Monday, September 27, 2010

Barristers injured by pillbox during bar ops

Pinoy English FTW

(with updates -- 28 Sep 2010)

By now you would have heard of the explosion outside the DLSU last 26 September injuring several people during the Bar examinations. If you havent, here's a link. This post is only tangentially about that tragedy.

The title of this blog post is remarkable because anybody who is not from these islands would find it incomprehensible. The words are recognizable as English, sure, but they do not mean what a non-Pinoy would think it means. It is in fact Pinoy English.

A barrister for instance means a lawyer in the UK and several other mostly British Commonwealth countries, whereas here it is someone who is taking the bar exams. This is the word as used in a Malaya report.
Initial police investigation showed that the blast took place between 5 and 5:30 p.m., just after the bell signaling the end of the examinations, and as the barristers were preparing to leave the school premises.
I started seeing the word used in this manner last year in mainstream media. I dont know if it was used in this way prior to that, although Ive seen references to it in blogs and other online material. So as far as new word adaptations go, this one is pretty new. (Update: a link is provided below, dated February 2004, to a Supreme Court resolution wherein the term 'barrister' is used for bar examinees.)

This is what a barrister looks like outside the Philippines
(Photo nicked from the Wikipedia article Barrister)

And this is what barristers looks like here.
(Photo nicked from Philstar.)

As for pillbox, outside of our islands, it can refer to several things: a small box for pills, a small brimless hat usually worn by ladies, or a concrete bunker that usually houses a machine gun or two. See below. (Photos below nicked from their respective Wikipedia articles.)

This is a pillbox.

So is this.

And so is this.

In the Philippines, a pillbox is a small homemade bomb. I first heard of these devices as a child growing up during Marcos's time (70s -- yes I was already around at that time) when student protesters hurled them against riot police. Here's the word as used in a Philippine Information Agency report from an incident in 2008:
The blast, believed to have been from a pillbox, tore at least three middle fingers of the arresting officer, PO3 Alfonso Villamil and wounded him in other parts of the body. An unidentified barangay tanod who helped bring in the suspect, Albert Alvarez, for investigation and custody was also slightly injured as he stood nearby.
And here's one from 1970 from a Philippines Free Press article:
By then, their brothers in militancy were ramming Gate 4 open with a commandeered fire truck whose driver they had first mauled. They set fire to another parked car inside the gate. They threw Molotov cocktails, pillbox bombs, and stoned the windows of the Malacañang clinic.
Notice that the 1970 article called them 'pillbox bombs' which is probably the proper term since these were small explosive devices the size of pillboxes but colloquially they were simply referred to as 'pillbox'. Later, 'pillbox' was showing up alone in written pieces in media without the 'bomb' and the device was called simply pillbox, and although they are still referred to as 'pillbox bombs' in reports today, that is slowly giving way to the shorter term. Here for instance is a Supreme Court decision referring to the device as 'pillbox'.
That on or about the 21st day of December, 1994, in the Municipality of Las Piñas, Metro Manila, Philippines and within the jurisdiction of this Honorable Court, the above-named accused...with intent to kill and without justifiable motive and evident premeditation and by means of treachery and use of explosive (pillbox), did, then and there willfully, unlawfully and feloniously attack, assault and throw a Pillbox to one Jose Mesqueriola y Labarosa, thereby inflicting upon the latter serious and mortal wounds, which directly caused his death.
I coudlnt find a picture of one but I could describe how we used to make them. But I won't. Suffice it to say theyre very dangerous and we were very, very stupid for making them and actually using them as noisemakers for New Year's. You hurl it in the air as high as you can and run the heck away as fast as you can. It explodes on impact. It usually doesnt need more shrapnel than the stuff that's already in there to make it explode but people actually put more stuff in there to make it more lethal. That's what those crazy/stupid college kids did to their device.

Which brings us to bar ops. Here's a Supreme Court resolution, dated 2004, that uses the term (it uses the term 'barrister' as well):
Bar Ops are the biggest activity of the fraternity every year. They start as soon as new officers of the fraternity are elected in June, and they continue until the bar examinations are over. The bar operations consist of soliciting funds from alumni brods and friends to be spent in reproducing bar review materials for the use of their ‘barristers’ (bar candidates) in the various review centers, providing meals for their ‘brod’-barristers on examination days; and to rent a ‘bar site’ or place near De la Salle University where the examinees and the frat members can convene and take their meals during the break time.
I suspect this is another one of those uniquely Pinoy traditions you won't find anywhere else and would leave even a Pinoy scratching his head in wonderment. I havent found anything on the net as to when the tradition started though. In bar ops, during bar exams conducted over four Sundays, law schools and law fraternities each send a delegation to the exam venue and cheer the examinees on with parades and such. The atmosphere is festive and is indistinguishable from the hoopla that accompanies college sporting events like the UAAP or NCAA. Different schools and fraternities stake out different areas surrounding the exam venue while the bar examinees -- the barristers -- take the exams. No other professional licensure examinations has this (although I suspect engineers and accountants would want one too after seeing how much fun the law fratboys are having). That's what we see, we meaning those of us who generally dont give that much of a hoot. It's all good, clean fun. The ole college spirit. Hip, hip, hooray! There are even moms there.

But there's another side to the fun and fanfare as reported by several sources on the web. Lawyer Connie Veneracion writes this in her blog:
The boisterous celebration is often accompanied by beer (champagne, for the more affluent groups). The males, especially members of fraternities, would occasionally get doused with beer. All in jest. But, sometimes, the jesting went too far. There were occasions in the past when these cheerers and supporters — drunk by the time the last exam is over — would hurl beer bottles right in front of the gate of the exam venue. I know. As a law student waiting for friends who took the bar exams, I have witnessed a few of those.
But there is a darker, more sinister side to the bar ops. Apparently, and this is spoken of only on the QT, part of the 'ops' is the distribution of 'tips' that law school or review school operators give their examinees, and these tips sometimes are the actual exam questions illegally obtained. Bar exams have been controversial in the past because of these tips such that the Supreme Court which supervises the exams have ordered results to be nullified and a retest be taken. To be fair, there are no reports of leakage (another Pinoy Englishism, btw -- other English-speaking countries just use leak) in the 2010 exams. The Supreme Court has announced new security measures to the exams starting 2011.

Connie Veneracion laments the fact that those involved in the violence during the bar exams are future lawyers. She didnt go far enough. The Law profession is the King Kong of all professions in the Philippines because it is usually from their ranks that congressmen, senators, justices of the Supreme Court, and presidents come from, and that, my friends, is a scary thought indeed.

In any case, Filipino English marches on. Mabuhay!

(Updates include references to 'pillbox' and 'bar ops' in Supreme Court documents and other sources.)

Thursday, September 16, 2010

This isnt funny

We're in the middle of a deadly dengue season and I've come across several reports pointing to a local herb called tawa-tawa (Euphorbia hirta) as a 'cure' for dengue hemorrhagic fever (DHF). Apparently, it's supposed to raise the platelet count in patients afflicted with DHF. This report by Reggie Aspiras for instance quotes former DOH secretary Jaime Galvez Tan saying, “The first evidence that it increases the platelet count came from doctors in Cebu.” (I must note here that the article linked is not a scientific article. It was written by a chef writing a food column. No citation was given for this alleged claim by Dr. Tan.)

Another article, this time by renowned poet Krip Yuson recounts his experience with tawa-tawa. His son was stricken with dengue and he attributes his recovery to several herbal remedies, including tawa-tawa. "There should be no harm in trying tawa-tawa capsules," he writes. This popular blog (Jessica Zafra's) also extols the virtues of tawa-tawa, claiming that it is a hemostatic. Again it must be noted that neither Mr. Yuson's article, nor the blog post by Ms. Zafra, is a scientific article so aside from the odd mention of the internet, they provided no citations for the claims in the articles. As such they offer anecdotal support for the claims of its anti-dengue properties.

This is amazing, I thought. Could we be on the verge of a medical breakthrough? Can a lowly little native weed hold the key to licking this killer disease? I had doubts that it could kill the virus that causes dengue, but maybe it did something. Maybe it did help raise platelet count. I did some googling of my own.

According to this study, a feature of DHF in its acute phase is the inhibition of platelet aggregation. Platelets are cells in our blood responsible for clotting. From the abstract of the article Platelet function during the acute phase of dengue hemorrhagic fever, Srichaikul T, Nimmannitya S, Sripaisarn T, Kamolsilpa M, Pulgate C.:
Platelet aggregation, plasma betathromboglobulin (BTG) and platelet factor 4 (PF4) were studied in 35 children with dengue hemorrhagic fever. The suppression of platelet aggregation was demonstrated during acute phase of DHF in both shock and non-shock patients. Simultaneous with abnormal platelet aggregation, there was increased release of BTG and PF4 from platelets into plasma during the acute phase which lasted only 3-4 days after shock or subsidence of fever.
I'm not a virologist, nor am I an epidemiologist, nor any other -ist that has any relevance to this subject, but if there's anything I know it's that suppression of platelet aggregation = bad. The platelets have to be able to cause blood to clot and they do this by aggregating. That suppression of platelet aggregation is a feature of DHF in its acute phase indicates to me that suppression of platelet aggregation isn't what you want when you have dengue. So, is tawa-tawa a hemostatic as claimed in that blog post by Ms. Zafra? I went to the International Center for Science and High Technology - United Nations Industrial Development Origanization (ICS-UNIDO) website and looked up Euphorbia hirta. It does have a lot of medicinal properties:
It is regarded as medication for gastrointestinal disorders, particularly intestinal parasitotosis, amoebic dysentery, diarrhoea, and ulcer. An aqueous decoction is used for the treatment of acute enteritis and dysentery. The plant is also used in bronchial and respiratory disorders including asthma, bronchitis, and hay fever. Other uses are in diseases of the urinary system for example as diuretic; diseases of the genital apparatus (metrorrhagia, gonorrhoea, urethritis, agalactosis). It also has lactogenic properties. In ocular diseases, the plant is used against conjunctivitis and corneal ulcer. The latex of the plant is used for warts and cuts.

Other uses of the plant are affections of skin and mucous membranes (scabies, tinea, guinea-worm), as sedative, antipyretic and anti-inflammatory indications. For externally painful stings of the large brown scorpion, Bambara in Mali alleviate pain by applying the pulverised leaves. The plant has a reputation as an analgesic in severe headache, rheumatism, pains in pregnancy etc.
Nothing there about it being a hemostatic. Dengue isn't even mentioned. Then it goes on to say this under the Pharmacological Studies section:
Additionally extracts exerted an inhibitory effect on platelet aggregation and depressed the formation of carrageenin induced rat paw oedema.
citing this study. Influence of some traditional medicinal plants of Senegal on prostaglandin biosynthesis, A. Hiermann, and F. Bucar. (Abstract only. The full paper has to be purchased.)

It turns out that components in tawa-tawa actually inhibit platelet aggregation. This could be useful in other diseases, but this isnt what you want when you have DHF. You want your platelets aggregating. It may be fortunate that the decoction of tawa-tawa given to DHF patients doesnt have the concentrated amount of the platelet suppressants that the extract form contains, or else it may have done more harm than good.

Like I said, the evidence for the efficacy of tawa-tawa presented in the articles by Aspiras and Yuson, and the blog post by Zafra are anecdotal. Although I do hope that there is indeed something in tawa-tawa that alleviates the symptoms of DHF, at this time I strongly suspect that the evidence presented are of the post hoc ergo propter hoc variety. Person had DHF, person takes tawa-tawa tea, person feels better. Ergo, tawa-tawa cures DHF.

Last year, when I was in Jakarta, my daughter contracted DHF only we didnt know it was DHF at the time. My mother just told me that my daughter was running a fever and has lost her appetite. She asked my daughter if she wanted to go to the doctor and she said no, she's fine, so we didnt think it was anything serious. My mother was giving her paracetamol and I told her to keep my daughter hydrated. This went on for a few days. She developed stomachaches which my mother attributed to the fact that she wasn't eating that well. My daughter told her she was fine but my mother brought her to the hospital anyway. The doc ran a blood test and the diagnosis came that she had DHF. She had rashes all over her body and the doctor said this was a good sign that the disease was in its last legs. In other words, my daughter was able to recover from the disease on her own.

Now imagine that instead of just keeping her hydrated with water and soup, etc., my mother gave her a decoction of tawa-tawa since she saw this on TV or read it in a blog somewhere, and my daughter recovered (as she was going to do anyway). She would have attributed her recovery to the tawa-tawa. (Instead of the super-fantastic dengue-busting genes she got from me. Heh.) That's what I think is behind all this tawa-tawa hype.

Bottom line is: Be careful. Don't believe everything you read. Investigate. Try to develop an internal bullshit detector. I have to say mine is pretty acute and I wish they taught bullshit detecting in school, but it's one of those things one has to develop on one's own, since school is oftentimes just a giant bullshit factory... but that's another story.

Update, 17 September: Trawling the internet for testimonies, I came upon this one from last year. Dengue Can be Treated by a Herbal Remedy
A nurse on duty in the ICU connives with us on the use of this plant [tawa-tawa]. She even gave us instructions on how to do it, although she reprimanded us not to show our doctors we’re giving it to the patient because a patient on NGT should not be given something orally.
Also known as snake weed or cat’s hair, tawa-tawa has shown promising results based on the initial tests conducted by the health department.
It is interesting that tawa-tawa was given to the patient with the tacit approval of a health professional (the nurse), even doing so despite the fact that a "patient on NGT should not be given something orally." The nurse apparently did so presumably because the attending physician wouldnt have approved. There is also an allusion to an uncited study ostensibly conducted by 'the health department'. The blog post goes on to narrate how the mother administered the decoction.
In my case, I dip a cotton ball into the decoction, and slowly pinch the cotton ball and drop the liquid into her mouth. Perhaps she was very thirsty, the first time I drop off the liquid into her mouth, she grabbed my hands to ask for more.
The patient, thank God, recovered after being given a transfusion of platelets. As you can see, despite the sureness of the declaration in the title of the blog post, the effect of tawa-tawa was inconclusive. The patient was receiving other medication at the time and even a blood transfusion. It is probably a case of post hoc ergo propter hoc with the mother attributing her daughter's recovery to the herbal decoction.

This blog post from 2 years ago (Herbal Cure for Dengue?) was written by a doctor and expresses the same sentiment I do in this blog post: Caution. It ends with this (emphasis in the original):
In spite of its hype and anecdotal popularity, I still think drinking Euphorbia hirta extracts and concoctions is not safe.
I echo the doctor's frustration that studies have not been conducted as to the efficacy of this herb as a cure for DHF despite the fact that we have some of the highest number of dengue cases in Asia. So far the only study I have located with regards to Euphorbia hirta and its effects on platelets is the Hiermann and Bucar one linked above in which they used an extract of the plant, which to my layman's understanding indicates they used a more concentrated form of the plant's ingredients than one prepared in a decoction. Perhaps smaller doses have a different, more beneficial effect. We just don't know.