A cardiologist who takes social welfare by heart Esperanza Icasas-Cabral, MD
By Sunly Coo, Contributing Writer
Dr. Esperanza Cabral is a giant among her colleagues and a legend among younger doctors. Before becoming the secretary of the Department of Social Welfare and Development (DSWD), she has built an impressive career as a leading cardiologist and prolific researcher who has published more than 85 papers on hypertension, cardiovascular pharmacology, and clinical and preventive cardiology. Extensively trained at Harvard Medical School, Massachusetts General Hospital, and the Joslin Clinic in Boston, Massachusetts, the University of the Philippines graduate returned to the hallowed walls of her alma mater to serve as professor at the College of Medicine. She reached the height of her profession when she became chief of cardiology at the prestigious Asian Hospital and Medical Center. But it was probably her eight-year reign as the director of Philippine Heart Center that brought her to the attention of President Gloria Macapagal-Arroyo, when the untimely resignation of then-secretary of DSWD left a vacuum that needed to be filled. She recalls: "Initially, I refused the position. Number one, I wasn't familiar with the operations of the social-welfare department. But they kept saying that I should give it a try and that it was another helping profession…. It came to a point where I felt it was already some kind of arrogance my repeated refusal of the job. Sa loob-loob ko lang, you're suppose to be a public servant, and here's an opportunity for you to be one and to reach more people, so what's the matter?" Thus after months of rumination, she finally accepted the appointment and was sworn in last year. Switching hats was no easy trick. Her biggest challenge was to learn quickly everything about social work and the department. And while both roles were forms of public service, her current clientele is vastly different from her previous one. "As a doctor, the patient that I was examining was my universe," she says. "Now, as the secretary, it's the entire country and the people who are our constituents-the poor, the vulnerable, the disabled, the disadvantaged, the marginalized." But what the job demanded the most from her was her leadership skill. As head of a department, "a lot of things you need to do pertain to executive abilities, your vision more than your expertise as a social worker," she explains. What is her vision? "To put the DSWD out of business," she says, "in the sense that there is nobody who's poor, disadvantaged, and marginalized. I know that it is an unattainable vision, but I still want to hold that as my vision, something to reach for." As they say, shoot for the stars, and you might reach the moon. Cabral's strategy is to focus on the oft-neglected social-develop-ment thrust of the department, since there's more to DSWD than organizing relief operations, dealing with disaster victims, and rescuing abandoned elderly. "Even as we do all of these necessary and urgent things," she explains, "I think our department needs to focus on development work so that these things can be minimized as much as possible." Working with out-of-school youth, for instance, is one issue she is taking a proactive stance on. Through her program Ahon Pamilyang Pilipino, indigent families are supplied each month with cash worth PhP300 for each school-age kid with a maximum of three kids, plus PhP500 for health care, as long as the children stay in school. The conditional cash transfer initiative is aligned with the one of the United Nations' Millennium Development Goals: giving kids universal access to primary education by 2015. "In the Philippines, out of 100 seven-year-old kids, only 85 enroll, and six will drop out every year," she reveals. Cabral and her team also helped pass into law the Juvenile Justice and Welfare Act, which increased the age of criminal responsibility from nine to 15. Instead of throwing juvenile delinquents into jails, they are sent to transition homes or Bahay Pag-asa for counseling and rehabilitation. To raise funds for more homes-one for each province, she hopes-the doctor organized a grand concert featuring school choirs at the Marikina Sports Complex in December. Despite her many other DSWD projects, the doctor finds time to host Infomedico, a short segment on health and prevention in the evening newscast on RPN 9. Once her appointment ends, Cabral will return to her medical practice which she sorely misses. In the meantime, Juan dela Cruz and his family needs all the help they can get. M
Grace Roxas, Contributing Writer
Unlike his biblical namesake, the stubborn prophet from the Old Testament, Dr. Jonas del Rosario, cited as one of Ten Outstanding Young Men (TOYM) in 2004 and a pioneering interventional pediatric cardiologist, didn't need a tempest and a big fish to find what-and where-his true calling is. Faced with a choice of forging uphill with a worthy but lonely cause or signing away his difficulties with a cushy career abroad, del Rosario in 2000 was only a flick of a pen away from nipping in the bud a medical legacy that has so far spared 300 congenital-heart-disease patients (children and adults alike) from undergoing open-heart surgery, and has given access to about 1,000 Filipino patients newly diagnosed each year to a treatment option previously available only in hospitals abroad. Never one to brook challenges, his dilemma at the time was of a different order from the ones that this intellectual achiever was able to breeze through in the past. Finishing at the top of his high-school class, he went on to a path of academic distinctions that's to be expected: magna cum laude in college, topping the Philippine medical boards, and finally, securing not just one of only eight slots available in the US for interventional-pediatric-cardiology fellowship, but getting into one of the two top programs around. That last achievement could have been just another feather in his intellectual cap. Del Rosario thought he knew better. Things had begun to make sense in a way that his Old Testament namesake would have understood. He said: "Sabi ko, pag natanggap ako, I really need to go back to the Philippines. I didn't expect it. It's like a message that I should go back, even for just a short time, to pay it forward." Thinking this way led to eschewing the obviously safe choices. He already got started by choosing to subspecialize immediately instead of taking the popular "green card" route of working in underserved areas in the US as a general practitioner for two years before specializing. "Some of my friends were telling me not to super subspecialize because it might be hard for me to find a job," says Del Rosario. "Taking the green-card route was very enticing to a lot of my classmates and friends, but deep inside, I think I wanted to go home and try it out." It also foreshadows the more challenging decision he had to face later when things began to take a decidedly more biblical turn for the difficult. A year after going home and trying to introduce what was to earn him the TOYM distinction-the nonsurgical treatment of congenital heart diseases by therapeutic cardiac catheterization-he was feeling more like a lost prophet in the wilderness rather than a returning messiah with a mission. He recalls: "I was getting a little frustrated. I wanted to do a lot more but I couldn't. There was lack of resources, intrigues, and the system itself was difficult. What hit me was mahirap ang pera. I was told that even if I can do it, 'We cannot afford your services or we cannot afford the device that you want to use.'" His decision to subspecialize immediately and go home was also informed by an advice from mentors at the UP College of Medicine two years before that there might be a professional gap he could fill. With reality falling short of his expectations, he began to entertain job offers that had been coming from abroad in anticipation of the end of his mandatory two-year stay in the Philippines after US training. And that was how he found himself one day in 2000, signing pen in hand, wrestling with an inner test where his intellectual abilities, considerable as they are, only played a minor part. He went so close to just deciding on the basis of what side of the bread is buttered that people around him were writing him off as just another UP graduate lost to the greener pastures of the US. He notes that among his 15 batch mates who went home after training to practice here and have since returned to the US, he was the last holdout. But finally, the part of him that embraces challenges and looks out for signs won out. "Somebody was telling me that you have not done enough. It's only been one year," he recalls. People from the University of Florida hospital were understandably upset to have lost their future director for the cardiac-catheterization lab without him even having set foot there. But it is this incident which somehow led to the deliverance part of Del Rosario's quasibiblical tale, as it helped put him in the radar of parties who could help make things work out. A company certified him to use their device for therapeutic cardiac catheterization and helped him set it up here. "That's a sign from above that just be patient and things will happen," he says. Indeed, he started doing more procedures and things got so busy that even if he had reconsidered going abroad, there were too many things keeping him here. At present, he now heads two pediatric-cardiology departments (in St. Luke's Medical Center and Philippine Children's Medical Center), the pediatric-cardiac-catheterization laboratory at the UP-Philippine General Hospital where he also teaches pediatric cardiology at the College of Medicine, and serves as officer in various professional associations. With all these professional commitment, he still finds space to aspire to become a professional studio portrait photographer. A former university basketball varsity player, he also finds time to coach and play during summers. That would seem a handful to most but not for Del Rosario who, at 42, still aches to be able to do more. "Theoretically, we can do around five patients a day because we can do the procedure in an hour. What motivates me is there are still a lot of things to be done. Also, I want to do something different all the time and challenge myself," he says. M
Grace Roxas, Contributing Writer
Some people work to live. Others live to work. Dr. Perla Santos Ocampo, pioneering developmental pediatrician, institution builder, wife, and mother, lived her work. Happily married and having raised three highly accomplished children who have taken up the torch of a family tradition in medicine, her personal life is the most convincing argument yet for what she preaches. It wasn't so much a deliberate project as it was an inevitable facet of a purpose-imbued existence where the clinical has always intertwined with the personal. Even as a small child, Perla had always known what she wants. Wanting to become a doctor is a common enough childhood fancy. What pushed young Perla's aspiration beyond the idle musings of child was that she had the chance to play the little doctor to real patients. Born to physician parents who practiced in Pangasinan, she was an enthusiastic helper who rode with her parents on carabao-drawn sleds and little bancas to reach patients in the hinterlands. Exposed early to the life of a country doctor, she would twice choose the seeming backwater of a Philippines-based career over the glittering prospects of a US-based medical practice. And these decisions were made in the shadows of two of the most trying times in recent history-the declaration of Martial Law, and the edsa Revolution. When Martial Law was declared in 1972, she and her husband were being invited back to practice in Cleveland, Ohio, where they had undergone training. In the early, uncertain days of the edsa Revolt, she was in Bangkok. Everyone-including the crew of the Bangkok-Manila flight she was on-was amazed that she should be returning home at all instead of putting more distance between her and the local tumult by going to the US upon her husband's urging. "I had the whole plane to myself because everyone was afraid to go back," she recalls. "But I wanted to go back because I wanted to watch history in the making."
She herself would've been a developmental pediatrician's dream while growing up. While other four-year olds would cry their heart out if kept away from a favorite game or toy, little Perla's idea of deprivation was being left behind at the house while her elder sister attended school. Starting out as a "saling-pusa" (Filipino idiom for an informal participant) in her sister's class, she was accelerated to second grade by the end of the school year. Such early promise could have been a blueprint for living one's prime years centered on the demands of a high-flying career, with the family having to come in second. Not with Perla Santos Ocampo. Recalls Santos Ocampo: "You should not put your career first. I had a light practice only until my last child went off to school. In the beginning, it was just the kids, home, and some teaching in UP (College of Medicine). Fortunately, UP allows part-time work." Her work was not entirely family-free territory either. Her kids were able to see a lot of the country and the world at a young age as she brought them along when she had to take business trips. She didn't even make these trips at all until the kids were old enough to have some measure of independence. How then did she find the time to do all the things that earned for her accolades such as The Outstanding Filipino (tofil) Award for Medicine in 1998? "People say I don't have a lazy bone in my body and that I must have two or four thyroids. Sometimes, I think I have a hyperactivity thing, which is ironic since I am in developmental pediatrics," she quips. Very little, if any, of Perla's typical 18-hour day ever goes to seed. For a time, she was juggling six to seven roles in a day as wife, mother, academic and researcher, organization person, private practitioner, and last but not least, university administrator. A self-described day-and-night person, Santos Ocampo starts her working day at seven in the morning and wraps up at around midnight. "I wake up in the morning and I already see how I can accomplish what I want. My brain must already be working during the night," she says. She has almost always managed to be home for dinner, and when her kids were younger, she was around to tuck them to bed-all that after a busy day spent seeing patients (some years ago she saw as many as 80 patients a day); nurturing new medical talents, especially in the field of pediatrics; and later on, charting the course of a premier learning institution as chancellor of UP Manila. The UP Manila-National Institutes of Health was established under her watch to provide a venue for medical graduates to do research. She also founded a number of organizations, most but not all of which had to do with medicine and child care. These include the Philippine Society for Developmental and Behavioral Pediatrics, Philippine Society for Gastroenterology and Nutrition, and the Philippine Association for the Gifted. Into the ocean of human endeavor, she wants to pour in more than the usual drop. It's not enough that each day is lived accomp-lishing more than what two or more people combined could accomplish in a day. She also wants each action to reach as many people as possible. This is why her academic and institution-building activities eventually took precedence over her private practice. "I wanted to influence on a big scale. By providing opportunities to young doctors, I feel I am helping more people that way. More patients can be attended to. It's a multiplier effect," she explains. Grand as these may sound, there is something unabashedly maternal about her desire to help and nurture. "I am most gratified when I see my students successful. Sometimes, I say, I bask in their glory. It is still part of mothering and nurturing. I am now a mother to so many people," she gushes. Now in her late 70s, she is still full of plans. She says: "I wanted to update our local textbooks in pediatrics. Right now, we still rely so much on foreign textbooks. It's important to learn the epidemiology of the Philippines so we will manage diseases in a way that is adapted to the Philippine setting." M
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