Storytelling the Enhanced Hospital TB-DOTS experience

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Transcript of Storytelling the Enhanced Hospital TB-DOTS experience

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    Storytelling the Enhanced Hospital TB-DOTS experience

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    Storytelling the Hospital TB-DOTS Experience

    Writers: Bernadette V. Neri Sharon Anne Briones PangilinanEditors: Bernadette V. Neri Sharon Anne Briones Pangilinan Dr. Mariquita Mantala Dr. Ma. Lorela Averilla

    Cover and Layout Design: Jennifer T. PadillaPhotos: Jennifer T. Padilla

    2013Printed by:

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    Telling success stories usually prick everyones attention and interest. Unlike statistics or numbers, they are easily visualized, they evoke good feelings and they generate a desire to undergo the same experience and get the same results. Thus, when the question of how do we share the CATCH TB cases project achievements to a wider audience, we decided to do it through personal sharing or storytelling.

    CATCH TB cases project stands for Collaboration for Additional TB Cases through Contacts and Hospitals against TB. It was a three year, collaborative project on TB control by the Department of Health, the World Health Organization and the Canadian International Development Agency.

    In 2009, the National TB Control Program (NTP) was grappling with the missing TB cases - those who were not notified to the program. At that time, 160,000 cases were reflected in the NTP report - almost 100,000 short of the estimated total TB cases. This is an unpleasant reality despite the free TB diagnostic and treatment services being provided by thousands of health centers all over the country. Evidences were gathered and reviewed and, eureka!!! A national survey revealed that four out of ten patients with signs and symptoms of TB went to the hospitals more than those who consulted the health centers. Understandably, since hospitals have the experts, a wide array of diagnostic tests and are open 24 hours a day. Thus, the CATCH project assisted 17 big public hospitals in Metro Manila to improve its TB services. In 3 years, these hospitals found, treated and successfully referred 15,000 TB cases. All were reported to NTP.

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    The selected ten stories featured here will give the reader a snap shot of the thousands of stories that took place in the 17 hospitals in the past three years. They came from various perspectives TB patients who got treated, health care providers who learned and felt appreciated, hospital head who felt proud of what they did, and the program managers who discovered an approach in finding many of the missing TB cases. We thank them for sharing their stories.

    We urge our readers to read the stories carefully, imagine the journey they undertook and understand the results. But at the end we encourage you to act. It may be simply advising your neighbor to consult the hospital TB-DOTS clinics, asking why your hospital is not doing the same thing, instructing your staff to adopt this approach or contacting the Department of Health or hospitals for more information and offer support.

    These stories are for all of us who dream of a TB-free Philippines where each can maximize ones potential without the burden of illness and where we can equitably enjoy the fruits of a productive nation.

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    Basta TB, DOTS the way to go! 6Rosalind G. Vianzon, MD, MPHNTP ManagerDepartment of Health (DOH)

    Upholding Accessible TB Treatent for the Masses 10Victor J. Dela Cruz, MD, CESO IVMedical Center Chief II Tondo Medical Center (TMC)

    UP PRIME TB-DOTS: A PGH Legacy 14 Regina P. Berba MD, MSc., FPCP, FPSMIDClinical Associate Professor, UP PGH Coordinator for Internal Networking, UP PRIME TB Program Team

    Diagnosis and Treatment: A Delicate Balance 18Daphne D. Bate, MD, FPCP, FPCCP, MsPHTB Team HeadQuezon City General Hospital (QCGH)

    Pioneering Health 22Margery R. Genabe, MDSan Joaquin Health Center Physician, andNTP Medical CoordinatorPasig City

    Birthing a Child Twice 26Mommy Arlene Ganacial and daughter Fhoebe Ganancial Student

    Leaving No Stones Unturned 30Melinda C. Santiago, RNTB Clinic NurseJose R. Reyes Memorial Medical Center (JRRMMC)

    Continuous Care 34Ian ArselonWorker

    TB-DOTS as a Viable Social Capital Investment 36 Evelyn F. Camarador, RN, MANNurse SupervisorHEPO DesignateNTP Nurse CoordinatorAmang Rodriguez Memorial Medical Center (ARMMC)

    Surpassing Tuberculosis 40 Salvacion DomoStore owner

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    Basta TB, DOTS the way to go!Rosalind G. Vianzon, MD, MPHNTP ManagerDepartment of Health (DOH)

    It has been more than 20 years of government service for Dr. Rosalind Vianzon but the burning desire for the betterment of peoples physical wellness and the passion for community health stay because of her love for public health. In this field, she explained, medical practice is not just confined within its clinical aspect. There are administrative and management tasks, too. Public health doctors do not only manage the health of an individual, they manage the well-being of the whole community.

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    That principle guides Dr. Vianzon in her responsibilities as the current National TB ControlProgram (NTP) Manager especially in implementing TB-DOTS, which is a strategy employed by the NTP to treat and control tuberculosis in the country.

    The primary role of NTP is to develop policies, standards, and guidelines on how to betterdeliver TB-DOTS services to the public. They also do partnerships with the private sector, both local and international. Dr. Vianzon stated that these stratagems work as proven by NTP outputs through the years.

    Efforts to control tuberculosis in the Philippines already started since 1910 through the initiative of nongovernmental organization Philippine TB Society, Inc. (PTSI). The government started to assist the PTSI and eventually took over the management of the whole program almost a decade after. Since then, the TB situation in the country has improved. In 1986, the NTP was enhanced to further strengthen the battle against the disease.

    Statistics will show the effectiveness of the TB-DOTS program. Hindi na nakakatakot ang TB ngayon dahil nagagamot na siya. (Tuberculosis is not to be feared

    Basta TB, DOTS the way to go!

    anymore because it is curable.), Dr. Vianzon proudly stated. More than 90% of the patients recover from TB after undergoing the six-month medication plan. This is a major leap as compared to the old treatment when a patient used to take various drugs for months if not years yet with limited recovery.

    She also stressed that tuberculosis is a disease affecting the economic age group. Today, a TB patient can still work and be productive because there is cure. This is very important because once the disease is controlled, it can have a positive impact on the economic growth of the country.

    Department of Health (DOH)

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    The NTP Manager emphasized that hospitals are significant components in the project. According to her, whether private or public, 42% of TB suspects went to hospitals

    because they provide 24-hour service as compared to health centers that work on an outpatient basis only. Encouraging hospitals to adopt TB-DOTS widens the number of patients that can be treated. CATCH TB Cases Project, a WHO/CIDA intiative, and Secure TB, a PTSI/TBLINC/USAID project, have demonstrated that hospital TB-DOTS is effective and feasible.

    According to Dr. Vianzon, this campaign is moving strong in Metro Manila public hospitals. Some private clinic and hospitals are starting to get involved due to the programs success and positive results. For NTP, the challenge now is how to engage more private hospitals.

    Adopting TB-DOTS both in the public and private hospital setting can also help control difficult situations

    such as the development of multi-drug resistant tuberculosis. As explained by Dr. Vianzon, If every hospital is linked to the program, there will be unity in the process of medicating patients. Kung iisa lang ang galaw ng public at private, iisa lang ang ii-implement na policy. Maiiwasan ang problema ng multi-drug resistant bacteria. (If both public and private hospitals employ the same methods in treating TB, problems of multi-drug resistant bacteria could be prevented.)

    Dr. Vianzon also said that TB-DOTS could help in boosting the stature of the hospital because it is designed to treat large numbers of TB patients. It will also help in their training mechanism, particularly in TB medication, because they are implementing a program that is nationally accepted.

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    She explained that to encourage more TB patients to undergo treatment, the whole TB-DOTS program is designed to be for free. Private hospitals need not worry about this because the NTP will provide the drugs and laboratory services needed. The hospitals task is only to put up a space and designate a person to focus on quality TB-DOTS implementation.

    When asked why she stayed in the program, Dr. Vianzon confidently smiled and said, It is rewarding and professionally fulfilling. There are clear outputs in whatever you do. With the directions and standards implemented, you see how these really contribute to the society. And it makes you think and hope that it can be done and the whole country could benefit from it. Kayang-kaya naman pala. We just need to implement the program and show results.






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    Upholding Accessible TB Treatment for the Masses

    Tondo is not only home to Bonifacio and thousands of other brave Filipinos who fought against colonial oppression. It is also home to the dedicated health workers of t