TOTO to TATA “A Gift of Life” As Totoong Serbisyo para sa Bagong Maguindanao! From Gov. Esmael G. Mangudadatu
Contents Acknowledgement
................................................. 3
Overview
................................................. 4
Objectives
................................................. 5
Human Resources
................................................. 5
Patient’s Profile
................................................. 5
History of Illness
................................................. 6
Medical and Surgical Treatment
................................................. 6
Chemotherapy Sessions
................................................. 7
Other Patients
................................................. 8
Documentations
................................................. 9
Annexes
................................................ 20
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Committee Membership
2
Acknowledgement First and foremost, the technical team expresses their utmost gratitude to the Almighty Allah, the Most Merciful and the Most Beneficent for giving us life that treasured most, above all things. To our Honorable Governor Esmael ‘Toto’ G. Mangudadatu and his administration personnel for deepest concerns in our financially deprived constituents, for provision of any means possible and accordingly, has given hope amongst cancer patients; To the DOH-ARMM Secretary Dr. Kadil Sinulinding, Jr. and staff for performing the surgery and providing post-op needs of the patient. To Dr. Elizabeth A. Samama, OIC-Provincial Health Officer of Maguindanao for her support to ensure that patient needs will be addressed and quality health services will be afforded; And for her encouragement and guidance in making this report. To the Southern Philippines Medical Center (SPMC)’s Children Cancer and Blood Disease Unit (CCBDU) Senior Consultant Dr. Mae Concepcion Dolendo and Staff; and, St. Jude Children Research Hospital, Memphis, TN USA and World Children Foundation for all the unconditional assistance. To Buluan District Hospital Staff for countless efforts in providing extended care to the patient in her pre and post surgery. And lastly, to everyone, who in one way or another, has shared and did their part in trying to make sure that the patient can recover.
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OVERVIEW The Provincial Government (PG) together with the IPHO-Maguindanao and other multi-sectoral partners are one in trying to ensure effective and efficient provision of Quality Health Services to underserved communities. Along with this, regular dispatch for free medical; dental and surgical procedures under Mobile Hospital has been started already and thousands of constituents have benefited. With the protocol of Mobile Hospital as stated in its Operational Manual, under its special considerations, “Patients diagnosed as having extensive disease and needs to undergo major operation shall be scheduled in a secondary hospital such as Buluan District Hospital Under this case, in one of the medical outreaches conducted, patient Tata Lawan has been diagnosed as having Retinoblastoma in her left eye and is considered to be a Major disease and has to undergo major operation in a tertiary hospital with the help of a competent surgeon. However, the patient is belonging to the indigent/constituent in our province and cannot meet the needed expenses of this type of hospitalization. With this prevailing situation, the Provincial Government of Maguindanao through the initiative of Governor Esmael G. Mangudadatu and DOH-ARMM Secretary Dr. Kadil Sinulinding, Jr., the operation of the patient was made to be feasible. Moreover, provision of free medicines and surgical operation is not enough to totally purge cancer cells. The need for specialized treatment was recognized as networking with higher level of care. Hence, the Provincial Government of Maguindanao
has
tapped
various
health
organizations
that
grant
free
chemotherapy for cancer patients that cannot afford it. Luckily, the Southern Philippines Medical Canter’s Children Cancer and Blood Disease Unit sponsored by the St. Jude Children’s Research Hospital based in Memphis, TN USA is now in union with Governor Mangudadatu and embraced Tata Lawan throughout her Chemotherapy course.
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OBJECTIVES 1. To address health concerns especially of the underserved members of the community. 2. To strengthen network with CSO’s, iNGO and other agencies that provide medical services to poor and deprived constituents. HUMAN RESOURCES In provision of the assistance, the following personnel participated: 1. Maguindanao Mobile Hospital Team 2. DOH-ARMM Personnel 3. IPHO-Maguindanao Personnel 4. Southern Philippines Medical Center’ s Children Cancer and Blood Disease Unit 5. Provincial Budget Office Personnel 6. Provincial Planning and Development Office Personnel 7. Municipality of Buluan LGU Officers and Staff 8. Buluan District Hospital Staff PATIENT’S PROFILE Name
: Tata Empa Lawan
Sex
: Female
Age
: 4 y.o.
B-day
: March 10, 2007
Father
: Thong Lawan
Occupation : Fisherman
Family history of cancer : None Mother
: Monera Lawan
Occupation : Housewife
Family history of cancer : None Siblings
: Rosana E. Lawan
Surab E. Lawan
Popoy E. Lawan Address
: Poblacion, Buluan, Maguindanao 5
HISTORY OF ILLNESS Between March to April 2010, patient started having simple swelling of the left eye as claimed by the mother. There was no consultation done and no medications taken. Few months later, the reported swelling progressed and this time, noted with an abnormal appearance of the pupil and was described by her parents as -like cat’s eye. It caused distortion of her physical appearance. With this insufficient knowledge regarding the disease, parents did not seek advice and treatment from health practitioners instead went to a “quack” doctor as they believe caused by “Satan” and self-medicated with Amoxicillin and Mefenamic Acid Syrup. In one of the Medical Outreach of the Mobile Hospital, the patient was examined by the Doctor and ordered admission to the hospital for further evaluation and management. During this stay at the hospital, the Provincial Governor of Maguindanao and the DOH-ARMM Secretary of Health sought this need in attention and planned to do the immediate surgery and other treatments needed by the patient. MEDICAL AND SURGICAL TREATMENT The patient was admitted in Buluan District Hospital on March 14, 2011 where initial laboratory and medical treatments including daily dressings were done. Multivitamins and antibiotics were also given. During this admission, patient had abdominal pain and diarrhoea but were all controlled. Patient has undergone CT-Scan which revealed “Rhabdomyosarcoma” of left eye. The patient was then, referred to Dr. Sinulinding, Jr. and scheduled surgery. Two days before the surgery, patient was transferred to Cotabato Medical Specialist where procedure will be done. Consultation to a Pediatrician- Dr. Singgon was initiated and laboratory work-ups were started. During this time, parents were noted to have physical and emotional distress because of days without proper sleep and rests. Hence, the staff prepared them through family counselling. The patient was scheduled on March 24, 2011 for surgery and on this day of the operation the staff of Provincial Government of Maguindanao, the personnel of the said hospital and especially the parents were all agitated for the outcome of the procedure and hope for a positive result from the doctors. 6
The patient was brought to the operating room where all instruments and equipments were well set-up. Headed by Secretary of DOH-ARMM Dr. Kadil Sinulinding, Jr. and his staff, enucleation of left eye was done. A tumor was totally excised under general anaesthesia. No notable problems encountered and the procedure ran smoothly with aid from the Almighty Allah. After the procedure, biopsy of the specimen revealed that the tumor is a retinoblastoma and it’s already at stage IV. Hence, chemotherapy of the patient is now a priority facet for patient’s faster recovery. Upon discharge of the patient from Cotabato Medical Specialist Hospital, she was then brought back to Buluan District Hospital (BDH) and waited for chemotherapy session to be scheduled in Southern Philippine Medical Center. Patient was started on antibiotics, anti-inflammatory drugs and anti-pyretics. At the hospital, there was noted no decline of fever, thus immediately referred to the BDH-resident on duty and to Dr. Singgon, who ordered new antibiotics and other drugs for the patient. CHEMOTHERAPY SESSIONS The patient was transferred to Southern Philippines Medical Center (SPMC) in Davao City on April 01, 2011 and directly brought to Children Cancer and Blood Disease Unit or CCBDU. The CCBDU of SPMC is the only hospital in Asia affiliated by St. Jude Children’s Research Hospital and World Children Foundation. It started its operation on November 18, 2006 and has its own Filipino Doctors, Nurses and other staff especially trained in their hospital to cure children’s cancers here in Mindanao. They provide free chemotherapy drugs, counselling of the parents and House of Hope where parents and relatives can stay while their patients are on sessions. Patient stayed in the Pediatric Intensive Care Unit (PICU) for 16 days for vital signs stabilization. Chemotherapy sessions were started on April 25, 2011, and were based from the Retinoblastoma Protocol of Dr. Carlos Galindo-Rodriguez of St. Jude Children’s Research Hospital. The patient’s regimens per course are as follows: 1. IV Vincristine 2. IV Carboplatin 3. IV Etoposide 7
The patient is now on the first course of chemotherapy, correction of fluid/electrolyte imbalance and completion of antibiotics. OTHER PATIENTS When patient Tata Lawan was admitted in the CCBDU of SPMC, the Provincial Governor heard of the other two (2) cancer patients and immediately ordered to provide the patients any means possible that the provincial government can offer. The following are the list of cancer patients with their corresponding diagnosis: 1.
Balading, Roaida Macarimbang, female, 5 years old, residing at Matanog, Shariff Aguak, Maguindanao and diagnosed as having Wilm’s Tumor, right (a type of cancer affecting the right kidney). The patient had undergone removal of affected kidney.
2.
Dampas, Abdulrauf Blaim, male, 11 years old, residing at Datu Odin Sinsuat,
Maguindanao
and
diagnosed
with
Acute
Lymphoblastic Leukemia (a type of cancer affecting the blood). The patient is currently having chemotherapy sessions.
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Documentations i. The patient while still at their house and not yet examined by the physician
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ii. Sec. Sinolinding, jr. visited, examined and ordered immediate surgery
iii. Transporting the patient to the tertiary hospital for the surgery
iv. Outside the operating room waiting for the surgery
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v. Dr. Sinulinding, Jr. and Dr. Singon inside the OR waiting for the nurses to finish the preparation.
vi. Cyst removed and about the size of a 10ml syringe
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vii. Tata Lawan after the surgery
viii. 8th day after the surgery
ix. Chemotherapy sessions at SPMC
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x. Balading, Roaida and Dampas, Abdulruf also supported by Provincial Government
xi. Ms. Lynette Estandarte with Senior Consultant Dra Mae Concepcion Dolendo
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ANNEXES COMMITTEE MEMBERSHIP CHAIRMAN: Gov. Esmael G. Mangudadatu VICE CHAIR: Medical Concerns: Dr. Kadil Sinulinding, Jr.
Dr. Tahir B. Sulaik
Dr. Elizabeth A. Samama
Administrative Concerns:
Engr. Abdulwahab V. Tunga
Budget Concerns:
Lynette A. Estandarte
MEMBERS: Provincial Government of Maguindanao Staff Maguindanao Mobile Hospital Team DOH-ARMM Staff IPHO-Maguindanao Staff BDH Staff
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