Medical Mission Committee Report

UNIVERSITY OF THE PHILIPPINES MEDICAL ALUMNI SOCIETY IN AMERICA Board of Governors Spring Meeting Hyatt Regency Downtown Hotel Indianapolis, Indiana Saturday, April 22, 2017

MEDICAL MISSION COMMITTEE REPORT

Table of Contents: A) Vigan Medical Mission B) Vigan Mission Financial report C) Mati, Davao Oriental D) Donation of portable ultrasound systems E) Donation of an anesthesia machine

Attachments: List of UPMASA and Pahinungod volunteers

A. Vigan medical mission: Last Feb 5-10, 2017 UPMASA and Ugnayan ng Pahinungod conducted a medical-surgical mission in Vigan in Ilocos Sur. UPMASA was led by Frances Velcek, MD while Ugnayan ng Pahinungod by Eric Talens, MD. Valentin Dolorico, MD helped organize and raise funds for the mission. He also visited Vigan in January to survey the site and met with the LGU officials. The Ilocos Sur LGU under Gov. Ryan Singson, Ladies for Ryan under Mrs. Patch Singson and Drs. Trina Tabboga-Talaga and Camelot Agdeppa were the local partners in the mission. Glenn Batiller, MD of UPMASA and Jovel Dacumos of Pahinungod were the logistics coordinators of the mission.

There were a total of 68 UPMASA volunteers: 1. 8 Surgeons: 4 major/minor GS; 1 Pediatric; 1 Plastic; 1 Orthopedics; 1 US surgical resident 2. 2 OB-GYN 3. 6 Anesthesiologists (including 1 US anesthesia resident) Note that this was the first time that the American Board of Anesthesiology had approved a one-week rotation in the Philippines of a resident (Dr. J. Rackley) under the supervision of Dr. Dennis Dimaculangan, Director of Regional Anesthesia in SUNY-Downstate Medical Center. According to Dr. Dimaculangan, he will be requesting the ABA again to approve the same for next year’s mission. Another volunteer was Mohammed Zalzala, MD of Kings County Hospital Center in Brooklyn, NY. 4. 14 Medicine: 4 Family Medicine; 7 Internal Medicine; 2 General; 2 Neurology; 1 Endocrinology; 1 Infectious Disease; 1 Nephrology; 1 Radiology; 1 Pathology; 1 Cosmetic 5. 9 Pediatricians: 6 General; 1 Allergy; 1 Cardiology; 1 Genetics 6. 1 Acupuncture/Oriental Medicine – Jennifer Velcek provided acupuncture and oriental medicine to the patients and the staff. 7. 17 RNs: 5 General; 1 OR; 3 Minor Surgery; 3 PACU; 2 ICU; 2 Pharmacy; 1 Pediatric 8. 11 DT/DT: Two were 1) Stephanie Funk, daughter of Lisa Peñas, MD of Chicago, IL and a recent college graduate and; 2) Radi Sauro, a Dartmouth College student also of Filipino heritage, who both were visiting the Ilocos for the first time. Both were tasked to be the official photographers during the mission.

While Pahinungod sent 23 volunteers: 1 Surgeon; 6 Surgical residents; 2 OB-GYN residents; 2 Anesthesia residents; 7 OR nurses; 3 Dentists; and 2 Coordinators.

The Gabriela Silang Provincial Hospital was the site for the entire major and most of the minor surgeries, which were done at the new OPD building. There was one day (Feb 7) when a team from minor surgery joined the medical team to Narvacan.

2017 MEDICAAL MISSION COMM REPORT/pgo Page 1 The medical team conducted the clinics in a different site each day upon the governor’s request. Mon Feb 6: GSPH grounds Tues Feb 7: Cabugao and Sto Domingo; Narvacan Wed Feb 8: Cervantes Thurs Feb 9: Narvacan

Note that on Feb 7 the medical team split up into 2 teams because of a scheduling conflict between the LGU schedule and a previous commitment to Narvacan.

Surgical statistics: 1. Minor surgeries:113 (107 “lumps and bumps” and 6 cleft lips) 2. Major surgeries:45 a. 9 Gynecology (4 TAH, 2 ovarian cystectomies, 2 myomectomies and 1 labial cystectomy). b. 34 General and Pediatric (9 cholecystectomies, 7 thyroidectomies, 8 herniorraphies, 1 modified radical mastectomy, 3 hemorrhoidectomies, 2 anal fistulectomies, 1 submandibular mass excision, 1 cis-trunk procedure, 1 G-tube insertion and 1 lipoma excision) c. 2 Orthopedics and Pediatrics (1 ORIF of L forearm fracture and 1 correction of bilateral clinodactyly)

Note that Anesthesia performed 2 regional anesthesia blocks under ultrasound: 1 interscalene nerve block for the ORIF; 1 pectoral block for post-op analgesia for the mastectomy

Medical statistics: Total patients: 2340 Medicine 1576 Pediatrics 609 Dental 141 Ophthalmology 14

Total eyeglasses distributed: 639 Note that in Narvacan on Feb 7, a local had donated eyeglasses and a number of patients received them without prior consultation.

Breakdown by town and date: Feb 6 Vigan total - 315 (242 Medicine, 63 Pediatrics and 10 Dental) / 145 eyeglasses Feb 7 Cabugao total – 267 (115 Medicine, 106 Pediatrics and 46 Dental) / 72 eyeglasses Feb 7 Sto Domingo total – 477 (352 Medicine, 110 Pediatrics and 15 Dental) / 101eyeglasses Feb 7 Narvacan total – 630 (452 Medicine, 169 Pediatrics and 9 Dental) / 151eyeglasses Feb 8 Cervantes total – 313 (209 Medicine, 84 Pediatrics and 20 Dental) / 12 eyeglasses Feb 9 Narvacan total – 338 (206 Medicine, 77 Pediatrics, 41 Dental and 14 Ophthalmology)/158 eyeglasses

Note that the low number of reported dental cases was due to the fact that local volunteer dentists saw all the patients Note a local ophthalmologist joined the mission in Narvacan on Feb 9. Note also there may be a discrepancy between our numbers based on the collected charts and those reported by Dr. Trina Talaga, which were based on patient registration.

B. Vigan mission financial report:

In summary: Total medical mission funds prior to Vigan mission $33,143.19 1) National Treasury Funds $24,803.43 2) PNB account: $ 3,004.17 (150,208.47 PHP) 3) Pahinungod funds: $ 5,335.59 (266,779.41 PHP) Total donations for Vigan mission: $25,610.00 Total Vigan mission expenses: $18,648.88 Total post-medical mission funds as of March 2, 2017: $39,346.69 1) National Treasury Funds: $27,241.52

2017 MEDICAAL MISSION COMM REPORT/pgo Page 2 2) PNB account: $ 8,284.35 (414,217.29 PHP) 3) Pahinungod Funds: $ 3,820.82 (191,040.81 PHP) Note: conversion at 50 PHP/1USD

2017 MEDICAAL MISSION COMM REPORT/pgo Page 3 C. 2018 Medical mission: Mati, Davao Oriental

Governor Nelson Dayanghirang has invited UPMASA-Pahinungod to hold the medical-surgical mission in his province in 2018. Tentative dates are Jan. 28-Feb. 2, 2018.

General information: Davao Oriental, the easternmost province in the Philippines, is part of Davao region in Mindanao and has a population of 558,958 of mostly Visayan migrants as of 2015. The rest are ethnic groups such as the Mandayas, Mansakas, Manobos and Kalagans.

It has 1 city, 11 municipalities and 183 barangays. The city of Mati, the capital of the province, is about 151 kilometers from Davao International Airport or a 3-4 hour drive on well-paved highway along the coast of Davao Gulf.

The economy is mostly agricultural, the province being a producer of copra, corn, abaca, banana, rice and fruits. Fishing and mining are other sources of income. Recently tourism has increased following a push by the LGU to develop the natural attractions such as white sand beaches (like Dahican beach), waterfalls (like Aliwagwag falls), bonsai forest (Mt. Hamiguitan) and the Subangan museum.

It is one of the poorer provinces with access to health being inadequate and lacking.

Concerning medical missions, most have been conducted by local groups with funding from foreign donors such as the Kiwanis International in 2010. For the past 2-3 years a mission group from CA has conducted 2 surgical missions for OB-GYN patients in Mati, the latest in January 2017.

Hospital: The province has 1 provincial and 5 district hospitals.

The new DOPH was completed in 2012 and is located along the national highway close to the center of Mati. It has a 200-bed capacity with an MICU, SICU, PICU, OB special care unit and recently a dialysis center.

There are 4 ORs, of which 2 are in use. The other 2 are outfitted with OR lights but no OR table, anesthesia machine or AC. On the OB floor there is another OR for gynecology cases. Also within the OR complex are the PACU and another large room that can be converted for minor surgeries. The surgical floor and SICU are located on the same floor as the OR. Surgeries currently being performed are GS, gynecology and orthopedic cases.

Another wing is under construction to add more patient beds. There is an OPD building beside the main hospital. The grounds are large enough to conduct a medical clinic.

2017 MEDICAAL MISSION COMM REPORT/pgo Page 4 There is also a GSP court close to the hospital, which can be converted either into a clinic or a temporary surgical ward, according to Dr. Catbagan, the MHO.

Lodging facilities: There are many small hotels and resorts within the city of Mati, two of which are close to the hospital and large enough to accommodate the volunteers. Most resorts are within 15-minutes drive from the town center.

Other partners: Two local mission groups will join the mission. One, the Halad Mission Group will work with the surgical team. Dr. Rollie Lobo, a native of Mati who trained in surgery at PGH and volunteered with Pahinungod during his residency, is the head of the foundation and will be bringing a team from Southern Philippines Medical Center (SPMC) in Davao City. SPMC is willing to lend the mission some surgical and anesthesia equipment. Two, the Social Concern Foundation under Max Libre MD will provide free cataract surgeries.

A local dental team will also join the mission to provide preventive care aside from the usual extractions.

Referrals: We will be referring patients seen during the mission to SPMC in Davao City for tertiary care instead of PGH.

D. Donation of portable ultrasound machines

“Mobisalus (dealer for smartphone and ultrasound systems) donated a total of 24 portable ultrasound systems to UPMASA for distribution to several PGH departments. This was made possible by Ms. Jo Pelaez, the daughter-in-law of Eileen Morales, MD ’68, who works in Mobisalus”. Dr. Dolorico suggested that UPMASA issue a certificate of appreciation to Ms. Jo Pelaez in recognition of the donation, the value of which was estimated at $100,000.00.

Last January 24, Dr. Val Dolorico handed the ultrasound machines to Dr. Gap Legaspi, director of PGH. Ugnayan ng Pahinungod received 2 of the machines.

E. Donation of an anesthesia machine Six members of Class ’80 donated a total of $7,800 to replace another anesthesia machine which could no longer be used during the missions. The amount was enough to buy a machine and a capnograph from DreMed. This will bring the total of new anesthesia machines to three. Plus UPMASA has agreed to purchase a fourth machine.

The six members are: Glenn Batiller, Horner Chen, Lisa Peñas, Albert San Juan, Epison Tan and Benedict Tanbonliong.

Submitted by: Glenn Batiller, MD UPMASA Logistics Coordinator

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