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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.

Sunday, August 30, 2015

#UCSMclass15 Tweetchat: Increasing Health Research Output among Medical Professionals in Cebu

Interest in research among medical professionals in Cebu is not that high based on observation as a medical teacher for more than 10 years. Researchers are mostly done by individuals with training or graduate school requirements. Seldom are researches done outside training.

But there is hope. More attention has been given to health research and funds are available to support research according to the Philippine Council for Health research and Development in the recent PNHRS week. Especially with the thrust towards Universal Healthcare, health research has been put forward.

With the age of social media available to this generation of researchers, information is just right in the fingertips. Perhaps what is just needed is a realization of why health research is important...a wake-up call.

And so the Research Class of the University of Cebu School of Medicine's Pioneer Batch will have a tweetchat tomorrow August 31 3 PM using the hashtag #UCSMclass15

It will be centered on the following:

T1. Why is research important for healthcare?
T2. What can be done to encourage more from Cebu to do researches beyond training requirements?
T3. What is the role of social media in health research?

For those joining, here are the instructions:
Go to twitter. Search ‪#‎UCSMclass15‬
Then choose all tweets (not top tweets). You will see all tweets using that hashtag.
When tweeting during the chat, always add the hash tag #UCSMclass15 so your tweet will count in the discussion.

You may use Hootsuite or Tweetdeck for easier monitoring of tweets.
Batch Primoris of UCSM, See you there.

Sunday, May 3, 2015

A glimpse of University of Cebu Medical Center and School of Medicine

As I took my first good look at the University of Cebu Medical Center, fondly called UCMed, I can't help but smile. Somehow I have a good feeling about this hospital-to-be and the medical school that comes with it.

First the hospital.

Going inside the feel is that of a hotel. There are escalators going to the second floor. The place just looks modern.So relaxing. So fresh.

The Main Lobby

View from the outside
Take a glimpse of the admitting section below...

And the smiles of the people and welcoming committee from's a good sign that this hospital, though modern with state-of-the-art equipment and facilities, will really cater and be welcoming also to the masses as its owners are known for. Look at their legacy and it shows -- Elizabeth Mall, Cebu Coliseum, University of Cebu and now, UCMed and University of Cebu (UC) School of Medicine.

 On the 6th floor, the view is breathtaking...

There's Cebu Doctors' University from the view above UCMED
And the majestic building with a logo that I truly like ... with good name recall, branding...very medical...simple but modern.

Here are some of the wards with no beds yet...

President Benigno S. Aquino III inspected the hospital May 1, 2015 and the pictures where you can see some high tech equipment are in the Official Facebook page of the Official Gazette of the Republic of the Philippines. You can check it out here.

I think the hospital will soon have its soft opening within this year. What is really definite though is UC's medical school is going to start this coming schoolyear. The glimpse I will give you of the school is more on the faculty and not of the building. Let me show you some of them in this next photograph.

Some of the future Faculty of the University of Cebu School of Medicine
The person 2nd to the left of the photo (the one next to me in the pic) is the dean, Dr. Melfer Montoya. And with her UC School of Medicine is definitely in good hands.

She is a Biochemistry mentor and classmate of mine in our Masters Degree in Health Professions Education (MHPEd) which we took in the University of the Philippines Manila. MHPEd is like a degree in education for teachers but in our case, specifically for health professions teachers (like that in a medical school). In MHPEd, we take these subjects which will definitely help Dr. Montoya in her stint as dean. In some instances already, those with MHPEd are nominated as deans or chancellors in colleges like that in UP Manila. And with Dr. Montoya's degree, her many many years as a medical educator plus experience in being part of the administration of a PAREF school in Cebu, University of Cebu School of Medicine is in capable hands with the help of the administration and rest of the faculty.

Check some of the basic faculty:
Photo of Freeman newspaper page showing some of the members of the UC School of Medicine Faculty
As you can see in the newspaper, you have the "veterans" perhaps considered the Mothers or Father in Cebu of the particular subject they are teaching. Dr. Virginia Mesola is the authority in Medical Microbiology in Cebu both in classroom, laboratory and in practice. Ask a graduate who was under Dra. Llenes in Anatomy and definitely she will be pointed as one of the best Anatomy teachers in Cebu medical schools. Dr. Francisco Tan knows histology and anatomy even with his eyes closed being in the department for more than a decade. The rest of the teachers is a good mix of vast experience, passion and youth ensuring continued quality medical education in the future.

As I sit watching guests coming in wishing UCMed well last May 1, I could not help but smile.  I realized that this development is really good for healthcare in Cebu. Furthermore, the city hospitals will be decongested. And another promising medical school will be added to the other quality medical schools in Cebu. By the way, the school of medicine campus is in Banilad in their building across Gaisano Countrymall. Information about application for first year medical student is in this page. Deadline for application is May 15, 2015.

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