MARCH 2015
NEWSLETTER
Rhode
Island-based Humanitarian Group Returns from 2015 Philippines Medical
Mission
The Rhode Island-based
humanitarian group “Lingkod Timog” that translates to “Serving the poor in
the Southern Philippines” recently returned from its 11th annual medical
mission in the Philippines from February 20 to 25. The group provided
medical, surgical and dental care to tribal communities in southern Palawan
Island.
Nurse and Executive Director
Irene Covarrubias Sabban coordinated the volunteer doctors, dentists and
nurses as well as security and support personnel. The mission team included
US, Canada, Europe and Philippine-based volunteers, local private and public
doctors and Philippine military doctors, nurses and dentists.
The Southern Palawan barangays
or villages of Ocayan, Rio Tuba in Batarasa and Culasian in Rizal, are home
to a mix of indigenous people including Tagbanuas, Tao’t Bato (cave
dwellers) and Muslims. Those seeking treatment walked for miles to reach
the announced mission sites, or to the pickup points where trucks were
waiting to transport them. After screening, more than 1,400 patients were
attended to by the volunteers. Most of the reported medical ailments were
upper respiratory tract infections, urinary tract problems, skin ailments,
and elevated blood pressure, blood sugar and eye problems. Care included
multiple teeth extractions for each dental patient seen.
The group president Cecilia
Heredia praises its partners in the mission. Johnson Ng Tan joined the
mission with his son and their Tan Lin & Ng Oh Tee Foundation of Manila
donated half of the medicine. The Western Command of the Armed Forces of
the Philippines gave its full support for the mission and its doctors,
dentists and nurses helped provide medical care. The Philippine Navy’s
Naval Forces West and the 3rd Philippine Marines Brigade ensured security
and transported medicine and supplies. Local government units coordinated
the movement of patients and provided the treatment areas.
The treatment sites were more
than five hours away by land transportation from Puerto Princesa, the
capital city of Palawan Island. As had happened in past missions, the
organizers had to turn down volunteer doctors, dentists and nurses because
of limited transportation. Other volunteers from Newport and Fall River
were not able to join the mission because of the past winter’s blizzards.
Dr Andrew Wilner of Newport,
Rhode Island, is the group’s medical director. An eight-time volunteer,
neurologist, and medical author, Dr. Wilner combines the medical mission
with his writing, diving and passion for underwater photography. He is also
in demand as a lecturer in Manila’s many medical schools. Dr. Tiago
Villanueva Marques, whose mother is from the Philippines, is a repeat
volunteer to the medical mission. He is a family physician from Lisbon,
Portugal, and is London-based as an Assistant Editor of the British Medical
Journal.
Marc, a nurse came from the
Middle East to join his wife and veteran Ces Sabban-Marfil, also a nurse.
Villa Halo coordinated the pharmacy and other yearly volunteers included Mon
Covarrubias, Bing Diones and Irene Pallir. Second-year volunteers Cleo and
nurse Vivian Erfe came from Virginia with nurses Helen Gaitana of Canada and
Rose Perico of Virginia who have joined medical missions organized by other
groups in the past. Additional medicine and supplies came from Lingkod
Timog funds and private donors, who responded to last-minute appeals, such
as surgical supplies from Dr. Maria Petrillo-Bolanos of Portsmouth, Bent and
Myrna Blondal of Newport, and Myra Taghap Deus of Portsmouth and Ireland.
Through Fr. John O’Brien, St. Lucy’s Church in Middletown provided the venue
for fundraising.
This joint
Lingkod Timog and the Philippine military medical mission started when
retired Lieutenant General Juancho Sabban was with his family and studying
in Newport’s U.S. Naval War College in 2003, and Retired Philippine Navy
Captain Armando Heredia and wife, Cecilia were their local sponsors.
Cecilia Heredia formed the group and Irene Covarrubias-Sabban coordinates
the activities. General Sabban, who had been Commandant of the Philippine
Marines and Commander, Western Command, and Captain Heredia are active
advisers. All missions involve private and government agencies, military
and police, and municipal and tribal health care providers. The tribal
people see not just the foreign and Manila-based volunteers, but their own
community leaders and neighbors helping them. Lingkod Timog’s missions have
helped more than 20,000 Badjaos and Samals in Zamboanga, Basilan and Sulu;
Lumads in Davao; Tagbanuas and Tao’t Bato in Palawan, and Aetas in Luzon.
Cecilia is the music teacher at
St Philomena School in Portsmouth, Rhode Island, and a Companion in Mission
of the Faithful Companions of Jesus (FCJ). St Philomena School also raises
funds through Broadway musicals for the Development Center projects of the
Sisters FCJ in Manila for indigent women, and for the victims of calamities.
For more
information, to join or to donate, visit www.medmission.info or
www.lingkodtimog.com or find us on our public page on Facebook.
-----------------------
A Neurologist
on a Medical Mission
March 09,
2015
By
Andrew Wilner, MD
·
For the
past 8 years, I have participated in annual medical missions to rural areas
of the Philippines with Lingkod Timog, a nonprofit group composed primarily
of Filipino Americans. Lingkod Timog’s mission is to conduct “charitable,
educational, cultural, medical, and life enrichment activities to needy
areas in the Philippines.” Our group treated approximately 800 patients a
day, which is typical for our makeshift clinics. I personally saw about 100
patients a day, along with my translator/assistant. In this part of the
world, health expectations and standards of safety are clearly different
from what most of us are used to.
·
A
72-year-old man related that he had been taking antibiotics for 6 months
because of a “spot on his lung.” The most likely diagnosis was tuberculosis.
His lungs still sounded terrible and he was referred back to the government
clinic for consideration of another course of antibiotics.
·
Necessity
can be the mother of invention. This man employed a bicycle pump to
aerosolize ampules of salbutamol for his asthma.
·
According
to the parents, this 8-month-old infant was diagnosed with hydrocephalus at
birth and told to wait a few months before having surgery. To date, nothing
had been done. It was unclear whether this was because of lack of funds or
whether the due date for the next doctor visit was still pending.
Development had been grossly normal. The child’s hypertelorism and facial
deformity suggested a midline developmental defect as opposed to pure
uncomplicated hydrocephalus, but without neuroimaging it was just a guess.
The parents were encouraged to follow up at a regional hospital.
·
This
elderly woman had experienced sudden speech loss with complete mutism
without any other apparent neurologic deficit. I asked her to stretch out
her arms and elicited some drift on the right, suggesting that she may have
had a stroke in Broca’s area in the left frontal lobe. In my neurologic
practice in the US, she would have received an ECG, brain MRI, and carotid
ultrasound at a minimum. If the lesion was ischemic rather than hemorrhagic,
she would receive antiplatelet therapy. In this case, without any
technology, I was at a total loss and referred her to the local hospital.
·
This man
works in the rice fields all day without shoes. Unfortunately, we did not
have any skin creams this year and were unable to treat patients with severe
skin ailments.
·
With the
help of military physicians and local health workers, we were able to
provide medical, dental, and surgical services, as well as haircuts and
circumcisions. Here, we are preparing a blood smear for malaria testing.
·
8 people
on one motorcycle . . . clearly unsafe transportation—and no helmets.
·
Since
2004, Lingkod Timog has performed annual medical missions with the
assistance of the Philippine Armed Forces in diverse areas of the
Philippines. Here, the Armed Forces help unload medical supplies.
·
Lingkod
Timog volunteers at Culasian, Rizal, Palawan.
For the past 8 years, I have participated in annual
medical missions to rural areas of the Philippines with
Lingkod Timog,
a nonprofit group composed primarily of Filipino Americans. Lingkod Timog,
translated as “Service to the South,” is composed of volunteers with no paid
administrative overhead. This structure allows us to dedicate all
fund-raising toward the purchase of medicines to distribute during medical
missions. Lingkod Timog’s mission is to conduct “charitable, educational,
cultural, medical, and life enrichment activities to needy areas in the
Philippines. We strive to alleviate poverty while strengthening relations
between the Philippines and the United States.” Volunteers come from the US,
Philippines, Portugal, and Sweden.
History of Lingkod Timog
Lingkod Timog was created in 2004 by Irene Sabban and
Cecilia Heredia, both wives of Filipino military officers who wanted to help
tribal people in the Philippines. Since then, the group has performed annual
medical missions with the assistance of the Philippine Armed Forces in
diverse areas of the Philippines, including rural areas of Mindanao Island
(Basilan, Davao, Zamboanga) and several locations on Palawan Island (Bataraza,
Coron, Rizal). In these regions, health expectations and standards of safety
are clearly different from what most of us are used to. Our missions are
scheduled months in advance in cooperation with local governments and not in
response to natural or man-made disasters. I have written about our missions
here,
here,
and
here.
Mission 2015
This year, our group of 22 members flew from Manila to
Puerto Princessa, the capital of the island province of
Palawan.
We then drove by convoy to the southernmost region of the island, stopping
at a Marine base along the way. We visited this same region in
2012.
Last time, the drive took more than 6 hours and was punctuated by a minor
traffic accident due to a giant pothole. On this trip, it took only 5 hours,
since more of the narrow road had been paved. Over the next 2 days, we
performed clinics in 2 locations; Barangay Culasian, Rizal, and Barangay
Ocayan, Bataraza. We were joined by military physicians and local health
workers, which enabled us to provide medical, dental, and surgical services,
as well as malaria screening, haircuts, and circumcisions.
Security
Most of our mission locations are far from
“civilization” and unsafe for the casual traveler because of the presence of
rebel groups and virtual absence of police protection. The Philippine Armed
Forces, including Marines, Navy, and Army, provide Lingkod Timog with
logistic support and security. The Philippines has no shortage of
rebel groups,
such as Abu Sayyaf, the New People’s Army (NPA), Moro Islamic Liberation
Front (MILF), and Bangsamoro Islamic Freedom Fighters (BIFF). The presence
of these lawless groups hinders development of infrastructure in these rural
areas, thereby perpetuating poverty and limiting access to social services.
Thanks to our military escort, I have been privileged to visit rural areas
that would be off limits to a tourist because of real threats of
kidnappings. To date, we have never had a security incident, most likely
because of our extensive preparation in cooperation with local authorities
and overwhelming military presence during the missions. Our medical efforts
are performed in concert with the military’s peaceful outreach programs.
Medical Clinic
Our
group treated approximately 800 patients a day, which is typical for our
makeshift clinics. I personally saw about 100 patients a day, along with my
translator/assistant, Irene Pallir. Histories are complicated because many
patients do not speak Tagalog, the national Filipino language, but rather a
regional dialect, in this case, “Native Palawan.” Needless to say, patients
receive an abbreviated history and physical exam. Although I keep my own
notes, there is no formal visit documentation. If the patient has an illness
for which we have a medication, they receive a prescription and are sent to
our “pharmacy,” where they receive free medication and instructions.
Typical prescriptions are antibiotics for urinary tract infections;
antihistamines and decongestants for children’s colds; analgesics for aches,
pains, and headaches; and a month’s worth of antihypertensives for high
blood pressure. Untreated high blood pressure is common, with many patients
relying on herbal medications of unproven value. (I suspect that many early
deaths in this population due to myocardial infarction and disability due to
stroke could be averted if high blood pressure were consistently
controlled.) Unfortunately, we did not have any skin creams this year and
were unable to treat patients with severe skin ailments.
Given the rudimentary nature of our clinic and limited supplies, many
patients receive insufficient diagnostic investigations or treatment. I
often have to balance my frustration regarding the inadequacy of our
services with the rationale that our clinics are better than nothing at all,
often the alternative for these tribal people. When we do identify a problem
that needs further evaluation, patients are referred to local facilities or
the military hospital.
Medical missions with Lingkod Timog provide a glimpse into the health care
needs of tribal peoples in the Philippines. Although there is much that we
cannot deliver during a brief mission, we do provide clinical evaluations,
minor surgical procedures, teeth extraction, malaria screening, and
antibiotics and other treatments. It is my impression that “laying on of
hands” offers encouragement and hope. Eventually, as local infrastructure
improves, our medical missions will no longer be necessary. I hope I live to
see the day.
[Note: My assistant, who speaks fluent Tagalog, does
much of the communication with patients on our missions. Patients are
routinely asked for their permission to use their photographs.]
