|The Philippine Universal Health Care through Republic Act 11223 left some persistent challenge such as access to specialties like Surgery were concentrated mostly in urban and affluent areas, leading to a disturbing lack of access to essential surgical services in more rural or remote areas. This was particular dramatized during the “covid focused” health care system all over the world where surgically treated illnesses were among those most neglected.
Other countries have implemented Rural Surgery programs in hopes of increasing access to safe and affordable plus quality specialist surgical services in these marginalized areas. This program can be introduced and mainstreamed in the Philippines with a properly studied pilot implementation and will be the first of its kind. The Co-Operasyon Rural Surgery Program will collaborate with Mabini Community Hospital (MCH) in Mabini, Batangas and the UP PGH Department of Surgery (DOW-PGH) and will be supported by the DOH Center for Health Development.
The Pandemic and recent fire created reduced PGH surgical productivity creating need for cases for Residents in order to graduate and an excess of supply of surgical expertise. The idea is to send a team of 3 Residents (1 senior, 1 intermediate and 1 junior) to go on a 1-2 week rotation and man the Operating Rooms and outpatient of MCH. A General Surgeon (MHO of MHC) will supervise residents as on-premise consultant while PGH consultants supervise remotely through teleconferencing for every case or be on the premises as availability allows. Cases that cannot be done because of safety and capability will be elevated to the Batangas Medical Center or to PGH. This becomes a win-win situation where surgical expertise and access is spread centrifugally (rather than centrally focused). Trainees will fulfill the requirements for their surgical residency and at the same time provide services where there were little to none. It exposes them to potential areas where they may want to practice someday and elect to stay particularly if the collaborating hospital upgrades its capability in terms of support of these experts.
Parallel to this developing concept of Rural Surgery, the pandemic halted the UPMASA Medical Mission initiative. Serendipitously, this called for a search of alternative ways to channel the momentum that the UPMASA Medical Mission goes through when preparing every year. The goal is the same: to provide Surgical and Medical expertise to remotely underserved areas of the Philippines, albeit doing it SWAT style, however, non-sustained and no lasting legacy except for memories and perhaps lasting change to those helped in that 5-day mission work.
Championed by an idea from Dr. Hernan Reyes, Emeritus Chairman of the Department of Surgery, Cook County Hospital Chicago, Illinois, a UST Graduate and a product of UP Diliman, and our very own Dr. Frances Tollete-Velcek and Dr. Susan Echiverri, an independent idea blossomed on supporting and sending Residents from PGH Surgery Department to rural areas to do teaching and service for periods of time instead of Medical Missioners coming from the USA. While discussing the PGH Fire needs, Dr. Henry Echiverri mentions this intent to classmate Dr. Armando Crisostomo during a telephone conversation while the Department of SURGERY Business meeting was ongoing. It was announced and accepted and the collaboration was born. The Grant Application was approved by the Project Coordination Committee. A monthly support of $2500 for 3 months as a pilot project to support the financing of the RURAL SURGERY Co-operasyon Program will be initially financed by the donations from its proponents: Dr. Frances Tollete-Velcek, Dr. Susan Echiverri, Dr. Henry Echiverri, and Dr. Hernan Reyes. If successful, then the program will continue through individual generous support as UPMASA pass-through donation.
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The overall success of the Co-Operasyon Rural Surgery Pilot Program will become a blueprint that will aid in replication, policy-making and further innovation and improvement. Imagine the implication once we have UP PGH in Diliman, UP College of Medicine in Mindanao, UP Medicine in Clark. These centers will be the hub that will support the spokes of spreading the edge of Medicine and Surgery.