Putting a Face on Global Need (2003) 

By Angelica Cecilia Cu, RN, PACU

Editor's Note: Angelica Cu, RN (EPS Lab) and Tina Johnson (Bed Coordinator for Cardiac Service Line) recently completed a medical mission to the Philippines. Ms. Maggie Smith, RN, volunteered her services by packing medicine and supplies for the trip. The trip is described in the article that follows.

February 10 11: "The adventure begins..." At the airport we were met by FAMI's Philippine Coordinator, Ms. Marietta Santos. We drove to our hotel for a short rest and later boarded a bus carrying boxes of medicine destined for the north. In the middle of the night we arrived at our destination nestled in the northern remnant of Cordillera Mountains. Another 20-minute drive brought us to the city of Vigan in the province of Ilocos Sur. Vigan, the oldest surviving Spanish colonial city in the country, was a vital stop on the old Silk Route that connected Asia, the Middle East and Europe. Gabriela Siland General Hospital was our first mission site, a mere 10 minutes from the compound where we stayed. After observing the customary formality with our hosts, we quickly transformed the hospital's front open space into a triage area (for admissions and blood sugar testing), a waiting area, a clinic, and a pharmacy. How can I describe that first day? All around us stood people of all ages, waiting to be seen. Crucial to the strength of teamwork lies the continual assessment and reassessment of the need to put a sense of order to seemingly impossible tasks. Yet by 4 pm, we had seen 1028 patients.

February 11th: It was a clear, fresh, cool morning. Despite our efforts to set up the clinic earlier than usual, 45 patients had already arrived before us! How our doctors managed to see 910 patients by 12 noon is beyond me. The changing voices of the volunteers (growing more and more hoarse as the day progressed) became a source of fun. Scarcely had we finished our lunch break when another sea of people materialized. We were invigorated by an afternoon walk and after dinner we honored our local hosts and volunteers. We left Vigan at 9 pm that night to return to Manila.

February 12th: "A Time of Refreshing" We arrived in Manila at 4:30 am, and the streets were already alive with people. Today was more carefree and we had a social dinner with our local sponsors.

February 13th 14th: Our mission site was St. Martin de Porres Charity Hospital. Building relationships with the local medical professionals was an integral part of our mission. More than 116 volunteer nurses, nursing students, medical doctors and surgeons helped us provide care. These days were a learning experience for me. I am confronted by the realization that physical healing is not simply a secular exercise. It is total care because it is a personal event focusing on one individual or family. One cannot discount the simple acts of checking someone's blood pressure, blood sugar, and weighing and measuring babies, educating a pregnant woman on the importance of prenatal vitamins, providing basic health information to communities and marginalized people who do not have access to such or simply sharing a new gleam of hope with a parent who is taking care of a handicapped child.

February 15: "The adventure continued..." The mission’s trip is over but the journey continues. FAMI hosted an appreciation dinner to honor all the volunteers (foreign and local) and sponsors. Ms. Niles Perlas, CRNA (Hospital for Special Surgery) and founder of FAMI reflected on the past accomplishments of the organization and talked about the vision and challenges that lie ahead. Overall, we treated a total of 4750 patients in 4 days, per formed 250 glucose tests, distributed $1.2 million worth of medicines in addition to various medical supplies and pieces of equipment to the 2 hospitals and 8 other non-government organizations. Joining a medical mission brought me to a new dimension of caring. The NYPH logo has the Good Samaritan saying, "Go and Do Thou Likewise." One simply has to look at the large sign at the entrance to our hospital "at the gate of the temple which is called BEALJTIFUL..."to know our dedication to community service. Our concern for healing is not an option, but an opportunity. And so, I pause to salute the volunteers who are dedicating their expertise, time and energy to bring a message of hope and healing to others. Indeed, if we can just extend our hearts and our hands, together, we can put a face on the global need. Maggie Smith, RN (Peri Operative Services) on the left and Tina Johnson, RN (Cardiac Cluster Bed Coordinator) on the right help pack medicines at the Philippine Center, In New York. 2003 FAMI Volunteers

Healing Bridges Across Nations

 By Angelica Cecilia Cu, RN, PACU (2002)

Our journey began at the"Ospital ng Makati"in Makati City, Metro Manila. On the first day, our volunteer doctors conducted lectures on ovarian and breast cancer and gave updates on anesthesiology and cardiology for the local medical professionals. (Among the presenters were Weill Cornell physicians Dr. Cephas Swamidoss, (Clinical Assistant Professor Anesthesiology), Dr. Antonio Calanog, (Clinical Professor of Gynecology Oncology) and Dr. David Lee, (Clinical Assistant Professor of Anesthesiology). Surgical charts were reviewed and preoperative assessments were initiated that afternoon. At the same time, the first clinic was set up by the medical team, offering free medical consultations and distributing free medicines. The hectic

days ahead were punctuated by social meetings with the local government officials. On the third evening, we left Manila with our medical supplies, and traveled 8 hours by bus to my hometown in Laoag City, Ilocos Norte. Crossing the arched Williams bridge the following morning was a memorable experience for Dr. Robert Ulsetgh, s family practitioner from Massachusetts. His grandfather and his grand uncle were both stationed in Laoag City in 1898, while serving in the U.S. Army.

Our next mission site was the Governor Roque B. Ablan Sr. Memorial Hospital in Laoag City. How we managed to take a small space and turn it into a pharmacy, an exam room and a clinic for the physicians, medical interpreters, patients and their families, local volunteers and hospital staff is beyond me, but we did it! Meanwhile, the volunteers kept up a wholesome and cheerful demeanor despite the steamy weather.

On the evening of the 5th day, we flew back to Manila and enjoyed a short respite. Malacanang Clinic was our final mission site. It is situated in the ground of Malacanang Palace (official residence of the President of the Philippines) in Metro Manila. Overall, we provided medical services and distributed $500,000 worth of medicines to more than 8000 patients. We donated medical supplies, too. We performed 33 surgical operations (mastectomies and other breast procedures, hysterectomies, thyroidectomies, etc) and various minor procedures.

Retrospectively, I cannot help but fall silent to honor the men and women volunteers of FAMI and our host volunteers who answered the call for servant leadership. I am a recipient of their good will, and I wish to pay tribute to them:

You give form and beauty to the word compassion. You speak through your eyes of mercy, willing hearts and powerful hands of healing. You confound me by the streams of goodness you

have shown to others. Your patience and dedication transcends space and culture. Your hand of sympathy brought substantial healing and hope to thousands of lives. You are ready to serve whatever the risk, whatever the cost. But the greatest marvel of all is that you have shown to me the deep joy of service. 

(I also wish to acknowledge Tina Johnson, RN, Cardiovascular Coordinator, and Maggie Smith, RN, of Stich Radiation Center, who volunteered their time during the preparation for this trip)

FAMI Mission 2001: A Mission to Remember

by Ronnie Alejandro and Leus Perlas

With the various team leaders' direction, 48 boxes and 20 luggages were safely loaded to two additional vans. This is an exceptional task to do especially when local porters tried to assist adding confusion to the whole operation. With the team's previous experiences everything went under control and with the help of the Quezon City motorcycle "Tourism Police" we breezed through Metro Manila to their hotel at due time. The group slept well that evening in spite having to travel halfway round the globe.

Seven hours later the team leaders were already waiting for the group at the lobby of the hotel. The medical mission was divided into two groups. The first group was headed by Maria Mamawal, Dr. Lnda Kamal and Dr. Amir Sitafalwala who were to proceed to Angeles City, 60 miles north of Manila. Maria had little sleep as she met Niles and Leus Perlas an hour earlier to prepare the medical supplies.  Angeles City in the province of Pampanga is where the former Clark Air Force Base (one of the largest American bases outside the United States) was formerly located. The two-day medical mission there included 3 medical clinics at an open area where Dr. Kamal and Dr. Sitafalwala with the assistance of the local medical volunteers examined and dispersed medicines. A total of 3,000 prescriptions from our suppliers were given to the less fortunate.

The second group was the surgical team lead by Niles Perlas with Dr. James Norris, Dr. James Beckman, Dr. Andrew Lee, Dr. Michael Castellano and Dr. Joshua Miranda who boarded a minibus to Quezon City General Hospital (QCGH), which is also a teaching municipal hospital that treats the poor. There were three operating rooms but only two could be used since one is reserved for local emergency. The operating room was small and although the air conditioner was in full blast the number of people assisting and observing made the room warm and cramped. Nonetheless, Dr. Norris, Dr. Jeffiey Brande, Dr. Miranda and Dr. Castellano operated skillfully to the delight of the patients and hospital staff. Dr. Castellano even performed an emergency gunshot wound that with great pain, the patient thanked him for his kindness.  The hospital hallways were clean and spacious with health posters and department signage prominently displayed. There was constant traffic of people: patients, medical staff, students and visitors moving from one side of the building to the other side using staircases. It was a busy environment but there seemed to have order especially between the outpatient service area and the improvised pharmacy.  Patients were sitting outside, fanning themselves while waiting for their numbers to be called. They were seen by the medical staff with improvised set-up tables processing their papers. It was the impression of the medical mission that these tables were not set up daily but since the group brought the medicines, some were distributed to the underprivileged in the surrounding poor neighborhood. In two days of clinical work at QCGH medicines were distributed to more than six hundred patients.

 On our third day at about 2 AM members of the mission with their supplies left Manila and traveled by land to the province of Marinduque. They arrived at the port in Batangas at 7:30 in the morning and, unfortunately, missed the ferryboat. They were able to take the next ferry to Marinduque. While waiting, the foreign doctors observed the busy port where commercial cargoes and newly caught fishes were being transported to the local market.

When we landed in the island of Marinduque, we were greeted by a singing ensemble and were given leis of shells---a gesture of Philippine hospitality and the legendary "welcome” offering of the Filipinos. Marinduque is an exotic lush tropical green island and the blue sky greeted us with a breezy warm air. The uneven terrain with mountaintops and hilly sides were filled with coconut trees. We missed the shorter way to the beachfront home of our host, Governor Carmencita Ongsiako Reyes, but the hour-long trip was worth viewing the beauty of the countryside.  After an alfresco lunch overlooking the sea under a large open-air gazebo, our team had an ocular inspection of the hospital to do pre-operative rounds and to setup the medical rooms and improvised pharmacy. The two-story hospital was clean with a center courtyard garden planted with orchids. The operating room was also impeccably clean but was lacking of supplies and equipment. The number of cleft lip and goiter patients were overwhelming. The sad part is that the mission could only do less than twenty operations. They selected the best candidate and advise the local hospital head of the mission's limitation and promised that they would send additional medicine once the group returned to Manila. This was able to reduce the thyroid patients that could not be operated on this trip. Dr. Marquez, who was so compassionate to his patients, advised them that the doctors could not do surgery and would return at a later date and that medicines would follow once they return back to Manila. He later used his own vehicle to bring these patients back to their villages in the island.

 For two days, from 7 in the morning to 8 in the evening, the team operated on 15 patients. The mission's doctors and nurses in their eagerness to help the poor wanted to work late into the night. It was only Niles who asked them to stop. Now we realized how the commitment and dedication of these selfless doctors and nurses to their callings. It is their sharing with their God-given talents, knowledge and skills to help the unfortunate made us realized how important these mission is. Their compassion that came from their heart without consideration of any material reward epitomizes the goodness and greatness of their profession.

 Our medical team started seeing patients on the afternoon of our arrival in the island. There were already patients waiting all day to see us. In one day, Dr. Kamal saw almost tow hundred patients which surprised herself In two days and a couple of hours during our arrival, Drs. Kamal and Sitafalwalla with local physicians, nurses and medical volunteers examined and dispensed almost two thousand patients. The medicine line send endless until our last night at about 8 PM. Some of the volunteers who were touched by the sick specially the babies wanted to do more than work as pharmacy dispenser. They organized a donation campaign to help a malnourished anemic baby to receive blood from a prisoner working in the hospital garden. Such act improved the chances of the infant's recovery from a fever.  One volunteer, while waiting for our bus, gave money to an unknown elderly woman whose husband was brought out of the hospital in a stretcher covered with sheet loaded in a colorless, black vinyl covered burial jitney. She was crying and suddenly stopped to thank the volunteer. Afterwards, she started to cry again as the jitney drove away.  Five days after we landed in the Philippines, we returned back to Manila, which took us 10 hours by bus! On Sunday morning, we got up at 7 AM to setup for our final medical clinic at an orphanage in Manila in cooperation with the Knights of Malta. This one-day event started with a Mass. The Knights of Malta set up the prescreening, identified the needy and help us organize the line for the patients. We had four doctors and some for the surgeons perform physical examination and our nurses and volunteers dispensed the medicines.

 The open-air assembly yard was full of people waiting to register at a long table set up by the Knights of Malta. Once registered and got their numbers, Bernie Muldong who took their blood pressure and weight and help determine the needs of the patients met patients. Drs. Amir and Sitawalfalla, together with local doctors, surgeons and an anesthesiologist prepared six tables with translators beside them in a large open office with a huge ceiling fan to cool them off The improvised pharmacy was less organized since everyone wanted to have a medicine. It was fortunate that Lorna from Florida who kept everyone on line like a military drill officer. While Lisa Pompei, RN and Natalie Trezza, RN were in the back filling up prescription as the patients came in. Patricia Ramos and Lisa were handing them out to Lorna.  That Sunday, our mission was over. Our remaining supplies were given to the Knights of Malta, EDSA Shrine, QCGH, Pampanga Relief and Marinduque General Hospital.  At the traditional closing dinner at the Peninsula Hotel, many mixed emotions were shared but many cannot forget the ultimate credit to those who helped in organizing this mission. Maria Mamawal, vice-chair, handed the certificates of appreciation to the participants and the Humanitarian Award was given to Marietta Santos.

 The dinner was in honor of the FAMI Surgical and Medical Team who shared their time and skills unselfishly to help the less fortunate. Two members expressed how many felt that reception, "While I don't think of our efforts will change the world, I am happy to have changed the lives of a few, " said one "The important thing is that you do what you can---and if everyone does just a little together, we can really get something done," said another.

 Flying back to New York everyone was exhausted but was pleased to have served unselfishly the poor. Back at home in our apartments and houses, it seemed too surreal to travel halfway round the globe to help the needy. One has just had to ponder and smile in one's contribution in making this world a little better place to live in. This third annual mission of FAMI was made possible by the generous donation of medicines by the Catholic Medical Mission Board.

FAMI Mission 2000 : An Overview

Danny Miranda MD

At the NAIA( Ninoy Aquino International Airport ), through the generous efforts of the Vice President Gloria Macapagal Arroyo, our entourage was welcomed with a distinct banner making us celebrities of sorts. We were literally whisked through immigration and customs (political connections help) and accommodated in a plush Makati condominium for a few hours of sleep.

Next morning, early enough to beat the infamous Manila traffic, we were on our way northward to San Fernando, La Union, along with the hectic Mission itinerary for the week as given to us by Leus and Niles Perlas (well organized ). It was a nice and scenic 7 hour bus ride, with catnaps in between and an unscheduled stop for physiologic necessity at a house in Mabalacat, Pampanga whose welcoming residents demonstrated what Filipino hospitality is to complete strangers. Our American friends were impressed.

Arriving in San Fernando, lunch was first served in the Philippine Naval Base (when in the Philippines, you never get hungry - "kumain ka na?") along with Dr. Fernando Astom (US trained surgeon and La Union project coordinator) orienting us about Ilocos Regional Training Medical Center ( a government hospital ) the venue of the Mission.

After settling in a seaside resort hotel that afternoon, on we went to the IRTMC for a "press conference". Kapwa Ko Mahal Ko Foundation- a non-profit organization- under the Secretary of Defense Orlando Mercado, was part sponsor of the project with FAMI. Being apolitical in a Mission like this was ideal. However, being in the Philippines, this was a necessity, evil or not. Facilitation was the key to get things moving.

That afternoon, we were faced with the reality of the Mission. Doing our pre-operative rounds, Lloyd Gayle, plastic surgeon, was faced with a ward full of cleft lips and palates. I was in another hospital ward with a maximum occupancy of 12 thyroid cases and 20 more on the waiting list. We had our work cut out. Our anesthesiologists, Drs. David Lee and Jim Beckman were occupied with the surgical rooms and anesthesia machines (crude by US standards) as was Michael Lee, orthopedic surgeon.

That evening, just like every following evening, was a respite from our hectic schedule. Native, luscious, ergonomic dishes were always served us. Lunch, was always there for us, after morning surgeries. The schedule really went like this daily : Wake up 6am. A little peck at food. 7am - on to the hospital with pre-op and post-op rounds and surgeries started thereafter till about 5 PM. Recovery room nurses were the last to leave. Evenings were taken cared of by the Governor and back to bed exhausted late at night. It was a blessing to have surgical residents, anesthesia residents, ENT residents available for help. Our experiences surely added to their education. Cases, even as far as Baguio, were pouring in. Osteogenesis imperfecta, breast cancer, burn contractures, even pancreatic cancer, were surfacing out of nowhere.

Unfortunately, we could only do so much with so varied cases. These destitute patients were pitiful and there was a sense of guilt on our part that we had to depart