Missions Possible

Dr. Agnes Alikpala examines one of the 1,071 pediatric patients (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

Dr. Agnes Alikpala examines one of the 1,071 pediatric patients (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

What started out as a group of Filipino physicians in the San Francisco Bay Area 42 years ago seeking collegial support and camaraderie has grown into one of the most dynamic and largest medical missions to trek the rural areas of the Philippines.

The Philippine Medical Society of Northern California (PMSNC), which assists indigent communities that have little or no access to medical care, just embarked on its 29th yearly medical mission. Its destination: the city of Tagbilaran, Bohol.

PMSNC has been conducting community outreach programs and medical missions to selected rural areas in the Philippines since 1986. It relies mostly on volunteer hours and donations from private individuals, hospitals and pharmaceutical companies.

A core group of physician-members conducts the missions, which has evolved over the years into comprehensive free services comprised of surgeries (general surgery, gynecology, ophthalmology/optometry, plastics), dental, and outpatient clinics.

The 140-member team of doctors, dentists, nurses and staff starts the day with a prayer (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

The 140-member team of doctors, dentists, nurses and staff starts the day with a prayer (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

Volunteers

According to Dr. Maria Araceli DeGuzman, overall coordinator for the Medical Missions who started volunteering as an anesthesiologist about 12 years ago, all the volunteers pay for their own airfares and hotel accommodations.

“Volunteers are physicians, surgeons, dentists, nurses and support personnel, including premed students of Filipino descent who typically are enrolled at the University of California, mostly from Berkeley,” she continued.

DeGuzman also stated that the mission volunteers include about 15-20 percent non-Filipinos, and these are the members’ colleagues or friends in the profession.

“We invite our colleagues in different medical specialties to our mission trips, and indeed a few of our non-Filipino friends have also become regular and dedicated volunteers,” she said.

Some 30 percent of volunteers are doctors and dentists, 30 percent nurses, and the rest are support personnel. Non-clinical volunteers help with work ranging from educational presentations to data analysis, administrative support to packing medical supplies and counting pills for dispensing in a makeshift pharmacy.

The number of volunteers on a given mission averages 150, with a high of 200 and a low of 120. If a community sets a limit, they cap the number of volunteers at that number and will usually give priority to the essential medical professionals such as doctors, nurses, dentists and pharmacists.

Resources

DeGuzman noted that the members are sensitive to the community's resources; the lack thereof is taken into consideration (e.g., the proximity to a hospital that can handle the major surgical procedures, availability of hotels and lodging facilities can be a factor).

Fundraisers in the Bay Area are held to cover the costs of the medications and medical supplies that are provided for target indigent patients. Over the last few years, PMSNC has included health education in its missions, focusing on preventive medicine.

Choosing a Location

How do they determine its target location for each year’s mission? According to DeGuzman, “We usually have two or three communities that write us each year, requesting the PMSNC to conduct a medical mission. Usually it's either the city mayor, provincial governor, a civic group like the Rotary or a high school class alumni group, etc. We base our decisions on the readiness and enthusiasm of the potential host community, but ultimately we decide to go where the need is greatest.”

Why Bohol in 2015? The decision to pick Bohol was mainly influenced by the recent earthquake that devastated the province. The area was recently ravaged by a 7.2 earthquake that destroyed or damaged several homes and buildings including 24 churches. Still reeling from the devastation, the island was one of the areas hard-hit by Typhoon Haiyan before it reached Tacloban, Leyte, which received most of the disaster aid.

With the Bohol death toll in the hundreds and thousands of citizens displaced, the health problems of the victims have barely received needed attention due to the focus on the other islands also hit by Typhoon Haiyan. Boholanos have relied on their own limited resources to help rebuild the lives of those who lost loved ones and properties.

The medical team started preparing for their 10-day mission with a projected estimate of 5,000-9,000 patients as soon as the location was picked. The final report on Bohol by PMSNC indicated they served over 7,600 patients, not including [those reached by] the students and faculty who attended the health education talks led by nutrition, weight control and exercise expert Joseph DeGuzman, Ph.D (who happens to be Dr. DeGuzman’s spouse). This group lectured on the Filipino diet, cessation of smoking, weight control and healthy lifestyle. 

Patients fall in line to register at the cultural center in Tagbilaran, where the Philippine Medical Mission set up its temporary health facility. The mission served 7,666 patients (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

Patients fall in line to register at the cultural center in Tagbilaran, where the Philippine Medical Mission set up its temporary health facility. The mission served 7,666 patients (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

Choosing a President

PMSNC elects a president yearly to run its medical mission and pursue other objectives for the annual term. Members who exhibit good leadership qualities are tapped by a nominating committee, and invariably one or two will agree to run. An election is held every year in November.

The roster of past presidents of the PMSNC reads like a Who’s Who in the Filipino American community of doctors, as many of them have been involved in outreach programs outside of their medical practice, including pioneering the development of media resources, community development and service in philanthropic circles and supporting civic causes. Notables, to name a few, are Dr. Ernesto Hilario, a urologist who produced the first Filipino news broadcast in San Francisco in the 1970s, before The Filipino Channel (TFC) got started, by buying airtime from a struggling public broadcasting station called KQED; Dr. Leonilo Malabed, a family physician, published Filipino-American, one of the first Filipino owned newspapers in California serving the greater Sacramento area in the 1970s; and Dr. Agnes Alikpala, a pediatrician in charge of PMSNC memberships and a familiar name in the Filipino American community, is one of the main players in Philippine International Aid, an organization built to provide funding for the education of needy children.

Soon after the election of its current president, Dr. Peter Bretan, MD, FACS in November 2014, the medical mission was already booked for its next mission to Bohol in January. Bretan, a renal transplant surgeon and urologist, is also the founder and CEO of LifePlant International, a non-profit organization whose medical objective is to provide kidney transplants to the needy. Bretan performed the very first laparoscopic kidney removal in the Philippines in 2004, a year after founding LifePlant. On his term as president Bretan stated, “I am proud to briefly take the helm of this 42-year-old ‘International Lifesaving’ organization.”

Dr. Peter Bretan (left), 2015 President of PMSNC, in operating room. Dr. Bretan, a transplant surgeon and urologist, led this year’s mission and also oversaw the surgical team in Bohol (Source: Life Plant International).

Dr. Peter Bretan (left), 2015 President of PMSNC, in operating room. Dr. Bretan, a transplant surgeon and urologist, led this year’s mission and also oversaw the surgical team in Bohol (Source: Life Plant International).

Mission Itinerary

After all the pre-planning and preparation, including preliminary visits to the Philippines to meet with the local government and organizations in the targeted community, the volunteers prepared for the trip in January.

“The mission trip takes about 10 days, including travel time to the Philippines,” according to DeGuzman. “We leave on a Thursday so that we are at our mission site by Saturday, to unwind and unpack. The hard work actually starts on Sunday -- unpacking, repacking, sterilizing, organizing our outpatient ‘pharmacy,’ exam rooms, setting up assigned work areas in the O.R., and so forth.”

The first surgical cut is done on Monday morning, but the surgeons and anesthesiologists actually start doing the final screening of pre-surgical patients that same Sunday, a day after arrival. The outpatients start lining up on Monday morning, and except for a brief lunch break, patients are seen by doctors nonstop from 8:30 a.m. to 5:00 p.m.

Two hundred sixty nine patients had surgeries (190 general procedures, 66 major, 124 minor and 79 ophthalmology surgeries) (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

Two hundred sixty nine patients had surgeries (190 general procedures, 66 major, 124 minor and 79 ophthalmology surgeries) (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

“As the coordinator for the mission, however, I would have made at least two trips to the locality before I leave again for the actual mission week,” DeGuzman explained. “We ship supplies in ‘balikbayan boxes’ a few months in advance. These boxes are the fruit of people collecting surplus materials from their places of work, then packed by volunteers themselves. It is a serious commitment of time, effort and resources.”

Supplies for the medical mission partly come from donations through third party charitable institutions like AmeriCares. The organization also purchases hospital and pharmaceutical surplus supplies at minimum cost from MedShare, which collects supplies specifically for medical missions and disaster aid to third world countries.

“I must have made at least three trips last year to the MedShare warehouse in San Leandro to fill my van with whatever I could get my hands on -- gloves, surgical drapes, airway equipment, hypodermic needles and syringes, etc.” recalled DeGuzman. “However, these are never enough, and we end up purchasing a lot more of the supplies, but most especially medicines. Thus, the need for fundraising. I have tried writing to companies for grants but sadly most of these companies do not support medical missions. Our main sponsor in Bohol was the provincial government and partly, the city government of Tagbilaran.”

Waiting room for hundreds of patients (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

Waiting room for hundreds of patients (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

Occasional Snags

Apart from the challenge of finding enough resources to cover the cost of medical supplies, the mission occasionally encounters other snags. Some incidents have challenged the group's ability to do the work. DeGuzman related, “There are, occasionally, local specialty groups of doctors in the Philippines who have established their own set of rules about which doctors can do surgery in their ‘turf.’ This can be a double-edged sword, because while they seem to set standards of competence for missionary doctors, this also discourages some doctors from volunteering. So yes, we've encountered some form of resistance from local doctors, but this is the exception rather than the rule.”

The Future

The physicians who serve in the medical group are all driven by the calling to help those in need. Dr. Bretan’s many contributions to the community deeply reflect this calling as expressed in his philosophy, “In life, there are no careers that yield greater rewards than those that help comfort the weary, heal the sick and save lives.”

On his hopes for the future of the medical missions: “We are in great shape as there as so many talented American-born Filipinos coming up from one of the most prestigious and tough academic premed institutions in the world, UC Berkeley, who will ultimately take my place in medical society leadership, not just here locally, but nationally.”

As for his vision for PMSNC, “It is my goal that PMSNC, as the largest medical mission organization to the Philippines, will be able to extend our brand as ‘International Lifesavers’ globally, working closely with the California Medical Association and American Medical Association. I intend to continue to serve and lead those organizations for our profession of medicine to expand access of care for those in need to save lives everywhere.”

A very cooperative pediatric patient gets examined by a pediatrician (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

A very cooperative pediatric patient gets examined by a pediatrician (Photos used with permission by the Philippine Medical Society of Northern California (PMSNC)).

(Next year’s mission: If Laoag City, Ilocos Norte feels like a destination for you, get your passports ready. PMSNC is now accepting applications for volunteers – the 2016 Medical Mission is scheduled for January 18-22, 2016. To volunteer or for more information, check the PMSNC website at http://www.pmsnc.com.)


A recent update posted on the PMSNC website: Bohol 2015

About 140 volunteers joined the 2015 mission to Tagbilaran, Bohol. In 2013, the province was devastated by a magnitude 7.2 earthquake which was then followed by the deadliest Philippine typhoon ever recorded in modern history, which killed at least 6,300 people. Seven thousand six hundred and sixty six patients were served. Two hundred sixty nine patients had surgeries (190 general procedures, 66 major, 124 minor and 79 ophthalmology surgeries). The outpatient service took care of 7,397 patients with 2,815 adult, 1,071 pediatric, 1,782 dental and 1,303 optometry patients; 257 lab tests were performed and 169 received health education.


Manzel Delacruz

Manzel Delacruz

Manzel Delacruz is a freelance writer living in San Francisco.


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