Building Partnerships for Health

What keeps me busy these days is connecting, organizing, and collaborating.  It's not easy to be a people person.  You have to cultivate your patience, tolerance and the skill to make people comfortable.  It's a habit you develop and improve everyday you meet new people.  #HealthXPH has taught me how to be kind to strangers and how to connect with people who are different from you.  Based on the connectivist theory, you learn in the digital age not just within the individual but within and across networks.  Connectivism sees knowledge as a network and learning as a process of pattern recognition.  Every Saturday, we learn how to be gracious and as the participants how their week was, and to introduce yourself and be conscious of one another's mental health.  Through this process, we build communities.

This process of building communities online has taught me how to effectively build communities offline.  You see, I am a government employee and working in a patient-congested tertiary government hospital with a lot of maternal deaths motivated me to organize periodic meetings with stakeholders from referring institutions like provincial and city hospitals.  Initially, we presented our needs and solicited suggestions for improvement and how the stakeholders could help us improve our health service delivery.  From there we proceeded to lay down our cards to become accountable for our performance, where each hospital presented their own accomplishment reports and best practices.  No blaming, no name-calling, but with constructive criticism to help each other improve to reduce maternal mortality.  We all agreed that the apex hospital cannot do it alone, we each should contribute to achieving the same goal of reducing maternal mortality.  Here was a prime example of building partnerships toward one common goal: to reduce maternal mortality.

Last May 2018, the Association of Medical Colleges of the Philippines (APMC) urged each medical school to develop its own HIV program.  This spurred a move to coordinate with HIV coordinators of each medical school to link them to the HIV treatment hubs and social hygiene clinics as well as community-based organizations, to unify the efforts for HIV advocacy campaigns.  This lead to the development of the informal group called #TEACHCebu which stands for "Targeting Enhanced Awareness and Control of HIV in Cebu".

We were able to organize an HIV Forum with free HIV counseling and testing for medical students for each of the six (6) medical schools in Cebu.   By December 1, 2018, we will be launching "KAAMBAG (meaning partnership): together we TEACH..." an HIV Congress for Healthcare Professionals on December 1, 2018 at the Cebu Doctors' University auditorium.  We hope that this is the first of many successful unified efforts to increase HIV awareness among service providers to reduce stigma and discrimination against people living with HIV.

These are just some personal experiences in building partnerships to achieve health-related goals. 

Share experiences of building partnerships and collaborating with other groups for health-related goals.  What are the benefits and challenges of working together toward one health-related goal? What is the role of social media in building partnerships for health?

Enhanced Awareness and Control Program for HIV

It all started in May 2018 when Dr Gruet invited me to attend the AMPC Seminar Workshop on Setting Up HIV Programs for Medical Schools.  The model unit was that of UP PGH system where the UP College of Medicine, their base hospital Philippine General Hospital and the SAGIP HIV treatment hub were all in one geographic location. However, the set up is not the same in Cebu.

In Cebu, there are six (6) medical schools, namely Cebu Doctors' University College of Medicine, Cebu Institute of Medicine, Matias H. Aznar Memorial College of Medicine, Southwestern University-PHINMA College of Medicine, UV Gullas College of Medicine and University of Cebu School of Medicine. We may even expand our reach to the Silliman University Medical School in Dumaguete. The base hospitals are also located separately, and the main HIV treatment hub in the Visayas is located in the Vicente Sotto Memorial Medical Center.

Looking at our strengths, we have highly motivated HIV advocates and a well-connected group of social hygiene clinics.  Hence, our strategy to have all medical students tested for HIV was to conduct a caravan of HIV fora for awareness raising coupled with free HIV counselling and testing. Learning from my experiences with #HealthXPH in engaging stakeholders thru social media, we formed a facebook chat group where one by one passionate faculty HIV coordinators and dynamic student leaders representing each medical school started expressing their ideas and giving suggestions. We all committed to organizing HIV fora for medical students in our respective schools.

The Cebu Doctors' University College of Medicine, led by Accentuating Lives thru Service and Advocacy (ALSA) conducted a highly successful HIV Forum with the theme #TOUCHMOVE "Think Before You Play" where more than 169 medical students underwent HIV counselling and testing. Other scheduled HIV fora include September 21 and 28 for SWU PHINMA, October 13 for CIM, October 20 for MHAM and October 27 for UCMED. We hope that by targetting our medical students, we address misconceptions by improving HIV knowledge and reducing stigna and discrimination against people living with HIV (PLHIV). These soon-to-be doctors will be our frontliners in testing, managing and supporting our PLHIV.

HIV counselling and testing is the gateway to prevention, treatment, care and support. Knowing your status is your responsibility to taking care of your own health. An HIV diagnosis is not a death sentence. HIV should not be a barrier to reaching your dreams of becoming a doctor.  So long as the viral load is undetectable, then the virus becomes untransmissible. The risk is not knowing.

Training Activities from January 2018 to June 2018

 Here is a summary of training activities from January to June 2018.

January 3, 2018 – Flag Ceremony sponsored by the Department of Obstetrics and Gynecology

Figure 1 shows consultants and residents prepared for the first flag ceremony for 2018 sponsored by the Department of Obstetrics and Gynecology.

Figure 2 shows picture-taking session with the Executive Committee (EXECOM) members after the flag ceremony and modern dance presentation by the consultants and residents of the Department of Obstetrics and Gynecology

January 5, 2018 – General Assembly and Presentation of Annual Statistics

Stakeholders of the VSMMC Department of Obstetrics and Gynecology were invited to attend the General Assembly and 2017 Annual Statistics Presentation.  Attendees were from the Cebu Provincial Health Office with the Chiefs of Cebu Provincial Hospitals, City Health Offices (Mandaue City, Cebu City and Talisay City) with the Chiefs of the Different City Hospitals, as well as representatives from the Department of Health Regional Office VII.

Figure 3.  Class Picture of Stakeholders attending the Department of Obstetrics and Gynecology General Assembly and Annual Statistics

Figure 4. Department Picture-Taking during the Annual General Assembly

January 18, 2018 - POGS Cebu chapter Residents’ Interesting Case Contest

Two of our residents were included as finalists in the POGS Cebu Residents’ Interesting Case Contest in Chong Hua Mandaue Hospital Conference Room:

Dr Kathleen Faye Llamera / Dr Kristina Dosdos presented a case report of obstructed labor in a Multigravid secondary to vesical calculus, which was also a finalist in the poster presentation at the 2017 DOH Research Congress.

Figure 5.  Consultant co-authors and other co-residents attended the contest to lend moral support to the resident finalists

Dr Genevieve Vista / Dr Helen Madamba presented a case of Pulmonary Aspergilloma in pregnancy, which was also a finalist in the poster presentation at the 2017 PSMID Annual Convention in PICC, Manila

 January 26, 2018 - Visit by POGS Philippine Nationwide Statistics System

According to the PNSS, VSMMC Department of Obstetrics and Gynecology reported one of the highest number of maternal mortality in the country, which warranted a visit from the society to determine ways to reduce maternal mortality and to improve statistics reporting.

Figure 6.  Welcoming Committee for the representatives of the POGS PNSS

February 2, 2018 – Annual Trophoblastic Disease Census

There are several patients admitted under the Department with Gestational Trophoblastic Diseases – from hydatidiform moles to gestational trophoblastic neoplasia, a type of cancer which is highly responsive to chemotherapy.

Figure 7.  Dr Thalia Tubungbanua and Dr Donnah Laizabeth Dones present the 2017 Annual Trophoblastic Diseases Census

February 21, 2018 - POGS Cebu Interesting Case Writing Workshop

To improve research skills of residents in writing case reports and/or case series, POGS Cebu tapped an expert to conduct a workshop on writing interesting case reports and case series at Southwestern University.  First year residents from the Department of Obstetrics and Gynecology participate in the workshop.

Figure 8.  Residents of Different Training Hospitals attend POGS Cebu Interesting Case Writing Workshop

February 26, 2018 – POGS Mock Exams

To simulate the oral diplomate examinations, the POGS Cebu chapter organized unified residents mock oral examinations for senior residents.  Dr Karen Kris Balbosa, Dr Gladys Hojas, Dr Michelle Alcantara and Dr Mhea Lasola participated in these mock oral exams.

Figure 9.  Chair, training officer and senior residents of the Department of Obstetrics and Gynecology participate in the unified resident mock oral examinations

March 1, 2018 – Quarterly Maternal-Perinatal Statistics and Census of Referrals

Stakeholders of the VSMMC Department of Obstetrics and Gynecology grouped together to form the Technical Working Group which aims to reduce maternal mortality and improve the system of referrals.  Talks about a memorandum of agreement was begun, to allow two-way referral between VSMMC and Cebu Provincial Hospitals.  Each referring institution presented their accomplishment reports as well.

Figure 10.  Members of the Technical Working Group for Maternal-Perinatal Statistics during the first quarter maternal-perinatal statistics

April 22-24, 2018 – Department Team Building Activity

During the teambuilding activity, the consultants and residents were divided into four (4) teams:  yellow, pink, blue and green teams.

 

 

Figure 11.  Consultants and residents take the day off to engage in team-building activities promoting cooperation, communication and camaraderie.

May 8-9, 2018 - Central Visayas Consortium on Health Research and Development (CVCHRD) Central Visayas Research and Innovation Conference

Two of our residents, Dr Cindivy Rupita and Dr Karen Kris Balbosa represented the Department of Obstetrics and Gynecology and VSMMC during the CVCHRD Central Visayas Research and Innovation Conference last May 8-9, 2018 at the Cebu Normal University.  Dr Cindivy Rupita presented her research on the Association of Adverse Childhood Experiences with Teenage Pregnancy in the infomercial contest, while Dr. Karen Kris Balbosa presented her research on Anemia in Pregnancy as an infographic, which won the Best Infographic Award.

Figure 12.  The Department of Obstetrics and Gynecology represented VSMMC in the CVCHRD Central Visayas Research and Innovation Conference

May 23, 2018 – National VIA Day

As part of the celebration of Scarlet May for cervical cancer awareness campaign, we conducted the National Visual Inspection with Acetic Acid (VIA) Day with lectures, cervical cancer screening with VIA and human papillomavirus (HPV) vaccination of 100 patients.

 

Figure 13.  Prominent obstetricians grace the National VIA Day celebration of 

VSMMC Department of Obstetrics and Gynecology

May 20, 2018 – Consolacion Mass VIA Screening Activity

Figure 14. Consultants and residents of the department volunteer in the POGS Cebu chapter community outreach activity on VIA cervical cancer screening

June 22, 2018 - Urogynecology Workshop

We were blessed to have with us an expert in Urogynecology and Pelvic Surgery, Dr Geoffrey Que, a medical specialist from Southern Philippines Medical Center (SPMC) to give a lecture and to demonstrate the cystometrogram (CMG) urodynamic studies and surgical missions on patients with pelvic organ prolapse. 

Figure 15.  The consultants and residents 

with Dr Geoffrey Que 

June 29 – Pre-residency Training

The Department welcomed eight (8) applicants for residency training who underwent two weeks of pre-residency rotation at the labor room and in specified service areas.

Figure 16.  Eight (8) pre-residents presented their patients in a case conference

Department-Sponsored Voluntary Bloodletting Activity

Even Williams noted that “Obstetrics is a bloody business!” hence hemorrhage remains a top cause of maternal death.  To address the scarcity of blood units available for emergency life-saving blood transfusion, the Department of Obstetrics and Gynecology organized voluntary bloodletting activities with partners from the community.  From a bi-annual activity, we made it a quarterly activity to enhance collection of blood units for our patients.

Figure 21. Consultants, residents, post-graduate interns and medical interns donate blood to save lives.

This effort was recognized by the Department of Health Regional Office VII and the Department of Obstetrics and Gynecology was awarded the Luis Flores Awared last April 27, 2018 at the Summit Circle, Fuente Osmena, Cebu City.

  

Figure 22.  The Department of Obstetrics and Gynecology was awarde a certificate and a plaque of appreciation for the voluntary bloodletting activities organized.

14-day Writing Challenge

SUPACA #childrightsPH 14-day Writing Challenge

Since our last monthly meeting, I've taught my "kids" about how powerful social media is as a tool to effect change.  We learned about twitter, about facebook, about slideshare and about how to make their own personal blogs.  They were given a list of topics to write about and I am happy that they seem to be taking this challenge to heart.  As I read each write up, no matter how short or how much they seem to be struggling, a good motto would be to "just do it" and to keep on doing it because practice makes perfect!

I realized that writing on their personal blogs help them track their progress and be proud to share their work!  All of this is original.  Check out #childrightsPH on twitter where they share links to their blogs.  I would appreciate kind words of encouragement, it can go a long way!

So therefore, in solidarity with them, I join in and catch up with the 14-day writing challenge!

Day 1 - Take a selfie and say something about yourself!

I am Helen, Sleepless in Cebu.  I am an obstetrician-gynecologist infectious disease specialist by profession, taking care of women living with HIV.  I am a researcher, child rights advocate and a teacher by heart.  I am a social media enthusiast and I am willing to do new things and enjoin others to learn by experience.

I have never given birth, but I feel connected to the kids I mentor and the residents I train.  I can't cook, nor draw, nor paint... but I can take selfies and groupfies and do a lot of things with my laptop and have a lot of ideas for research.  

Day 2 - Bucketlist: Name three things you want to do before you die

1.  I want to have a farm.  My dream has always to have a big tract of land with a small kubo in the middle and cultivate an integrated sustainable agricultural farm - with one aspect using the waste of the other component.  I'm thinking of the vertical integrated pasture system where you have goats or rabbits on top, poultry in the middle and vermiculture at the bottom.  I'm thinking of aquaponics where fish poo provides nitrogenous fertilizers to plants in a growbed, and the plants filter out these wastes to provide fish with clean water.  I hope to have fruiting trees, rootcrops, vegetables and herbs.  I hope to also have a carabao, goats, rabbits, dogs, pigs, chickens, ducks and quail.  I pray that this is not too far in the future.

2.  I want to develop a training center for the youth.  I have always found ways to push through with trainings for youth development and empowerment despite little to no budget.  It would be great to put up a training center facility where we can minimize cost of these trainings (most of these due to venue and food expenses) to ensure that youth advocates have team building, leadership training, public speaking workshops, spiritual retreats and even sporty events.  This would be something I hope to save up for, to make a meaningful impact on the lives of our children, in an effort to empower them to become morally upright and productive citizens of the world.

3.  I want to travel through Europe with my mom and my darling niece Krissy.  I am so poor at geography, but I have always wanted to see Lourdes and Fatima, and visit Lisieux where my favorite saint Therese of the Child Jesus spent her heaven praying for souls on earth.  I hope to see more of the world so that I may have a different perspective of other cultures and how we can strengthen and be proud of our own heritage.  Travel makes your soul richer.  I want to walk in another man's shoes.

Day 3 - Write a poem about your expectation of the Sangguniang Kabataan

You who are called to service, serve.

You who are chosen to lead, lead.

You who have, give.

You who can, do.

You who believe, love.

The future of the country depends on you.  

Be the best you can be, achieve your full potential.

Follow and join our SUPACA 14-day writing challenge on #childrightsPH!

Day 1	May 19, 2018	Take a selfie and write something about yourself
Day 2	May 20, 2018	Bucket list:  Name three things you want to do or places you want to go to before you die
Day 3	May 21, 2018	Write a poem expressing your expectation of the sanggunian kabataan (SK council).
Day 4	May 22, 2018	Describe to us your most memorable experience.
Day 5	May 23, 2018	UNCRC and Children’s Rights:  Choose one of the rights of children which you think you have already claimed for yourself.
Day 6	May 24, 2018	True Love Waits: Suggest ways to know the difference between infatuation and true love
Day 7	May 25, 2018	Child Labor Trafficking: How do you make sure you won’t be working as a slave to anyone?
Day 8	May 26, 2018	Online Safety: how do you guard personal information and chose what to show the world?
Day 9	May 27, 2018	GGGADS (guns, gangs, gambling, alcohol, drugs and sex): How do you advise adolescents on critical thinking skills for issues such as addiction, violence and risk-taking behaviors?
Day 10	May 28, 2018	Mental Health: Why do we get sucked into bad habits like alcohol and drugs – gateways for addiction?
Day 11	May 29, 2018	Sexually transmitted Infections and HIV/AIDS: How do we reduce risks of transmission among the youth?
Day 12	May 30, 2018	Materialism: How has gadgets and new technology affected the manners and courtesy of young people today?
Day 13	May 31, 2018	Barangay Council for the Protection of Children: What is the role of the youth in their BCPC and how can they participate?
Day 14	June 1, 2018	Write about your hero.  How can you emulate the traits of your hero?