"Tumataba ka ngayon"; "Pumapayat ka ngayon": Why we greet each other with physical appearances

by Gideon Lasco

In the Philippines, family and friends sometimes greet each other by commenting on changes in their physical appearances. Common examples include:

“Tumataba ka ngayon ah!” (You’re getting fat nowadays!)
"Bakit parang nangangayayat ka?" (Why is it that you're becoming thinner?)
“Bagong gupit!” (New hair!)
“Blooming ka ngayon ah!” (You’re 'blooming' today!)

Many have wondered why physical appearances figure in Filipino greetings, and some have frowned upon - or even ridiuculed - this practice. But before we form a negative opinion about it, let us first examine what this form of greeting does in our everyday lives. In what follows, I offer my insights based on my personal experiences:

First, it establishes when people last saw each other. By using the body as a clock, people are able to date their previous encounters. Take note that the greeting is not “You’re fat”, but “you’re getting fat”; tumataba, not mataba. The progressive tense links past and present, and invites people to talk about what transpired in between.

I realized this when, in a previous reunion, one of my titas said I was getting fat, and another said I was getting thin. At first I thought that such contradictory comments are proof of the greetings’ perfunctory (and therefore meaningless) nature - people just say it because they feel compelled to say something. But it later dawned upon me that the two titas actually saw me in different times: one saw me after I arrived from the US (where I almost always gain weight thanks to my relatives), and the other saw me after my PhD in Europe (where I almost always lose weight due to the pricey food and my tight budget).

The fact that I had to explain my changed body by telling them where I traveled, and what transpired in those travels, made me realize that the body, by establishing previous encounters, serves as a starting point for further conversation.

Second, it communicates a concern for one another’s health and beauty, as when, instead of just asking “how are you today?”, a family member comments on your growing belly. Take note that in these greetings, people are not measured against other individuals, but against their own (previous) selves.

We can see this during high school and college reunions, where people tease their former classmates for having gained weight, fully expecting them to return the ‘compliment’. Can we not link these greetings, then, to a shared nostalgia of our former bodies?

Finally, it speaks of a different kind of openness in our culture. We always think of Filipinos as more reserved (“mahiyain”) in the way we express our feelings, compared to the more straightforward Westerners. But there are also aspects of our lives where we are more open. Filipino psychologists speak of our notion of “kapwa” as proof that our society has never seen the "self" and the "other" as fully distinct - and I think we should move towards "embodied" way of looking at this intersubjectivity.

***

As Christmas draws near, we will hear more and more of these greetings in parties and gatherings. Surely, one year of cross-fit will earn for a young man a “ang ganda na ng katawan ni Junior!” from his doting grandparents; the young woman who cuts her hair short will not go unnoticed. On the other hand, when I hear stories of people who suffer beneath their smiles, I also agree that in some contexts, this way of greeting has become offensive in a day and age when people have increasingly staked their identities and notions of self-worth in their physical appearances.

One way of dealing with this problematique is to reserve our appraisal in settings where people share the same level of intimacy: I don’t think it’s a good idea to comment about your teenage niece’s weight in front of her barkada. Another is to be sensitive for instances when it can be offensive: surely, someone who is struggling with weight not need be to be reminded of her obesity. In other words, we must learn to appraise not just other people’s physical appearances, but their feelings.

These concerns notwithstanding, I hope we can appreciate the good in our customs, and not always resort to self-disparagement. Our way of greeting, I submit, invokes an intersubjectivity that involves not just our social selves, but our physical bodies; a concern for each other’s health and beauty, and a desire to link the present and the past. In the Philippines, we greet each other by commenting on changes in physical appearance, and I think that's wonderful.

Los Banos
December 5, 2016

Cancer and the merchants of hope

“Sayang ang mga buhay.”

Thus was the lament of my colleague, a medical oncologist, who confided to me her frustration over cancer patients who seek alternative treatments: “They would come in the early stages, and we would advise surgery and other treatments. But instead, they would resort to unproven kinds of alternative medicine, from cabbage leaves to mangosteen tablets. As expected, these treatments didn’t work and they would come back months or years later, at a higher stage. By then, the treatments are much more expensive. Had they opted for treatment early on, it would cost them much less - and their cancers could have been cured.” 

She concludes: “These ‘No approved therapeutic claims’ treatment modalities and their advertisements should really be regulated.”

***

My colleague, whose request to remain anonymous underscores the sensitivity of this matter even among oncologists, raises insights that are worth reflecting upon, in light of the growing incidence of cancer - the third leading cause of death in the Philippines. What is the role of alternative medicines in cancer treatment? What benefits and dangers do they have, and what factors lead patients to choose them over biomedicine? 

To be fair, we must note that there could be a “selection bias” at work here: Doctors are unlikely to encounter the "success stories” of alternative medicine: they will not come back for follow ups. Instead they will be blogging and telling people about how they recovered. Indeed, patients can be “cured” by other means. In fact, even without any form of active intervention, some cancers can just disappear: “spontaneous regression” is a rare but well-documented phenomenon in the scientific literature. In real life, however, cancer is rarely left alone; people attempt various kinds of treatments, and when they do experience some improvement, in the absence of a definitive explanation, they will attribute it to something specific: the religious to divine intervention, the healthy eater to diet, the MLM networker to the pill or a product that they could better sell.

Nonetheless, while testimonials can magnify these miracles, statistics show a dire picture: without biomedical treatment, most people progress through the stages of cancer. In one Canadian study for instance, the 5-year survival rate was 86% for breast cancer patients that accepted conventional cancer care and only 43% for those who didn’t.

The lack of evidence for their claims, however, has not stopped people from marketing all kinds of products as cancer treatments. Some manufacturers trumpet on the wonders of a single herb, while others claim to gather all kinds of curative herbs in one tablet. Many of them make use of scientific terms (i.e. “antioxidants”, “cytokines”) to sound authoritative, invoking laboratory and animal studies that are scientifically insufficient but are convincing enough for the general public. 

They will also be advertised as “FDA approved”, as if it were an endorsement, even though the FDA only registers supplements as a matter of procedure and makes no actual evaluation of the products themselves or their claims. 

Finally, many alternative medicines are promoted as harmless vis-a-vis the well-known side effects of chemotherapy. Left unsaid is the fact that supplements, too, can have side effects and more importantly there is a heavy opportunity cost of each day that goes by without getting proven treatments. 

It is worth mentioning that others go even further, offering not just unproven treatments, but unproven diagnostic tools, using dubious methods such as special urine and blood tests, oftentimes with “high-tech”-looking devices. By “diagnosing” someone as having “cancer”, these quacks can then offer a treatment that is sure to work, as there was no disease in the first place. 

 

***

Complementary and alternative medicine (CAM) must be taken seriously for a number of reasons. Firstly, biomedicine should never shut its door to new knowledge. Vincristine and vinblastine - derived from an periwinkle long used in India and China as an herbal medicine - are now important anti-cancer drugs. Immunotherapy - once set aside in favor of immunosuppression - is showing promising results and is now an exciting avenue for research. Indeed, CAM shouldn’t be generalized as ineffective. Moreover, while biomedicine’s paradigm is treatment, other forms of healing focus on prevention, and their view that modernity itself - our diets, lifestyles, and environments - has become carcinogenic is something that we must seriously consider.

Secondly, the health care system should see these alternatives as symptoms of its own problems and shortcomings. Perhaps it is not able to allay people’s fears and misconceptions about the causes of cancer and its treatment options (i.e. surgery, chemotherapy, radiotherapy). For people who fear cancer, taking supplements has “symbolic efficacy” in assuring themselves that they are doing “something” about their perceived risk. Perhaps, too, the cost of cancer treatment remains - or is perceived to be - prohibitively expensive to many Filipinos. Surely, better PhilHealth coverage will relieve patients of the hesitation brought about by the threat of financial ruin (On a positive note, the Z-benefit package is a step towards this direction). 

Finally, alternative medicines speak of the toothlessness of the Food and Drug Administration in controlling the ways in which supplements and other products are marketed. Disclaimers such as  “No approved therapeutic claims” and the newer “hindi ito gamot” (This is not a drug) are meaningless when drowned by imagery and language suggest otherwise. While the FDA has done a great job in issuing public advisories against false claims, the fact that these claims are even allowed in advertisements underscores the need to give the FDA more regulatory teeth - and inter-agency support.

Ultimately, however, the decisions will have to come from cancer patients and their families. While it is easy to dismiss them as gullible or irrational, we must understand that they are caught in desperate situations in which there is nothing more attractive than hope, something that Western medicine itself cannot offer in clear and reassuring terms. 

Until a cure for cancer is discovered - or unless we step up efforts towards information dissemination and regulation - the search for alternatives will go on, and “merchants of hope” will continue to profit from people’s desperation and hopelessness. 

(Originally published in Rappler on December 2, 2016)

Note to self: How to engage with others in social media

by Gideon Lasco

Note to self:

Before you post something online, ask yourself what good can come out of it. Will it inform? Inspire? Educate? Entertain? There are many valid reasons for posting something, but self-praise is not one of them.

Second, always consider the truthfulness of what you're going to share or post. Be discerning, especially when people begin to trust in your discernment. Hold on to facts, to evidence, to logic, and to reason. But don't forget that sincerity is the most important form of truthfulness, for it involves being true to one's convictions, values, and feelings.

Choose your words wisely and carefully. Some words can hurt, but others can heal. Some can divide, but others can unite.

Some people will try to refute what you're going to say. Others will use your words against you, take them out of context, and interpret them in the worst possible light. The natural impulse is to be defensive, but the noble response is to be humble and gracious.

Some people will disagree with your points of view. Others will question the logic of your arguments. Welcome their dissent. Always remind yourself that you can be wrong, so that when others correct you, your response will be gratitude.

Even when you're convinced that you are absolutely right, resist the temptation of humiliating people and rubbing in the flaws of their contentions. It is better to win people's respect and lose an argument, than win an argument and lose people's respect.

Don't let your desire to be proven right get in the way of being nice to people.

Don't let your desire to be vindicated lead you to vindictiveness.

Never fight hate with hate, just as it has been said that one must never fight fire with fire. Avoid posting something out of anger or frustration. If someone insults you, you are no different if you insult them back. Don't forget that silence is oftentimes the best way to communicate dignity.

Draw inspiration from the people who like or share your posts; never take their support for granted, nor be desensitized to their goodwill. However, never make them the sole measure of your success. A popular lie will go viral, but an inconvenient truth may go unnoticed. Even so, truth is always preferable to fame.

Don't give up on social media. When you dwell too much on the negative, you lose sight of the positive. Not all the hatred in the Internet can nullify the fact that life is beautiful and we can see glimmers of this beauty in people's posts that make us laugh and smile.

As for what you write, even just one person who profits from it makes it worthwhile - and you never know what your drop in the bucket will help lead to. Perhaps you will embolden someone far better than you, and you would have paved the way for greatness.

Keep writing. And keep encouraging those who do. You are not alone.

Minneapolis
01 Sept 2016

The eye of the storm and the blind eye of international media

Image: CIMSS via Stu Ostro on Twitter

by Gideon Lasco

I have mixed feelings with the way the Philippines has been covered by international media in the past few months.

On one hand, I have seen really good journalism. Many well-written and balanced articles have successfully conveyed what is going on in the country, in some ways more in-depth than our local newspapers have covered. Because they are writing for a foreign audience, these articles often offer political and cultural contexts that many local writers take for granted. 

On the other hand, I have seen the tendency to go for the dramatic override journalistic principles of fairness, and even a basic sense of humanity. 

Just look at the coverage of the Supertyphoon Meranti (Local name: Ferdie) - and the headlines about it. When a satelite photo of Itbayat Island being right at the eye of the world’s fiercest storm was released, it caught international attention, not out of concern for the people, but out of fascination over the amazing image.

“Crazy satellite images show Super Typhoon Meranti swallowing tiny island” Mashable goes, inviting its readers to marvel at the “craziness” of the image and of a supertyphoon swallowing a "tiny island”.

“See Pics! NASA satellite captures the fierce might of super typhoon Meranti” ran an India TV headline. Surely, if a cyclone hit Kolkata with the same "fierce might", they would never imagine the exclamatory "pictures" as more interesting than the "people" who are suffering the fate. 

“Watch: Super Typhoon Meranti Topples Shipping Containers Like a House of Cards” goes another news story as if they had stumbled upon a deleted scene of a Spider-man movie. 

Juxtaposed with the Ivatan’s lament that they are being ignored amid this calamity, I cannot help but be indignant at the inhumanity of the news coverage. It’s as if the supertyphoon were a mere spectacle; one big show. 

But in a way, we shouldn't be surprised. They are after all, writing for their readers, who would be more fascinated by a dramatic satelite image than the (rather boring) bit about people in a faraway island being hit by a typhoon. Of course, for Americans, it would be an entirely different story if the "tiny island" in question - even smaller than Itbayat - were Manhattan.

And of course, if many people died, that too, would merit their attention. Alas, with so many tragedies and calamities happening everyday, a disaster would have to be quantitatively more significant for it to get coverage - and this is no exact mathematics: 10 deaths in London would surely merit more attention than a hundred in Liberia. Can we blame English newspapers for being more concerned about the Londoners? 

How then should we respond to this "blind eye of international media"?

First, we need to realize that we (and by "we" I mean the Filipino people) are not their primary audience, and even when they adhere to journalistic ethics, the issues that they would highlight are the ones that resonate with their audiences more. When Rodrigo Duterte made a speech about an independent foreign policy, it was the perceived slight to Barack Obama that caught the West's attention - not Duterte's assertion of an independent foreign policy (which is probably more significant in geopolitical terms). Duterte's invectives had particular currency in America because they reminded them of Donald Trump. And in their worldview of the Americans (and West) being the protagonist, they are always on the lookout for people who can be cast as colorful enemies -as in any James Bond or superhero movie. Duterte, like Putin and Kim Jong-Un, happened to fit the bill.

And so I think we should have a healthy dose of skepticism over how the Philippines is being portrayed by foreign media. Not because they are politically motivated in a local sense (I do not buy for a second those conspiracy theories that foreign media have been blinded or bought by the Liberal Party - these journalists are no fools - even though they may have their own political leanings back at their home countries) - but because there is already an inherent bias among them by virtue of their positionality, their upbringing, their audiences, their values. News itself is geared towards the dramatic, as our high school journalism teacher once taught us: "When a dog bites a man, that's not news. When a man bites a dog, that's news." Thus we shouldn't complain that a plane crash gets reported while the millions of flights that go smoothy don't.

Second, we should appreciate and support our local journalists, because they are more invested about our country than foreign correspondents are. Sure, they are more prone to bias in terms of local politics, but they are also more prone to care about what's happening, and share our concerns. While international media marveled at the satelite images, local media like Rappler shared details of relief operations and how you can help - even airing the lack of media attention to the calamity.

Sure, there are some bad eggs (there's a radio reporter in Palawan who sings praises of coal plants), but vilifying all of local journalism as "bayaran" (paid) and "biased" does not do justice to people who put their name on what they say and risk their lives in doing so (a BBC reporter does not have to worry about consequences of his article about the Philippines; Filipino journalists risk their lives each day as the Maguindanao massacre made stark).

Of course, local journalists too are prone to sensationalism, partly because Filipino audiences, too, are more receptive to the dramatic, the unusual, the scandalous. We too, have been desensitized to all forms of spectacle, and must be presented with "crazy" images, dramatic stories, "insane" personalities" for our attention to be piqued. Thus the stuff of entertainment becomes the stuff of news.

Third, this knowledge of the intrinsic biases of media (and humanity at large) should temper our expectations of their role in society. Dismissing media reports as "biased" is no longer a valid excuse to disregard their content, because bias does not preclude the possibility of truth. Indeed, that media is biased shouldn't automatically discredit them in our eyes - nor cause us to impute any ill motives.  What we need are more voices to complete the whole picture; one voice should not be expected to carry the whole weight of the truth. Precisely because it is biased, we need more media, not less.

Finally, this should make our leaders deal with it with a mindfulness that for all of its imperfections, media reports does have agency and carry weight throughout the world. Saying "I don't care" in response to negative press coverage is fine, until that negative press translates to the loss of investor confidence, and the driving away of tourists.

In short, if we already know that foreign media is looking for villains, our leaders will do well to make sure they don't fit the bill. And we will do well not to dismiss their news reports and opinions outright, because for all we know, their notions of villainy and our notions of treachery one and the same. We too, have a blind eye for the things around us, sometimes because of pride, oftentimes because of our politics.

And so while we should take every bit of news with a proverbial grain of salt, we cannot blame the foreign media for placing us at the eye of a storm. Especially if we created the storm ourselves.

Augmenting reality with Pokemon Go

by Gideon Lasco

FUKUOKA, JAPAN - News that Pokemon Go had finally reached Philippine shores came to me just as I finished hiking up Kuju Volcano - the highest mountain here in Kyushu island. Though it came alongside many other developments that day - i.e. the opening of the Rio Games, the plan to bury Marcos at the Libingan ng mga Bayani, and Donald Trump’s latest gaffe - it was the one that excited my peers the most, judging by my Facebook feed.

Pokemon Go is the latest iteration of a game that many in my generation of “90’s kids” fondly remember. Set in a fantasy world full of cute, fascinating creatures, the game invites players to roam around the world to catch Pokemon - all 151 of them (the number has since grown).

Many of us embraced it. The now-primitive-looking graphics of ‘Pokemon Red’ sufficed in the pre-smartphone, pre-broadband Internet age, and I spent many hours ‘walking’ on a computer screen while my younger brother watched by my side. Later, he developed an evanescent ability to mimic the sounds of various Pokemon with such fidelity that I regret not making a videos of it.

The craze over Pokemon at the time was such that there was a much-awaited Pokemon anime series, a Pokemon movie (1998), a Pokemon card game, and lots of stuffed Pikachu in Divisoria.

Now, almost two decades later, comes Pokemon Go. It has the same premise as the original game, but instead of playing the game on a tiny screen, they made our world - the real world - the very ground where the game is played (albeit through the ‘lens’ of your smartphone). Walk along EDSA and you may encounter not just physical rats, but virtual ones called Ratata. Walk along Pasig River and you may catch a fish called Magicarp (thankfully you don’t have to eat it).

As soon as I got back to Fukuoka from Kuju Volcano, I downloaded the app. The game, I have to admit, has a user-friendly, intuitive interface, and as soon as I caught my first Pokemon (a Charmander), I was hooked.

Very soon I learned that the game is essentially about walking: you need to walk a certain distance for ‘eggs’ to hatch into new Pokemon, and it is by walking that you encounter more PokeStops (where you can get free items) - and of course, the Pokemon themselves.

Thus from my apartment in Hakata I ended up walking all around Fukuoka. I realized that the more densely populated the area is, the more Pokemon, so I gravitated towards Canal City - a popular shopping mall - and ended up in a nearby park by the Yanagawa river.

At first I thought I would look silly wandering at night with a smartphone on hand. But I soon realized that I needn’t be embarrassed: As it turned out, everyone in the park was playing Pokemon Go.

***

From a public health perspective, the prospect of many people finally being able to choose both playing a ‘computer game’ and doing a physical activity is surely a game changer. Already, there are reports of people losing weight, prompting some doctors to hail Pokemon Go as a “health app”. But there are also safety concerns: already, there are reports of people falling off cliffs and getting hit by cars while playing the game. Are our streets walkable, and our parks - if we have them at all - safe for people to wander about at night? The app’s popularity may end up bringing issues of urban livability to the fore.

From an economic perspective, the biggest winners are Niantic and Nintendo - the app developer and the game owner, respectively - who now have the awesome power to choose which establishments will draw crowds: a power they will be sure to capitalize on. Moreover, the game is already already engendering a “Pokenomics”: of people offering Pokemon tours; malls gaining more foot traffic by being venues to Pokemon gyms and PokeStops; and tech stores selling out of powerbanks (It’s free to play the game itself but paying for add-ons can give you a big advantage).

While we sort out the pragmatics of Pokemon, however, we will also do well to reflect on the implications for human experience of the virtual further merging with the real. Playing the game while hiking up Mt. Kaimon also here in Kyushu, I have to admit that in my excitement over catching a rare Pokemon overshadowed my usual interest in the actual fauna on the trail. And it got me thinking: Is augmented reality a way of re-animating the natural world, now that the real creatures have gone? Will a future kid see a butterfly and say: “Look, mom, a Butterfree!”?

Between the virtual and the real, there are times when the real should still take precedence. Attending the 71st anniversary of the atomic bombing in Nagasaki, I learned that there are no Pokemon on the peace park: the city officials, after seeing it overwhelmed by Pokemon players, had asked Niantic for it to be cleared of Pokemon out of respect for what the places signify. If it ever happens in Luneta, Manila should do the same for Rizal Shrine.

As for concerns that players will be closer to Pokemon than their real-life family and friends, it has so far proved unfounded. Like all games, there is a sociality to Pokemon Go: of comparing notes and hunting Pokemon together, and and even meeting new people (there are already stories of people hitting off after a PokeStop encounter).

For old friends - especially those who played the original Pokemon games together - Pokemon Go is something new to talk about; a reason to reconnect, reunite, and reminisce.

In fact, I better check with my high school classmates to see who among us thus far has caught the most number of Pokemon.

Ten years later, still an inconvenient truth

by Gideon Lasco

CEBU CITY - Ten years ago, when Al Gore released Inconvenient Truth, the documentary detailing how our planet is being affected by a rapidly-warming planet, perhaps it was still possible to dismiss it as a doomsday prophecy. Perhaps it was still possible to imagine that the world will simply continue the way it was; that we could keep burning fossil fuels and squandering our natural resources with impunity.

Perhaps it was still possible to acknowledge global warming as a reality - but one that is eons away, and thus as irrelevant to our time as the eventual expansion of the Sun, or the ultimate destruction of the Universe.

What a difference ten years make.

Today, echoes of Yolanda’s devastation still reverberate in our country and many victims are still reeling from its effects. Even as the blame game continues, there is little doubt that a changing climate was a predisposing factor - one that can continue wreaking havoc to our country in the typhoon seasons to come.

Today, a massive wildfire in Alberta, Canada still rages, having already burned 500,000 hectares of forest - almost the size of the entire island of Cebu. Experts agree that this fire is an unprecedented disaster that goes far beyond natural limits.

Today, our very own Mt. Apo - the country’s highest peak - has barely began recovery from a massive fire that destroyed hundreds of hectares of tropical rainforest. And while it is only Apo that has received media attention, many other mountains suffered fires, from Mt. Hamiguitan in Davao Oriental to the Cordilleras in Northern Luzon. As in Canada, the scope and magnitude of these fires are unprecedented.

The worsening El Niño has not only affected the environment - but humans as well (it is naive for us to separate ourselves from the ecosystem to which we belong). In Cebu alone, at least seven deaths have been attributed to heat stroke due to this year’s El Niño, and the toll to humans is far more catastrophic once we start connecting the dots: When farmers in Kidapawan cry for help amid their hunger - a hunger that is due to the destruction of their crops, which in turn is due to the severe drought - are we not seeing the consequences of a planet that is becoming hostile to crops it once nourished?

If ten years ago, the truth was debatable, today, many people - at least in our country - accept it as a reality (conspiracy theories notwithstanding). But while we have been acknowledging and experiencing the truth of climate change, acting upon its implications remains inconvenient.

It remains inconvenient because while global warming calls upon us to reduce our carbon footprint, we still find it inconvenient to do so: many would still find it a “hassle” to bring their own bags while shopping - or cut back on air conditioning. Indeed, the comforts of modernity, unsustainable though they are, remains too difficult for many to let go. Moreover, even if we wanted to, our society has not made it convenient for us to reduce our impact: There may be people who wish to walk, bike, or take public transport - but there is no infrastructure to do so.

Secondly, it remains inconvenient to live up to the implications of climate change partly because for every inconvenient truth, there is a convenient falsehood.

Today, we hear politicians talk about “clean coal”, as if the word “clean” before coal can exorcise the dangers of coal and other fossil fuels to human health and the environment (coal plants alone account for 1/3 of global carbon emissions). Today, we hear people talk about “responsible mining”, which, while it may indeed be a possibility in the future, detracts from the fact that mining has been responsible for the environmental degradation in many areas, from Semirara to Surigao.

But perhaps the most convenient falsehood of all is the idea that we are too insignificant to make a difference. Indeed, if there is something we can draw inspiration from in the past ten years, it is the fact that no effort is too small not to count in our fight to save the planet.

Our own country is a good example. Geopolitically, we have never been one of the big players - and neither have we been one of the big polluters. But in the international effort to deal with climate change, we have taken a position of moral leadership that is borne out of our experiences. The road to last year’s Paris negotiations “started in Manila”, and Filipino scientists, activists, and lawmakers alike have been a strong voice in the global conversation to combat climate change.

Small innovations and advocacies can also make a difference. From scientists pouring their time and effort to make clean technologies - and to make technologies clean - to activists lobbying for the enactment of laws creating protected areas, or ordinances to discourage the use of plastic bags - we all have a role to play in whatever field we find ourselves in.

***

Ten years ago, the challenge was to convince people of the inconvenient truth of a warming planet. Today, the challenge is no longer to make people accept this truth, but to make them live up to its implications.

Thus we have to continue clamoring for political leadership that can act on this planetary menace - and stand up to dirty industries. We have to continue making use of our knowledge and skills in coming up with new ideas, technologies, and practices that can help us move towards sustainable development.

And we have to lead an example of how we can reduce our carbon footprints - starting with our own lives.

The parable of the lost cellphone

I used to lose cellphones all the time. I lost my phone to knife-bearing 'holdapers' while riding a jeepney in E. Rodriguez, Quezon City and to a snatcher on a Manila-bound bus from Batangas. The most careless of all when my phone slipped into the sea while I texting on a boat in Coron - an episode witnessed by my friend Olivia Mejia. Helpless, all I could do was post on Facebook that "I may have lost my phone but at least I found paradise".

But there was a time when I thought that my phone was gone, only for me to get it back in a way that helped me appreciate an often-misunderstood part of our country. I was traveling in Maguindanao when, upon returning to Cotabato City, I realized that my phone was gone. At the time, the Maguindanao massacre was still fresh on people’s minds and I have to admit that I felt a bit of unease while traveling in the area. In any case, even if the disappearance happened anywhere else in the Philippines, I honestly thought that there was no chance that I could ever get my phone back.

To my surprise, however, my friend and host in Cotabato - Dr. Zhamir Umag- got a text message from my mobile number that night, with someone saying that he had found my phone. "How can I return it?" the sender asked. It turned out that I had left it on the jeepney back to Cotabato, and it was picked up by someone from Buldon, Maguindanao. Zham communicated with the finder and they made arrangements for the phone to be brought back to Cotabato the next time the finder goes to the city.

I was already back in Manila when the phone arrived by courier. When I opened the phone, I saw various pictures that the finder must have taken using the phone. It revealed a mountainous area and a wooden house (like the one in the picture) that must have been the finder's home. Surely, if he had sold the phone, it would have made for a significant sum. The more I looked at the photos - the finder's young kids, his wife, and their village - the more I marveled at the kindness of the finder.

Grateful, and thrilled, I asked Zham to offer a token of appreciation to the honest finder and his family.

But the finder turned it down, saying:

"Please tell him that we're not expecting any reward. We're just being good Muslims."

Note: I originally posted this photo on Facebook where it went viral, getting over 32,000 likes and 5,400 shares. It was also carried by several news outlets and websites:

"The Heartwarming Story Behind this Viral Photo" (ABS-CBN)
http://rachfeed.com/look-photo-small-nipa-hut-gone-viral-touching-reason/
http://www.thesummitexpress.com/2016/05/gideon-lasco-viral-photo-small-shanty.html
http://www.trendingnews.ph/touching-story-behind-viral-photo/
http://www.mindanews.com/top-stories/2016/05/please-tell-him-were-not-expecting-any-reward/

Mother's Day essay: There are no plain housewives

by Gideon Lasco

It has already been rejected many times in the past but the use of the term 'plain housewife' has continued to this present day, not just in ordinary conversations, but in news reports. A quick Internet search reveals that in the past year alone, the term was used in local media at least 18 times. “From being a plain housewife, [she] is now earning enough for her family to live a comfortable life,” says one report about a Cebu businesswoman. Even the Philippine Information Agency describes one beneficiary as a “plain housewife”.

What is so “plain” about housewives?

In the Philippines, women and men have always shared the tasks of raising a family. That our languages don’t distinguish between males or females (asawa can mean husband or wife) is just one of the evidences of the more egalitarian society we have enjoyed long before the colonial encounter. In many societies, the mag-asawa shared in various responsibilities of the oft-inseparable domains of earning a living and tending the household.

This mode, however, changed in modern times. Men - for whom the jobs were initially available - had to leave their homes throughout the day; consequently, the women had to stay. Eventually, there were more opportunities for women, but the higher-paying jobs were still the province of men, due to educational and social barriers.

As a result of these circumstances, the working woman was seen as “sophisticated” - highly-educated and well-heeled - while the housewife was seen as “plain”.

What is wrong about his narrative? First, women who stay at home are also working, perhaps even more so than their husbands. One website, Salary.com, computed that all the tasks of a stay-at-home mom in the US amounted to a $113,568 salary in 2014. Surely, in the Philippines, full-time housewives can also claim a competitive pay were we to put an economic valuation to the work they do.

Moreover, many housewives run sari-sari stores, participate in multi-level marketing, do handicrafts, and engage in many other sources of income. It is only our prejudice for formal employment that colors our view of other forms of hanapbuhay (livelihood), but they are no less important.

Second, being a housewife has never meant being unsophisticated. In fact, staying at home is a choice that many highly-educated women make. Rather than see women who stay at home as subordinated, or confined, we must see that oftentimes these choices are made by couples together. Financially, emotionally, and socially, it takes courage to be a housewife.

Finally, in our society today, many women are actually the breadwinners of the family. Women and men take turns in caring for their children, and in many cases it is the “house husbands” who stay at home. Will they, then, become “plain house-husbands”? These inversions of an imagined “norm” expose the double standards that should invalidate not just our use of “plain housewife”, but our prejudices for women who stay at home.

Cory Aquino is probably one of the most famous examples of a “plain housewife”. During the bitter campaign that ended in the fall of the dictatorship, Ferdinand Marcos and his supporters dismissed Cory as “just a woman” and a “plain housewife”. But Cory Aquino took up the label and it doing so, resonated with millions of women and men around the world. By identifying herself as a "plain housewife", Cory demonstrated that one way to challenge the use of a term is by being its living contradiction.

***

Terms like “plain housewife” remind us that language can reinforce ideologies of power. More than grammar (as the so-called 'grammar police' are wont to do), it is the seepage of oppression and inequality that we must be most wary about in our choice of words. Not to go to the extremes of “political correctness”, but simply to be mindful of the meanings of the words that we say. Surely, social attitudes that are reflected in these words weigh heavily in women’s decisions to stay or not to stay at home. But studies in health and education are unequivocal in seeing the advantages of close parental support.

Of course, many families do not have the luxury of someone staying at home, and I am not advocating for every mother to be a housewife. What I am against is the notion of a “plain housewife” because it shapes our way of thinking about women, and the way women think about themselves. Whatever choices women and men make - as couples or single parents - we should create an environment that supports these choices and family configurations.

I say this as the son of a mother who has devoted a big part of her life to her children. She was many things to us: storyteller, teacher, cook, driver, guidance counsellor, and many more…long before she became our mentor and friend. As a doctor who has witnessed mothers give birth and care for their babies and toddlers, I can also suggest that perhaps the greatest labors our mothers did for us predate our own memories. Surely, their lives are anything but plain. When we reflect on the many tasks of motherhood, we ought to realise that one of the greatest gifts that anyone can have in this world is a mother’s love.

Indeed, there are no plain housewives, just as there are no plain individuals: women and men alike. As we celebrate Mother’s Day, we must celebrate the women of our lives in all their uniqueness. Whether they decide to stay at home, or pursue careers that keep them from home, surely theirs is a labor of love, which deserve our utmost affection and appreciation.

Duterte as folk hero

Photo from Inquirer.net

by Gideon Lasco

Whether or not Duterte actually wins in the coming presidential elections, he has already scored a victory by becoming a folk hero for many Filipinos: those who are disenchanted with our democratic institutions, those in Visayas and Mindanao who feel underrepresented by an “Imperial Manila”, those who are fed up with usual names in politics, and those who are searching for authenticity in our leaders: an authenticity they can relate to.

A folk hero is, as Cambridge Dictionary puts it, “someone who is ​popular with and ​respected by ​ordinary ​people”. Certainly, the inspired following of Duterte all over the Philippines qualifies him by this measure. Even before his “reluctant” candidacy, his name was been uttered by many a taxi driver, as one of them once told me: “If only Duterte were president, surely he can solve the traffic in EDSA!”

Folk heroes, furthermore, are, “ambiguous figures”. Australian folklorist Graham Seal points out that “Many folk heroes walk a thin and fuzzy line between the admirable and the rephrensible. This line is seen is seen most clearly…where the practicalities of defying the law are continually balanced by the injustices - real or otherwise - inflicted by those who control the law.” Like Robin Hood breaking the law to serve the poor in the time of King John’s tyrannical abuses, Duterte’s seeming willingness (by his own words) to resort to extrajudicial measures has alarmed many, but has, in equal measure, convinced others of his heroic qualities.

Sociologists point out that folk heroes embody cultural values - so much so that many scholars actually study folk heroes as a way of understanding the cultures where these heroes belonged. In looking at Duterte as folk hero, then, we can make sense not only of the appeal of his candidacy, but of values many Filipinos hold dear.

Part of Duterte’s appeal lies in his promise of doing things differently in government. Held in the context of the still-unresolved Maguindanao massacre and Mamasapano “misencounter”, his willingness to resort to extraordinary measures serves as a sign of his potential to break the status quo in many other areas. This anti-establishment posture resonates with many who believe that the present system needs changing: those who feel that the problem is Filipinos’ lack of disipline, those who lament the continuous degradation of our natural resources, those who have not felt “inclusive growth” despite claims of an improved economy.

Another part of Duterte’s appeal is in the way he represents Mindanao, Visayas, and the rest of the Philippines outside of Manila. Whether warranted or not, many feel left out, and think that someone from Davao would be more understanding about the concerns of Cebu, than someone from Luzon. Boosting this case is Duterte's espousal of federalism - something that many regions have long been clamoring for.

Duterte’s perceived freshness in national politics is also appealing. While Poe, Binay, Santiago, and Roxas are surnames that have held - or ran for - national positions for decades, this is the first time a Duterte will appear in a national ticket. While this does not mean that he is no political dynast (his daughter Inday was mayor of Davao; his father Vicente was governor of the then-undivided Davao province), at least in the national level he is perceived as new.

Finally, Duterte’s appeal lies in the way people can relate to him. Unlike the mansions (alleged or real) of his rivals, he has a modest house in Davao with a kulambo in tow. While pundits cry foul over his not-so-subtle allusions to womanizing, many actually see his womanizing as a sign of strength and authenticity (at least, the thinking goes, he is honest about it, unlike others who are hypocritical). While pundits cry foul over his use of swear words (something that he has disavowed), it is a language of the street that nether Mar Roxas, with his Ateneo and Wharton education - nor Miriam with her eloquence - can emulate. It is the language that makes people say that “he is one of us”.

***

Folk heroes, however, are the stuff of legend, not of reality, and Duterte is already taking on a legendary character thanks to his ardent followers, who have given him apocryphal endorsements coming from Stephen Curry, AlDub, and even the Pope (which the CBCP had to refute). It is to Duterte’s credit that he can inspire such tales, but what they construct is an image of an infallible leader that is unhelpful to Duterte himself as he needs to be pushed to become a better candidate - not worshipped for what he already is. Moreover, in the process of making someone a folk hero, people make villains of out his enemies, at times with outright lies (i.e. the fictional nurse who bashes Roxas’ Yolanda response). This is not helpful to our political process.

If he loses the elections, Duterte will still live on as a folk hero, and a potent reminder of people’s dissatisfaction about our democratic processes, of the need to pay attention to the entire country, and of people’s growing mistrust of old names in positions of power. He will inspire others to emerge and take up his double-edged sword of no-nonsense leadership.

If he wins, he can capitalize on his popular support in pushing for badly-needed reforms in government. However, with the very high expectations he has set (i.e. “Kill me if I don’t resolve crimes in 6 months”) in the performance of this folk heroism, will he be able to deliver on his promises?

Only the elections will tell if enough people are willing to give him a chance.

Manila
April 2016

GIDEON LASCO ON THE 2016 ELECTIONS
Duterte as folk hero (gideonlasco.com)
Tough love for Duterte (Philippine Daily Inquirer)
Social media advice for Mar Roxas (Philippine Daily Inquirer)
The presidency of the forests (Philippine Daily Inquirer)
The politics of physical appearance (Philippine Daily Inquirer)

Smoking marijuana in Amsterdam

Photo from zambeza.com

by Gideon Lasco

Smoking marijuana in Amsterdam
by Gideon Lasco

AMSTERDAM - The distinctive aroma of cannabis is unmistakable, and there are parts of the city  center where, even with my eyes closed, I could tell that I’m in Amsterdam.

For four years now, I have kept coming back to this city for my graduate studies at the University of Amsterdam. Before our university moved further away from the city center, our department building was right at the red-light district, and when I had not yet mastered my way around the confusing streets and canals that look the same, I would sometimes end up in alleys where sex workers have their glass cubicles - or where coffee shops are suffused with the unerring vapor of the weed that is inexorably associated with the city itself.

As any local would point out, however, the monicker “Weed Capital of the World” is a misrepresentation of Amsterdam itself - a city that many of its residents love for its “small town” feel, and pragmatic sensibility. And while many in the city capitalize on its reputation by selling marijuana-themed souvenirs like cannabis leaf-shaped magnets, the Dutch government has actually introduced restrictions on marijuana use in recent years.

Yet it is still very acceptable to smoke cannabis here, and if I were to smoke a joint in Dam Square or the Museumplein - home of Van Gogh Museum and the Rijksmuseum - no one will notice, let alone arrest me. The city’s official website states that: “those aged 18 and above are permitted to smoke cannabis outside as long as doing so does not create nuisance to others.”

In one of his imaginative pieces in the Inquirer, Ambeth Ocampo interviews Jose Rizal, and gets the national hero to admit that he tried marijuana (a fact supported by Rizal’s own diary). If our national hero used marijuana, why couldn’t I?

***

Smoking weed, of course, has become morally and politically contentious in ways Rizal never anticipated (he, like many youths today, was most likely just “trying out stuff”). A series of legislations starting in the early 20th century turned marijuana into a forbidden substance, even as its very forbidden-ness increased its appeal (“Masarap ang bawal”). By 1972, following the US-led “War on Drugs”, the Dangerous Drugs Act (RA 6425) classified marijuana as a “prohibited drug” - making it even more forbidden than shabu.

Supporters of this drug regime justified these draconian measures by asserting that marijuana is “gateway” drug that could lead to “hard” drugs such as shabu and cocaine. Thereafter, the war on drugs was taken for granted as the righteous thing to do, and it was anathema to even question it. Politicians readily took up the cause, and Gloria Macapagal Arroyo even made the penalties harsher in 2002 with an amended Dangerous Drugs Law that imposes 12 - 20 years of jail time to anyone in possession of less than 300 grams of cannabis. In 2005, a man found in possession of two hand-rolled sticks of marijuana got sentenced to 15 years in prison.

The Dutch, on the other hand, took an entirely different approach, changing its policies on marijuana in 1976. Contrary to popular belief, they didn’t actually legalize marijuana (it’s still technically illegal until now), but they made a sharp distinction between “hard drugs” like methamphetamine and “soft drugs” like marijuana for which they pursued a policy of “non-prosecution”. Instead of looking at these drugs as a criminal problem, they saw them as a public health concern, and focused on reducing the harms associated with drug use. By permitting “coffee shops” to openly sell marijuana, for instance, Dutch policymakers felt that they were isolating users from dealers who would also be selling cocaine alongside marijuana. Importantly, they were not alienating drug users from society, welcoming them to avail of medical and rehabilitative services.

Forty years later, despite these policies, the lifetime drug use prevalence in the Netherlands is no more than that of neighboring countries, and it has the lowest rate of injecting drug use in Europe. Meanwhile, in the US where billions of dollars have been spent on a “War on Drugs”, states like Oregon and Colorado are beginning to legalize or decriminalize medical and recreational marijuana, following the Netherlands’ lead.

***

The Dutch context, of course, is very different: euthanasia, abortion, and same-sex marriage have been legal here for decades - and what has worked for them may or may not work for us, given our own sociocultural, demographic, and economic circumstances. The Dutch drug policy, moreover, is not without its problems and challenges - such as dealing with increasingly more potent varieties of cannabis, and the tenacious presence of an illegal drug trade.

Nonetheless, the Dutch experience on drugs should call into question the policies we have been unreflectingly following all these years. If, as a Mayo Clinic study demonstrated, marijuana poses less risk (9%) in developing dependence compared to “legal addictions” like nicotine (32%) and alcohol (15%), why impose such a heavy penalty for its users? If, as Canadian researchers have found, it is a safe and effective treatment for chronic pain relief, why ignore its potential health benefits?

We need an open and vigorous conversation about drugs. Not because someone like me can freely smoke marijuana in Amsterdam, but because many are smoking it in the Philippines, and they - along with those who seek its potential health benefits - are needlessly suffering the consequences of laws that don’t make sense.

Too many tourists spoil the view

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

by Gideon Lasco

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

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

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

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

***

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

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

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

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

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

***

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

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

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

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

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

by Gideon Lasco, MD

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

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

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

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

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

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

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

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

***

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

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

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

***

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

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

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

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

An open letter to the grammar police

An open letter to the grammar police
by Gideon Lasco

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

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

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

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

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

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

***

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

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

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

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

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


Heidelberg, Germany
March 8, 2016

Nutrition facts and fictions

by Gideon Lasco, MD, MSc

It takes some faith to be a modern eater. In the past, most people knew exactly what they were eating, because they themselves planted and harvested the rice, raised and slaughtered the chicken; picked the fruits and plucked the leafy vegetables. But today - at least in much of the lowlands - the sites of production (i.e. the farms) - and processing (i.e. the factories) - are far removed from the site of consumption (i.e. our dinner tables) and oftentimes we rely on food labels to tell us what exactly we are eating.

But can food labels be trusted? Are nutrition facts and ingredients intelligible enough for most consumers to help them make decisions? These questions, fundamental as they are for consumer rights, are even more relevant today as more and more people are getting sick because of the food they eat, and as food companies increasingly market their products to health-conscious consumers. In this essay let us look at food labels and examine what they reveal (and conceal).

Pick a random item in any supermarket and first thing you see are the illustrations: luscious strawberries, Dutch windmills, New Zealand cows. Cast off these images! In this exercise, and in our everyday food shopping, we need to focus on the fine print, for it gets us to closer to the truth of what we are about to eat. 

First, look at the generic name of the product, because it can make a whole world of difference in nutritional content. Many people would consider juices to be healthier than softdrinks, but juice, by industrial definition must come entirely from real fruits. In reality, most of the so-called juices in the market are actually “flavored juice drinks”: beverages with little or no actual fruit juice, and a lot of flavors and sweeteners. 

Another example: “Condensed milk” and “evaporated milk” are, by definition, milk where water is removed, and, in the case of the former, sugar is added. But many of the products we assume to be condensed or evaporated milk are actually “creamers”: in place of real milk are vegetable oils and milk powders. Nutritionally speaking, this substitution is very alarming, in light of the long history of these products being used as infant formula.

Second, food labels can trumpet a certain kind of health benefit, but can mislead in terms of what that benefit actually means, and distract attention away from unhealthiness of the product as a whole. Most “whole wheat bread” in the market does have some whole wheat, but still has enriched flour - and the inevitable sugar - as ingredients. One 75-g pack of junk food boasts that it has “0g trans fat” but the fine print shows that its saturated fat content is 7.5g - a whopping 39% of the recommended daily allowance! “Organic” is great, but organic chocolate will still make you fat if you overeat it. 

Finally, although manufacturers are required to list their ingredients and nutrition facts, these seemingly-objective parameters can also mislead, as when serving sizes do not correspond with the actual quantity of a product that is commonly consumed in its entirety. A serving of one popular junk food has 170 calories, but there are actually 4 servings in a 100g pack, making for a total of 680 calories - equivalent to over three cups of rice! 

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For the food to be in the supermarket in the first place, nutritional sacrifices have to be made, such as the addition of chemicals and the removal of certain nutrients for longer shelf life. There is also the imperative to make the products affordable, hence many of the “cheese foods” we think of as real cheese are actually made of water and oil more than “natural cheese”. Alas, what remains within the budgets of many Filipinos are foods that are rich in flavor but poor in substance; high in calories but lacking in nutrition.

The good news is that there are healthy and affordable foods out there - healthy eating is (and should not) be regarded as a province of the rich. A glass of pure dalandan juice costs just P15 - cheaper than those sugary, dalandan-flavored beverages. Kamote and saging na saba remain affordable and great snacks, even though it takes some patience for our taste buds to rediscover the deliciousness of natural foods - having been made pihikan (picky) by artificial flavors. While the specifics of healthy eating may change with new research, the core tenets are timeless: Choosing foods that are low(er) in sugar, salt, and fat and as unprocessed as possible (the fewer the ingredients the better); going for variety; and eating in moderation. 

But how will consumers be able to tell? This is where the government should step in. In Ecuador, food products are required to prominently display the levels of fat (graza), salt (sal), and sugar (azucar) in “traffic light labels” that show green for low, yellow for medium, and red for high. A similar move in our country would be very much in the spirit of our own Food and Drug Administration’s call for food labels to help people “acquire the knowledge necessary to be informed consumers”- but sadly, this call has largely been ignored by the market.

Alongside our plea for government action, we can equip ourselves - and others - with a critical eye for food labels, ingredients and nutrition facts. In an age when profit margins are oftentimes more valued than product quality, and when many of our lifestyle diseases can be prevented by a healthy diet and regular exercise, we must add to our common sense the ability to differentiate between nutrition fact and fiction.