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A PROPOSED REHABILITATION COMMUNITY FOR DRUG AND ALCOHOL ADDICTS IN TUGUEGARAO CITY

A Thesis Proposal Submitted to the College of Architecture University of Santo Tomas

In Partial Fulfillment Of the Requirements For the Degree Of Bachelor of Science in Architecture

Paulo S. Schulte 5AR-16

September 2017


Table of Contents

Page No.

1. Chapter 1 – Introduction…………………………………………………………3 1.1. Background and Nature of the Project……………………………………..4 1.2. Statement of the Problem……………………………………….………….6 1.3. Project Goals……………………………………………………………….7 1.4. Project Objectives………………………………………………………….8 1.5. Significance of the Project…………………………………………………9 1.6. Scope and Delimitations…………………………………………………...9 1.7. Definition of Terms…………………………………………………....…10 2. Chapter 2 – Review of Related Literature…………………………………......12 2.1. Drug Rehabilitation and Treatment……………………………………….12 2.1.1. Drug Addiction Treatment………………………………………..12 2.1.2. Approaches for Drug Addiction Treatment……………………….12 2.1.3. Related Health Problems…………………………………………14 2.1.4. Process of Drug Rehabilitation………………………………...…15 2.2. Alcohol and Drug Rehabilitation Centers in the Philippines……………..16 2.2.1. Expense of Drug Rehabilitation…………………………………..16 2.2.2. Low Rehabilitation Rate in the Philippines………………………17 2.2.3. Disadvantages of Rehabilitation Centers…………………………18 2.2.4. The Lack of Rehabilitation Centers in the Philippines…………...19 2.3. Therapeutic Architecture…………………………………………………19 2.3.1. Therapeutic Communities in Drug Rehabilitation………………..19 2.3.2. Therapeutic Architecture in Drug Rehabilitation…………………22 2.3.3. Kinesthetics and Landscaping………………..…………………..26 2.4. Case Studies………………………………………………………………29 2.4.1. International Case Studies (Outside the Philippines) …………….29 2.4.2. Local Case Studies (Within the Philippines) …………………….33 3. Chapter 3 – Research Methodology………………..………………..…………34 3.1. Research Proper………………..………………..………………..………34 3.1.1. Descriptive Research………………..………………..…………..34 3.1.2. Case Study Approach………………..………………..…………..35 3.2. Research Participants………………..………………..…………………..35 3.3. Research Instruments……………………………………………………..36 3.3.1. Case Studies and Resource Centers……………………………….36 3.3.2. Ocular Inspection and Site Reconnaissance………………………37 3.3.3. Photo Documentation…………………………………………….38 3.3.4. Interviews………………………………………………………,,,38 3.3.5. Observation Analysis……………………………………………..38 4. Chapter 4 – Site Profile………………………………………………………….39 4.1. Site Selection Criteria…………………………………………………….39 4.1.1. Land Size…………………………………………………………39 4.1.2. Soil Character…………………………………………………….39 4.1.3. Topography………………………………………………………39 4.1.4. Geological Character……………………………………………..40 4.1.5. Climate Character………………………………………………...40 4.1.6. Natural Features………………………….……………………….40


4.2. 4.3.

4.4.

4.5.

4.1.7. Environmental Concerns…………………………………………40 4.1.8. Transportation and Acessibility…………………………………..41 4.1.9. Adjacent Structures………………………………...……………..41 4.1.10. Security……………………………………...……………………41 4.1.11. Utilities……………………………………………………...……42 4.1.12. Land Value……………………………………………………….42 Site Justification………………………………………………………….42 Macro Site Analysis………………………………………………………43 4.3.1. Historical Background………………………………………...….43 4.3.1.1. History of Name………………………………………43 4.3.2. Demographics…………………………………………………….44 4.3.2.1. Tuguegarao City…………………………..………….44 4.3.2.2. Household Profile…………………………………….44 4.3.2.3. Drug Dependency……………………….……………44 4.3.3. Land Use and Zoning……………………………………………..44 4.3.3.1. Land Area…………………………………………….44 4.3.3.2. Land Use………………………………………….…..45 4.3.3.3. General Site Zoning…………………………………..47 4.3.4. Geotechnical Information………………………………………...47 4.3.4.1. Geographical Location……………………………….47 4.3.4.2. Topography…………………………………………..47 4.3.4.3. Climate……………………………………………….48 4.3.4.4. Soil……………………………………………………48 4.3.4.5. Slope………………………………………………….48 4.3.4.6. Water Resources…………………………………...…49 4.3.4.7. Infrastructure……………………………………...….49 Micro Site Analysis………………………………………………………50 4.4.1. Vicinity……………………………………………………...……52 4.4.2. Site Profile………………………………………………………..53 4.4.2.1. Land Profile…………………………………………..53 4.4.2.2. Soil Character……………………………...…………53 4.4.2.3. Topography…………………………………………..54 4.4.2.4. Flood Map…………………………………………….54 4.4.2.5. Geological Character…………………………………56 4.4.2.6. Climate Character…………………………………….56 4.4.2.7. Natural Features………………………………………56 4.4.2.8. Environmental Concerns……………………..………56 4.4.2.9. Transportation and Accessibility……………………..57 4.4.2.10. Adjacent Structures…………………………………...57 Site Analysis……………………………………………………………...57 4.5.1. S.W.O.T Analysis………………………………………………...58 4.5.1.1. Strengths…………………………………………...…58 4.5.1.2. Weaknesses…………………………………………..59 4.5.1.3. Opportunities………………………………………....59 4.5.1.4. Threats………………………………………………..59


1. Chapter One – Introduction Alcohol and drug addiction is one of the biggest problems of the modern Filipino society not just because of the huge number of people that fall victim to it but also because of its long-term effects on the lives of the addicts as well as the people close to them. It does not matter where they get addicted – age-old addictions such as drugs or alcohol (also known as substance addiction), or modern addictions such as computer games (or non-substance addiction) – people who fall victim to the clutches of addiction all suffer the destructive effects of whatever they are addicted in. Addiction is defined as a chronic, often relapsing brain disease characterized by compulsive drug use. The initial decision to take drugs, for most people is voluntary, whether experimenting recreationally or having been prescribed medication for any number of symptoms. While some people will never display negative responses, others will find themselves, over a period of time, relying on the effects produced by the drug. Seeking help with drug addiction is a pro-active step toward taking back control of one’s life. Reports of drug related crime are common in the Philippines media. The main concern tends to be towards Shabu which gets the most media attention. It does seem that illegal drug use is on the rise, and this has worrying implications for the future. There is an urgent need to educate young people as to the dangers of drug use, and there is also a great need to help those who are already addicted to escape their misery. Failure to do this could mean there will be further deterioration within many Filipino communities.


1.1.

Background and Nature of the Project Following the start of the current Philippine Government’s war on drugs, drug abuse and addiction has become a subject of fear and death for many Filipinos nationwide. Many Filipino and families linked to drugs have also become the subject to the Philippine National Police or the PNP’s anti-drug operations. Based on the data of the PNP, a total of 1,020, 244 people surrendered to the authorities from July 2016 to February 2016 with 940,000 of those who surrendered are drug users and addicts while 75,000 are drug pushers. A US government report in 2009 concluded that illegal drug use was a significant problem in the Philippines due to corruption and poor law enforcement. There was particular concern expressed about the amount of methamphetamine (shabu) and cannabis production in the area. Drug addiction appears to be on the rise in the Philippines. There are believed to be as many as 6.7 million drug abusers according to figures from 2004- this is a dramatic increase from 1972 when there was only believed to have been around 20,000 drug users in the Philippines. The drug that is most abused in the Philippines continues to be Alcohol – they are the second highest consumers of alcoholic drinks in South East Asia. Fortunately, there are ways to treat this negative condition in the country. Currently, rehabilitation is the most common and effective form of getting people out of their addictions.


In the Philippines, there are only 48 accredited rehabilitation centers (or “rehab” centers, as they are popularly called) and dozens more scattered across a country that is home to more than 98 million Filipinos, which is quite concerning considering the growing number of addiction cases in the country. Alcohol and drug rehab centers provide guidance when it comes to dealing with withdrawal symptoms, which can be dangerous if not addressed accordingly. These symptoms occur when a dependent chooses to abstain from drugs or alcohol that the body has been accustomed with. These physical and psychological episodes can escalate dramatically and can cause serious health issues. Rehabilitation centers provide medical treatments in coordination with a licensed physician of a legitimate hospital. Drug rehab facilities help drug addicts prepare to re-enter society. Drug addiction often changes a person's behavior, which can affect all aspects of his or her life, including work and relationships. In drug rehab, patients do their best to regain their normal lives in a safe and healthy way. There are many different types of drug rehab facilities. Some specialize in helping patients with a specific drug addiction; others offer a broader range of drug addiction services. Some rehab facilities are even gender- or agespecific, as this often helps patients feel more comfortable in the rehab setting. Inpatient and outpatient rehab facilities are also available. Drug rehab treatment centers often carry the stigma that patients are forced to stay. However, this stereotype is untrue. Patients in rehab centers are free


to leave anytime they choose to. One reason for this is that drug rehab can only be truly effective when the patient has a desire to be there and to change his or her addictive habits. That being said, in instances where individuals are compelled to go to rehab -- such as via a court order -- the rehab process can still be effective, even if they were initially reluctant to go. Drug rehab centers in the Philippines range from very basic facilities to luxury treatment centers. The type of center a patient attends depends upon his or her budget and level of insurance coverage. While luxury centers offer more amenities than basic facilities, they are not always the best treatment centers.

1.2.

Statement of the Problem With the growing number of drug abuse and addiction cases together with the growing population of drug surrenderees around the Philippines, it is alarming to realize how there are so few of these institutions in the country, and how only a few Filipinos actually turn to rehab centers to treat their addiction issues or get the chance to be accommodated in these facilities. Together with the lack of rehab facilities, a lot of people find rehab centers expensive and less practical; most Filipinos would rather ignore the addiction issues of their family members than spend money and send them to treatment facility where they would get real attention. This mindset often leads to the worsening of addiction cases, resulting in bigger problems in the future. Moreover, substance abuse related problems such as domestic


violence, crimes on the street and illegal activities increase affecting those people who are innocent. It is essential for the Filipino people to realize how important rehab centers are in addressing the addiction issues in our country. Rehabilitation is not an overnight solution; there is no scientific solution that would promise you quick results. If it took drug dependents and alcoholics a long time to succumb to their addictions, it will take some time for them to completely turn away from it. But there is one thing that rehab centers can guarantee – the procedures used in these treatment institutions will ensure that the results are long-lasting and effective.

1.3.

Project Goals Member countries among the United Nations have also adopted a set of 17 global goals known as the Sustainable Development Goals that act as a universal call to end poverty, protect the planet and ensure the prosperity of the world’s people. The Philippines, being a third world country, shall need to prioritize certain goals to take on the problem of poverty, health and social peace and justice. Of the 17 goals listed, the proposed project shall prioritize the following sustainable goals listed below: 1. To end poverty in all its forms everywhere, 2. Ensure healthy lives and promote well-being for all at all ages,


3. Promote

peaceful

and

inclusive

societies

for

sustainable

development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels.

In line with the sustainable goals above, the researcher’s goal for the proposed rehabilitation center is to set new standards, in terms of design and operation, for public health care and rehabilitation facilities in the Philippines.

1.4.

Project Objectives 1. The project aims to provide a facility that will rehabilitate people with drug addiction in the province of Cagayan. 2. The project aims to study the significance and effects of therapeutic architectural design and space on the treatment and reformation of patients and addicts residing in drug rehabilitation centers when applied in the local Philippine context. 3. The project aims to study the social impact of rehabilitation centers on the reformation of drug addicts and their re-enter back to their respective communities.


1.5.

Significance of the Project The need to develop a Rehabilitation Center for Drug Addiction and Alcoholism is beneficial to the following: To the reformation and rehabilitation of drug addicts in the Philippines, the research and the project can provide various architectural solutions that can render psychological and therapeutical factors seen in the social reintegration of these users to the public. To serve as a potential standards for the improvement in the design towards public health care facilities in the Philippines for the benefit of their users and their beneficiaries. To the advancement of the architectural community, this dissertation will provide further information on architecture in accordance to the principles of health facilities that can be improved upon by other professionals practicing in this field.

1.6.

Scope and Delimitations The current lack of new drug rehabilitation centers in the Philippines shall be the mien of the project to create a basic framework as to what extent the project aims to cater. The proposed project focuses on the design and development of a new Rehabilitation Center for Drugs and Alcoholism. Additionally, the project also focuses on the drug users, addicts, and pushers in the local area. The initial research shall involve a survey for those


currently residing at drug rehabilitation centers as to aid in the design stage of the project. The initial research is also designed to have thorough knowledge of problems of the current problems in drug abuse treatment together with common problems found in local drug rehabilitation centers. The project, being public, will be in accordance to the local guidelines of the Department of Health (DOH) for rehabilitation centers and treatment facilities. Despite this, the proposed project will still integrate and focus on applying new practical standards and technology that would aid in the treatment of health care facilities.

1.7.

Definition of Terms -

Addiction – shall refer to the persistent compulsive use of a substance known by the user to be harmful (Merriam-Webster Dictionary)

-

Alcohol – shall refer to ethanol especially when considered as the intoxicating agent in fermented and distilled liquors (Merriam-Webster Dictionary)

-

Alcoholism – shall refer to the a chronic disorder marked by excessive and usually compulsive drinking of alcohol leading to psychological and physical dependence or addiction (Merriam-Webster Dictionary)

-

DOH – shall refer to the Philippine Department of Health. It is the principal health agency in the Philippines and is responsible for ensuring access to basic public health services to all Filipinos through the provision of quality


health care and regulation of providers of health goods and services. (Department of Health) -

Drug – shall refer to something and often an illegal substance that causes addiction, habituation or a marked change in consciousness. (MerriamWebster Dictionary)

-

Drug Abuse/Substance Abuse – shall refer to the excessive use of a drug (such as alcohol, narcotics, or cocaine) without medical justification (Merriam-Webster Dictionary)

-

PNP – shall refer to the Philippine National Police. It is the armed, civilian national police force of the Philippines.

-

Pusher – shall refer to the one that pushes illegal drugs

-

Shabu – shall refer to an amphetamine derivative (trade name Methedrine) used in the form of a crystalline hydrochloride; used as a stimulant to the nervous system and as an appetite suppressant

-

Rehab/Rehabilitation – shall refer to a program for rehabilitating especially drug or alcohol abusers

-

Rehabilitation Center – shall refer to a facility providing therapy and training for rehabilitation.

-

UN – shall refer to United Nations

-

UNESCO – refers to The United Nations Educational, Scientific and Cultural Education, a specialized agency of the United Nations


2. Chapter Two – Review of Related Literature The following are gathered and compiled materials from books, online published journals, news articles and from internet sources all of which are related to this proposed project. 2.1.

Drug Rehabilitation and Treatment 2.1.1. Drug Addiction Treatment Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, take many different forms, and last for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a longterm process that involves multiple interventions and regular monitoring. 2.1.2. Approaches for Drug Addiction Treatment There are a variety of evidence-based approaches to treating addiction. Drug treatment can include behavioral therapy (such as cognitive-behavioral

therapy

or

contingency

management),

medications, or their combination. The specific type of treatment or combination of treatments will vary depending on the patient’s individual needs and, often, on the types of drugs they use. Treatment medications, such as methadone, buprenorphine, and naltrexone (including a new long-acting formulation), are available


for individuals addicted to opioids, while nicotine preparations (patches, gum, lozenges, and nasal spray) and the medications varenicline and bupropion are available for individuals addicted to tobacco. Disulfiram, acamprosate, and naltrexone are medications available for treating alcohol dependence,1 which commonly cooccurs with other drug addictions, including addiction to prescription medications. Treatments for prescription drug abuse tend to be similar to those for illicit drugs that affect the same brain systems. For example, buprenorphine, used to treat heroin addiction, can also be used to treat addiction to opioid pain medications. Addiction to prescription stimulants, which affect the same brain systems as illicit stimulants like cocaine, can be treated with behavioral therapies, as there are not yet medications for treating addiction to these types of drugs. Behavioral therapies can help motivate people to participate in drug treatment, offer strategies for coping with drug cravings, teach ways to avoid drugs and prevent relapse, and help individuals deal with relapse if it occurs. Behavioral therapies can also help people improve communication, relationship, and parenting skills, as well as family dynamics. Many treatment programs employ both individual and group therapies. Group therapy can provide social reinforcement and help enforce behavioral contingencies that promote abstinence and a nondrug-using lifestyle. Some of the more established behavioral


treatments, such as contingency management and cognitivebehavioral therapy, are also being adapted for group settings to improve efficiency and cost-effectiveness. However, particularly in adolescents, there can also be a danger of unintended harmful (or iatrogenic) effects of group treatment—sometimes group members (especially groups of highly delinquent youth) can reinforce drug use and thereby derail the purpose of the therapy. Thus, trained counselors should be aware of and monitor for such effects. Because they work on different aspects of addiction, combinations of behavioral therapies and medications (when available) generally appear to be more effective than either approach used alone. 2.1.3. Related Health Problems People who are addicted to drugs often suffer from other health (e.g., depression, HIV), occupational, legal, familial, and social problems that should be addressed concurrently. The best programs provide a combination of therapies and other services to meet an individual patient’s needs. Psychoactive medications, such as antidepressants, anti-anxiety

agents,

mood

stabilizers,

and

antipsychotic

medications, may be critical for treatment success when patients have co-occurring mental disorders such as depression, anxiety disorders (including post-traumatic stress disorder), bipolar disorder, or schizophrenia. In addition, most people with severe addiction abuse multiple drugs and require treatment for all substances abused.


2.1.4. Process of Drug Rehabilitation Rehabilitation centers start action by readying all psychological factor of patient, including the level of addiction of patient and their common background, to make a decision of the way of treatment. A patient is advised, and at times given medicine. There is whole series of treatment to select from. Time required for recovering changes from person to person. Money could be a main control for handling. Mainly treatment program is expensive, other than few helpful centers. It is important to keep patient away from the surrounding or public where the addiction began while selecting rehabilitation center. An outpatient handling program is sufficient, in early period of addiction. Those patients whose history with alcohol addiction requires an inpatient management program wherein patient’s improvement is monitored all the day and is supervised. This type of treatment is done in a housing surrounding or in hospital that offers control like hospital.

2.2.

Alcohol and Drug Rehabilitation Centers in the Philippines 2.2.1. Expense of Drug Rehabilitation Rehabilitation is expensive, but addressing a person’s addiction issues will cost more in the long run and can be very harmful to both him and to the people around him. This is true particularly for severe SUBSTANCE addiction issues such as illegal drugs and alcohol,


which not only corrupts a person’s sanity and personality, but also causes a person’s body to breakdown much faster than it should. Every time a person abuses alcohol and drugs, it dramatically increases the possibility of liver, brain and heart diseases. In this situation, it is actually sensible to invest to a rehabilitation facility to prevent further damages than to spend the money to the treatment of its associated illnesses. Not only that it is beneficial to the health aspect but also covers the financial side of the issue. Seeking professional help from rehab centres is also favorable to the familial and social aspect. Most of the programs of these facilities include family therapies that allow family members to show their full support to the patient. This family support systems provide the patient the motivation and inspiration he needs in order to continue walking on the right path. Rehab programs also involve social reintegration so that recovering individuals will have an easier return to the society. In fact, there are many private rehab centers in the Philippines that provide jobs for their residents who just completed their rehab program. There are around 60 rehabilitation centers in the Philippines, and most, if not all, are fully equipped to cater to the needs of drug or alcohol addiction victims. Privately owned rehab facilities usually cost more, with monthly prices ranging from 10,000.00 PhP – 100,000.00 PhP, depending on the facility and the type of rehabilitation that a patient may require. Government operated rehab


centers cost less, with monthly fees ranging from 5,000.00 PhP – 10,000.00 PhP. For people who cannot afford to pay for monthly rehabilitation fees, most government-run rehab centers offer free rehabilitation programs. All you need is to visit your local government office to know more about the admission requirements and what local agency can help you. The monthly fees cover the patient’s stay, the rehabilitation programs and most often, the day-to-day needs of the person. In government operated rehab centers, daily necessities such as food and water are taken care of by government funding, while in privately-owned rehab centers, they usually charge additional monthly personal allowance fees. 2.2.2. Low Rehabilitation Rate for Filipinos In the Philippines, a lot of people suffering from drug or alcohol addictions prefer not to have themselves rehabilitated mostly for two reasons: the fear of being discriminated by others for having an addiction, and the concern to the costs and fees with doubts of whether or not the rehabilitation will succeed in taking away that person’s addictions. This is a result of a misunderstanding of the effectiveness of rehabilitation in the community. We need to have campaigns that will make people aware of the danger of leaving the victims of addiction as they are and the positive and long-term results of having them rehabilitated. As said earlier, when viewed in the proper


perspective, undergoing rehabilitation effectively costs less compared to not doing anything at all. People who have been diagnosed and treated early will expect less expenditures and will have a better chance of recovery. 2.2.3. Disadvantages of Rehabilitation Centers A certain mindset exists in a lot of people that prevent those with addiction issues to have themselves rehabilitated. A lot of people believe that treatment facilities who charge less expensive fees have less equipment and less effective rehabilitation programs, which cause them to conclude that having one’s self rehabilitated in one of the less expensive rehab centers, would be a complete waste of money. While there is truth in the fact that more expensive treatment facilities can afford to purchase advanced equipment or construct very comfortable spaces for the rehabilitation patients, it does not guarantee that these facilities are the best in effectively treating drug or alcohol addiction issues. A lot of government-run institutions have volunteer specialists that are among the best in their field, and design rehabilitation programs that are effective in treating addiction issues. It goes without saying though, that the environment does contribute to the speed of rehabilitation, which is one of the strengths of privately owned rehab centers.


2.2.4. The Lack of Rehabilitation Centers in the Philippines Lack of drug rehabilitation centers as well as poor success rate in helping substance abusers are lingering problems in the drug war. Dangerous Drugs Board chairman Felipe Rojas Sr. told senators during a hearing on the multi-sectoral campaign against illegal drugs that the success rate of the rehabilitation programs was a mere 24 percent. Assistant Secretary Elmer Punzalan of the Department of Health said that the cost of rehabilitating drug users was P10,000 per patient per month. Ideally, each province should have at least one rehabilitation center but the reality is that there are only four existing regional rehabilitation centers around the country, Punzalan said. According to Rojas, these are obviously not enough to accommodate the drug users now surrendering for fear of being killed in the course of the government’s anti-illegal drugs campaign. All in all, there are only 44 drug rehabilitation centers across the country and these can only hold a maximum of 5,000 persons. Of the 44 drug rehabilitation centers, 15 are state-run while the rest are privately operated.

2.3.

Therapeutic Architecture 2.3.1. Therapeutic Community in Drug Rehabilitation It must only be a foundation or facility in name. In essence, the therapeutic community should become ‘society away from society’, a shadow of reality for those with the determination or even so, the decisive push by family and relatives to rediscover and re-coordinate


that inner creativity self, the social and individual personality lost through drug abuse. As argued, this type of healing process, its residential philosophy aside (and this is where architectural design comes in), does not usually apply to a fixed setting , “but rather to the principles of the care that is offered…a communal approach which

is

also

democratic,

collaborative

and

encourages

participation…”. Thomas Main was the British psychoanalyst who coined this term in the 1950s, as the response of psychoanalysis to the failure of psychiatry, incarceration programmes which viewed addicts as mere criminals and stigmatized them as outcasts or even mentally disturbed through abuse, as well as purely medication approaches. Strangely enough though the therapeutic community model developed by Maine and other analysts was based on a world war two experience in Britain, as army psychiatrists, who had to deal with hundreds of traumatized soldiers returning from the front, considered, in their desperation from the failure of the conventional medication or one to one therapy approach, to apply a group method that would allow those who had suffered severe distress to overcome their psychological fears and return to the front as physically and emotionally healthy as possible. “The psychiatrists at Northfield Hospital in Birmingham decided to focus on the unit as a whole rather than on individual problems; they


structured the wards as communities, encouraging mutual support and cooperation in living.” Instead of medication treatment therefore, they provided the necessary tools to the community of patients in dealing with their own problems, making them part of the process with which they could overcome their traumatic experiences. As Crampling notes, this later became known as the ‘living-learning’ method. Maine took this and applied a psychoanalytic approach to it. Some later appropriately dubbed it ‘social psychiatry’. It formed the beginnings of an attempt to consider drug rehabilitation as a psychological awakening through a group environment, in which members (not patients) and experienced professionals interact in a setting promoting trust and individuals are encouraged to become part of a community with the goal of rebuilding their social skills, such as responsibility and integration. This community philosophy essentially places the healing process into the hands of addicts themselves in a controlled and voluntary but not institutionalized environment, finding methods that allow them to rebuild their ability of dealing independently with their own problems.

Architecture fits into this process, as the outer shell providing the necessary support to the inner self-corrective therapy. There are of course no guarantees of success in such cases. However, at least the


connection of interior design and community spirit as a means of molding a socially functioning individual forms an alternative that puts the individual first, as opposed to the medication institution like processes that have not managed to make any headway, both in attracting the trust of addicts who make the step to rehabilitation, as well as eradicating existing prejudices and public opinion views. The therapeutic community, as referred to earlier in the paper is not about being locked in, but a home in which the individual with the need for care, becomes part of the method of their gradual return to physical and emotional health, they become involved in the decision-making process, improving their creativity through the group. The basic premise is to become the change within themselves, to sense that even though they live in a treatment community, the environment surrounding them is one in which they feel not part of the problem, but part of the solution on their way to re-learning the social process.

2.3.2. Therapeutic Architecture in Drug Rehabilitation If drug addiction rehabilitation is mostly about bringing positive feelings to the fore and helping to build a new identity for members of therapeutic communities, then architectural design, is perhaps the most decisive of factors in how space is utilized, both in practical terms and landscape wise, to uplift the spirit and provide the


necessary environment in which community daily life and activities can become most effective. Christopher Day believes that buildings have the life the architect gives them, a personality that is either positive or negative, and that aura is captured by those who reside in them. “…The more ‘felt’ are buildings, the more connected to rhythms of day…they value the individuals they will house…environment can heal as well as harm…places of spirit…nourish both individual and society”. A host of studies have shown that the surrounding environment, the ‘place’ as a physical sense, is associated with drug addiction risks. Starting from this premise it can be said that building design is more than just a backdrop to health issues, but is more of a forefront. A wide ranging research paper pointing to the need for safer environment interventions, even though its main topic might be drug injection in public, comes to a conclusion highly relevant to the importance of place as both physical and social in nature. “Place is not simply a set of coordinates, but is constructed through finding meaning in the social and built forms we inhabit”. In other words, the building, a city and the way it is designed does not just form slabs of concrete, but is literally a social construction, that can have an influence on those who reside in it. As outlined earlier, this is truer of people, in this case, addicts who are in


a process of rehabilitation, a tough community healing program that seeks to root out their negativity. In such an instance, the energy and individuality their residence might project could be crucial in how they respond to this process. Color, the way they are able to move within the building, staircases, connections between rooms, surrounding nature can all play a role, as will be analyzed, not just in underpinning the mood of the residents, but also whether they feel welcome in the building, whether it forms a connection to their emotions and physical presence and by extension if it provides a motivation for them to follow the program. A rehabilitation center in the Netherlands has left nothing to chance, paying particular attention to natural but also artificial lighting as both aspects of mood and energy. “…Natural daylight deep in the heart of the 30 meters wide building was allowed. The interior was enlivened by interplay of striking but subtle color and direct and indirect artificial lighting”. The same connections are made about color, with Day pointing out that preference in this case is highly personal. For the individual in a therapeutic community the slightest detail in a room, be it his personal space or a place of group therapy and activities might affect the way the individual receives the treatment, bringing about as negative physical or psychological reaction.


“…How different is the living grey of an overcast sky or a blue wash over brown to the dead grey of a concrete wall.” Clearly, a building balance or imbalance, whether be it color, the light in a building, design or even the length of a corridor can affect the way in which residents in a therapeutic community react to the energy of the space and can relax and release themselves. The example of a group therapy session in Reading, England, provides quite an amazing example of how architectural space can play with the psychology of the individual, particularly so when this is a member of a therapeutic community, seeking positivity. The Winterburn Community had moved to a new home and as described, although the building had much more pleasant small group rooms, the large therapy group room looked much smaller than they were used to. And this was not the only detail. The community previously lived in an old mental hospital, so were not used to the modern amenities of the new abode. Even transition to new surroundings can have its effects. “…The dependency culture of being in an old asylum was symbolized every lunch time when the food was delivered and plugged in by a porter”. In essence, the daily life within community housing individuals who need to feel as close to a home as possible must be designed having buildings in mind that are both practical but also do away with any


institutionalized emotions. According to Leibrock researchers in the field of anthroposophic medicine have maintained that color can be a major contributing factor towards patients regaining health. She describes green as a color which is psychologically perceived as providing safe refuge, while coral, peach and yellow are seen as warmer choices for a dining room and blue is considered relaxing. 2.3.3. Kinesthetics and Landscaping “…Kinesthesia is the exploration of our environment through movement; this can be movement with the eyes or with our body…” The sense of movement in a space, deriving from the combination of the Greek words ‘kinisi’ and ‘aisthisi’ has been said to affect the way the individual reacts to the building, how it marks their behaviour, mood, how it creates and maintains a positive or negative attitude to the particular situation they are facing. Architecture can become a strong determinant in the successful kinesthetics of individuals, particularly in the case of people with psychological imbalances such as drug addicts, who have joined therapeutic communities seeking to regain the peace of their innerself in order to build or regain their social identity. So the way they are able to physically interact with their surroundings, the kinesthetics of human bodies, can be said to be decisive in how they adapt to their daily routine in a group community.


Ziada, utilizing the model of the ritual space of Muslim mosques and Soviet assemblies, argues that building spaces for collective activities, (much like therapeutic communities), can, through their design, produce a positive sense of kinesthetics in individuals, who are in situation of ‘conjoined attention and communal practice’. For people in drug reformation this can be said to be highly relevant, as they need to adapt to their new tasks and responsibilities and learn new skills that can change their mobility in a positive manner. So in other words, improving one’s kinesthetic skills in a setting that encourages techniques and therapies to do so is a highly significant step towards an improved physical presence that also brings about internal changes. In simple terms, building positivity produces body positivity, as well as techniques to further improve this positivity. Besides, movement is a major part of sensory perception. According to Dutch architect Jasper Schaap, who co-wrote the paper ‘Design your own Mind’ in 2009, contemporary architecture must turn the tide of its alienation, through buildings that are not monochromic and mono-visual, spaces that participate and affect human movement and action, designs which encourage multi-sensory perception, bringing to the fore the power of the senses, beyond the visual and the spatial. As the ‘Design your own Mind’ researchers point out, buildings which encourage a highly positive sense of kinesthesia, connect with the individuals that reside in them. The Schaap thesis is that moving through space with the body,


automatically makes the architecture experience less static. What Pallasmaa (cited in the paper) calls ‘the eyes of the skin’. If you manage to wake up these eyes, the building immediately becomes a source of positive energy of particular importance to drug addicts who need to develop a new self. “…If we succeed in enticing the senses, people can participate again in their surroundings and regain their identity in the contemporary world…” A 2000 paper on a Rehabilitation and Education village for Drug Addicts uses the same premise in designing an art therapy room. The senses are prodded through a wide space that allows rich daylight, distance between individuals so each one can feel the space of their own creativity, as well as an informal furniture setting, that further encourages a spontaneous reaction, limiting the emotion, the perception of you will, that this is an exercise or an obligatory activity. But landscape can also contribute to a heightened positive kinesthesia in therapeutic communities, with Ling providing the case study of The Good Samaritan Regional Medical Centre in Arizona, whereby the space triggers the senses through an award winning health design. The surrounding garden awakens “…patients’ senses of sight, smell and touch, prompting body movement by inspiring the patient to explore the garden”.


Water flowing through the garden as well as proximity of plants to all patients, allows, as pointed out in the Ling paper, the interactive sense of touch. 2.4.

Case Studies 2.4.1. International Case Studies (Outside Philippines) Proyekto Hombre by Elsa Urquijo Arquitectos

This building was created in response to the need to accommodate new facilities to the HQ of Proyecto hombre in the city of Santiago de Compostela. This initiative works to identify social problems that lead to addiction and seeks to regain the autonomy and responsibility to bring the individual back to being an active member of society. To achieve this it is necessary to work from both a therapeutic and educational setting. This building is devised to adopt this inclusive idea, to accompany the individual in his recovery with its peaceful architecture.


The building is a shelter for the life that takes place in it, a serene space, unpretentious, with a strong presence and to endure. The approach of this work follows a simple horizontal line, able to visually express one direction, movement and development.

The new headquarters of Proyecto hombre is an architectural space that revolves around the individual. It is a multifunctional structure that is developed in horizontal surfaces interconnected to each other and which houses the following services: outpatient therapy area, administrative area, residential area, workshop area and sports area.


Sister Margaret Smith Addictions Treatment Centre by Kuch Stephenson Gibson Malo Architects and Engineer + Montgomery Sisam Architects

The Sister Margaret Smith Addictions Treatment Centre provides residential and non-residential services for the treatment of addictions including drug and alcohol, gambling and eating disorders, among others.


The organizing spine of the building, called the Hall of Recovery, is where

clients

are

introduced and oriented to this dignified, calm and welcoming setting. The building has been arranged

around

two

landscaped courts: one for residential clients and the other for nonresidential clients. Both courts provide a safe environment and are used for various therapeutic programmes. The spiritual space has been designed in a circular form to be respectful of the aboriginal community, who make up a large portion of the client population.

The St Joseph’s Care Group was very eager to embrace the principles of sustainable design from the onset, particularly as they relate to their mission to provide holistic care. It was understood early on that a healthy building environment can be an essential part of the healing process and that environmental stewardship equates to compassionate care for all. The building is targeting LEED® Gold, the first in north-western Ontario. Results are pending approval of the Canadian Green Building Council.


2.4.2. Local Case Studies (Within the Philippines) BALAY Rehabilitation Center, Diliman, Quezon City The BALAY Rehabilitation Center, Inc. is an organization that practices psychosocial rehabilitation and is committed to the promotion and protection of human rights. It particularly provides psychosocial services and advocacy support to persons deprived of liberty due to political circumstances, survivors of torture and other forms of organized political violence. This includes political prisoners and individuals and communities displaced by wars and armed conflicts. It also provides services to survivors of massacres and extra-judicial killings and their families. The center supports young people at risks, particularly children in situations of armed conflicts and those who have encountered torture and other forms of state violence. It lends humanitarian assistance to those displaced and stricken by natural disasters as well, subjects to its capacities and resources. The facility upholds the integrity of all human beings as it respects the interconnectivity of the different forms of life. It aspires for a society where the right and dignity of every person is respected; and where the people are free to express their ideas and political viewpoint and can exercise without fear of oppression their options for social, economic and cultural development.


BALAY envisions a society where peoples of different ethnicity and faith, including the children and young people, are living a meaningful life free from fear and want and discrimination. A society where the people can exercise informed citizenship and practice a culture of peace as they strive to attain the development of their full human potential.

3. Chapter Three – Research Methodology 3.1.

Research Proper For better understanding and pursuance of the project, studies and research were conducted by the researcher in order to come up with the best solution possible. To gather the necessary data and information needed for the task, both qualitative and quantitative methods were used to gain a broader perspective regarding the topic. All these methods for data gathering were required in order for the researcher to come up with a realistic solution that will address the current problem and condition of the site. 3.1.1. Descriptive Research The researcher utilized this strategy to depict and underline current conditions, circumstances, practices and structure of existing comparable facilities. Through compiling and analyzing different data and information from online sources, books, reports and news articles were utilized by the researcher to produce various results.


3.1.2. Case Study Approach Studies conducted by the researcher in similar projects and facilities provided information on how to innovate, improve and/or create a brand new facility into a new study or project. Evaluating and carefully studying these case studies helped the researcher in addressing various issues and problems and has incorporated new design strategies and solutions for the proposed project and the surrounding community.

3.2.

Research Participants The participants in this study were people significant to the local health and government institutions of the city, and the city itself. Among the participants were the current teachers, professors and administrative heads of local health institutions, current and former political leaders of Tuguegarao and Cagayan Province, current and former heads and positioned staff of the Department of Health agencies, the employed workers and staff in the local health facilities, the professional and experts in the field of architecture and engineering involved in similar buildings, structures and facilities, the drug users, drug addicts residing in drug treatment and rehabilitation facilities, residents of Cagayan Province and their respective parents and family members, local police officers and all those involved with existing similar facilities around the Philippines.


3.3.

Research Instruments Various research instruments and methods were used by the researcher throughout the entirety of the study and research period. 3.3.1. Case Studies and Resource Centers To make use of the descriptive research method, the researcher had made use of online articles, journals, library books, handbooks, archives, online articles and journals that are relevant to the study. Topics comprising or related to design, existing conditions, policies and programs, environmental studies, case studies, etc. The following are vital resource centers for the researcher: 

The Internet allows for the broad research of related literature and journals from various countries that may provide as potential case studies to the project.



The UST Central Library and the UST Medical Building Library has a good collection of resource data and information regarding minor information needed to support the project proposal. Relevant data pertaining to the designs, trends, creative industry, and Architecture related researches are found in the Humanities section, 5th level; and for locally related archives, data and case studies, at the Filipinana Section, 4th level of the library.



The UST Central Library and the UST Medical Building Library has a good collection of resource data and information regarding minor information needed to support


the project proposal. Relevant data pertaining to the designs, trends, creative industry, and Architecture related researches are found in the Humanities section, 5th level; and for locally related archives, data and case studies, at the Filipinana Section, 4th level of the library. 

The DOH Central Library offers an open stack area consisting the General Collection, WHO Publications and DOH Publications sections. There are six OPAC stations with access to Internet.



The Resource Center for Health System Development (RCHSD) portal is the virtual repository of knowledge on health system development of the Department of Health (DOH).



National Epidemiology Center (NEC) Library provides materials and services to meet the instructional research and extension needs of all FETP fellows and staff that may provide sufficient aid and relevance to the research.

3.3.2. Ocular Inspection and Site Reconnaissance Experiencing the events, running of errands and paper works, and careful observation of the research participants, community members and suggested users helped the research with providing


more information and workflow that will contributed to the success of the proposed project and development. 3.3.3. Photo Documentation This tool was used to keep track of the activities of the researcher in times when the researcher forgot or missed out any details about the site and its surroundings. 3.3.4. Interviews This method was conducted by gathering information from important and reliable informants by means of scheduling personal interviews. The questions formulated and asked were related to the project’s feasibility, impact, relevance and other technical data that the correspondent may give. This research method became beneficial for the study as it provided various opinions and inputs for the proposed project. 3.3.5. Observation Analysis This method was conducted by gathering information from immersion and observance in related facilities.


4. Chapter Four – Site Profile This section examines the site criteria, the investigation and the different procedures in deciding the conceivable and most reasonable site for the venture. It additionally incorporates the history, physical profile and area of the site picked. 4.1.

Site Selection Criteria 4.1.1. Land Size For Rehabilitation Centers, a lot size of at least 400 sq.m for every 30 patients is required for the project; as required by the Department of Health Planning Guidelines for the Manual Operations of Drug Abuse Treatment and Rehabilitation Centers. The proposed project will accommodate a maximum of 300 beds with the minimum area of 4000 sq.m or 0.4 hectares. 4.1.2. Soil Character It is recommended that the site features load-bearing type soils. At the event that the existing site may feature soil types of clay loam, sandy loam and similar types, the proposed project may require additional cost for structural foundation of the facility. 4.1.3. Topography As much as possible, site must be relatively flat for areas to be used for medical equipment and medical aids such as wheel chairs. Outdoor spaces for the intention of outdoor activities, may be located in lower or higher elevations at a considerate level for


disabled patients. A slope of 0%-5% is recommended, though, not required. 4.1.4. Geological Character Project’s site does not require sloping terrains. For user safety, site may not be located at least five (5) kilometers of any fault line. Nearby volcanic activity will be avoided as well. Lastly, site will not feature mines, quarries, and ore deposits as material production is not part of project parameters. 4.1.5. Climate Character Conditions, such as constant rain, extreme heat and humidity, will be avoided for this project to ensure the health and wellbeing of users. Average temperature of 28o-30o C and an average humidity of 75%-80% is recommended. 4.1.6. Natural Features Existing green areas are not a requirement for the project. As much as possible, vegetation and trees at the site’s perimeter may be kept as noise buffer. Existing vegetation may be integrated into the proposed structure’s planning and design. The site does not require a body of water, natural and/or artificial. 4.1.7. Environmental Concerns Project aims to be as minimally intrusive as possible. Protected wildlife and forest areas will be off limits for the institution. Site


will not be located along coastal areas as well. Additionally, it is recommended that the project is not located in heritage districts. 4.1.8. Accessibility and Transportation Site must be accessible to members of Class C-D. Public utility vehicles (PUV), bus, jeepneys and other modes of alternative transport must have routes that pass through the area. 4.1.9. Adjacent Structures Existing establishments are not a requirement, but it is recommended that the site may be supplemented by nearby surrounding facilities (at least 2 kilometers away) like hospitals, government buildings and other institutional buildings that may be considered as nearby relevant infrastructure to aid the project. It is also recommended to avoid nearby commercial and residential areas as to include the consideration of privacy for the users of the proposed rehabilitation center. 4.1.10. Security Site may be located away from illegal housing settlements to prevent unwanted interventions in the health facility. A nearby police outpost or center is not required, though, the presence of one will greatly aid the project.


4.1.11. Utilities Utilities, such as electricity, and water supply, must be provided for site. Connection to main sewage line is a consideration as project will produce a moderate volume of wastewater. Garbage collection routes must also pass through site. 4.1.12. Land Value Considering budget constraints, site selection will be restricted to low cost areas. Special provisions for high cost areas may be allowed, given donors/sponsors are available for the project. 4.2.

Site Justification Amidst the current drug war in the Philippines, multiple regions and provinces have joined the agenda of putting up more rehabilitation centers to accommodate the increasingly growing rate of drug surrenderees around the Philippines. The researcher had decided to choose a site that would need most a Drug Rehabiliation Facility in its area. As of September 2016, it was drastically announced that Region 2 (Cagayan Valley Region) would need more rehabilitation centers in its 4 provinces. In these 4 provinces, Cagayan Province prevailed with the most number of drug surrenderees with the highest population of 7,528, with Isabela Province coming at second with 6,588. It was then decided by the researcher to choose Tuguegarao City, as the chosen site due to its institutional context to the proposed Rehabiliation Center of the researcher and designer, and the city being the Institutional Capital of Cagayan Province.


4.3.

Macro Site Analysis 4.3.1. Historical Background 4.3.1.1.

History of Name There are several versions of the origin of the name, Tuguegarao. One is the abundance of "tarrao" trees in the area. Another is "garrao" meaning swift current, possibly of the Pinacanauan River. Another is from the word "tuggui" meaning fire. Another recorded version is, the town was formerly called Twerao by the people of the northern towns. Still another is that the name Tuguegarao comes from two Ibanag words "tuggui" (fire) and "aggao" (day), possibly referring to a daytime fire that happened in the town. However, the version most accepted is that the name Tuguegarao comes from the sentence "Tuggui gari yaw", meaning "This was cleared by fire" possibly referring to the kaingin areas pointed by the natives to the Spaniards. This means therefore that the town, Tuguegarao, was carved out of the wilderness by fire


4.3.2. Demographics 4.3.2.1.

Tuguegarao City Based on the 2010 Census of Population and Housing (CPH), Tuguegarao City, a second-class component city in the province of Cagayan, Region II, posted a total population of 153,502 persons as of May 1, 2010. The city currently has the highest population among the cities in Region 2.

4.3.2.2.

Household Profile Tuguegarao City has an average of 4.7 persons per household, which is higher than the national average of 4.6 in the Philippines.

4.3.2.3.

Drug Dependency There is currently no drug-free barangays in the Tuguegarao City. Cagayan province has the highest population of drug surrenderees compared to its neighboring provinces in the region with an estimated population of 7,528 surrenderees.

4.3.3. Land Use and Zoning 4.3.3.1.

Land Area Tuguegarao City, a second-class component city of Region 2, has an area of 144,800 hectares, or 144.8 sq. It is politically divided into 49 barangays, 31 of which are urban.


4.3.3.2.

Land Use

Existing Land Use Map for the City of Davao (2011)


Detailed Land Use Plan for the City of Tuguegarao (1993-2022)


4.4.3.3.

General Site Zoning Institutional Zone Tuguegarao City is considered both the regional center of Region 2 (Cagayan Valley) and the institutional capital of Cagayan Province. The city currently has 3 major institutional zones and barangays namely, Centro, Carig and Cagay with each one having a number of institutional and government buildings within.

4.3.4. Geotechnical Information 4.3.4.1.

Geographical Location Tuguegarao City is located at the Northern part of mainland Luzon covering an area of about 26,858 sq. km or about 2.7 hectares. It is located on a peninsula surrounded by the Cagayan and Pinacanauan Rivers. The Pinacanauan joins the Cagayan River in Tuguegarao. It is bounded on the east by the Sierra Mountain Range, on the west by the Caraballo and Cordillera Ranges, and on the north by the South China Sea.

4.3.4.2.

Topography Due to the city’s perimeter being surrounded by the Cagayan River and Pinacanauan River.


4.3.4.3.

Climate Tuguegarao City owns the highest temperature ever recorded in the Philippines at 42.2 degrees Celsius or 108.0 degrees Fahrenheit. Average temperatures of the city during March and April is at 38 degrees Celsius or 100 degrees Fahrenheit, one of the highest in the Philippines.

4.3.4.4.

Soil The soil in and around Tuguegarao consists of clayey soil in the hilly areas and the sand and sand/gravel in the alluvial plain. Abundant fine sand is distributed along the rivers and waterways of the city. The sand could be recommended to be used as embankment for structures to save the amount of the expensive clay material due to long distances required for transportation and how existing clay soils within the city are vulnerable to erosion.

4.3.4.5.

Slope About 26% of the total area of the region or 5,021.48 sq. kms. has slope range of 0-8%. These areas, which maybe for non-forest purposes, e.g. agriculture, industries and settlement.


4.3.4.6.

Water Resources Tuguegarao city is bordered by two bodies of water, namely Cagayan River at its north and the Pinacanauan River at its south. The main water system in Tuguegarao is run by The Metropolitan Tuguegarao Water District (MTWD), a local government-run water district, to serve the water needs of the city

4.3.4.7.

Infrastructure Tuguegarao City, being considered the regional center of Region 2 and institutional capital of the Cagayan Province, houses a great number of health, government and educational institutions within the city. The city also currently houses one of the 4 airports of Region 2, namely Tuguegarao Airport. The Tuguegarao Airport was classified as secondary, which services mainly to the nearby city’s institutional centers and its locality. As of January 2017, there are currently five (5) proposed and approved major infrastructure projects on their way in the city ; Rehabilitation of Tuguegarao Airport, Declogging of Existing Drainage Canal of Tuguegarao Airport, Construction of School Library Building of Tuguegarao West Central School, Construction of One (1) Storey Classroom Building in Carig Sur Elementary School, and the Construction of One (1) Storey Primary School in


Carig

Norte.

There

is

currently

no

proposed

rehabilitation center for drug addiction amidst the city’s high rate of drug surrenderees. Tuguegarao city also accommodates other infrastructure namely, bus/jeep/taxi terminals, carbarns, depots, freight storage and buildings, airport and related facilities, piers/harbords/dockyards,

power

plants/stations,

telecommunication facilities, water pumping stations, seaports and other related facilities

4.4.

Micro Site Analysis For better understanding and pursuance of the project, studies and research were conducted by the researcher in order to come up with the best solution possible. To gather the necessary data and information needed for the task, both qualitative and quantitative methods were used to gain a broader perspective regarding the topic. Adjacent structures are factors to be considered in analyzing a project site. More than the immediate structure of the site, areas of interests within the particular ranges of the site can also be checked that they may be beneficial to the proposed project.


20km Radius from Site

5km Radius from Site


4.4.1. Vicinity

Location Map

Vicinity Map


4.4.2. Site Profile The site is located at the barangay of Carig Norte across the Police Regional Center of Tuguegarao. Carig Norte houses the major institutional zones in the city. The site is within one of the regional institutional zones with close proximity to other relevant institutional facilities in the area within a kilometer or two away.. Nearby facilities and institutions include the Police Regional Center, Medical Colleges of Northern Philippines. The Cagayan Valley Medical Center Drug Testing Laboratory, Cagayan Provincial Capitol and the Carig Regional Center which houses the main government buildings and institutions in Tuguegarao. 4.4.2.1.

Land Profile The chosen site is a 1.1 hectare or 11,325 sqm. parcel of land located at Barangay Carig Norte, Cagayan Province. Its land area is justified as the proposed project will function as a residential-sprawling type of rehabilitation center in the province.

4.4.2.2.

Soil Character Carig Norte has two soil types namely 570-Carig Clay Loam and 571-Carig Loam. Carig Clay Loam has a scope of 46,405 hectares in the two barangays of Carig (Carig Sur and Carig Norte) as well as near municilipalities such as Baggao, Iguig, Lal-lo, Gattaaran and Lasam.


4.4.2.3.

Topography The site is located at a leveled ground. The slop does not exceed 5% making development of the proposed project more feasible.

4.4.2.4.

Flood Map The site of the proposed project is situated 2 kilometers away from the banks of the Pinacanauan River. Despite this, the site does not have any present flood risk with the lowest risk level in DPWH’s Flood Hazard Map of Tuguegarao City, Cagayan Province.



4.4.2.5.

Geological Character The site of the proposed project is situated 2 kilometers away from the banks of the Pinacanauan River. Despite this, the site does not have any present flood risk with the lowest risk level in DPWH’s Flood Hazard Map of Tuguegarao City, Cagayan Province.

4.4.2.6.

Climate Character The climate of the proposed project’s site is very tropical. Tuguegarao owns the highest temperature ever recorded in the Philippines at 42.2 degrees Celsius or 108.0 degrees Fahrenheit. Average temperatures of the city during March and April is at 38 degrees Celsius or 100 degrees Fahrenheit, one of the highest in the Philippines.

4.4.2.7.

Natural Features The site presents a dense number of existing trees and vegetation within and just outside the lot and road boundaries. Addition of greenery within the proposed project is recommended.

4.4.2.8.

Environmental Concerns The site is not classified as a natural conservation area and is located within an institutional zone of the region and thus allows for the construction of a rehabilitation center.


4.4.2.9.

Transportation and Accessibility The site is located along a two way road that connects to a main highway Pan-Philippine Highway that connects to other main barangays of the city. The site is also located at an estimate of 2 kilometers away from the Tuguegarao Airport, the only existing airport inside the city.

4.4.2.10.

Adjacent Structures The site is located across to the Police Regional Center of Tuguegarao with other no other existing buildings beside it as security and privacy are two factors majorly considered in the proposed project. That said, the site is 1-2 kilometers away from other institutional buildings of the regional area.

4.5.

Site Analysis The site is a 1.7 hectare site located at the barangay of Carig Norte across the Police Regional Center of Tuguegarao. Carig Norte houses the major institutional zones in the city. The site is within one of the regional institutional zones with close proximity to other relevant institutional facilities in the area within a kilometer or two away.. Nearby facilities and institutions include the Police Regional Center, Medical Colleges of Northern Philippines. The Cagayan Valley Medical Center Drug Testing Laboratory, Cagayan Provincial Capitol and the Carig Regional Center


which houses the main government buildings and institutions in Tuguegarao. As seen in the figure below, there are not obstructions, natural/and or artificial, that shield the site from the natural elements. Surrounding development is categorized as institutional and residential.

4.5.1. S.W.O.T. (Strengths, Weaknesses, Opportunities, Threats) Analysis 4.5.1.1.

Strengths The site is located right across the Police Regional Office which greatly pertains to better security and safety considerations for the site and the proposed project. The


site’s location also adds to the privacy of the users of the facility. 4.5.1.2.

Weaknesses The site is only accessible through one existing road that may be difficult to find without landmarks. Although privacy and security being two of the major considerations, its seclusion from the public may create a negative social impact for the users of the proposed rehabilitation facility.

4.5.1.3.

Opportunities The site is located within 1-2 kilometers away from relevant institutional facilities like the Medical Colleges of Northern Philippines and the Cagayan Valley Medical Center

Drug

Testing

Laboratory.

This

creates

opportunities for further research from these institutions that may aid help the project, the facility and its users. 4.5.1.4.

Threats The site does not show any threats pertaining to flooding, but due to the city and the province’s geography over the Philippine archipelago, the site may be bound to weather abnormalities like extreme heat and rain fall. The site is not near nor on an existing fault line in the area/region.


5. Chapter Five – Project Profile 5.1.

Market Analysis

5.2.

Profile of the Client The Department of Health (DOH) holds the over-all technical authority on health as it is a national health policy-maker and regulatory institution. Basically, the DOH has three major roles in the health sector: (1) leadership in health; (2) enabler and capacity builder; and (3) administrator of specific services. Its mandate is to develop national plans, technical standards, and guidelines on health. Aside from being the regulator of all health services and products, the DOH is the provider of special tertiary health care services and technical assistance to health providers and stakeholders. Together with its attached agencies, the DOH – constituted of various central bureaus and services in the Central Office, Centers for Health Development (CHD) in every region, and DOH-retained hospitals – performs its roles to continuously improve the country’s health care system.

5.3.

Vision and Mission Vision by 2030 – A global leader for attaining better health outcomes, competitive and responsive health care system, and equitable health financing. Mission – To guarantee equitable, sustainable and quality health for all Filipinos, especially the poor, and to lead the quest for excellence in health.


5.4.

Company Core Values While pursuing its vision, the DOH adheres to the highest values of work, which are: 

Integrity – The Department believes in upholding truth and pursuing honesty, accountability, and consistency in performing its functions.



Excellence – The DOH continuously strive for the best by fostering innovation, effectiveness and efficiency, pro-action, dynamism, and openness to change.



Compassion and respect for human dignity – Whilst DOH upholds the quality of life, respect for human dignity is encouraged by working with sympathy and benevolence for the people in need.



Commitment – With all our hearts and minds, the Department commits to achieve its vision for the health and development of future generations.



Professionalism – The DOH performs its functions in accordance with the highest ethical standards, principles of accountability, and full responsibility.



Teamwork – The DOH employees work together with a result-oriented mindset.



Stewardship of the health of the people – Being stewards of health for the people, the Department shall pursue sustainable development and care for the environment since it impinges on the health of the Filipinos.


5.5.

Corporate Culture

5.6.

Organizational Structure 5.6.1. The Philippine Department of Health (DOH) 5.6.1.1.

Organizational Structure At present, the Department is headed by the Secretary of Health, with five undersecretaries and seven assistant secretaries. 

Undersecretary for Health Regulation



Undersecretary for Field

Implementation and

Management 

Undersecretary for Health Service Development



Undersecretary for Technical Services



Undersecretary for Policy and Health Systems



Undersecretary for Administration, Finance and Procurement



Assistant Secretary for Technical Services



Assistant Secretary for Administration, Finance and Procurement



Assistant Secretary for Special Concerns



Assistant Secretary for Health Regulation



Assistant Secretary for Field Implementation and Management



Assistant Secretary for Mindanao Cluster


Bureaus The DOH is composed of bureaus, namely: Epidemiology Bureau (formerly National Epidemiology Center) 

Bureau of Health Devices and Technology



Bureau of Health Facilities and Services



Bureau of International Health Cooperation



Bureau of Local Health Systems Development



Bureau of Quarantine



Disease Prevention and Control Bureau (formerly National Center for Disease Prevention and Control)



Food and Drug Administration



Health Emergency Management Bureau



Health Facility Development Bureau (formerly National Center For Health Facilities Development)



Health Human Resources Development Bureau



Health Policy Development and Planning Bureau


5.6.1.2.

Organizational Chart

5.6.2. Drug Rehabilitation Center The proposed drug rehabilitation center shall be a legally constituted entity. For a single proprietorship, it must be registered with the Department of Trade and Industry and for a corporate entity, it must be registered with the Securities and Exchange Commission. Its organization and structure shall contribute effectively to the goals of Republic Act 9165. It shall develop broad community and professional acceptance in order to implement the goals effectively. The organization shall clearly define the purpose, scope, direction and goals of the Center. It shall document and disseminate the Center’s values, vision statement, mission and philosophy. 5.6.3. Classification of the Proposed Drug Rehabilitation Center 5.6.3.1.

Ownership Government – the proposed drug rehabilitation center shall be maintained and operated partially and wholly by the city and municipal government of Tuguegarao.

5.6.3.2.

Institutional Character Freestanding – the proposed drug rehabilitation center shall operate separately from any other institution.


5.6.3.3.

Service Capability Residential

(In-Patient)

–

the

proposed

drug

rehabilitation center shall provice comprehensive rehabilitation services utilizing, among others, any of the accepted modalities: Multidisciplinary Team Approach, Therapeutic Community Approach and/or Spiritual Services towards the rehabilitation of a drug dependent. 5.7.

User Profile 5.7.1. Personnel Requirement 5.7.1.1.

General Qualifications for Personell 

Must be drug free



Must have no pending administrative or criminal records



Must be mentally and physically fit



With good moral character



If foreigner, working permit is issued by the Bureau of Immigration and Deportation (BI) is required

5.7.1.2.

Residential Treatment and Rehabilitation Center A. One (1) Center/Program Director/Administrator 1. Minimum of three (3) years experience as rehabilitation worker; 2. Adequate training not only on the modality being utilized but also other training pertinent to


treatment and rehabilitation and/or background in any behavioural sciences; and 3. At least two (2) years college education 4. If former drug dependent, must be drug free for three (3) years 5. Duties and Responsibilities: 

Coordinates

all

medical,

social,

psychological, and spiritual services of the Center; 

Directly responsible for the day to day activities and needs of the Center;



Oversees the entire rehabilitation program;



Responsible

for

the

residential

needs,

maintenance, upkeep and security of the Center; 

Responsible for the personnel management of the Center



Provides policy direction for the Center

B. One (1) DOH Accredited Physician (On Call) 1. Directly responsible for the diagnosis, treatment of all medical, minor surgical, psychological problems of patients 2. Oversees the entire treatment process


3. Responsible for writing progress report and submit medical reports and other pertinent documents 4. In

coordination

with

other

staff,

he/she

recommends for discharge, transfer or referral of patients 5. Performs other duties and functions that are relevant to the position. C. One (1) Licensed Dentist (on Call) 1. Attends to all dental referrals 2. Performs other duties and functions that are relevant to the position D. One (1) Licensed Nurse/Midwife – ratio: 1 nurse for every 50 patients 1. Assists the physician in the treatment process 2. Does regular visitation to every patient 3. Administers medication as prescribed by the physician 4. Provides counselling to patients 5. Attends to emergency cases 6. Performs other duties and functions that are relevant to the position E. One (1) Licensed Social Worker – ratio: 1 for every 50 patients


1. Conducts social case studies for all admitted patients in the Center 2. Assess the social status of the patient; 3. Responsible for house visits; 4. Conducts counselling 5. Performs other duties and functions that are relevant to the position. F. One (1) Psychologist – ratio 1 for every 50 patients 1. Responsible for psychological testing and evaluation for all admitted patients 2. Provides psychological counselling 3. Conducts psychological and behavioral program of the Center 4. Performs other duties and functions that are relevant to the position G. One (1) Clerk – ratio: 1 clerk for every 100 patients 1. Ensures confidentiality of all records of patients 2. Ensures cleanliness and orderliness in the office 3. Performs other duties and functions that are relevant to the position. H. Non-professional Staff - ratio 4 staff for every 100 patients 1. Supervises the preparation of well-balanced diet of the patients


2. Maintains the cleanliness and orderliness of the facility 3. Goes on periodic duty 4. Provides security 5. Performs other functions/tasks as assigned 5.8.

Schedule of Activities/Operations On September 19, 2016, the Dangerous Drugs Board passed Board Regulation No. 4, Series of 2016, entitled “OPLAN SAGIP – Guidelines on Voluntarily Surrender of Drug Users and Dependents and Monitoring Mechanism of Barangay Anti-Drug Abuse Campaigns.” Apart from establishing clear guidelines in dealing with drug personalities who voluntarily submit themselves to authorities, the regulation also mandated Local Government Units (LGUs) through their Anti-Drug Abuse Councils (ADACs) to facilitate the establishment of community-based treatment and rehabilitation services and interventions to surrenderers found to be of lowrisk or having mild substance use disorder. Based on statistics, this comprise at least 90% of drug users.


5.8.1. Client Flow for Wellness and Recovery


5.8.2. Community Based Treatment Pre Implementation

5.9.

Voluntary Surrender

Legal Framework Republic Act 9165, otherwise known as “Comprehensive Dangerous Drug Act of 2002”, mandates the Department of Health to regulate, oversee and monitor the integration, coordination and supervision of all drug rehabilitation, intervention, aftercare and follow- up programs, projects and activities as well as the establishment, operations, maintenance and management of Drug Abuse Treatment and Rehabilitation Centers nationwide


5.10.

Project Analysis

6. Chapter Six – Technical Research Data Presentation 6.1.

Hydrological Study

6.2. 7. Chapter Seven – Spatial Programming and Analysis The proposed drug rehabilitation center shall be exclusively for the treatment and rehabilitation of drug dependents. The Center shall not provide services to patients with primary psychotic behaviour. Patients exhibiting psychosis as a result or consequence of certain dangerous drug use shall be referred to a psychiatric care facility. However, patients with borderline psychosis may be admitted or be allowed to stay in the Center provided that there is a psychiatrist’s order and if it poses no harm to the other patients. 7.1.

List of Space Requirements The center shall have at least 400 square meters (for 30 patients) for the following: A. Registration area/waiting area/reception B. Counselling/testing room C. Administrative office/Director’s office (with secured storage files) D. Emergency clinic – must be located near the area where the center E. personnel are on duty F. Living quarters, separate rooms for male and female G. Toilet/bath/lavatory – one for every 10 patients H. Multipurpose area/recreational area I. Dining area


J. Kitchen area with provision to secure/lock all sharp objects K. Area for outdoor activity

7.2.

Room Data Sheet

7.3.

Summary of Area Requirements L. Registration area/waiting area/reception M. Counselling/testing room N. Administrative office/Director’s office (with secured storage files) O. Emergency clinic – must be located near the area where the center P. personnel are on duty Q. Living quarters, separate rooms for male and female R. Toilet/bath/lavatory – one for every 10 patients S. Multipurpose area/recreational area T. Dining area U. Kitchen area with provision to secure/lock all sharp objects V. Area for outdoor activity

7.4.

Adjacency Matrix

7.5.

Bubble Diagram


Wat

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