BASELINE HEALTH PROFILING AMONG TOBACCO FARMERS IN ILOCOS REGION

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1 TECHNICAL REPORT BASELINE HEALTH PROFILING AMONG TOBACCO FARMERS IN ILOCOS REGION Unit 12, 4 th Floor, Castro Building, Luis Sianghio corner K1st Street, Kamuning, Quezon City 1103 Tel/Fax: Address: ash.philippines@gmail.com

2 PROJECT INFORMATION PROJECT TITLE BASELINE HEALTH PROFILING AMONG TOBACCO FARMERS IN ILOCOS REGION, PHILIPPINES QUARTER COVERED December 2017 To March 15, 2018 REPORT COMPLETED BY Ma Encarnita B. Limpin, MD, Executive Director Action On Smoking And Health Philippines, Inc SPECIFIC OBJECTIVES a. To describe the socio-demographic profile of tobacco farmers b. To describe their farming practices and characterize the environmental exposure of tobacco farmers c. To determine the common occupational health problems afflicting tobacco farmers, including possible green tobacco sickness d. To determine if an association exists between their tobacco farming practices and current occupational health problems in the area e. Recommend action areas to minimize significant adverse impacts on health and environment PROJECT AMOUNT USD 10,000-WHO Funding with Counterpart from DOH R1 LOCATION Region 1, Philippines DURATION OF PROJECT 2 Years (December 2017 to November 2019) Summary: After a series of meetings with our government partners (Department of Health, DOH and Department of Agriculture, DA) in Region 1, we were able to gather the following informations: From the Department of Agriculture (DA): October marks the beginning of the region s dry season: A perfect weather to start seedling followed by planting of tobacco on the following month; Tobacco is considered one of the major cash crops being planted in the region, which is widely grown after rice or corn; Ilocos region (Ilocos Sur, Ilocos Norte, and La Union) is the top tobacco producing region in the country Ilocos Sur is considered the tobacco capital of the country accounting for 75% share of the national production output Tobacco farming employs an estimated 840,415 males (Region 1 and 2) Given that more farmers are shifting to non-tobacco crops, and the reality that tobacco industry production is declining and that it is labor intensive and less profitable, still more farmers continue to cultivate tobacco due to: - Ready market

3 - Technical assistance from NTA and PMFTC - Availability of financial assistance in the form of a loan - Climate suitability of the crop - Belief that it is the only profitable crop - Availability of farm inputs - Neighbors also cultivate tobacco - And the aggressive encouragement by government officials to farmers who are already growing other crops to go back to tobacco. There are existing SEC registered farmers organizations in the region. Most are tobacco farmers who operate under the supervision of the Regional Agriculture and Fishery Council (RAFC). The RAFC is under the DAs Executive Office. From the initial activities to lay the foundation for the work on assessing the health effects of tobacco farming, it was learned that the Department of Health and the Department of Agriculture had several consultations with the tobacco farmers. The consultations were focused primarily on Art. 17 (Provision of support for economically viable alternative activities) and 18 (Protection of the environment and the health of persons) of the World Health Organization - Framework Convention on Tobacco Control (WHO-FCTC). As a result, a resolution on the project for tobacco farmers was drafted by the DOH and the DA for the Local Chief Executives (LCEs) approval. The following informations were gathered: The DOH and DA started courtesy calls with the identified LCEs in the targeted local government units (LGUs). Unfortunately, the Department of Labor and Employment (DOLE), a member of the project team, was not around during the initial meetings. With the 4 identified large tobacco producing LGUs (Sinait, Cabugao, San Juan and Candon), only Sinait LCE agreed to the idea of crop diversification. Alternative livelihood as a term, though used in RA 7171, is apparently unacceptable to some LCEs primarily because it gives the impression that they will have to discourage tobacco farmers to grow tobacco. With reservation, however, the Mayor of Candon still provided the team with a relatively small barangay as pilot testing. The concerns of most of the local officials about the project for tobacco farmers is that it may result to a lower share of funds from RA 7171 in the coming years. The argument of the local leaders is No one can provide what 7171 provides the province, cities, municipalities and the congressional districts of the Ilocos region.

4 It is very clear that Tobacco farming in the Philippines, specifically in Region 1, is considered a political crop and is thus a sensitive issue for the local officials. With the promise of RA 7171, it is very difficult to convince local chief executives (LCEs) on the idea of FCTC Art. 17 and 18.. unless the resolved comes from the tobacco farmers. Progress against Workplan Objective 1: To determine the baseline health profile of the tobacco farmers in selected municipalities in Ilocos Sur and Ilocos Norte province with regards to environmental exposures and health outcomes. Output 1: Formulation of public health monitoring framework among tobacco farmers and implementation of the baseline health profiling study. Activity Progress against activity Explanation of variance 1.1 Proposal Development Done /Approval 1.2 Inception report shall include concept note, time table, work plan and costing. 1.3 Finalization of Protocol, Development of Questionnaire and other tools 1.4 Institutional Ethics Review Board Approval (Philippine Heart Center/Mariano Marcos Memorial Hospital and Medical Center) 1.5 Convene series of consultative meetings. Done On-going Progress: Initial meetings with Dr Otayza of Mariano Marcos Memorial Hospital and Medical Center conducted and discussions on the operational plan of the project were done. Another meeting shall be held within the 1 st quarter of Awaiting finalization of the protocol Done. Result: ASH Phil Project Team headed by Dr Limpin, Engr Abordo and Mr Paje conducted consultative meetings with WHO, DOH BHIC. Ground work initiated with DOH-R1, DA and with some tobacco farmers organizations Outcome: Project proposal was approved/initial target project areas were.

5 identified Meeting with DOH R1: Outcome: Started targeting prospective LGUs to be included in the health assessment project Meeting with Farmers Organization in Region 1, and Department of Agriculture Region 1 Outcomes: - Project partners within the Department of Agriculture to serve as champion in the area was identified. - existing farmers organization also identified coupled with establishment of linkages 1.6 Survey Implementation Sheduled for reporting Q4 1.7 Data Collection: Physical Scheduled for reporting for Q7 Examination /Laboratory/ Biological Testing 1.8 Biostatistics Scheduled for reporting for Q7 1.9 Data Analysis & Technical Scheduled for reporting for Q7 Writing 1.10 Approval/Submission of Final Report/Output/ Dissemination Scheduled for reporting for Q8 MA. ENCARNITA B. LIMPIN, MD 18 April 2018 Authorized Signature Date