FAR EASTERN UNIVERSITYINSTITUTE OF ARCHITECTURE & FINE ARTS

RESMEARResearch Methods in Architecture

TABIRAO, Jack Nicole T.AR1042

Submitted to:Arch’t. Mar Lorence G. Ticao

In partial fulfillment of the requirements for the course

RESMEAR - Research Methods in Architecture

STEP UP THE FIGHT: A study on the proposal for an HIV Health and

Research Center of the Philippines and its implications to

Medical Tourism and Specialized Healthcare

INTRODUCTION

Even though a relatively low risk country, still, the Philippines

is at the list of top countries where HIV cases are alarmingly

rising. This leads us to question if whether the Department of

Helath is doing its job in effectively and efficiently

disseminating information or the people just simply choose to

ignore it. The stigmas Filipinos with this disease are facing are

dire and in need of help, for they are either labeled unclean or

irresponsibly promiscuous. But none of this would’ve been

embedded on our culture of critics if only we open ourselves to

the possibility of finding a way on how to alleviate its effects

on the person inflicted for there is no known cure yet for

HIV/AIDS. The only thing a healthcare facility can do is to

manage the symptoms the virus inflicts on the person.

BACKGROUND OF THE STUDY

Officially, the Philippines is a low-HIV-prevalence country, with

less than 0.1 percent of the adult population estimated to be

HIV-positive. As of January 2013, the Department of Health (DOH)

AIDS Registry in the Philippines reported 10,514 people living

with HIV/AIDS. Of the 10,514 HIV positive cases reported from

1984 to 2013, 92% (9,637) were infected through sexual contact,

4% (420) through needle sharing among injecting drug users, 1%

(59) through mother-to-child transmission, <1% (20) through blood

transfusion and needle prick injury <1% (3). No data is available

for 4% (375) of the cases. Cumulative data shows 33% (3,147) were

infected through heterosexual contact, 41% (3,956) through

homosexual contact, and 26% (2,534) through bisexual contact.

From 2007 there has been a shift in the predominant trend of

sexual transmission from heterosexual contact (20%) to males

having sex with other males (80%).

Overseas workers from the Philippines (e.g., seafarers, domestic

helpers, etc.) account for about 20 percent of all HIV/AIDS cases

in the country. Most-at-risk groups include men who have sex with

men (MSM), with 395 new human immunodeficiency virus

(HIV) infections among within this group from January to February

2013 alone, 96% up from 2005’s 210 reported infections. A

spokesperson of the National Epidemiology Center (NEC) of the

Department of Health says that the sudden and steep increase in

the number of new cases within the MSM community, particularly in

the last three years (309 cases in 2006, and 342 in 2013), is

“tremendously in excess of what (is) usually expected,” allowing

classification of the situation as an “epidemic". Of the

cumulative total of 1,097 infected MSMs from 1984 to 2008, 49%

were reported in the last three years (72% asymptomatic); 108

have died when reported, and slightly more MSMs were reportedly

already with AIDS (30%).

Among MSM's, ninety percent of the newly infected are single (up

to 35% of past cases reported involved overseas Filipino workers

or OFWs and/or their spouse), with the most of the affected

people now only 20 to 34 years old (from 45 to 49 years old in

the past). The highest number of infections among MSMs is

from Metro Manila. An HIV surveillance study conducted by

Dr. Louie Mar Gangcuangco and colleagues from the University of

the Philippines-Philippine General Hospital showed that out of

406 MSM tested for HIV from entertainment areas in Metro Manila,

HIV prevalence using the rapid test was 11.8% (95% confidence

interval: 8.7- 15.0). Increasing infection rates were also noted

in the cities of Angeles, Cebu, and Davao. 1 to 3 percent of

MSM's were found to be HIV-positive by sentinel surveillance

conducted in Cebu and Quezon cities in 2001.

Another at-risk group are injecting drug users (IDUs), 1 percent

of whom were found to be HIV-positive in Cebu City in 2005. A

high rate of needle sharing among IDUs in some areas (77 percent

in Cebu City) is of concern. Sex workers, because of their

infrequent condom use, high rates of sexually transmitted

infections (STIs), and other factors, are also considered to be

at risk. In 2002, just 6 percent of sex workers interviewed said

they used condoms in the last week. As of 2005, however, HIV

prevalence among sex workers in Cebu City was relatively low, at

0.2 percent.

PROBLEM STATEMENT

In accordance with all the data acquired and evaluated, there is

a relevance to a creation of an HIV Health and Research Center of

the Philippines (HHRCP). Not only will it promote optimum

healthcare services to those in need of it, but it will also

promote the medical tourism industry for foreigners seeking

affordable yet world-class treatment, while jobs are generated

for those in the medical field (nurses, specialists, etc.). Also,

with the research center in place, the exchange of knowledge and

information with other countries dealing with the same dilemma,

and with guidance from UNAIDS, the Philippines will spearhead

itself into a larger role in the prevention, and hopefully, the

cure for it.

REVIEW OF RELATED LITERATURE

SPACES

Nord, C. (2007). Spaces of hope: Architectural design for HIV

services in Uganda. Royal Institute of Technology. School of

architecture and built environment.

Division of Built Environment Analysis, BBA. Retrieved from

http://www.isv.liu.se/nisal/staff/nord-catharina/arkiv1/1.153366/

Spacesofhope.pdf

This study aims to glimpse on the architectural solutions two

facilities catering to the needs of Ugandans pertaining to

HIV/AIDS information and healthcare provided by the facility, and

as it also stresses the aim of creating an environment of hope

for people infected with the virus.

Chen, C. (February 2013). HOPE Health Center: Project Proposal.

Retrieved from

http://www.hopehospitalcu.org/_img/tables/HOPE_proposal.pdf

The proposal aims in creating a health center for a village

currently deprived of medical services with a hospital far from

the village. Not only will it cater to provide medications to

those infected with HIV, but also those with other sicknesses

like diarrhea, malaria, and the likes.

INFORMATION

Philippine National AIDS Council (January 2010). HIV/AIDS 101:

Philippines HIV and AIDS scenario. Philippine National AIDS

Council. Retrieved from

http://www.pnac.org.ph/uploads/documents/presentations/HIV

%20AIDS_101_Jan_2010.pdf

This slideshow intends to report the status of the Philippines as

a country with an ever-increasing number of reported cases of

HIV/AIDS. It portrays the realities faced by the authorities in

combating the disease and what are the implications of the

sickness and how it can be prevented.

UNAIDS (May 2008). Fast facts about HIV. Philippine National AIDS

Council. Retrieved from

http://www.pnac.org.ph/uploads/documents/publications/Fast

%20Facts%20about%20HIV%20-%20UNAIDS%202008.pdf

This gazette informs the reader of the meaning of HIV and the

implications of the sickness, how it is spread and how it can be

managed through thorough medication. It enlists the stages of

infection as the sickness worsens if not treated immediately.

National Epidemiology Center, Department of Health (August 2012).

Newly diagnosed HIV cases in the Philippines. Manila Philippines.

Department of Health. Retrieved from

http://www.doh.gov.ph/sites/default/files/NEC_HIV_Aug-

AIDSreg2012.pdf

The report breaks down the latest of information regarding

HIV/AIDS, its affected demographics, and all relevant data in

determining the current state of affairs of the country with

regards to HIV/AIDS.

LEGAL IMPLICATIONS

S. 1818, H. 10510, 10th Congress, R. A. 8504

Also known as the Philippine AIDS Prevention and Control Act of

1998, it intends to “promulgating policies and prescribing

measures for the prevention and control of HIV/AIDS in the

Philippines, instituting a nationwide HIV/AIDS information and

educational program, establishing a comprehensive HIV/AIDS

monitoring system, strengthening the Philippine National Aids

Council, and for other purposes.”

PREVALENCE

Gangcuangco L., Tan M., Berba R. Prevalence and risk factors for

HIV infection among men having sex with men in Metro Manila,

Philippines. Southeast Asian Journal of Tropical Medicine and

Public Health. 2013 Sept; 44(5): 810-

816. http://www.tm.mahidol.ac.th/seameo/2013-44-5/10-5743-12.pdf

It discusses the prevalence of the transmission of HIV thru MSM

or men having sex with men, as casual sex or prostitution.

ARCHITECTURAL SOLUTIONS

Arendse, M. (October 2012). New home for Africa Centre for HIV

and AIDS Management. Stellenbosch University. Retrieved from

http://thehopeproject.co.za/hope/blog/Lists/Posts/Post.aspx?

ID=135

The article cites the solutions the architect of the project

introduced into the building, for example, the use of large

windows to reduce electricity costs as it aims to be a low carbon

footprint building.

Unknown author (June 2013). Lichauco Designs Anglo: client

confidentiality drives architecture. Loveyourself.ph. Retrieved

from http://www.loveyourself.ph/2013/06/Lichauco-designs-

Anglo.html

The article sheds light onto a new facility that widens the

network of clinics the Love Yourself Project are facilitating.

Architect Dan Lichauco, who has designed healthcare facilities

like the Medical City, The Asian Hospital and Medical Center, was

tapped to plan the newest addition to the privately-funded

endeavor thru Love Yourself Anglo, located in Shaw Boulevard in

Mandaluyong. As Lichauco puts it, “paramount to the clients’ need

for counseling and testing is the guarantee that the procedure

shall remain confidential.”

Findley, L. (April 2011). Ubuntu Center. ARCHITECT Magazine.

Retrieved from http://www.architectmagazine.com/healthcare-

projects/ubuntu-centre.aspx

It highlights a health center providing services to townspeople

inflicted with HIV/AIDS while also being ambitious in an

architectural perspective. The new center embodies Ubuntu’s

innovative and uncompromising attitude toward everything it does.

Included in this article are the materials used in the building

that make it

Unknown author (May 2011). Ubuntu Centre / Field Architecture.

ArchDaily. Retrieved from http://www.archdaily.com/?p=135432.

Accessed 27 Jan 2014.

Similar from the aforementioned article above, it elaborates the

architectural vision for the facility as it aims to be

sustainable and at the same time destigmatizing the treatment and

testing of HIV in the area.

GOVERNMENT PLANS

Philippine National AIDS Council. (August 2008). AIDS Gazette.

Manila, Philippines: Philippine National AIDS Council. Retrieved

from http://www.pnac.org.ph/uploads/documents/publications/AIDS-

Gazette_2011-03.pdf

From the website, the issue “summarizes statements from Secretary

Cabral, Pinoy Plus Association, and National Federation of

Filipinos Living with HIV and AIDS, and presentations from Chief

Epidemiologist Enrique Tayag, Interior and Local Government

Undersecretary Austere Panadero, and Social Welfare and

Development Undersecretary Alicia Bala. Highlights of the

Summit's open forum, participant's reports from breakout

sessions, and synthesis of lead rapporteur Mario Taguiwalo are

also included.”

Philippine National AIDS Council. (October 2010). 2011-2016 National

Monitoring and Evaluation Plan. Manila, Philippines: Philippine National

AIDS Council. Retrieved from

http://www.pnac.org.ph/uploads/documents/publications/5th-

AMTP_ME-Plan_ALL_MSWord.pdf

As quoted from the website, “The Philippines tracks its AIDS

epidemic through passive and active surveillance. The Philippine

HIV and AIDS Registry is a passive reporting system with

nationwide reach that includes newly diagnosed cases, those on

ART, and mortalities. On the other hand, active surveillance

among key affected populations called the integrated HIV

Behavioral and Serologic Surveillance (IHBSS) is conducted every

2 years.”

HEALTH CARE DESIGN

Cama, R. (2009). Evidence-based healthcare design. John Wiley & Sons,

Inc. New Jersey

The book talks about the importance of evidence-based healthcare

design to improve the well being of patients in a hospital or

health care center. It gathers data from patients and their

families, then analyzes the cultural, strategic and research

goals. It also aims to hypothesize outcomes, innovations, and

implementation of the translated design.

Guenther, R. (2008). Sustainable healthcare architecture. John Wiley &

Sons, Inc. New Jersey

It shares the wealth of knowledge one must acquire in attaining a

sustainable healthcare facility. As it focuses on hospital

architecture, it also gives a glimpse on environmental aspects

that are important in making a health facility cozy and at the

same time ecologically friendly. It showcases the best case

studies in the hopes of preparing the planner/architect in

planning such facilities with specific needs.

Sternberg, E. (2009). Healing spaces: the science of place and well-being.

Harvard University Press. Cambridge, Massachusetts

Though conversational in form, it boasts information you need if

you want a good insight on providing a place of healing for

patients. It shows how powerful a room can be in the wellness of

a person only because the room was designed and thought off well.

The book reveals the force of architecture in promoting a healing

space for the patient.

PSYCHOLOGICAL HEALTH

Catalan, J. (1999). Mental health and HIV infection: Psychological and

psychiatric aspects. UCL Press. London

It discusses the psychological difficulties an infected person

deals with and how the patient’s mental health affects recovery

and eventually, acceptance of medication and treatment. From men

to women to sex, it promotes the awareness of understanding the

life and thinking of people with HIV as with us uninfected.

Social dilemmas about the disease are rampant due to

misinformation thus lacking the capability to fully grasp the

complexity of the sickness.

GOALS & OBJECTIVES

SIGNIFICANCE OF THE STUDY

SCOPE & LIMITATIONS

REFERENCES

BACKGROUND

HIV/AIDS in the Philippines. (November 2013). Retrieved 1/28/14

from Wikipedia:

http://en.wikipedia.org/wiki/HIV/AIDS_in_the_Philippines

SPACES

Nord, C. (2007). Spaces of hope: Architectural design for HIV

services in Uganda. Royal

Institute of Technology. School of architecture and built

environment.

Division of Built Environment Analysis, BBA. Retrieved from

http://www.isv.liu.se/nisal/staff/nord-catharina/

arkiv1/1.153366/Spacesofhope.pdf

Chen, C. (February 2013). HOPE Health Center: Project Proposal.

Retrieved from

http://www.hopehospitalcu.org/_img/tables/HOPE_proposal.pdf

INFORMATION

Philippine National AIDS Council (January 2010). HIV/AIDS 101:

Philippines HIV and AIDS

scenario. Philippine National AIDS Council. Retrieved from

http://www.pnac.org.ph/uploads/documents/presentations/HIV

%20AIDS_101_Jan_2010.

pdf

UNAIDS (May 2008). Fast facts about HIV. Philippine National AIDS

Council. Retrieved from

http://www.pnac.org.ph/uploads/documents/publications/Fast

%20Facts%20about%20HIV%20-%20UNAIDS%202008.pdf

National Epidemiology Center, Department of Health (August 2012).

Newly diagnosed HIV

cases in the Philippines. Manila Philippines. Department of

Health. Retrieved from

http://www.doh.gov.ph/sites/default/files/NEC_HIV_Aug-

AIDSreg2012.pdf

LEGAL IMPLICATIONS

S. 1818, H. 10510, 10th Congress, R. A. 8504

PREVALENCE

Gangcuangco L., Tan M., Berba R. Prevalence and risk factors for

HIV infection among men

having sex with men in Metro Manila, Philippines. Southeast

Asian Journal of Tropical Medicine and Public Health. 2013

Sept; 44(5): 810-

816. http://www.tm.mahidol.ac.th/seameo/2013-44-5/10-5743-

12.pdf

ARCHITECTURAL SOLUTIONS

Arendse, M. (October 2012). New home for Africa Centre for HIV

and AIDS Management.

Stellenbosch University. Retrieved from

http://thehopeproject.co.za/hope/blog/Lists/Posts/Post.aspx?

ID=135

Unknown author (June 2013). Lichauco Designs Anglo: client

confidentiality drives architecture. Loveyourself.ph.

Retrieved from http://www.loveyourself.ph/2013/06/Lichauco-

designs-

Anglo.html

Findley, L. (April 2011). Ubuntu Center. ARCHITECT Magazine.

Retrieved from

http://www.architectmagazine.com/healthcare-projects/ubuntu-

centre.aspx

Unknown author (May 2011). Ubuntu Centre / Field Architecture.

ArchDaily. Retrieved from

http://www.archdaily.com/?p=135432. Accessed 27 Jan 2014.

GOVERNMENT PLANS

Philippine National AIDS Council. (August 2008). AIDS Gazette.

Manila, Philippines:

Philippine National AIDS Council. Retrieved from

http://www.pnac.org.ph/uploads/documents/publications/AIDS-

Gazette_2011-03.pdf

Philippine National AIDS Council. (October 2010). 2011-2016 National

Monitoring and

Evaluation Plan. Manila, Philippines: Philippine National AIDS

Council. Retrieved from

http://www.pnac.org.ph/uploads/documents/publications/5th-

AMTP_ME-Plan_ALL_MSWord.pdf

HEALTH CARE DESIGN

Catalan, J. (1999). Mental health and HIV infection: Psychological and

psychiatric aspects. UCL

Press. London.

Sternberg, E. (2009). Healing spaces: the science of place and well-being.

Harvard University

Press. Cambridge, Massachusetts.

Guenther, R. (2008). Sustainable healthcare architecture. John Wiley &

Sons, Inc. New Jersey.

PSYCHOLOGICAL HEALTH

Cama, R. (2009). Evidence-based healthcare design. John Wiley & Sons,

Inc. New Jersey.