Editorial - December 29, 2007 ISSUE

Annual RP Health Missions
For Returning Physicians

by JEREMAIAH M. OPINIANO

FOR over 20 years, surgeon Domingo Alvear eluded the chilly American winter and warmed up in motherland Philippines by joining other doctors for weeks-long medical missions. December to February is the season for these US-originated medical, surgical, or dental missions to the Philippines.
But Alvear’s experience with annual health missions in poor communities in the Philippines is chilling his desires for improved health service delivery. “Since they’re one-shot services, these missions can only do so much,” said Alvear, founding president of the World Surgical Foundation, Inc. The doctors, most of whom are at the tail-end of their medical careers, agreed to transform their usual health missions into sustained community health interventions.
They want: less politics during missions, less stringent regulations governing medical practice and the entry of equipment, and more involvement from Philippine partners.
This wish-list is urgent because “age is getting to me” and other “veterans” in these health missions,” Alvear pointed out. “Take advantage of us when we are still healthy. If not, it’s over,” he told participants of an impromptu summit held at the sidelines of an annual convention of the Philippine College of Surgeons (PCS).

Politics and Tax Ills

SOME politicians like San Isidro, Nueva Ecija mayor Sonia Lorenzo acknowledged the concerns raised by Alvear’s group. Lorenzo admitted some of these health missions have been “politically exploited”, not pointing out her administration.
Former Southern Leyte governor Rosette Lerias cited that some medical mission doctors were forced “to keep their medicines in a hotel because they simply mistrust local politicians”. Lerias didn’t say if that occurred during her time as governor.
Other doctors complained of red tape in processing the entry of medical equipment they’re bringing in. Others experienced the same when processing their licenses for mission doctors to practice their professions during these visits.
Dr. Juan Montero, a 2003 awardee of the American College of Surgeons for volunteering, complained about taxing the recipient of donations. Taxing recipients of donations is a burden since the US government already taxes donors of these medical equipment, Montero said.
Worse, he said, district hospitals receiving these donations “see their budgets deducted to represent donees’ taxes for the donations received”.
Dr. Esperanza Lahoy is more concerned with post-operative care.
She is the PCS’s program (officer) on Surgery for the Underserved Regions for Education. According to her, no one is monitoring the progress of beneficiaries’ intake of medicines.
Pennsylvania, United States-based Alvear said, these are things that dampen the interest of doctors doing more health missions to the Philippines.

Cure Beyond One–Shot Deal

MEDICAL volunteer groups in the United States are weary of confronting these issues surrounding health missions to the Philippines.
One of these groups, the Daly City, California-headquartered Community Care Missions, took matters unto their hands and adopted the Rizal Medical Center in Pasig City in 2004.
The agreement cited the CMC would provide equipment as well as training hospital specialists while Rizal Medical Center would accommodate health missions from various groups.
CMC’s initiative was based on a 2002 study by doctors at the University of the Philippines College of Medicine on the conduct of health missions by local and foreign groups.
The study noted that some doctors, like those from the National Institute of Health, rated the conduct of these “temporary health care services” as highly effective.
However, they didn’t cite how effective these services are in the barangays where the missions were held.
“This may be due to the missions’ ‘inability to address the full spectrum of health care, or the total needs of their clients,’” wrote the study team led by Dr. Juan Pablo Nañagas.
Data from the Lingkod sa Kapwa Pilipino (LinKaPil) program of the state-run Commission on Filipinos Overseas showed that some P1.43 billion worth of cash and in-kind donations received from donors abroad went to health services.
LinKaPil also facilitated the conduct annually of some 40 to 50 health missions such as cataract extractions and cleft lip operations.
The missions were done in Central Luzon, Southern Tagalog, the National Capital Region, Bicol, and in Western, Central and Eastern Visayas. These are areas perceived by mission organizers to be “safe” and “attractive” for its members.
As for other areas of rural Philippines, their near-absence from being served by these missions is “lopsided,” said PCS’s new president Armand Crisostomo.
According to Crisostomo, PCS will convene a working group to operationalize recommendations put forward by participants of the recent surgical mission summit, held December 5.
“We must begin to craft an understanding to upgrade health services delivery in the Philippines,” said Dr. Jose Yamamoto, another surgeon who heads the Gawad Kalusugan Foundation, Inc.
Ofelia Maristela, a pediatrician who’s also with CCM said, “it is painful to introduce reforms in health missions by Filipinos abroad, doing so could be a cure,” however.
“But we need to go beyond one-shot deals,” she said. /MP