Operation Smile traces RP roots
The plight of hundreds of children born with cleft lips or palates in Naga City inspired the founding of Operation Smile 25 years ago after Dr. Bill McGee and his nurse wife Kathy had joined a group of American doctors on a medical mission to the Philippines in 1981 to perform reconstructive surgery on those suffering from the condition. Realizing the magnitude of the problem in the country, where the incidence of inborn cleft lip or palate was one in every 500 births, Bill and Kathy McGee were moved to return every year thereafter to extend help to other Filipino children with these facial deformities. This gave birth to Operation Smile International based in their home in Norfolk, Virginia. Organizing volunteer doctors and other health-care professionals, soliciting donations of surgical equipment and supplies, and raising funds to finance these yearly medical missions, Operation Smile operates in 25 countries around the world. The global foundation seeks to address the problem of orofacial clefts prevalent in Asia, Africa, South America, Eastern Europe, and the Middle East. Since its founding, Operation Smile volunteers have treated more than 100,000 children worldwide, including about 20,000 Filipinos, putting the smile back on their faces and changing lives dramatically for the better. The benefits of reconstructive surgery for cleft patients are not merely cosmetic. Aside from medical problems associated with the condition, including chronic ear infections, malnutrition, dental problems, and speech impairment, the emotional effects in terms of shattered self-esteem and social acceptance may be even more devastating to a child. Operation Smile is committed to substantially increase the number of children benefited by its medical missions and raise public awareness and donations to continue its advocacy around the world. To commemorate its 25 years of existence, Operation Smile is mounting The World Journey of Smiles from November 8 to 16, with the objective of treating an estimated 5,000 children during 40 medical missions spread across 25 countries all over the world. To kick off the celebration, Bill and Kathy McGee will return to the Philippines and lead a medical mission in Naga City, Operation Smile's birthplace. The couple will unveil a commemorative marker in the hospital where the Operation Smile vision to Change lives one smile at a time as embodied in its foundation motto, all started. M
In a culture where most families are still squeamish about talks of dying as it immediately relates to one of their own, a national hospice-care network aims to further bring down this cultural barrier and enlist more grassroots help by tapping barangay health workers (BHWs) as hospice-care givers in their communities. "For Filipinos, taking care of the sick member of the family is a respected creed," said Atty. Asuncion Kalalo, president of Hospice Philippines, a network of groups and individuals in hospice care. "However, the care extended to a terminally ill family member is characterized with secrecy. Family members continue to feed hope to the patient … or the patient may know he is dying but so as not to alarm the family, he refrains from discussing the matter. In this setting, the family and patient are usually unprepared for death "At the Seventh Asia Pacific Hospice Conference held in Manila, Kalalo disclosed that the network to plans to train BHWs as part of a multi-disciplinary team in hospice care, a relatively new concept in local health care introduced only in 1994. "The barangay is the smallest and prime unit of government in the country and a very promising growth area for hospice care in the country. BHWs could be the eyes, ears, and hands by which services can be made available," she noted, citing the urgency of coming up with a training program and setting aside funds for this initiative. Hospice-care providers in the country have been embarking on a community-based mode of service by doing regular home visits, a practice that also seeks to lower cultural resistance to professional care for the dying. Kalalo noted: "The growth of hospice and palliative institutions saw the acceptance of homecare for hospice patients. Under the direction of the hospice care medical team and volunteers, family members are empowered to take care of the sick in their homes." She said that with the rising incidence of cancer and other lifethreatening diseases such as HIV/AIDS, Hospice Philippines also seeks to serve more indigent patients and their families. Recent activities along this line include visits by volunteers among slum dwellers living along the national railroad tracks. The network, founded in 2003 under the auspices of the Philippine Cancer Society, serves as a focal point for organizing the delivery of services on a national scale. It now counts 24 hospice-care units and more than 500 individual care providers under its umbrella. The network facilitates cross referrals of patients to institutions catering to distinct segments such as children with cancer, persons with HIV/AIDS and rabies, and offering special services such as halfway house care and quality of life support activities (e.g. music and art sessions, spiritual formation, beauty regimens, microfinance). Its existence has partly resolved the availability issue of morphine, a drug restricted by the national Dangerous Drugs Board, among terminally ill patients in need of pain relief. The Department of Health has authorized it to distribute the painkiller through its members, especially for indigents. The government has also declared the first week of October as National Hospice and Palliative Care Week. But Kalalo admitted that funding remains a perennial issue. Financial assistance for hospice care usually comes only from the church and philanthropic individuals and is almost never enough. And although hospices employ volunteers-a task that poses its own challenge in terms of recruitment-salaries for doctors, nurses, and other workers who regularly staff the facilities are a constant requirement. Hospice Philippines proposes to help address this by having palliative care as part of the Philippine Health Insurance Corporation's package. M Grace Roxas
Often, when cancer is diagnosed, the next thing that a patient or his family expects to hear is how many months or years will the patient live. The Philippine Society of Medical Oncologists (PSMO), being an advocate of multidisciplinary care for the treatment of cancer wants to correct this notion. After years of hard work and research, medical oncology has been consistently growing, providing hope for cancer patients. Such new trends in the field of cancer were discussed in the 21st annual PSMO convention in October at the EDSA Shangri-la. "The incidence of cancer in the Philippines is growing," said Dr. Gerardo Cornelio, PSMO president. Philippine Cancer Facts and Estimates (2005) reveals that the lung is the top site of cancer in the Philippines. This is followed by breast, colon, and rectal cancers, and liver cancer. If one looks at the magnitude of the problem by sex, among males, the lung, liver, colon, prostate, are the leading sites; in females, the breast, cervix, lung, colon, and rectum, and ovary are the most common. The current treatment for cancer, which should be a multidisciplinary-team approach, could offer patients and their families a wide range of effective treatment strategies. This approach was highlighted by the convention theme, Power of Two, which represents the integration of chemotherapy and biologic agents. "There is now a paradigm shift in the treatment of cancer," said Dr. Ma. Noemi Alsay-Uy, PSMO vice president. "We don't talk only about chemotherapy but there are drugs that have targeted against molecular changes." Hormonal therapy for certain types of cancer, as well as complementary therapy may also be beneficial. Each of these modes of treatment has its benefits and side effects. According to experts, it is a matter of balancing the benefits and side effects. As far the effectiveness of current treatment is concerned, Cornelio said that "the best chance for the cure for any of the cancer types that we see would be early detection." That is the only way to get them at an early stage and possibly cure them, he said. Thus, to be able to beat this enemy, increasing awareness of patients and doctors is one of their priorities. With the increasing use of supplements which have not yet undergone evidence based studies, but offers therapeutic benefits for patients, creating awareness would also help educate and empower patients in making the right decisions as far as treatment is concerned. M Mabelle Aban
One out of every three Filipino women, as well as one in five Pinoy men, is likely to suffer from osteoporosis. These are higher than the number of people succumbing to cancer of the breast or prostate-and should be given the attention they deserve. Speaking at the ninth scientific meeting of the Osteoporosis Society of the Philippines Foundation (OSPF), Dr. Julie Li-Yu, OSPF treasurer, discussed the current osteoporosis scenario in the country-and what is likely to befall Filipinos and their bones in the next few decades. In the Philippines, institutional data show that the leading osteoporosis-related fractures are hip fractures, since they are easily recognized due to associated pain and minimal trauma, unlike the vertebral or spine fractures, which usually go unrecognized. The National Nutrition and Health Survey (NNHeS, 2003) revealed that fracture incidence among patients 50 years and above is 11.23 percent in women and 8.97 percent in men. Overall prevalence in the 50-and-above group is 0.2 percent. The study used the Osteoporosis Assessment Tool for Asians (OSTA), a fairly sensitive screening tool for osteoporosis. The NNHeS also revealed that the rates go higher as the respondents go older. In the 60-to-69 age group, 26 percent for women and 11.4 percent for men were considered high risk for osteoporosis; in the 70-and-above group, a whopping 79.1 percent of females and 62.2 percent of females are considered high risk. Added: Li-Yu: "Using the high risk category as our best estimate for osteoporosis, the projected number of at high risk for osteoporosis in 2020 and 2050 is four million and 10.2 [million] respectively." The statistics are as overwhelming as the health-care costs they bring. "Direct costs of hospitalization among patients who sustained hip fracture was estimated to be PhP92,000 in a government facility and PhP300,000 in a privately owned health facility, " said Li-Yu, citing a study by Bonifacio (2004). The same study revealed that given the same prevalence (160/10,000), the projected direct costs of hospitalization in the same group would amount to PhP3.2 billion in 2020 and PhP8.55 billion in 2050. The OSPF, in collaboration with the Philippine Health Insurance Corporation, looked into the reimbursements for osteoporosis-related fractures to estimate the costs of direct hospitalization and professional fees, and indirect costs like those of orthoses. It found that a hip implant costs PhP46,000 on the average and rehabilitation costs about PhP1,500 per session. M Mabelle Aban |
