CHAPTER 3

REVIEW OF RELATED LITERATURE

This chapter presents the Related Literature, case studies which are
relevant to the present study. These materials gave the researcher valuable
information and deeper insights in the preparation conduct and formulation of
design solution of this study.

3.1 RELATED LITERATURE

3.1.1 FOREIGN LITERATURE
Health and Nature: The Influence of Nature on Design
Of the Environment of Care
Much of the recent research in the fields of therapeutic and environmental
design has to do with patient stress and health outcomes, which refer to an
indicator or measure of a patients condition or progress. Now, healthcare
designers are using this research to approach healthcare facility design with a
different focus than the traditional methods. According to Ulrich, health outcomes
research can potentially indicate the degree to which gardens in healthcare
facilities are medically beneficial and cost-effective relative to such alternatives
as not having gardens (Ulrich 1999). In fact, research has documented that the
appropriate use of nature reduces stress, improves health outcomes, supports
pain management, and promotes a sense of overall well-being among patients,
visitors, and staff. Patients who are in direct or sensual contact with nature have
demonstrated higher thresholds of pain. And interaction with nature in chronic
and terminal patients yields higher levels of quality of life. When way finding and
landmarks are associated with nature and are clearly identified, visitor stress is
reduced.
Benefits of Nature
Within the environment of care, where life-challenging and life-threatening
events are amplified, the pronounced focus on individual situations at hand
necessitates diversions or distractions to allow those within to manage stress.
Providing access to nature within healthcare facilities supports these evidencebased design concepts and offers opportunities for positive distractions.

Therapeutic Environments
Within the healthcare, there should be numerous opportunities for the
various user groups to encounter nature. Areas may be interior or exterior and
encountered physically or by sensory perception. Any contact with nature, from
looking at a picture to lying in the grass, has a wide range of positive
psychological effects and subsequent benefits. Interior environments are
enhanced when views or elements of the outside world are brought into the
interior design. Indoor plantings or pictures of nature should be incorporated into
the context of the interior design. Aquariums and terrariums are also sources of
life that bring nature within reach. Light wells and skylights be incorporated into
the context of the interior design. Aquariums and terrariums are also sources of
life that bring nature within reach. Light wells and skylights bring natural light into
an interior space that may not be adjacent to an exterior wall. Also, fountains and
water features provide natural movement and sound to an otherwise sterile
institutional environment. Wherever possible, views of nature from patient rooms
and public spaces should be considered throughout the design process of
healthcare facilities. The interior design should also incorporate nature into the
environment through interior courtyards and atria. These spaces are often
landmark design elements and way finding queues in the public spaces. They
provide a year-round benefit to visitors by bringing natural daylight to the major
gathering spaces of the facility. Even when building sites have limited views of
nature, designers are using interior spaces to create healing gardens and walls
of windows to connect inside and outside. Exterior environmental factors provide
the setting for the healthcare campus and help to establish its character of
healing. Providing landscape and green screening along the arrival sequence
from the property boundaries, to the gateway, to the parking space, to the front
door will facilitate the therapeutic campus-design concepts.
Biophilic or sensory experiences with nature involve enhancing or
stimulating one or more of the five sensesseeing, hearing, smelling, tasting,
and touching. The senses are the basic foundations for what individuals consider
their sense of self and what they know as familiar (Wilson, E.O., 1984; Kellert &
Wilson, 1993). Experiencing events of nature offers a common familiarity to all
ages and backgrounds, regardless of their current situation, and it becomes a
positive distraction. The way a visitor experiences nature can be both conscious
and subconscious, but the overall effect of the experience is deemed to be
beneficial.

Some examples of ways to incorporate design elements that address the senses
are the sight: gardens views or familiar sights of nature from pictures, such as a
view of the outdoor space or a painting. Sound: nature noises, such as a running
stream or other soothing sounds. Smell: aromatherapy, such as the scents of
flowers and herbs. Taste: herbal therapy, such as hot teas
The design goals of a therapeutic environment, simply stated, should
improve the health outcomes of its users and reduce their levels of stress.
Establishing these design parameters early in the design process will help the
integrated design team set up the framework for specific design objectives and
considerations. Design objectives provide attainable metrics that the design team
can establish in the early visioning sessions of the conceptual design phase.
Some of the design objectives for therapeutic environments include, enhance the
work setting. Provide accessibility to nature, include comfort and userfriendliness. Incorporate visibility and visual interest into/out of the garden.
Provide a sense of security and safety. Promote a sense of control of
surroundings. Address the five senses (diversity of biophilic input). Underscore
the distinct difference from interior. Balance the functional and aesthetic design
variety.
In addition, these garden spaces should incorporate multiple-use
opportunities and provide separate space for contemplation and reflection,
walking and movement, shelter from sun and wind and social activity
(encouraged by an open space)
Other design considerations should be addressed to support the functional
design and layout of the healthcare campus. Zoning and building requirements,
vehicular and pedestrian circulation, safety, and quality of care are all important
design elements that need to be addressed.
Supportive Design Considerations
Supportive design considerations are intuitive and functional to the
specific space and its user group. Considerations should also address the
mission of the institution and connection to community and should include
convenient way finding and circulation clarity, accessibility, access to privacy,
seating that facilitates social interaction, exercise opportunities, contact with
nature, support of the sense of community, enhancement of the institutional
image and improvement of the overall quality of the space. (Health Design, 2012)

Stress is one cause of having sick. Through the help of nature or good
environment, patients suffering from different kind of sickness can recover easily.
Integrating the concept of having a garden in a healthcare institution is one way
of providing a quality service as a goal of the project. The literature above gives
background on designing functional facilities that can be adopted on the study.

Design Recommendations and Considerations for Healthcare Facilities

Based on the research and evidence-based design process on the
positive health outcomes that access to nature provides recent design guidelines
for hospitals and healthcare facilities have included language and metrics to
encourage the incorporation of these concepts into future building initiatives.
Views to Nature
The outdoor areas should be visible from interior public spaces for
security, administrative, and medical purposes. Visual access to nature from
within the facility should also be addressed from patient rooms and public spaces
alike. Indoor places of respite should have direct line of sight to the outdoor
environment for 90 percent of the total aggregate net program area and 50
percent of those qualifying areas with direct views of nature.
Access to Nature
Exterior spaces, courtyards, or gardens should be handicap accessible
and located adjacent to public spaces, such as reception areas, corridors, waiting
rooms, and dining areas. In addition, user-specific departments within the
environment of care should also have adjacent exterior spaces that may address
specific needs of the user groups of that particular area.
Designated Exterior Spaces
The healthcare facility design should provide for designated exterior
spaces for the purpose of nature-centered restoration, rehabilitation, and therapy
for the various user groups within the environment of care. Such areas should be
free of negative distractions, such as smoke and fumes, noise pollution, strong
sunlight, distracting views and activities, insecurity, crowding, and ambiguous
design features or art that may be interpreted in multiple ways. Including shorter
patient stays, reduced staff turnover, and improved staff longevity. The defined
area designated as Outdoor Places of Respite should be 5 percent of the net
usable program area, specifically programmed and with direct connection to the

natural environment and an additional 2 percent of the net usable program area
as outdoor places of respite dedicated for staff. (Healthcare Recommendation,
2012)

Guidelines in designing a healthcare facility should also be incorporated

with a nature-centered design to facilitate the recovery and the good ambience of
the user. Spaces within the interior of the structure should have a view from the
outside. This literature gives idea to the proponents and must be incorporated on
the design solution.

Hospital Outdoor Spaces - Therapeutic Benefits and Design Considerations

General Design Considerations in planning of hospital outdoor spaces that
would support, enhance and promote positive healthcare outcomes relies on the
design considerations set up to meet strictly defined norms, regulations and
criteria. They provide information and achievable measures which need to be
incorporated as early as in the conceptual phase in order to fully integrate the
use of outdoor space into a hospital's routine.
Potentials of the Site in hospital's site is certainly one of the most
significant generators of its form in many aspects. Numerous analyses and
investigations need to be undertaken by the design team with the aim of truly
understanding its advantages, disadvantages and potentials. In an ideal case,
optimal distribution of the total site area of a hospital complex should be the
following: 30% for the buildings, 15% for internal communication routes and
parking, 50% for vacant area (25-30% in case of hospitals with a limited capacity
for future growth) out of which 10% is reserved for recreational areas.
While planning suitable locations for different types of outdoor areas, there
are several issues that need to be taken into account, such as: environmental
factors (e.g., orientation, insulation, wind exposure, views); distance from
distractions (e.g., urban noise, parking lots, mechanical systems); physical
configuration of the complex; internal traffic system and its access points; specific
needs of different user groups; etc. Proper acknowledgment and implementation
of these factors may generally enhance beneficial value of the outdoor space.
Positive and negative distractions in current studies on design of hospital
outdoor spaces also suggest featuring of restorative and positive distractions that

may effectively induce health restoration. Emphasis on natural features as

grounding points, such as the use of plants, rocks, wood or water, can only be
beneficial to recovery. Given that art, according to Ted Hughes, represents "a
psychological component of the auto-immune system that gives expression to
the healing process", implementation of carefully chosen art pieces should also
be encouraged.
Accessibility, familiarity and security in all hospital outdoor spaces must be
designed to be physically secure and accessible to people of all ages and
abilities, thus contributing to their positive psychological perception. When feeling
stressed or depressed, many users search for environments that seem familiar
and safe. These applies to implementing visual amenities which are rooted in the
sub consciousness of the majority of users and creating outdoor spaces that are
human scaled and evoke memories. Furthermore, constant monitoring by the
nursing staff and provision of additional medical support (e.g. oxygen outlets)
may allow their extended use and lead to a higher degree of comfort.
Healing vs. therapeutic garden in the term healing garden applies to the
gardens that promote recuperation from illness. In this context, 'healing' does not
necessarily refer to curing, but to the overall improvement of well-being. While
these gardens are more focused on spiritual, psychological and physical aspects
of health restoration, therapeutic gardens as a new trend in hospital outdoor
spaces' design relate to specific curative therapies, such as the allopathic
method in which a disease is treated by producing effects or conditions different
from those caused by the disease itself. Consequently, gardens are also
becoming the location and means of treatment.

Green roofs
There are many examples of using flat roofs as additional outdoor places
of respite, especially in the hospitals within city quarters with a high construction
density. Their use may influence and enhance the general quality of healthcare
environment. Depending on the hospital's physical configuration, one of the
options in case of limited site area is to create accessible or inaccessible roof
gardens visible from the upper floors of higher buildings in the vicinity. Not only
that green roofs accommodate places for contemplation and relaxation, but they
also minimize energy consumption they reduce heating loads by adding mass
and thermal resistance value and lower cooling loads through evaporation.

View out
The outdoor hospital areas should be visible from patients' rooms, interior
public spaces and corridors, for both security and medical purposes. View out is
also psychologically therapeutic, since it reduces feeling of isolation and
claustrophobia by providing a constant contact with the outside world. It may also
add patient's interest to the surrounding environment, leading either to immediate
use or a decision to visit it later. When building new or reconstructing an existing
hospital with budget restrictions or a limited site, one of the solutions is to
incorporate an indoor 'viewing garden' a small garden that cannot be entered,
but may be seen from the building interior. If there is enough space, an
alternative is to apply 'a walk-in garden', which is accessible to a certain number
of people.
Integration and unity of hospital buildings and their surrounding outdoor
spaces contribute to creation of hospital as a 'small city within a city', with its own
specific patterns of use. Features that are relevant for the quality evaluation of
any public space may also apply to these spaces, since they should be
considered and experienced as a vital part of urban landscape. What makes
them different from other public spaces are their physical characteristics,
determined and preconditioned by specific contents, functional units and
communication lines that all need to be planned and designed according to strict
requirements of modern medical technology. The approach in design proposed in
this paper is structured upon the premise that the primary function of the hospital
outdoor space is creation of calming environment which represents an additional
healthcare amenity that provides therapeutic benefits and positive health
outcomes. The list of features that a hospital outdoor space may comprise was
also given as an illustration of various aspects that need to be taken into account
in order to generate a new and more positive image of a hospital as a nonthreatening place. In relation to patients' experience, the essence of presented
approach may be found in a possibility of creating a common and familiar
everyday environment within a space that a majority perceives as psychologically
bounded. Experiencing these spaces as islands isolated from everyday life
occurrences may, among others, lead to a loss of faith in curing or complete
recovery, thus the true worthiness of the outdoor spaces of modern hospital
facilities is based on their appropriate and diverse program, social, psychological,
environmental and ambient characteristics, which can be valued upon daily
presence, positive experiences and satisfaction of patients, as well as other user
groups. In a long-term sense, the role of a design team is to integrate hospital

outdoor space into a hospital's routine in a manner that would help compensate
extra costs by reducing the length and cost of therapies. This leads to
improvement of general effects of timely diagnostics and treatments and
contributes to healthcare promoting qualities, but requires a more complex
hospital infrastructure and poses additional considerations to the outdoor
planning process. (Therapeutic Benefits in Hospital, 2012)

Planning a healthcare institution should be in consideration with the

guidelines provided by the healthcare governing bodies. Each component
pertaining to the design should be utilized. The site, relationship of each building
and their functions should be analyzed.

The Next Wave of Healthcare Design Makes Architecture Part of the

Prescription
While it may seem self-evident that a patients experience should be the
central factor in the design of healthcare facilities, the average medical setting,
however, is hardly salubrious. The typical hospital encounter, notes Turan Duda,
principal of Duda/Paine in Durham, North Carolina, involves waiting in a sterile
room with a television on and being seen in a clinical, often intimidating
environment
That sentiment has spread across the healthcare field, due in part to the
advent of evidence-based design, which considers the impact of hospital
environments on patient care. Studies have found, for example, that spending
time in a garden offers therapeutic benefitsthe more soothing the setting, the
more quickly patients are likely to recover. At the same time, patients today are
far more informed about hospital choices than earlier generations. Statistics on
readmission, infection rates, and procedures are widely available, making
consumers ever choosier about facilities. This competitive market approach to
healthcare means that hospitals and clinics need to make spaces as appealing to
patientsread customersas possible. (Architects Newspaper, 2012)
Facilities and equipments in healthcare institutions is one of the bases of
some patients in choosing a health service provider. Presence of a good and
relaxing environment contributes to the healing factor of a patient and each
space should have an appealing quality to the user.

How to Design a Unique and Profitable Spa or Wellness Property

Design for Massage/Touch Therapy Room
Massage rooms should have a small sink and linen cabinet and also
provide storage above and below sink. Rooms need to be sound insulated. Use
lever-type hardware for door knobs (therapists have oil on their hands)
Tables should have built-in shelves and an adjustable face cradle attached
to the end of table--adding another 12" to the end of table. Massage table
upholstery should be made from Naugahyde with a smooth surface with medium
firm padding on a 72x30. In space requirements generally 120-140 sq. ft., room
variations include: 9'x12', 19'x12', 10'x14', 12'x12'. Therapist requires a min 3'
work-space around the massage table. In location and access the "dry" therapy
area should have access to laundry storage and drop off.
In room set-up, the sink and cabinet should be in corner at an angle in
9'x12' rooms. Sinks should have hot and cold water. Floorings should be either
vinyl tile, wood, or cushioned recreational surface. Avoid tile, marble, or granite
(too hard for the therapist to stand on). Allow doors to open comfortably and
provide lettering or numbering and an "in use" sign or light.
Indirect lighting with dimmer control on walls or overhead (not directly
above massage table) should be used. Windows lighting preferred with vertical,
horizontal, or roman blinds.
Provide one centrally located sound system, with speakers in each room
that have an individual volume control knob.
Smaller rooms can have tables with built-in storage space for linens,
towels, oils, bolsters etc. If room is too small to provide storage inside, storage
directly outside room is necessary.
Designing Spa Treatment Rooms
Treatment Rooms
A wet area treatment room should feed off of each wet area. Access to
these treatment areas should be from both the men's and women's locker rooms
through a hallway. The area should include: treatment tables, sink, counter
space, clean and soiled linen storage, floor drain, overhead showers or treatment
shower and infra-red heat lamps recessed into ceiling over each table

Dry Treatment Rooms

Keep treatment areas as flexible as possible. Rooms to change when
program changes. Provide for sinks, lockable storage cabinetry, counter space
with mirror above, clothing hooks on back of door, clean & soiled linen storage,
electrical outlets on two side walls and above counter, floors of an easily
cleanable material (ie. vinyl tile). All lighting should be indirect and on rheostats.
All treatment rooms should be as sound proof as possible. Provide for separate
music system with individual controls. Provide for clothing hooks. Provide for "In
Use" signage on all treatment room doors. Provide for lockable storage in each
room. Provide for numbers or letters on doors of each room for identification
balance of nature and man-made elements focus on healing environment. (How
to Design a Unique and Profitable Spa, 2012)

Minimum or standard sizes of each space provided by local codes should

be observed to have a good and functional design. To come up with a suitable
design solution, the application of this related literature can achieve the goal of
the project. Other spaces will be based on the number of users but should
always in accordance with the existing codes of designing.

3.1.2 LOCAL LITERATURE

General Observations on Spa Design

Interior design should provide a residential not institutional feeling. A
simple yet effective zone keying system should be installed. A proper "signage"
system should be installed for easy traffic flow. All treatment areas should be as
sound proof as possible
Materials
Non-corrosive materials should be used in all high moisture areas (Vents,
ducts, drains, ceiling & wall cover). Easy to clean moisture resistant materials
should be used in all high moisture areas. Consider using local materials and
integrating cultural and artistic traditions.
Locker / Changing / Vanity Area

Provide appropriate number of half size lockers (two per full size locker
banks) on each side. Provide a separate alcove with third-size lockers (two per
full size locker banks) for members on each side. Utilize movable benches or
Ottomans on casters for seating by lockers. Provide wall mounted soap,
shampoo & conditioner dispensers in showers. Provide make-up lights around
vanity mirrors on women's side. Provide wall mounted magnified shaving mirrors
at vanity on men's side. Provide wall mounted hair dryer units at vanities on both
sides. Provide for electrical outlets above vanities. Flooring in locker and
changing area should be carpeted, all other areas tiled
Locker Room Wet Area
Accommodate Sauna, Steam, Whirlpool and Cold Pool (if applicable).
Provide lounge with water proof seating near each wet area. Provide clothing
hooks throughout area. Flooring should be non-slip easily cleanable tile. Provide
for non-corrosive ventilation ducts in this area. Outflow of HVAC should be
provided for 25 air changes per hour. Provide for ozone water purification system
for whirlpools. Provide a self service beverage service station with sink, counter,
storage cabinet, mini-fridge & ice machine. Provide for clean and soiled linen
storage. (General Spa Design 2012)

Choosing suitable materials that were to be used in the design is

important factor to be considered. The character or the function of the building
should have a consideration to the patients need to provide a more comfortable
and relaxing feeling for easily facilitation of healing of every patients in the center.
Observation on various related structures is very important to the proponent to
have an idea pertaining to the design solutions that can be applied.
Making Your Clinic Building Work
Health facilities should be functional and economical to run and maintain.
Whether the clinic is large or small, the layout should be organized in such a way
that different functions are correctly placed in relationship to each other. The
layout should make it easy for client and provide to enter, move through and
leave the facility. It is important to plan ahead and space and organization
required to expand services, serve a greater number of client, and continue to
function efficiently under new service circumstances.
The facility planning process for health care clinic building is done at the
regional or central level rather than at the local level. No matter where planning is

carried out, involving local community and staff member in the planning process
helps ensure that the facility more accurately reflects the health priorities of the
community.
The planning process is shortened by the use of type plans, which they
are standardized building plans for specific kinds of health facilities such as
urban health care clinic or a rural health post. Type plans can serve the need of
different communities better if they are adapted the respond to the needs
expressed by local user both staff and community during the planning process.
Involving local users ensures that a type plan allocates sufficient spaces to meet
the community immediate and long-term health care priorities and takes local
condition into consideration. (Making Your Clinic Building Work, 2012)

Using the clinic space to improve quality of care, the physical environment
in which clinics provide health care activities has a direct influence on the quality
and efficiency of the services. The above literature gives the proponents an idea
on how the center maybe becomes more functional to ensure the feasibility of the
proposed project.

3.2 CASE STUDY

3.2.1 FOREIGN CASE STUDY
Duke Integrative Medicine

Duke Integrative Medicine located at North Carolina USA is committed to

transforming the way healthcare, delivered in the 21st century. Their expert
provider integrates the best of Western scientific medicine with proven
complementary therapies to address the whole person--body, mind, spirit, and
community. The center

innovative model of care includes primary care,

physician consultations, health coaching, annual membership, and a broad array

of clinical services, classes, workshops, and trainings--are focused on healing
and provide personalized, comprehensive support across time.
The center goals and guide to their missions is to transform health care, to
develop, demonstrate, and implement effective integrative models for clinical
service. Educate a new generation of health care professionals about integrative
approaches to care for the benefit of their patients and in their own lives.
Establish, through rigorous academic research, the efficacy and costeffectiveness of integrative models of care and integrative models of education. A
leading voice in the national discourse shaping the future of healthcare, based on
their experiences in new models of medicine, professional education, and
research.
Also Duke Integrative Medicine, an ideal, state-of-the-art healing
environment where tradition and innovation come together to create a spirit of
health and healing. Situated next to the woodlands and streams of Duke Forest
on a serene campus, there is a 27,000 square foot building in close proximity to
Duke University's internationally renowned medical and educational facilities.
Environmental stewardship is integral to their daily operations and is a
major consideration in the building's design. Their facility incorporates many
sustainable features and has been registered for LEED (Leadership in Energy
and Environmental Design) certification.
They offer warm and comfortable therapeutic treatment rooms, workshop
spaces, meditation spaces, fitness facilities and a state-of-the-art cafe designed
for healthy cooking demonstrations, guest meals and catered events.
Duke Integrative Medicine is a national model of innovative healthcare set
in at state-of-the-art healing environment at one of the most prestigious academic
medical systems in the world. Their clinical service model is based on the very
best medicine available; both conventional and complementary services are
offered in a system of care that is focused on patient-centered, whole-person

medicine. Partnership, planning over time and prevention are among the core
principles of their treatment model. They complement the clinical care with a
robust research initiative, professional and medical education programs, and a
commitment to translating what they are doing and learning across settings and
systems..
Their custom-designed executive session offers team leaders from
medical practices or systems a one-on-one session with the executives of Duke
Integrative Medicine to gain a better understanding of how to develop an
integrative medicine practice and/or center. (Duke Integrative Medicine, 2012)
The concept and methods used in the study stated above is adoptable to
the proposed project. This can give a background to the proponents on what
other services are suitable to the center.

OSHER CENTER FOR INTEGRATIVE MEDICINE

UCSF Mount Zion Campus in San Francisco,USA

Osher Center for Integrative Medicine is located at the UCSF Mount Zion
Campus in San Francisco. As an interdisciplinary center that is a part of UCSF,
the Center is the premiere place where integrative medicine comes together on
three important levels: research, education, and patient care.
The Osher Building is a 5-floor, 48,000 square foot building that the UCSF
Osher Center shares with the UCSF Department of General and Internal
Medicine. The UCSF Osher Center occupies the top three floors, an estimated
24,000 square feet.
The building design creates a healing environment that is in harmony with
the philosophy of integrative medicine. The environment reflects openness to
diverse healing systems contributes to the well being of patients, practitioners,
and staff and provides a supportive environment for research and education.

It includes spaces not usually found in conventional medical clinics or

academic institutions, such as: Group rooms for yoga and tai chi instruction; calm
areas for meditation and reflection; treatment rooms for acupuncture, massage
therapy, biofeedback, and mind-body awareness; and the Takahashi Garden, a
Japanese healing garden.
The design incorporates nature, natural light and fresh air, simply
organized spaces, water features, and pleasant colors and textures. Spaces are
intimate, friendly, and promote relaxation and humanistic values. The building will
contribute to the general health of the occupants and aid the healing process of
the patients.
For patient care, the UCSF Osher Center integrates modern medicine with
established practices from around the world. Their clinical programs focus on
prevention, patient empowerment, and whole person healing. Unlike the rushed,
revolving-door feel of hospital medicine, their patients spend an average of 60
minutes with the doctor or practitioner during their first visit.
Their clinical practice offers a variety of integrative medicine services;
treatments and therapies. Practitioners are trained in both conventional and
complementary therapies and offer a professionally guided, comprehensive
approach to patients health care.
The center realizes that hospitals and clinics can seem overwhelming,
especially when someones ill. Their site includes many of the services and
facilities they offer as well as guidelines for requesting appointments, billing and
preparing for a hospital stay.
To ensure a smooth visit, the visitor/patient may find it helpful to review
their information Getting Care, Additional Support, Hospital Stay, Billing &
Records, Maps & Directions, including public transportation and shuttles, and
Parking.
They also have information for patients who live overseas and for those
who are visiting patients. For special needs the patient have any special needs,
some of their special services include: Internet Access and Videoconferencing.
The UCSF Medical Center has partnered with Skype to connect hospital patients
with family and friends who are unable to visit in person. The Skype video and
voice-calling program is available to patients during their stay in UCSF hospitals.
Using designated laptop computers with Skype software, patients can have
virtual visits on a secure network. Laptops also are available to patients for

Internet access. Also the center is a smoke-free environment. (Usher Medical

Center, 2012)
Integrating research, education and patient care in a health care service is
important factor to consider. These three factors can provide a vast knowledge to
the users and can help in improving the facilities. Environment can contributes to
the well-being of patients, practitioners and staff so it is necessary to always
incorporate nature in design.

INTEGRATIVE MEDICINE CENTER AT GRIFFIN HOSPITAL

Lower Naugatuck Valley Region United States

The Cancer Center at Griffin Hospital, the IMC offers individualized holistic
therapies for current patients undergoing conventional cancer therapy. They can
help minimize side effects with strategies for pain control, weight maintenance,
increasing energy, and optimizing immune function. They can provide expert
dietary advice and recommendations for nutritional supplements with particular
emphasis on synergistic benefits and avoiding interactions with conventional
therapies. Other aspects of treatment include stress reduction and wellness
promotion through acupuncture, meditation, imagery, and breathing techniques.
Preventive Interventions, the IMC offers individualized recommendations
to reduce risk for cancer. These recommendations take into account family
history, genetic factors, lifestyle practices, and environment. They work with
people with no known risk factors and aim to optimize health. Also they work with
people with specific family history, including family members of current Griffin
Cancer Center patients, to minimize risk. Recommendations incorporate lifestyle,
diet, nutritional supplementation, and other preventive and complementary or
alternative techniques as needed.

Griffin Hospital is a 160-bed acute care community hospital serving more

than 100,000 residents of the Lower Naugatuck Valley Region. Griffin Hospital
also serves as the flagship hospital for Planetree, an international leader in
patient-centered care and has received national recognition for creating a facility
and approach to patient care that is responsive to the needs of patients. Many
healthcare facilities around the world send visitors to Griffin Hospital and
incorporate its concepts into their healthcare models.
Griffin Hospital has more than 280 active and courtesy physicians who
have admitting privileges. Griffin Hospital is recognized for having industryleading patient satisfaction ratings and has received numerous quality and
clinical excellence awards.
Planetree Programs & Services an innovative model of healthcare that
puts patients' needs first. Griffin Hospital is the flagship of the Planetree network
of hundreds of hospitals in the United States, Canada, South America, Japan and
the Netherlands. Every aspect of care at Griffin Hospital is shaped by Planetree
principles - from their welcoming, comfortable interiors, to their emphasis on
patient and family education and involvement, to their exceptional healthcare. As
a result, Griffin Hospital receives consistently high patient satisfaction scores.
The components of the Planetree model are designed to empower patients, to
foster their independence, to honor their humanity, and to enhance the healing
environment at a time when they often feel vulnerable and anxious
The primary focus of Planetree is to deliver healthcare in a manner that
works best for patients. In a patient-centered approach to healthcare, providers
partner with patients and their family members to identify and satisfy the full
range of patient needs and preferences. Patient-centered care is the core of a
high-quality health care system and a necessary foundation for safe, effective,
efficient, timely, and equitable care.
Planetree Components are Human Interaction, Family, Friends, & Social
Support contribute to the quality of the hospital experience by promoting caring
connections between the patients and their support systems, Information &
Education, Nutritional & Nurturing Aspects of Food, Architecture & Interior
Design: The Planetree design considers the patients wellbeing. The hospital is
welcoming and accessible, providing clearly marked signs for direction,
comfortable and familiar rooms, and designs that engage the senses and break
down barriers, Arts & Entertainment, Spirituality and Human Touch.

Complementary Therapies expand the choices offered to patients.

Aromatherapy, therapy dog visitation, acupuncture, and Reiki are offered in
addition to clinical modalities of care.
Architecture & Design, Griffin Hospital's adoption of the Planetree model
of patient-centered care over twenty years ago prompted us to design a distinctly
warm, nurturing and healing environment, their hospital-wide implementation of
the Planetree model of patient-centered care has set the stage for Griffin Hospital
to better respond to the needs and expectations of our patients and community.
The center features a healing environment inspired by nature and created
for comfort, with quiet, calming interior spaces infused with natural beauty and
light, designed for comfort and serenity.
The Griffin Imaging & Diagnostics Center in Shelton, combines diagnostic
confidence and patient comfort in one of the most advanced imaging facilities in
the State. As a Planetree facility, the Griffin Imaging & Diagnostics Center is
designed entirely around the patient experience, with the sensitivity of Griffin
Hospital's renowned model of personalized care:

Comfortable furnishings, WiFi

Internet with PC access High-definition TV, Saltwater aquarium, Interactive

children's waiting area and Refreshment station. (Griffin Hospital, 2012)
Planetree as a concept adopted by Griffin Hospital is a innovative
principles that puts patients needs first. The Planetree design considers the
patients wellbeing which is welcoming and accessible, providing clearly marked
signs for direction, comfortable and familiar rooms, and designs that engage the
senses and break down barriers, arts & entertainment, spirituality and human
touch structure and this concept can be adapted to the proposed project.

TAO GARDEN HEALTH SPA

Located in the Himalayas' green foothills, Tao Garden holistic Health Spa
& Resort is an oasis of healing. Their 32-acre lush garden that looks like an
enchanted forest offers a perfect environment to relax, rejuvenate and find your

inner peace. Tao Garden was founded by the Taoist & Qigong Master Mantak
Chia, utilizing his experience with Thai and Chinese medicine, Indian and
Western holistic medicines, along with different kinds of treatments and healing
practices.
At Tao Garden, ancient Eastern health systems are combined with the
latest developments in the Western medicine. Together they create a singular
health system based on the theory of cleanest blood, cleanest cells, good Chi,
and good health as a result. Taoism, Ayurveda, Acupuncture, traditional Thai
massages,Chi Nei Tsang and Karsai Nei Tsang massages, body organs
cleansing, detox and weight loss programmes are just a few modalities that can
be experienced at Tao Gardens Pakua Clinic and Anyamanee Spa.
Chemical free salt-water swimming and salt hydrotherapy pool, steam
room, a fully appointed gym, and organically grown food served buffet style add
to the pleasurable experience. Stroll among lush fifty acres of Feng Shui
designed gardens and paths with mature trees, bonsai trees, and Chinese
Vases, enjoy lusciously scented blossoms surrounded with various species of
birds & butterflies. Find yourself blanketed with an abundant sense of well-being
at the Best Destination Spa in Thailand. Allow yourself to set out upon your path
of inner exploration and peace, and partake in a healing adventure that is at once
both dynamic and a most tranquil respite.

Leading Health Spa & Resort, Chiang Mai, Thailand

Created by world renowned Qi Gong and Taoist Inner Alchemy Master
Mantak Chia in the lush environment of northern Thailand, Tao Garden is an
oasis for the body, mind and spirit where the senses are soothed and the heart
encouraged to open.
Large sun drenched swimming pool, shaded lounging chairs with a
complimentary chilled coconut drink, herbal steam bath, exercise room, tennis
courts, basketball court and other amenities.
All the treatments are given in their beautiful new Anyamanee Spa, which
also includes a fully equipped hydrotherapy pool.
The Pakua Clinic, a Holistic Medical Facility, has few rivals for the breadth
and diversity of medical treatments and diagnosis. Each guest receives a
comprehensive analysis of their state of health guided by a licensed allopathic

physician with data garnered by sophisticated laboratory analysis. All their

physicians are also trained in Naturopathic and Eastern Healing Arts such as
acupuncture, meditation and Qi Gong.
At Tao Garden they use Adobe Brick for the accommodations
construction. Adobe bricks are a fireproof, durable yet biodegradable, non-toxic
building material which provide sufficient thermal mass to buildings to ensure
excellent thermal performance. Other benefits include low sound transmission
levels through walls and a general feeling of solidity and security. Due to the
production process and the nature of clay, Adobe bricks have good water
resistance. Nevertheless it is very important to provide adequate weather
protection of the earth walls, especially in exposed situations. This is normally
done with the provision of adequate eaves. Moreover, the process of making
Adobe brick is environment safety which has no burn, just wait until it dries in the
sun, also it can avoid using wood for fuel and no smoke as well.
Dirt suitable for adobe brick should have a high enough clay content to
help the brick resist moisture and provide strength to the brick. The problem is
that dirt with too much clay in it will crack upon drying. If dirt has too much clay,
one must add sand to it or dried grass; sand is the better additive. Dirt with too
little clay will mean that the dried brick will be too brittle to use. Experience has
shown that cement added to a standard adobe mixture can all produce a strong
brick. For Tao Garden, their compositions are clay 70%, sand 15% and cement
15%. (Tao Garden Health Spa, 2012)
At Tao Garden, ancient Eastern health systems are combined with the
latest developments in the Western medicine. This method can be adapted to the
project. The materials that were used to Tao Garden was adobe brick, and this
type of construction materials is good on weather adaptation but requires more
time in maintaining the cleanliness, so bricks is not advisable to the project.

3.2.2 LOCAL CASE STUDY

The Farm at San Benito
Barangay Tipakan, Lipa City, Batangas

Located in an exceptional healing environment, The Farm at San Benito,

rests on 119 acres in the foothills of Mount Malarayat, 1,025 feet above sea level.
Guests enjoy year round tropical weather and the comforts of a world-class
resort while discovering paths to a healthier and happier lifestyle. Programs are
supervised on-site Integrated Medical Physicians & Licensed Therapists,
Movement Consultants, Living Food Chefs while experiencing the miraculous
healing hands and caring hearts that Filipinos are known for. Consistently
recognized as one of the few truly integrated medical and wellness resorts in the
world by leading publications and sophisticated travelers, this award-winning
resort in Batangas, Philippines offers a complete immersion into healthy and
mindful living.
Dedicated to the promotion of overall health and well-being, The Farm
specializes in "Wellness Holidays" or "Healing Retreats". A specialty retreat is the
Performance Enhancement program, a powerful, weeklong experience designed
to help one make positive lasting lifestyle changes through integrative wellness
methods. The Farm's team of professionals creates a personalized plan to
improve one's physical-emotional health, spiritual vitality, fitness & movement,
nutrition, and stress management. Other expertise includes treatment of lifestyle
related diseases such as digestive disorders, weight loss, diabetes, infertility,
arthritis, hypertension, and other chronic degenerative diseases. Each program is
designed to be specific to the individual to achieve optimal health & recovery.
Additional on-site amenities include three swimming pools, a boutique,
library, meeting hall, working organic gardens, open air yoga amphitheater, and
gym. With just 24 rooms, privacy and personalized service is guaranteed in this
picturesque setting.

The Farm at San Benito is a world-renowned holistic health and wellness

retreat. Nestled amidst a lush tropical forest with the impressive Mount Malarayat
as its backdrop. Also an ideal for sanctuary for soul searchers and those in need
of a literal physical or spiritual healing get away spot for a romantic and relaxing
retreat for health enthusiasts or those looking for full immersion in a lifestyle
leading to a hale and hearty mind and body.
Their facilities are Accessible to Mount Malarayat Golf & Country Club and
Summit Point Golf and Country Club, both of which offer stunning scenery and
year-round

golf

activities.

European-inspired

holistic

wellness

services

supervised by on-site medical doctors.100% natural and organic spa treatments

made fresh daily, health and fitness center offering a variety of high and low
impact activities.
Indoor and outdoor private area designed for quiet moments and
communing with nature a swimming pool, wide gardens, and stone walkways.
The Farm Boutique, which has a range of products for sale, transportation
services and business center, laundry facilities, and room service. (The Farm at
San Benito Batangas, 2012)
The Farm at San Benito has a good and relaxing ambience. Consideration
to nature is very important to this type of structure and this study gives an idea to
the proponent on choosing and proper designing the site vicinity to achieve the
goal of having a relaxing and comfortable environment which is very important to
on health maintenance of every person.

Amezcua Wellness Centre

Katipunan Avenue White Plains, Quezon City

Amezcua Wellness Centre is an oasis for serenity and rejuvenation with

its combination of integrative diagnostic and screening facilities, spa treatments,
wellness therapies, and fitness activities designed to guide one towards a healthy

lifestyle. The first modern urban medispa in the Philippines, boasting a team of
well-trained, licensed professionals who care for, and pamper clients with 5-star
service throughout their visit. All of Amezcuas services are based on the concept
that true health comes with the balance of body, mind, and spirit. As such, it
offers a comprehensive approach to health care with traditional, alternative
therapies and treatments that complement modern methods. No other
establishment has been able to equal its standards in terms of having exactly the
same kind of service offerings in a highly-comfortable, exclusive environment
so much so that it was nominated Best MediSpa in the Baccarat Asia Spa
Awards 2007.
Amezcua is differ from hospital because it offers a holistic approach to
restoring the balance of the body, mind, and spirit, and thus bring back quality to
life amidst the fast pace of modern living. Amezcua advocates the use of
preventive medicine to detect weaknesses in the system before the symptoms of
disease manifest in the body. Hospitals use synthetic drugs to alleviate the
problem as it exists in its current state; Amezcua uses complementary methods
that tackle the source of the problem, aiming to prevent disease by strengthening
the bodys immune system. If damage has occurred to the system, the Centre
helps in managing the illness or disease by alleviating pain or similar discomfort,
to make it easier for the individual to deal with the condition .Amezcua also
espouses the use of homeopathy natural, organic-based medicine that has a
therapeutic effect on almost any health condition. Its benefits are numerousno
chemical components, safe, non-toxic, no risk of overdose, no side effects, and
most of all effective.
Amezcuas state-of-the-art medical facilities and service offer the most
comprehensive in Asia, boasting some of the worlds most modern equipment
and facilities which are rarely, if a tall, used by other medical establishments
.Meridian Stress Assessment(MSA) is a high-technology method that measures
electrical energy throughout the body as it passes through acupoints and
meridians. MSA shows normal, weak, and stressed areas, and indicates possible
remedies. Only Amezcua has this high-technology machine in the Philippines. It
is recommended for those who have suffered strokes, nerve problems, and
psychological and emotional problems.
A spa helps maintain ones physical, mental, and emotional well-being by
providing an environment for serenity and rejuvenation; while addressing various
body needs such as stimulation of the system, improving circulation, relieving
aches and pains, and reducing tension and anxiety. Services include body

massage, scrubs and wraps, basic facial, and hand and foot treatments that use
only the finest infused herbs, essential oils, minerals, and sea-plant extracts to
cleanse, firm and tone the skin, slim down the body, and boost the immune
system and energy levels. (Medical Spa, 2012)
Amezcua is a wellness center that is totally different from other existing
health institution. Their principles, practices and methods used in treatment are
adoptable to the proposed project. Many similar therapy and treatments are also
being offered in the proposed project and this study can give the proponents an
idea on the design solution.
Ananda Marga Wellness Center
Natural Healing in the Philippines
Pagsabungan, Mandaue, Cebu, Philippines

Situated in a quiet neighborhood of Cebu, the Ananda Marga Wellness

Center is the country's first affordable stay-in alternative healing center. It
practices a holistic approach to health through various natural therapies, the
practice of yoga, meditation and vegetarian diet. They do not only assist their
students in their healing, but they also teach them the path to life-long health.
They empowers people to overcome problems caused by excess fat, stress and
disease, to cure themselves through a system of natural therapy without
depending on medicines, to become physically fit, mentally relaxed and fully
conscious and to learn new healthy systems of eating, exercise, drinking water
and harmonious thought. They offer a complete systematic, in-patient natural
therapy program. Daily activities are not only therapeutic but also entertaining
and educative.
Located on the tropical island of Cebu, Philippines, AM Wellness is a
detox health center (also called a natural health farm or natural health resort)
using holistic healing and natural therapy to overcome disease and achieve total
health and well-being. They also teach their students the keys to life-long health
through the practice of yoga, meditation and vegetarian diet.
Rather than use the word patient, they prefer to call the people who
come to their center students because the student/patient only to be cured but
also to experience how to remain healthy and disease-free for the rest of their
lives.
Their naturopathy treatment courses run between 2 days and 4 weeks or
more, and include juice fasting detoxification, raw food and other cleansing diets,

herbal colonic cleansing, mud/water/sun therapies, water cleansing, alternative

medicines, and exercise. These are complemented by music, art, classes,
outings and games.
Their unique dome shape structure is designed to harness positive energy
that greatly helps in healing and recovery.
Situated in a normal but quiet Cebu neighborhood, the Center is in a
village with mostly dirt roads. Even though it is only a few minutes away from the
city, the air is clean and fresh and there is a small number of goats and cows
grazing in the empty lots across the street and nearby. The houses are a mix of
well-to-do and wooden huts.
Their facilities include students bedrooms available for sharing or private
use. The innermost room called the cave, designed by renowned artist
Jayakrisna, is where they often do meditation, yoga, art workshops and classes.
Their hall upstairs is also for yoga classes and group meditation. The open
kitchen is where cooking classes are held to teach students vegetarian cooking.
The garden and lawn is a good place to have sunbathed and other treatments. It
is also ideal for fun activities and games. Though their property is small it is rich
in foliage and vegetation. (Natural Healing Philippines, 2012)
The practices and approach of Amanda Marga Wellness Center is
adoptable to the proposed project. Their facilities can be used as basis for
making a design solution to the proposed project.
THE MEDICAL CITY (Wellness Center)
Ortigas Avenue, Pasig City
The facility is located on a 1.5-hectare property along Ortigas Avenue in
the business district of Pasig City, Metro Manila. It is composed of 115,000
square meters of floor space and includes two Nursing Towers, which can be
fitted for up to 800 beds, joined by a Podium, bridgeways, and a Medical Arts
Tower. The 18 floors of the Medical Arts Tower house 280 doctors' clinics and
select commercial spaces. Located within the six-floor Podium are diagnostic and
intervention facilities, as well as support and administrative offices. The threelevel basement parking accommodates over a thousand vehicles. The complex is
also equipped with a broad range of state-of-the-art security features, an
advanced building management system, and biosafety features incorporated into
sensitive patient areas.

TMC also serves as the hub for a network of satellite clinics and hospitals,
delivering a full range of diagnostic and therapeutic services to patients in Manila
and

select

provinces.

TMC's

aggressive

national

expansion

strategy

demonstrates a commitment to bringing its unique, world-class brand of health

care straight to the communities of its patients.
The Center for Wellness and Aesthetics is a flagship program of The
Medical City, dedicated as a one-stop shop for preventive, promotive, proactive,
diagnostic, therapeutic and rehabilitative interventions, and employs methods
and methodologies guided by the principles of evidence-based medicine. The
Center helps people adopt a healthier lifestyle and facilitates positive health
behavior changes through a combination of efforts to enhance awareness,
change behavior and create environments that support good health practices. It
offers organized, comprehensive services appropriate to various segments
from the young to the young at heart.
The Department of Physical Medicine and Rehabilitation focuses on
prevention, rehabilitation, and the clinical management of problems associated
with disability, and facilitate ones return to his previous lifestyle after a condition
that requires prolonged healing, or in spite of the presence of irreversible
pathological deficits. With the complexity of a situation involving various
disabilities, the specialty is based on a holistic approach to medical care utilizing
the interdisciplinary team approach. Rehabilitation is an integral part of total
medical care. It is best achieved through the coordinated work of various health
disciplines headed by a physiatrist. The interdisciplinary team is composed of
physical

therapists,

occupational

therapists,

speech

therapists,

nurses,

vocational and social workers, and other medical specialists. All patients referred
to us are considered individual persons, and not just patients with disease.
They cater to patients suffering from a wide range of conditions such as,
but not restricted to: pain syndrome: low back pain, neck pain, arthritis. Pediatric
conditions: cerebral palsy, spina bifida, developmental delay, SMA, muscular
dystrophy. Neuromuscular conditions: multiple sclerosis, Parkinsons disease ,
myasthenia gravic , guillain barre syndrome, poliomyelitis. Sports-related
conditions/musculoskeletal conditions: acl injury meniscal injury, tennis elbow,
tendonitis. Orthopedic conditions: hip replacement, knee replacement, fracture;
osteoporosis, joint dislocation, amputation. Pulmonary conditions, asthma,
chronic bronchitis, pneumonia, emphysema. Cardiac conditions: myocardial
infarction, angioplasty, cabg. Neurologic conditions: stroke, traumatic brain injury,

peripheral nerve injury, spinal cord injury. Other medical conditions: diabetes
mellitus, obesity; metabolic disorders, Renal Diseases .
The Out-patient Chemotherapy Unit is specially designed for patients who
only wish to be provided chemotherapeutic medications without having to be
confined in the hospital. (The Medical City, 2012)
Medical City is a high rise structure and offers a high quality of security
management. This type of building is not applicable on the proposed project but
the security management can be adopted for patient security. Other services of
Medical City is not applicable in the center but it can also gives an idea to the
proponents.

Oakwood Wellness Center

Corinthian Plaza Suite 12, 121 Paseo de Roxas
Legaspi Village, Makati City, Philippines
The Oakwood Wellness Center, a totally new concept of natural medicine
clinic, is practicing Advanced Alternative Medicine. The uniqueness of this clinic
is providing Alternative Healing combined with both Western and Oriental
Medicine. It is a private Natural Medicine Clinic that provides quality patient care.
Their physicians are both Koreans and Filipinos, who were all well- trained to
their chosen specialization. They are providing excellent services with high
regards to the welfare of each individual who has specific health problem.
They provide quality time to every client with accommodating attitude and
in approachable manner, offering solutions and remedy to each individual. The
registered nurses, nutritionist and psychologist are all highly competent to their
area of specialties. They also undergone in depth trainings and orientation about
Oriental Medicine.
The facilities and equipments are highly modernized, and accessible to
the general public. The clinic offers the highest degree of quality care in the field
of Acupuncture, Aromatherapy, BMSI (Body, Mind, Spirit, and Integration)
therapy, Chelation therapy, Vitamin C Mega-dose therapy, Detoxification Therapy,
Lights and Sound therapy (Brain Wave therapy), Meditation and Mind Therapy,
Oxygen Therapy, Thermotherapy, and specially designed physical exercises. In
addition, the clinic offers wellness products like slimming injectable medication,
food enzyme supplements, and herbal medicine that are proven, highly effective,

and safe for use because it is made from plant's seeds, berries, roots, leaves,
bark, or flowers for medicinal purposes which are non toxic and natural.
Oakwood

Wellness Center was registered in

Security and

Exchange

Commission on the 17th of September 2009.

Wellness comes from within; diseases originate from our mind. At the
present time, Western Medicine is focused in treating the physical aspect.
Therefore, Body, Mind, Spirit and Integration (BMSI) therapy is their basic
philosophy is selflessly dedicated to their patients. The patients total health
indeed is their primary concern. They aid in disease prevention and ensure that
their physical energy, emotional health, mental state, and spirit are all into the
patients optimum level. Their aim is to be an ideal Integrated Natural Medical
Clinic recognized nationally and internationally. To deliver excellent healthcare
through caring and highly qualified physicians and nurses to utilize a world class
diagnostic program and or therapeutic system. To build a fresh and reliable
image of new paradigm of alternative medicine to the people of the Philippines.
To endeavor and lead a task to conquer Incurable and Hard-to-cure-diseases .To
expand the realm of curing diseases by using Vital Food or Enzyme Food
Their service is lifestyle related diseases (Cancer, Hypertension, Diabetes,
etc.) detoxification, anti-aging, sports injury clinic, stress clinic, pediatric clinic,
geriatric diseases and gynecology obesity.
Acupuncture originated in china over five thousand years ago. It is based
on the belief that health is determined by a balanced flow of qi (also referred to
as chi), the vital life energy present in all living organisms. According to
acupuncture theory, qi circulates in the body along twelve major energy
pathways, called meridians, each linked to specific internal organs and organ
systems. There are over one thousand acupoints within the meridian acupoints
within the meridian system that can be stimulated to enhance the flow of qi.
When special needles are inserted into these acupoints (just under the skin),
they help correct and rebalance the flow of energy and consequently relieve pain
and/or restore health.
Aromatherapy is a unique branch of herbal medicine that utilizes the
medicinal properties found in the essential oils of various plants. Through the
process of steam distillation or cold-pressing, the volatile constituent of the
plants oil (its essence) are extracted from its flower, leaves, branches, or roots.
The oils exert much of their therapeutic effect through their pharmacological

properties and their small molecular size, making them one of the therapeutic
agents to easily penetrate bodily tissues.
Yoga is among the oldest known systems of health practiced in the whole
world today, and research into yoga practices has had a strong impact on the
fields of stress reduction, mind/body medicine, and energy medicine.
The meaning of yoga is union; the integration of mental and spiritual
energies that enhance health and well-being. The yoga teaches a basic principle
of mind/body unity: if the mind is chronically restless and agitated the health of
the body will be compromised, and if the body is in poor health, mental strength
and clarity will be adversely affected. The practices of yoga can counter these ill
effects, restoring mental and physical health.
Yoga is commonly practiced throughout the whole world and holds
prominent place in the emerging field of mind/body medicine.
Meditation is a safe and simple way to balance a persons physical,
emotional, and mental states. It is easily learned and has been used as an aid in
treating stress and pain management. It has also been employed as part of an
overall treatment for other conditions, including hypertension and heart disease.
Meditation can be broadly defined as any activity that keeps the attention
pleasantly anchored in the present moment. When the mind is calm and focused
in the present, it is neither reacting to memories from the past nor being
preoccupied with plans of the future, two major sources of chronic stress known
to impact health. Meditation helps to keep us from identifying with the movies of
the mind.
Heat therapy, also called thermotherapy, is the application of heat to the
body for pain relief and health. It can take the form of a hot cloth, hot water,
ultrasound, heating pad, hydro collator packs, whirlpool baths, and many others.
It can be beneficial to those with arthritis and stiff muscles and injuries to the
deep tissue of the skin. Heat may be an effective self-care treatment for
conditions like rheumatoid arthritis.
Heat therapy creates higher superficial tissue temperatures, which aids
the healing process in some conditions. Heat applied superficially to the skin
directly increases the temperature of the skin and the tissue immediately
underneath the skin. Muscle temperature increases through a reflexive effect on
circulation and through conduction.

The word chelation is derived from the Greek word chele that means claw
(like that of a scorpion or crab). The concept of chelation is based on the
observation that when a certain amino acid complex called EDTA (ethylenediamine-tetra-acetic acid) comes in contact with certain positively charged metals
and other substances such as lead, iron, copper, calcium, magnesium, zinc,
plutonium and manganese, it grabs them (hence the chele or claw), and removes
them. Chelation therapy is the process of removing from the body the
undesirable ionic material by the infusion, or taking orally, of an organic
compound which has suitable chelating properties.
Light therapy or phototherapy consists of exposure to daylight or to
specific wavelengths of light using lasers, light-emitting, fluoresence, dichroic
lamps or very bright, full-spectrumlight, for a prescribed amount of time and, in
some cases, at a specific time of day. Light therapy directed at the skin is used to
treat acne vulgaris and neonatal jaundice, Light therapy which strikes the retina
of the eyes is used to treat circadian rhythm disorders such as delayed sleep
phase syndrome. Bright light to the eyes treats seasonal affective disorders with
some support for its use also with non-seasonal psychiatric disorders.
Oxygen may be classified as an element, a gas, and a drug. Oxygen
therapy is the administration of oxygen at concentrations greater than that in
room air to treat or prevent hypoxemia (not enough oxygen in the blood). Oxygen
delivery systems are classified as stationary, portable, or ambulatory. Oxygen
can be administered by nasal cannula, mask, and tent.
Herbal medicine is the most ancient form of health care known to
humankind. Herbs have been used in all cultures throughout history.
Herbs have always been integral to the practice of medicine. The word
drug comes from the Old Dutch word drogge meaning to dry, as pharmacists,
physicians, and ancient healers often dried plants for use as medicines. Today
approximately 25 percent of all prescription drugs are still derived from trees,
shrubs, or herbs. Some are made from plant extracts; others are synthesized to
mimic a natural plant compound.
The World Health Organization notes that of 119 plant-derived
pharmaceutical medicines, about 74 percent are used in modern medicine in
ways that correlated directly with their traditional uses as plant medicines by
native cultures.

Detoxification Therapy involves the removal of toxic substances. Our body

naturally eliminates or neutralizes toxins. But due to industrial revolution the
accumulation of toxins (food additives, industrial chemicals, anesthetics and
residue of pharma drugs, pesticides, paint, gasoline, and heavy metals)
surpasses its elimination.
Many alternative medicine practitioners fear an epidemic that they call
bioaccumulation, or a buildup and trapping of toxic substances in the body that
weakens the organs of elimination as well as the immune system and gradually
erodes health. They also claim that toxic accumulation alters the body's
metabolism and causes enzyme dysfunction, nutritional deficiencies, hormonal
imbalances, and damaged immune systems, all of which contribute to
physiological and psychological decline.
Sound and music can have a very powerful effect on ones health. Sound
Therapy is simple, effective and effortless. By listening to the specially recorded
music tapes while you go about your daily routine, you can create the changes
needed to enhance your quality of life. It is used in hospitals, schools, corporate
offices, and psychological treatment programs.
Recent research has demonstrated that diet alone may not be adequate to
supply the nutrients essential for overall good health. While most experts agree
that nutritional supplements are vital for a variety of illnesses, injuries, and agerelated problems, vitamin and mineral supplements can also help to maintain
optimal physical and psychological health, and promote longevity and chronic
disease prevention.
Enzyme therapy is a plan of dietary supplements of plant and animal
enzymes used to facilitate the digestive process and improve the body's ability to
maintain balanced metabolism.
Chiropractic is a health care discipline which emphasizes the inherent
recuperative power of the body to heal itself without the use of drugs and
surgery. The practice of chiropractic focuses on the relationship between
structure (primarily the spine) and function (as coordinated by the nervous
system) and how that relationship affects the preservation and restoration of
health.
Vitamin C Megadose Therapy is the consumption of vitamin C (ascorbate)
in doses well beyond the current Dietary Reference Intake. It is given via
intravenous route for faster absorption. Vitamin C is one of the most widely used

and highly valued vitamins in the world. It is a recognized antioxidant, which has
led to its endorsement by some researchers as a complementary therapy for
improving quality of life. (Oakwood Wellness Center, 2012)
Oakwood Wellness Center is very similar to the proposed project. The
services, facilities and treatments they offered is adoptable and it is useful to the
proponents as bases for the design solution. Like any other wellness center,
Oakwood introduced new types of medicine the natural medicine and this is also
one of the goal of the proposed project, to introduce the natural medicine.

HEALTHCARE WASTE MANAGEMENT

CAPITOL MEDICAL CENTER INC
GENERAL BACKGROUND
Capitol Medical Center Inc. (CMC) is a tertiary hospital located at Quezon
Avenue corner Magbanua St., Quezon City along a major thoroughfare of Metro
Manila in a middle income area and is very accessible to the nearby low income
areas including some slum and squatter settlements.
The Capitol Medical Center is a modern medical center and has four (4)
major departments namely, Medicine, Surgery, Pediatrics and Obstetrics
Available facilities in the hospital include Radiology, Laboratory, Spine Center
(specialty), CT scan, Ultrasound, Homography and Mammography. The
institution's progress over the years can be clearly seen from its rapid expansion.
From an initial 8-storey building hospital with a 150-patient bed capacity, the
CMC II (annex) building was constructed in 1975 after barely 5 years of operation
to increase their capacity to 200 beds and additional doctors' clinics and offices.
Patient admission also grew from an average of 5,000 at the beginning of its

operations to 10,000 patients a year at the end of the first decade. A third
building,

the

CMC

III,

was

constructed,

which

presently houses

the

Comprehensive Out-Patient Center of the hospital. Bed capacity was increased

to 250 beds in 1989 with the construction of additional private rooms and
installation of hospital equipment. A fourth building started last November 1996
and it will add another 100 private rooms, new medical equipment and a three
floor parking space. This building will expand the medical facilities such as
cancer

treatment

facilities

like

cobalt

and

linear

accelerator,

and

comprehensive physical and medical rehabilitation center. In addition, the

hospital has acquired a 3,575 sq.m neighboring parking lot for future expansion.
Bed occupancy rates all along this time averaged 80-85 percent, reaching as
high as 95% during peak periods. Peak periods are those months where the
average patients' admissions reached more than one hundred seventy (170)
patients. During the period from July 1995 to June 1996 the average occupancy
rate was 75.4%. As of September 1996 there are 473 regular employees of
Capitol Medical Center. Janitorial service is being contracted to the Building Care
Corporation while the Safeguard Security Agency is rendering security service.
Solid waste management is the responsibility of the housekeeping section under
the administrative department There are a total of 65 personnel being provided
by these two contractors to the CMC.
WASTE MANAGEMENT PRACTICE
The housekeeping section under the administrative department is
responsible for the implementation of the hospital policy on waste management.
The janitors of the Building Care Corporation, the contractor for janitorial
services, are under the supervision and control of the housekeeping section. The
maintenance section that is responsible for the maintenance of the infrastructure
for solid waste management is under the engineering department. Close
coordination with the housekeeping section is being undertaken to keep the
hospital premises clean.
Segregation
There are two janitors assigned to each floor. Usually, one (1) hour before
the end of each shift the assigned janitors collect the waste from each room.
These are brought to the electrical room (8-10 sq.m) in each floor that also
serves as the storage and segregation area for hospital waste. After the janitors
for each floor collect the black, yellow, and green plastic bags, they segregate the

recyclable (paper and cartons) from the black plastic bags. The supervisor of
janitors makes the rounds on every shift to ensure that all wastes are collected
properly. The collected wastes are then placed temporarily in a room to await for
the scheduled time for them to use the elevator so that they could place the
garbage in the central storage room. This storage room (8 sq.m) has a two-day
capacity and is located at the back of the main building. A laboratory aide is
collecting infectious waste for the whole hospital. Infectious wastes are supposed
to be placed inside the incinerator room, but the incinerator operator instructs the
janitors to place the yellow plastic bags outside the incinerator room. During data
gathering, yellow plastic bags were observed aligned along those that are going
to the incinerator room. Syringes are collected and placed in a big plastic
container (hard plastic) at the nurse's station, these syringes are incinerated.
Previously, they use to separate the needles from the syringe body (plastic) but
because of the risk and labor involved; they just incinerate the syringes and the
needles together. The blades of scalpels are included in the sharps container for
disposal while the scalpel handles are autoclave and re-used again. Separating
the blades from the handles, forceps are utilized to minimize possible
contamination or infection. Tools used for segregating waste includes gloves,
liners and carts. Some gloves (thick rubber gloves) that are used for noninfectious waste segregation are being autoclaved and reused again. The
laboratory aide usually collects infectious waste around 5:30-6:30 in the
afternoon. Incineration takes place every night around 8:00 PM. However, if the
quantity of infectious waste is minimal, the hospital incinerates them every other
day. Hospital linen of patients with contagious diseases are segregated from the
rest of the linen and properly tagged. These are soak with a chemical disinfectant
before undergoing the usual laundry procedures. This cleaned linen is then
issued to patients with similar diseases. Ordinary linen are used up to six months
while linen issued to patients occupying hospital suites are used up to three
months. These condemned linen together with other linen are then cleaned and
donated to the Golden Acres, a home for the aged as rags.
Storage
The storage phase is largely influenced by the size of their central storage
room located at the back of the hospital. It can only store around two-day
equivalent of solid waste generated by the hospital. The unreliability of the
garbage collector assigned to collect from the Quezon City government has
adversely influenced the storing of waste by CMC. Usually, the garbage collector
collects the waste only one or twice a week. In these cases, the waste, plastic

bags that cannot be accommodated in the storage room are placed near the
incinerator. Traditional recyclable materials such as cullets, cartons and paper
are stored in a bodega inside the hospital. When sufficient quantity has
accumulated the personnel in charge of selling these materials call the cullet
traders and/or bidders for cartons and paper to verbally offer their buying price.
Buyers pick up the recyclable materials. Placentas that are produced in the
delivery room during delivery of babies are put in a freezer supplied by Prime
Commercial, a business entity that buys placentas from hospitals in Metro
Manila. In cases where the mothers request to keep the placentas, the hospital
gives the placentas to the mothers. There are some parents who bury the
placentas in their yards in the belief that these will help their lives to financially
prosper while others bury them together with ballpens or pencils in the belief that
the children will become talented. Some parents plant trees on the spots where
they bury the placentas in the belief that the newly born child will have long lives
like the trees planted. Presently, Prime Commercial has stopped buying the
placentas. CMC disposes them together with other biodegradable to produce
compost that will be used in the hospital premises and for the residence of the
head of the hospital. The hospital is presently looking for other buyers of
placentas. In the meantime, these placentas are buried in a pit inside the hospital
grounds near the parking lot. The hospital management has given instructions to
the security force to prevent unauthorized
persons from entering the storage area and collecting recyclable materials. This
was a response to previous incidences wherein scavengers were retrieving
recyclable and in the process scattering the waste Even stray dogs are not
allowed to go near the storage room to rummage or scavenge Based on
interviews with some key informants in the hospital, it is estimated that around
80%-90% compliance on waste segregation is being achieved by CMC. Frequent
violators are visitors of patients who are ignorant or apathetic to the ongoing
segregation of the hospital
Collection
The collection of solid waste from the hospital is the responsibility of the
local government unit. In the case of CMC, the Quezon City government is
responsible for the collection, transport and disposal of solid waste. Hospital
waste is collected together with other municipal waste within their jurisdiction The
Quezon City government utilizes contractors for the collection of solid waste REN
Transport one of the solid waste collectors of Quezon City covers the area of
CMC. An open garbage truck (12-15 cubic meter capacity) is assigned by the

contractor to collect all the hospital waste in Quezon City. REN Transport collects
the bulk of the hospital waste generated by CMC. The garbage collector
servicing majority of the hospitals in Quezon City is Carlito Manuel, who is an
employee of REN Transport. He drives the garbage truck that collects hospital
waste in Quezon City. Usually, he has four helpers with him in collecting garbage
from the hospitals One helper is tasked to segregate the recyclable on top of the
truck (palero) while the three helpers collect the waste.

His assigned truck

figured in a vehicular accident recently and he is borrowing a truck from his fellow
drivers to collect the waste from the hospitals. The lack of transport adversely
affects the collection of waste in his assigned route. CMC generates
approximately 50 bags (around 0.20 cubic meter per bag) a day. In addition, the
contractor also collects the ashes that are produced in incineration. These are
stored in plastic bags or sacks and placed in cartons (24" x 15" x 8") including
burned needles and blades. The hospital produces an average of 3-4 cartons of
ashes a month. For each load of waste being delivered in the dumpsite, the
operator of the Payatas Dumpsite is charging a dumpsite fee of P200 00. This is
partially defrayed by the incentives being paid by some private hospitals as in the
case of CMC where it is giving P700.00 a week to the garbage collector.

Incinerator
CMC uses a commercial type of incinerator that was bought around 1969.
Through the years, the incinerator was periodically rehabilitated and remodeled
to its present form. Presently, the incinerator uses LPG gas fuel and can
incinerate around 50 kg per loading. The firing time of the incinerator is at
nighttime. There are plans to replace the incinerator by January 1997 The
proposed incinerator can accommodate even the general waste of the hospital if
the garbage collector fails to collect their waste. The bigger incinerator can also
accommodate the toxic and hazardous waste of other hospitals for incineration.
Reuse and Recycling
The driver of the garbage truck assigned to collect the hospital waste
deliver the recyclable to Clarita's Junk Shop at Payatas, Quezon City, a junkshop
owned by his mother who specializes on hospital waste The recyclable that are
normally retrieved are paper, empty bottles, plastic, and cartons. The infectious
materials such as blades and syringes are not usually retrieved by the paleros of
the garbage truck.

Empty dextrose bottles are segregated and crashed to

produce cullets in the hospital. This is also done to reduce the volume of waste in
the hospital. The cullets are then sold to two junkshop specialists namely,
Chrisma Enterprise and Mallari Trading for a total of around P2,000 to P3,000 a
month Uncontaminated paper and cartons are also segregated in the hospital.
Confidential papers are shredded before these are sold to the buyers through
oral bidding. These are then sold to interested buyers who pick up these
recyclable. These buyers are usually itinerant buyers of recyclable who own or
rent a vehicle to pick up the materials from the hospital. The buying prices of
recyclable vary depending on the prevailing buying prices in Metro Manila. The
purchasing department is negotiating the selling prices of these recyclable with
the buyers The proceeds of the sales go directly to the Treasury of Capitol
Medical Center Previously, scavengers enter the hospital premises and separate
paper and other recyclable from the black plastic bags However, when
management found out the practice and the mess that this created, it instructed
the janitors to automatically separate papers and cartons to centralized the
retrieval of materials and prevent the unhygienic conditions that this practice has
created. Biodegradable waste from the kitchen and canteen are stored and
collected every day by a businessperson for hog-feed Besides food waste, she
also collects used cooking oil. Collection time is usually at around 4:00 in the
morning when there are minimal activities in the hospital.
HERBAL MEDICINE FOR ALTERNATIVE HEALTH CARE
Herbalism And The Different Types Of Herbal Medicine
Herbalism is a reputable profession and has been for many thousand
years, it actually laid the groundwork base for modern medicine, botany,
pharmacy, aromatherapy and chemistry, unfortunately the attraction with
technology and other reasons, and it was relegated to an experimental and
partially wonderful art. Herbalism is both an art and a science, which has always
varied well with other treatments. Thriving today using whole plants to treat whole
people and it is as significant now as in the secluded past, and perhaps will be
more

applicable

in

the

future

now

that

has

been

re-discovered.

(http://www.infoherb.com/Herbal_medicine.html)
The Types of Herbalism
There are three types of herbal medicine systems. These are Chinese
Herbalism, Ayurveda and Western Herbalism.

Chinese Herbalism is one of the main components of traditional Chinese

medicine (TCM) or Oriental medicine (OM). In traditional Chinese medicine,
herbs are use in alternative with other technique like acupuncture or massage.
Chinese medicine is a holistic medical system, which it looks at treating a patient
as a whole person, looking at the mental and spiritual health, as well as the
physical health of the individual. Illness is seen as a disharmony or imbalance
among aspects of the individual.
Ayurveda was derived from the two Sanskrit words - Ayus, or life and
Veda, or knowledge. Ayurveda has been translated as the knowledge of life
and as the science of life. It has been suggested but one modern writer that a
more appropriate translation would be the knowledge of life span. According to
Ayurvedic philosophy, Health is dependent upon ones ability to live in harmony
with ones self and with the external universe. Traditionally, as much attention
was given to illnesses of the mind as to the illnesses of the body. According to
Ayurveda, Life is a combination of the senses, mind, body and soul. This
system believes that human beings and nature should be in perfect
synchronization and that diseases occur when there is an imbalance between
bodys three humors, the vata or nerve energy; pitta or catabolic fire energy; and
kapha or anabolic nutritive energy. Restoration of this primary balance with the
help of innate products is the main goal of this medicinal branch.
Western herbalism is a form of the healing arts that draws from herbal
traditions of Europe and the Americas and that emphasizes the study and use of
European and Native Americans herbs in the management and prevention of
illness. Western herbalism is based on physicians and herbalists clinical
experience and traditional knowledge of medicinal plants remedies preserved by
oral tradition and in written records over thousands of years. Western herbalism
like much older system of traditional Chinese medicine relies the synergistic and
restorative properties of the plant to treat symptoms and disease and maintain
health. This type has evolved along with western civilization. It is consequently
describe here in terms of the communal cultural history form Greeks to the
present day. Hippocrates categorized all foods and herbs by the qualities of hot,
cold, dry or damp and this related to the four elements water, earth, fire and air.
Herbal Medicines Approved By The Department Of Health
This is the list of the ten medicinal plants that DOH through its Traditional
Health Program have endorsed. All of these ten herbs have been thoroughly

tested and have been clinically proven to have medicinal value in the relief and
treatment of various ailments.
1. Akapulko (Cassia alata) - also known as bayabas-bayabasan and ringworm
bush in English, this herbal medicine is used to treat ringworms and skin fungal
infections
2. Ampalaya (Momordica charantia) - known as bitter gourd or bitter melon in
English, it is most known as a treatment of diabetes and for non-insulin
dependent patients
3. Bawang (Allium sativum) - popularly known as garlic, it mainly reduces
cholesterol in the blood and hence, helps control blood pressure
4. Bayabas (Psidium guajava) guava in English. It is primarily used as an
antiseptic, to disinfect wounds. Also, it can be used as a mouth wash to treat
tooth decay and gum infection
5. Lagundi (Vitex negundo) - known in English as the 5-leaved chaste tree. It's
main use is for the relief of coughs and asthma
6. Niyog-niyogan (Quisqualis indica L.) - is a vine known as Chinese honey
suckle. It is effective in the elimination of intestinal worms, particularly the
Ascaris and Trichina. Only the dried matured seeds are medicinal.
7. Sambong (Blumea balsamifera) - English name: Blumea camphora. A diuretic
that helps in the excretion of urinary stones. It can also be used as an edema.
8. Tsaang Gubat (Ehretia microphylla Lam.) - Prepared like tea, this herbal
medicine is effective in treating intestinal motility and also used as a mouth wash
since the leaves of this shrub has high fluoride content.
9. Ulasimang Bato (Peperomia pellucida) - also known as pansit-pansitan. It is
effective in fighting arthritis and gout. The leaves can be eaten fresh as salad or
like tea.
10. Yerba Buena (Clinopodium douglasii) - commonly known as Peppermint, this
vine is used as an analgesic to relive body aches and pain. It can be taken
internally as a decoction or externally by pounding the leaves and applied directly
on the afflicted area.
According to Mrs. Zaidee A. Loyola, a nurse in Velazco Hospital, Silang,
Cavite, despite the fact that herbal medicines have slower effectivity rate, many

medical doctors are now recognizing the validity of these approved DOH herbal
medicines and recommending it as an alternative to preventive care.

Research About the Recognition of Herbal Medicine

Ninety percent (9 out of 10 student nurses) agreed that medical doctors

are now recommending the DOH approved herbal medicines to cure diseases
while ten percent (1 out of 10 student nurses) said that he do not believe in it.
Nowadays, doctors have arrived to introduce new concepts almost at every
corner of our country. Of course, modern medicine is a wonder compared to the
use of herbs. After all, there is still no herbal medicine comparable to antibiotics,
vaccines, anti-inflammation, and symptomatic drugs. As modern drugs were
increasingly available at much cheaper prices, the popularity of herbal medicines
declines considerably and faces extinction.

Sixty percent of the respondents (6 out of 10 student nurses) believe that

herbal medicines are much better than the genetic or even branded medicines.
Forty percent (4 out of 10 student nurses) still prefer to use the branded
medicines. For most herbs, the specific ingredient that causes a healing effect is
not known. Whole herbs contain many ingredients, and it is likely that they work
together to produce the desired medicinal effect. Many factors affect how
effective an herb will be. For example, the type of environment in which a plant
grew will affect its components, as will how and when it was harvested and
processed.
They informed us that it is better to prepare the intake of herbal medicines
if we use whole plants rather than extracting single components from them.
Whole plant extracts have many components. These components work together
to produce healing effects and also to lessen the chances of side effects from
any one component. Several herbs are often used together to enhance
effectiveness.

Seventy percent (7 out of 10 student nurses) think that the accessibility

of the herbal medicines satisfy the demand in the Philippines while thirty percent
(3 out of 10 student nurses) think likewise. In point of fact, there are also herbs
available in most stores which come in several different forms like teas, syrups,
oils, liquid extracts, tinctures, and dry extracts. Teas are simply dried herbs left to
soak for a few minutes in boiling water. Syrups, made from concentrated extracts
and added to sweet-tasting preparations, are frequently used for sore throats and
coughs. Oils are extracted from plants and often used as rubs for massage,
either alone or as part of an ointment or cream. Tinctures and liquid extracts are
solvents that contain the active ingredients of the herbs. A dry extract is the most
concentrated form of an herbal product and is sold as a tablet, capsule, or
lozenge.

Again, seventy percent (7 out of 10 student nurses) believe that it is still

better to consult the doctor if allergic reactions occur when taking herbal
medicines. Thirty percent (3 out of 10 student nurses) said that herbal medicines
do not actually develop any allergic reaction.
It is said that before, the curative effects of the herbs were tested by
traditional healers on their patient on trial and error basis. The knowledge and
skills on the curative application of any herbal medicine has been handed down
from generation to generation. Through generations of selective process, the
herbs that were known to be effective were kept alive while the ineffective one
were soon forgotten.

Eighty percent (8 out of 10 student nurses) said that nurses nowadays are
recommending the use of herbal medicines as an alternative to preventive care.
Twenty percent (2 out of 10 student nurses) believe that nurses should not
recommend the use of herbal medicines.
However, the rural folks and the poor continued to rely on herbal
medicines available in abundance. Herbal medicines have become legacy of the
past and the number of users is fast dwindling. But the big problem is that
villagers who are unable to obtain services from government hospitals resort to
drugs without prescriptions or proper advice. Keep in mind that herbal
preparations are best taken under the guidance of a trained professional. Be sure
to consult with a doctor or an herbalist before self-treating. Many herbs are
considered safer than conventional medications, but because they are
unregulated, herbal products are often mislabeled and may contain undeclared
additives and adulterants. Self-prescribing herbal products will increase risk, so it
is important to consult a doctor or an herbalist before taking herbal medicines.

Issues and Challenges in the Use of Herbal Medicine in the Philippines

According to Miriam Torrecampo, writer of Peoples Tonight, we should be
aware in taking herbal or other medicine to avoid kidney ailments. Important
kidney experts said that chemical composition in herbal products like slimming
tea and analgesics such as Ibuprofen and Mefenamic Acid, if taken rashly, could
add and in the end destroy the liver and kidney in a period of two to six years up
to eight years. Dr. Josephine Valdez, nephrologists from the UP-PGH, has advice
that popular juices or mixtures that claim healing contents could cause illness
instead of making a person well. She said that Cranberry juice, for one, which is
known to cure urinary tract infections, has high oxalate contents that could
develop more stones in kidney.
Anna Liza Villas of Manila Bulletin, said that the Bureau of Food and
Drugs (BFAD) advised the public to stop buying unsure herbal medicine products
sold in malls as it prepares to form a team to confiscate them. Also she said that
there was an identified suspect named Ismael Rivera alias Dr. Ismael River, 35,
single, a citizen of General Tinio, Nueva Ecija. He was arrested in the act of
illegal practice of medicine and unlawful statement of authority inside his clinic
located his house. One of the victims claimed that Rivera issued a prescription
for a medicine when he consulted the suspect. When the suspected victim
sought a second opinion from another doctor, he realized that he was given a
wrong medicine in the prescription.
Also, according to Jenny Maongdo of Manila Bulletin, Bureau of Food and
Drugs said that we must be aware of buying imported products. Consumers must
not buy unregistered imported products like diet pills or herbal and Chinese
medicines sold almost anywhere. The June 7 Health Advisory added that the
Department of Health-Bureau of Food and Drugs hereby repeats its advice to the
public to be suspicious of unregistered processed food, cosmetic, medical device
products. Currently, no organization or government body regulates the
manufacture or certifies the labeling of herbal preparations. This means there is
no assurance that the amount of the herb contained in the bottle, or even from
dose to dose, is the same as what is stated on the label. In addition, according to
the advisory, in Reoublic Act 3720 or the Food, Drugs and devices and
Cosmetics Act as well as Republic Act 7394 or the Consumer Act of the
Philippines, the transfer of any drug or device which is not registered with BFAD
is strictly prohibited. But City Councilor Arsenio Pacaa, in a resolution, said that
the failure of the BFAD to set up a standard is the main reason why several
herbal products and medicines are now out in the market, promising instant cure

and remedy to illnesses that range from simple colds to cancer. He also states
that while there are herbal products that are registered and legal, others are fake
and pose danger to ones health.
On the other hand, Manila Mayor Lito Atienza ordered the policy that will
attack the merchants of death who are into the sale of herbs and pills being
used for abortion. Next day, sidewalk vendors were arrested. Merchants broke
their promised. Congressman Biron said that the most important reason is to
protect consumers and patients from misuse and abuse of OTC medicines which
offer therapeutic value. Because of the promise of cure, patients tend to selfmanage and hence result in late diagnosis and accurate treatment of their illness.
Dr. Luis Limchiu Jr., of the UP-PGH, said that herbal medicine could relate with
other medicines that one is taking; and since it is not regulated it could be
mislabeled (by manufacturers); it could be carrying contaminants; and contains
active ingredients that could be toxic.
While Ilo-Ilo Rep. Fernejel Biron warned against the improper use of nonprescription drugs without professional guidance from physician, doctors note
that there are lots of promising herbal medicines that are capable of curing. But
still keep in mind that herbal preparations are
best taken under the guidance of a trained professional. Be sure to consult with a
doctor or an herbalist before self-treating.
The alertness and understanding about herbal medicine is a must. There
are lots of counterfeit herbal medicines. Some of them are low-priced so the
tendency of the people is to buy it because its practical. But not all cheap herbal
medicines are authentic so be careful. Real herbal medicines are pretty obvious
effective. A lot of articles are written concerning on herbal medicines so as a
consumer, be aware and discover the better ones. (Herbal Medicine for
Alternative Healthcare, December 2012)
Herbal medicine is needed as part of the treatment in the proposed center.
This related literature shows that DOH recognized the validity of herbal medicine
and thus recommend it to the patients. Knowing that doctors nowadays are
recommending it as alternative, it gives idea to the proponents that the proposed
type of medicine is feasible nowadays.