A Cry for HELP

[Randy Roberson]

This is the story of a 14 month old boy born to an 18 year old mother who tragically died on the island of Mindanao in the Philippines. This report/plea for assistance came from Philippino medical staff at one of the remote rural clinics HELP visited during "Needs Assessment" operations recently.

See more about how you can help at the bottom of this page.


One afternoon on a very busy consultation day at the rural health unit, one little fellow carried by a young lady caught my attention. I was stunned to see a little boy who looked like a 75 year old man, weak and in respiratory distress. Upon seeing the patient, I immediately walked out of my room and approached the patient.

The patient came in for consult because of 5 days cough. Respiratory rate is 62breaths/min, temperature of 37.9 C, and only weighs 4.9 kg at 1 year and 2 months. Patient is in respiratory distress with nasal flaring, with chest in drawing with sub costal and intercostals retractions. On auscultation there were crackles all over the lung fields. But on top of his illness and physical state of malnutrition lies the much severe and depressing sickness of poverty.

The Rural Health Unit does have oxygen tank but doesn’t have oxygen regulator, we do not have pediatric ambu bag either. Despite the need to give the patient Oxygen inhalation, we could not do more because of the limited resource. Sad to say, we really are not equipped with the equipment necessary to provide emergency treatment for our patients. So depressing!

The best management we could offer was to give oral anti pyretic and oral anti-biotic then send the patient to the hospital for immediate management. But despite the urgency shown by the health personnel, the parents seem to be hesitant to go. Upon further inquiry, it was found out that they don’t have the money for hospitalization, though pretty quite obvious as seen in the nutritional status of the patient.

We tried to convinced the parents to send the child to the hospital immediately if not the patient may die in a few hours time. We escorted the patient to the Department of Social Welfare and Development for assistance. Then, patient was brought to the hospital.

At that point, we were trying to treat the physical and biological sickness of the child. But as public health personnel working in a rural community, I understand the urgency and need to address the much severe illness of the family, their socio economic state.

The day after, I asked the midwife about the condition of the patient and I was saddened and dismayed that the patient expired few hours after admission.

If only we have the materials and equipment necessary for emergency management we might have saved him. We hope that somebody out there will hear this cry……So that no more little MYCO gone.

Felicita Sampul,MD,MPH
Doctor to the Barrio
Mutia, Zamboanga del Norte
Philippines

Photo - HELP President Randy Roberson and other volunteers from the US and Canada join clinic and university staff outside clinic mentioned in this story.


W E N E E D Y O U R H E L P C L I C K H E R E T O D O N A T E N O W

HELP is working to gather the support needed to not only get this one clinic the Oxygen and Ambubag they asked for but an entire 40 foot cargo container filled with hundreds of thousands in donated medical equipment and supplies.

Through strategic partnership with Sir Edward Artis and our good friends at Knight’s Bridge International the Equipment we need is obtained for free. What we desperately need are the funds to send this life-saving container from the USA to Manila Philippines and then down south to the Ateneo de Zamboanga University Medical Center in Zamboanga City on the island of Mindanao.

This clinic mentioned above is one of numerous clinics operated by the physicians and med students from the Ateneo de Zamboanga University in Zamboanga City. The university uses teaching methods that are being studied by Georgetown University and other US-based institutions. Their focus is to provide "problem-based learning curriculum." This means 1st year med students are assigned to small rural clinics.

As there are huge populations who go without any type of medical care, this is well received by the rural populations. Incidentally there are approximately 80 million people living in the Philippines. With only 30 million living the metropolitan areas, 50 million live dispersed in the rural areas of the approximately 7600 islands that make up the Philippines.

Most have no way to even travel to modern medical facilities so these rural clinics are their only hope when facing the chronic health needs of the area. The most significant of these challenges are Malaria, Dengue Fever, Pneumonia, TB, Water-born Disease and Malnutrition. The talented students and Physicians from the university pledge themselve to the plight of the people in rural Philippines.

The cost to send a 40′ container from the USA to Manila $10,500US

Cost to then send it to Mindanao $2,500US

Total cost to bring life-saving supplies and equipment to numerous rural clinics on Mindanao $13,000US. The wish list at the bottom of this page come from medical staff at partner clinics in the same region. It is these tools we are striving to deliver in a place of desperate human need.


HELP is also working to establish more telemedicine links to the various clinics as well as the university. These links can provide advanced medical consultation from physicians at the University and around the world.

CAN YOU HELP US HELP THEM?

C L I C K H E R E T O D O N A T E N O W

MEDICAL EQUIPMENT WISH LIST

Wish List for the Doctor-In-A-Box/Bag

Target Areas: Bongao in Tawi-Tawi Island, Southernmost part of the Philippines, to include nearby islands such as Simunul and Sibutu Islands.

Doctors: Dr. Shadrina Tahil (Bongao), Dr. Jamar Sarapudin (Simunul Island), Dr. Yashier Maali (Sibutu Island), Dr. Shernand Felisario (Internal Medicine, Zamboanga City), Dr. Bernadette Macrohon (Pediatrics, Zamboanga City), Dr. Clint Macrohon (Interventional Radiology, Zamboanga City)

Needs:

Nebulizer and tubings – for rapid and immediate treatment of bronchial asthma and COPD so that we can gauge response to treatment while the doctor is in clinic
X-ray machine – pneumonia with complications such as pleural effusion or empyema or consolidation, pulmonary tuberculosis, and trauma are common conditions that doctors often see in the remote villages. An x-ray machine can help send images asap to the radiologist in Zamboanga City. A common practice in Jolo (where they have an x-ray machine) is to compile all x-ray plates together for the last six months and send over in a big box to the radiologist in Zamboanga for reading ——— six months later.
Pulse oxymeter – short of having an arterial blood gas machine, this can help us gauge oxygen saturation of patients, specially when dealing with respiratory problems
Ultrasound – this is useful for marking and guiding minor emergency surgical procedures such as thoracentesis and liver abscess aspiration, besides the standard use for gall stones and kidney stones as well as for obstetric follow-up.
Electrocardiogram – for use in helping to identify hypokalemia in diarrhea (low to flattened T waves) or with myocardial ischemia and cardiac monitoring of heart failure patients.
Microscope with staining reagents – for complete blood count, malarial smears, CSF staining, peripheral blood smear
Negatoscope – to be able to present the films properly for better picture quality when we take and send the pictures to the radiologist
Centrifuge – for processing of specimens for blood counts and smears
Blood sugar level determination – portable and fast, these bedside, palm-sized instruments can help us screen for diabetes among the population in the different islands who couldn’t even take the boat for routine check up.
Blood chemistries – for lipid, triglycerides, BUN, crea and liver enzyme determination as part of screening during hypertension and management
Screening panels – ELISA tests for typhoid, dengue, hemophilus, streptococcal, meningococcemia for rapid diagnosis and treatment
Minor surgical kits – for cases of wound suturing, circumcision, foreign body extractions (shrapnel wounds)
Opthalmoscope/Otoscope – for evaluation of common eye and ear infections
Software that can transmit all these data to a cellphone (Nokia E70, Nokia Nseries) instead of a laptop so that specialists in the city can respond instantly instead of having to open up their laptops or keep their laptops open
Refrigerator – for storage of specimens and immunizations
Defibrillator – in cases of ventricular fibrillation and cardiac arrest
Laryngoscope – for neonates, pediatric and adult patients
Ambubags – for cases needing advanced life support
Delivery set – surgical scissors for cutting the umbilical cord (locals use bamboo slivers), clamps, and clips for the umbilical stump.
Instrument sterilizer – for proper sterilization of equipment
Loup and shiotz tonometer – for screening of glaucoma
Drop light – for keeping newborn babies warm as well as for added lighting during surgical procedures
C L I C K H E R E T O D O N A T E N O W