The numbers are staggering. One billion of the world’s human population harbor soil-transmitted helminths. In the Philippines alone, conservative estimates place at least 20 million Filipinos as "chronically infected." Infection increases maternal and fetal morbidity and mortality rates, with the helminths migrating to the liver, gall bladder, and other organs. In surgical operations, it is not unusual to find a bolus of worms causing intestinal obstruction.
How does one get worms? Poor hygiene is the leading cause of helminthiasis. In areas where environmental conditions are less than ideal, there is a greater chance of being infected. "But I live in a good area, so I won’t be infected," you might be tempted to say. Well, one cannot be too certain. Flies, cockroaches, and other insects carrying worm ova can contaminate your food. Besides, you also eat out, don’t you? A 2002 study showed that one out of five in a sample group of food handlers in Manila had hookworms. If one of them didn’t wash his hands and just happened to handle your food ... Well, think about it.
Children who are not infected by worms do better in school. Studies funded by the World Health Organization indicate that the school performance of elementary school students is adversely affected when they have intestinal parasites. In a study group of third grade public elementary school students, the honor section showed the least percentage of infection while the seventh section, where the weakest students were placed, showed the greatest infection percentage. Results of the study become even more alarming when you consider the fact that seven out of 10 elementary schoolchildren nationwide are infected with roundworms, hookworms, and whipworms.
With mounting concern about the deteriorating quality of education, the problem of intestinal parasitism must be addressed. Perhaps, the problem is not simply the lack of classrooms, inadequacy of teaching materials or overworked teachers. Feeding programs will prove futile if nutrients are siphoned off by intestinal parasites. Coupled with the symptoms of helminthiasis – constipation, diarrhea, abdominal pain, restlessness, and the inability to concentrate – one does not wonder why many of our children under-achieve in school. Indeed, the effects of helminthiasis are not as sudden or dramatic as that of other epidemics. However, the consequences are just as dire. Extensive infection will lead to the "dulling" of our children. This, in turn, will eventually translate to a physically and mentally stunted citizenry.
Considering its magnitude, the problem of helminthiasis cannot be solved by one agency alone. Thus, the cooperative effort of the Biñan, Laguna community to eradicate intestinal parasitism is noteworthy.
The story starts in 1998 when Dr. Vicente Belizario Jr., scion of a prominent Biñan family, held regular weekend clinics in the town. Armed with a master’s degree in tropical medicine and hygiene from the Uniformed Services University of the Health Sciences in Bethesda, Maryland USA, Dr. Belizario noted that many patients complained of abdominal pain or digestive problems and, in fact, were infected with roundworms, whipworms, and hookworms. With funding from the World Health Organization, Dr. Belizario and a team of public health experts from the University of the Philippines, undertook a school-based study to determine the extent of helminth infection among elementary school students.
The results were dire. In the Biñan study group, 94 percent of schoolchildren were infected. Thus, it was decided to increase the scope of the study.
Schoolchildren from other provinces such as Nueva Ecija, Cebu, Pangasinan, Cavite, Davao, and Quezon City were also examined. Sixty-six percent were infected, with 9.9 percent of these showing heavy intensity. Simply put, seven out of 10 children had worms. One in 10 children had very many worms! Clearly, the Department of Health (DOH) community-based worm control efforts and the Department of Education Culture and Sports’ (DECS) deworming of Grade 1 school entrants were inadequate.
Faced with the results of the study, Dr. Belizario, the local government, and the Department of Education (DepEd) School District of Biñan put together a school-based worm control and health education program in their town. With the support of Janssen, a division of Johnson & Johnson that manufactures the antihelminthic drug mebendazole (Antiox), the infected children were given the required dosage. Since the drug came in the form of a palatable, chocolate-flavored chewable tablet, getting the kids to take it was relatively easy. In addition, "Deworming Days" with parades and school programs were held to promote awareness.
The results were positive and the performance of the Biñan schoolchildren improved dramatically. From a 15th-16th school ranking, five of the 20 top-performing schools in Laguna today are Biñan schools.
Romana Espinosa, school district supervisor, is quick to emphasize that the improvement is not due to the deworming program alone. "The improved rating is also due to the fact that more school intervention programs in reading and math were undertaken," she says. "We have also had supplementary feeding programs in school." However, she acknowledges the importance of the deworming program. Reading and math enrichment programs, after all, are wasted on sick, inattentive kids. On the other hand, the worms in the child’s gut will be the first to benefit from a feeding program. "(With deworming,) all roads to quality education have been cleared," avers Miss Espinosa.
The success of the school deworming program is also largely due to the support of the local government of Biñan.
Lawyer Armand Dimaguila, town councilor, shares that P1 million is set aside yearly for the deworming program. In addition, to solve the garbage program and further lessen helminthiasis, Biñan is set to open a Waste Conversion and Livelihood Center.
The eradication of intestinal parasitism among school-aged children is a community effort. Recognizing that the good health of the youth is vital to their success, local government, school officials, health professionals, and community members have bonded together to fight helminthiasis and other roadblocks to educational achievement.