PSVM's "channels for health"
Two years ago, a group of doctors set up the Philippine Society of Vascular Medicine (PSVM) to impress upon their colleagues the importance of the study of the vascular system for appropriate diagnosis and treatment of diseases.
The PSVM pioneers realized that the blood vessels, far from being mere conduits for blood flow, are an organ system that is crucial for homeostasis in the human body.
Said PSVM founding president Fatima Collado: "Disruption of the health of the vascular system is central to most, if not all, diseases and the ageing process."
PSVM thus worked towards guiding clinicians away from the notion that blood-vessel abnormality is just part of a bigger medical problem. This mindset, explained Collado during PSVM's second annual convention on September 16 and 17, attends to the affected organ while leaving unaddressed the real culprit--the blood vessels.
To be able to provide optimal vascular care to Filipino patients, PSVM got strongly involved in research, local and international, Collado reported. In one of the international multicenter trials it participated in, the Prospective Registry On VEnous Thromboembolism (PROVE), it was found that the prevalence of deep-vein thrombosis and its complications in the country are similar to the rest of the world. PSVM also took part in studies on peripheral arterial disease and on the efficacy and safety of anticoagulation therapies.
Continuing medical education was also made a priority, and several seminars on the importance of vascular medicine were conducted.
The 2004 convention held in cooperation with the Philippine Heart Association's Council on Stroke and Peripheral Vascular Diseases and the Venous Forum of the Philippines featured lectures on vascular and cerebrovascular diseases--their diagnosis and treatment.
Wound management and the use of anticoagulants were extensively discussed as well as the challenges of managing renovascular disease. Specialists then shared their insights on managing the damage to peripheral blood vessels, brought about by diabetes, and discussed how to go about saving the ischemic limb.
In October, PSVM piloted a mobile wound clinic project in Vigan, where internists and general practitioners in various parts of the country were taught about the causes and proper treatment of nonhealing wounds.
PSVM is currently headed by Drs. Florimond Garcia, president; Ma. Teresa Abola, vice president; Diana Jean Roxas, secretary; and Renato Villanueva, treasurer. The board of directors is composed of Drs. Simonette Ganzon, Celine Aquino, Johnny Shia, Benny Barbas, and Patricio Palmes.
M. Ciriacruz
Facing threats in OB-Gyn
Thrusts and Threats in Ob-Gyn Practice--this served as the theme for the annual convention and 59th anniversary celebration of the Philippine Obstetrical and Gynecological Society (POGS) on November 9 to 12 last year at the Philippine International Convention Center.
Dr. Rosendo Roque, POGS president, said that the theme was not "limited to our institutional concerns, but also sensitive to national and international issues that affect not only our practice but society in general."
In his message, Dr. Bu Castro, president of the Philippine Medical Association, commended the convention's theme because it "articulates the continuing search of medical science for better treatment modalities." But he also warned of "threats" to medicine and called on doctors to unite in addressing them. Said Castro: "[The] possible 'threats' confronting us, however, are the changing sociopolitical climate and the introduction of onerous legislative measures that might interject new sets of social values on the way we practice our profession. The test, however, of how we can measure up with changing dynamic conditions of our time does not depend merely on coping with these changes. Much will depend on how we continually improve the medical and technological processes in patient care…In fact, that should be our main thrust."
Dr. Jericho Luna, clinical associate professor at the University of the Philippines-Philippine General Hospital, spoke about fertility-sparing management in gynecologic malignancies. He said that with the advances in cancer treatment, the cure rate of women with some malignancies is higher. He said: "However, loss of fertility as a consequence of therapy is still a major drawback of some cancer treatments affecting younger patients still in their reproductive years and desirous of pregnancy."
Meanwhile, Dr. Rey De Los Reyes, consultant at the Far Eastern University Medical Center, talked about screening for and management of inherited gynecologic malignancies. He said: "Advances in molecular genetics have led to the identification of more than 40-germ-line mutations associated with the susceptibility to cancer in a variety of hereditary syndromes."
Aside from holding lectures, the POGS also highlighted during the four-day meet the achievements of its many different projects. These include Advances in Labor and Risk Management (ALARM) and Adolescent Health Issues and Perspectives. Also, Dr. Delfin Tan delivered the Baldomero Roxas Memorial Lecture, while Dr. Bernardita Javier was awarded the Ramon Lopez Award for Community Service. Both are past presidents of the POGS.
M. Pagsuguiron
PNA champions professionalism
The Philippine Nurses Association celebrated its 82nd year of founding October 26 to 29 last year. The event was all the more significant because it coincided with the annual commemoration of Nursing Week, and the holding of the PNA's annual convention, which carried the theme Commitment To Quality Service through Professionalism.
The theme, said Ms. Ruth Padilla, PNA president, "[spoke] very well of our desire to induce our members to embrace and practice a universally acceptable standard in the performance of their duties and functions--a constant call for us to be globally competitive, if not excel in the field of health care."
"This convention gives us the rare opportunity to advanced learning and new ideas. It helps us build a strong sense of conviction and confidence," she added.
Ms. Catherine Fischer, senior health adviser at the United States Agency for International Development (USAID), delivered a lecture titled "Nurses Then and Now." She noted that nursing roles have changed dramatically over the years since Florence Nightingale. Nurses gradually began to take on more skilled hospital procedures that required great training. Then hospital-based nursing programs began to teach specific skills to nurses.
Thus the result-nursing became more specialized. She said: "Today, a nurse is a professional who has a high level of training. Many skills are often highly specialized. She is independent in her practice and is a trained leader and a manager."
One of the pressing issues that has affected nursing in the past few years is the exodus of qualified Filipino nurses to developed countries like Canada and the United States. Considering that nurses play a critical role in the health-care system, this issue is bound to pose a number of challenges.
Fischer suggested ways to encourage registered nurses to stay in the workplace. One of these is to encourage professional autonomy and clinical decision-making, as well as demonstrate the relationship of timely nursing interventions to patient outcomes. Recognizing unique professional procedures and developing career incentives, implementing marketing strategies to address nursing image, reevaluating nursing education, and implementing strategic action to enhance profession also offer considerable help.
Ms. Lerma Ung of the Australian Society for HIV Medicine spoke about "Tomorrow's Nursing Leaders."
She said that a leader possesses a "mastery of SELF." The SELF can critically assess himself--what's good and not so good both generate a realization, prompts him to act on his strengths and weaknesses. She added: "A level thinker who thinks out of the box, is resourceful, is technically adapt by means of good communication and people skills. A leader also develops leaders. In short leaders are the BEST--[which stands for] Builders of Effective, Sustainable Teamwork."
The PNA, the only professional nursing organization recognized by the Professional Regulation Commission, seeks to help nurses to:
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Appreciate the value of competency, setting standards in the practice of the profession.
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Acquire more knowledge, skill, and attitude needed to exercise total
customer satisfaction through quality service.
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Enhance personal attributes to promote oneself as an effective provider on
high-quality nursing care.
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Value the need for renewal of one's passion and full commitment for professionalism and quality care.
A. Ordoñez
PSPME holds lay forum
The Philippine Society of Pediatric Metabolism and Endocrinology (PSPME) held its first pediatric endocrine lay forum on October 26 last year at the Manila Pavilion Hotel. The event was able to take in more than a hundred participants, most of whom were people involved in the care of children with metabolic and endocrine disorders.
The PSPME envisioned the forum to be the first step toward the organization of future assemblies that will help raise awareness on pediatric endocrine and metabolic disorders. Dr. Sioksoan Chan-Chua, PSPME president, said that the Philippine Pediatric Society designated October as endocrine month.
Dr. Sylvia Estrada of the National Institutes of Health spoke about the significance of newborn screening and the conditions it seeks to recognize early: congenital hypothyroidism, congenital adrenal hyperplasia, phenylketonuria, galactossemia, and glucose-6-phosphohydrase deficiency. She emphasized that early detection of congenital hypothyroidism and congenital adrenal hyperplasia may prevent mental retardation or even death.
Estrada noted that in the Pacific region, the Philippines is not a backwater in the implementation of newborn screening. The Newborn Screening Act of 2004 is now in place, and to date, there are 379 hospitals doing newborn screening.
Speaking about growth disorders, Dr. Carmelita Domingo, also of the NIH, said that constitutional growth delay is the most common cause of short stature among Filipinos while nutritional deficiency is the most common cause of growth failure, which may be poverty-related.
Five simultaneous workshops were held during the forum, covering such topics as congenital hypothyroidism, congenital adrenal hyperplasia, type 1 diabetes mellitus, obesity, and growth and nutrition. The workshops followed this general pattern: pretest, registry, feedback and a lecture, a posttest, and open forum.
The other officers of PSPME' are Drs. Melinda Atienza, vice president; Lorna Abad, secretary; Susana Campos, treasurer; Pilar Regidor, PRO; and Caridad Santos, auditor.
J. M. Nailes, MD
Blood experts aim high for 2007
The Philippine Society of Hematology and Blood Transfusion (PSHBT) has this vision for 2007: a hematologist for every 50,000 Pinoys; adequate number of accredited training institutions for hematology; eradication of common preventable hematologic conditions such as nutritional anemia; and elevation of hematology--in terms of patient care and research--to the same level as that in other ASEAN countries.
Toward making this vision a reality, PSHBT adopted the approach, Hematology: Academe to Bedside in its 2004 annual convention.
Convention chair Dr. Alendry Caviles said that the scientific program was designed to enable not just hematologists but also all caregivers to give their patients the best diagnostic and pharmacologic management of their blood diseases, with equal concern given to patients' emotional and spiritual well-being.
Immediate past president Ernesto delos Reyes pointed out that the first day offered clinicians and technologists recent developments in hematologic diagnosis and blood-banking procedures. The program for the next two days was devoted to apheresis (a procedure in which the patient is transfused with his or her own blood from which certain elements, like plasma and platelets, have been removed), bone-marrow transplant, and leukemia.
PSHBT pioneering officer Luz Gamez--president of the society from 1976 to 1979--keynoted the event. She was instrumental in PSHBT's membership with the International Federation of Hemophilia.
PSHBT was founded 44 years ago. At present it has 122 members, composed mostly of adult and pediatric hematologists and several blood bankers. PSHBT members are actively involved in developing and upgrading coagulation procedures, immunohematologic techniques, and cytogenetics in the country.
Dr. Priscilla Caguioa is the president while Drs. Sonia Narcissa Comia, Allan Robert Racho, and Ma. Angelina Mirasol are the vice president, treasurer, and secretary. The board of regents is composed of Drs. Jose Antonio Quiteves, Ernesto Yuson, Roselina Anastacio, Ernesto Yuson, and delos Reyes.
M. Ciriacruz
A sound pact, all right
Ultrasound Month--October--gave birth to a sound beginning. The Philippine Society of Ultrasound in Clinical Medicine and the other medical societies that use ultrasound in clinical practice signed a Sound Pact on October 27. They pledged to adhere to high-quality and ethical practices in using the ultrasound.
The signatories to the Sound Pact included representatives from the following: Philippine Society of Pediatric Cardiology, Ultrasound Society of the Philippines, Fetus as a Patient Institute-Philippines, Philippine Society of Vascular Medicine, Pediatric Adolescent and Gynecology Society, Philippine Urological Association, Philippine Obstetrical and Gynecological Society, Philippine Society of Echocardiography, Philippine Society of Ultrasound in Surgery, Stroke Society of the Philippines, Philippine Neurological Association, Philippine Society for Vascular Surgery, Child Neurology Society of the Philippines, and Philippine Physical Therapy Association.
New approaches in cancer
The Philippine Society of Oncologists (PSO) held its 20th annual convention on October 27 to 29 with a goal of seeking New Approaches to Old Problems in Cancer Prevention, Diagnosis, and Treatment.
"We are called upon to take a new look at cancer as a clinical and public concern, to reexamine our treatment philosophies as well as capacities, and to find new approaches to old challenges," said Dr. Rafael Claudio, PSO vice president and overall convention chair.
Ms. Regina Paz Lopez of the ABS-CBN Foundation delivered the keynote address, saying that doctors may find something of value in alternative medicine for the management of cancer patients. She said that alternative medicine is a heterogeneous group of hygienic, diagnostic, and therapeutic philosophies and practices whose theoretical bases and techniques diverge from those of modern scientific medicine.
Lopez firmly believes in the usefulness of alternative medicine, and described her experience of its use in Bantay Bata 163. Of the 198 children between seven months and 12 years old in Bantay Bata who were undergoing chemotherapy, only four percent survived, while another four percent survived combined chemotherapy and surgery. "I cannot justify these numbers," Lopez said.
Considering the dismal success rate of chemotherapy in these children, Lopez set out to look for better means other than chemotherapy to manage cancer. That's when she came upon a former patient--a 73 year-old man who survived prostate cancer with the help of alternative medicine.
With this man's story and those of others like him, Lopez became convinced that the study of alternative medicine should be pursued. She encouraged doctors to keep an open mind about it and its possible use in cancer management.
Meanwhile, former PSO president Dr. Antonio Villalon talked about the status of modern oncology in a developing country. He spoke of doctors giving good quality service to patients, adding, "Let us not force them to accept our personal choice of drugs or medicines to please our friends in the pharmaceutical industry or perhaps to have our own financial gain. Let us not use expensive drugs to be fashionable, if cheap ones can do it."
Villalon concluded: "We all have to work together for one ultimate objective: The best care of our patients…As cancer fighters, we are entrusted [with the task of] enforcing the highest standards of ethics in our profession. Our patients deserve nothing less."
M. Pagsuguiron
Rotarians join fight against TB
Known for service above self, Rotarians add another cause to their agenda--treating and fighting the spread of tuberculosis (TB) in the country.
They have observed that this disease remains a public-health menace in the Philippines, killing about 70 Filipinos daily and infecting dozens more. Most of the victims are in their most productive years, ages 15 to 59, making TB an economic as well as a health burden.
Rotarians are convinced, however, that this war with TB can be won--with concerted effort, commitment to a goal, and the right resources and manpower, which Rotary International has.
On September 11, Rotarians of district 3780 (Quezon City) launched an anti-TB initiative, which aims to remove TB from the list of public-health problems through proper education about and access to treatment and cure for those affected by TB.
They will work in partnership with the government, international agencies, and the private sector to support the directly observed therapy shortcourse (DOTS) as the most cost-effective way of controlling tuberculosis in both adults and children.
Through medical missions, Rotarians will help identify those who exhibit the symptoms of TB and refer them to the nearest health center for enrollment in DOTS.
"Our role now is to bring as many TB suspects and TB patients on board [the government's infrastructure for TB control]," explained Rotary Club president Dr. Virginia Irene Santos.
Eventually, Rotary district 3780 hopes to put up its own DOTS center. In the meantime, it hopes to maximize the use of the government's resources, Santos said.
There is a need to address TB, stressed the district's centennial governor, George Howard, lawyer and director at Club Filipino in Greenhills, "not only to control but finally to stop the disease from destroying the human body, if not the totally the human spirit--if not addressed on time."
Partners in the anti-TB initiative are the Department of Health, World Health Organization, Philippine TIPS-US Agency for International Development, Department of Education, Philippine Pediatric Society, Philippine Coalition against Tuberculosis, and the Office of Quezon City Mayor Feliciano Belmonte Jr.
Rotary International is a worldwide organization of business and professional clubs established in 1905 in Chicago, Illinois, to engage in activities that foster international understanding and community service. It has 30,000 clubs and 529 districts in 149 countries, with about 1.2 million members.
M. Ciriacruz
C-Network goes online
I'm so scared. I'm alone. I'm going to die."
For someone with cancer, these sentiments make up much of their ordeal.
Unfortunately, not only do they make life harder for a cancer patient, they could also make dying from the disease inevitable.
According to the Philippine Cancer Society (PCS), awareness of the facts of cancer and cancer treatment is very low in the Philippines. While other cancer specialists agree that misconceptions about cancer are widespread among Filipinos.
For instance, so many Filipinos don't know that a third of cancer is actually curable--if detected early and treated properly--and most are preventable by leading a healthy lifestyle. And there are those experiencing symptoms already but are too scared or in denial to consult a doctor about them.
"We didn't even want to think that we were sick," a cancer patient or survivor may recount.
All these contribute to the increasing rate of cancer-related deaths here. In the Philippines, cancer is the fifth leading cause of deaths. Cancers of the breast, lung, liver, cervix, colon and rectum, leukemia, thyroid, stomach, prostate gland, and ovaries are the 10 leading cancers.
It is a serious concern, but one that an intensive public information and health-education campaign can address.
To meet this need, the PCS, together with Roche Philippines, Department of Health (DOH), and I Can Serve Foundation, launched a cancer-advocacy campaign called the C-Network September last year.
Besides serving as a source of cancer information to Filipinos--through brochures and a cancer advocacy web site (cnetwork.org.ph), the C-Network aims to empower cancer patients and their kin to be more proactive decision makers in cancer care and control, says Roche Philippines general manager Warwick Bedwell.
It hopes to bring cancer patients, cancer survivors, their families, the medical community, cancer support groups, and the government together in the fight against cancer.
To this end, the C-Network participated in a fund-raising activity, the Relay for Life, on December 11 and 12 at the Philsports Oval in Pasig City, where all those affected by and concerned with cancer had camping, singing, and dancing activities and shared stories with one another.
M. Ciriacruz
Now showing: Obesity wars
The foes of diabetes and obesity intensify their efforts. They have to, with the number of adult and child casualties of diabetes and obesity growing over the years.
Consider: In 1997, the Food and Nutrition Research Institute (FNRI) found that four out of 100 Filipinos have type 2 diabetes. In the next 25 years, the World Health Organization (WHO) predicts that the prevalence of this disease will double globally.
Data from FNRI also show that the incidence of obesity, which increases the risk for developing type 2 diabetes, is becoming more frequent among the young and older people.
In 1987, the prevalence of overweight Filipinos was 11.8 percent; in 1999, it has risen to 17 percent. In children, FNRIs 1998 National Nutrition Survey shows that one in 250 kids under five are overweight. In another survey five years later, it has become four out of 250.
Observed Dr. Rosa Allyn Sy: "[Diabetes] is exacting a substantial toll on the morbidity, mortality, health cost, and economy [of the country]."
Sy is the president of Philippine Diabetes Association (PDA), which held a press conference on November 10 to mark the observance of World Diabetes Day on November 14. She noted that prior to the onset of clinical type 2 diabetes, a prediabetes condition called impaired glucose tolerance (IGT) sets in, wherein the amount of glucose in the blood after fasting is higher than normal but lower than in the blood of diabetics. In IGT, either the body produces enough insulin, but cells are unable to make maximum use of it or there is already a defect in the beta cells that produce insulin.
Sy added that because of environmental risk factors like obesity, fat-rich diets, and sedentary lifestyle, the risk of IGT's progression to type 2 diabetes is heightened.
This year, PDA, together with its mother organization, the International Diabetes Federation and WHO, focuses on the fight against obesity in its war with diabetes. Its weapons, Sy revealed, are the Exercise and Nutrition Videos, produced and directed by the PDA and backed by Merck Inc., through a continuing-medical-education (CME) grant.
PDAhopes that the videos will reach a large part of the Philippine population through the PDA's different chapters and educate them on the benefits of exercise and proper nutrition.
She explained that doctors in diabetes clinics or clubs can make use of these videos to initiate and impart lifestyle modification among patients or members, "as part of a multipronged intervention for diabetes prevention and control."
The media can also show the videos on television or discuss their contents, which include different exercises and tips on how to shop for someone with diabetes, on print or on air.
Citing studies of intervention with lifestyle changes, Sy pointed out that exercise and proper diet have shown effective in reducing the incidence of diabetes. These studies are the Diabetes Prevention Program (United States, 2002), Da Qing (China, 1997), and Finnish Diabetes Prevention Study (Finland, 2001).
The big picture
After observing World Diabetes Day, the PDA focused on Looking at the Big Picture of Diabetes. In its annual convention on November 23 and 24, prominent specialists on diabetes management and diabetes patient care presented lectures ranging from treatment strategies, both conventional and alternative, to neglected issues in diabetes care like depression among diabetics. Among the speakers were Drs. Augusto Litonjua, Rody Sy, Ricardo Fernando, Ruby Go, Roberto Mirasol, Raymond Rosales, Cynthia Halili-Manabat, Lina Lantion-Ang, Elizabeth Paz-Pacheco, Sioksoan Chan-Cua, Editha Arceo-Dalisay, Mary Anne Lim-Abrahan, Rima Tan, Teresa Plata-Que, Cecilia Montalban, Romina Danguilan, Sherrie Querubin, Agnes Mejia, and nutritionist-dietitian Sanirose Orbeta.
M. Ciriacruz
Action v. drug and chemical hazards
The Philippine Society of Clinical and Occupational Toxicology (PSCOT) held a meeting among toxicologists and other public health advocates in behalf of the Asia-Pacific Association of Medical Toxicology (APAMT) to take action against chemical and drug hazards. The meeting coincided with APAMT's fourth international conference on November 24 to 26, held as part of its goal to promote chemical safety, poison control, prevention and treatment in the Asia-Pacific region.
APAMT is an international organization established by a group of medical toxicologists in 1989. Its members are engaged in collaborative research on poison information and the writing of poison-information monographs, which form part of the database used by Poison Centers in Asia and the Pacific.
It also represents the nongovernment organization in the standing committee of the Intergovernmental Forum on Chemical Safety (IFCS), the president of which, Dr. Suwit Wibulpolprasert, gave the keynote address at APAMT's conference.
Wibulpolprasert questioned the political, economic, and social forces that create much of the shortcomings in the health-care delivery systems around the world.
Citing The Truth About the Drug Companies: How They Deceive Us and What to Do About It (published by Random House in August 2004) by Marcia Engel, Wibulpolprasert zeroed in on how the pharmaceutical industry is helping little to improve this situation. As related by Wibulpolprasert, Engell, former editor in chief of the New England Journal of Medicine, wrote that the pharmaceutical industry:
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Claims to be a high-risk business--but year after year, drug companies have higher profits than those in any other industry, by a long shot.
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Claims to be innovative, but only a small fraction of these drugs are truly
new. Most are simply variations on older drugs.
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Spends far less on research and development--contrary to popular
belief--than on marketing.
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Has an iron fist on Congress and the White House. It has the largest lobby
in Washington.
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Promotes diseases to match their drugs. "Millions of normal Americans have come to believe that they have grievous or exaggerated ailments, like generalized anxiety disorder and erectile dysfunctions," commented Wibulpolprasert.
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Has enormous influence over what doctors are taught about drugs and what
they prescribe.
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Has substantial control over clinical trials of drugs--much of product research is biased as a result, explained Wibulpolprasert.
He laments that because of these forces, if a health need, like pesticide poisoning, is not profitable, it is ignored. Pesticide poisoning is a "disease of the poor," he explained.
Health and medical professionals should support public research and development for diseases of the poor, he urged.
The rest of APAMT's conference tackled environmental health, pharmacovigilance, substance abuse, and capabilities for monitoring chemical incidents.
M. Ciriacruz
Getting rid of--and over--leprosy
Can someone who has had leprosy really be cured of leprosy?
Among the dilemmas and difficulties in leprosy management, the answer to this question may be the greatest one yet. This was pointed out during the second leprosy forum of the Philippine Dermatological Society (PDS) on November 9.
According to the forum's chair, Dr. Belen Lardizabal-Dofitas, leprosy is a chronic stigmatizing disease of the nerves and skin.
Leprosy, though curable, leaves a lasting impression on a person's appearance and self-esteem.
"Although the problem of leprosy has diminished dramatically since the National Leprosy Control Program (by the Department of Health) was established, the Philippines remains the top contributor of new leprosy cases in the Western Pacific Region (WPR)," Dofitas revealed.
For decades, leprosy has been endemic in the WPR. Following a massive campaign, spearheaded by the World Health Organization, the incidence of leprosy dropped dramatically (less than one per 10,000 people in 1991) in the region.
However, the Philippines continue to contribute to the caseload. For the past three years, an average of 2,300 individuals are detected each year with leprosy.
The PDS, therefore, collaborates with the government as well as the Philippine Leprosy Mission (PLM) to strengthen the knowledge and skills of medical professionals in leprosy control. It organizes leprosy forums for updates, exchange of ideas, updates, and discussions on the different aspects of the disease.
"Our goal is to stimulate a more concerted effort towards eliminating leprosy as a public-health problem and an obstacle to the productivity of persons with leprosy and those affected by leprosy," Dofitas explained.
Discussions in the forum ranged from how to deal with resistant leprosy and lepra reactions to rehabilitation and prevention of disability.
The resource speakers are all well known here and abroad for their leprosy work.
Dr. Hugh Cross, the American Leprosy Missions' regional consultant for prevention of impairment and disabilities in Asia, described the secondary effects of leprosy and the challenges they represent. His talk also focused on nerve inflammation and its detection through the nerve function assessment test and voluntary muscle testing.
Dr. Gertrude Chan stressed that the threat of antibiotic resistance in leprosy, though still unclear, should not be ignored. The threat comes mainly from a widespread primary and secondary resistance of the Mycobacterium leprae to the antibiotic dapsone. She discussed combination drug regimens, as recommended by the WHO committee on chemotherapy, to counter this resistance to dapsone.
How to manage the special needs of patients with leprosy--those who are pregnant or lactating, with drug reactions and G6PD deficiency, and who have concurrent diseases like AIDS and tuberculosis--was the topic of American Leprosy Missions country representative in Myanmar Dr. Tin Shwe.
Section head of dermatology at the Philippine Children's Medical Center Roberta Romero discussed lepra reactions. She also related the dramatic results from treatment of a leprosy-related disorder, erythema nodosum leprosum (ENL), with thalidomide--which was widely used as a sedative by pregnant women in the 1950s.
The drug's popularity turned out to be disastrous, however, as the drug was found to cause severe malformations in the developing fetus. More than 10,000 infants were born without limbs before thalidomide was taken off the market in 1961.
Nevertheless, research continued on the uses of thalidomide on other diseases, like painful canker sores in AIDS patients and other impaired immune disorders. Thalidomide seems to significantly inhibit the growth of new blood vessels, which makes it a promising drug as well to prevent the growth of cancerous tumors.
Meanwhile, the PDS also works with PLM not just to address leprosy medically but also socially. A volunteer, nonprofit, church-related agency dedicated to the welfare of those affected by leprosy, the PLM is chiefly involved in social development work.
It assists in the integration of those suffering from leprosy and their families into society. It is also involved in providing research opportunities into the cause, nature, method of treatment, and prevention of leprosy.
M. Ciriacruz
Soliman urges eye doctors to get out of their comfort zone
Social welfare and development secretary Corazon "Dinky" Soliman has called on Filipino ophthalmologists to help bring not just good eyesight but hope to people who need it most and in the process help fuel a much-needed "national transformation."
Keynoting the opening session of the annual meeting of the Philippine Academy of Ophthalmology (PAO) on November 18, Soliman urged members of the PAO to think of their work not just in terms of providing eye care for the population but also in terms of helping people see "the possibilities to make our [national] vision come true."
"As eye doctors you can help [bring about] a compassionate society, and articulate our vision of transformation for our country," she said.
"We must all help in seeing the potentials in our country and not be blind to the needs of our own people," she said even as she called attention to what she called a "doctor deficit" prevailing in many parts of the country.
Soliman was referring to the overseas exodus of Filipino doctors and other health workers in search of financial stability, which has aggravated the dearth of health-care services especially in the rural areas.
"We have a doctor deficit especially in rural areas, [owing in part to the] inability of government to give competitive salaries for professionals in the medical profession," she said, noting that a government doctor receives roughly PhP15,000 a month while a Filipino nurse working in the US fetches as much as P200,000 a month--"which is why we have doctors training to become nurses."
Soliman noted that one rarely finds a doctor--especially an eye doctor--in the rural areas on a regular basis, which is one of the reasons why vision impairment is also common in the rural areas.
She cited six most common eye disorders in the country--cataract, error of refraction, glaucoma, corneal opacity, trauma, and corneal blindness due to infection. But she said the most common eye disease of the poor is corneal blindness due to infection. "Obviously the infection comes from the polluted environment that we have and the lack of knowledge on how to care for the eyes--because eye care is the least available health care in the rural areas," she explained.
She commended PAO for its commitment to encourage its members "to remain in the country and provide health-care services where they are at the moment."
Said Soliman: "This is the challenge for eye doctors. Each one of us is called upon to serve-to move out of our comfort zones, to move out of what is familiar, and go to the places you think are dangerous, where you might think people will not accept you or people will harm you."
In opening the convention, Dr. Marcelino Banzon, PAO president, spoke of the same challenge. Said he: "Let me challenge all of us to do our share, to get out once in a while from our comfort zones, do charity work, and give back and share to society the blessings we have been given."
"The prevention of childhood blindness is our moral and social responsibility as eye specialists. It is also our commitment to help in the international community's efforts in fighting remediable blindness worldwide," he said.
The meeting, which had Look the Future in the Eye for its theme, focused on "pediatric ophthalmology and strabismus in a global perspective."
"Children are our hope, our future. But their future looks bleak," said Banzon, noting that about 1.5 million children worldwide are blind, one million of them in Asia. He said nearly half of these could have been prevented with proper ophthalmic care. In the Philippines, children below 15 years of age make up 37 percent of the population. The prevalence of blindness in this age group is 0.9 per 1,000.
"An estimated 100 children lose their sight every week" because of causes that are preventable like poor nutrition, measles, and premature birth, lamented Banzon.
To help address the problems, the PAO and the Philippine Pediatric Society have joined hands for a vision-screening program for children so that vision problems can be addressed early. During the convention, the two societies issued a Joint Policy Statement on Retinopathy of Prematurity Screening, which came on the heels of the PPS Policy Statement on Pediatric Blindness Prevention and Vision Screening.
These are meant to boost the Elimination of Avoidable Childhood Blindness Project launched in 2003 and the Five-Year Strategic Plan for Vision 20/20 launched in August 2004 to bring down the national-blindness prevalence rate to less than 0.5 percent in five years.
Drs. Kenneth Wright, Mohamad Jaafar, Ken Nischal, and Sonal Farzavandi discussed recent development in pediatric ophthalmology. Dr. John Shore spoke on oculoplastic surgery while Drs. Takeyuki Akahoshi and Abaykumar Vasavada shared pearls on phacoemulsification cataract surgery. The meeting also featured two new courses on ophthalmic photography and computerization of ophthalmic practice. PAO members also got tips on investing from two investment advisers of ING Bank.
M. Dumalagan
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