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    A Heart for Service and Excellence

    Message at the 33rd Homobono Calleja Heart and Vascular Institute Anniversary Opening Ceremony and Annual Business Meeting

    St. Luke’s Medical Center, Quezon City

    Thank you very much. Kindly take your seats.

    Dr. Anthony Uygongco, Assistance Chief Medical Officer, of the St. Luke’s Medical Center (SLMC); Dr. Gregorio Rogelio, Director, Homobono B. Calleja Heart and Vascular Institute; Dr. Homobono B. Calleja, Director Emeritus of the Heart and Vascular Institute, SLMC; members, board of trustees of SLMC; members of the executive committee of SLMC; former chief medical officers; consultants; fellows; unit heads and staff; honored guests; ladies and gentlemen: Magandang umaga po sa inyong lahat. Pagpasensyahan niyo na, nagulat ako. Ako na pala agad. [laughter] Akala ko mayroon pang ibang magsasalita.

    It is an honor to join you as you celebrate the 33rd Founding Anniversary of the Homobono Calleja Heart and Vascular Institute of the St. Luke’s Medical Center.

    Let me also congratulate this year’s Homobono Calleja Awardee, Dr. Florimond Garcia, whose work and contributions in the field of Vascular Surgery is affirmation that St. Luke’s Heart and Vascular Institute is truly one of the best training institutions for Vascular Medicine in the Philippines. This is a prestigious recognition in a nation where heart diseases take the lives of many of our people every day.

    St. Luke’s Quezon City has always felt like home, not only because both my residence and my office are only a few hundred meters away, but also because my daughters and I depend on Dr. Bimbo Sibulo for almost all of our health concerns. Pati po mga kasambahay namin sa kaniya namin dinadala. [laughter] Dr. Bimbo is a cousin; his father and my mother are first cousins. Iyong lolo niya po at saka iyong lola ko, magkapatid. We both come from Naga City.

    I have a very personal appreciation for the difficulties you face in your profession. My late husband, Jesse, came from a family of doctors. My second daughter, Tricia, is on her way to becoming one; she started her internship last July so malapit-lapit na. Malapit nang mag-boards. Sa Ateneo po kasi, nauuna iyong internship kaysa sa graduation. I have been a witness to the countless all-nighters, the overnight shifts, and how hard work, selfless service, and excellence are required from all of you in the medical profession.

    When I hear of inspiring stories of doctors who have defied great odds, I am even more amazed by the nobility of your profession.

    Last Wednesday, we visited Itbayat, which was severely affected by a series of strong earthquakes last Saturday. Kung nalalaman po natin iyong mapa ng Pilipinas, Itbayat is the northernmost island of the province of Batanes and also the northernmost town of our country. To go to Itbayat, you will have to ride a boat—it’s a two-hour boat ride away from the main island of Basco. The devastation that greeted us was a little too much to bear—iyong nag-iisa pong ospital was severely damaged, hindi na magagamit, and so were churches, schools, and houses. Everyone has camped out of the town plaza. Lahat po ng taong nandoon sa town plaza, living in tents. Pero in the midst of all the confusion, we met this doctor. Sabi niya po—batang-bata pa na doktora—sabi niya, nag-iisa lang daw si Dr. Jennifer Robillos. Isa siya sa tatatlong doktor sa Itbayat. Hinahanap ko iyong dalawa. Sabi niya, iyong isa nag-iikot. Iyong dalawa palang nag-iikot, iyong isa hindi taga-roon pero nakapangasawa ng Ivatan. Pero iyong isa is also a very young doctor. Ano siya, one of the doctors to the barrios, tapos na raw iyong term pero nagpa-extend pa. At siya iyong pangatlo—and she is a native Ivatan. Ang kuwento niya, napakahirap ng pamilya nila. Nakatapos siya ng pag-aaral because of scholarships. So she was able to put herself through med school because of scholarships. But it was very clear to her that after passing the boards, she would return to Itbayat. Kaya nakabalik na siya, nakapasa na siya ng boards three years ago. Pero nakita ko iyong dedication—nagiba rin iyong bahay nila pero hindi pa siya nakakauwi, hindi pa siya nakakaligo, ubos iyong kaniyang panahon, nagpapa-anak, nagde-declare ng mga dead, nag-aasikaso ng mga may sakit—you know, the amount of passion and dedication that I saw in her was really very inspiring.

    And this is the same passion that I have seen among a group of doctors in Nueva Vizcaya, who embarked on a project to ensure that the poor get the same kind of medical services as those that live in the city. Hindi ko alam kung familiar kayo but I was able to personally visit Salubris Medical Center during its inauguration in June of—October pala, October of 2017. To those living in that remote province—iyong Nueva Vizcaya—up north, the medical center was such a huge breakthrough. The group of doctors who first thought of it mobilized the community amid a lot of resistance, pooled resources, and built the hospital on what used to be rice paddies. Even local farmers invested in the project! In fact, noong inauguration nandoon iyong mga magsasaka na nag-invest doon sa proyekto. Napaka-inspiring.

    And I always tell their story whenever I get to talk to doctors and other medical practitioners because it shows how far empathy, selfless service, and excellence can go. In the Artificial Intelligence-abundant world of tomorrow, where technology will do much of the heavy lifting, our ability to deliver compassion and empathy will become much more valuable.

    Technology is truly changing the world of medicine. In more advanced countries, modern machines have taken over medical procedures. Robots are now performing heart surgeries and virtual blood tests can be availed of—making it easier for patients to receive services without leaving the comforts of their home. In fact, I was told —hindi ko po alam kung totoo—that robotic surgery is already being done at St. Luke’s!

    But these developments also highlight the grim reality that for millions of Filipinos, quality healthcare is still far from reach. People who live in far-flung communities have to travel for hours to the next barangay or even the next town to be examined by a doctor. Government health facilities are overcrowded. Some barangays do not have proper equipment and staff for their health centers, and many do not have health clinics and ambulances at all. Children grow up without getting preventive vaccines and immunizations. Around 1.5 million Filipinos fall into poverty because of health care expenses.[1] A study showed that medical inflation in the Philippines is expected to increase to 13.7 percent in 2019 from 13 percent in 2018.[2]

    What does these all mean? That the issue of public health is truly a silent crisis that deserves our full attention. We need to find ways to improve primary healthcare so that hospitals do not get too crowded and there is less strain on facilities and human resources.

    Given these circumstances, how can we ensure that the Filipino people have access to quality and affordable healthcare, especially those in far-flung areas?

    First, we need to make sure that we effectively carry out our country’s health reforms. With the recent passage of the Universal Healthcare Act (UHC), we are now a step closer to turning our dreams into reality but we know that there is more work to be done. It is very important that a very good, comprehensive IRR is crafted to ensure that the heart and spirit of the law will be encapsulated. And once it is rolled out, there has to be regular monitoring and evaluation to ensure its faithful compliance. One of the ways to do this is to create safeguards so that healthcare systems in local governments are successfully integrated with their provincial counterparts.[3] This is because of the realities that we saw on the ground after health services were devolved to LGUs. People tend to work in silos: the local municipality would often have its own separate health programs and, sometimes, these programs are completely different from the health programs of the province to which it belongs. As a result, there is so much waste of resources. We have to find ways to weave all these existing programs together so that healthcare reforms will truly be effective.

    More importantly, we need to lobby policies that will push the universal healthcare agenda forward such as empowering and capacitating barangay health workers. From our many visits to remote communities, we have observed that oftentimes, local clinics and centers are not responsive because even when we have enough hardworking community health workers, most of them are grossly underpaid and under-trained. This is why when I was still in Congress, I filed a bill that would have institutionalized the hiring of barangay health workers and barangay nutrition scholars as regular government workers with the accompanying salaries and benefits. Ang problema lang, the bill has not been passed into law, but I’m continuing to advocate for it.

    Second, we need to find innovative ways to improve access to healthcare services, especially to those in the poorest, farthest, and smallest communities. Health budgets should be more socialized. Localities that need more should get more resources not just for medical equipment and medicines but, more so, for skills training and capacity building because ultimately, they have the primary task of making our health programs work. Ang nangyayari po kasi ngayon: mas mayaman iyong lugar, mas marami ring nakukuhang pera. Iyong mas mahirap na lugar, mas kaunti rin na pera iyong nakukuha because of the formula for computing our internal revenue allotments. But we hope that will change soon because there have been Supreme Court decisions recently na medyo mababago iyong computation. Meaningful collaborations between the private and the public sector is also key.

    When I was still in Congress, we partnered with Seaoil Foundation in creating a Senior Wellness Program for the Third District of Camarines Sur, which I was then representing. Along the way, we realized that most local government units did not have the baseline numbers that are critical in designing a responsive program. Ito po iyong nakakalungkot: kasi lahat na LGU na puntahan mo, marami namang programa—maraming ginagastos pero una, walang baseline numbers na inuumpisahan. Sunod, hindi nila sinusukat—hindi nila sinusukat kung effective ba iyong ginagawa nila. We also discovered that the medicines that were available for free at their local health centers were not usually the ones that everyone—not just the seniors—needed! So, we started from scratch, brought specialists to do in-depth medical assessments of patients, and created an inventory of their illnesses, the interventions that they needed, and their prescribed medications. Using the health profiles that we created, government was already able to provide for correct medical treatments and right medicines. That simple exercise alone helped lessen the worries of senior citizens when it comes to the cost of staying healthy.

    When I became Vice President, I swore an oath to uplift the lives of the Filipino people, especially those in the fringes or what we call “mga pamilyang nasa laylayan ng lipunan.” Prioritizing healthcare is imperative in fulfilling that oath so we made it one of our key advocacies through our anti-poverty program called Angat Buhay. Our dream is simple: that quality and affordable healthcare should be available for all Filipinos, never discriminating between rich or poor.

    We are starting to witness this in San Remigio, Cebu, one of our adopted communities under the Angat Buhay program. Hindi ko po alam kung familiar kayo sa San Remigio but it is one of the small coastal municipalities in the northern part of Cebu province. We have been working with both the local government and our other partners to address the mental health needs of the community. We first visited San Remigio in March of 2017 for, initially, a dialogue with a fishing community. But while we were there, we discovered that there was a large number of mentally ill residents locked up in cages and chained by their families because of their violent episodes. We knew we needed to do something and we needed to do it fast.

    So we sought the help of the Philippine Mental Health Association–Cebu Chapter. In partnership with them and the local government of San Remigio, we did a mapping of the community to have a clear baseline that will guide the creation of the most effective strategy and intervention for the community. And since then, barangay health workers have been trained on the intricacies of dealing with mental illnesses. Medicines and community-based treatments are now being provided to the patients on a regular basis, as well.

    Our office also built a mental health facility for the patients which we turned over to the local government unit last February. We partnered with Solanaland Foundation and ANCOP USA, which provided for the facility’s furnishings and medical equipment. Beautiful things happen when people and organizations work together, and our prayer is for the community to be a safe and nurturing environment for the mentally disabled.

    The good news is that we have already been hearing stories of remarkable transformations in San Remigio. During one of my visits, family members were profusely thanking us because their patients were already leading more normal lives. Sabi po nila, nakakatrabaho na sila nang maayos kasi hindi na masyadong kailangan bantayan o tutukan iyong mga pasyente. There was one patient, a 41-year-old man whose father and brother were murdered in 2006. He was diagnosed with severe depression with psychotic features. We were told that this illness was more difficult to deal with, since society responds to them in a very negative way. He experienced discrimination, judgment, and fear—making his recovery very difficult.

    But his inclusion in the San Remigio health program, has changed the course of his life’s journey and he has shown dramatic improvements in his mental condition. We were told that he is now working as a helper and a construction worker in San Miguel Elementary School. These are developments that bring us great joy, because one man’s struggle with depression and mental health can show us how others can survive it too. And true enough, he’s just one of the many stories of individuals and families getting their normal lives back because of the program.

    Another significant story of transformation under our Angat Buhay program is that of Agutaya—I don’t know if you’ve heard of Agutaya but it is a group of small islands in Northern Palawan. To reach its shores, you have to take a gruelling 10 to 16-hour boat ride from Coron.

    The first time we went in November 2016, the people met us with tears of joy. We were told that it was one of the few times that a national official visited their place. When we visited the only elementary school in Brgy. Diit, we noticed that the Grade 5 students were as small as the Grade 1 students. The doctor who accompanied us told us that most of the kids on the island were stunted. Stunting, as you all know, is an irreversible condition after the age of five. According to a Save the Children report, the Philippines had 3.78 million stunted children — the 9th country in the world with the highest number of stunting.

    The entire island did not have electricity and potable water. There is no clinic or any modern health facility nearby. There is no doctor or nurse on stand-by. If you are coming from one of the farthest barangays in Agutaya, the nearest hospital is six hours away on the island of Cuyo. So imagine how difficult it is for the locals to respond to medical emergencies.

    Through the generosity of our Angat Buhay partners, Agutaya is slowly being transformed into a healthier and livelier community. For instance, through our Angat Buhay partners, Team Energy and ASA Philippines, more than 400 households already have electricity. Another Angat Buhay partner, Andres Soriano Foundation, is already building a Water System aside from spearheading health caravans, which are providing families with free medical services, physical examinations, and clinical tests. Other partners have also initiated feeding programs, gave away boats to the fishermen, installed WASH facilities in schools, put up a toy library, and started livelihood programs.

    These are just some of the many things we have been doing for the past three years. There are many more stories from places like San Remigio and Agutaya that show the lingering health-related problems that Filipinos face on a daily basis. Stories that show us that there are a lot of opportunities for collaboration and that we must rally behind a common goal to uplift the welfare of our people.

    It is our dream that together, we can make our health care system work better for patients and health professionals alike because for every Filipino that is given proper access to healthcare, an entire family can break free from poverty.

    As doctors, routines and responsibilities are critical to our success, but the lesson for all of us is never to forget the human aspect of our work—that public healthcare is, first and foremost, about improving the human condition. That compassion and empathy will cure apathy and neglect. That your generous hearts for selfless service and excellence will cure our nation in these difficult times.

    So together, let us never forget to serve the last, the least, and the lost. The Filipino people deserve the best. So thank you very much and happy anniversary to everyone! [applause]

    Posted in Speeches on Aug 05, 2019