participants were consistently adherent, 9 consistently non-adherent, 9 increasingly adherent, and 4 increasingly non-adherent. For the consistently adherent, positive views about prescribed medication and family support encouraged adherence. Conversely, negative views of medication and lack of family support were notable amongst the consistently non-adherent, along with resistance to accepting a 'sick' label. A shift toward positive views of medication was detected amongst those whose adherence improved, along with worsening health and increased family support. A decrease in financial resources drove some participants to become less adherent, especially if they already held negative views toward medication. This study sheds light on the variety of medication adherence patterns among poor people with hypertension in the Philippines, as well as the complex web of elements influencing their treatment choices. The results point to the potential for measures that address concerns about medicines and increase family support.
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Affiliation(s)
- Maureen Seguin
- The Centre for Global Chronic Conditions, The London School of Hygiene and Tropical Medicine, UK
| | - Jhaki Mendoza
- College of Medicine, University of the Philippines Manila, Philippines
| | - Gideon Lasco
- Development Studies Program, Ateneo de Manila University, Philippines.,Department of Anthropology, University of the Philippines Diliman, Philippines
| | | | - Benjamin Palafox
- The Centre for Global Chronic Conditions, The London School of Hygiene and Tropical Medicine, UK
| | - Alicia Renedo
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, UK
| | - Martin McKee
- The Centre for Global Chronic Conditions, The London School of Hygiene and Tropical Medicine, UK
| | - Dina Balabanova
- Department of Global Health & Development, London School of Hygiene and Tropical Medicine, UK
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Lasco G, Renedo A, Mendoza J, Seguin ML, Palafox B, Palileo‐Villanueva LM, Balabanova D, McKee M. 'Doing' hypertension: Experiential knowledge and practice in the self-management of 'high blood' in the Philippines. Sociol Health Illn 2022; 44:1167-1181. [PMID: 35929521 PMCID: PMC9540552 DOI: 10.1111/1467-9566.13503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 05/15/2022] [Indexed: 05/15/2023]
Abstract
Patients' embodied experiences do not always correspond to the biomedical concepts of particular diseases. Drawing from year-long fieldwork in the Philippines that involved semi-structured interviews, focus group discussions and digital diaries, we examine how individuals 'do' hypertension through their embodied experiences and the knowledge and practice that emerge from them. Drawing inspiration from Annemarie Mol's work on the notion of 'multiplicity' of disease, our analysis was informed by a commitment to privileging patients' embodied experiences and the multiple ontologies of hypertension. We find that for patients diagnosed with hypertension in the Philippines, symptoms enact illness; patients rely on their own embodied knowledge to define their illness' nature (e.g., diagnosis), experience (e.g., frequency of symptoms and non-chronicity) and praxis (e.g., self-care practices). We show how this knowledge gained from having embodied experiences of living with the disease interacts in various ways with biomedical knowledge, other diagnostic labels and clinical practices, to shape how hypertension manifests and is managed by patients. Beyond interrogating the relationship between what counts as a 'disease' and what is considered a 'symptom', our findings underscore the need to pay attention instead to the mutually co-constitutive processes of embodied experiences and disease categories in co-producing patient knowledge.
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Affiliation(s)
- Gideon Lasco
- Department of AnthropologyUniversity of the Philippines DilimanQuezon CityPhilippines
- Development Studies ProgramAteneo de Manila UniversityQuezon CityPhilippines
| | - Alicia Renedo
- Department of Global Health & DevelopmentLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jhaki Mendoza
- College of MedicineUniversity of the Philippines ManilaManilaPhilippines
| | - Maureen L. Seguin
- Centre for Global Chronic ConditionsLondon School of Hygiene and Tropical MedicineLondonUK
| | - Benjamin Palafox
- Centre for Global Chronic ConditionsLondon School of Hygiene and Tropical MedicineLondonUK
| | | | - Dina Balabanova
- Department of Social and Environmental Health ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - Martin McKee
- Centre for Global Chronic ConditionsLondon School of Hygiene and Tropical MedicineLondonUK
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Lasco G. "I Think I Have Enough for Now": Living with COVID-19 Antibodies in the Philippines. Med Anthropol 2022; 41:518-531. [PMID: 35771129 DOI: 10.1080/01459740.2022.2089569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Drawing on face-to-face and virtual fieldwork in the Philippines, I document the emergence of antibody testing as a popular practice among Filipinos during the COVID-19 pandemic, helping them make decisions about vaccines and other life choices. Antibodies gave people a sense of agency and control amid a health crisis for which political and medical authorities failed to offer certainty and hope, particularly at a time of vaccine scarcity and viral surges. However, by diverting attention from the health care system to individual immune systems, antibodies also reinforced the individual "responsibilization" that has characterized the Philippine government's pandemic response.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines.,Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
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13
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Lasco G, Yarcia LE. The Politics of Drug Rehabilitation in the Philippines. Health Hum Rights 2022; 24:147-158. [PMID: 35747271 PMCID: PMC9212821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The international consensus to end compulsory drug treatments and close forced rehabilitation facilities needs urgent transformation to country policies. In the Philippines, as with other countries in Asia, rehabilitation can be compulsory and is seen as the humane alternative to the "war on drugs." In this paper, we present the landscape of rehabilitation and narrate the ways in which people who use drugs are forced to undergo treatment. We unpack the politics behind rehabilitation and explain the sociocultural foundations that support compulsory treatment. We argue that a transition to a human rights-based approach, including voluntary alternatives in community settings, is possible by capitalizing on the reforms that are, unwittingly, the result of the "war on drugs."
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Affiliation(s)
- Gideon Lasco
- Senior lecturer in the Department of Anthropology, University of the Philippines Diliman, and a research fellow at the Ateneo de Manila University’s Development Studies Program, Quezon City, Philippines.,Please address correspondence to Gideon Lasco. .
| | - Lee Edson Yarcia
- Senior lecturer in medical jurisprudence and constitutional law at the College of Law, University of the Philippines Diliman, Manila, Philippines, and a drug policy expert at the United Nations Joint Programme for the Protection and Promotion of Human Rights in the Philippines
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Eala MAB, Maslog EAS, Robredo JPG, Pedro RJLS, Medina PVN, De la Paz EP, Lasco G. Violence against health-care workers in the Philippines. Lancet 2022; 399:2012-2013. [PMID: 35644150 PMCID: PMC9135372 DOI: 10.1016/s0140-6736(22)00785-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/19/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Michelle Ann B Eala
- College of Medicine, University of the Philippines Manila, Manila 1000, Philippines.
| | | | | | | | - Paolo Victor N Medina
- Department of Family and Community Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Edelina P De la Paz
- Department of Family and Community Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Gideon Lasco
- Social Medicine Unit, University of the Philippines Manila, Manila 1000, Philippines; Development Studies Program, Ateneo de Manila University, Quezon City, Philippines; Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
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Affiliation(s)
- Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Gideon Lasco
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines; Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
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Lasco G. Anthropological Responses to COVID-19 in the Philippines. Anthropology in Action 2022. [DOI: 10.3167/aia.2022.290104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This article reflects on the roles anthropologists have played in responding to the COVID-19 pandemic in the Philippines, and identifies the challenges – from the methodological to the political – they faced in fulfilling these roles. Drawing on the author’s personal and professional experiences in the country, as well as on interviews with other anthropologists, this article identifies three major roles for anthropologists: conducting ethnographic research; bearing witness to the pandemic through first-person accounts; and engaging various publics. All these activities have contributed to a greater recognition of the role of the social sciences in health crises, even as anthropologists struggle to gain the same legitimacy as their clinical and public health counterparts. The article concludes by making recommendations that can better prepare local anthropologists in responding to future health crises.
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Affiliation(s)
- Gideon Lasco
- Senior Lecturer, University of the Philippines Diliman, Philippines
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17
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Abstract
In this essay, I show that notwithstanding the undeniable colonial origins of punitive drug policies around the world, such policies have figured in nationalist projects and populist platforms in various postcolonial states, and today they are viewed as local responses to the 'drug problem.' Instead, it is harm reduction and other efforts to reform drug policies that are seen as a colonial, or Western, imposition. I argue that to overcome such perceptions, there is a need to decolonize harm reduction alongside decolonizing drug policies. I conclude by offering recommendations toward this move, including involving Global South actors in leadership positions within the harm reduction movement, supporting pilot harm reduction programs in postcolonial states, and highlighting local scholarship.
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Affiliation(s)
- Gideon Lasco
- University of the Philippines Diliman, Rm. 1317 3/F Palma Hall, Diliman, 1101, Quezon City, Philippines.
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18
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Mendoza JA, Lasco G, Renedo A, Palileo-Villanueva L, Seguin M, Palafox B, Amit AML, Pepito V, McKee M, Balabanova D. (De)constructing 'therapeutic itineraries' of hypertension care: A qualitative study in the Philippines. Soc Sci Med 2021; 300:114570. [PMID: 34802782 PMCID: PMC7613024 DOI: 10.1016/j.socscimed.2021.114570] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 10/11/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
Abstract
Hypertension, a major risk factor for non-communicable diseases, remains poorly controlled in many countries. In the Philippines, it is still one of the leading causes of preventable deaths despite the accessibility and availability of essential technologies and medicine to detect and treat hypertension. This paper characterizes the ‘therapeutic itineraries’ of people with hypertension from poor communities in rural and urban settings in the Philippines. We employ longitudinal qualitative methodology comprised of repeat interviews and digital diaries using mobile phones from 40 recruited participants in 12 months. Our findings demonstrate that therapeutic itineraries, rather than being organized according to categories that stem from the structure of the health system (i.e., diagnosis, treatment, follow-up, adherence), diverge from clinical pathways. Therapeutic itineraries begin at a stage we label as ‘pre-diagnosis’ (PD). Following this, itineraries diverge according to two possible entry points into the healthcare system: via incidental diagnosis (ID) whereby participants were diagnosed with hypertension without deliberately seeking care for hypertension-related symptoms and symptom-driven diagnosis (SD) whereby their diagnosis was obtained during a clinical encounter specifically prompted by hypertension-related symptoms. Participants whose itineraries follow the SD route typically oscillated between periods of regular and intermittent medical treatment, while participants who were diagnosed incidentally (ID) typically opted for self-care As we follow our participants’ therapeutic itineraries, we explore the confluence of factors informing their care journey, namely, their conceptions of hypertension, their social relationships, as well the choices and trade-offs they make. We conclude with policy implications from our findings, chief of which is our proposition that models of care based on mere access and availability of clinical interventions fail to reflect the complexity of people’s lay understanding and their lived experiences of hypertension and are thus ultimately unhelpful in improving its control.
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Affiliation(s)
- Jhaki A Mendoza
- College of Medicine, University of the Philippines Manila, Manila, 1000, Philippines.
| | - Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, 1111, Philippines
| | - Alicia Renedo
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | | | - Maureen Seguin
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Benjamin Palafox
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Arianna Maever L Amit
- College of Medicine, University of the Philippines Manila, Manila, Philippines; School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | - Veincent Pepito
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | - Martin McKee
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Dina Balabanova
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
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19
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Lasco G, Yu VG. Pharmaceutical messianism and the COVID-19 pandemic. Soc Sci Med 2021; 292:114567. [PMID: 34794852 PMCID: PMC8734002 DOI: 10.1016/j.socscimed.2021.114567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/12/2021] [Accepted: 11/12/2021] [Indexed: 12/04/2022]
Abstract
As part of their populist performances during disease outbreaks, public officials and politicians tend to offer ‘miracle cures’ or ‘wonder drugs’ that can supposedly treat or prevent the disease in question. This article analyzes contemporary instances of what we call ‘pharmaceutical messianism’ and proposes four characteristics for this phenomenon, namely, that it: (1) emerges during times of extraordinary health crisis; (2) builds on pre-existing knowledge, practices, and sentiments; (3) borrows from medical, often heterodox, authority; and (4) involves accessible, affordable, and/or familiar substances. Demonstrating the analytic value of our framework, we present three case studies, constructed using academic and journalistic sources, during the COVID-19 pandemic: hydroxychloroquine in France, ivermectin in the Philippines, and Covid-Organics in Madagascar. We conclude by identifying some implications of our findings on public health and avenues for future research.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Philippines; Development Studies Program, Ateneo de Manila University, Philippines.
| | - Vincen Gregory Yu
- Development Studies Program, Ateneo de Manila University, Philippines; Social Medicine Unit, College of Medicine, University of the Philippines Manila, Philippines
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20
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Affiliation(s)
- Peter Lloyd-Sherlock
- School of Development Studies, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK.
| | - Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Lucas Sempé
- School of Development Studies, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK
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21
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Abstract
With millions of cases and thousands of deaths every year in Asia and Latin America, dengue fever continues to be of global public health significance. This article uses the concept of 'medical populism' to analyse the political construction of the 2019 dengue epidemics in Bangladesh, the Philippines, and Honduras. Through this framework, we examine the narratives of these outbreaks by reconstructing how political actors simplified the discourse, spectacularised the crises, offered multiple knowledge claims, and forged divisions between the people and 'dangerous others'. Taken together, our case studies, obtained through government, journalistic, and scholarly sources, illuminate the role of medical populists (who are almost always politicians) in defining and responding to public health emergencies, underscoring the performative dimension of disease outbreaks. By detracting attention from less spectacular but more substantive policies and programs, these 'performances' of health crises perpetuate health inequities, especially in fragile democracies like the aforementioned Global South countries. We conclude by reflecting on the implications of medical populism to public health, health communications, and the inevitable recurrence of epidemics.
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Affiliation(s)
- Gideon Lasco
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines.,Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | - Vincen Gregory Yu
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
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22
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Yu VG, Lasco G, David CC. Fear, mistrust, and vaccine hesitancy: Narratives of the dengue vaccine controversy in the Philippines. Vaccine 2021; 39:4964-4972. [PMID: 34330555 DOI: 10.1016/j.vaccine.2021.07.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/14/2021] [Accepted: 07/19/2021] [Indexed: 11/16/2022]
Abstract
This article applies a qualitative approach to the 2017 dengue vaccine controversy involving Sanofi Pasteur's Dengvaxia to understand vaccine hesitancy and related anxieties in contemporary Philippines. Through a multisited project that investigated the health aspirations and lived experiences of low- and middle-income Filipinos across urban and rural Philippines, this article distills the perspectives of both ordinary community members and health workers in local and national capacities regarding the controversy-and how it altered their perceptions toward vaccines, health care, and government. Our study reveals widespread mistrust and fear in the communities toward both the state and health institutions following the controversy, with frontline health workers bearing the brunt of the communities' apprehensions, and the media partly responsible in fomenting these fears. Given the repetitive nature of health and vaccine controversies, this article suggests the importance of responsible journalism, well-calibrated crisis communications, and a people-centered health paradigm that involves exploring local contexts of vaccine hesitancy and mining people's lived experiences in tackling present and future health crises-especially now in the advent of COVID-19 vaccinations.
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Affiliation(s)
- Vincen Gregory Yu
- School of Government, Ateneo de Manila University, Quezon City, Philippines; Development Studies Program, Ateneo de Manila University, Quezon City, Philippines.
| | - Gideon Lasco
- School of Government, Ateneo de Manila University, Quezon City, Philippines; Development Studies Program, Ateneo de Manila University, Quezon City, Philippines; Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines.
| | - Clarissa C David
- School of Government, Ateneo de Manila University, Quezon City, Philippines
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23
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Abstract
Understanding people's concepts of illness and health is key to crafting policies and communications campaigns to address a particular medical concern. This paper gathers cultural knowledge on infectious disease causation, prevention, and treatment the Philippines that are particularly relevant for the COVID-19 pandemic, and analyzes their implications for public health. This paper draws from ethnographic work (e.g. participant observation, interviews, conversations, virtual ethnography) carried out individually by each of the two authors from February to September 2020. The data was analyzed in relation to the anthropological literature on local health knowledge in the Philippines. We find that notions of hawa (contagion) and resistensiya (immunity) inform people's views of illness causation as well as their preventive practices - including the use of face masks and 'vitamins' and other pharmaceuticals, as well as the ways in which they negotiate prescriptions of face mask use and physical distancing. These perceptions and practices go beyond biomedical knowledge and are continuously being shaped by people's everyday experiences and circulations of knowledge in traditional and social media. Our study reveals that people's novel practices reflect recurrent, familiar, and long-held concepts - such as the moral undertones of hawa and experimentation inherent in resistensiya. Policies and communications efforts should acknowledge and anticipate how these notions may serve as either barriers or facilitators to participatory care and improved health outcomes.
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Affiliation(s)
- Michael Lim Tan
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines.,Social Medicine Unit, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines.,Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
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24
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Lasco G, Yu VG, Palileo-Villanueva L. How ethics committees and requirements are structuring health research in the Philippines: a qualitative study. BMC Med Ethics 2021; 22:85. [PMID: 34210301 PMCID: PMC8246435 DOI: 10.1186/s12910-021-00653-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The last few decades have seen the rising global acknowledgment of the importance of ethics in the conduct of health research. But research ethics committees or institutional review boards (IRBs) have also been criticized for being barriers to research. This article examines the case of the Philippines, where little has been done to interrogate the health research and IRB culture, and whose circumstances can serve as reflection points for other low- and middle-income countries. METHODS Semi-structured interviews were conducted from July to October 2020 to elicit health researchers' perspectives and experiences regarding IRBs and the ethics approval process in the country, as well as counterpoint narratives from researchers who have also worked for IRBs. RESULTS Across the fields of clinical, public health, and social science research, the issue of ethics review revealed itself to be foremost an issue of inequity. IRB processes serve as a barrier for those outside the academe; those belonging to institutions, cities, or entire regions without their own accredited IRBs; and researchers working independently, without ample budget, or on highly specialized topics-more so for non-clinical researchers who must grapple with the primarily biomedical framework of most IRBs. Consequently, the research landscape invariably favors those with the resources to do research, and researches that tend to attract funding. CONCLUSION The broader challenge of equity in health research will entail more fundamental reforms, but proximal interventions can be done to make the ethics approval process more equitable, such as enhancing institutional oversight, regulating IRB fees, and enabling a more supportive and welcoming environment for early-career, student, independent, and non-clinical health researchers. This article ends by reflecting on the implications of our findings toward the larger research culture.
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Affiliation(s)
- Gideon Lasco
- Development Studies Program, School of Social Sciences, Ateneo de Manila University, 4th Floor, Ricardo & Dr. Rosita Leong Hall, University Road, Katipunan Ave., Loyola Heights, Diliman, 1108, Quezon City, Philippines.,Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines.,College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Vincen Gregory Yu
- Development Studies Program, School of Social Sciences, Ateneo de Manila University, 4th Floor, Ricardo & Dr. Rosita Leong Hall, University Road, Katipunan Ave., Loyola Heights, Diliman, 1108, Quezon City, Philippines. .,College of Medicine, University of the Philippines Manila, Manila, Philippines.
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Selvarajah S, Deivanayagam TA, Lasco G, Scafe S, White A, Zembe-Mkabile W, Devakumar D. Categorisation and Minoritisation. BMJ Glob Health 2021; 5:bmjgh-2020-004508. [PMID: 33380415 PMCID: PMC7780538 DOI: 10.1136/bmjgh-2020-004508] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
| | | | - Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | - Suzanne Scafe
- School of Humanities, University of Brighton, Sussex, UK
| | - Alexandre White
- Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Wanga Zembe-Mkabile
- Health Systems Research Council, South African Medical Research Council, Tygerberg, Western Cape, South Africa
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
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26
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Lasco G, Mendoza J, Renedo A, Seguin ML, Palafox B, Palileo-Villanueva LM, Amit AML, Dans AL, Balabanova D, McKee M. Nasa dugo ('It's in the blood'): lay conceptions of hypertension in the Philippines. BMJ Glob Health 2021; 5:bmjgh-2020-002295. [PMID: 32646854 PMCID: PMC7351273 DOI: 10.1136/bmjgh-2020-002295] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/04/2020] [Accepted: 05/15/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction Understanding explanatory models is important for hypertension, a leading risk factor for cardiovascular disease and stroke. This article aims to determine what adult patients with hypertension in the Philippines attribute their condition to, how these views might be explained and what the implications are for hypertension management. Methods This is a qualitative study drawing on 71 semistructured interviews (40 initial and 31 follow-up) and four focus group discussions with patients diagnosed with hypertension. The setting was urban and rural low-income communities in the Philippines. Results Four prominent perceived causes were identified—genetics, heat, stress and diet—for what patients refer to as ‘high blood’. We propose a ‘folk physiology’ that rests on local understandings of blood and blood flow, draws from broader cultural notions of illness causation and accounts for a dynamic, non-chronic view of hypertension that in turn informs the health behaviours of those affected. Conclusions By understanding that hypertension is frequently seen not as a chronic constant condition but rather as an episodic one triggered by external influences, although in those genetically predisposed to it, it may be possible to address patient’s beliefs and thus adherence to treatment.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines .,Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
| | - Jhaki Mendoza
- Department of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Alicia Renedo
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | - Antonio L Dans
- Department of Medicine, University of the Philippines Manila, Manila, Philippines
| | | | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, UK
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27
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Marshall AI, Lasco G, Phaiyarom M, Pangkariya N, Leuangvilay P, Sinam P, Suphanchaimat R, Julchoo S, Kunpeuk W, Zhang Y. Evidence on Child Nutrition Recommendations and Challenges in Crisis Settings: A Scoping Review. Int J Environ Res Public Health 2021; 18:ijerph18126637. [PMID: 34203109 PMCID: PMC8296440 DOI: 10.3390/ijerph18126637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/21/2022]
Abstract
Adequate child nutrition is critical to child development, yet child malnutrition is prevalent in crisis settings. However, the intersection of malnutrition and disasters is sparse. This study reviews existing evidence on nutrition responses and outcomes for infants and young children during times of crisis. The scoping review was conducted via two approaches: a systematic search and a purposive search. For the systematic search, two key online databases, PubMed and Science Direct, were utilized. In total, data from 32 studies were extracted and included in the data extraction form. Additionally, seven guidelines and policy documents were included, based on relevance to this study. Overall, the existing evidence demonstrates the negative impacts of crises on nutritional status, diet intake, anthropometric failure, and long-term child development. On the other hand, crisis-related interventions positively affected nutrition-related knowledge and practices. Further studies should be carried out to explore the sustainability of the interventions and the success of existing guidelines. Since this study focuses only on nutrition among children under three, further studies should likewise consider an extended age range from three to five years.
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Affiliation(s)
- Aniqa Islam Marshall
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | - Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City 1107, Philippines;
- Development Studies Program, Ateneo de Manila University, Diliman, Quezon City 1106, Philippines
- Equity Initiative, Bangkok 10110, Thailand; (P.L.); (Y.Z.)
| | - Mathudara Phaiyarom
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
- Correspondence:
| | - Nattanicha Pangkariya
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | | | - Pigunkaew Sinam
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
- Equity Initiative, Bangkok 10110, Thailand; (P.L.); (Y.Z.)
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Sataporn Julchoo
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | - Watinee Kunpeuk
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | - Yunting Zhang
- Equity Initiative, Bangkok 10110, Thailand; (P.L.); (Y.Z.)
- Child Health Advocacy Institute, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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28
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Abstract
Abstract
This paper uses the lens of medical populism to analyze the impact of biocommunicability on COVID-19 testing through a case study approach. The political efficacy of testing is traced through two mini-case studies: the Philippines and the United States. The case studies follow the approach of populism scholars in drawing from various sources that ‘render the populist style visible’ from the tweets and press releases of government officials to media reportage. Using the framework of medical populism, the case studies pay attention to the ways in which coronavirus testing figured in (1) simplification of the pandemic; (2) spectacularization of the crisis; (3) forging of divisions; and (4) invocation of knowledge claims. Identifying and critically analyzing how knowledge is generated is an essential step to recognizing the impact that political styles have on the COVID pandemic. The political actors in each case study have shaped knowledge of the epidemic, in the way they construct the idea of ‘testing’, and in how they mobilize testing as an ‘evidence-making practice’. Their actions shaped how the pandemic—as well as their responses—is measured. This framework contributes to public policy debates by providing evidence of the impact of medical populism on pandemic response efforts.
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Affiliation(s)
- Kristin Hedges
- Department of Anthropology , Grand Valley State University , Allendale, MI 49401-9403, United States
| | - Gideon Lasco
- Department of Anthropology , University of the Philippines Diliman , Quezon City , 1101 , Philippines
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Lasco G, Yu VG. Communicating COVID-19 vaccines: lessons from the dengue vaccine controversy in the Philippines. BMJ Glob Health 2021; 6:bmjgh-2021-005422. [PMID: 33653732 PMCID: PMC7929792 DOI: 10.1136/bmjgh-2021-005422] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 02/19/2021] [Accepted: 02/20/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines .,Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
| | - Vincen Gregory Yu
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
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Seguin M, Lasco G, Bin Idris K, Mendoza J, Mohd Kadri NH, Krauss S, D'Silva J, Shaffril HM, Fadzil MF, Palafox B, Renedo A, Nafiza MN, Majid F, Razak AA, Yusoff K, Palileo-Villanueva L, Dans A, Mallari E, Balabanova D, McKee M. Patient pathways for cardiovascular diseases in Malaysia and the Philippines: a systematic review. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16412.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Cardiovascular diseases (CVDs) are the leading cause of premature mortality in the world and are a growing public health concern in low- and middle-income countries (LMICs), including those in South East Asia. Their management requires coordinated responses by a range of healthcare providers, which should preferably be based on knowledge of the national context. We systematically review evidence on the pathways followed by patients with CVD in Malaysia and the Philippines to understand patient journeys, along with the barriers at each stage. Methods: We searched seven bibliographic databases and grey literature sources to identify material focused on the pathways followed by patients with CVD in Malaysia and the Philippines, and performed a narrative synthesis. Results: The search yielded 25 articles, 3 focused on the Philippines and 22 on Malaysia. Most articles were quantitative analyses that focused on hypertensive patients. Three examined secondary prevention post myocardial infarction, and one each examined acute myocardial infarction, heart failure, and atrial fibrillation. Reported barriers reflected capability (knowledge of behaviours to achieve control or the capacity to conduct these behaviours), intention (attitudes or motivations toward the behaviours to achieve control), and aspects of the health care system (availability, accessibility, affordability and acceptability of services). Conclusions: There are large gaps in our understanding of patient pathways in Malaysia and the Philippines that limit the development of evidence-based strategies to effectively address the CVD burden in South East Asian countries and in LMICs more broadly. Addressing these evidence gaps will require longitudinal mixed-methods studies following patients from initial diagnosis to long-term management.
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Lasco G, Yu VG. "Shabu is different": Extrajudicial killings, death penalty, and 'methamphetamine exceptionalism' in the Philippines. Int J Drug Policy 2021; 92:103168. [PMID: 33608208 DOI: 10.1016/j.drugpo.2021.103168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND This paper articulates and problematises the 'exceptionalism' in the way shabu (crystal methamphetamine) is framed in political and popular discourse in the Philippines, and how these framings have informed and enabled the drug regime in the country, creating a 'state of exception' and justifying the killing-whether extrajudicially or through the death penalty-of people associated with the particular drug. METHODS Two case studies are presented in this paper to demonstrate how political and civil society actors treat shabu, drawing on official statements, journalistic reportage, and published articles from various sources as empirical material, and using a problematisation framework to guide analysis. DISCUSSION 'Methamphetamine exceptionalism' pervades public discourse in the Philippines, creating a social and political environment that is permissive for, if not outright supportive of, draconian measures particular toward people associated with shabu. Such views are rooted in the perception that shabu is especially dangerous as opposed to other drugs, thereby posing an exceptional threat to the body politic. CONCLUSION This paper underscores the importance of nuance in constructing and interrogating the objects of drug policy, given that different drugs are treated differently. Policy and communication interventions must therefore specifically address the ways in which shabu has been framed to justify not only Duterte's deadly drug war, but other such wars throughout the region.
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Affiliation(s)
- Gideon Lasco
- Ateneo de Manila University Development Studies Program, 4th Floor, Ricardo & Dr. Rosita Leong Hall, School of Social Sciences, Katipunan Avenue, Loyola Heights, Quezon City 1108, Philippines; University of the Philippines Diliman Department of Anthropology, Room 1317, 3rd Floor, Palma Hall Pavilion 1, Diliman, Quezon City 1101, Philippines.
| | - Vincen Gregory Yu
- Ateneo de Manila University Development Studies Program, 4th Floor, Ricardo & Dr. Rosita Leong Hall, School of Social Sciences, Katipunan Avenue, Loyola Heights, Quezon City 1108, Philippines
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32
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Palafox B, Renedo A, Lasco G, Palileo‐Villanueva L, Balabanova D, McKee M. Maintaining population health in low- and middle-income countries during the COVID-19 pandemic: Why we should be investing in Community Health Workers. Trop Med Int Health 2021; 26:20-22. [PMID: 32985024 PMCID: PMC7537160 DOI: 10.1111/tmi.13498] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Community health workers in low- and middle-income country primary health care systems are well suited to perform essential functions on the frontlines of Covid-19 pandemic responses. However, clear and coordinated guidance, updated infection control training, and reliable access to personal protective equipment must be ensured in order to deploy them safely and effectively. With these additional responsibilities, community health workers must also be supported to ensure that hard-fought gains in population health, including progress on non-communicable diseases, are sustained throughout the pandemic.
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Affiliation(s)
- Benjamin Palafox
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Alicia Renedo
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Gideon Lasco
- Department of AnthropologyUniversity of the Philippines DilimanQuezon CityPhilippines
| | | | - Dina Balabanova
- Department of Global Health & DevelopmentLondon School of Hygiene & Tropical MedicineLondonUK
| | - Martin McKee
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
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Affiliation(s)
- Gideon Lasco
- University of the Philippines Diliman, Quezon City 1101, Philippines.
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Mallari E, Lasco G, Sayman DJ, Amit AML, Balabanova D, McKee M, Mendoza J, Palileo-Villanueva L, Renedo A, Seguin M, Palafox B. Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines. BMC Health Serv Res 2020; 20:860. [PMID: 32917203 PMCID: PMC7488850 DOI: 10.1186/s12913-020-05699-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/31/2020] [Indexed: 11/17/2022] Open
Abstract
Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.
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Affiliation(s)
- Eunice Mallari
- College of Medicine, University of the Philippines - Manila, Metro Manila, Philippines
| | - Gideon Lasco
- Department of Anthropology, University of the Philippines - Diliman, Quezon City, Philippines
| | - Don Jervis Sayman
- College of Medicine, University of the Philippines - Manila, Metro Manila, Philippines
| | - Arianna Maever L Amit
- College of Medicine, University of the Philippines - Manila, Metro Manila, Philippines
| | - Dina Balabanova
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Martin McKee
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Jhaki Mendoza
- College of Medicine, University of the Philippines - Manila, Metro Manila, Philippines
| | | | - Alicia Renedo
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Maureen Seguin
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Benjamin Palafox
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
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Abstract
This paper uses the vocabulary of 'medical populism' to identify and analyse the political constructions of (and responses to) the COVID-19 pandemic in Brazil, the Philippines, and the United States from January to mid-July 2020, particularly by the countries' heads of state: Jair Bolsonaro, Rodrigo Duterte, and Donald Trump. In all three countries, the leaders' responses to the outbreak can be characterised by the following features: simplifying the pandemic by downplaying its impacts or touting easy solutions or treatments, spectacularizing their responses to crisis, forging divisions between the 'people' and dangerous 'others', and making medical knowledge claims to support the above. Taken together, the case studies illuminate the role of individual political actors in defining public health crises, suggesting that medical populism is not an exceptional, but a familiar response to them. This paper concludes by offering recommendations for global health in anticipating and responding to pandemics and infectious disease outbreaks.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines, Quezon City, Philippines.,Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
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Lasco G, Hardon AP. Keeping up with the times: skin-lightening practices among young men in the Philippines. Cult Health Sex 2020; 22:838-853. [PMID: 31662041 DOI: 10.1080/13691058.2019.1671495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 09/19/2019] [Indexed: 06/10/2023]
Abstract
The desire for light(er) skin is widespread around the world and has been the subject of extensive critical scholarship. But far less attention has focused on skin-lightening practices among boys and men, even as historical and contemporary data show that it is both a long-standing and growing trend in many Asian countries. This study builds on a focused ethnography of young men's skin-lightening practices in two Philippine cities. Using Norbert Elias' notion of 'figurations', we look at how shifts in gender ideologies, socio-economic changes, processes of urbanisation and popular culture trends are reflected in these practices. We find that the pursuit of a whiter skin is not an individual project, but a mode of body modification which is enacted in figurations among male peers, between men and women, and between men and their employers and customers in a globalising economy. Overall, skin practices and preferences among young men in the Philippines are best understood in terms of changing notions of masculinity, the unchanging quest to look compatible (bagay) with one's peers, and the desire to keep up ever-changing trends.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Diliman, Quezon City, Philippines
| | - Anita P Hardon
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
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Lasco G. Drugs and drug wars as populist tropes in Asia: Illustrative examples and implications for drug policy. International Journal of Drug Policy 2020; 77:102668. [DOI: 10.1016/j.drugpo.2020.102668] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman Quezon City, Philippines
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
| | - Heidi J. Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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Abstract
This article is a reflection on doing anthropology in the Philippines amid the government’s punitive antidrug campaign and on the impact of ethnographic research on public discourses on drugs. Using my own ethnographic research as a starting point, I outline how a journal article I published about the lived experiences of young men who use drugs took on renewed significance years later, in a different policy regime. I then outline a research agenda for the anthropology of drug use in the country. Despite the ethical, methodological, and personal challenges of drug-related research, the potential to give voice to ‘hidden populations’ and argue for humane, evidenced-based policies should encourage anthropologists and other social scientists to persevere.
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Palafox B, Seguin ML, McKee M, Dans AL, Yusoff K, Candari CJ, Idris K, Ismail JR, Krauss SE, Lasco G, Majid FA, Palileo-Villanueva LM, Razak AA, Renedo A, Balabanova D. Responsive and Equitable Health Systems-Partnership on Non-Communicable Diseases (RESPOND) study: a mixed-methods, longitudinal, observational study on treatment seeking for hypertension in Malaysia and the Philippines. BMJ Open 2018; 8:e024000. [PMID: 30061449 PMCID: PMC6067392 DOI: 10.1136/bmjopen-2018-024000] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Hypertension is a leading contributor to the global burden of disease. While safe and effective treatment exists, blood pressure control is poor in many countries, often reflecting barriers at the levels of health systems and services as well as at the broader level of patients' sociocultural contexts. This study examines how these interact to facilitate or hinder hypertension control, taking into account characteristics of service provision components and social contexts. METHODS AND ANALYSIS The study, set in Malaysia and the Philippines, builds on two systematic reviews of barriers to effective hypertension management. People with hypertension (pre-existing and newly diagnosed) will be identified in poor households in 24-30 communities per country. Quantitative and qualitative methods will be used to examine their experiences of and pathways into seeking and obtaining care. These include two waves of household surveys of 20-25 participants per community 12-18 months apart, microcosting exercises to assess the cost of illness (including costs due to health seeking activities and inability to work (5 per community)), preliminary and follow-up in-depth interviews and digital diaries with hypertensive adults over the course of a year (40 per country, employing an innovative mobile phone technology), focus group discussions with study participants and structured assessments of health facilities (including formal and informal providers). ETHICS AND DISSEMINATION Ethical approval has been granted by the Observational Research Ethics Committee at the London School of Hygiene and Tropical Medicine and the Research Ethics Boards at the Universiti Putra Malaysia and the University of the Philippines Manila. The project team will disseminate findings and engage with a wide range of stakeholders to promote uptake and impact. Alongside publications in high-impact journals, dissemination activities include a comprehensive stakeholder analysis, engagement with traditional and social media and 'digital stories' coproduced with research participants.
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Affiliation(s)
- Benjamin Palafox
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK
| | - Maureen L Seguin
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin McKee
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK
| | - Antonio L Dans
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Khalid Yusoff
- Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
- Centre for Translational Research and Epidemiology, Faculty of Medicine, University Teknologi MARA, Shah Alam, Malaysia
| | - Christine J Candari
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Khairuddin Idris
- Institute for Social Science Studies, University Putra Malaysia, Serdang, Malaysia
| | - Johan Rizwal Ismail
- Centre for Translational Research and Epidemiology, Faculty of Medicine, University Teknologi MARA, Shah Alam, Malaysia
| | - Steven Eric Krauss
- Institute for Social Science Studies, University Putra Malaysia, Serdang, Malaysia
| | - Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | - Fadhlina A Majid
- Centre for Translational Research and Epidemiology, Faculty of Medicine, University Teknologi MARA, Shah Alam, Malaysia
| | | | - Azlina A Razak
- Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Alicia Renedo
- Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Dina Balabanova
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK
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Lasco G. Kalaban: Young drug users’ engagements with law enforcement in the Philippines. International Journal of Drug Policy 2018; 52:39-44. [DOI: 10.1016/j.drugpo.2017.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 10/20/2017] [Accepted: 11/01/2017] [Indexed: 10/18/2022]
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Lasco G. Pampagilas: Methamphetamine in the everyday economic lives of underclass male youths in a Philippine port. International Journal of Drug Policy 2014; 25:783-8. [DOI: 10.1016/j.drugpo.2014.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/28/2014] [Accepted: 06/11/2014] [Indexed: 10/25/2022]
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Psillakis JM, Albano AM, Zanini S, Casa A, Lasco G. [Osteotomy of the middle third of the face in the sequelae of cleft palate]. AMB Rev Assoc Med Bras 1978; 24:175-8. [PMID: 308679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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