UPMAS Health Advocacies

The 2017 UPMAS Homecoming Writing Team. Front: Dr. Tony Perez, Dr. May Desquitado-Tranquilino, Dr. Sandra Dy-Natividad, Dr. Fred Hawson. Back: Dr. Gar Eufemio, Dr. Aileen Apolinario-Dualan, Dr. Jun Ruiz, Dr. Alnette Tan, Dr. Cecille Maramba-Lazarte, Dr. Mayos Pe-Yan


The University of the Philippines College of Medicine (UPCM) was founded in 1905, as approved by the Second Philippine Commission, and it opened its doors to aspiring physicians in 1907. Throughout its 110 years of existence, the former deans of the medical college have repeatedly affirmed that the greatest legacy of a learning institution to the society is its graduates. UPCM’s vision is to train physicians who not only have the scientific and clinical competence, but also has the social conscience to improve the medical landscape in the Philippine society


Numerous members of the UP Medical Alumni Society (UPMAS) have been contributing their advocacies in the national health scene for decades. We are putting a spotlight on some important advocacies by members of the celebrating Silver Jubilarian Class geared toward uplifting the health of the Filipino people.

These include plans for universal health care and strengthening local health systems. War against cancer is waged by advocating screening strategies to beat colorectal cancer. Advancement of surgical practice is achieved with minimally invasive surgery. These are just a few of the advocacies we have compiled. After all, an advocacy is “at its core, an exercise of empathy.”


Universal health coverage for Filipinos

Universal Health Coverage (UHC) is more than just poor people getting a minimum set of basic health services. It is about guaranteeing that all people – you and me – get the necessary preventive, curative, rehabilitative and palliative care without the risk of financial hardship. It is about mobilizing money to reduce inequality – prioritizing those at the bottom of the pyramid or those below the poverty line. It is about innovation and better regulation by the Department of Health (DOH). It is about efficient use of resources primarily through strategic purchasing by PhilHealth.

UHC marks the end of medical missions, charity beds and debt of gratitude or utang na loob sa duktor where nobody will die unnecessarily because necessary services will be accessible. With UHC, everyone can and will demand for quality health care services because it has been paid for.” “Great strides have been made in the quest for UHC and health for all. We can only succeed when you – whether you become a clinician, a researcher, an academic, a policymaker or health manager – live the systems perspective and passionately take to heart the lessons of patience, humility, creativity, collaboration and courage (UP gave us).” “The story of how the Philippines achieve UHC is still being written. It is a story of wins yet also a story full of missed opportunities, unmet challenges and broken hearts. As we move forward, the story must have – should have – will have a great happy ending – Health for All Filipinos.


Beating colorectal cancer

There has been an increasing awareness of colorectal cancer (CRC) in the Philippines in the last 5 years. It is an important campaign as CRC is the 3rd most common cancer among Filipinos. CRC is preventable, treatable, and beatable. CRC screening can save lives, but not that many people are being screened. As an advocate, I believe that now is the time to educate the public and mobilize the health sector in this advocacy.

Almost all of these cancers start as abnormal growths in the colon and rectum called polyps. These polyps grow slowly and take 10 years for some to develop into cancer. Polypectomy during a colonoscopy reduces the risk of developing cancer by nipping it at the bud. Age > 50 is the most common risk factor. Living a healthy lifestyle can also lower your risk. I advocate screening colonoscopy at 50. For those who do not want a colonoscopy, there is an option of doing a stool test called Fecal Immunochemical Test (FIT) that can detect microscopic blood from a malignancy.

The Colorectal Clinic of The Medical City aims to be at the forefront when Filipinos battle against CRC. I was inspired to continue my advocacy in the Philippines when I moved here in 2014 as I was a part of Kaiser Permanente’s screening program (that holds the best screening rates in the United States). I have organized and spoke in conferences, and wrote a multitude of articles. By promoting patients to undergo screening colonoscopy or FIT, we can all beat CRC.


Minimally invasive surgery within reach of the Filipino masses

The advent of Minimally Invasive Surgery (MIS) has truly revolutionized the way surgeons handle a constellation of diseases, in the magnitude by which antibiotics and sterility altered the outcomes of surgical procedures. Laparoscopic surgery has been applied in almost all abdominal procedures in the last two decades. The concomitant development of better equipment and instrumentation allowed the increasing complexity of procedures through laparoscopic surgery. Unfortunately, this reliance on technology resulted in increased cost, rendering advanced laparoscopic surgery inaccessible to Filipinos who are unable to spend for procedures which will result in less pain, shorter hospital stay and early return to normal activity.

Though known for excellent service and expertise, the limitations in equipment have prevented surgeons in government hospitals from providing our patients care similar to what is being provided in private hospitals. The massive support given to the PGH last year has finally addressed that need, enabling us to secure state-of-the-art equipment in Minimally Invasive Surgery. The UP-PGH Department of Surgery, through the Division of Endosurgery, will strive to maximize the use of this equipment to benefit the indigent patients from all regions of the country. It is our vision that procedures considered the standard of care in modern surgery previously only accessible to affluent patients will eventually be available to all Filipinos who will require surgical treatment, regardless of socioeconomic status. This will truly establish PGH as the hospital of THE FILIPINO.


Partnering with government for better Tuberculosis control

The results of the 2016 National TB Prevalence Survey remains bothersome – approximately one million Filipinos have tuberculosis (TB). Despite improved government funding and program innovations, TB control status in the country remains dismal. Government cannot hope to control or eliminate TB on its own.

I firmly believe the Filipino private sector is a dynamic and responsive entity in TB control. Harnessed the right way, collaboration with this sector has been proven to translate to better and improved figures in TB control. Undeniably, this sector occupies an inimitable niche in the health landscape with its undeniable influence and reach. We have the unique platform of our professional medical societies and non-government organizations; occupy key positions in the academe, training institutions, and hospitals; sphere of influence in allied paramedical professions and media; and perceived and respected as key opinion leaders in various communities and localities.

I have been very fortunate to have worked with persons whose passion and advocacy is like mine- engaging the private sector and sustaining their interest in TB control. I utilized the various platforms that are available to me. I have great mentors whose tireless efforts were truly inspirational. I have been working with this advocacy both in the national level and at the forefront. It is indeed rewarding but more still needs to be done. We cannot rest until there will be zero suffering from TB!


Making Our Moms Safe Foundation, Inc (MOMS)

Seven years ago, God planted a dream in my heart as an OB-GYN. It was a good time in my life where I found my calling. God made me write in a brown envelope- God will put up a home for giving life! What did it mean? I had no clue.

In 2012, data showed that 610,000 Filipina women resorted to abortion, and 3 women die every day due to unsafe abortion complications. It is common to have women come in asking for abortions. After convincing them to keep their baby, the next question is how will they fend for themselves? Who will take care of them?

So after five years, we put up Making Our Moms Safe Foundation Inc (MOMS). Bo Sanchez from the Light of Jesus introduced me to the late Rey Ortega who mentored me. This led to the foundation of MOMS, a 7 bed-facility in Cabuyao Laguna where pregnant women and teenagers who were raped, abused, abandoned or just those who made poor judgements can stay. We take care of their medical, emotional and spiritual needs. We also deliver their babies and keep them until 2 months post-partum. We believe that “Happy mommies make happy babies”.

To sustain this foundation the Calamba Medical Center put up the Our Health Center Inc. a PHIC accredited Birthing center adjacent to the facility. We are a young foundation but 2 babies have been saved. Our dream is that every province in the Philippines will have a MOMS so that no Filipina will ever think of aborting her baby. Every life counts!


Philippine herbal medicine research and development

Usage of herbs as therapy is the predecessor to modern pharmacology. Most traditional medicine systems use herbal formulations as an integral component of curing and caring for their patients. Many modern medicines were derived from plants. At present, there is a resurgence of interest in herbal products worldwide.

Unfortunately, there are many herbal products which are marketed and sold widely, yet have little evidence for its efficacy in human illness. Fantastic claims are made by some manufacturers backed up only by anecdotes or testimonies. Pre-clinical and clinical research has to be performed to ensure their safety and efficacy for the indications claimed. It is the mission of the Institute of Herbal Medicine (IHM) to undertake scientific, ethical and culturally-sensitive research on Philippine Medicinal Plants. The IHM has several units to undertake the necessary studies, similar to those performed for synthetic drugs. Thus the end goal would be to produce safe and efficacious low-cost medicinal plant products for priority health problems.

Formulations produced by the IHM include the lagundi (cough and asthma), sambong (diuretic), and Yerba Buena (analgesic). As the Director of the Institute, I act as the CEO of the Institute, responsible for drawing-up of the research agenda, find research grants, monitor the implementation of the research agenda, and undertake research in herbal medicine. We hope to develop more herbal medicines which will benefit more Filipinos.

Anterior cruciate ligament reconstructions

An athlete does not need to have a medical background to know that an anterior cruciate ligament (or ACL) tear is a serious problem. Every now and then, we hear about an elite player who suffers a knee injury and we all wonder if he or she will ever get back to previous levels. The ACL is easily the most studied ligament in all of sports medicine. Its primary function is to prevent the leg from translating too far forward relative to the thigh. An ACL-deficient knee is unable to perform pivoting movements properly. Patients often complain of their knees “giving way” on certain activities, occasional locking episodes, swelling and pain. Left alone, early onset of osteoarthritis ensues.

All studies support the need for surgery. An ACL tear is no longer repaired; it does not heal so it has to be replaced (hence the term ACL reconstruction). The two most popular sources for the new ACL are the hamstrings (specifically the semitendinosus and gracilis tendons) and the patellar tendon. The commonly used implants are suspensory devices and screws.

During my stint as the head of the UP-PGH Sports Clinic, I developed an implant-less procedure to help our indigent countrymen. It is actually my technique-of-choice in case I encounter patients who re-tear their reconstructed ACL. Depending on the post-operative program that you follow, patients can go back to competitive sports anywhere from six to twelve months.


Strengthening local health systems

I started working on health leadership and governance program in 2014. This is a part of the Zuellig Family Foundation’s initiative, together with the Department of Health (DOH), to fix the crumbling health system of the nation by strengthening health leadership and governance in each of its local government units (LGUs).

I am the program leader of the UPV MLGP team with UP Visayas as the DOH6 academic partner in Western Visayas and so far we have trained 44 LGUs in the Municipal Leadership and Governance Program (MLGP) cycle 1 (2015) and started with 25 LGUs for MLGP cycle 2 (2017). Each LGU team is composed of the mayor, municipal health officer, and/or municipal planning and development officer/the municipal social welfare officer. Cycle 1 was a 1-year 2-module 2-practicum program. The modules are 4 days in duration, 6 months apart with 2 practicum periods after each module. So far, there had been a slight improvement of the health indicators of Western Visayas after cycle 1.

We continue to try to improve the training design and become more effective in delivering the necessary knowledge and skills to our local government officials in improving the health outcomes of their municipalities.

Care of the professional voice

Every year on April 16 since 1999, otolaryngologists and other voice health specialists all over the world observe World Voice Day. The mission of this special day is to promote awareness for vocal health and take action to improve or maintain good voice habits. Ever since it was observed locally by the Philippine Academy of Laryngo-broncho- esophagology and Phoniatrics (or PALP) of the Philippine Society of Otolaryngology-Head and Neck Surgery, I had actively participated in this advocacy for the Care of the Professional Voice.

The activities we organize in the celebration of this day all aim to increase public knowledge about how valuable their voices are in their daily lives and how they should take care of it. Over the years, I had lectured in lay fora for voice professionals, like teachers, actors and singers. We had also conducted free laryngeal endoscopy for indigent patients who suffer from hoarseness and other throat problems. I also help organize and participate in non-medical activities like concerts and musical plays. These cultural programs remind everyone about the unique range and beauty of the human voice.

“After all, an advocacy is, at its core, an exercise of empathy”

November 2017 Health and Lifestyle

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