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Removing the Baggage of Sickness

During the large-scale Tzu Chi free clinic held in Tacloban, the Philippines, from 22 to 24 October 2015, members from the Tzu Chi International Medical Association (TIMA) conducted the eye and major surgeries at the Eastern Visayas Regional Medical Centre (EVRMC). Six doctors from Singapore and TIMA Philippines, together with five doctors from the EVRMC worked together over the two days, conducting surgeries such as hernia repair, tumour and cataract removal.

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The free clinic’s youngest hernia patient, Matthew, with his parents. (Photo by Wang Jun Xuan)

“If not for Tzu Chi, we will have nothing. We are fortunate to have its help.” Talking about the destruction that Typhoon Haiyan brought still brings tears to the eyes of Gabriel’s wife. Her family was among the tens of thousands of typhoon survivors who benefitted from Tzu Chi’s aid in the aftermath. Two years after the disaster, Gabriel’s family visited the Tzu Chi free clinic in Tacloban and were very grateful that their two-year-old son, Matthew, could undergo a surgery to repair his hernia. After the procedure, little Matthew no longer cried from the pain of his past affliction.

During the free clinic, three out of the four surgical rooms in the Eastern Visayas Regional Medical Centre were allocated to Tzu Chi. Though the rooms looked worn and very basic, the equipment inside were models at the forefront of medical technology. The hospital was still in the midst of rebuilding its wards after the typhoon disaster, and hence, there were sick beds placed along the long corridors. The patients who stood out among the rest were those suffering from goitre.

“Goitre is very commonly seen during free clinics; the condition is painless and does not cause inconvenience to the sufferer. In addition a goitre surgery is expensive, hence many choose to delay treatment,” said Dr. Dante Mercado.

A familiar face at the numerous Tzu Chi free clinics held in the Philippines in the past, Dr. Mercado further explained that delayed treatment may lead to heart problems and affect the patient’s metabolism, making surgery completely impossible. In the big cities like Manila, patients will undergo surgery before the swelling becomes obvious. Yet, many of the goitre sufferers at the Tzu Chi free clinic had had the condition for more than ten years as the cost, rather than the lack of facilities, was an obstacle for them.

Surgery Brings New Hope for the Future

Jacilyn, a 48-year-old goitre sufferer, had her neck covered by a scarf, but her swollen neck was still obvious to the casual observer. Some of her fellow sufferers of the condition even had swellings that were comparable to the size of two fists.

“There is no pain and not much inconvenience, but people look at me in a different manner.” She had had the affliction for 15 years, and it had started to affect her children. Her youngest child even got into a fight after his classmates teased him about her swollen neck.

Hearing about the free clinic, Jaclyn had brought her asthmatic child for treatment and did not expect that she could also get her own problem treated. After the operation, the wound still hurt, but she was filled with happiness and her radiant smile said it all. A single operation had the power to remove 15 years of suffering; her appearance and life were changed and she could look forward to living her life more confidently.

While Typhoon Haiyan had affected the lives of the poor, it similarly left its mark on many in the middleclass. Diosdada another goitre sufferer, is a statistician in a local university. She draws a monthly salary of roughly 9,000 pesos and is much better off compared to many of the other patients. Yet, to rebuild her house which was damaged during the catastrophe, she took a loan of 300,000 pesos, and this left her with very little to live on every month after accounting for loan repayments and tax.

Initially, she was hesitant to seek out surgery for her goitre as apart from the cost, one of her friends who had undergone the procedure had lost her voice. However, a friend who had regained her sight after a successful cataract operation with Tzu Chi gave her new hope. “If not for this free clinic, I would not have had the courage to undergo the operation,” said a grateful Diosdada.

Inspired to Give

The youngest patient at the free clinic was two-year-old Matthew, who was only four months old when Typhoon Haiyan struck. He was placed in a styrofoam container by his father before they made their way to the rooftop of the house to escape the disaster. Only after a harrowing 10 hours were they saved and reunited with the rest of their family.

Subsequently, the government announced that the area would be abandoned, and his father, Gabriel, was unable to make a living with his trishaw any longer. It was at this point that Tzu Chi gave them new hope with its “cash-for-work” programme, where affected residents were paid for cleaning up their own homes.

Having escaped calamity once, little Matthew was doubly precious in his parent’s eyes. So when he was diagnosed with hernia, his parents were crushed. After deductions from medical insurance, Gabriel still needed to pay 25,000 pesos. With his monthly income of 9,000 pesos, he would have to save every cent he earned for three months to be able to afford the operation. With a wife and three children to support, Gabriel gave up hope for his son’s surgery.

Now that his son had benefitted from the free clinic with a successful operation, a thankful Gabriel hoped to join the ranks of Tzu Chi volunteers and help the needy. Currently tied up with their jobs, Gabriel and his wife are unable to realise that dream yet, but they remember to make a daily donation into the Tzu Chi bamboo coin bank, returning it back to the NGO at its aid distribution events.

Dr. Lewis Liew, a urologist from Singapore who conducted hernia operations at the free clinic, had a few words to add: “Many of the patients have been suffering for a long time; some may have turned up at the last minute, but as long as they are certified fit to undergo the procedure, we will try our best to operate on them.”

Seeing the joy on his patients’ faces, fifth-time TIMA free clinic participant Dr. Liew felt that all his efforts were worthwhile.

Going All Out to Help Eye Patients

During the period of the free clinic, more than 150 cases of eye operations were done, including pterygium lesion and cataract removal. In particular, cataract operations made up 90% of the cases.

Dr. Anthonia Say, the convenor for TIMA Philippines, led a team of eye specialists from Manila, and together with Singapore doctors, they offered eye operations to the residents of Tacloban. Two years after the typhoon disaster, the EVRMC boasts of two simple but adequately equipped surgical rooms, each equipped with three beds. Dr. Say also specially arranged for medically advanced equipment and supplies to be brought in from Manila, including phacoemulsification surgical devices.

He explained that as the residents of Tacloban work in jobs, such as fishing, farming and driving trishaws, they are exposed to many hours of UV radiation in the sun and this hastens the signs of bodily ageing. Coupled with illnesses induced by malnutrition, such as Type 3 diabetes, this can result in secondary development of cataracts. In Tacloban, cataracts is not just seen in the elderly; there were many young sufferers of the condition at the free clinic and the youngest was just 15 years old.

Though the local government has subsidies and medical insurance in place which allow residents to have the procedure done for free or at a low cost, this benefit is restricted to those who have stable jobs. Those who did not have their birth registered with the relevant authorities, housewives or the sick who are unable to work, do not have access to the medical benefit. As a result, though the free clinic only opened at 6am, many patients from near and far arrived there in the wee hours of 3am or 4am, hoping to have their operation completed early.

As the patients needed to fast before undergoing surgery, Dr. Say decided to start conducting the surgeries before the scheduled time so that they would not need to go hungry for too long. With his patients’ comfort in mind, he made it a point to commence the first surgery at 6am.

Though the eye specialists started work the earliest, they ended the day the latest. On the second day of the free clinic, the medical workers put in 14 hours of work; not only did they serve patients who registered in advance, they also tended to walk-in patients by examining them and scheduling them for operation.

Humane Doctors Restore Sight

“I can see! I have finally regained my sight! Thank you, Tzu Chi, I want to go back to earning money as a trishaw driver,” exclaimed Rito, who was sitting on the operating table after his cataract operation. Unable to hide his joy, he was already peering around his environment with excitement, now that the problem he had been suffering from for the past three years had been removed.

Dr. Say commented that a cataract operation can range anywhere between 4 to 15 minutes. However, as many of the patients had delayed the procedure for a long time, this necessitated a longer time to remove the cloudy lens in the eye. Though it is a short operation, the outlay can reach 30,000 pesos and a single operation usually costs the equivalent of five months of salary for many of the locals.

Rito, who is already 63 years old, is a good example. Three years ago, his vision became cloudy and with no means to afford an operation, he depended on his 59-year -old wife Wilma to take care of him. Recently, his condition deteriorated further such that he had to crouch on the ground to properly see the dirt that he was sweeping up.

“I can’t remember how many items he has already broken,” said Wilma as she revealed that they inevitable squabbled over this.

Seven months ago, their lives hit a new low when Wilma was also diagnosed with cataract. “I cannot imagine the day when I, too, lose my vision. What will happen to us then?” Thus they were delighted when they found out that Tzu Chi was offering cataract removal operations at the free clinic. After their operations, both of them raised their thumbs in gratitude to Tzu Chi as they cheerily exchanged smiles with each other.

Health is the greatest form of wealth; under the humane hands of TIMA doctors, the needy do not have to forsake their dreams and hopes for a better life through the lack of medical resources.

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At the Eastern Visayas Regional Medical Centre (EVRMC), one of the two locations of the Tzu Chi free clinic, patients line the corridors as there are not enough wards. (Photo by Ng Shey Ying)

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Philippine and Singapore TIMA doctors made use of the blackboard in a classroom to keep track of updates to their patients’ details and care status. (Photo by Ng Shey Ying)

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Goitre patient Jacilyn (middle) has suffered from the condition for the past 15 years, and her affliction has started to affect her children who were bullied in school because of it. (Photo by Ng Shey Ying)

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Fifth-time TIMA free clinic participant Dr. Lewis Liew shared that seeing the smiles on his patients’ faces made him feel his time spent was worth it. (Photo by Ong Leng Hong)

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On the last day of the Tacloban free clinic, cataract patients came back for a review and raised their thumbs in gratitude for the medical care they received. (Photo by Yan Su-Yuan)

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At 3pm in the afternoon, there were still many patients waiting outside the EVRMC for their turn at the free clinic. (Photo by Wang Jun Xuan)

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Cataract patient Rito is unable to hide his joy after the operation. (Photo by Wang Jun Xuan)

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A medical volunteer carefully explaining to cataract patient Marissa how to use her eye medications. (Photo by Wang Jun Xuan) 

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On the last day of the free clinic, patients came back for a review and everyone, including the Singapore and Philippine medical teams, volunteers, and cataract sufferers, came together to express mutual gratitude. (Photo by Bernard Ng)

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