A mother's heartbeat, a newborn's first breath and a family's deepest hopes

Sharing here the Message from Dr Gerardo M. Aquino Jr, addressing the 2nd Quarterly Maternal Perinatal Statistics:

MAAYONG BUNTAG SA TANAN!

AS WE GATHER TO SHARE THIS QUARTER’S MATERNAL-PERINATAL STATISTICS, LET US PAUSE AND REMEMBER THAT EVERY DIGIT ON THE PAGE REPRESENTS A MOTHER’S HEARTBEAT, A NEWBORN’S FIRST BREATH, AND A FAMILY’S DEEPEST HOPES. THESE FIGURES ARE FAR MORE THAN CLINICAL DATA—THEY ARE STORIES OF COURAGE, MOMENTS OF VULNERABILITY, AND THE PRECIOUS TRUST OUR PATIENTS PLACE IN US.

WHILE PROTOCOLS AND GUIDELINES GIVE US STRUCTURE, IT IS COMPASSION THAT BRINGS OUR WORK TO LIFE. A CAREFUL HAND, A PATIENT’S TEAR MET WITH A GENTLE WORD, A MOTHER’S FEAR ANSWERED WITH GENUINE WARMTH—THESE ARE THE MOMENTS WHEN RULES STEP ASIDE AND OUR HUMANITY LEADS THE WAY. IT IS COMPASSION THAT TURNS SKILLED TECHNIQUES INTO HEALING EXPERIENCES.

AND YET, DATA IS OUR COMPASS. EVERY PERCENTAGE POINT, EVERY TREND LINE, EVERY COMPARATIVE CHART SPOTLIGHTS WHERE WE EXCEL AND WHERE WE MUST GROW. IT TEACHES US WHICH PRACTICES SAVE LIVES AND WHICH MUST BE REFINED. BY HONORING THESE INSIGHTS, WE COMMIT TO CONTINUOUS IMPROVEMENT—SO THAT EACH QUARTER, OUR OUTCOMES SHINE BRIGHTER, OUR INTERVENTIONS BECOME SWIFTER, AND OUR FAMILIES REST EASIER.

BUT THE HEALTH OF MOTHERS AND NEWBORNS DOES NOT REST ON OUR HOSPITAL ALONE. IT BELONGS TO A VAST TAPESTRY OF CARE—GOVERNMENT MATERNITY CENTERS, BARANGAY HEALTH STATIONS, PRIVATE CLINICS, BIG HOSPITALS, AND SMALL BIRTHING HOMES. WHEN A MIDWIFE IN A REMOTE BARANGAY CALLS FOR GUIDANCE, WE ANSWER. WHEN A SISTER HOSPITAL SHARES ITS BREAKTHROUGH, WE LISTEN. TOGETHER, WE FORM A NETWORK UNWAVERING IN ITS DEDICATION TO LIFE.

VICENTE SOTTO MEMORIAL MEDICAL CENTER PLEDGES TO STAND WITH EVERY ONE OF YOU—SHARING EXPERTISE, RESOURCES, AND UNWAVERING SUPPORT. OUR DOORS, OUR HEARTS, AND OUR KNOWLEDGE ARE ALWAYS OPEN, BECAUSE EVERY MOTHER AND EVERY CHILD MATTERS. WE WILL WALK THIS JOURNEY ALONGSIDE YOU, SHOULDER TO SHOULDER, DAY AFTER DAY, YEAR AFTER YEAR.

KAY DINHI SA SOTTO, KALIDAD NGA SERBISYO, AMONG GARBO. DAGHANG SALAMAT.

Lead with Compassion

Bad leaders are empathetic.

Great leaders are compassionate.

https://www.instagram.com/reel/DMoIO0PB_jt/?igsh=ZHF4OWtlYnd3OWMy

TEACHCebu HIV Hub Caravan

 

We have reached the culmination of our week-long HIV Hub Caravan in celebration of National Hospital Week 2025.  I am filled with a profound sense of gratitude and  hope.  Over the past few days, we have virtually traveled across Cebu, to bridge the gap between people and the life-changing services available to them.  We've had the opportunity to showcase the vital work being done by our different HIV treatment hubs in Cebu including the following:

•       Cebu Social Hygiene Clinic

•       Visayas Medical Center Balay Malingkawasnon

•       Love Yourself

•       Eversley Childs Sanitarium and General Hospital

•       Mandaue City Social Hygiene Clinic

•       Talisay City Social Hygiene Clinic

•       Minglanilla City Social Hygiene Clinic

•       Naga iShine City Social Hygiene Clinic

•       Vicente Sotto Memorial Medical Center KAAMBAG Clinic

•       AIDvocates

•       Glory Reborn

•       Cebu South Medical Center

•       Cebu Provincial Hospital - Bogo

•       Cebu Provincial Hospital – Balamban

•       Cebu Provincial Hospital – Carcar

•       Danao City Social Hygiene Clinic

We've seen firsthand the dedication and expertise that these hubs offer in providing prevention, testing, treatment, and care services.  I want to extend my heartfelt thanks to everyone who made this caravan a success:

·      To the dedicated staff and volunteers from all the participating HIV treatment hubs.  Your commitment and passion are the driving force behind the care and support that save lives everyday.

·      To the local government units and community partners who welcomed us and helped us reach a wider audience. Your collaboration is vital in creating an environment where people feel safe and supported.

·      And most of all, to all of you – the viewers, the individuals and the families who joined us.  Your willingness to learn, ask questions, and to engage is the most important step in ending the stigma surrounding HIV.

This caravan was more than just an event; it was a crucial step in building a more informed and supportive community. We've hopefully empowered individuals with the knowledge to protect themselves and others from HIV, and we've broken down some of the barriers that prevent people from accessing the care they need.   This caravan has highlighted a critical truth:  we have the tools to manage and prevent HIV.  We have the knowledge, the medication, and the unwavering support of our healthcare community.  Our treatment hubs in Cebu are more than just clinics; they are sanctuaries of hope, offering a range of services from confidential testing and counseling to life-saving anti-retroviral therapy (ART) and holistic care.

However, our work is far from over. Our mission continues.  Stigma and discrimination continue to be major obstacles in the fight against HIV. We must all commit to creating a more inclusive and understanding environment, where everyone feels safe and empowered to seek help. 

As we move forward, let us remember the information and resources shared during this caravan. Let us continue to support our local HIV treatment hubs and advocate for policies that promote access to quality care for all. Let us carry the message of hope and empowerment we’ve shared this week back to our homes, our families and our communities.  Let’s be advocates for ourselves and for others, reminding everyone that:

·      TESTING IS KEY.  Knowing your status is the first step towards a healthy future

·      TREATMENT IS EFFECTIVE.  With consistent care, people living with HIV can live long, healthy and fulfilling lives.

·      STIGMA HAS NO PLACE.  We must continue to create a culture of acceptance and understanding, safe places for our PLHIV clients, enrolled alive on ART.

Let us all work together to ensure that every individual in Cebu has access to the information and services they need.  Let us move forward with compassion, courage and a shared vision of an HIV-free future.  Together, we can make a difference in the lives of those affected by HIV and work towards a future free from AIDS. Thank you for your participation and commitment.

 

No Balance Billing

The 2025 State of the Nation Address was the fourth State of the Nation Address (SONA) delivered by President Bongbong Marcos on July 28, 2025, at the Batasang Pambansa Complex. The SONA of the President mentioned "Bayad na ang Bill Mo!" through No-Balance-Billing at DOH Hospitals.  These are some of the steps towards full implementation of Universal Health Care.

Join us tonight at 9PM MLA time on #HealthXPH to discuss about no-balance-billing:

T1.  What type of services should be ensured no-balance-billing?  Share your experiences, if any.

T2.  How do we ensure that essential and basic health services are equitably accessible and affordable to those who need it the most?

T3.  With government hospitals still congested with patients provided services regardless of ability to pay, how do we provide sufficient compensation and benefits to healthcare workers?

Health is wealth and should be considered a priority over economic activities.

The Best Version of Yourself

It is nice to meet up with one's former mentees, now colleagues, to discover how they too have experienced the same challenges of being young ideal consultants with a strong desire to reform systems for patient welfare and safety.  However, it is NOT COOL when the pressures of training residents start eating up pieces of you that you no longer feel whole.  This would be the shift from physiological stress to pathology.  This would be the time to take a step back, to review and reassess priorities and strategies to attain the set goals.

We started thinking about SERVICE rather than training, because we can also train younger generations through modelling.  By building a company that targets the middle income women who also need treatment, care and support, we provide for our own needs while contributing to healthcare service delivery, bridging gaps and meeting patients where they are.

Running over the ideas in my head, my dream health facility "Balay Kalinga" or Home of Care would provide the following:

1. Primary obstetric care, prenatal care services
2. Immunization for Filipino women
3. Family Planning 
4. STI/HIV Screening, Treatment, Care and Prevention
5. Cervical Cancer Screening
6. Ultrasound
7. Hysteroscopy
8. Protection against Gender-Based Violence

This would branch out as other OBGYNs join us in this vocation of service to the Filipino women of Cebu, just like our forebears in the Cebu Women's Club or our partners in Glory Reborn.  Remembering also the efforts of Jerson See in setting up the Link2Care Diagnostics Clinic.

The ideals of this company would still be anchored on SERVICE, TRAINING and RESEARCH but probably at a different level to connect the grassroots level with our work at the tertiary referral hospital.

 

Choose Your Difficult

It's difficult to exercise, but the consequences of not exercising is difficult too.

https://www.facebook.com/share/r/16q3YDq3uk/

You're not walking alone

 

Mother's Month-long Birthday Celebration

 

At La Union, we considered our vacation as part of the celebration of mommy's July birthday.

 

Today I decided to splurge on fine dining with steak and duck and panna cotta.  A 72nd birthday does not happen often after all...

PSMID Midyear Convention and 50th Anniversary

 

Free from Drama

Last night was a record-breaker in EXECOM meetings.  Discussing 33 agenda items, we finished past 11:00 p.m. with a number of discussions on urgent and relevant topics that involve good governance, transparent administration and accountability not only for the delivery of targets but also for the safety of employees as well.

On the other hand, those under the supervision of a manager are expected to behave professionally no matter how much one disagrees with one's superior.  In the work place there should be respect, psychological safety, integrity and trust.  Without it, the team will not function properly or work cohesively.

Organizations blessed with visionary leaders also need faithful and loyal implementers, those who understand the assignments and know how to row the boat towards the right direction.  Those who are not part of the solution become part of the problem.

 

Let them be

I have recently encountered complaints at work, being sucked in to the blame for failure of clients complying with requirements of their training program.  As our commitment is to provide an enabling environment for our clients, it is quite difficult and almost impossible to do this if the providers are unwilling to be flexible and insist on doing things "their way" and looking into barriers instead of finding ways to make things happen.

Fortunately, I am the head of the office and as far as I can assess, unless empiric data is provided to prove that the staff are indeed suffering from burn out, I will continue to be facilitative in order for our clients to reach their goals.  I will continue to be a bamboo swaying against the stress and reaching out to humbly ask help from everyone and anyone who would be willing to help us assist our clients.  As long as it is within my power to coordinate and collaborate, I am a self-effacing boss who will absorb as much as I can to meet the goals of the office.

Yes, it is disappointing to be treated a certain way, especially by a subordinate - who insists on doing only what is planned and not give in to sudden changes and contingencies, but traditionally following a cookbook activity design, especially considering the work we do is still in uncharted waters, and exploring how far we can go as an institution in engaging its staff and stakeholders.

This is a sign of maturity for me to not be affected by what people say.  I follow the attitude of my lawyer colleague and partner who does not give a damn about the opinion of others so long as rules and regulations are followed, each action is based on a good reason and sound judgment, and the outcomes will speak for itself.  I will no longer waste my precious time disciplining and explaining to subordinates who refuse to understand, because maybe this will reflect more on them than on me.  Maybe later on they can decide for themselves whether they belong to my team or not, because those who do not espouse the same values, passion and dedication to achieving goals should think about their place in the team.

so, I will let them.

"We get what we expect.  We deserve what we tolerate."

I have this mantra drilled into my brain by our management committee secretariat.  If this happened before, I would be crying and languishing in the negative opinion of others about me, and I would be writing to obtain justice for a subordinate disrespecting me.  But now, I realize that there are other more urgent matters to attend to, and it will suffice to document this and pass the task of explaining and justifying to the person who committed the disrespect.

Even when elder leaders seemingly humiliate me in public, I no longer react because I realize that the unprofessionalism of public humiliation reflects more on the speaker that the receiver of the comments.  I am confident enough in my work and honest enough in my intentions to even take offense.  Note to self:  you are getting older and FINALLY learning from your experiences.  You have no control over the actions of others, but you have control over your reaction to them.

Let them be.

Vacation Trips: Disconnect, Rest, Recharge and Explore

I am currently on vacation leave.  I joined my family driving up north to La Union for a little surfing.  The last vacation I took with the family was a few years back.  A lot of people have been telling me to take a rest, to take a vacation even... so now I did, and it was terrific!  Now that I am nearing the tail end of my vacation, I would like to discuss the impact of vacation trips for healthcare workers for them to disconnect from the stress of the daily grind, to take much needed physical, psychosocial and mental rest, to recharge one's spirits and to explore other aspects of life outside of work.

Join us tonight on Bluesky https://bsky.app as we discuss about vacation trips for healthcare workers to disconnect, rest, recharge and explore other interests outside of work:

T1.  Share with us the last vacation you took: where, when, with whom and what you did.

T2.  How do vacation trips impact your mental health and your efficiency as a healthcare worker?

T3.  What's in your bucket list for the next vacation trip?

A Surfing Adventure

We went surfing today, but before we did we thought we could just go swimming in shallow water and enjoy the waves... I noted that the current sucks you in before the bid waves hit, much like a tsunami sucks dry the water from the shore to build volume before the tidal wave hits land...  it turns out there was a sign on the beach that said "no swimming area, strong current"

This was the point when I decided to go surfing with my brother.  I tried several times but I couldn't manage to stand up.  In the end, I managed to ride a wave kneeling down with my hands outstretched until I reached the beach.  Sadly, this was not captured on camera.

So next time you feel that you are overwhelmed by stress and your task sheets, and you feel like you are sucked and drowning in the undertow, know that this is because God is planning to shower you with a rocking wave of blessings! 

Family Adventure

We're all on the road, but not yet moving...  we're off for another family adventure to La Union!  Soon as the car started moving, the girls promptly fell asleep.

PRIMACORDIS

Here's another milestone for the Vicente Sotto Memorial Medical Center: the first Investiture and Commencement Exercises of the CNU-VSMMC College of Medicine.  Congratulations to Batch Primacordis!

 

Choices you fear

Here I will park the plans for the KAAMBAG Clinic HIV Advocacy Campaigns to be established throughout the year:

FIRST QUARTER

• January - Anniversary Labs and Annual Physical Examination of PLHIVs
• February 13 - International Condom Day CombiPrEP
• March - International Women's Day

SECOND QUARTER

• April - KAAMBAG Team Building Activity
• May - International AIDS Candlelight Memorial with AIDS Quilt Exhibit, HIV Mortality Audit and Expanded HACT Fellowship, KAAMBAG Coffee Table Book
• June - PRIDE Month Postgraduate Course

THIRD QUARTER

• July - Nutrition month
• August - Hospital Week, Children Empowerment Activity
• September - Medicine Week

FOURTH QUARTER 

• October - Month of the Girl Child, Training on HIV Counseling and Testing
• November - HIV Youth Congress, POGS Annual Convention, PHA Annual Convention, PSMID Annual Convention
• December - World AIDS Day with Baskog Run, Regional HIV Treatment Hub Conference and HIV Research Summit, Program Implementation Review and Annual Planning Meeting, AIDS QUILT Exhibit with Kids Arts and Crafts Show

Protect your Peace

 

Bayang Pilipinas Ginigiliw

Happy Philippine Independence Day!

Be Grateful!

June is PRIDE month and the KAAMBAG Clinic prepared a strategic program for BEYOND THE RAINBOW: A Deep Dive into Mental Health, Disclosure and the LGBTQIA Journey - the 2nd KAAMBAG Postgraduate Course.

This crucial postgraduate course on PRIDE Month and HIV awareness delved into these important topics, fostering understanding and promoting positive change.

The Department of Health (DOH) has called for a national public health emergency declaration due to a 500% surge in HIV cases in the Philippines. This rapid increase, reaching 57 confirmed cases per day between January and March, is the highest in the Western Pacific Region. The DOH is also urging the public to get tested, emphasizing the importance of free, confidential testing. Additionally, the DOH is recommending various preventive measures, including the use of condoms, lubricants, and pre-exposure prophylaxis (PrEP) to curb the spread of HIV.   95% of all PLHIVs are male with male-to-male sex driving this HIV epidemic.  This statement may or may not trigger stigma and discrimination against the LGBTQIA community, but this is a fact based on the DOH National Epidemiology Bureau HIV/AIDS and ART Registry.

By highlighting the significance of PRIDE Month and HIV awareness, we are setting the stage for a meaningful learning experience.

We will be exploring the current health status, stigma and rights of the LGBTQIA+ community and the challenges they face in their gender-affirming journeys, as well as the access to these communities with strategies for promoting inclusion and prevention, treatment of HIV infection and care and support for people living with HIV (PLHIVs).

IMPORTANCE OF COLLABORATION

This course is a collaborative effort, and we look forward to hearing from the participants, sharing their insights through the comment section of this Facebook LIVE program on several burning questions:

1. How do we celebrate PRIDE MONTH to promote inclusion and genuine acceptance of LGBTQIA+ rights to health, dignity, respect and love?
2. Accepting that male-to-male sex is the key driver of this HIV epidemic is the first step to finding ways to halt HIV transmission.  How do you love the sinner but hate the sin?  How do you be gentle but firm, knowing that while they continue to have sex, you want them to have SAFE SEX.
3. Having new methods of prevention in our armamentarium for HIV treatment hubs and primary HIV care centers like pleasure-based messaging, condoms, lubes, PrEP and self-test kits, how do we implement effectively considering that knowing is not enough?
4. Research shows that although social media and mobile apps facilitate hook ups, Grindr users are more open to HIV prevention measures.  Therefore, HIV program implementers should be where our patients are, and they are online!

The morning session was enlightening about the health status and rights of LGBTQIA+ in the Philippines, self-stigma, pleasure-based messaging and the psychosocial challenges of gender-affirming journeys.  There are gaps in the health system with need to provide access for the LGBTQIA communities.  There should be a paradigm shift in how we approach patients within the spectrum from using fear of HIV transmission as motivation for uptake of preventive measures to pleasure-based messaging, accepting that sexuality is part of health.

The early afternoon session focused more on MEDICAL aspect of managing LGBTQIA and PLHIVs:  Healthcare Needs of LGBTQIA+; Sexual and Social Network Testing as an innovative approach to reaching taboo populations for increased HIV testing, as well as the routine laboratory tests to screen for ARV toxicities and opportunistic infections.

The late afternoon focused more on the pharmacologic innovation of the 3-in-1 pill with dolutegravir-based ARV regimens, the need for ARV adherence and when to offer pre-exposure prophylaxis and post-exposure prophylaxis.  These topics enhanced the health literacy of our PLHIV patients.

 

Philippines HIV Epidemic: A Public Health Emergency Call

HIV/AIDS Surveillance Report for the first quarter of 2025

The Philippines is currently facing a severe public health crisis.  While initial panic-inducing reports were about MPox cases in selected areas in the country, these index cases were found to be among immunocompromised hosts with multiple sex partners.

This week, DOH Secretary Ted Herbosa sounded off the alarms that the HIV epidemic is even more problematic than mounting fears about MPox due to the more than 500% increase in HIV case findings from 2010 to 2025, based on the DOH National Epidemiology Bureau HIV/AIDS Surveillance Report for the first quarter of 2025.  This prompted the DOH to call for the declaration of a national public health emergency to mobilize resources and intensify intervention efforts. 

Here are the key findings:

1. Dramatic increase:  From January to March 2025, the Epidemiology Bureau recorded 5,101 newly diagnosed HIV cases with 57 new cases detected per day.  Compared to 2010 statistics, this represents 564% increase, making the Philippines the country with the fastest-growing HIV epidemic in the Western Pacific region. 

https://web.facebook.com/DOHgovPH

2.  Youth Most Affected:  Although half (74,081, 50%) of cases were 25-34 years old and 44,187 (30%) were among the youth aged 15-24 years old, the increase is most pronounced among the 15-24 years old age group with some reports indicating a 500% rise in cases.  The youngest reported was a 12 year old from Palawan.

https://bit.ly/HASP2025Q1

3.  Predominant Mode of Transmission:  Although there are people who inject drugs in Central Visayas who get HIV, sexual contact remains the primary mode of HIV transmission, with a significant shift towards male-to-male sexual contact since 2007.

https://bit.ly/HASP2025Q1

4.  Total Cases:  As of March 2025, the cumulative number of reported HIV cases in the Philippines since 1984 is 139,610 (55% of the estimated) PLHIVs who have been diagnosed or laboratory-confirmed, and are currently living or not reported to have died. Further, 92,712 (66% of the diagnosed) PLHIV are currently on life-saving Antiretroviral Therapy (ART), of which, 41,786 (45%) PLHIV have been tested for viral load (VL) in the past 12 months. Among those tested for VL, 36,630 (88%) were virally suppressed.  The latest Philippine HIV estimates show that by the end of 2025, there will be 252,800 estimated People Living with HIV (PLHIV) in the country.  If left untreated, by 2030 there will be an estimated 400,000 PLHIVs who will need anti-retroviral drugs provided by government funding.

https://bit.ly/HASP2025Q1

5.  Advanced HIV Disease at Diagnosis: Reporting of Advanced HIV Disease (AHD)17 cases only started in 2011. Among the total reported cases, 41,550 (29%) were diagnosed with AHD, 8% higher compared to the same quarter of the preceding year.  Advanced HIV Disease at the time of diagnosis indicates delayed testing and treatment.

https://bit.ly/HASP2025Q1

6.  Funding Challenges:  On January 20, 2025, the Trump administration issued an Executive Order freezing all foreign assistance funds for 90 days, citing the need to align programs with the administration's foreign policy priorities.  On January 24, 2025, the U.S. Department of State sent a cable to all U.S. Embassies ordering the immediate suspension of all foreign assistance.  This "Stop Work Order" halted funding for programs including the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) with significant impacts on HIV prevention, treatment, care and support.  

Join us tonight on #HealthXPH at 9PM on BlueSky to discuss this public health emergency call:

T1.  What do you think are the causes and contributing factors to escalating the HIV epidemic in the Philippines?

T2.  With a national public health emergency declaration for HIV, what government response would you recommend to address this crisis?

T3.  What is the role of social media for a comprehensive and multi-pronged approach to halting HIV transmission?