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Rehabilitation in the Philippines

by World Rehabilitation Fund
Rehabilitation in the Philippines
Rehabilitation in the Philippines
Rehabilitation in the Philippines
Rehabilitation in the Philippines
Rehabilitation in the Philippines
Rehabilitation in the Philippines
Rehabilitation in the Philippines
Rehabilitation in the Philippines
Rehabilitation in the Philippines
Rehabilitation in the Philippines
WRF
WRF's partner providing care to an amputee

Dear Supporters,

As the medical and rehabilitation needs persist in the wake of the Typhoon Haiyan (Yolanda), WRF is working with local and international partners to garner support for quality rehabilitation services for those affected by the storm in the Tacloban region.

While our efforts thus far have made a significant impact—our partner, the Philippine Academy of Rehabilitation Medicine (PARM), recently confirmed that more than 7,000 people have received rehabilitation services since WRF’s donation of essential supplies and equipment to three major hospitals: Remedios Trinidad Romualdez Hospital, Divine Word Hospital and Eastern Visayas Medical Center—these hospitals still need rehabilitation equipment, as well as a Prosthetics and Orthotics workshop in order to serve the needs of persons with disabilities in the more isolated towns of Leyte, Samar, Ormoc and Northern Mindanao.

In February, PARM CARES produced a short video (see the link below) to document the needs of those affected by the disaster, and the collaborative efforts of those working tirelessly to provide essential rehabilitation services.  WRF is proud of our partnership with PARM, and we are humbled to be a part of an international team collaborating to ensure that persons with disabilities are not forgotten.

As we move forward, PARM advises that the best way to provide assistance would be to obtain Physical and Occupational Therapy equipment and materials that would enable the hospitals to re-establish rehabilitation medicine units, in particular a Prosthetics and Orthotics workshop. PARM’s needs assessment includes an inventory of specific rehabilitation equipment and supplies needed in order to scale up services.

We are close to achieving our goal, but we need your help. WRF is seeking support to provide the remaining items so that we can send these essential supplies in 2016.

Please join us as we endeavor to provide essential equipment and supplies to serve persons with disabilities and improve the lives of those impacted by the Typhoon Haiyan in Tacloban. Thank you for your continued support!

Best wishes,

The WRF Team

PARM team thanking WRF for our support
PARM team thanking WRF for our support
Delivery of WRF
Delivery of WRF's equipment donation

Links:

Dear Supporters,

We at WRF wanted to share our gratitude and wish you well during this holiday season.  WRF could not make a difference in the lives of persons with disabilities without your support!

As the year comes to a close, we also wanted to give you a project update on the Rehabilitation Project in the Philippines.

STILL SEEKING SUPPORT FOR REHABILITATION SUPPLIES

As the medical and rehabilitation needs persist in the wake of the Typhoon Haiyan, WRF’s local partner, Philippine Academy of Rehabilitation Medicine  (PARM), recommended that support continue to focus on the Tacloban region, and confirmed that the Remedios T. Romualdez Medical Center (RTR), Divine Word (DW) Hospital, and Eastern Visayas Regional Medical Center are the hospitals best positioned to provide quality rehabilitation services for those affected by the storm and those whose service options became severely limited because of damages to health services.

PARM advised that the best way to provide assistance would be to obtain Physical and Occupational Therapy equipment and materials that would enable the hospitals to re-establish rehabilitation medicine units. PARM’s needs assessment includes an inventory of specific rehabilitation equipment and supplies needed in order to scale up services.

Through outreach to various partners, WRF was able to obtain donations that accounted for approximately three-quarters of the needed supplies and materials. We are close to achieving our goal, but we need your help. WRF is seeking support to provide the remaining items so that we can send these essential supplies in 2016.

Please join us as we endeavor to provide essential equipment and supplies to serve persons with disabilities and improve the lives of those impacted by the Typhoon Haiyan in Tacloban. Thank you for your continued support!

Happy Holidays,

The WRF Team

Ensuring greater mobility with a new wheel chair.
Ensuring greater mobility with a new wheel chair.

Dear Supporters,

We at WRF hope that you are having a wonderful summer! While it’s been a busy summer at WRF, we have been taking a moment to pause and reflect on WRF’s history as we approach our 60th anniversary this fall. With that in mind, for our report this quarter we wanted to share a little bit about our history in the Philippines as well as give you an update on the recovery plans and current needs of our partners who are working with persons with disabilities in the Tacloban region.

REFLECTING ON WRF'S LEGACY

  • 1960s

WRF’s involvement in the Philippines goes back some 50 years when WRF inaugurated the first Rehabilitation Medicine training program in the country at Santo Tomas University, the oldest University in Asia. Virtually all rehabilitation physicians and physical therapists in the Philippines were trained in that program.

  • 1970s 

Dr. Tyrone Reyes, a graduate of the Rusk Institute in New York, modernized the Rehabilitation Medicine program at Santo Tomas Medical School so that training for this field could take place in the Philippines and helped establish a physical therapy program in 1974. Moreover, Dr. Reyes re-formed the Philippine Academy of Rehabilitation Medicine (PARM) as the country’s branch of the International Society of Rehabilitation Medicine.

  • 1980s

In the 1980s, WRF provided a fellowship for Dr. Antonio Periquet, who launched a pioneering program in Community Based Rehabilitation (CBR). The program provided outreach services throughout most areas of the nation and its success was documented in a WRF publication that acted as an influential stimulus in spreading CBR methodology for developing countries throughout the world. In the 1980s, a donation by WRF of an electromyography nerve conduct machine enabled the Philippines General Hospital to develop a diagnostic center for detecting nerve conduction problems. Dr. Periquet eventually became the Minister of Health for the Philippines, and Dr. Reyes became a Regional Director for WRF in the Philippines and the first President of PARM.

  • 1990s

The Physical Medicine and Physical Therapy programs have continued to operate not only educating physicians and physical therapists from the Philippines but from neighboring countries as well, including Indonesia and Malaysia. WRF provided more specialized assistance in 1991 to assist victims of a 1990 earthquake that devastated Cabanatuan City. Also in the early 1990s, WRF sponsored the training of Chinese doctors in rehabilitation medicine at Santo Tomas University. In addition, WRF provided funding for a medical library in rehabilitation and discontinued the Regional Office in the late 1990s having helped accomplish the establishment of a viable and highly competent rehabilitation medicine infrastructure in the Philippines.

  • Today

In response to the devastation of Typhoon Haiyan in 2014, WRF re-initiated program activities in the Philippines. Partnering with PARM, WRF identified hospitals seriously affected by the storm. WRF provided critical rehabilitation medicine, supplies, and equipment to three hospitals in the Tacloban region: Remedios T. Romualdez Medical Center (RTR), Divine Word (DW) Hospital, and Eastern Visayas Regional Medical Center, which collectively serve thousands of people annually.

The donation of equipment and materials from WRF coupled with hospital renovations by the Philippines government enabled the launch of fairly full rehabilitation service in November 2014. In the months following the opening of rehabilitation services in the three hospitals, more than 2,300 persons have been served, including over 1,800 outpatients and over 500 persons who required hospitalization.

RESPONDING TO REHABILITATION NEEDS IN 2015

As the medical and rehabilitation needs persist in the wake of the storm, WRF’s local partner, PARM, recently conducted a needs assessment to identify how best to respond during the long-term recovery phase of the disaster. PARM recommended that support continue to focus on the Tacloban region, and confirmed that the Remedios T. Romualdez Medical Center (RTR), Divine Word (DW) Hospital, and Eastern Visayas Regional Medical Center are the hospitals best positioned to provide quality rehabilitation services for those affected by the storm and those whose service options became severely limited because of damages to health services.

PARM advised that the best way to provide assistance would be to obtain Physical and Occupational Therapy equipment and materials that would enable the hospitals to re-establish rehabilitation medicine units. PARM’s needs assessment includes an inventory of specific rehabilitation equipment and supplies needed in order to scale up services. Through outreach to various partners, WRF was able to obtain donations that accounted for approximately two-thirds of the needed supplies and materials. Currently, WRF is seeking support to provide the remaining third of the items.

Please join us as we endeavor to provide essential equipment and supplies to serve persons with disabilities and improve the lives of those impacted by the Typhoon Haiyan in Tacloban. Thank you for your continued support!

Warmest wishes,

The WRF Team

WRF equipment helping people in the Philippines
WRF equipment helping people in the Philippines

REPORT FROM REHABILITATION UNITS IN TACLOBAN 

Dear supporters,

During the last three months the hosptials in Tacloban have continued serving people with disabilities. Below you can find the numbers of In- and Out-patients served at each of the Rehabilitation Medicine Units at Trinidad Romualdes Hospital, Divine Word Hosptial, and Eastern Visayas Reginal Medical Center.

In addition, the evaluation of needs of the Rehabilitation Units of the three hospitals revealed the need for additional equipment. Renovations at the Eastern Visayas Center are currently being done with the support of the government of the Philippines. World Rehabilitation Fund is seeking additional funding and or donations to meet the equipment needs of the hospitals. 

                               RTR         DW        EVRC         All

DECEMBER 2014      

Inpatients                27             89          21             137

Outpatients              79            292        127            498                                                                                                                   

JANUARY 2015         

Inpatients                33            101        34              168

Outpatients              99           357         186            642                                                                                                                        

FEBRUARY 2015      

Inpatients                65           126         20              211

Outpatients              91          397         183             671

TOTAL 3 MONTHS    

Inpatients                125         316         75              516

Outpatients              269        1046        496            1811                                                                                                                

TOP CASES SEEN

During the first three months of services provided by the rehabilitation units supported by WRF include the following types of commonly seen problems:

  1. Amputation
  2. Stroke and Bell’s palsy
  3. Spinal cord injuries
  4. Developmental disabilities
  5. Knee, joint and shoulder disorders
  6. Fractures
  7. Arthritis
  8. Cerebral palsy
  9. Cancer

Remedios Trinidad Romualdes Hospital

  1. STROKE
  2. LOWBACK PAIN
  3. Fracture
  4. OA/RA
  5. SCI
  6. Adhesive Capsulitis
  7. Bursitis
  8. Meniscal Injuries
  9. Cancer
  10. Scoliosis

Divine Word Hospital

  1. LOWBACK PAIN
  2. MPS
  3. STROKE
  4. Adhesive capsulitis
  5. OA
  6. Fracture
  7. Bell’s Palsy
  8. Scoliosis
  9. Deconditioning
  10. Cerebral Palsy

Eastern Visayas Regional Medical Center

  1. Fracture, S/P ORIF
  2. STROKE
  3. Global Developmental Delay
  4. Amputation
  5. Autism Spectrum Disorder
  6. Cerebral Palsy
  7. Intellectual Disability
  8. Osteoarthrtits
  9. Pott’s Disease
  10. Motor Delay

Links:

The assistance from WRF to the hospitals in Tacloban have enabled them to operate responsive services to the needs of persons with disabilities of the area. However, a considerable amount of equipment, materials and supplies are still not available to the rehabilitation service providers at the three hospitals.  Moreover, renovations for the optimal use of the buildings were not accomplished and are key in addressing the needs of the hospitals.

In this report, we would like to report on status of one of the three hosptial that WRF has assisted in the Philippines instead of covering developments in all three, to give an overview of how Rehabilitation Services in the Eastern Visayas Regional Medical Cetner developed, how they were affected by the disaster, how they recover, and what their future needs are.  

EVRMC Rehabilitation Medicine Profile

After Typhoon Hayian the department was left in need of repairs, that have been and are continuously being done. It was just recently, April of 2014, when the Department of Rehabilitation Medicine was established. In earlier years, EVRMC Rehabilitation Medicine Department started as a Physical Therapy Unit established on July 13, 1981. Initially, the unit was under the supervision of the Chief of Clinics, and later on transferred under the Department of Orthopedics. Please see attached the layout of the department and the brief description of the needed renovations. 

The EVRMC Department of Rehabilitation Medicine is a new department of EVRMC with a vision of providing Rehabilitation services and education to the people of the Eastern Visayas Region, and the mission of helping patients reach maximum potential and resume their place in society within the limits of their capacity with effective, efficient, and compassionate service. The Department is headed by a Physiatrist, and the workforce is composed of a Chief Physical Therapist, and two Physical Therapists (currently on job order positions). There is an applicant Occupational Therapist and Physical therapist, that are currently considered for positions as well.

Psychiatry and Social Services are provided for in the hospital as an integral part of rehabilitation. Patients referred to the department include pediatric, adult and geriatric population of varied musculoskeletal and neurological conditions that need rehabilitation. Currently, services include consultation, counselling, and rehabilitation through physical and electrical modalities, therapeutic exercises and patient education. Majority of patients are initially seen by Rehabilitation Medicine, or referred by the Departments of Orthopedics, Internal Medicine, Family Medicine, and Pediatrics.

EVRMC is a regional hospital; hence, referrals come from the northernmost part of the region in Samar, and down to Southern Leyte, including the island of Biliran. The monthly number of patients census from January to July 2014 ranges from 50 – 90 patients, with a weekly of 20 -30 patients, and a daily of 5-10 patients. The numbers were seen to increase this August with a daily of 10-15 patients a day, and gradually increased once the requested equipment arrived.

The Eastern Visayas Regional Medical Center started out as a 14 bed capacity and 8 personnel hospital in 1916.  And has changed its name from the original Leyte Provincial Hospital to Speaker Daniel Z. Romualdez Memorial Hospital. It was then changed to Tacloban City Medical Center, and finally to EVRMC. Currently, EVRMC is a 350 bed capacity, Level  III Government Hospital, and has been approved for expansion to 500 bed capacity.

Location

Current location of the Department of Rehabilitation Medicine is at the second floor, Out-Patient Department. The Rehab Department has been transferred to the second floor to give way to expansion of the Laboratory Department. This has met minimal concern since the building is provided with a ramp, and wheelchairs can be used to transport patients to the second floor. Current area is approximately 40-50 square meters, but with renovation, an additional area annexed to the current space is given to the department, to a total floor area of 84 sq meters. Clinic space currently includes 3 separate rooms (2 treatment areas and consultation room), a storage area, a pantry/preparation area, an open space of ~ 10 sq meters divided into a gym/ambulation area and a receiving area.

Description of damage

Damage to the Rehabilitation Unit consisted of the whole Rehab area, previously located at the ground floor of the OPD Building, to be flooded with sea water and mud. Cabinets filled with equipment/supplies fell, and were soaked as well. Majority of equipment and supplies were considered damaged and were set aside or thrown out. Few were considered for re-use after clean up. The Rehab Unit after the typhoon was left with minimal supplies and equipment. Yet, the Unit still functioned despite the lack and has since requested for procurement of replacement and new Rehab facilities.

The top 10 causes seen in the Out Patient Department are:

  • Fractures
  • CVA
  • CP/Developmental Delay
  • Bell’s Palsy
  • MPS
  • Low Back Pain
  • S/P Tendon Repair
  • Adhesive Capsulitis
  • Amputees
  • De Quervain’s Tenosynovitis

The top 10 causes in the In-Patient are:

  • CVA
  • CNS Infection/ Meningitis with Developmental Complications
  • Fractures/ Post-surgical Implant Application
  • New Born with seizure disorder
  • Spinal Cord Injury
  • Pneumonia
  • Arthritides
  • Hypokalemic Periodic Paralysis
  • Burn
  • GBS 

Needs

  • Repair of the Rehabilitation Department:

5-6 curtained treatment bed areas, low bed/mats area, hydrotherapy room, pediatric/OT room, gym/ambulation area, consultation room, comfort room, pantry/preparation area, sitting treatment area, storage room  

  • Equipment Needs:
    • For Pediatric use – walker, child stander, activity boards, toys, wedges/bolsters, ball pool, glider, sensory integration tools, table and chair set, art and music appreciation sets, mobility aids, theraputty
    • For adults – tilt table, adult stander, mobility aids, ADL tools, activity boards
    • For Strengthening – exercise mats, dumbbells and ankle weights, leg press/bench press/shoulder press, elliptical machine, stability system, quad board, dynamometer/grip strengthening tools
    • For Assists – UE/LE orthosis, patient lifter, body harness for weight assist during ambulation training
    • For Department Use – portable ultrasound machine, ES/TENS units, safety gears, Vital Stimulation Set, weighing scale with height scale, goniometer, 2-pt discrimination set, water heater, hot pack sleeves, paraffin mittens, cold packs/cryotherapy unit, Standard Examination/evaluation tools (for Physiotherapy and OTs), Rehabilitation books/journals
    • Other Need: Additional training of staff 

Existing Equipment

  • Equipment requested and delivered:

Therapeutic ultrasound (1); hydrocollator machine( with 24 HMP); paraffin wax bath; multi-exerciser with shoulder wheel, finger ladder, wrist rolls, knee extensor/flexor exerciser, shoulder pulley; bicycle ergometry (1); exercise bikes: recumbent (1) and upright (1); stainless parallel bars, IRR Lamp (1), whirlpool, treadmill, and cervical and lumbar traction machine (1).

  • Existing equipment:

ES/TENS unit (3), IRR lamp (1), balance board (1), therapeutic ball (2), elastic band (1), ankle weights (8: 4 – 1.5 lbs, 4- 1 lb), dumbbells (3: 2 – 1 lb, 1 – 2 lbs), parallel bars (Wood), overhead pulley (non-functional), peg board ( 1 set), staircase (1), hot moist pack (5: 3 cervical, 1 lumbar, 1 standard), gait belt (2), crutches ( 2 pairs BAC), quad canes (2 pcs), treatment bed (3), mat (1).

The overview and the description of the ongoing work and needs are compiled by Liezel P. Calina, MD, Rehabilitation Medicine, Eastern Visayas Regional Medical Center.

Links:


Attachments:
 

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Organization Information

World Rehabilitation Fund

Location: New York, NY - USA
Website:
Facebook: Facebook Page
Project Leader:
Leyla Dursunova
New York, NY United States

Funded Project!

Combined with other sources of funding, this project raised enough money to fund the outlined activities and is no longer accepting donations.
   

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