World No Tobacco Day – Tobacco Surveillance in Barangay Looc, Province of Zambales, Philippines; Reflections on GTCB’s Worldwide ImpactPosted on by
As an IT Specialist working for the CDC Foundation and assigned to the Office on Smoking and Health’s Global Tobacco Control Branch (GTCB), I have had the opportunity to travel to many places around the world. We conduct several surveys and I mainly work with the Global Adult Tobacco Survey (GATS). I provide technical support and guidance to countries implementing GATS. The survey is the global standard to systematically monitor adult tobacco use and track key tobacco control indicators. It is a nationally representative household survey of adults 15 years of age or older. GATS is conducted utilizing an electronic data collection system installed on tablets.
Recently, I had the opportunity to travel to the Philippines to conduct a pretest training for the Philippine Ministry of Health and the Philippine Statistics Authority (PSA). The training consisted of 5 days of classroom training and 2 days of fieldwork. We typically conduct fieldwork in both urban and rural settings. I was designated to attend the rural fieldwork in the municipality of Castillejos, about 3 hours northwest of Manila. Castillejos is a small rural area located about 40 minutes northwest of Olongapo city in the province of Zambales.
The research team I accompanied for fieldwork training consisted of 10 field interviewers, 2 field supervisors and a driver. In addition, Erma Aquino, Chief of Statistics for the Philippines Statistics Authority and Mina Kashiwabaram, Regional Surveillance Officer for the WHO Western Pacific Regional Office accompanied me during the trip. Our goal was to interview 50+ households in the barangay (village) of Looc.
The team began our drive out of Manila on Saturday morning in a convoy of cars and vans and arrived a few hours later in Olongapo, at the Statistics Authority office for the Zambales province. There was a home-cooked lunch waiting for us (very delicious!) and we conducted an afternoon briefing with the research staff, who were preparing for the fieldwork the next day.
Early the next morning, the research team drove up to Castillejos and out to the barangay of Looc. After arriving, we met with the barangay Captain (each barangay has an elected official who oversees the village’s finances and services) at the barangay hall and briefed him on the survey, our methodology, and procedures. After the briefing, he gave us approval to conduct the survey. The team then dispersed through the village to find the households each interviewer was assigned. I accompanied Karen, an interviewer who works for the PSA, on her rounds.
The first home we visited was far from the village hall. Our protocol requires that the interview be conducted in private between the interviewer and the respondent. However, during pretest events, with the approval of the respondent I sometimes have the opportunity to sit in on an interview. This household provided that opportunity as the respondent immediately asked for me to join them and pulled out a stool for me to sit on. We conducted the interview outside the young woman’s home as she held her newborn baby. The respondent was very nice and offered us glasses of water, which we accepted as it was very hot that day. As I sat there watching the interplay between Karen and the young woman, I was proud to see the efforts we’ve put forward to make this survey a success and the impact that it has on the people the teams interview. I was also awed by the intersection between technology and rurality and how our electronic data collection system bridges the gap.
After finishing up with our first household, we continued on to the next house. Finding homes in some countries is not like finding a house in the US. The houses don’t have addresses as we know them. In the Philippines, you have a map that is drawn by the country’s statistical office (updated during prior censuses or other surveys), which lays out the barangay you are working in. On the map you have head of household names listed, along the areas where homes are located. As an interviewer, you use these maps and walk the paths in the barangay to the location where you believe the home is located. You then ask neighbors about the family name and you will finally be pointed to the right home. We did this for the next 4-5 hours; walking from home to home and completing interviews.
As we walked, we were greeted by people and waved at by young children. I felt like southern hospitality was present in the rural Philippines. At one point, we came across the barangay’s school. As I looked inside through glassless windows, I could see and hear the children going through their daily activities. This wasn’t like a typical school in the US where children of different ages are in different classrooms. There was only one classroom and all the children, regardless of age, were learning together. As we worked to find the next home, we heard the children start to sing a song together.
We continued to interview respondents on their tobacco use, secondhand smoke exposure, cessation, purchasing habits, exposure to media and knowledge attitudes, and perceptions on tobacco. As I thought about the day so far, I realized how much our work makes a difference in providing data for policy makers to make good decisions on tobacco control.
News gets around fast in a small village. As we continued to walk the area, neighbors were hoping that we stopped at their home to interview them. From the family of 12 who lived in a mud spackled home, to the mother who recently lost her husband, we only found courteous and hospitable people. Many asked about our handheld tablets and how they worked. There was a small child who wanted to play with the tablet because he thought it was a game console.
We ended the day back at the village hall, where the caretakers had cooked us a wonderful late afternoon lunch. Afterwards, we debriefed the barangay Captain and departed the barangay. That evening, we spent the night in Olongapo. In the morning, the research team headed back to Manila to analyze our pretest.
The Global Tobacco Control Branch has a very broad scope; the world is a very large place. The goal of GATS is to obtain national level data needed for each country to understand the burden of tobacco use. To do this, we visit people in their homes, throughout the world, and ask them questions; and they welcome us with open arms. This is such rewarding work. I know this work can help reduce the tobacco burden and save lives. I hope that one day I am able to return to Looc and visit with the people of this wonderful area of the world. And if you are in the area, drop by; I am sure they will welcome you, as they did us.