Some Post-mission Notes [Tiny]

The 2008 mission was the first time I went onsite after staying behind the scenes (in the comfort of the city, you might say) in prior years. Having witnessed and participated somewhat in the actual work of the mission, there are a few observations that probably can be considered in future missions.

1. The Crowds. Oh yes the crowd. We can't blame them. The unavailability of medicines, and their cost whenever available, and the inconvenience of seeking medical help due to the cost of the commute and the distance of it all make an onsite medical mission a 'must go.' Because of this, the limited time operating time for each mission will always have the potential of disappointng people who have queued for so long and not get to see a doctor. This year, those who did not get to see the doctor at least had their blood sugar (not FBS) and blood pressure checked. An effort to try to not disappoint them which probably had a salving effect.
   
   This can now be avoided. Because this year, we know how fast a doctor can process a patient—about 12 patients per hour, or 5 minutes per patient. In operations research terms, the working speed of our doctor is where our critical productivity path lies. If we had more doctors, then the effects can be reasonably expected to be just about arithmetical.
   
   So, if we know how long we are going to operate in an area, we more or less know how many patients can be actually seen by a doctor. Which means, a prior announcement can be made as to how many of the 'early bird' queuers can be seen on mission day with a certain number waitlisted. If other tests/services can be administered in greater volume, then a suitable announcement about that can be made as well.
   
   This way, we maintain a level of intellectual honesty and avoid disappointing people who were looking forward to seeing a doctor but who had to be turned away due to physical constraints.
   
   
2. Meds. Through the years, we more or less have an idea of the meds that are in demand and those that are not although things do change. For example, Lipitor was not as hot as the previous missions. However, vitamins, and the basic over-the-counter meds literally flew out of the boxes. Moving the meds to the site is also the biggest logistical task because as it was done this year and in prior years, the meds moved with the mission personnel. And a lot of them were still in their bulky physician's sample packaging.
   
   I suggest that these be repacked into those large thousand-pill bottles, if possible in the US. Drop a label or stick it on and ship via air or sea to arrive in enough time for us to pre-position them in the site. We will take care of import formalities including customs of course.
   
   Seal all bottles/boxes to be opened only when mission volunteers arrive on site.
   
   
3. Let's be Self-contained. This is the spirit of the medical mission. We go into an area, do our thing and hope we leave an impression. We cannot move making assumptions about what resources government should or would not have in the area. We have no control over how government decides to allocate and distribute its resources. Precisely, we aim to fill a void that is unserviced by government.
   
   
4. Resources do not have to be US-centric only. Given time, credentials, mission documentation, a lot of donations can be generated in-country. Pagasa Medical Mission has a gtrack record. But little to document that it does. I dare say that with a proper mission folio to present to companies in the Philippines, in-country resources have the potential of matching if not exceeding US-donations—at least in quantity. The high quality meds will always be a standout from US donors. But all the large companies have large corporate social responsibility budgets and a few encounter a dearth of organizations through which these resources could be channeled. For example, the members of the Japan–Philippines Chamber of Commerce need only to be asked and there are a few hundred of them. This year, transportation was a problem we did not solve until 48 hours before. It would ave been so easy with the help of Ito-san, the President of Toyota Philippines for example.
   
   But to do this, we need a portfolio. We now have pictures and a video. I am willing to have the patient records for this year and even past years 'crunched' so that we get to extract information from the data they contain. Even if the data is old. We will still end up with a collection of bell curves that might prove to be a revelation. But we would not know it until we get our hands dirty. Please send these slips of paper back to Manila where I can 'outsource' it and have it encoded and processed. You guy probably already know how good we are back here at outsourcing.
   
   Perhaps too good?
   

Day -1: Road trip to Candelaria, April 3 [Tiny]

With six of the jumbo-sized balikbayan boxes [balikbayan: Returning/visiting Filipino expatriates and their children] stuffed with all sorts of meds plus personal luggage to schlep the 250 kms (about 155 miles) to Candelaria, Zambales we needed three SUVs.

A rented Toyota Revo, my friend Irma's Toyota Previa, and my ever reliable but ever thirsty Ford Explorer had to do. Fitting people was not a problem. There was enough space for the 14 souls making the trip but cargo space was still at a premium and Niña's forgetting to unload a fully stuffed super XL-sized trash bag of our weeks' laundry at her Lola M's house for the lavandera to "process" did not help.

Finally underway, we were the last to push off, held back by a last minute 'adjustment' by Auntie B, Anna's mom. The agreement with the drivers of the other two vehicles was that being the fastest vehicle (and probably the most reliable) I would hold up the rear of the train in 'Badong' (a Ford Explorer, made in Canada, imported to Japan, and imported into the Philippines after being rescued from a Japanese materials recovery facility).

Apparently, not a good day for driver comprehension, the two vehicles scoot on ahead and disappear in Metro Manila's very organic traffic flow (Anna's & Stefan's description). Not really unexpected as Auntie B had to make a filing deadline at the Iba, Zambales Hall of Justice before 3 p.m. (200 kms/120 mi away yet).

We tool around through the NLEX (North Luzon Expressway - a nice tollroad, quite world-class). I was looking forward to saving about 45 mins of travel by going through the new toll tollroad that links the Clark EcoZone (Formerly Clark AFB of the USAF) to SBMA (Subic Bay EcoZone, formerly Subic BayNaval Base of the USN) but the signage was not up so rather than risk losing time, we took the regular route through Pampanga and Bataan province.

We hit SBMA at about 11:30 a.m. decided to do a late lunch in Iba instead. We discovered that we were way ahead of everyone as Auntie B and Uncle A in the lead car decided to try to hit the new highway which turned out to be closed so they had to double back. Auntie B left her mobile phone inside Badong so there was no communicating with them. John F and León B and Maria in the Previa were in touch via J's phone and they were following Auntie B.

We all meet up in Iba, the capital of Zambales province which itself is a long sliver of land hugging the northwestern coast of Luzon Island. At this time of year, Zambales is known for its beaches (fairly clean and unspoilt with black volcanic sand beaches in the mainland, and white, fine coral sand in the outlying islands) and mangoes (called Manila Super Mangoes, the fruit is a bright yellow, with a thin, flat, slightly hairy seed in between two cheeks of succulent yellow flesh. It is very sweet at this time of year and hyperglicemics are well advised to take care lest it cause their blood sugar to shoot up and turn them into insufferable monsters.

From Iba, its a short 40 minute drive through thin traffic on a winding mountain pass. Some 80 kms later we are in Candelaria. The first step is the Town Hall where a streamer was up to announce our presence. We also discover that it was fiesta time in Candelaria, a festival of thanksgiving in honor of the town's patron saint, San Vicente Ferrer whose feast day is April 5.

Being fiesta time, they had a flea market going in town and I thought I had a bargain when I picked up a pair of Speedo board shorts, and two IZOD walking shorts for a total of the equivalent of $3.00. But Niña topped this with a pair of faded denim cutoffs from ZARA for what turned out to be $0.11!

Madame Mayor happened to not be in her office for the how-are-you, and how-do-you-dos so off we went to our first billet at the Dawal Beach Resort, which was exactly 250 kms from the center of Manila.

Farewell to Madison & Limay Volunteers (04/06/08)

Farewell luncheon at local sponsor Olivia's fine home. Run-in batian [meet and greet] with her nanay {mother] upon entering for the indoor Comfort Room [slang for restroom]. Spectacular spread - oh.. it's the leftover from the last night's pistahan guests (as we all heard about it). Divine dessert of buko [coconut meat] salad made only from fresh papaya, piña, young coconut and a light cream; plus local suman [sweet sticky rice dessert] with again, mangga [mangoes: it is prime mango season]. And for the final bow, a round of good-bye pics in front of the PAGASA banner, the usual teary goodbye...hugs, kisses, halik halik balik[kiss kiss return] ... "come visit us anytime" and the team is on its way, with the Escalers-Maria (sabit) heading North towards Pangasinan, and the TinyMobile and Minivan rental heading South back to Manila.
hanggang sa muli!*


[*'til later]