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Mendero Medical Center: Finally, a tertiary hospital to serve Cebu's northern towns

Consolacion and North Cebu will soon welcome a general hospital within their reach.

The 2nd Globe Cebu media Excellence Awards

Yours truly was a finalist of the 2nd Globe Cebu media Excellence Awards.

Two from a Cebu medical school top the boards, 100 percent passing for said medical school

Two students from the same medical schoolin Cebu topped the medical board exams.

Tuesday, April 12, 2016

The Filipino Heart

By: Keith Andrew Chan, MD

The national elections are fast approaching, and a quick glance at my newsfeed tells me that the in this age of freely available, albeit sometimes dubious information, the average netizen has been transformed from being a personality buried in the masses subject to the receiving end of engineered political propaganda into a well informed, grounded and highly vocal individual not afraid to seek out and defend the truth. Knowledge, therefore, is power – and in the words of Spidey’s late uncle Ben: “With great power comes great responsibility”.
As a doctor, I’ve seen my share of both triumphs and failures in the country’s national health system.  Now, without wanting to sound like a political ad, I’d just like to point out that, yes, our country’s health care has benefitted from several extremely well placed and promulgated policies: the expanded program on immunization (EPI) established in 1976 has curbed numerous childhood illnesses and diseases and continues to do so with ever increasing coverage from urbanized areas to rural health centers,  vitamin supplementation to basic foodstuff and commodities have likewise decreased numerous micronutrient deficiencies in the country, neonatal care in the form of “Unang Yakap” has also significantly lowered childhood mortality and aims to place us in line with the World Health Organization’s standards for proper maternal and child care. All of these and so much more triumphs have – at the heart of each initiative and strategy – one common denominator. That is the grace, strength and resilience that is the Filipino Heart.
What is the Filipino Heart? What keeps us going? What makes us pursue the virtues of charity, unity and nationalism in the face of overwhelming adversity? After spending close to 10 years in the pursuit of knowledge in the field of medicine, one can’t help but notice that we have an innate want and genuine desire to help not just our countrymen, but the desire to help our fellow man. But unfortunately, even a genuine desire to help – in the face of ignorance or the lack of knowledge – equates to nothing more than a bag of good intentions. The Filipino Heart, therefore, needs to be coupled with the spirit to lead, learn and empower.
For the uninitiated, Avelino “Samboy” Lim Jr. was a highly prolific PBA superstar and the recipient of numerous athletic accolades, consistently being chosen to represent in the country in numerous sporting events held globally in the 1980s. One fateful day in November of 2014 – he collapsed after an exhibition game and went into cardiac arrest. Unfortunately, no one present was equipped with the knowledge on the basics of Cardiopulmonary Resuscitation (CPR) and, despite being rushed to the hospital in under 25 minutes, Samboy still remains in a semi-comatose state until today. Doctors and health experts all agree that, had CPR been initiated early, the devastating effects of Samboy’s current state may have been minimized or circumvented altogether. Readers, lawmakers, citizens – it is about time that we empower the Filipino Heart.
In an effort to empower and impart us with knowledge, a new law has been proposed to members of congress in the form of House Bill No. 5891 known as “The CPR Training in Schools Act” or “The Samboy Lim Act” in memory of the PBA superstar. This law will mandate the training of students in both private and public schools in an effort to equip them with skills and knowledge necessary to perform life saving CPR. The Philippine heart association’s statements further add to the utility of this bill – stating that properly performed by-stander CPR has been linked to a greater likelihood for survival and better patient outcome. Passing this law will enable us to empower the Filipino people in their genuine desire to care for their fellow man. But with such knowledge comes great responsibility. Although I hardly believe that such implementation will be carried out smoothly and without hitches – I can only hope that such a great initiative will go down in history as one of this nation’s triumphs in the health care sector.  Maybe. Just maybe. That fateful day in November will be nothing more than a distant memory that sparked desire to empower the Filipino Heart.

Monday, November 9, 2015

Chronic dialysis patients are PWDs too

Chronic dialysis patients are PWDs too based on RA 7277.
Republic Act No. 7277 or the Magna Carta for Disabled Persons defines Disability as "a physical or mental impairment that substantially limits one or more psychological, physiological or anatomical function of an individual or activities of such individual." While impairment in the same document, is defined as "any loss, diminution or aberration of psychological, physiological, or anatomical structure of function."
In patients undergoing chronic dialysis, the kidneys fail to operate resulting in failure or loss (even more than just impairment or substantial limitation) of a physiological/anatomic function that is needed to support life. These patients are even called Chronic Renal FAILURE patients. Likewise there is an impairment of the activities of the said individual as he or she is restricted from any work such as lifting heavy objects and the low hemoglobin common in these patients will bar them from some of their usual activities especially strenuous ones. Dialysis patients may experience in various points of their life, difficulty breathing, difficulty sleeping, movement difficulties and pain. These patients will have to set aside time (4 hours per session at least)  for their dialysis schedule sacrificing some of their usual activities. (Heck, these patients have more than impairment as they may die without a functioning kidney in a few days that even the blind and those without an arm have better survival chances.)
Given this information and considering the fulfillment of the criteria in the definition, undoubtedly, chronic dialysis patients can be considered Persons with Disabilities (PWD) even if they appear to be physically okay with complete limbs and with no blindness. SSS even gives disability benefits to these patients.
Many dialysis patients currently are denied of PWD IDs
Unfortunately, many chronic hemodialysis patients when applying for PWD ID are not granted PWD status despite presentation of a medical abstract/certificate from the doctor or nephrologist. These includes patients with expired PWD IDs which were considered PWD before. How can those considered PWD in the past, be not considered PWD in the present time? Some of the reasons given are "you still appear OK. You can still walk...and the like. When does outward appearance become the main basis of giving PWD cards? Unfortunately, even those dialysis patients with "pamamanhid" or edema are not given PWD IDs.
Perhaps due to lack of proper information dissemination, some people appear to be puzzled also as to why dialysis patients are found in lines for PWDs in pharmacies and supermarkets.
Even if with PWD cards, some pharmacies do not grant discounts to dialysis patients
For some pharmacies,  PWD classified as with chronic diseases are not included in those entitled for discounts. And dialysis patients have the label "chronic disease" as PWDs. But again looking at the definition of the magna carta, it is clear that dialysis patients are also PWDs.
Dialysis patients may appear "normal" but without dialysis, chances of survival is much lower compared to those without eyesight or without an arm since the absence of functioning kidneys is incompatible with life. The absence of functioning kidneys is like having NO kidneys at all. Like other PWDs, they need assistance, assistance which a PWD ID can help provide due to the benefits that come with it, like medicine discounts and dialysis discounts among others. All these benefits are of big value to dialysis patients who spend a lot for medications, erythropoietin injections, vaccinations and possible blood transfusions and hospitalizations.
We appreciate your support
And so dialysis patients, humbly ask the Mayors, Baranggay Captains, other concerned personnel and our DSWD secretary Corazon "Dinky" Soliman who is also the Chair of the National Council for Disability Affairs  to ensure the consistent and objective application by their personnel of RA No. 7277 to chronic dialysis patients, who based on the said Republic Art are actually PWDs. So that they too (like other deserving PWDs) may be able to avail of the entitled benefits given by virtue of the possession of a PWD ID card.
To the public, we are asking for your valuable support in this petition so that this issue will be brought to the attention of the concerned agencies and authorities. Your support will actually help save lives as the PWD benefits can help sustain the needed intervention and medications of these patients. Thank you and God bless.
This petition is found in this link. Feel free to sign there and share.

Thursday, October 1, 2015

Keynote Speech during Opening of 26th National Statistics Day hosted by DOH Region 7

Director Florendo of the Philippine Statistics Authority;  Dr. Eddie Llamedo, Chief Public Affairs Office; Dr. Jonathan Neil Erasmo; Friends from the Philippine Statistics Authority; Colleagues in the DOH; Friends from various Government officies;

Ladies and gentlemen.

Isang Pabebe Wave sa Inyong Lahat.

It’s National Statistics Day so let us talk of Aldub to illustrate how important statistics is. Do you know that statistics plays a role in the TV network wars betwwn Aldub and Pastillas? The statistics we are gtalking about is the no. of tweets for hashtags such #Aldub or #Pastillas.

So you see statistics is indeed very important. Even TV networks recognize its importance. Data in the internet such as no. of tweets on Twitter with certain hashtags are now being analyzed.

Statistics is important much more so with us in government.  Decisions are made on policies to benefit the public based on statistics -the policy on the use of seatbelts in vehicles for example.

Success of programs are evaluated using statistics.

A number of statistics - results of various surveys are published online in the Philippine Statistics Authority website covering various fields of interest - Education and Mass Media, Labor and Employment, Income and Poverty, Agriculture and Fisheries, Energy Consumption, to name some. We should take advantage of these as we make decisions and policies.

In Healthcare, statistics played an important role throughout history. Vaccination to protect against certain infectious diseases have been justified with the help of statistics. Smoking came to be known as associated to many diseases including cancer because of it. Risk factors of heart disease were identified with its help. And so we encounter terms used in textbooks, journals and other scientific literature such as odds ratios and risk ratios.
Statistics is now made easy for us these times because of technology. We have statistical softwares to help us. Very big chunks of data can be collected, processed and analyzed. There is no denying, data is within reach in the same way that we can say Universal Health Care is within arms reach.

The theme for this 26th National Statistics Month celebration is “Pagyamanin at Gamitin ang Estadistika, Kalusugan para sa Lahat ay Abot Kamay na.”

I am sure you have heard of the DOH’s Goal of Kalusugang Pangkalahatan under President Aquino’s administration. Healthcare now more than ever is being made more accessible. Indigents now need not fear going to hospitals when the need arises because of their own financial constraints with Philhealth’s programs such as Tsekap and No Balanced Billing. More and more patients are enrolled in Philhealth to avail of benefits and with each enrolment, loads of data is being supplied and stored, waiting to be analyzed, potentially helpful data.

Technology as mentioned earlier has introduced new data sets such as Big Data.  The term “Big Data” came about with the rise of social media. It is characterized by 4 V’s -  Volume, Velocity, Veracity and Variety. The best example to illustrate Big Data is data obtained from social media (Facebook, Twitter, Youtube, etc.) Each day, how many people  log in their social media accounts and post statuses on Facebook, 120 character words in Twitter known as tweets at the same time? Millions. They post what they see, how they feel, if they are sick. Each second, imagine how many such posts are made. That’s Volume and Velocity. Just about anyone can post in various forms – video, audio, photos, short messages, comments, blog posts, etc. VERACITY and VARIETY. This is BIG DATA and it is a gold mine of data even for health. We need to add a fifth V to it – VALUE and that’s where statistics can also come in. By analyzing the content and themes for example of these posts and applying statistics, we may be able to predict upcoming outbreaks.

But actually BIG DATA is not just limited to social media or the internet.  In fact, data collected by Philhealth is considered potentially as BIG DATA. It also possesses the 4 V’s with many patients hospitalized, undergoing hemodialysis or procedures each day. Philhealth data is rich with data that may be beneficial in establishing disease associations with information such as demographic data, diagnosis, length of stay, cost of treatment and many more. Imagine the valuable statistics that can be generated by these data of course without disregarding ethical, privacy and security issues that need to be addressed. In fact, in the recent Global Forum for Research and Innovation I just attended, I just learned that South Korea has been analyzing their BIG DATA from Philhealth’s counterpart there for generating useful statistics for health providing information such as distribution of medicine, prescribing tendencies, medical equipment distribution, supply and demand of medical service, among others. To make this possible, establishment of a fully functional health information system is key along with a solid IT infrastructure.

Let me go back to this celebration’s theme.
Pagyamanin at Gamitin ang estadistika. 

We have the potential of Big Data from Philhealth which may be combined with other data collected from other hospitals, agencies, communities or baranggays. The first challenge perhaps is moving from paper-based records to making everything digital or electronic. That’s one way para pagyamanin ang Estadistika but a very challenging one.

Big Data will figure prominently in the future of statistics - A treasure chest of data that will go hand in hand with our goal of Universal health Care. We need more data scientists for this. We also need to be prepared and equipped in processing these complicated data, and walking the pathway of Health Information Technology is the way to go. But there’s reason to celebrate….exciting days are ahead as we are on the right track. Philhealth has the Philhealth Information Management System and the DOH is for a Unified Health Information System that works on interoperability of systems among authorized parties and caregivers so that sharing or exchanging of data is made possible to eventually improve the quality, safety, and efficiency of healthcare delivery. That way, statistics will also have its contribution to the goal of Universal Health Care. Sa Tamang Panahon. Thank you and Happy National Statistics Month to all.

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