Chapter 1a

MINA DE ORO PROVINCIAL HOSPITAL AND CENTER FOR RESPIRATORY HEALTH Application of Therapeutic and Healing Design Approaches in a Patient- Centered Health Facility

Chapter 1 – INTRODUCTION 1.1

BACKGROUND OF THE STUDY 1.1.1 Mindoro Mindoro is the seventh-largest island in the Philippines. It is located of the coast of Luzon, and northeast of Palawan. The southern coast of Mindoro forms the northeastern extremum of the Sulu Sea. In past times, it has been called Mai or Mait by Chinese traders and, by Spaniards, as Mina de Oro (meaning "gold mine") from where the island got its current name. According to the late historian William Henry Scott, an entry in the official history of the Sung Dynasty for the year 972 mentions Ma-i as a trading partner of China. Other Chinese records referring to Ma-i or Mindoro appear in the years that follow. From 1920 to 1950, the island was a single province with Calapan City as the provincial capital. In 1950, it was divided into its two presentday provinces, Occidental Mindoro and Oriental Mindoro, following a referendum that was pushed through by then acting governor Romeo Venturanza. 1.1.1.1 Oriental Mindoro A province of the Philippines located in the island of Mindoro under MIMAROPA region in Luzon, about 140 km southwest of Manila. The province is bordered by the Verde Island Passage and the rest of Batangas to the north, by Marinduque, Maestre de Campo (or known as Sibale but official name is Concepcion) Island, Tablas Strait and the rest of Romblon to the east, by Semirara and the rest of Caluya Islands, Antique to the south, and by Occidental Mindoro to the west. Oriental Mindoro is composed of 14 municipalities, with one city, Calapan City serving as the provincial capital. 

City: Calapan City

    

Municipalitie s: Baco Bansud Bongabong Bulalacao Gloria

Figure 1: Political Map of Oriental Mindoro Source: Ph fil oriental mindoro" by Roel Balingit Figure 2: Political Map of Oriental Mindoro Source: Ph fil oriental mindoro" by Roel Balingit

 Mansalay  Naujan  Pinamalayan  Pola  Puerto Galera  Roxas  San Teodoro  Socorro  Victoria

Chapter 1 - Introduction

1.1.1.2 Occidental Mindoro A province of the Philippines located in the MIMAROPA region in Luzon. Its capital is Mamburao and occupies the western half of the island of Mindoro, on the west by Apo East Pass, and on the south by the Mindoro Strait; Oriental Mindoro is at the eastern half. The South China Sea is to the west of the province and Palawan is located to the southwest, across Mindoro Strait. Batangas is to the north, separated by the Verde Island Passage. Occidental           

Mindoro is subdivided into 11 municipalities. Abra De Ilog Calintaan Looc Lubang Magsaysay Mamburao (Capital) Paluan Rizal Sablayan San Jose Santa Cruz Figure 2: Political Map of Occidental Mindoro Source: "Ph fil occidental mindoro" by Roel Balingit

1.1.2 Population/Mindoreneos Statistics 1.1.2.1 Tagalog Below is a table on Total Population by Province, City, and Municipality from 2010 National Statistics Office: Census of Population and Housing as of May 1, 2010. In Oriental Mindoro,the City of Calapan has the biggest population and San Teodoro has the least while in Occidental, San Jose has the biggest population (bigger than Calapan’s) and Looc has the least. Mindoro has a total population of 123, 8573. 1.1.2.1.1

Oriental Mindoro

Table 1: Oriental Mindoro Population

CITY/ MUNICIPALITY

POPULATION

Baco

35,060

Bansud

38,341

Bongabong

66,569

Bulalacao (San Pedro)

33,754

City of Calapan (Capital)

124,173

Gloria

42,012

Mansalay

51,705

Naujan

94,497

Pinamalayan

81,666

Pola

32,984

Puerto Galera

32,521

Roxas

49,854

San Teodoro

15,810

Socorro

38,348

Victoria

48,308

TOTAL POPULATION

785,602

2010

1.1.2.1.2

Occidental Mindoro

Table 2: Occidental Mindoro Population

CITY/ MUNICIPALITY

POPULATION

Abra De Ilog

29,225

Calintaan

28,148

Looc

9,758

Lubang

23,068

Magsaysay

31,969

Mamburao (Capital)

39,237

Paluan

15,223

Rizal

34,458

Sablayan

76,153

San Jose

131,188

Santa Cruz

34,544

TOTAL POPULATION 2010

1.1.2.2

452,971

Mangyan

According to Mangyan Heritage Center in Calapan, Mindoro, There are around 300 million indigenous peoples in the world. In the Philippines, of the projected population of 94 million in 2010, about 15% belong to indigenous groups. Mindoro is the seventh largest island in the Philippines, with an area of 10,224 square kilometers and two provinces – Oriental and Occidental. Of the total population of one million, the indigenous population is estimated at 100,000 +, 10% of the total population of Oriental and Occidental Mindoro, 70% animists and 30% Christians, but official statistics are difficult to determine under the conditions of remote areas, reclusive tribal groups and some having little if any outside world contact.

Figure 3: Ethnographic Map of Mindoro (Mangyan Tribes) Source: Mangyan Heritage Center

Mangyan is the collective name for the eight indigenous groups living in Mindoro, each with its own name, language, and set of customs: Iraya, Alangan, Tadyawan, Tau-buid, Bangon, Buhid, Hanunuo, and Ratagnon. Census of Population and Housing of the 8 tribe’s population (total of 104,056 Mangyans) from National Statistics Office : Household population by Ethnicity and Sex as of May 1, 2010 gives the following figures: Oriental Mindoro

Occidental Mindoro

1.1.2.2.1 Iraya (26,789 population 2010 NSO ) The Iraya occupy the northwestern part of Mindoro, where one of the country's highest peaks, Mount Halcon, is located. The word "Iraya" is derived from the prefix "i" - denoting people, and "raya", a variation of "laya" which means "upstream," "upriver" or "upland". Thus the meaning of the word is "people from upstream" or "uplanders". Historically, however, the Iraya occupied the coastal region in some distant past, until they were pushed further inland by settlers from other places. The word also means "man", "person", and adult" (Servano, 2006) 1.1.2.2.2 Alangan (16,595 population 2010 NSO ) The Alangan occupy northwest central Mindoro. One theory about this term is that it could mean "a group of people whose culture is awkward", from the Tagalog

word alangan, which means among other things "uncertainty", "doubt" or "precariousness". (Servano, 2006) 1.1.2.2.3 Tadyawan (4,271 population 2010 NSO ) There is scant information available regarding the Tadyawan, who live in sparse settlements in the northeast part of the island. 1.1.2.2.4 Tau-buid (11,716 population 2010 NSO ) The Batangan or Taubuhid (also Tawbuhid), the most numerous of the Mangyan groups, occupy the central highlands of the island in the Occidental Mindoro. They live in a region where mountains tower 1950 m high. The word "batangan" derives from "batang", meaning "trunk of a felled tree", and "an", meaning "place", and refers to a place where felled tree trunks may be found, probably a swidden field. (Servano, 2006) 1.1.2.2.5 Bangon (13,656 population 2010 NSO ) The Batangan are also known as Bangon or Taubuhid. Other names used to refer to them are Bukid, Bu'id, Buhid, and Buhil, despite the fact that there is a separate identifiable group to the south, the Buhid. Local subgroups include the Bayanan and Saragan. (Servano, 2006) 1.1.2.2.6 Buhid (913 population 2010 NSO ) The Buhid occupy the south central part of Mindoro. Their territory just about equally straddles the eastern and western provinces comprising the island. (Servano, 2006) 1.1.2.2.7 Hanunuo (29,188 population 2010 NSO ) The Hanunoo Mangyan live in a mountainous area about 800 sqkm in the southeastern part of the island, mainly in Oriental Mindoro. Their territory is under the municipal jurisdiction of Mansalay, Bulalacao, and a certain part of San Jose, which is the capital of Occidental Mindoro. 1.1.2.2.8 Ratagnon (928 population 2010 NSO ) The Ratragon occupy the southernmost tip of the island province, quite close to the coast facing the Sulu Sea. They lie nearest the aquatic route going to Busuanga Island in the northernmost Palawan and the Cuyo islands, two places where the language spoken is Cayunon, which is also used by the Ratagnon (Servano, 2006) 1.1.3 Healthcare 1.1.3.1 Hospitals and Infirmaries Statistics 1.1.3.1.1 Oriental Mindoro Name of Facility

Address No./Street Name

Barangay

Mun./City

License Date Validity Name of Head Classification No. Issued Period ABC of Facility

GOVERNMENT/ PUBLIC as of February 23, 2015 4B10 1515I 1

Bulalacao Community Hospital Naujan Municipal Hospital

Santiago St.

Naujan

4B21 1510I 1

Jan 1, 2015

Jan 1 Dec 31, 10 2015

Jan 1 Jan 1, Dec 31, 2015 2015

10

Archie S. Yboa, MD

Infirmary

Lenelinda C. Onanad, MD

Infirmary

4B20 15100 H11

Jan 1 Jan 1, Dec 31, 2015 100 2015

Marpheo Marasigan, MD

Level I

Anthony K. Cruzado, MD

Infirmary

Oriental Mindoro Provincial Hospital

Ilaya

Calapan City

Roxas District Hospital

Odiong

Roxas

4B14 1525I 1

Jan 1 Jan 1, Dec 31, 2015 2015

Renato Umali Reyes Hospital of Bongabong

Brgy. Labasan

Bongabong

4B06 1522I 1

Jan 1 Jan 1, 2015 Dec 31, 2015

22

Pinamalayan

4B01 1510I 1

Jan 1 Jan 1, 2015 Dec 31, 2015

Guillermo A. 10 Gonzales, MD

Pinamalayan Community Hospital

Strong Republic, Nautical Highway

25

AS OF MAY 1, 2010

BED TO POPULATION

2010

Infirmary

Infirmary

177 BEDS

TOTAL GOVERNMENT/PUBLIC BEDS ORIENTAL MINDORO

Levon Franco V.R.F. Baldoza, MD

785,602

POPULATION

1:4438

RATIO

PRIVATE as of February 23, 2015 Children's Medical Clinic Hospital of the Holy Cross

Bonbon

V.R. Medrano Sr., cor. T.M. Kalaw Sts.

Ilaya

Calapan City

Calapan City

4B07 1510I 2 4B15 1530 H12

Jan 1, 2015

Jan 1 Dec 31, 10 2015

Jan 1 Jan 1, Dec 31, 2015 2015

30

Emmanuela K. Lim, MD

Infirmary

Renato Jose M. Priela, MD

Level I

Poblacion IV

Victoria

4B19 1508I 2

Jan 1 Jan 1, 2015 Dec 31, 2015

Tawiran

Calapan City

04B 10014 50H22

Jan 1 Dec 31, 2014

Ma. Estrella General Hospital

Tawiran

Calapan City

4B04 1575 H12

Jan 1, 2015

Jan 1 Dec 31, 2015

75

Senor Tesoro Hospital

Poblacion II

Victoria

4B32 1508I2

Jan 1, 2015

Jan 1 Dec 31, 2015

Pinamalayan

4B10 1530 H12

Jan 1, 2015

Jan 1 Dec 31, 2015

4B15 Pinamalayan 1510I2

Jan 1, 2015

Jan 1 Dec 31, 2015

10

Jan 1 Jan 1, Dec 31, 2015 2015

5

Virgilio D. Umali, MD

Infirmary

25

Vicente Jeronimo L. Santos, MD

Infirmary

Baldomero A. Esteban, Jr., MD

Infirmary

Charis S. Santiago, MD

Infirmary

Mina de Oro General Hospital MMG Hospital & Health Service of Oriental Mindoro

J.P. Rizal St.

Pinamalayan Doctors Hospital

Francisco St.

Saint Paul General Hospital

Quezon St.

Umali Medical Clinic

Gelacio Ocampo St.

Sta. Maria Village Clinic

Block 4, Sta. Maria Village

St. Lawrence Hospital

Grace Mission Hospital

Strong Republic, Nautical Highway

De los Reyes Medical Clinic

Aguinaldo St.

Nuestro Espiritu Medical / Surgical & Diagnostic Clinic

Poblacion I

Victoria

4B24 1505I 2

8

Infirmary

Claro M. Reyes, MD

Level II

Melinda Corazon N. Goco, MD

Level I

8

Leo P. Geronimo, MD

Infirmary

30

Eloisa N. Mambil, MD

Level I

Paulette Tessa G. Candelaria, MD

Infirmary

50

Calapan City

4B42 1425 H12

Jan 2, 2014

Jan 2 Dec 31, 2014

Poblacion III

Victoria

4B20 1504I2

Jan 1, 2015

Jan 1 Dec 31, 2015

Catinigan

Socorro

4B37 1515I 2

Jan 1, 2015

Jan 1 Dec 31, 10 2014

Pinamalayan

4B23 1510I 2

Jan 1 Jan 1, 2015 Dec 31, 2015

10

Bongabong

4B18 1504I 2

Jan 1 Jan 1, 2015 Dec 31, 2015

4

Brgy. Ipil

Gregorio S. Valdez, Sr., MD

4

Antonio M. de los Reyes, MD

Adolfo P. Espiritu

Infirmary

Infirmary

Luna Goco Medical Center

Lalud

Calapan City

Atienza Polyclinic

Poblacion II

Victoria

04B 01914 30H22 4B16 1506I2

Jan 1, 2015

Jan 1 Dec 31, 2014

30

Jan 1 Dec 31, 2015

6

AS OF MAY 1, 2010

BED TO POPULATION

Level II

Rosinico F. Fabon, MD

Infirmary

315 BEDS

TOTAL PRIVATE BEDS

ORIENTAL MINDORO

Mario Augusto Lorman L. Goco, MD

2010

785,602

POPULATION

1:2493

RATIO

TOTAL PROVINCIAL BED COUNT

499 BEDS

TOTAL PROVINCIAL BED TO POPULATION (2010) RATIO

1: 1575

1.1.3.1.2

Occidental Mindoro

Address

Name of Facility

No./Street Name

Barangay

Mun./City

License Date Validity Name of Head Classification No. Issued Period ABC of Facility

GOVERNMENT/ PUBLIC as of February 23, 2015 Poblacion

Abra de Ilog

4B41 1510I 1

Jan 1 Jan 1, 2015 Dec 31, 2015

10

Carlos R. Dipasupil, MD

Lubang District Hospital

Brgy. Tangal

Lubang

4B09 1525I 1

Jan 1 Jan 1, Dec 31, 2015 2015

25

Venmar S. Sayapal, MD

Occidental Mindoro Provincial Hospital

Brgy. Tayamaan

Mamburao

Paluan Community Hospital

Brgy. Alipaoy

Paluan

4B11 1510I 1

Jan 1 Jan 1, 2015 Dec 31, 2015

San Jose

4B08 1550I 1

Jan 1 Jan 1, 2015 Dec 31, 2015

Abra de ilog Municipal Hospital

Venturanza St.

San Jose District Hospital

National Highway

San Sebastian District Hospital

Sitio Macambang

Sta. Cruz Community Hospital

Buenavista

Sablayan

Poblacion II

Sta. Cruz

4B03 15100 H11

4B01 1525 H11 4B02 1510I 1

BED TO POPULATION

AS OF MAY 1, 2010

2010

Infirmary

Jan 1 Jan 1, Ner T. Dec 31, 100 2015 Agoncillo, MD 2015

Level I

Rosario M. Barrales, MD

Infirmary

50

Noelito S. Fernandez, MD

Level I

Jan 1 Dec 31, 2015

25

Paulino D. Legaspi, Jr., MD

Level I

Jan 1 Jan 1, 2015 Dec 31, 2015

10

Leonida M. Pallayaban, MD

Infirmary

Jan 1, 2015

10

230 BEDS

TOTAL GOVERNMENT/PUBLIC BEDS

OCCIDENTAL MINDORO

Infirmary

452,957

POPULATION

1:1969

RATIO

PRIVATE as of February 23, 2015 St. Magdalene Hospital 0218 Bonifacio St.

San Jose

4B42 1507I 2

Jan 1 Jan 1, 2015 Dec 31, 2015

7

Lope C. Asilo, MD

Infirmary

Zapanta Maternity & General Hospital

Liboro St.

Westmin United Doctors Hospital Co.

Gomez St.

St. Martin's Mission Hospital

San Roque

Brgy. Pag asa

San Jose

4B30 1515I 2

Jan 1 Jan 1, Dec 31, 2015 2015

San Jose

4B59 1410I 2

Feb 18, 2014

Feb 18 Dec 31, 2014

Jan 1, 2015

Jan 1 Dec 31, 2015

Poblacion

Sablayan

4B03 1515I2

Infirmary

10

Eleanor S. Costibolo, MD

Infirmary

15

Sr. Josephine Rose F. Blanco, OP, MD

Infirmary

47 BEDS

TOTAL PRIVATE BEDS OCCIDENTAL MINDORO BED TO POPULATION

Senen M. Zapanta, Jr., MD

15

AS OF MAY 1, 2010

2010

POPULATION

452,957 1:9637

RATIO

TOTAL PROVINCIAL BED COUNT

277 BEDS

TOTAL PROVINCIAL BED TO POPULATION (2010) RATIO

1: 1635

MINDORO PROVINCE TOTAL BED COUNT

803 BEDS

TOTAL POPULATION (2010

1,238,559 1: 1543

TOTAL BED TO POPULATION (2010) RATIO

1.2

STATEMENT OF THE PROBLEM The Oriental Mindoro Health Investment Plan (OMHIP) admits that “public health facilities which cater to the poor are mostly illequipped, with inadequate supply of drugs and medical supplies. Private hospitals that provide better health care are beyond the reach of the poor.” It also acknowledges the limited access of Mangyans to health services. In addition, this development is aiming to give solution to the following problems that currently exists on our health care for lung and respiratory health: 

In this province, respiratory diseases still rank as the leading causes of mortality and morbidity. The most common causes of morbidity are upper respiratory tract infection, bronchitis, pneumonia, diarrhea and pulmonary tuberculosis (TB). In Occidental Mindoro, acute respiratory infection has also been the leading cause of morbidity, followed by diarrhea and gastroenteritis. There is no hospital development that specialized in prevention and cure of lung and respiratory diseases to efectively reduce the case of such diseases. As shown in the 1.1.3.1 Table of Hospitals and Infirmaries Statistics, existing and new facilities ofers limited type of service and care for the prevention, cure and treatment of lung and respiratory diseases. Most of the public hospitals are at Infirmary level and four (4) out of 13 in the whole province is at Level 1 Hospital which is a very small hospital, an emergency type one that ofers ONLY:

initial treatment for cases that require immediate treatment and that provides primary care for prevalent diseases in the area o general medicine, pediatrics, minor surgeries, and non-surgical gynecology o primary clinical laboratory, pharmacy and first level radiology o nursing care for patients needing minimal supervised care Patients have no choice but transfer to private hospitals because of the limited services and equipment. o

Source: Center for Health Development- Region IVB Statistics as of 2010 (Highlighted are disease/ ailments connected to Respiratory System)

Oriental Mindoro Provincial Profile Leading Causes of Morbidity Causes Acute Respiratory Infection Rate/100,000 3417.67 Bronchitis 451.87 Urinary Tract Infection 372.82 Wounds all forms 337.63 Pneumonia 322.51 Hypertension 285.66 TB, all forms 280.85 Diarrhea 265.59 Rhinistis 230.40 Tonsilo Pharyngitis 190.67

No. 24,861 3,287 2,712 2,456 2,346 2,078 2,043 1,932 1,676 1,387

Leading Causes of Mortality Causes Diseases of the Heart Cancer Pneumonia COPD Hypertension Pulmonary Tuberculosis Diabetes Mellitus Multiple Organ Failure Accident Degenerative Diseases

Rate/100,000 79.05 34.23 30.79 30.79 19.38 12.51 12.37 11.00 10.72 9.35

Leading Causes of Maternal Mortality Causes No. Partum Heorrhage Rate Post 5 Pre‐eclampsia 67.13 2 Uterine Atony 26.86 2 26.86 Leading Causes of Infant Mortality Causes No.Prematurity Rate 15 1.74 Congenital Malformation 8 Pneumonia 0.93 7 Septicemia 0.81 6Undetermined 0.70 5 Asphyxia 0.58 5 0.58 Tetanus Neonatorum 5 Membrane 0.58 Hyaline Disease 3 0.35 Diseases of the Heart 3 0.35 Respiratory Distress Syndrome 2 0.23

Occidental Mindoro Provincial Profile

No. 575 249 224 169 141 91 90 80 78 68

Leading Causes of Mordibity Causes Rate/100,000 Acute Respiratory Infection 3417.67 Bronchitis 451.87 Urinary Tract Infection 372.82 Wounds all forms 337.63 Pneumonia 322.51 Hypertension 285.66 TB, all forms 280.85 Diarrhea 265.59 Rhinistis 230.40 Tonsilo Pharyngitis 190.67

No. 24,861 3,287 2,712 2,456 2,346 2,078 2,043 1,932 1,676 1,387 Leading Causes of Mortality

Causes Rate/100,000 Diseases of the Heart 79.05 Cancer 34.23 Pneumonia 30.79 COPD 30.79 Hypertension 19.38 Pulmonary Tuberculosis 12.51 Diabetes Mellitus 12.37 Multiple Organ Failure 11.00 Accident 10.72 Degenerative Diseases 9.35 Leading Causes of Maternal Mortality

No. 575 249 224 169 141 91 90 80 78 68

Causes No. Partum Heorrhage Rate Post 5 Pre‐eclampsia 67.13 2 Uterine Atony 26.86 2 26.86 Leading Causes of Infant Mortality Causes No. Prematurity Rate 15 1.74 Congenital Malformation 8 0.93 Pneumonia 7 0.81 Septicemia 6 0.70 Undetermined 5 Asphyxia 0.58 5 0.58 Tetanus Neonatorum 5 0.58 Hyaline Membrane Disease 3 Diseases of0.35 the Heart 3 0.35 Respiratory Distress Syndrome 2 0.23



Currently, the Bed to Population Ratio for Public and Private Hospitals in Oriental and Occidental Mindoro is 1:1,596 and 1:1,635, respectively which is insufficient compared to a standard of 1:1000. MINDORO

HOSPITAL FACILITY

TOTAL HOSPITALS

TOTAL BEDS

MINDORO PROVINCE TOTAL

35

769

POPULATION 2010

BED TO POPULATION RATIO

1,238,559

1: 1631

POPULATION

BED TO POPULATION RATIO

ORIENTAL MINDORO HOSPITAL FACILITY

TOTAL HOSPITALS

TOTAL BEDS

GOVERNMENT

6

177

785,602

1:4438

PRIVATE

16

315 BEDS

785,602

1:2493

TOTAL

24

492 BEDS

785,602

1: 1596

2010

OCCIDENTAL MINDORO HOSPITAL FACILITY

TOTAL HOSPITALS

TOTAL BEDS

POPULATION

GOVERNMENT

7

230 BEDS

452,957

1:1969

PRIVATE

4

47 BEDS

452,957

1:9637

TOTAL

11

277 BEDS

452,957

1: 1635

2010

BED TO POPULATION RATIO

• Facilities are deteriorating because of lack or insufficient fund allocation or subsidy. Thus, resulting to poor medical care to patients. These are the main challenges confronting the public hospitals are: (1) deficient infrastructure, (2) deficient manpower, (3) unmanageable patient load, (4) equivocal quality of services, (5) high out of pocket expenditure. 1.3

SIGNIFICANCE OF THE STUDY Challenges in providing health care for everyone is the focus of the research. Some factors are given below that made the study significant: 1.3.1 Significance of the study to the patients There are two Primary Users- Patients in this study the Tagalogs and Mangyans. This study will show how healthcare should be universal and equal (age, gender, class and special conditions including PWDs). 1.3.2 Significance of the study to the healthcare providers The study will provide healthcare providers a better understanding on Mangyans health beliefs and be able to make solutions or necessary adaptations on cultural diferences 1.3.3 Significance of the study to the field of Healthcare Architecture The study will also have significance in the field of architecture since the development is one of the new concepts in a building development. Architecture will be the medium on how social factors afect the design of buildings. 1.4

GOALS AND OBJECTIVES 1.4.1 GOAL To plan and design Mina de Oro Provincial Hospital and Center for Respiratory Health 1.4.2 OBJECTIVES 1.4.2.1 To design a Tertiary Level General hospital with specialized services for cure and prevention of lung and respiratory diseases that will can also cater other provinces in MIMAROPA; To make health care services more accessible for Mangyan and Poor Communities, a culture-sensitive facility, by allocating special Mangyan wards and provision of free medical services to Mangyan patients and training of Mangyan volunteer health workers. 1.4.2.2 Design a New Hospital by applying the principles of therapeutic and healing design approach for better comfort and convenience of the users and for faster recovery of the patients in the

1.4.2.3 Design a Self- Sustaining Hospital to minimize operating and maintenance cost, and maximize expenditure on health related services. 1.5

SCOPE AND DELIMITATIONS OF THE STUDY 1.5.1 SCOPE The study will discuss the significance of a Provincial Hospital and Center for Respiratory Health: its organizational structure: the people and spaces which involves such development. It will also identify the best location for the development and its specific architectural design planning and development schemes This study will give the reader a broad knowledge of what a culturesensitive hospital is like, especially in the province of Mindoro and how it will help the poor health status in the province and in its region. 1.5.2 DELIMITATIONS This study is delimited to architectural concept, design and ideas as well as its planning and organization of spaces and brief structural schemes. Environmental systems may difer depending on site location; studies of other potential sites can be done. The solution will also be limited because of budget restrain but provision for expansion will be allocated. Set of users showed in this book is based on the standards and may be changed depending on the location and functions/level of hospital. However, this book can serve as a reference on similar health facilities that also aims for the ware fell of other Indigenous people or tribes.

1.6

JUSTIFICATION OF THE STUDY For the past years, the poor and the disadvantaged groups in the region have encountered many kinds of barriers when trying to gain access to health care and medical services, basic education, water and sanitation, nutrition services and shelter. The inequities in access to health facilities and services resulted to poor health condition across rural and urban population and communities. With the increasing regional population, the provision of health and nutrition services must be expanded and intensified considering the anticipated level demand for these services. The challenge to meet these demands to improve the well-being of the people will require an orchestrated actions from the national and local governments, private groups, non-government organizations and the people/communities themselves. (MIMAROPA Regional Development Plan 2011-2016, 2015) Social Sector: Health Services Goal 1. A socially developed city with healthy, highly skilled and globally competitive individuals and well-protected citizenry with access to basic social services in a well-balanced environment. Objectives 1. To attain quality standard of health and promote a peaceful, lively and productive life. 2. To accomplish the majority set of regional targets in terms of the Millennium Development Goals.

3. To achieve full access to socially responsive and quality health services to all the people of MIMAROPA region. 4. To greatly improve the health status of all the regional populace and contribute to the poverty alleviation and socio-economic development of the region.

Strategies  









Promote the upgrading, expansion and modernization of community health facilities and manpower resource; Initiate a public-private partnership in the construction of health infrastructures and in investment in development of natural /herbal drugs where local government’s resources is limited or inadequate. Increase the coverage, access and utilization of health care services through implementation of sector wide approach and providing equitable pro-poor, clientoriented and best quality services. Accelerate the financing, construction and delivery of specialized/advanced secondary and tertiary health facilities in major towns and cities to increase and expand people’s access to modern and quality health services. Intensify health promotion and education and disease prevention in the school through provision of standard toilet and safe water facilities, package of basic school health services and inculcating healthy habits and practices and sex education in school children. Intensify the service delivery and management of projects/programs and prevention and control of communicable diseases (STI/HIV/AIDS, tuberculosis, malaria, etc.) through community mobilization and participation in the control of the infectious diseases.

Existing Oriental Mindoro Provincial Hospital In the Province of Proposed Mina De Oro Provincial Hospital Oriental Mindoro, there is an existing Provincial Hospital which is level 1 with 100 beds which is located in the City of Calapan. The poorest of the population are the main users of government health facilities, yet these health facilities are too remote to them especially from the Municipality of Bulalacao and Manansalay which is at the farthest end of the Province, approximately 6 hours away through the usual means of transportation, which at worst case because of still insufficient service and equipment will be further referred to Region IV-A’s Regional Hospital which is 1-2 hours away via boat plus 30 minutes on land transportation.

The proposed Provincial Hospital in Pinamalayan, which is centrally located provincially and Regionally is an attempt to give solution to the previously stated problems in persisting causes of mortatlity and morbidity; very insufficient number of hospital beds compare to the province’s vastly increasing population; and cultural problems especially of the Mangyan’s

Figure 1 ORIENTAL MINDORO SPECIAL DEVELOPMENT PROGRAM on Health Sector

The study is not a physical plan yet but is under ORIENTAL MINDORO SPECIAL DEVELOPMENT PROGRAM of Hon. Alfonso V. Umali, Jr. and Hon. Reynaldo V. Umali on Health Sector.

1.7

DEFINITION OF TERMS, ABBREVIATIONS AND CONCEPTS 1.7.1 General Textual Definitions 1.7.1.1 Contextual Definitions BLT (build–lease–transfer) - Under BLT a private entity builds a complete project and leases it to the government. On this way the control over the project is transferred from the project owner to a lessee. In other words, the ownership remains by the shareholders but operation purposes are leased. After the expiry of the leasing the ownership of the asset and the operational responsibility are transferred to the government at a previously agreed price. For foreign investors taking into account the country risk BLT provides good conditions because the project company maintains the property rights while avoiding operational risk. Building Height Limit (BHL) - the maximum height allowed for structures or buildings expressed as number of floors or storeys. Comprehensive Land Use Plan – refers to a plan which includes a land use map, factors indicting the socially desired mix of land uses and a set of policies to guide future development. Ethnicity – a primary sense of belonging to an ethnic group. Ethnic group is consanguine in nature, meaning, the ties are reckoned by blood and traced through the family tree. Thus, ethnicity refers to the household member's identity, by blood and not by choice nor by adoption/confirmation for any ethnic group, primarily the Indigenous Peoples (IPs). Epistemology – diferent forms of knowledge of that reality, what nature of relationship exists between the inquirer and the inquired? How do we know? Floor/Area Ratio (FAR) - is the ratio between the Gross Floor Area of a building and the area of the lot on which it stands. Determined by dividing the Gross Floor Area of the building and the area of the lot. The Gross Floor Area of any building should not exceed the prescribed floor area ratio (FAR) multiplied by the lot area. Hospital - refers to a place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment and care of individuals sufering from illness, disease, injury or deformity, or in need of obstetrical or other medical and nursing care. It shall also

be constructed as any institution, or building, or place, where there are installed beds, cribs, or bassinets for twenty-four hour use or longer by patients in the treatment of diseases General – a hospital that provides services for all kinds of illnesses, diseases, injuries or deformities. A general hospital shall provide medical and surgical care to the sick and injured, as well as maternity, newborn and child care. It shall be equipped with the service capabilities needed to support board certified/eligible medical specialists and other licensed physicians rendering services in, but not limited to, the following: i. Clinical Services 1) Family Medicine 2) Pediatrics 3) Internal Medicine 4) Obstetrics and Gynecology 5) Surgery ii. Emergency Services iii. Outpatient Services iv. Ancillary and Support Services, such as clinical laboratory, imaging facility and pharmacy. Other Health Facilities - refers to a Primary care facility; Custodial Care Facility; Diagnostic/ Therapeutic Facility; and Specialized Outpatient Facility Infirmary - refers to a first contact healthcare facility that ofers basic services including emergency service and provision for normal deliveries and hospitalization (short stay average of one to three days length of time spent by patients before discharge) in simple cases. Institutional Uses – uses that pertain to the provision of government, social, religious, educational, cultural, police / military and other services such as, but not limited to, government offices, schools, hospitals / clinics, academic/research, convention centers and police stations. Land Use Intensity Controls (LUIC) - refer to controls on open spaces (PLO), building bulk (FAR), building height (BHL) and impervious surfaces (AISAR). The LUIC is imposed to control, among others, traffic generation, requirements on utilities, over-building, over-crowding, visual access and to attain the desired zone character. The LUIC is applied as follows: a. Maximum Allowable Building Area per Floor in Square Meters = Lot Area x Allowable PLO b. Maximum Allowable Gross Floor Area in Square Meters = Lot Area x Allowable FAR c. In determining the maximum number of floors per building, BHL regulations shall apply. Methodology – What tools do we use to know that reality? Mina de Oro - Mindoro province’s name was coined from the Spanish phrase “Mina de Oro,” which literally means “mine of gold.” Mindoro’s rich soil is awash with mineral deposits, including gold, as well as other natural wonders that can be considered a gold mine for tourism.

Ontology - ways of constructing reality, “how things really are” and “how things really work” Population Projection – computation of future changes in population numbers, given certain assumptions about future trends in the rates of fertility, mortality and migration. Demographers often publish high, medium, and low projections of the same population based on diferent assumptions of how these rates will change in the future 1.7.1.2

Operational Definitions

Center for Respiratory Health - a building or establishment housing local medical services or the practice of a group of doctors that focuses or specializes in aiding and preventing respiratory diseases. Healing Design/ Environments - for healthcare buildings describes a physical setting and organizational culture that supports patients and families through the stresses imposed by illness, hospitalization, medical visits, the process of healing, and sometimes, bereavement. The concept implies that the physical healthcare environment can make a diference in how quickly the patient recovers from or adapts to specific acute and chronic conditions. (Stichler, 2001) Lung Diseases - refers to many disorders afecting the lungs, such as asthma, COPD, infections like influenza, pneumonia and tuberculosis, lung cancer, and many other breathing problems. Some lung diseases can lead to respiratory failure. Mindoreneos - refers to collective inhabitants of Mindoro Provinces Patient-centered care - Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. (IOM, 2001) Provincial hospital - refers to a central hospital with its catchment area of whole population of the province Respiratory Health - state of complete physical, mental and social well-being and not merely the absence of disease or infirmity in the organs that are involved in breathing, including the nose, throat, larynx, trachea, bronchi, and lungs. Also known as the respiratory tree. Tagalog – this term is not associated with “ethnicity” but refers to Mindoreneos aside from the Mangyans, these people are lowlanders who consist of diferent Ethnicity such as Bisaya, Ilocano and of other local and foreign ethnic groups. Therapeutic Architecture - can be described as the peoplecentered, evidence-based discipline of the built environment, which aims to identify and support ways of incorporating those spatial elements that interact with people physiologically and psychologically into design. Urban Corridor (UCD) – refers to the strip of land on both sides of the National Road from the Socorro to the Gloria boundaries. It also

includes the strip of land along the Airport Road from Barangay Sto. Niño to the boundary with Gloria. The depth of the UCD shall be 250 meters on both sides of the said roads, reckoned from the road rights-of-way. It covers portions of the following barangays: Bangbang, Cacawan, Del Razon, Malaya, Maliancog, Nabuslot, Pagalagala, Palayan, Pambisan Malaki, Pambisan Munti, Panggulayan, Papandayan, Quinabigan, Sta Isabel, Sta. Maria, Sta. Rita and Sto. Niño. 1.7.1.3

Abbreviations

BHFS – Bureau of Health Facilities and Services, the bureau of DOH charged with the implementation of these rules and regulations CHD – Center for Health Developent, the regional health office of DOH CON – Certificate of Need DOH – Department of Health MIMAROPA - MIndoro (divided into Occidental Mindoro and Oriental Mindoro), MArinduque, ROmblon and Palawan MOOE – Maintenance, and Other Operating Expenses PPP – Public-Private Partnership