Jan 22 2016, Friday
Today the team finished up the week of clinics with a busy day. Two clinics- in the morning we collapsed two villages (Balcon melliza and Balcon Maravilla) in a school at Balcon Maravilla. It was a busy clinic with the two villages. The local ladies kept feeding us! Rice wrapped in banana skins, salted peanuts from the island, sticky rice.
The school was generous and gave us multiple rooms – which helps with flow and crowd control.
We had 3 dentists and two doctors- so lots of help.
At noon we had lunch which was pork, rice, mixed vegetables and our favorite- mangos.
We then loaded up our bags and headed about 15 minutes down the road to Morubuan- which is a coastal fishing village- it has been there for many generations. The village sits on a 500 hectare plot of land that has been owned and passed down through a family in Iloilo. This family is now trying to develop the property – which is prime beachfront. The owner has offered the community free land to relocate higher and further from the beach – but the villagers are resisting- saying they are fishermen and this is where we need to be. It is going to be a battle as even the school is located on the property. It is hard to imagine this village gone – it is like stepping back in time….with the homes made of bamboo, storefronts, and children playing….fish drying.
The village has 2,727 residents and the main employment is fishing and making charcoal. The school is in the heart of the village and where we set up the clinic. I had a chance to speak to a teacher and the school has 296 students from grades 1 to 6. School starts at 0730 and goes to 4 pm. Some students go home for lunch which is from 11 to 1. As far as class size- the grade two class has 37 children and one teacher and the grade 5 class has 59 with one teacher. All the kids are very polite courteous, well behaved. We have found the teachers do everything, cook some meals for students, clean up, pretty much anything needed. The starting salary is 18,000 Philippine pesos or about 350 per month. The school year is from June to March with their summer break being April and May.
The average RN salary is 250 to 300 per month- with most being employed in a private clinic or hospital but there are some public health nurses. There is no formal Home Care- a future expansion area for CarePartners! Ha ha.
The nurses, dentists (3) and our two MD’s and glasses table set up in the open air pavilion with fluoride in a classroom and pharmacy off the staff lounge. Our meds shoe boxes are becoming tattered and weak from all the opening up and tearing down the pharmacy but holding together. Our biggest challenge is the numbers. With 3 dentists we are doing 90 extractions in just a morning – which is what we used to do in a busy day. It means we are going through freezing, antibiotics and pain killers very fast and sending Anabelle’s family on repeated runs to the city for supplies. They have been a tremendous help.
Mayor Chavez and the governor are asking for a team to return in Jan, 2019 – so we need to start to think about that in our schedule. We are becoming well known all over the island!
We had a busy day with big numbers at both clinics….close to 800 with fluoride.
Back to the hotel for spaghetti, chicken, salad, and homemade potato chips….and off to bed.
Jan 21 2016 Thursday
Today the team headed to Lawri- which is a little fishing village on the coast. We had just this one location today so it was much easier on the team and we finished early- but still saw a large number of patients.
The clinic was a school and by now the team very quickly gets set up. Fluoride in a classroom with a kitchen attached – where rice was cooking most of the day on an open flame. We had a long table which made it easier for the Fluoride team – Mark, Trish and Lincoln. They treated 10 kids at a time – and have got this down to an assembly line. Lincoln keeps the kids entertained with magic tricks and games of Red Rover between fluoride treatments. At 6 ½ feet tall- Lincoln is quite a novelty here. Big John is as well- the Filipino people are just smaller.
The pharmacy team is Joe, Donna, Sabrina, Anabelle and Linda – it was busy with the large crowds and when we have additional doctors the prescriptions pour in.
Eyeglasses is Cal and Gloria with some help from locals who translate- they have had busy days.
Dentistry is Tiffany and Yda May who assist 2 to 3 dentists. We all marvel at this. Little kids sit in a lawn chair, get freezing and teeth pulled while lots of others are waiting their turns. They are stoic and there is no fuss, no tears. Many many issues with cavities here. Pop and candy are very cheap and even the schools sell this stuff.
Nursing teams are in the zone – There is Diane, Jennifer, Carolyn, Allison, Lee Anne, Joana, Lorna, Lillian and Margaret- all highly skilled solid nurses. They can set up and take down a station in no time and are the heart and soul of what we do both here and in Canada.
John does traffic control and is really big guy – so is quite a novelty and the kids gravitate to him like the pied piper.
Jean is roving all over – helping wherever needed, keeping registration on point. Pablo helps us get anything we are missing…..he is well connected in Ilo Ilo – and can get us pretty much any med we are running out of.
Supporting all of us is Anabelles family who feed us, make sure we have anything we need, act as interpreters, run to town, get water, meals for the support team.
The Mayor’s team is there every day – and includes Dentists, MD’s, nurses, ETMS crew, security and drivers that take us from clinic to clinic. He supports us by coming every day and his team ensure each barangay is ready for us and the communities are aware.
Today we were excited to have an MD from the last trip join us – Ava and her husband Jem who will be with us tomorrow as well.
In Lawi we saw over 300 patients and did 168 fluoride.
The team made a stop at the monastery where they sell jams and cashews and then a long swim at the hotel and learned a new game from Jean- Polish poker which was lots of fun.
Dinner was fish that Linc bought on the beach and also adobo which is the national dish – a soy sauce based marinade with garlic and onions- really good.
Tomorrow we are back to two villages so we will be busy.
Philippines 2016: Day 4
Jan 20 2016 Wed
Today we left the hotel with some experience under our belt. It is day 2 of clinics – and we went to a small village in the Barangay of Buluangan in the am and the Barangay of Sinapsapan in the afternoon which is about 7 miles away – but seems farther due to the winding roads and hills. There are 6 Barangays (or districts) in the province of Jordan.
Buluangan clinic site was a school- we were met with line ups and the registration staff there to get ahead of the line.
Flow is a very important term when it comes to these clinics- and there is a lot to consider. First you have to keep registration away from the various services or there are people wondering all over the clinic. You have to look at what we have to work with- we consider all of the following:
• How many people are we expecting?
• Where do we put registration? Will locals help us?
• Do we have any private rooms (classrooms, principal’s office) for the doctor and possibly dentist?
• Do we have any water or easy access to water?
• Where is the shade now? Where is it going to be?
• We need tables- can the locals go get them? What chairs do we have?
• We need pharmacy to be last stop as they leave- but still be shaded.
• How many nursing stations will we need?
• Where can we put fluoride – we need a location that can handle a lot of kids and keep that part away from the clinic.
• Where can we put waiting areas?
There is a lot to consider- and this is why the first half hour is total bedlam in the clinics while we try to figure it out.
Buluangan was a village that was small enough to quickly get good patient flow and set up. The team kept up and we finished in good time. For lunch the team had eggplant and dried fish with rice. Every day we have little bananas that are some of the sweetest you have ever tasted. We saw 209 patients plus 77 flouride.
The registration team moved to Sinapsapan early to get ahead of the crowd. Nursing, glasses and the fluoride team followed in the Jeepney while the pharmacy group finished up the last few patients.
The Jeepney driver took a “short cut” down a narrow dirt road through rice fields- very pretty and gave us the chance to see the real back country. Very dry areas with little topsoil, lots of rocks.
Sinapsapan is a small village and we were set up in the school. Pharmacy, Dentists, MD’s and nurses in classrooms, fluoride and glasses under the trees. Lots of help from the Mayor – the EMS guys, the public health nurses- all helping us to see patients in an efficient manner.
We had a great day- in Sinapsapan- we saw 237 patients, and 111 school children for fluoride. Glasses was 148 in total.
The mayor and governor came as well as his wife who is a physician. She was able to help the other 3 MD’s that came to provide support.
The team made it back to the hotel by 5 or so, swim and supper. The hotel is doing a great job with meals for us. Today we had calamari, ribs, fries, vegetables and watermelon.
Tomorrow we have Lawi – and are in one place for the whole day!
Philippines 2016: Day 3 Jan 19 2016 Tues
Our clinics begin. The team was up and ready to go early- 6:30 breakfast and out on the Jeepney and trucks for departure at 7:15. The Mayor has provided many things for the team including security support, public health nurses, emergency response staff and the transportation for the team and our supplies. We have a 20 person jeepney to get us around which is like an open air truck with bench seats. We pile our hockey bags on top and tie them down….It is really nice to travel with the warm breeze blowing. Some of the team (Gloria, Lillian and Jennifer) are hardy and prefer to travel in the back of the pick-ups that provide support.
Today was an unusual clinic day. We had two clinics booked – in Espinosa in the am and St Teresa in the afternoon. Both clinics were in schools – and St Teresa was the school that Anabelle attended. It was a very busy day with large crowds and a lot of kids for fluoride. We saw 260 patients in the am plus 172 fluoride and in the afternoon 420 in the pm with another 127 fluoride. We are asking the Mayor’s staff to organize one clinic site per day and bus people to us- which is much easier than taking down and putting up the clinic due to the lost time seeing patients. We have two clinics again tomorrow – but after that it will be one location per day.
The team is coming together and the new staff to the clinic format have jumped in. The flow of patients was excellent with all the support we had. The mayor and his team stopped in to check on us and are bringing in another dentist and MD to help us manage the large numbers turning up for the clinics. In the afternoon we did not have a doctor but our nurse practitioner Allison and pediatric specialist Lorna stepped up to cover.
All the stations were swamped with high numbers today and we definitely need more supplies which Anabelle’s family are sourcing for us.
As we found last time, there are many very young patients with hypertension, some skin conditions and general health issues. We did see a very ill young man with a facial lymphoma that we are hoping to help more- his father is bringing him back to clinic next Monday. Another child has cotton seeds in his ear- we tried to flush out but were unsuccessful. We will try again on Thurs.
The team had a swim after clinic – then dinner and off to bed early. It was a great first clinic day.
Philippines Day 2 Jan 17 2016 (Monday)
After the long plane ride, crossing the international dateline/losing a day, and finally getting to our destination, today was a day for the team to recover from jet lag and get ourselves oriented and ready for clinic on Tues. All in all, the team is in good shape, tired but adjusting. Many were up at odd hours as we try to get used to the new time. That first swim in the Pacific Ocean was wonderful.
We are staying at a hotel called the Raymen – which is able to accommodate us all, and provide the team with meals and lunches on clinic days. It is on the beach so we really get to feel the “Philippines lifestyle” which is centered on the ocean. At 11 we loaded into trucks, a van and headed to town to see the market and exchange our money. 1 USD = 47.5 Philippino Pesos. The market is a busy place with motorcycles, trucks, bikes. From there we were invited to Anabelle’s family’s home where they had prepared a traditional meal for us. We had bbq pork, rice, shrimp, fish, and crab. They also had mangos that taste like no mango you have ever had. The island is famous for their mangos and ship them to Queen Elizabeth. The Mayor and Governor came to greet us and we had a lovely few hours on the porch with the warm breeze.
Around 3 we headed back to the hotel where we opened up every hockey bag and got ready for the clinics starting tomorrow. It was a beehive of activity as we sorted out what to bring, who would be stationed where. We have a great mix of nurses experienced at these clinics and those who are not – and our support team are great to step up and try anything.
After a swim and supper we all headed to bed to get ready for the first clinic day tomorrow.