Tag: Medicine

  • An Electronic Health Record for Philippine healthcare system

    screen shot of FFEHR, an EHR for Philippine health care (photo taken from FFEHR project site)

    Long overdue and much awaited, an Electronic Health Record or EHR has been released for the Philippine healthcare system. Quoting DabawGNU, the co-developer of this EHR,

    The first beta release of FFEHR, an electronic health record application commissioned by the ASEAN+3 node of the International Open Source Network (IOSN), was released to the public last April 28, 2008. This release comes six months after the University of the Philippines Manila-National Telehealth Center tasked free/open source software (F/OSS) programmer Nathaniel Jayme and Davao-based F/OSS organization DabaweGNU, Inc. to jointly develop FFEHR. This release marks an important milestone as the project now opens its doors for public review.

    Basically just a first step towards implementing a well designed and stable EHR for our healthcare, it will definitely fuel an onslaught of interest from the so many healthcare professionals who have wanted a robust, scalable and free EHR.

    Details of this said project can be read here in FFEHR website or the DabawGNU site. A beta version for linux and windows can be downloaded here.

  • I "heart" the Philippines: The reason I’m staying…

    Loving the Philippines is not exactly the most popular addiction nowadays. The myriad of reasons (financial gains tops these reasons) for us to “pack up our things” and go somewhere else is all too alluring.

    Hearting” the Philippines (as Doc Ian would aptly term it), is a costly fling I should say-one that is volatile and daunting. And for some ironic reasons, I grew to love My Philippines despite the countless setbacks I have and will endure. Here is the “why“.

    I heart the Pinoy.
    Okay, screw the corrupt, scoundrels, bigots, trapos, charlatans and the wicked. I’ll happily kick their butt to the scorn pit and the ass burners. There are countless other people however who overwhelmingly overshadow the rotten traits of these kibitzers and traitors. Joy, Russ, my family and the good people I learn from and serve.

    Russ my fair boy…

    Joy of my heart..
    A family that stays together…


    Some of the people I served…

    I am forever bound to them, and not even any monetary promise (unless that monetary renumeration is enough to save the whole Pinas) will separate me from their love and service. I hold them dear. And they are here in My Philippines.

    I love the place
    You see, whenever I get tired or bored from the so many bad news around, I go hopping places inside my Philippines on backpack and wits.

    Marvel at the ingenuity and diligence of our Ifugao brothers when all seems hard enough in life…
    Climbing mountains to get close to heaven…

    Frolic in the beach after a weeks hard work…

    Find a cool soothing underground river whenever you feel lost…


    Kid around with friends on some hidden paradise..

    Or simply jump below some crater lake for the heck of it…

    Awed by the beauty that I long so ago overlooked, I am astounded as well by the rich flora and fauna that littered the archipelagic
    Pinas. And I can travel incessantly without having to dig deep into my pockets.

    Simplicity is a way of life
    I have grown accustomed to the way of life here in my place.

    No matter how disadvantageous some of our traits will be, I still don’t think it decayed the unique hospitable and magnanimous qualities of us Pinoys. If you go to the country side, you will see the simplicity, the resilience, the hope and the enduring attitude of Pinoys that survive waves of colonization.

    We have a rich culture and history
    So rich and so diverse, I still haven’t understood half of it.

    I am however fascinated by its evolution and of its unfolding. Leaving, means being not part of this history unfolding. That is something I am not ready to let go, yet.

    The cut for living
    If I had a choice where to be poor, I’d still choose to be poor in my Philippines.

    I don’t know but whenever I go hungry, there’s always anybody who would willingly share a bread for me to eat. Yes, I don’t have a penny in my pocket, but some people don’t just bother to ask for a dime when they help you. And that’s why Id say it’s a lot better to be poor in this land than anywhere else.

    I want my future family to be “homegrown”
    There is no better place to grow and nurture a Pinoy family than ‘Pinas itself.

    That in a nut shell, is more than enough reason for me to “heart” Philippines.

  • The Blog Rounds 7th ed:I "heart" the Philippines!

    “On some point, I agree these docs did something wrong. But some unscrupulous media people are just as scandalous hyping these controversies also. And to what end?”

    This was my response to a friend’s rants against physicians last night. The charade of controversies she enumerated against MDs in particular is nauseating. I couldn’t blame her, except of course when she generalizes the few scoundrels to the whole medical profession.

    The issues regarding pharmaceuticals and physicians conniving against Cheaper Medicine Bill, the PhilHealth scam, the VSMH Operating Room Scandal, and now this US Health Insurance scam. At the very least, it did nothing but put the medical profession in bad light. Worst, it may just kill this noble profession.

    No matter how hard we inch our way making good at doing ethical practice, the ripple effect is just darn too disturbed by the waves of infamy from scoundrels who don white blazers and stethoscopes.

    That’s why at times, it’s too tempting to just “pack our things up” and leave Philippines to rot on its ballyhooed corruption. But thats probably too much generalizing of a country (and the people) we loved to nitpick. Like any other profession, there are bad apples and rotten tomatoes, but this does not necessarily mean all tomatoes and apples are rotten as well.

    Why did we choose to stay here? Why do we love this place, this people so much? Why do we physicians tie our shoelaces here instead of wearing the cool and financially rewarding work abroad? Why will you endure the hardships when you can simply forget about My Philippines?

    These and more, will be the topic for the seventh edition of The Blog Rounds, a weekly compilation of the best in Philippine’s medical blogosphere. Hosted by Doc Ian on his blog So Far So Good, the theme revolves around what made us “heart” or love the Philippines. A very heartwarming theme indeed in these times of Hippocratic infamy.

    MD’s and paramedical bloggers who wish to join The Blog Rounds, please read this guidelines, submit your entries to Doc Ian here and join the lively discussions on tomorrow’s seventh edition of TBR to be hosted on Doc Ian’s blog!

  • First Cut, a baptism of fire for an orthopod

    I was expecting fireworks and a band playing for a great summer homecoming last year. Indeed, I was greeted by a different kind of “fireworks” but no band of course, one that ripped souls and six other lives. I was just starting a provincial, orthopedic practice then. This was my christening…

    It was one rainy afternoon.I just arrived from an orthopedic conference in another place.  My butt just landed on our sofa. Barely 5 minutes have passed since I heared a loud thundering blast that rocked the wits out of my ears. It was gone in a moment and I was too tired to even think about it. Besides, such loud noises frequently disrupts the still atmosphere of our neighborhood. Firecrackers are being manufactured on god knows where near our place so I didn’t bother.

    Kuya phone!!!!” came the second reminder from our helper. I lazily picked the land line first.

    Doc, we need you here in the hospital. A bomb just exploded in the market and patients are being wheeled in to the OR!” an ER nurse of hospital (A) told me. ” Bomb?!!!” the loud thundering blast flashed back and I froze in horror.

    How many injured victims there?” I asked. ” Lost count doc, ER is filled!” Came the obviously panic stricken nurse.

    OkayI’d be there in a minute. Please triage patients based on injury severity” Then I hang up the phone and hurriedly grabbed my scrubs. I almost didn’t noticed my  cellphone is still ringing.

    Doc, please come immediately to  hospital (B) , we have bombing victims with mangled extremity here.” Said a resident on duty from another hospital. “We have an emergency intra op referral for you a mangled extremity!”.” Said another ROD in another hospital.

    Oh God! This bad?!” and I’m the only ortho in town right now. Then the land line rang again. I suspect it was the other hospital nearby asking for the ortho to see the blast victims. Indeed it was.“This is nuts!” My first year and my first summer here.

    An improvised bomb planted by unknown persons exploded inside a jam packed billiard hall (that was just in front of a pedicab terminal) in Tacurong City. The bomb is an Improvised Explosive Device (IED) where the shrapnels consist of 1 inch long concrete nails, ball bearings and god knows what other dreadful things. Planted in a strategic and crowded location, it was planned with an evil thing in mind- maime people. Not to kill, but sow terror.

    The site where the bomb exploded is chaos and terror glorified. Blood stains littered everywhere. Stalls ripped apart. Glass windows blown into pieces. People where shouting, crying in pain and helplessness. A father was holding his bloodied dying son. A passerby was holding to his mangled left leg. Several injured people lay in agonizing pain just beside the sidewalk. It was hell on earth. A gory, horrific site.

    Those who recovered from the trauma and passing pedestrians began loading injured people into pedicabs and tricycles. The parish priest brought his pick up and hurled all injured persons he can and brought them into the nearest hospital.

    Most people on site were in shock to even move.

    I was taken aghast by the sight of patients still waiting to be seen by MDs in the hospitals. “Oh god!” Patients were coming in to no end. The ER is full, patients lay on hospital floor and benches. The nurses and hospital staff where all up,  rushing IV fluids, blood samples and splints. All MDs I know are in the hospital seeing patients already. Most hospital here are secondary hospitals so beds easily filled up.

    I grabbed my scrubs and then went on assessing patients and triaging them based on injury severity and treatment priorities.

    A 32 year old passerby driving his motorcycle was hit by shrapnel. He works as a par time driver to sustain his family of four. He had an Open 3C fx (fracture with open wound and blood vessel injury) of both his R leg and ankle. His right foot is barely recognizable. He also have an open femur, elbow and hand fractures. I have to cut his leg and put an external fixation to all his other open fractures.

    Another 40 year old driver was hit by a shrapnel in his right arm and chest. Lucky for him it did not went deeper into the lungs. I debrided the wound and put external fixation on his open fracture. He had no relatives to attend to him.

    I have to go to the other hospital!” I said to the ROD. I have to relegate the other more stable extremity injured patients to surgeons and MDs available in that hospital. All the patients I assessed for OR where prepared so that the we waste no waiting time. “Have to go to the other hospitals muna and see the other patients there! Please ring me when it is my turn to go to OR!” I instructed the nurse.

    Then I ran to the other hospital and saw the same gory sight again.

    Patients were already filling up the hospital corridor. Media men and hordes of bystanders are inside the hospital. I was passing through a maze of make shift beds and bloodied hospital floor. I saw all the extremity injured patients and prioritized who should be treated first.

    A 22 ear old store helper was hit by shrapnel near the blast site. He sustained second degree burns in his lower extremity and both his feet are beyond recognition. “He is in respiratory distress already! I have to bring him first to the OR or this patients die!” I shouted at the NOD, signaling him to prioritize this one for OR. But there is an ongoing OR of another blast victim. “I hope this guy makes it to the OR.” I stabilized the patient first. Then I looked at the other patients and prioritizing treatments.

    I lost count of the patients I saw. it was the longest patient triaging and stabilizing I experienced. More than what I experienced from where I trained. It was a nightmare of all sorts. Blood, pain, hysteria, crying and grief. “This is too much..”

    After juggling between patients and hospitals,I started OR immediately when my turn came in. I started around 8 PM then operated on successive blast patients until 6 am. “Do we have sufficient OR needs?” Do we have blood on standby?” What about our meds?” I queried the nurses. I slept for a total of one hour 30 minutes and then started doing ORs until 2 pm. I slept for another four hours and went back for OR from 6 Pm to 2 AM. I made rounds the whole afternoon. Then for the next whole week, I was doing OR every night till 2 am next day.

    It was a baptism of fire for me.

    A bombing cruelty. Six dead, 32 injured, 12 ortho patients needing OR and re ors. One whole week of nightly OR till wee hours of the morning. I was taking naps in between ORs, slept in the hospital benches, OR beds and make shift tables. I rarely slept in my bed, nor eat in my home. It was like I’m some far away war front like Afghanistan or Iraq.

    But no, this is not Iraq nor Afghanistan. This is my place. And when you see dead or injured people because of so called altruistic principles, I can’t help but curse at their bullshit war. People get killed, some maimed and families lost love ones. And these are civilians with no business whatsoever in their so called war to freedom.“You call this fight for freedom?” I have a better adjective for this type of people who sow terror in the guise of “freedom”- cowards!

    One year now, that summer, I still vividly recall the gory that baptized me into my practice. I can still remember the crying people losing their loved ones, of dying people under my care. Lost limbs, lost souls, all because of that “bomb” for freedom. I still have bombing patients under my care now, recovering from the trauma they sustained one year ago. Most of them became my friends. Some, lost on follow up.

    I hope this summer would not be the same summer as last year. Not again. Please?!!!

    (This is my supposed to be entry to TBR5 but just didn’t make it to the deadline. I had a last minute change of heart from the usual posts of outdoor adventures that summer. )

  • At A Crossroad: The Blog Rounds 3rd ed is up at In the Middle of Nowhere

    (The original picture in this post is owned by Kenny Gulley, entitled The Storms of Life, was removed upon the owners request, depicts a man at a “crossroad”)

    The thousands crossroads we face in our daily lives. Who makes these crossroads? Who serves us the options? Why do we have to face it? What makes us choose the road less traveled? How do we feel about our decisions now? Are we happy about it?

    These are some of the questions physicians have dissected, researched and the answers, blogged in The Blog Rounds 3rd ed. Themed “At a crossroad“, the third edition of The Blog Rounds is up at Doc Claires blog In the Middle of Nowhere. In this edition, you will see a growing community of Filipino doctors who blogged about their personal and medical life! What they wrote, will actually fill my whole week of reading and pondering!
    I am very thankful Doc Claire accepted and run a well thought of third edition of TBR. I am very much excited also of the growing number of Filipino MD blogger who joined TBR! My hat’s off to all of you!
    The Blog Rounds is a weekly compilation of the best in Philippine’s medical blogosphere, written by physician bloggers (or the medically inclined bloggers) and hosted on a participating blogger’s weblog. Archives and edition schedules ( plus the host blogger) are listed here. The next edition of TBR will be up this Tuesday, April 8,2008 7am PST and will be hosted by Doc Tess of An Eye Doctor in a Third World Country.

    For physicians and medically inclined bloggers interested in joining this blog carnival, please contact me through my email kokegulper[at]yahoo[dot]com or any of the participating TBR bloggers. Guidelines and updates are posted here in my website, The Orthopedic Logbook.