TOTO to TATA

“A Gift of Life”

As Totoong Serbisyo para sa Bagong Maguindanao!

From Gov. Esmael G. Mangudadatu

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Contents

Acknowledgement ................................................. 3

Overview ................................................. 4

Objectives ................................................. 5

Human Resources ................................................. 5

Patient’s Profile ................................................. 5

History of Illness ................................................. 6

Medical and Surgical Treatment ................................................. 6

Chemotherapy Sessions ................................................. 7

Other Patients ................................................. 8

Documentations ................................................. 9

Annexes ................................................ 20

- Committee Membership

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Acknowledgement

First and foremost, the technical team expresses their utmost gratitude to

the Almighty Allah, the Most Merciful and the Most Beneficent for giving us life

that treasured most, above all things.

To our Honorable Governor Esmael ‘Toto’ G. Mangudadatu and his

administration personnel for deepest concerns in our financially deprived

constituents, for provision of any means possible and accordingly, has given hope

amongst cancer patients;

To the DOH-ARMM Secretary Dr. Kadil Sinulinding, Jr. and staff for

performing the surgery and providing post-op needs of the patient.

To Dr. Elizabeth A. Samama, OIC-Provincial Health Officer of Maguindanao

for her support to ensure that patient needs will be addressed and quality health

services will be afforded; And for her encouragement and guidance in making this

report.

To the Southern Philippines Medical Center (SPMC)’s Children Cancer and

Blood Disease Unit (CCBDU) Senior Consultant Dr. Mae Concepcion Dolendo and

Staff; and, St. Jude Children Research Hospital, Memphis, TN USA and World

Children Foundation for all the unconditional assistance.

To Buluan District Hospital Staff for countless efforts in providing extended

care to the patient in her pre and post surgery.

And lastly, to everyone, who in one way or another, has shared and did their

part in trying to make sure that the patient can recover.

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OVERVIEW

The Provincial Government (PG) together with the IPHO-Maguindanao and

other multi-sectoral partners are one in trying to ensure effective and efficient

provision of Quality Health Services to underserved communities. Along with this,

regular dispatch for free medical; dental and surgical procedures under Mobile

Hospital has been started already and thousands of constituents have benefited.

With the protocol of Mobile Hospital as stated in its Operational Manual,

under its special considerations, “Patients diagnosed as having extensive disease

and needs to undergo major operation shall be scheduled in a secondary hospital

such as Buluan District Hospital

Under this case, in one of the medical outreaches conducted, patient Tata

Lawan has been diagnosed as having Retinoblastoma in her left eye and is

considered to be a Major disease and has to undergo major operation in a tertiary

hospital with the help of a competent surgeon.

However, the patient is belonging to the indigent/constituent in our province

and cannot meet the needed expenses of this type of hospitalization. With this

prevailing situation, the Provincial Government of Maguindanao through the

initiative of Governor Esmael G. Mangudadatu and DOH-ARMM Secretary Dr.

Kadil Sinulinding, Jr., the operation of the patient was made to be feasible.

Moreover, provision of free medicines and surgical operation is not enough

to totally purge cancer cells. The need for specialized treatment was recognized as

networking with higher level of care. Hence, the Provincial Government of

Maguindanao has tapped various health organizations that grant free

chemotherapy for cancer patients that cannot afford it. Luckily, the Southern

Philippines Medical Canter’s Children Cancer and Blood Disease Unit sponsored

by the St. Jude Children’s Research Hospital based in Memphis, TN USA is now in

union with Governor Mangudadatu and embraced Tata Lawan throughout her

Chemotherapy course.

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OBJECTIVES

1. To address health concerns especially of the underserved members of the

community.

2. To strengthen network with CSO’s, iNGO and other agencies that provide

medical services to poor and deprived constituents.

HUMAN RESOURCES

In provision of the assistance, the following personnel participated:

1. Maguindanao Mobile Hospital Team

2. DOH-ARMM Personnel

3. IPHO-Maguindanao Personnel

4. Southern Philippines Medical Center’ s Children Cancer and Blood Disease

Unit

5. Provincial Budget Office Personnel

6. Provincial Planning and Development Office Personnel

7. Municipality of Buluan LGU Officers and Staff

8. Buluan District Hospital Staff

PATIENT’S PROFILE

Name : Tata Empa Lawan

Sex : Female

Age : 4 y.o.

B-day : March 10, 2007

Father : Thong Lawan Occupation : Fisherman

Family history of cancer : None

Mother : Monera Lawan Occupation : Housewife

Family history of cancer : None

Siblings : Rosana E. Lawan Surab E. Lawan

Popoy E. Lawan

Address : Poblacion, Buluan, Maguindanao

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HISTORY OF ILLNESS

Between March to April 2010, patient started having simple swelling of the

left eye as claimed by the mother. There was no consultation done and no

medications taken. Few months later, the reported swelling progressed and this

time, noted with an abnormal appearance of the pupil and was described by her

parents as -like cat’s eye. It caused distortion of her physical appearance.

With this insufficient knowledge regarding the disease, parents did not seek

advice and treatment from health practitioners instead went to a “quack” doctor as

they believe caused by “Satan” and self-medicated with Amoxicillin and Mefenamic

Acid Syrup.

In one of the Medical Outreach of the Mobile Hospital, the patient was

examined by the Doctor and ordered admission to the hospital for further

evaluation and management.

During this stay at the hospital, the Provincial Governor of Maguindanao

and the DOH-ARMM Secretary of Health sought this need in attention and

planned to do the immediate surgery and other treatments needed by the patient.

MEDICAL AND SURGICAL TREATMENT

The patient was admitted in Buluan District Hospital on March 14, 2011

where initial laboratory and medical treatments including daily dressings were

done. Multivitamins and antibiotics were also given. During this admission,

patient had abdominal pain and diarrhoea but were all controlled. Patient has

undergone CT-Scan which revealed “Rhabdomyosarcoma” of left eye. The patient

was then, referred to Dr. Sinulinding, Jr. and scheduled surgery.

Two days before the surgery, patient was transferred to Cotabato Medical

Specialist where procedure will be done. Consultation to a Pediatrician- Dr.

Singgon was initiated and laboratory work-ups were started. During this time,

parents were noted to have physical and emotional distress because of days

without proper sleep and rests. Hence, the staff prepared them through family

counselling.

The patient was scheduled on March 24, 2011 for surgery and on this day of

the operation the staff of Provincial Government of Maguindanao, the personnel of

the said hospital and especially the parents were all agitated for the outcome of

the procedure and hope for a positive result from the doctors.

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The patient was brought to the operating room where all instruments and

equipments were well set-up. Headed by Secretary of DOH-ARMM Dr. Kadil

Sinulinding, Jr. and his staff, enucleation of left eye was done. A tumor was totally

excised under general anaesthesia. No notable problems encountered and the

procedure ran smoothly with aid from the Almighty Allah.

After the procedure, biopsy of the specimen revealed that the tumor is a

retinoblastoma and it’s already at stage IV. Hence, chemotherapy of the patient is

now a priority facet for patient’s faster recovery.

Upon discharge of the patient from Cotabato Medical Specialist Hospital, she

was then brought back to Buluan District Hospital (BDH) and waited for

chemotherapy session to be scheduled in Southern Philippine Medical Center.

Patient was started on antibiotics, anti-inflammatory drugs and anti-pyretics. At

the hospital, there was noted no decline of fever, thus immediately referred to the

BDH-resident on duty and to Dr. Singgon, who ordered new antibiotics and other

drugs for the patient.

CHEMOTHERAPY SESSIONS

The patient was transferred to Southern Philippines Medical Center (SPMC)

in Davao City on April 01, 2011 and directly brought to Children Cancer and

Blood Disease Unit or CCBDU.

The CCBDU of SPMC is the only hospital in Asia affiliated by St. Jude

Children’s Research Hospital and World Children Foundation. It started its

operation on November 18, 2006 and has its own Filipino Doctors, Nurses and

other staff especially trained in their hospital to cure children’s cancers here in

Mindanao. They provide free chemotherapy drugs, counselling of the parents and

House of Hope where parents and relatives can stay while their patients are on

sessions.

Patient stayed in the Pediatric Intensive Care Unit (PICU) for 16 days for

vital signs stabilization. Chemotherapy sessions were started on April 25, 2011,

and were based from the Retinoblastoma Protocol of Dr. Carlos Galindo-Rodriguez

of St. Jude Children’s Research Hospital.

The patient’s regimens per course are as follows:

1. IV Vincristine

2. IV Carboplatin

3. IV Etoposide

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The patient is now on the first course of chemotherapy, correction of

fluid/electrolyte imbalance and completion of antibiotics.

OTHER PATIENTS

When patient Tata Lawan was admitted in the CCBDU of SPMC, the

Provincial Governor heard of the other two (2) cancer patients and immediately

ordered to provide the patients any means possible that the provincial government

can offer.

The following are the list of cancer patients with their corresponding

diagnosis:

1. Balading, Roaida Macarimbang, female, 5 years old, residing at Matanog,

Shariff Aguak, Maguindanao and diagnosed as having

Wilm’s Tumor, right (a type of cancer affecting the right

kidney). The patient had undergone removal of affected

kidney.

2. Dampas, Abdulrauf Blaim, male, 11 years old, residing at Datu Odin

Sinsuat, Maguindanao and diagnosed with Acute

Lymphoblastic Leukemia (a type of cancer affecting the

blood). The patient is currently having chemotherapy

sessions.

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Documentations

i. The patient while still at their house and not yet examined by the physician

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ii. Sec. Sinolinding, jr. visited, examined and ordered immediate surgery

iii. Transporting the patient to the tertiary hospital for the surgery

iv. Outside the operating room waiting for the surgery

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v. Dr. Sinulinding, Jr. and Dr. Singon

inside the OR waiting for the nurses to

finish the preparation.

vi. Cyst removed and about the size of a 10ml syringe

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vii. Tata Lawan after the surgery

viii. 8th day after the surgery

ix. Chemotherapy sessions at SPMC

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x. Balading, Roaida and Dampas, Abdulruf also supported by Provincial Government

xi. Ms. Lynette Estandarte with Senior Consultant Dra Mae Concepcion Dolendo

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ANNEXES

COMMITTEE MEMBERSHIP

CHAIRMAN: Gov. Esmael G. Mangudadatu

VICE CHAIR:

Medical Concerns:

Dr. Kadil Sinulinding, Jr.

Dr. Tahir B. Sulaik

Dr. Elizabeth A. Samama

Administrative Concerns: Engr. Abdulwahab V. Tunga

Budget Concerns: Lynette A. Estandarte

MEMBERS:

Provincial Government of Maguindanao Staff

Maguindanao Mobile Hospital Team

DOH-ARMM Staff

IPHO-Maguindanao Staff

BDH Staff