The Mamasapano Incident

     On January 25, 2015, the Special Action Force (SAF) of the Philippine National Police (PNP) launched an operation in Mamasapano, Maguindanao in Mindanao called "Exodus" to arrest or kill Zulkifli ben Hir or alyas Marwan a well-known international terrorist who was involved in the Bali bombing where many tourists were killed. Another target of the operation is Basit Usman, a local terrorist and said to be an accomplice of Marwan. Reports say that around 4:00 A.M., the SAF troopers swooped down on the house where Marwan was last seen. The SAF troopers said that Marwan was awakened by the blast of booby traps set by him around the house and started firing on the raiding team who fired back and killed Marwan while Usman escaped. Proof of the death of Marwan is a photo showing him lifeless and bloodied with some missing fingers which the raiding team took for DNA analysis. Around past five in the morning, the SAF troopers were fired upon by armed men believed to be members of the Bangsamoro Islamic Freedom Fighters (BIFF), Moro Islamic Liberation Front (MILF), Moro National Liberation Front (MNLF) and private armed group operating in the area. At the same time, the blocking force of the SAF were also fired upon by armed groups

    As early as 7:00 A.M. the soldiers of the Armed Forces of the Philippines (AFP) were already in the highway of Mamasapano. Reports say that they tried to enter the encounter area but were fired upon by armed men and they were forced to retreat. The AFP said that they could not use their cannons because they do not know the exact coordinates of the SAF troopers who are fighting in the area. Later, the AFP Chief, Gen. Catapang said that they did not provide reinforcement to the SAF for fear of more casualties and could also result to an all out war that will destroy the peace agreement with the MILF and the government. It was already late in the afternoon when mediators for the cessation of hostilities finally succeeded in stopping the fire fight. The surviving SAF troops where extracted by the AFP. The following morning, the PNP and AFP returned to the encounter area to retrieve the bodies of 44 SAF troopers who died in the encounter. The SAF is an elite group of the PNP and their training is extensive and difficult, then why such a big casualty? Reports say that the area is called "the box" because it is surrounded by different armed groups who are mostly blood relatives. The area is a killing zone for the SAF soldiers and this was aggravated by their lack of familiarity of the terrain.

    The Mamasapano incident has created ripples of shock all over the country. The SAF Chief Director Getulio Napenas, was immediatedly sacked by President Aquino who made a press release saying that he knows about the operation but was not informed when it will be executed. He declared the 44 SAF men who died as heroes and said that the killing of Marwan is a priority to prevent more bombings that kill innocent people. It was also reported that the suspended PNP Chief Gen. Allan Purisima was also involved in the planning and giving of information regarding the operation whose success will give Purisima a chance to go back to his position. Initial findings indicated that Dir. Napenas did not coordinate with Pres. Aquino, DILG Sec. Mar Roxas and the AFP. The fallen soldiers were flown to the Villamor Air Base and many people were disappointed when Pres. Aquino was not able to welcome the dead soldiers because of his prior appointment with the blessing of the Mitsubishi plant in Laguna; but the next day he was able to attend the eulogy of the soldiers. The whole country is mourning the death of these 44 SAF troopers who were killed in action doing their duty to stop terrorism that affects the lives and livelihood of ordinary citizens in the country. In their effort to protect their countrymen, they have offered their life so that others will live peacefully.

     Below are questions that could also be asked by ordinary citizens who want to know the truth about the Mamasapano incident where 44 loyal SAF soldiers died. We pray that their death be not in vain and justice will be given to these courageous fallen heroes:

On the part of the MILF/MNLF/BIFF:

     Why is the MILF/BIFF/MNLF harboring terrorists like Marwan and Usman if they are sincere in the peace agreement?

     Why were  Marwan and Usman were not alerted when report was saying that as early as 10 P.M. there was already a SAF troop build-up in the area? MILF/BIFF/MNLF sympathizers or lookouts could easily have seen this troop build-up and could have sent runners to alert Marwan and Usman. At the same time the lookouts could have verified what type of troops are in the area and could have relayed this information to their commanders in the area for analysis and decision.

   Could the MILF/BIFF/MNLF have a prior knowledge of the operation to kill Marwan and this involves the US regarding the reward money of $5.0 million?

     Could Marwan be a victim of a set-up where after he (Marwan) is killed the US will give the MILF the reward money for providing information on the exact location of Marwan?

     Did the death of the 44 SAF soldiers provide a "smoke screen" of the true nature of the operation to kill Marwan?

     The MILF and the military have an on-going ceasefire agreement at that time. Most of the people in the area are blood relatives and could somehow act accordingly if told by their elders or superiors even if they belong to different armed groups. There could have been a hesitation on the part of the MILF or MNLF or BIFF to engage the SAF troops in a fire-fight for fear of jeopardizing the enactment of the Bangsamoro Basic Law (BBL).

   Was the fire-fight started by a private armed group thereby confusing the MILF/MNLF/BIFF fighters who later on joined the fire-fight? If this is true, the motive of the persons who owned the private army is to sow confusion and create trouble between the MILF and military which could result to demoralization and blaming within the ranks that could also lead to political destabilization. A TV interview of a private individual who allegedly joined the fire-fight attests that a private army of an influential clan was also seen participating in the fire-fight.

On the part of the SAF/AFP:

      Why was the arrest of Marwan and Usman timed during the processing of the BBL? There was a high risk of jeopardizing the enactment of the BBL which the Aquino government does not want to happen in order not to tarnish their image as peace advocate. Why did Dir. Napeñas did not wait for a little more time to give way for the passage of the BBL where the MILF could have surrendered their firearms and political situation in the area is already stable which can give way for peaceful negotiation for the surrender of Marwan and Usman?

      Was Pres. Aquino really not informed or briefed by SAF  Dir. Napeñas on the how, when and where of the "Operation Exodus" or the Mamasapano Marwan/Usman arrest considering that this is a very sensitive operation that could result to a critical situation. If this is true, who or what really influenced Dir. Napeñas to give the go signal assuming that he or they have calculated the risk?

    What took so long for the SAF arresting team to reach the area of Marwan assuming that the start of the insertion or operation is at 10 P.M.? Reports say that the SAF troopers reached the house of Marwan at 4:00 A.M. There was a time difference of six hours. If it is true that the SAF troopers rode  non-motorized boats to ensure a stealth movement, they could have reached their target much earlier, accomplished their task and retreated the same way as they came in. Time is of the essence and it is better to move in the cover of darkness.

     If it is true that the SAF troopers were able to kill Marwan and detached one of his fingers for DNA analysis. It should be their number one priority to send back some of its men to the highway where 300 SAF troopers are waiting as soon as possible in the cover of darkness. Were the remaining SAF troopers in the target area acted as decoy to provide cover to the retreating SAF troops safeguarding Marwan's finger? Why did the blocking force did not retreat as one of their comrades was able to escape alive. They could have avoided being sitting ducks to their enemies. Could there be a notion among the engaging SAF troopers that a reinforcement from the military will prevent further escalation of hostilities and they will be saved on time?

     What took so long to contact the members or mediators for the cessation of hostilities if as early as 7:00 a.m. the AFP is already in the area?

     Reports say that the AFP was already in the area as early as 7 A.M. and also with Dir. Napeñas. Why did the AFP did not ask for the exact coordinates of Marwan's house which is near where the fire-fight happened. The AFP said that they don't know the exact place of the fire-fight and that's why they could not provide reinforcement to the beleaguered SAF troops  fighting in the area. The SAF troops have a sattelite phone, why did they fail to provide the AFP with their bearings?

     If it is true that Dir. Napeñas decided and acted on his own and did not coordinate with Pres. Aquino, Gen. Catapang and Espina and DILG Mar Roxas for secrecy to ensure the security and success of the operation, then why send almost 400 SAF troopers in Mamasapano where they are highly visible and could easily alert their target? Commandos usually penetrate an area secretly and unnoticeable as much as possible.

     Even if it is true that there was no coordination between the SAF and the AFP, there could have been an Intel information by the AFP because of the mass movement of SAF troopers a day before mobilization and the AFP could have inquired on this matter from Dir. Napeñas. Senior security officers would have known about this movement and could have decided whether to halt or give a go signal to the operation.

   What was the knowledge of the senior security officers of the Philippine government/military on who will get the reward money after Marwan is killed?

On the part of the US Government:

     Reports say that it was the US Government who provided the location of Marwan and Usman by flying surveilance drone. If this is true, why did the US military did not bomb or strafe the house where Marwan is sleeping considering that he (Marwan) is a well known international terrorist like Bin Laden?

     Being a serious security matter, the US Government could have coordinated with Pres. Aquino and the generals of the military for consultation on how to arrest or kill Marwan and Usman?

     Who are the rightful person(s)/entity that is legible to take the $5.0 M reward? Is it some members of the MILF or the whole of MILF or part will go to the Philippine military or the whole Philippine government?

Were there any American military personnel who joined in the Mamasapano Marwan raid? Were these American personnel possibly got wounded or killed in the gun battle but covertly carried out of the battlefield?

     A lesson learned from the Mamasapano Incident is the significance of coordination in the line of command and other support government agencies like the AFP and  the PAF to prevent the loss of many lives including civilians. Simply it is not logical and it is stupid to risk the lives of your men only to kill one international terrorist considering negative factors in the terrain, timing and social complexity of the operation. Unless there is something more compelling and top secret that drove the PNP to go ahead with the mission. Why push through with a land operation if a quick air attack aided by GPS on the target will produce better result with less cost? Maybe the question on how to verify if it is really Marwan who is killed in the air attack arises; but it is better to conduct verification when the MILF/BIFF is fully aware that the NBI/FBI/PNP will enter the area where Marwan was killed to gather samples for DNA analysis. If an untoward incident happens while the verification is taking place, then this will warrant the government forces to take action without being accused of breaking the cease fire agreement.

     Regarding the BBL, the Aquino Administration has done its part to maintain peace and give chance for the passage of the BBL. It is clear that there are administrative lapses in the execution of "Operation Exodus" and it will not take long for those responsible for this blunder to be identified and penalized. The ball now is in the hands of the MILF. For the BBL to push through, the MILF should be able to show their sincerity and competence in complying with the requests of the Philippine Government regarding the Mamasapano Incident. The MILF should be able to: return the fire arms of the 44 fallen SAF troopers; identify, prosecute and bring to justice their soldiers who mercilessly killed the SAF troopers; help in the effort to arrest or kill Basit Usman; and, neutralize the insurgent activities of the BIFF and other insurgent groups operating in their area. These should be done by the MILF as a gesture of reciprocity and to ensure that previous mistakes in the past will not be repeated again before finally passing the BBL into a law.

A Wedding in the Family

    Months have passed by since Joshua, former boyfriend and now husband of our daughter Nadinne came to our house in Tagbilaran City, Bohol to ask for our permission to their wedding which they have set on December 14, 2014. The reason for their decision to wed soon is to facilitate the petitioning of Joshua to go to Australia. They have tried the Fiance Visa but they were discouraged by the numerous requirements. Nadinne is the second to the eldest and is a nurse working in Australia. The event is special since it is the first wedding in our family. My daughter decided to wed in Manila so we have to fly from Tagbilaran City one month before the wedding and I have to do my dialysis at Capitol Dialysis Center in Quezon City. Luckily I got a schedule even if there were many transient dialysis patients like me. A day after my first dialysis in Quezon City, me and my wife Belen was invited by Nadinne to shop in Trinoma. It was a bit hard for me to go around inside the mall due to my low Hemoglobin which is 8.7 at that time. I was prone to muscle fatigue due to the lack of oxygen in my body brought about by Anemia but I still decided to go with them. I was delighted when my daughter bought me an original Levis denim pants and a Nike Air shoes. There are a lot more walking and stopping to buy things and I forgot my facemask in our house so I have to brave breathing mall air which I know is full of viruses. It was already evening when our companions were finished shopping and they decided to watch a movie and more virus exposure. We went to the grocery after the movie to buy fruits and ingredients for their food menu.

     I felt very tired after that shopping session, my leg muscles were aching and I thought it will be gone after a day has passed but it did not. Again we were invited this time to Joshua's house to meet his parents and also watch the Pacquiao Algerri boxing fight. We ate a sumptuous lunch and drank beer while watching TV and later on sang Videoke songs. After we got home in Project 6, Quezon City, I felt more tired and now feverish. I will have my dialysis in the morning. During my dialysis I had a low fever and felt chills even with three blankets covering my body. I had low fever for three days. When I went back for dialysis, I was told by the doctor that I will be transfused with one bag of blood to elevate the level of my Hemoglobin to at least 9.0. During my dialysis and blood transfusion, I got feverish again with the usual chills. My body reacted to the foreign blood running in my veins and this went on for a week. I was afraid I will not be in top condition during the wedding but thanks to God I felt better the following week.

 

     The day of the wedding came and early in the morning we donned our formal clothing, me in a dark suit, the groomsmen in grey vests, the bridesmaids as well as with my wife wore long gowns in different colors that the motif which is turqouise. We stayed at the University Hotel in UP Diliman and the rooms are busy with camera men and make up artists walking around. The wedding will start at 1:30 p.m. sharp and after some finishing touches and picture taking, at last we were all ready to go to church. My daughter was very lovely in her wedding dress and it was not long enough and she was about to board the bridal car with us parents. Inside the car, the driver had set the air-conditioning to high cool and it was comfortable for us.                                                          

 

     We reached the church and the bride remained in the car until the wedding was about to start. The wedding entourage started walking towards the altar and my wife and I were the second to the last to walk and stop at the middle of the aisle to wait for the bride. The center door of the church opened and the bride started to enter and she was lovelier than ever with the UP Chorale at the background in the church balcony. We started walking towards the altar where the crying groom is waiting. My daughter kissed us before the groom took the bride to the altar. The wedding rites were solemn and the weather is just right (not too hot and not too cold). After the wedding rites, the usual picture taking took place. There were more photo opportunities outside the church before we finally went to the venue of the wedding reception at Blue Garden.                                           

 

     The reception started with the bride and groom coming down from the winding stairs of the garden with a beautiful fountain. When the newlywed were already seated at the center of the reception area, the emcee called on the relatives of the bride and groom for picture taking then their friends and officemates followed. As a surprise number the bride and groom together with the groom's nieces danced to the tune of 'Bang Bang'. Then came the part where the newlywed addressed the audience. The groom was the first but he was at a loss of words for about 3 to 5 minutes due to overwhelming emotions. At last the teary eyed groom was able to utter some words. The bride then gave her message of thankfulness. The putting of the garter on the leg of the bride came next with a different twist. The groom should enter the reception area with a sexy dance to the tune of a sexy music. The guests burst into laughter when the groom walked towards the bride like a macho dancer and slowly taking off his suit and waving it up along the way. There was a men's beer drinking contest where the winner, after imitating the groom on how to approach the bride, will have the chance to put on the leg garter to the woman who will win the contest (in lieu of the tossing of the bride's bouquet) where lady contestants were blindfolded and instructed to try looking for the safety pin in the body of the man who won the beer drinking contest. The lucky winning couple then imitate what the bride and groom is doing. If the groom kisses the bride then the couple should abide.

     Then  came the traditional bride and groom prosperity dance where anyone can pin money even checks on the bride/groom's clothing.The traditional cutting of the cake and toast were next. 

     

     Then the message of the principal sponsors and parents followed. I had the chance to present our surprise gift to the newlywed. I emphasized to the guests that even if our gift is of less material value, the true value and essence of our message which comes from our heart is for us priceless. Our gift is a collation of their pictures with a touching message at the back of the frame which read something like this: "Congratulations and best wishes to Nadz and Josh. Always put God in the center of your relationship so that you will be strong during your trials and will always keep the warmth of your love burning like you are feeling today when you are joined in matrimony." After the reception, more picture taking in the garden took place. The guests bade their farewell and received their wedding giveaways. We went back to the hotel where the newlywed's families and relatives gathered for an evening snack. Early in the morning, we went back to our respective homes. We felt tired but happy and fulfilled that the wedding was a successful one.

The Realities of Life

      

It is not too late to change our way of life. Amidst the confusion and noise it is still a beautiful world.

     It is common news today about many people involved in illegal drugs whether they are users or pushers. Despite the efforts of the police and drug enforcement agencies, there is still a rampant demand for illegal drugs. Many users, pushers and drug lords have been either jailed or killed but the drug industry in the country continues to flourish simply because many people are still buying and using these illegal drugs. The question is why do they (men and women including the youth) continue to patronize or use such substances which have been proven addictive and harmful to the body? Maybe they tried it for curiosity, got hooked and became drug addicts; or it can be purely for pleasure or just to escape the facts of life.

     Life they say has become easy and pleasurable due to the advance in technology and science; but we have to pay the price of these modernization. Children have been so used to gadgets and computers such that they are addicted to life of ease, game and pleasure and they have learned to abhor studying in schools and doing simple chores. This is aggravated by emotional imbalance when they see their parents constantly fighting and cheating each other. Other families do not fight but they have no time for each other. Parents who are supposed to be role models for doing good examples to their children and their community are the ones consciously or subconsciously doing bad things that affect the values and emotional growth of the children. The simple throwing of trash anywhere in the street and public places can give the impression to the child that such act is fine and well tolerated. The parents who are drinking liquor and smoking cigarettes can expect their children to follow their examples; how much more for parents who are physically and mentally stressed by the harsh realities of life who became drug addicts and for the worse have learned to sustain their vice by selling illegal drugs. As a result, the child who is still young to know what is good and bad gets confused and eventually tried to express his thoughts and feelings through his “barkada” or peers and through social media. If it is possible to spend the whole day and night laughing and chatting while drinking and smoking or taking drugs with his “barkada”, the confused child will do so because it is for him a way to escape the emotional and mental stress brought about by problems in the family and the community. For him, he is “happy” with: his “barkada”, a cell phone at hand always, the excitement of checking his notification and posts in Facebook  and experience a feeling of “high” to the detriment of facing his true situation that will destroy his future. The child later on will finally develop a mind- set of being “happy go lucky” with the notion that other people who “love” him will continue to provide him with what he needs and subsequently become a drug pusher to carry on with his cravings for illegal drugs.

     The above condition can happen to all people whether they are wealthy, middle income or poor. Life has become so complex despite the amenities and comfort due to the mechanical and digital boom all around the world that it is impossible to live without suffering stress. Wealthy families usually have no time for each other because the parents are busy with their work to maintain their financial status. Relationships have become more complicated as everyone is “tempted” to do illegal actions for the sake of comfort and social stability. Why are rich politicians involved in graft and corruption in the government? Why are CEOs, Presidents, Vice-Presidents of various corporations engage themselves in money laundering and other illicit activities or relationship? Why do police officers conduct “hulidap” or extortion and kidnapping? Why do ordinary employees and taxi or bus drivers take drugs while they are working? Why do street children inhale solvent and rob people of their belongings? They do these awful things either to cope up with the technological,   financial and social pressure or to try to escape the burden of life through fantasy with the aid of illegal drugs. They think they are doing well but the truth is they are jeopardizing their future as well as that of children and society.

     Although most of these people are not willing victims at the start; but because of the requirements of a system (political, economic and social) they are in, they are forced to “blend in” or else suffer the consequences if they do not conform. When the pressure gets too high, sensitive people become depressed and resort to drugs and sometimes they are hopeless to the point that they decide to end their own life. But what can we do with all these factors affecting our lives? Why is it that some people are learning or have learned how to adjust to their current situation without being drug addicts or constant wrongdoers? For me, I also experienced confusion as I was carried away by the hustle and bustle of life especially in my adolescent years. I was the youngest child of two siblings in our family and I was spoiled by my mother. When I was in third year high school I learned to associate with a “barkada” and later on we skip classes and spend our time in theaters and parks. My life is full of comfort and pleasure and I was carefree and happy go lucky. As a result, I have to repeat third year high school for three times in three different schools; the third school being a seminary for boys who “want” to be priests.  Luckily, I finished high school at the University of the East in Claro M. Recto, Manila. I believe that my stay in the seminary has taught me the right values although we (me and my co-seminarian friends) nearly got expelled when our head priest discovered our drinking sessions by conducting a “night patrol”. I entered college in UP Los Banos in Laguna and took up Agricultural Engineering. That was in 1971 when the political turmoil in our country is at its peak. Unfortunately, I got acquainted again with a new “barkada” and even got jailed when we were involved in a melee during a drinking spree outside the campus. I decided not to finish the first semester and took a leave of absence. Fortunately, during my “barkada” years, illegal drug use was still not rampant and I did not try to use a single one. My goal in life is not clear then, when my parents decided to live in the province to attend to our 10 hectare farm, I decided to go with them. 

     For six years, I have learned to live a simple life and value work as a source of living until the death of my father in 1975. In 1977, I decided to go back to college with a goal of going back to our farm after I have finished with my course. When I finished my 5 year Agricultural Engineering course in 1982, I applied for a job and got hired in a government agency. My job was stable and I even started to pursue my Master’s Degree in UP Diliman but was not able to finish it due to work pressure and my kidney disease has aggravated. I met my wife in Tagbilaran City, Bohol when I was temporarily assigned there because of our projects. I got married and I transferred to a private bank and I was based in Bohol. Married life is not all bed of roses and is full of trials and adjustments but we manage to send our four children to school and we have a happy family. At the age of 59, my kidneys failed and I was on dialysis since then. I have learned many things in dialysis, especially on how to face my fears like death. I have seen dying patients during their dialysis only to find out later that they already have died. Life is without assurance since dialysis patients whom you have talked to today will be dead tomorrow.

     My point is that I do not want other people, especially the youth, to take the path I took. With all my 62 years of experience in life I believe that in order for a child or the parents to be successful in coping with the rigors of life he or they must have the following:

1.      Spiritual growth and development. He could acquire this through:  his school which can provide him with the right values and discipline (the school should be chosen carefully); his parents could also provide him with the right values by showing the right examples and forming in him the fear of the Lord our God. Spiritual growth should start at a very young age to guide him properly;

2.      Self-awareness. He should be aware of himself and his environment and know the effect(s) of his action(s) to his being and to other people. Later on, he will know what is good and bad and with proper guidance, he will always choose the good side of things;

3.      Acceptance. When he is starting to mature, he will learn to accept things as they are. He will acknowledge his strengths as well as his weaknesses and his mistakes;

4.      Proper love of self. He cannot properly love other people if he has not learned to love himself properly. With the right values and principles, he will surely achieve this.

     I do not say that we should be perfect and will not commit sin. Although it should be our goal to be perfect as the Lord our God is perfect.  We will continue to sin or commit mistakes; but with the grace of the Lord our God, we could be aware of their graveness and accept that some things are beyond our control and with proper self-regard we could say no to our temptations so we can bravely face the realities of life!

     

During Uncertain Times

     

Loyalty is not measured by the material things you give but through the genuine thought and feelings that emanates within yourself.

   

      They say that the dog is man’s best friend since time immemorial. I have seen well trained and even ordinary dogs despite some punishments remain loyal and subservient to his master. This is shown with a jolly face and continuous wagging of the tail when the master has just entered the house. The dog does not seem to entertain a grudge even if he remembers the pain of the correction and “learn” later why he is punished for not obeying the rules or command. For some obvious reason, animals do this instinctually meaning without the proper thinking as men do. Subsequently, the loyalty that humans manifest to their fellow human being(s), country, organization, family and friends is totally different from some animals particularly the dog.

     There is temporary loyalty in politics where politicians are bound by common interests and goals mostly personal with the guise of working for the common good. When someone or something is of no more value and events and conditions are not favorable to his/her political career, the politician jumps out of the party and join a stronger one or puts up his own party. Out of the many praises, gifts, warm greetings, expensive trips and social gatherings, the politician seems to forget everything and only sees the new and useful “ones” that will further his “cause”. If only they could be true loyal servants there is no need for the “Pork Barrel”, PDAF and DAP which are all geared to make them subservient and supportive of the President’s programs/projects including “wishes”.

     But it is not only politicians who possess provisionary loyalty; this could also be true to people working in public or private offices, various organizations and other entities. There are plenty of “ass lickers” who seem to be loyal and shower their boss with beautiful praises, gifts, parties and sumptuous food expecting something like a promotion in return. Their true color shows during difficult times when their boss is under fire and needs support to clear his name and maintain his position. Very few people are loyal up to the end.

     The above type of loyalty also happens between husband and wife. When the husband is still earning and provides the wife with what she needs then all is well.  But when the husband suffers a setback where he loses his job and ability to work then the seemingly faithful or loyal wife quarrels and leaves the poor husband behind. “No money no honey”. Sibling rivalry also affects the loyalty of brothers and sisters with each other. He/she can be temporarily loyal to the other siblings when conditions are right but change loyalty when things go awry. The same is true with friends who leave their friend when they do not want to get involved in something that is not favorable to their self-interests.

     The business and show business world is full of people with temporary loyalty with each other so it is hard to see whom you will fully trust. You must truly exercise caution in your business affairs if you want to be successful. But many are forced to feign affection or loyalty just to achieve what they want. It is not incredulous but countries also practice this false loyalty to other countries just to protect their own national security through foreign “exercises”.

       I do not want you to be affected with all these negativity. I just want to point out what is truly happening around us today so that you will be aware and help you discern who is truly loyal to you. But despite these things, there are people who are truly loyal to each other like husbands and wives who are not perfect but accept each other for what they are through thick and thin. There are parents who sacrifice their comfort for the sake of their children. There are service providers/teachers who are truly concerned with the welfare of the students and the needy. There are true friends who will be loyal to their friend no matter what happens. But loyalty does not happen overnight, it is earned through time (in good and bad times); and for always there will always be like: Francis, Gandhi or Mother Theresa who offer their life for the sake of the people they serve. Be one of them!

    

    

Do's and Don'ts of Dialysis Patients

Fluid Intake:

     The first thing that a dialysis patient should not do is to drink too much water especially when his/her urine output is low or very low because this could cause Edema (swelling) of the legs and other body parts. The worst that a dialysis patient can get from drinking too much water is Pulmonary Edema wherein water could enter the lung cavity resulting to difficulty in breathing and high blood pressure. If the situation becomes serious the lung could not anymore function properly and the last resort for the doctor is Intubation (putting a tube in the trachea of the patient to facilitate breathing with the help of a manual/mechanical pump). Too much water volume of the blood strain the heart as it tries to pump the excess water and it could result to enlargement of the heart or heart failure. The question is how much water is too much? For dialysis patients with low or very low urine output they should drink not more than one liter per day or preferably less.

     To avoid drinking too much water, the dialysis patient should try licking small ice stick to quench his/her thirst. Water molecules in ice have already expanded and less water is contained in a certain volume compared to its liquid state. The dialysis patients should also avoid eating watery fruits like water melon, mango, banana, avocado, pineapple, oranges and papaya. The water content in these fruits is high and could contribute to the increase in the water intake of the patient. Eating too much cooked rice also contain high amount of water. The dialysis patient should sip small amount of water from the glass or mug and he/she should avoid frequent drinking of coffee or soft drinks. The patient should avoid salty foods as salt could cause water retention and will aggravate Edema. The patient should avoid sipping too much soup as this may contain too much salt and water. The dialysis patient should eat fruit with less water content like apple. The patient should regularly monitor his/her blood pressure as well as his/her blood sodium. Low blood sodium value result to low blood pressure and prone to painful cramps and Hypo-tension. High blood sodium value result to high blood pressure because of constriction of the blood vessels that could strain the heart resulting to either stroke, coma or death. 

    

High Phosphorous Toxicity:

     The second thing that a dialysis patient should watch for is Phosphorous. This mineral is found in almost all the foods that we eat and too much phosphorous in the body of the patient is dangerous because it is very toxic and could cause weakening of the bones or osteoporosis. Phosphorous may also deplete the amount of Calcium in the blood. Phosphorous binds with Calcium in the body that forms abrasive Calcium Phosphate crystals which finds its way in the skin causing it to itch and rupture with constant scratching. Cracks in the skin could be infected causing Cellulitis (painful infection of the skin and if left untreated it becomes life threatening as it may reach the bloodstream) which is treated with strong anti-biotic that could harm the liver. Always remember that it is the liver that replaces the function of the kidneys in breaking down and excreting harmful chemicals. Calcium Phosphate crystals are also deposited between soft tissues and joints causing pain and weakness. Calcification of organs such as the heart leads to heart disease and eventual death of the patient. To control Phosphorous, the dialysis patient should take at most 1,500 mg of calcium carbonate per day depending on how high is your phosphorous level. These can be taken either before, during and after eating. Calcium binds with Phosphorous in eaten foods in the digestive tract and excreted together with the stool. The other effective Phosphate binder is Sevelamer which is expensive (P80-P100 per tablet). This acts as a sponge and absorb the phosphorous in food in the stomach and also excreted with the stool. This tablet can be taken either before, during and after meals; but not more than 30 minutes after eating. The patient should monitor his/her serum or blood Calcium and Phosphorous level. Too much Calcium in the blood causes kidney stones or harmful deposits in the heart and artery. The patient should also avoid foods rich in Phosphorous like dairy product, chocolate, beans and nuts. Red meats are also rich in Phosphorous.

Hyper - Kalemia or High Serum Potassium:

     The third important element that a dialysis patient should watch for is Potassium. Too much Potassium in the blood is also dangerous because it could stop the beating of the heart causing heart attack and possible death of the patient. Potassium in large doses is used in jail inmates with death sentence to execute and kill them. Overdose of Potassium is less painful compared to electric execution. Foods rich in Potassium are: banana, avocado, papaya, mango, pineapple, oranges, potato, tomato, squash and other green leafy vegetables. The dialysis patient could eat small amounts of these foods only but not on a regular basis as Potassium could accumulate in the blood before dialysis. Patients who suffered Myocardial Infarction or heart attack (injury of heart muscle due to lack of oxygen) have high Potassium level in the blood and should undergo regular dialysis. Foods rich in Potassium supplements such as catsup should also be avoided.

Cholesterol level:

    The dialysis patient should properly choose the fat he/she eats. Foods rich in cholesterol and uric acid should be avoided such as: fatty meats like pork, beef and chicken skin. Processed coconut oil and other vegetable oil are also rich in cholesterol. Cholesterol is deposited in the arteries and veins causing blockage which result to high blood pressure, stroke and heart attack. Fats that are allowed are corn oil, canola oil, and olive oil. They are rich in omega fatty acid which is good for the heart. As the usual practice, patients should consume only small amount of the cholesterol rich oils found in foods such as fried vegetables and fish but should avoid eating, potato fries, milk shakes and ice cream for they contain more harmful fats per serving. The patient should monitor on a regular basis his/her cholesterol level or triglycerides so he/she can take the proper medicine if the level is high. 

Blood Uric Acid (BUA):

Dialysis patient should avoid eating too much of fish with no scales such as tuna and animal organs because it contains high amount of uric acid. Uric acid causes gout and arthritis and helps in the formation of hard kidney stones. The derivative of uric acid which is purine is rich in animal organs, some type of fish,  beans and nuts, some green leafy vegetables and fruits.

Uremia or too much toxic wastes in the blood:

     The dialysis patient should eat moderate amount of red meat such as pork and beef. Eating too much animal protein could lead to Uremia (high level of nitrogenous waste in the blood) which if left untreated will lead to confusion, convulsion, excessive vomiting, coma and even death.

Monthly Laboratory Tests: 

     One of the most important routine or practice that a dialysis patient should do is to check his blood count especially the Hemoglobin and Red Blood Cells for it indicates if the patient should be transfused with blood or not. Almost all of dialysis patients are Anemic and have below normal level of Hemoglobin. This is because it is the normal kidney that produces Erythropoietin (helps in the production of Red Blood Cells in the blood). Once the kidneys are damaged, production of Erythropoietin is affected and the same is true for Hemoglobin and the Red Blood Cells, thus causing Anemia. To maintain acceptable values of Hemoglobin, the dialysis patient should inject synthetic Erythropoietin Alpha or Beta two to three times per week at Hemoglobin value of ten or below while only once or twice a week for Hemoglobin value of more than 10 but not to exceed 12. If the Hemoglobin is high, 13 and above, the patient is at risk of having a stroke because Erythropoietin has a tendency to thicken the blood. The patient should stop injecting Erythropoietin. Optimum Hemoglobin value is at 11. For Erythropoietin to be effective, the patient should take organic iron supplements. Iron and Hemoglobin help in the distribution of oxygen in cells and tissues. Regular monthly or bi-weekly monitoring of the Hemoglobin is very important to prevent the patient having blood transfusion which increases his/her risk of acquiring hepatitis infection. Patient infected with hepatitis is not anymore accepted in some dialysis centers/clinics with no isolated machine for hepatitis patients. Also, patients with very low Hemoglobin cannot be dialyzed since he/she can strain his/her heart and may die while dialyzing. Patients should check their iron in their blood every three months.

The Dialysis Access:

     The dialysis access (it is where the dialysis needles are inserted or connected) of the patient is very important since it is the connection of the patient and the dialysis machine. Without the access, there is no way for the patient to be dialyzed and he/she is in danger of becoming uremic and will die if his/her blood is not cleaned. New dialysis patients have their access either on the neck, wrist or thigh. Few patients have a functioning fistula (artery and vein joined together to make the vein large enough for needle insertion) before the onset of dialysis. Proper care of the dialysis access is very important to prevent infection which could lead to sepsis (severe infection of the blood). This is done by regular cleaning using Povidine Iodine (Betadine) solution and anti-biotic ointment. Symptoms of infected access are shivering (feeling very cold) and fever during dialysis. The fistula that is infected means it cannot be used during dialysis such that a new emergency dialysis access should be inserted either in the neck or thigh.

Heart Care: 

   Dialysis patients should also take care of their heart by having chest x-ray and 2D Echo- cardiogram once in a while or when you feel pain or something not ordinary in your chest or experiencing difficulty in breathing. In dialysis, it is the heart that always compensates when you have low hemoglobin and RBC, high blood pressure, too much fluid in the blood or lungs, fast flow rate of the dialysis machine and when too much fluid is taken from your body and you are already dehydrated. The patient should feel if his/her heart is already stressed and should tell the nurse to lower the blood flow rate of the dialysis machine or lower the set goal of fluid to be taken. The most important is for the patient to discipline himself/herself to avoid drinking too much fluid and eating the right foods in their allowed quantity.

Prevention of infection:

      Dialysis patients usually have a compromised immune system or they are prone to infections like pneumonia. When the patient has a persistent cough with yellow phlegm for two to three weeks, this is a sign that he/she has a lung infection and should have an x-ray to confirm the diagnosis. Early detection and treatment is ideal to prevent complications such as sepsis (an infection of the blood). A monthly Complete Blood Count (CBC) or urinalysis will also help in the early diagnosis of infection(s). To prevent lung infection, the patient should wear a face mask while in the dialysis room especially if in-patients and out-patients have their dialysis at the same time (big hospitals have separate dialysis rooms for in-patients and out-patients). Wearing a face mask while in dialysis is important since some virus and bacteria is present in the air or they are lodged in air-con filters and dislodged into the air later. In-patients are also exposed to hospital acquired infections that are already immune to some anti-biotic and are difficult to treat. The patient should also wear a face mask if he/she is with many people like movie-houses, mall and other gatherings.

Important Remarks:

     The dialysis patient should develop his/her discipline of the mind and body by proper and regular (but not strenuous) exercises such as stretching, bending and brisk walking. This enhances proper disposition and keep the body healthy (with sufficient dialysis of two or more dialysis sessions per week). The patient should also grow in spirit to enhance awareness and acceptance and make him/her always hopeful that there is still life during dialysis. He/she should firmly believe that with God nothing is impossible and he will be cured of his disease. Of course this should be done with fewer expectations. With proper discipline the dialysis patient should realize that following his/her diet is not difficult if he/she believes that one should eat properly in order to live and not live to over eat foods that could aggravate his condition.