Friday, March 27, 2009

How to Conduct a Medical Mission?

This is answer to Dr. Genevieve Yap's question.



Medical mission is an effective event that can mobilize members of the community and stir an otherwise sleepy organization or town. With free medical, dental and/or surgical services, it could easily qualify for a town festival in the Philippines. Whether it is for political or humanitarian reasons, there are rules of engagement and here are a few tips:


1.) Right Intention


Always go back to your personal or your organization's principles of why you are conducting a medical mission. Remember, medical missions have been used for decades to sway political votes, gain an upperhand in land grabbing (i.e. mining / logging / farming companies) and a lot more, placing a sugar coat on a different intention. Most nonprofit organizations turn down politically motivated medical missions. Please save the money, the mission can be done after the election period. However, we commend the Tanadas in Bicol who conduct missions regardless of the political season.


A medical mission is often considered a dole-out project. In retrospect, a medical mission is beneficial when: a.) It is conducted as a relief operation for disasters such flood, earthquake, fire, landslide, war, famine, mass poisoning etc. b.) As a regular program with follow-up of the patients c.) Surgical / medical missions which are badly needed in medically deprived or remote areas in the Philippines d.)When it is not a stand alone project but integrated in a sustainable health program.




2.) Find a Partner

Don't begin a medical mission without a partner organization in the community. You cannot arrive in the community with a messiahnic outlook. You are not there to save the peole from their miseries because by the end of the day, you are off with the medical team. Collaborate with other organizations particularly the local government and other people's organization. The health center staff will be more than willing to assist even at weekends. This gives a boost to their purpose in the community. This could also empower a people's organization, such as an association of women, fisherfolks or drivers. In addition, these people know the place better than you do so it is always prudent to consult them. These sponsoring organizations should also contribute through the provision of an adequate venue, board and lodging for the volunteers and the like. Besides, no one is too poor not to give so there must be something they can share.



3.) Go local for insights, manpower and remedies.


Profiling and ocular visit of the site will include disease prevalence, local remedies and the health referral system. The health workers must quantify the common diseases so that the amount of medicines and surgical intruments can be prepared accordingly.


After the consult, the doctors can't do a follow-up of the patients. Hence, they must know where or whom to refer for complicated or chronic cases, a comprehensive list of the health centers and hospitals would be of great help for referrals.


There are ten recommended herbal plants by the Department of Health which are readily available in most rural communities. A good knowledge of available local medicines would promote reliance of locally available plants.


4.) Prepare, prepare, prepare...

Secure the following: a.) Venue w/ocular visit b.) Transportation, planned route and itenerary c.) Funds d.) Medicines which you can request from the Philippine Charity Sweepstakes Office or Pharmaceutical companies. Make a list of all medicines availabe including the generic names, preparation (mg/ml or mg/tab), volume per bottle (60ml / bottle), no. of tablets or bottles available. e.)Prescription pads, ballpens, BP apps, stethoscopes, curtains for the examination room, pentel pens, speaker or sound system.



The doctors and dispensary will be using the list as a reference. Usual medicines needed include Multivitamins, Antibiotics for upper respiratory and urinary tract infection(amoxicillin, cotrimoxazole, erythromycin, co-amox), Metronidazole during rainy season for Amoebiasis, Permethrin for head lice and scabies, Antifungal creams, Ferrous Sulfate, minor surgical set for circumcision purposes, Oral rehydration salts, Antihypertensives such as Metoprolol and Captopril, Anti-asthma such as Salbutamol, Anti-helminthics both tablet & syrup, Antipyretics such Paracetamol, Anti-inflammatory such as Mefenamic Acid, Dental set for tooth extraction, lots of alcohol for the health workers and few items for wound dressing.

Most patients would ask for antitussives such as Carbocisteine or Bromhexine but I don't believe in such placebo medicines. An emergency kit is always important for wound dressing and possible anaphylaxis.

As a bonus, you might want to include the alternative medicines available locally and the referral system with the list of local hospitals or clinics which can do further laboratory tests and management. Since you can't be serving the whole barangay for the whole day, you might consider distributing reservation tickets particularly to the most indigent patients through the local DSWD or barangay hall.



5.) Right perspective

Always brief your volunteers on the following: a.) All or nothing for the antibiotics. When you don't have enough meds to complete the antibiotic regimen then don't even prescribe or give it. You'll just start a new microbial resistance in the community if you do so. Besides most upper respiratory tract infection only need sufficient nutrition, increased fluid intake and rest. b.) Most well patients would go to a medical mission to ask for vitamins, a short lecture on eating a balance diet will suffice. Don't give vitamins to patients who think they can replace regular meals with vitamins since they'll end up having hyperacidity. c.) Doctors should always include the diagnosis of the patients for documentation purposes d.)Keep the instructions clear by explaining the intake of medicines to the patients. Always bring lots of pentel pen to write on the boxes or pieces of paper for the instructions in their own dialect.



6.) Coordinate

If everything is well coordinated then expect the following: a.) The barangay tanod or police securing and pacifying the people b.) The local health workers doing the registration and taking the vital signs of the patients c.) There is appropriate designation for the registration area with short history taking, vital signs station, doctors' station, dispensary of medicines, mess hall for the food preparation d.) Volunteers are taking turns in doing lectures to patients who are in line. e.) Someone is taking care of the little stuff such as the documentation, food and logistics. Never ever forget to give the appropriate food for your volunteers since that is their only consolation.



7.) Evaluate

Meet the staff after the medical mission and don't forget to give tokens or certificates to the volunteers including the local officials as a gesture of gratitude. You may want to leave the extra medicines to the health center except for the regulated drugs. Comments and suggestions are always welcome to improve the next medical mission. If you plan to keep or send a report, collect the registration forms and the prescriptions. Tabulate the common diseases, number of beneficiaries and the amount of medicines used. Usually funding institutions such as the Philippine Charity Sweepstakes require this. Hopefully your medical mission might empower the local organization and they would look forward for a renewed partnershipe someday.







COPYRIGHT @ PHILIPPINE-HEALTHNET thru Dr. Jason Abello
http://www.philippine-healthnet.blogspot.com

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