Jan 27, 2016 Wednesday
Our last clinic day. We are in San Miguel- which is a fairly big town. Set up was in the community gymnasium – which is good as it was pouring outside. It has been overcast the last couple of days….which has been fine - a warm rain. The land is parched so they can use it.
We are not used to all the space that a gym offers – so it was nice that we were covered – and the waiting patients were protected from the rain (which did get heavy at times) - but we kind of miss our rustic set ups.
We had a friend of Pablo join us – who is an MD – and was a big help for this last clinic.
Our hockey bag room looked very forlorn this am – every bit of supplies was packed into bags and when we leave we will be taking 48 empty bags except for personal items. We will divide it between the municipal clinic (to go to the villages) and the indigenous community which was very much in need.
The clinic was steady. We have had some record hypertension problems. 240/140, 220/112- these are readings we have never seen in clinics before. It is a combination of diet (very high salt), heredity, little medical follow up and lack of ability to afford the medications. Anabelle says that diet is the biggest contributing factor. Pork is cheaper here than fish – which is ironic when it is an island. The dried fish is heavily salted and the pork is cured. Everyone uses soy sauce which contributes to the problem.
We had a lot to pack up and give to the Mizhele from the mayor’s office and the aboriginal village – and with the help we had we finished clinic early. That allowed us time to empty the bags- get back to the hotel, get cleaned up and go to the Festival – dinner at the mayor’s office and then a dance. The mayor’s wife Lillbeth made us another amazing dinner – including traditional dishes like dinuguan (made from the blood and intestine of a pig), a turkey, a deboned chicken that was stuffed back into the skin and baked and black spaghetti – the sauce is made from the ink from squid, olive oil, and spices. The dessert was home-made chocolate cake, and fruit salad in a coconut cream. I feel like I am always talking about the food on this blog- but in addition to experience of the clinics, the team has been exposed to traditional Philippine food….and they have embraced it.
After dinner we moved outside. The mayor’s staff had a tent set up for us and at 7:30 a wonderful band started to play that was specially chosen by the mayor for the Canadians. It was an excellent rock and roll band that played music from the 80’s. They got us all up with Bohemian Rhapsody, Stairway to Heaven, Hotel California, Money for Nothing, Pretty Woman, Lady in Red and Smoke on the Water to name a few. The old members of the team loved it and the young ones actually knew some of these songs. The Canadians showed the community that we know how to party- ha ha. Lincoln spun and twirled the ladies as we all tried to keep up with him. The Mayor, the Governor and the Congressman and their families all joined us dancing in the warm breeze under the stars. It was a very special night that we will never forget.
One of the very best moments was when the Governor told us that the 15 year old girl needing the bowel reconstruction and colostomy closure was admitted to hospital today as the Governor contacted a friend who is a pediatric surgeon for help. Anabelle and I introduced her to the Governor at the aboriginal village and asked for his help and in just one day he came through for us. It will be life changing for this girl. As a team we offered to help with costs for her medications or the family to get her to appointments.
The team danced till midnight (we were having such a good time the Mayor and Governor asked the band to play an extra hour). The team piled into the vehicles and made it back to the hotel as at 5:15 am they headed to Boracay for a couple of days of tourism before heading back to Canada.
It was a wonderful experience and the team should be proud. We provided services to 5000 people, gave out 1000 pairs of reading glasses, pulled more than 600 teeth and gave medications to thousands of people.
Looking forward to Philippines 2019 – and the Governor is going to have us cover a larger area – with more support. We will start collecting our medications and supplies as soon as we get home as we will need a lot.
Jan 26 2016, Tuesday
Today the team headed into the city and held a clinic at the Mayors municipal offices. They have built a brand new medical facility in Poblacion but it did not officially open until today – with a full ribbon cutting, mass and blessing. All the government leaders were there. Unfortunately, two of our dentists and doctors were also at this ceremony …which did cause some delays in the clinic. The Mayor’s assistant Mizhele went to the children’s center next door early and organized the single large room. That set up is always a problem – as hard to keep the patients flowing properly but the crowds were not big so we were able to make it work.
We sent a little delegation back to the aboriginal village. That village has two nurses that have been working side by side with us. One is a midwife and the other an RN. They are the first aboriginal nurses in the village and one of them is received an award today at the mayor’s office. Most of the children in the village do not go to school- it is quite an accomplishment for these two nurses to make it through college and stay in the village to help their people. John packed all the little crocs we could find as probably 50% of the children in the village have no shoes. We also packed supplies for the palliative patient and fellow with the stroke. Jean, John and Lillian accompanied the local nurse to the village with these supplies, meds, canes, prenatal supplies and our 24 lunches for today. They provided home visits to these patients and bathed the fellow with the stroke. The aboriginal nurses plan to have regular clinics in the community center and we will be leaving supplies with them.
Lilibeth (the Mayor’s wife) made us lunch. Where to begin? It was an amazing meal - soup, and pasta and potato salad and beef dishes and fish and spring rolls and an entire BBQ’s pig – with the head on – in Philippines style. It was delicious. In the Philippines “have you eaten” - is a common greeting….and food is a big part of the culture. We are constantly offered food- at the clinics by locals and the mayor’s office.
After lunch- back to clinic - we saw large numbers again today – over 400 patients and 175 fluoride. We saw several extremely hypertensive patients….220/114, 220/120 – it is a serious problem here.
Tonight we hosted Anabelle’s family for dinner. The hotel prepared the meal – which was a selection of our favorite dishes over the past week. It was a small thank you for all they have done to support us.
Tomorrow- last clinic day…..
Jan 25 2016, Monday
Today the team was up early and had breakfast which was toast, eggs and a pork dish called tocino – a red coloured cured sweet pork dish – that is made with sugar and spices. Very low calorie (ha ha) – but we love it. Kind of like sweet and sour pork back home.
We loaded into the Jeepney and headed to the Barangay of Boognay. We have never been to this village before….and it is in an open area with nice breezes and a small school. There are 2,126 people in this Barangay and 468 households.
This is festival time on the island - celebrating the patron saints of each Barangay. We passed a parade that went on and on- with marching school bands, baton twirlers, drums…..a huge parade heading to the school grounds. The smallest of kids were involved with pom poms- to the older kids with drums- all dressed in their specific school colours.
We quickly set up for clinics- we are getting really good at this. Registration had started and the village is not too big – so we managed the patients quickly and efficiently. We saw 276 patients in 3 hours plus 150 kids got fluoride in the school. We would have seen more- but two teachers were off – and when that happens – there is no replacement found. The kids in that class just don’t go that day.
With the extremely high numbers we have we are nearly out of some meds again. Antibiotics, pain killers and freezing for the dentists in particular. We had planned on 1 dentist but have 3 and they are pulling close to 100 teeth a day – so this is a lot more than we planned for. Anabelle’s sister runs to the city to get more supplies….we could not manage without all this help.
In the afternoon we went to Sitio Kati – which is the aboriginal village on the island. When we came to the Philippines in 2013 – this village had the greatest need and that was the case again. Next trip (2019) we have to come here first. It is a small village with just 70 homes but very poor. Only a handful of the homes have electricity. Many children do not have shoes. The village has recently been relocated when the Mayor gave them their own land and each family has their own deeded plot. It is higher up on a hill than the previous location, more breeze and more space and has its own community well. We set up in a community center that is used as for meetings, day care. There is a missionary involved with the people – a woman from Bermuda named Claire. She knows each family and we left her with some supplies and medications. We also made two home visits- one to a palliative patient who was only 43 but had uncontrolled diabetes. Tomorrow we will make another home visit and bring supplies. The other was to a stroke victim that is unable to walk and needed a general health assessment. We could have taken a whole bag of kids’ crocs just to this village.
We also gave out purses to some of the women – stocked with toiletries – that were a huge hit. Thanks so much to all the nurses who sent them.
There are two children from this small village that we are following from 3 years ago. A 5 year old boy who had a bowel blockage at birth and needed a colostomy that has not been closed as the family cannot afford the surgery- which if fairly simple as he can have just one surgery. The other is a 15 year old girl who was born without an anus so she has a colostomy- this is more complicated as she needs two surgeries to allow the bowel to be connected. It is critical that both these children have this surgery to allow them to lead normal lives. We spoke with the Governor who came to the site and he promised to contact a pediatric surgeon to do the surgery. We left money to help with this in 2013 and told the governor we would help for both children to have this surgery if he could ensure that the surgery proceeds. The family need help with the logistics of getting to Iloilo, having the pre op work done, then the surgery and follow up …all this costs money here and these families just do not have it.
This team has become very versatile. Nursing was set up in Sitio Kati in an open air shelter. In the small community room we crammed in Pharmacy with Joe, glasses with Gloria and Cal, 2 MD’s and Allison our Nurse practitioner and Lorna our pediatric specialty nurse. Yda May and Tiffany went to a shelter with the Dentists and the fluoride set up outside- it was tight but did not take us long to get through the patients.
We were joined the last two days by Dominica and Chris – a couple from Stratford. Dominica is a nurse at Stratford Hospital and Chris is an electrician. They were both a huge help and a pleasure to work with.
The team loaded in the vehicles (Gloria, and Lillian in the back of the pick-up as usual!) and headed back to the hotel. Dinner tonight was at the festival in town. Then back home to get some sleep. Busy day tomorrow.
23/24 Jan 2016, Saturday and Sunday
These two days have been a break for the team – as they recharge to get ready for a heavy week coming up. We have two clinics Monday, then 3 collapsed clinics Tues and Wed back to two collapsed clinics. We will be busy and are running out of a lot of things. We have ordered more meds but next time will need to figure out how to get more supplies here for the team.
On Sat many of the group went on an “island hopping” tour. The boats here are very “Polynesian looking” with stabilizing arms at the sides and narrow hulls. The team swam in a cave with the bats and just enjoyed the beautiful scenery. Back to the hotel, dinner and then some had the energy for some Karaoke (or so I hear- lol).
John and Cal went fishing with the locals – used a “ball’ of fishing line and caught 26 fish before the wind kicked up.
The rest of us just stayed put with a book, the beach or catching up on emails.
Most of the team was up for breakfast at 6:30 then loaded into the Jeepney and headed to the wharf to go to Iloilo for the major festival in the city. It is one of the biggest festivals with the streets blocked off, music throughout the city and the city was packed. It was hot, crowded and extremely busy. Food vendors, music, native costumes and lots of activity. The staff hit the mall – got some souvenirs and made it back to the peace and quiet of the island for a swim.
The team made it to bed early- to get ready for a big day tomorrow.
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.