Iloilo’s remote islands battle heart disease; Struggles, costs, and healthcare gaps

Noel Parreñas, a 60-year-old fisherman, says he stopped taking his prescribed medication for hypertension and over-fatigue after he felt better, a common practice among those who cannot afford consistent treatment.
Noel Parreñas, a 60-year-old fisherman, says he stopped taking his prescribed medication for hypertension and over-fatigue after he felt better, a common practice among those who cannot afford consistent treatment.

ILOILO — For 60-year-old Noel Parreñas, a fisherman from Tabugon Island, Carles, his encounter with hypertension was life-changing.

“Sadtong mga lima ka tuig ang nagligad, naospital ako. Naagyan ko gid kung ano kabudlay. Halin sa isla asta sa banwa mga 30 minutos ang amon biyahe sa lawod. Nalipong ako gani samtang nagapanakayon kay kalayo gid kag kadugay sang amon biyahe. Pagbugtaw ko sa ospital,” he says.

(“About five years ago, I was hospitalized. I experienced firsthand how difficult it was. From the island to the town, our boat ride across the sea took about 30 minutes. I lost consciousness during the trip because it was so far and took so long. When I woke up, I was already in the hospital.”)

Parreñas’ condition was diagnosed as over-fatigue and hypertension, compounded by fatty liver.

“Antes sina, nakabatyag na ako ka pagpalanakit ka dughan ko kag nagpalanuka na ako dugo pay tungod nga pigado ako kag kalayo ka ospital ginpabay an ko lang, luwas nga kamahal magpabulong subong. Ang akon kita sa pagpangisda insakto lang gani ibakal ka maintenance man sang asawa ko nga may sakit nga diabetes,” he says.

(“Before that, I had already felt chest pains and was even coughing up blood, but because I was poor and the hospital was far, I just ignored it. Aside from the high cost of medicine, my earnings from fishing are barely enough to buy maintenance medication for my wife, who is also suffering from diabetes.”)

Parreñas recounts how the cost of his medication often forced difficult choices.

“What I earn from fishing barely covers the cost of medicine for both me and my wife, who recently underwent surgery for diabetes complications,” he says.

Though the local Rural Health Unit (RHU) visits the island monthly, medication is not always enough to meet the needs of all residents.

Parreñas admits he stopped taking his prescribed medication after he felt better, a common practice among those who cannot afford consistent treatment. To improve his health and reduce expenses, he just grows vegetables and avoids fatty food.

A Widow’s Daily Struggle

Elnor Adrias, a 54-year-old widow from Gigantes Island, shares a similar plight. Her health began to deteriorate with frequent chest pains and shortness of breath, eventually diagnosed as high cholesterol.

The 54-year-old widow Elnor Adrias of Gigantes Island in Carles, Iloilo suffers from hypertension. She avoids using oil as much as possible and ensures she takes her maintenance medication. However, challenges remain, including the high cost of medicine.

Permi ko ginahapo nga daw ginakulang sa ginhawa (I’m always running out of breath),” she says.

Adrias explains that her condition stems from years of poor dietary habits. As a housewife, she often cooked whatever was readily available, usually food fried in oil or high in fat.

Sa isla, limitado gid ang resources. We rely on what’s easy to cook and preserve,” she says.

Social drinking was also a common pastime among her neighbors, further compounding the problem.

“I went to Dr. Delleva, who prescribed maintenance medicine, but it’s not always available at the RHU,” says Adrias.

She thus made a conscious decision to be more cautious about her lifestyle choices.

Nahadlok ako nga basi maglala (I’m scared that my condition would worsen),” she says.

She avoids using oil as much as possible and ensures she takes her maintenance medication. However, challenges remain, including irregular RHU visits and the high cost of medicine.

Youth in Crisis: Ange’s Story

Ange Delos Reyes, diagnosed with high blood pressure, just manages her condition by avoiding triggers like extreme heat or overexertion. She admits she hasn’t had a proper check-up in years.

Heart disease has not spared the younger generation, too. Ange Delos Reyes, an 18-year-old from Buenavista, Carles, started experiencing chest pains as a child.

Gina hambalan ako ni Mama nga mag-relax kun ga abot-abot ang sakit sa dughan ko,” Ange recalls. “Pero sang nag-Grade 7 ako, grabe gid ang atake. Gindala gid ako ni Lola sa ospital sa city.”

Doctors diagnosed Ange with high blood pressure, despite her being thin and young. While she was prescribed medication, financial constraints and fear of dependency led her to stop treatment after her symptoms subsided.

Ange just manages her condition by avoiding triggers like extreme heat or overexertion, though she admits she hasn’t had a proper check-up in years.

Her story highlights a serious concern: the lack of awareness and education about hypertension and heart disease among younger populations. It also points to the importance of consistent medical monitoring, which remains inaccessible for many in remote areas.

Role of Carles’ Rural Health Unit

Nurse Franco Paulo Bacinillo of Carles, Iloilo’s Rural Health Unit and his team visit island barangays for health check-ups and disseminating health awareness, especially to senior citizens.

The Carles Rural Health Unit (RHU) is a lifeline for many island residents, yet its efforts are hindered by logistical and financial constraints. Public health nurse Franco Paulo Bacinillo explains that hypertension and heart disease are among the top causes of mortality in Carles.

“These conditions are particularly prevalent among senior citizens, but the entire population is at risk,” he says.

The RHU implements the Department of Health’s (DOH) Healthy Hearts Program, which includes cholesterol screening, awareness campaigns, and free medication distribution. However, these efforts are often undermined by challenges such as unpredictable weather, limited transportation, and a lack of healthcare workers.

“The geographical isolation of the islands makes regular medical visits difficult,” Bacinillo adds.

The RHU’s limited resources also mean that not all patients receive the medication they need. Budget constraints make it impossible to stock sufficient cardiac medicines, leaving many to rely on infrequent medical missions or expensive private purchases.

Alarming Numbers

Western Visayas has seen alarming increases in cases of hypertension and heart disease in recent years. According to Dr. Adriano Suba-an, then regional director of the Department of Health (DOH) VI, hypertension was the third leading cause of morbidity in the region, with 29,331 individuals seeking consultations for screening and medication in 2019 alone. Complications of hypertension, such as hypertensive cardiovascular diseases and cerebrovascular diseases, were the second and third leading causes of mortality, accounting for a staggering 12,893 deaths that year.

By 2020, these numbers escalated. DOH Region 6 reported that 60,947 hypertensive patients were screened and identified, with 44,020 individuals seeking consultations at health facilities. The data underscores an urgent need for intervention, particularly in geographically isolated communities like Carles.

Understanding Cholesterol and Heart Disease

Dr. Marc Louie Del Rosario, Head of the Cardiac Catheterization Category at the Asian Hospital and Medical Center, explains that cholesterol-related heart diseases, such as atherosclerosis, are leading causes of death worldwide.

“Atherosclerosis occurs when cholesterol builds up in the arteries, restricting blood flow and leading to heart attacks or strokes,” he says.

Dr. Del Rosario emphasizes that heart disease is a long-term condition.

“This disease doesn’t happen overnight. It takes years — sometimes decades — to develop,” he explains. “Most patients experience symptoms only in the later stages, when it’s often too late to reverse the damage.”

The leading risk factors for heart disease include high blood pressure, high LDL cholesterol, unhealthy diets, and sedentary lifestyles. In Carles, dietary habits and limited physical activity are major contributors to the rising cases of heart disease.

Prevention Is Key

Dr. Raul Lapitan, an adult clinical cardiologist at Makati Medical Center, advocates for prevention as the most effective way to combat heart disease.

“There are three key areas to focus on: diet, exercise, and medication,” he says.

He encourages a heart-healthy diet rich in fruits, vegetables, whole grains, legumes, and fish, while limiting sugary drinks and fatty foods. Regular exercise — at least 150 minutes of moderate activity per week — is also essential. Dr. Lapitan stresses the importance of regular check-ups to monitor cholesterol and blood pressure levels.

For those already diagnosed with heart disease, he emphasizes the need to take prescribed medications consistently.

“While lifestyle changes are crucial, some conditions require medication to achieve LDL cholesterol targets,” he says.

The Road Ahead

In the remote islands of Carles, the fight against heart disease is as much about addressing systemic healthcare gaps as it is about individual responsibility. Stories like those of Parreñas, Adrias, and Ange illustrate the challenges of managing chronic conditions in isolated communities. Yet, they also highlight the resilience and resourcefulness of residents who strive to improve their health despite the odds.

The efforts of the Carles RHU and programs like the Healthy Hearts initiative offer a glimmer of hope, but more needs to be done. Increased funding, better infrastructure, and community education are essential to ensure that no one is left behind in the battle against heart disease.

For the people of Carles, the journey to better heart health is fraught with challenges, but it is a journey worth taking — for themselves, their families, and future generations.

Call to action – ACT NOW!

* A – ASCVD is a top killer in the Philippines

* C – Cholesterol is a key risk but can be managed

* T – Take action to lower it fast

* NOW – The next heart attack or stroke could be worse — act now to stay protected.

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This article is part of the Unblock Your Heart Health Reporting initiative, supported by the Philippine Press Institute and Novartis, to improve health literacy on cardiovascular diseases. Know your numbers, understand your risks, and consult your doctor—so no Filipino heart is lost too soon.

Take control of your heart health today. Visit unblockedmovement.ph for more information./PN

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