You can Follow Dr. Ann Marie McKenna on Twitter! @smhcmr
We have now completed our ninth and final mission of our two-week sojourn to the Philippines. After seeing hundreds of patients and witnessing the reality in which most Filipino people live, we are humbled and grateful for the life we are privileged to lead in Canada. There are so many things which we now have a newfound appreciation for – our “top five” listed below!
#6) Azithromycin. This one didn’t make the top five but is worth mentioning. Without this antibiotic many of us would have been lost to traveler’s diarrhea…!
#5) A public sanitation system which provides clean, fluorinated water and diverts our waste from our public bathing and drinking waters. In the Philippines we saw countless patients with chronic diarrhea, rotten teeth, and chronically infected wounds – all of which might be remedied with a clean water supply.
#4) A public education system which guarantees children will be able to read and write. In the Philippines primary school (up to Grade 6) is publically funded, however parents cannot enroll children unless they can afford the cost of school uniforms, textbooks and other miscellaneous expenses. These costs are prohibitive for the 51 per cent of families that live below the poverty line. Local Filipino Red Cross volunteers in Caticlan told us that most parents do not enroll their children in school, preferring them to work and finance household expenses.
Lack of education has a profound impact; for example, most patients who presented with classic symptoms of Tuberculosis (“Tb”) were unaware of both their diagnosis and the fact that the public health system in the Philippines will pay for treatment of this life-threatening disease. The ability to read Tb campaign signs and notices would be life-saving for many.
Not to be-labour the point, but a public education campaign on the risks of salt and Mono-sodium glutamate (MSG – banned from restaurants in Toronto) would also be of benefit. Every Filipino we saw with high blood pressure was an avid user of these ingredients. The blood pressures (BPs) were on average 70 points higher than at home – one so high it exceeded the limit on the BP cuff!
#3) Allied health and nursing. Our own medical mission was staffed by a team of pharmacists, nurses, nurse practitioners and other volunteers which enabled the delivery of comprehensive, and at times very creative medical care.
We saw a two-year old girl on our 8th mission who was in the throes of a severe asthma attack and she needed treatment emergently. However, all of the inhalers we stocked in our pharmacy were designed for adults. We did not have a pediatric “spacer” through which we could effectively deliver the medication to her small lungs. Luckily, our clever pharmacy team created a spacer using a water bottle and we saw immediate results!
Our mission was also staffed by a large cohort of volunteer Filipino nurses. These men and women are equally resourceful, constructing wheelchairs out of patio furniture and splints out of cardboard. To our colleagues in IT reading along, we will officially stop complaining about the WiFi coverage at St Mike’s. It’s pretty remarkable what we have at home, in comparison.
#2) Family. On our first mission day we wandered about the local hospital and saw inpatients entirely being tended to by their loved ones. From feeding to bathing, and even manually ventilating, family members were keeping the patients alive. The role of family was also demonstrated in our outpatients, where we saw remarkable resiliency and support given by families to their ill loved one. In our own Canadian hospitals many patients suffer alone – and we struggle in discharging those who have no supports at home. The people of the Philippines are lucky in this regard – despite having no material wealth, they have true appreciation of what really matters most.
#1) Tommy Douglas and our amazing (yet widely criticized and under-appreciated) public health care system. We cannot say enough about how wonderful and comprehensive our system is. In the Philippines the majority of patients we met were seeing a doctor for the first time in their lives. Most heart-breaking was a one-year old girl, born in a village to a teenage mother, who presented with hydrocephalus. Her skull was swollen to thrice-normal size due to the buildup of “water in the brain” caused by a malformation of her brain at birth. She was having seizures, could not move half of her body, and developmentally was severely delayed. In Canada this condition would have been recognized in early infancy and surgically corrected, preventing the complications listed above and allowing her to lead a normal life. This was one of hundreds of cases we encountered that might have been saved by publicly funded health care and education.
In stark contrast, a family member of Ann Marie’s was diagnosed with a benign brain tumour this year. From diagnosis to operation date he was treated in under 28 days. It really doesn’t get any better than that.
And so as we conclude our reflections on an unforgettable two weeks in the Philippines we would like to thank all of the fantastic Canadian and Filipino volunteers we worked with for an amazing experience. On our return to Canada we face a busy month of cramming for our final licensing exams, but we will officially stop complaining about that too, as we are pretty damn lucky.