Download - PSO-HNS

TITLE:Cleft Lip Surgeryfor Rural Filipinos
AUTHOR:Edwin M. Cosalan,MD, FPSO-HNS
To "travel the last Travelled road " is how the This paper reviews the data and experience on
keynote speaker for our first annual ENT Convention, clel't lip surgery accumulated in my work as the lone
the honorable undersecretary of Health, Dr. Antonio ENT surgeon in all of the 41 surgical missions. We
Periquet puts it as he challenged the Society to reach have been doing 50 to 60 cleiloplasties a year under
out to the rural population, the program. Of the estimated 240 lip and palate
surgeries done, about 200 were cheiloplasties.
Our paper, "Cleft lip Surgery for Rural Filipinos"
will show that road is already being travelled, and
that challenge is being partly answered. REACHING THE TARGET POPULATION:
Orientals have the highest incidence of cleft
deformitites per thousand live births in the world.
INTRODUCTION: In our country, this is compounded by the lack of
available expertise and the unaffordability of these
In 1986, an ENT surgeon, an opthalmologist, services, if present, in the rural areas. It stands
a pastor, with some friends what was soon to be to reason, therefore, that many cases await the willing
known as PROJECT LUKE. It was a Christian ENT surgeon who travels outside the comfortable
organization and derived its name from St. Luke enclaves of his urban, practice to the relative discomwho
was himself a physician, fort of the rural area.
Born out of a perceived need to bring specialty How do we reach our beneficiaries
health care to rural areas where 60% of the Philippine
population reside, and to provide these services to Organizing surgical outreach missions, much less
indigents---the very people who cannot afford them, 41 missions, has its difficulties, but it lies at the
it developed 2 separate programs: a prevention very core of our success in reaching the target
of blindness program under the ophthalmologist, and population.
a RURAL ENT PROGRAM under the ENT surgeon.
Through the years, we have been establishing
Since then, over 82,000 People have been contacts with non-governmental organizations
beneficiaries of the Project Luke program. Over its (NGOs) all over the country. We have been in
3 1/2 years of experience, 41 surgical outreach missions touch with government entities as well. This networkhave
been conducted, and over 1,500 surgeries for inghasnow been formalized or institutionalized even
both programs have already been performed. Tray- as we continue seeking and forging parmerships
elling by land, by sea, and sometimes by plane, we with other groups for future missions. It is through
have reached places as far as Basilan and Zamboanga these local groups that all arrangements for the
in the South, Samar and Cebu in the Visayas, the missions in their locality are made, including the
Cordilleras, the Cagayan Valley, the Iloeos prov- recruitment and screening of patients.
inces, even-as far as Aparri in the North.
Screening is done at the two levels: a) screening
Under the rural ENT program alone, over 440 for the indigency status of the patients where the
surgeries have been performed to date. Of these, local DSWD sometimes help b) medical screeening
about half of the surgeries were for cleft lip and palate of the patients by local doctors or personnel
deformities (although palate surgeries are generally of participating hospitals. This includes cardiopulnot
done in outreach areas), monary and pediatric clearances after screening for
patients needing surgery.
52