SICPA is dead but unburied
BY AMADO P. MACASAET
Hope at the UPCM homecoming
A.G ROMUALDEZ JR., M.D
‘The Aquino administration is committed to achieving universal health care for all Filipinos by the end of 2015.’
ALMOST on the eve of the UP College of Medicine Alumni Homecoming celebrations that began last weekend, the College lost three of its most illustrious products.
Baltazar Reyes Jr., M.D., of the Class of 1954 passed away at the age of 81. He was a pioneer in the specialty of Psychiatry. "Balti," as he was known to his friends and the four generations of medical students who had the good fortune of learning Psychiatry from him, completed residency in his chosen specialty in 1957 at the University of California. When he returned to UP-PGH, the discipline was still part of the Neuro-Psychiatry Section of the Department of Medicine. It was not until a few years afterward that a separate Department of Psychiatry with Dr. Reyes as Chair and Professor was formally established.
Balti’s colleagues (many of whom trained under him) credit him with helping to establish the scientific basis of the practice of Psychiatry in the Philippines. His subspecialty of "Dynamic Psychotherapy" is a remnant of the pre-pharmaceutical era of the treatment of mental illness that remains relevant to this day especially in the light of questions about excessive reliance on biomedical interventions in a discipline with traditionally close links to social and behavioral aspects of human existence.
To those who knew him well, Balti will be remembered not only as the quintessential Professor of Psychiatry but also as one of the rare species of truly principled human beings.
Crisostomo Arcilla Sr., M.D., was also a member of the UP Class of 1954 who passed away a few days before his classmate. A general surgeon, "Cris" was one of the leading lights of the Philippine College of Surgeons. Many young surgeons will remember him fondly because of his support and encouragement at the start of their surgical practice. Dr. Arcilla’s contributions to the practice of surgery in the country will continue to be acknowledged by his colleagues and friends.
Benigno Agbayani, M.D., who graduated from the College of Medicine of UP in 1960 was younger than either of the aforementioned late alumni. He was a pioneer in the practice of allergology and clinical immunology. A dedicated researcher, "Benny" was also a long-time editor of the "Acta Medica Philippina", the UP College of Medicine’s medical journal that is currently enjoying a revival as the country’s most respected peer-reviewed publication.
For UP Medical Alumni of the 60s, Benny was also well known as an avid basketball aficionado. In this area, his most memorable achievement was coaching College of Medicine teams to two championships in the UP-wide intramurals and several other victories in inter-hospital and city-wide tournaments.
Moises Serdoncillo, M.D., was a much younger colleague who also moved on last week at age 51. He was a 1983 graduate of the Manila Central University who received his Masters in Public Health from the UP College of Public Health in 1991. "Moi," as his many friends in public health circles knew him, was a dedicated public servant who spent the early part of his career in the provincial hospital of Mindoro Oriental. He served in several capacities in the Central Office of the Department of Health, including a stint as Executive Assistant and chief trouble-shooter in the Office of the Secretary during the Estrada administration.
"Moi" was also a much sought after international health consultant following service with the UNFPA in Manila and in Laos. When he died, he was helping the Department of Health to put together its agenda for change under the present Aquino administration.
UP Medical Alumni sadness on the passing of colleagues was somewhat alleviated by hope in a better health future for this country generated during the continuing medical education program held in connection with the homecoming celebrations.
The keynote speech of the Secretary of Health was well-received as it emphasized the Aquino administration’s commitment to achieving universal health care for all Filipinos by the end of 2015. The presentations that followed all emphasized the fact that the aspirations of the administration were realistic and achievable if backed up by a strong political will dedicated to significant reforms in the health sector.
However, it was the reactions from two recent graduates of the UP College of Medicine that engendered the greatest feeling of hope in the audience. Both new doctors (from the classes of 2008 and 2009) had decided on careers of providing care for the under-served - one as a municipal health officer in an island municipality in Quezon province the other as a medical officer for an NGO providing service to urban poor communities.
The two young physicians specially cited experiences as medical students that helped them to decide pursue service-oriented pathways in medicine. The sincerity and passion apparent in their reactions was a source of encouragement for faculty members of the College who were present.
A recent news item reported that the Department of Health is now reviewing its ban on "non-directed organ donation" for transplantation (allowing a living donor to donate his or her kidney without an intended recipient who has some degree of affinity to the donor). In effect, this will allow the practice of recruiting organ donors for compensation - a very thin line away from commercialized organ donation.
The move is apparently supported by the highest levels of both the Department of Health and the Philippine Medical Association. Those who are knowledgeable about the commercial kidney transplantation scandals of the 1999 and 2008 are worried that revoking the current ban which was issued less than one year ago would be tantamount to encouraging the associated unethical and probably illegal practices associated with the "kidney trade".
More thoughtful health advocates also worry about further aggravating health inequities by allowing rich kidney patients and their doctors to exploit poverty-stricken and desperate individuals and communities - as happened in the Baseco compound and in Quezon province.
The sad fact is that the Philippines’ transplant community has not even scratched the surface of maximizing the availability of kidneys from cadavers. Buying kidneys is certainly the easy way out for those with money but this will create even greater obstacles to appropriate services for poor sufferers of end-stage renal disease (who by the way are the majority) as financial status becomes an even more critical determinant of adequate quality care.
Email: alberto.romualdez@ gmail.com