You are on page 1of 4


E ABAY II MD FACS Neurosurgery, USTMAAA President 2012

An estimated 20-25% of the Philippine population or 23.75 million Filipinos will not have
access to medical care of any kind, let alone see a doctor or nurse, in times of need. These
poorest of the poor suffer and die of their diseases and ailments without medical attention of
any kind.
Medical Missions (MMs) were started by local medical groups as early as 1961, later augmented
by MM from abroad, to fill this need that has exponentially grown.
The Numbers and Economic impact:
It is difficult to establish how many MMs groups from abroad actually come to the Philippines
annually in the absence of an accurate registry for the same. Careful search of the web from Jan
2011 to the present (Sept 2012) show there are about 475 published medical missions to the
Philippines from the U.S. alone. How many other unpublished groups there are remains
unknown. There are mission groups from Germany, Australia and other countries.
An average group consists of 15 members, doctors, nurses and support people, all volunteers
from medical or nurses associations, church or mission groups, civic organization or individual
sponsors. Some can be as large as 40 volunteers, others as small a 5. Most, if not all, bring
medical supplies, equipments and medicines. The average expenditure of a mission group for a
medical mission is approximately $35, 000 for the mission itself.
All, If not most, stay for an additional one to three weeks for rest and relaxation before or after
the medical mission. A MM volunteer may spend at conservative estimates between $ 1000 to
$5000 depending upon the length of stay. Accounting for only the 475 medical missions
published in the web, allowing 15 member average and $2000 only per volunteer out of mission
expense, we are looking at a $14,250,000 minimum annual injection into the Philippine
economy not to mention Tourism and investment these mostly expatriates bring.
The Problem:
Over the years bonafide complaints have been raised against medical/ surgical missions,
ironically mostly from local physicians themselves:

Little or no follow up was provided especially for surgical patients.

Complications, again esp. surgical, had to be addressed by local physicians.
Many potential paying patients end up getting treated or operated on by medmissioners, a net income or revenue loss for local doctors.
Concerns (though controversial) have been raised about surgeons in training doing the
Expired medicines use were objected to.
Medical/Surgical Missions used as political propaganda by incumbent politicians.
Duplication of Medical/Surgical Missions where they are not really needed.
Lack of Continuity of Care, especially in the remote areas of the country.


Little or No Coordination with local medical practitioners or groups.

Little or No Coordination amongst Medical/Surgical mission groups themselves.

Government Reaction and Requirements:

Requirements for Medical Missioners, spurred mostly by the above objections, published
elsewhere, have become more and more stringent and restrictive. The last ones requiring
medical malpractice insurance of medical missions have sparked an uproar and protests;
cancellation of several medical missions ensued, resulting in retraction of the ruling.
Many medical/surgical missions go unregistered, hosted by local governors, congressman or
mayor, bypassing all these requirements and regulations anyway.
Bottom line:
Medical and Surgical Missions have been given every indication they are unwelcome to do
medical mission in the Philippines, except by the local political officials and the people in need
themselves. A few medical missions that used to go the Philippines have opted to go to Latin
America, Africa and other countries, where they have been given a red carpet welcome.
Unfortunately, the net result:

Deprivation of our poorest of the poor to avail of what little medical and surgical
services they can get from these missions.
Potential loss of a minimum $14,250,000 annual injection to our country's economy.
Loss of Tourism from Medical Mission Groups,
Loss of Potential Incoming investments from members of the medical mission groups.

We cannot ignore the medical/surgical needs of our poor that remain without remedy in the
absence of personnel and budget to address them in the government sector. The Charity
Organizations, Churches, NGOs and Private Sectors have attempted to fill this need.
Conducting medical/surgical missions to the Philippines from foreign countries, the US
included, has become a literal rejection process, the general message being: We don't want you
In the meantime the 20-25% of Filipinos do not get any medical/ surgical attention of any kind.
What quasi-medical cares they get are from unlicensed, unregulated arbularios, whose
treatments and remedies are untested and unregulated anyway. Yet those who are willing and
able to deliver what little they can must go through stringent, utterly discouraging regulations.
The problems arising from the medical/surgical missions pointed to, mostly by our local
physicians and physician-groups are likewise realities that must be addressed.
A Proposal and A Dream:
We can potentially work together to address issues raised by both sides. After all we all want to
achieve the same goals:

Definition and identification of sites of need with DOH, DLG-Governors and Mayors,
DPSW throughout the Philippines and develop a centralized listing of these specific

areas with as much specific population, housing, household income, prevailing health
problems, etc., information as possible. Make a Comprehensive list of these sites, which
may even, be further classified into Class I, II, III etc., according to severity. DOH and
local Governments may already have this information.

Develop a comprehensive list of local physicians, physician-groups, churches, NGO's,

Civic Organizations willing to host and work with medical/surgical missions, at every
local site listed. Again, Local government may already have these available. If not, let us
develop the list; identify Key contact persons and their contact information.


Develop a centralized registry for Foreign Medical/ Surgical Missions which should be
matched with identified sites of need and connected with specific local organization
they must work with. Set and mark mutually agreed dates, defined goals and future
planning. All Medical/ Surgical Missions MUST go through this registry.


Local Host organization responsible for screening, identifying, organizing bonafide

patients for the Mission Group and work out details of operation and plan follow up of
the same. Develop a Post-Medical/Surgical Mission evaluation system, to be completed
by responsible members of both hosts and visitors.


Streamline the application process for Medical Mission groups through the Philippine
Embassies working with DOH, PRC, DOT, DFA, DLG, DF and Customs to facilitate such
medical missions. The Licensure requirements, fees details can be further discussed and
can be made just, realistic and encouraging, NOT prohibitive.


Facilitation of transport/ shipping / Release and Distribution of medical/ surgical

supplies and equipment can likewise be streamlined and made easier.


A pool of this medical/surgical equipment can be warehoused/maintained/ and released

to medical/surgical mission groups as they come in an organized distribution center.
Excesses can even be distributed to the local community and provincial hospitals as


Every 3-5 years most hospitals in the US upgrade their supplies and equipment. The
"old ones", still very much usable, are often simply warehoused or junked. If a receiving
system can be organized in the Philippines, a coordinated effort by Ex-pats, many of
whom are active staff in these hospitals, can be initiated to obtain these equipment and
Community and provincial hospitals can be assessed for needs and supplies distributed
by priority as they come.
Both sides can agree to realistic requirements and operations that would fulfill mutual


If properly coordinated and developed, select sites can even be made into year-round mission
venues providing med mission teams 52 weeks a year, providing a year round presence and
continuity of care. These sites can become a hub for certain regions. If organized and develop
well, medical mission teams can even come from US Universities and world renown medical
centers whose medical and surgical staff have expressed interest in taking part in such

programs. Professors, staff from the Mayo Clinic, George Washington University, University of
Virginia, Eastern VA Medical Center, Department of ENT-HNS, VCU-Medical College of VA,
Johns Hopkins, University of Kansas and other world renown institutions have expressed keen
interest in doing medical and surgical missions one or two weeks at a time in the proper
Foundations can be tapped for support and help. Several Foundations have limited themselves
to health programs worldwide. Possibilities and potentials can be tremendous. Public Health
programs and training for local young physicians can be developed. With partnerships with
US University public health schools, templates can be developed in the Philippines and
duplicated elsewhere in the world.
Lofty dreams? But realistically, the components and building blocks are all there, ready to
be mobilized and organized. If we all decide to work together, it can be done.
God Bless!