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Tuesday, January 3, 2012

My notes: Conducting and Organizing a Medical Mission

Dave and Macrine with the Morions, Medical Mission, 2011

This article was published in MI newsletter regarding the Medical Mission of Love III, February 2004.

Organizing and preparing for a medical mission is not an easy task. It takes a lot of preparation, organisation and communication besides the obvious fund raising activities. People outside the organization thinks it easy, after they have seen how smooth and successful were the previous medical missions conducted by Marinduque International, Inc (MI) to the province of Marinduque. The following article was taken from my notes during Medical Mission of Love III and published in our MI newsletter in 2004. Macrine, my wife, was President of MI, Inc at that time and I was her personal executive secretary.

Preparation for the Medical Mission of Love III started about 18 month ago during the presidency of Steve Sosa(2002-2003). After the MI Board of Trustees approved the mission, it was decided that each chapter should contribute $5000 to finance the project.

A list of respective assignments and expertise (MD's, nurses, pharmacists, and support personnel) was compiled. At the first MI, Inc. meeting in 2002, a specific member of MI, was assigned to contact each name in the prospective lists of missioners. This work was very slow. However, the Board of Directors have decided that the week of February 7-14, 2004 is the MISSION WEEK instead of May to avoid the hot, and humid climate in the month of May in the Philippines.

From December, 2002 to about October, 2003, the Internet wires were burning between Dr. Hector Sulit (physician-in charge of the mission), Mr. Steve Sosa ( former president and Chairman of the Board) and Mrs Macrine Katague ( current president)discussing the proposed mission activities. There was reluctance from a couple of chapters regarding the financing of the mission. However, by mid-2003, enough funds were received by MI, to continue planning for the mission.

By October, 2003, Macrine keeps reminding everyone to give her the names of individuals planning to join the mission. The names were entered into Macrine's Excel list, including their expertise and specialization. Half of the names appeared to be only support personnel. A desperate plea was directed to Dr. Sulit, Dr. Magsino, Dr. Madla, Dr. Ng and Dr. Jao to recruit surgeons, pediatricians, general practitioners and nurses.

By the end of December 2003, 71 names of prospective missioners were compiled, half of it support personnel with no expertise designation. Of the 71 names only 60 confirmed either by asking lodging accommodations or space in the complimentary bus from Manila to Cawit, Boac, Marinduque by the end of January 2004.

Around November, 2003, Dr. Sulit informed Macrine that the Philippine Regulatory Commission required that all medical personnel should have a current PI License to join the medical mission. The help of local health officials, Dr. Gerry Caballes and Dr. Honesto Marquez was solicited. The technology of e-Mail between the Philippines and Marinduque was utilized.

Luckily, for Dr. Caballes, his e-mail system work fine, but for Dr. Marquez, only silence was the response. In the meantime, communications between the governor's office and the offices of the six town mayors were also initiated. The various officials were informed of the mission tentative schedule, as well as the use of the municipal courts as venue of the proposed clinical operations and the schematic plan prepared by Nonoy Sto. Domingo on the various stages of the mission detailing the placement of tables and chairs.

The communication requested that local police officials be informed of the proposed mission for security, order and crowd control procedures. The governor promised that 24 hours security will be provided at the lodging places of the missioners as well as in the venues during the mission.

The Internet and telephone wires were also burning between Macrine and Dr. Freddie Ng (physician in charge of Hospital operations and drug procurement). The purchase of drugs available in the Philippines that is valuable and useful to the poor people of Marnduque were discussed in detail. The expertise of Dr Ng in purchasing drugs and surgical supplies was utilized. There are several reasons, why drugs to be given to the needy be purchased in Philippines. The minimal shipping costs, discounted price and availability of the drugs to the patients after the mission as well as the assurance that the drugs and supplies are in Marinduque during the mission were discussed.

We have learned a lesson regarding the late arrival of drugs from US during the previous mission. A few days prior to Macrine's departure for the Philippines, Dr. Sulit informed her that the need for Philippine license required by the Philippines Regulatory Commission(PRC) will no longer be required. This was due to the fact, that the local Philippine Medical Association(PMA) have no basis to complain about the mission taking their livelihood, since the mission is intended only for the poor and indigents of the province. Moreover, the president of the local PMA is our personal physician in Boac as well as personal friend.

In January 1, 2004, Macrine left Fair Oaks, CA for the Philippines. A couple of days later, she was in Boac. Her first assignment was to have a courtesy visit to the Governor. The next day the governor arranged a meeting of all provincial government health officials that will be involved with the mission. All provincial health officials from the six towns were able to attend except for Dr. Marquez. The schedule was discussed in details, including transportation, housing and lodging and security.

The governor offered the use of her 8 cottages in Lupac. The governor informed Macrine that the money, MI will pay for the lodging would be used to purchase drugs. If there are leftover drugs after the mission, then MI will donate it to the hospital. Macrine communicated this offer to MI Board of Trustees in the US. Everybody agreed that this was a good offer.

Macrine's next assignment was to contact all the six town mayors, starting in Boac with Mr. Madla. The personal visit was just to confirm the previous letters that were sent to the mayors asking for permits, use of public address system and the venue of the clinical as well as the involvement of the local police for security.

The next town mayors contacted were Mr. Jonathan Garcia of Mogpog, Mr. Percy Morales of Sta. Cruz and Mr. Tom Pizarro of Torrijos. The day of Macrine's visit to these three mayors were not very productive since none of them were in their offices at that time.

Torrijos has no telephone system. Mogpog and Sta. Cruz telephone systems were not reliable nor the 411 system in Marinduque appears to work. Only two people in the town of Torrijos have cell phones. However, the drive to these three towns were not a waste after all. In Mogpog, Sta. Cruz, and Torrijos, Macrine left messages for the respective mayors via their secretaries . While she was in Sta. Cruz, she was able to talk to Dr. T. Rejano and gave the pediatric drugs donated by MI for the town clinic. The drugs were specifically requested by him for use in research from the effects of the mine waste disposal to the children in the area.

The mayor of Mogpog and Sta. Cruz later return back the messages left by Macrine. However, Mayor Tom Pizarro of Torrijos didn't call Macrine back regarding the mission. The only communications we have about Torrijos was with the Director of Hospitals, Dr. Cynthia Del Rosario, Dr. Del Rosario was very cooperative with our mission.

January 7 to 14 was the date of unpacking, allocating, identifying and inventory of more than 72 boxes of drugs purchased in the Philippines as well as from US. If you think this is easy, you have to see that one of our bedrooms looks like a pharmacy warehouse and hardly no room to walk. Thanks to the help of Womens Club of Boac (thru Mrs. Nilda Jamilla), Aida Mariposque and daughter Concon and our driver Edwin, the inventory and equal allocation of the drugs for the six towns and the hospital was done in only one week.

There was a complaint about unequal distribution of medicines among the six towns. This complaint was without any basis and just plain ignorance from the complainer. We have more than a couple of witnesses to corroborate the facts.

On January 15, I arrived in Marinduque. I accompanied Macrine for the courtesy visit to Mayor Lau Lim of Gasan. Mayor Lim was happy to see us. She informed us, that Gasan is well prepared for all medical missions conducted in Gasan. She has formed a committee (food and operations) that coordinate all the mission activities in Gasan.

Gasan is the only town doing this. The last week of January, Macrine suffered an abscessed tooth, that required her to fly to Manila. Since this was almost just two weeks, before the Mission Week, Macrine appointed me to take over the advanced work.

I did some follow-up with patients' pre-registration in the hospital, confirmation of lodging and food preparation for lunch in Buevavista. We visited Mr. Wilfredo Pe, Mayor of Buenavista, after our visit with Mayor Vicky Lim of Gasan. We explained to Mr. Pe the stages of the clinical operation as outlined in Nonoy Sto. Domingo's schematic plan indicating the location of chairs and tables.

I did another follow-up regarding the pre-mission publicity thru the office of the governor and local churches. Confirmation of printing of banners, T-shirts, bottled water supplies and local transportation needs was done.

Special thanks to Agnes Lardizabal-Apeles and Miriam Trivino-Borlaza for recruiting relatives and friends to provide the missioners lunches and dinners one week before the mission. With their help, MI, Inc. has saved additional money. The money saved was needed for the purchase of additional medicines and supplies.

One of the hardest advance work is to solicit hosts for our lunches and dinners. First of all, we need to inform the host the number of people expected for lunches and dinners. From our list, we gave 60, since these are the number of people who confirmed their attendance. But, like most Filipinos, the 60 became 80 and with local volunteers and local security, the number becomes 100.

We will never forget, the response of a couple of our hosts, after we informed them to please increase the food prepared from 60 to 80 hungry mouths. They gave us a look we will never forget. A lesson learned, when you are in the Philippines, if you expect 60, you might as well multiply it by two.

Speaking about food, a local caterer informed us, that the population of baby pigs to be roasted (or made into lechon) was reduced to zero, the week of February 7-14, 2004. We know why!

IN THE PREPARATION of clinical operations schedule, we have a hard time assigning support personnel, since we have no idea, what their expertise or experience are regarding mission work. However, one of my lucky guess, was the assignment of Fausto (Jun) De Vera in the crowd control area. Thank you very much Jun. Your are welcome to come again at our next mission. All my other assingments were just a hit and miss, but overall the scheduling assignment turned out all right. We have also a lot of local volunteers that help in non-medical work as well as in the pharmacy section. Thanks to the local pharmacy association and to all of Macrine's relatives and friends that helped during the clinical operations in the six towns.

As a conclusion, advanced work required, a lot of time, patience and diplomacy. Our personal recommendation for the mission. We have to be selective with the support group participation activity. Advance confirmation of attendance (two weeks prior) is required as a courtesy to the advance person, who will arranged food and lodging and transportation, as well as contact all the medical and provincial officials regarding the mission activities. Again, thank you ALL, especially to our non-MI Missioners!

Reported by Dr.David Katague and approved by President Macrine Katague, MI Inc., March, 2004.

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