in F O cus

ISSUE NUMBER 3 Apokon, Tagum City

THE OFFICIAL NEWSLETTER OF DAVAO REGIONAL HOSPITAL

TO OUR sURgeOns dR. JESSE ROLANd R. MONTERdE dR. GEdEON B. TOLENTINO dR. RUSSLIN A. HUERTA dR. AMINA G. RASUL for passing the Qualifying examination (1st part) for Diplomate Philippine Board surgery From: ASEC. Busuego and DRH Family

Congratulations!

Congratulations!
TO OUR AnesTHesIOLOgIsTs dR. EMILITO SUAREZ dR. BENJAMIN LUY Full-fledged Diplomates of the Philippine Board Anesthesiology From: AseC. Busuego and DRH Family

ISSUE

in this

Revolutionizing
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Health Care Service

DECEASED ORGAN DONATION:

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A DRH Experience

Whats
with theZ

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in F O cus
ISSUE NUMBER 3

Universal Health Care (UHC)

UHC to Address Inequity in the Health System
Universal Health Care and Its Aim Universal Health Care (UHC), also referred to as Kalusugan Pangkalahatan (KP), is the provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public. The Aquino administration puts it as the availability and accessibility of health services and necessities for all Filipinos. It is a government mandate aiming to ensure that every Filipino shall receive affordable and quality health benefits.This involves providing adequate resources health human resources, health facilities, and health financing.

The MdG
Millennium Development Goals

larger capacity, to attend to all types of emergencies, and to handle non-communicable diseases. The Health Facility Enhancement Program (HFEP) shall provide funds to improve facility preparedness for trauma and other emergencies. The aim of HFEP was to upgrade 20% of DOH-retained hospitals, 46% of provincial hospitals, 46% of district hospitals, and 51% of rural health units (RHUs) by end of 2011. Financial efforts shall be provided to allow immediate rehabilitation and construction of critical health facilities. In addition to that, treatment packs for hypertension and diabetes shall be obtained and distributed to RHUs. The DOH licensure and PhilHealth accreditation for hospitals and health facilities shall be streamlined and unified. Attainment of Health-related MDGs Further efforts and additional resources are to be applied on public health programs to reduce maternal and child mortality, morbidity and mortality from Tuberculosis and Malaria, and incidence of HIV/ AIDS. Localities shall be prepared for the emerging disease trends, as well as the prevention and control of non-communicable diseases. The organization of Community Health Teams (CHTs) in each priority population area is one way to achieve health-related MDGs. CHTs are groups of volunteers, who will assist families with their health needs, provide health information, and facilitate communication with other health providers. RNheals nurses will be trained to become trainers and supervisors to coordinate with community-level workers and CHTs. By the end of 2011, it is targeted

UHCs Three Thrusts To attain UHC, three strategic thrusts are to be pursued, namely: 1) Financial risk protection through expansion in enrollment and benefit delivery of the National Health Insurance Program (NHIP); 2) Improved access to quality hospitals and health care facilities; and 3) Attainment of health-related Millennium Development Goals (MDGs). Financial Risk Protection Protection from the financial impacts of health care is attained by making any Filipino eligible to enroll, to know their entitlements and responsibilities, to avail of health services, and to be reimbursed by PhilHealth with regard to health care expenditures. PhilHealth operations are to be redirected towards enhancing national and regional health insurance system. The NHIP enrollment shall be rapidly expanded to improve population coverage. The availment of outpatient and inpatient services shall be intensively promoted. Moreover, the use of information technology shall be maximized to speed up PhilHealth claims processing. Improved Access to Quality Hospitals and Health Care Facilities Improved access to quality hospitals and health facilities shall be achieved in a number of creative approaches. First, the quality of government-owned and operated hospitals and health facilities is to be upgraded to accommodate

that there will be 20,000 CHTs and 10,000 RNheals. Another effort will be the provision of necessary services using the life cycle approach. These services include family planning, ante-natal care, delivery in health facilities, newborn care, and the Garantisadong Pambata package. Better coordination among government agencies, such as DOH, DepEd, DSWD, and DILG, would also be essential for the achievement of these MDGs. Source: Department of Health / www.doh.gov.ph
EDiTORS NOTES iN FOCUS is the Official Newsletter of Davao Regional Hospital and is published twice a year. For comments and queries, please write to: DAVAO REGiONAL HOSPiTAL Apokon, Tagum City, Davao del Norte Tel. Nos.: (084) 400-5323/ (084) 217-3571 Telefax: (084) 400-3050 email address: drh_tagum@yahoo.com / kamp2228@yahoo.com

in F O cus
ISSUE NUMBER 3

EDITORIAL

STAff

KAREN ANN M. PILAR, RN, CRN Editor-in-Chief IVY B. BALLESTEROS, RN Assistant Editor-in-Chief NENET C. BURIGSAY, RN, CRN Managing Editor

Advisers ROMULO A. BUSUEGO, MD, DPBS, FPCS ARTHUR P. SUYKO, MD, MAHA CARLITO U. PILLERIN, CPA MA. MERCY C. CORAL, RN, MAN, MHA JAMES PAUL B. DUMDUM, MD, DPBS ALVIN S. CONCHA, MD, CFP, MASOR

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ISSUE NUMBER 3

Registered Nurses for Health Enhancement And Local Service

by: Ma. Krizia Kaia B. Coral, RN The Department of Health (DOH) in collaboration with the Department of Social Welfare and Development (DSWD) and with the partnership with other agencies and organizations such as the Department of Labor and Employment (DOLE), the Department of Interior and Local Government (DILG), the Professional Regulation Commission Board of Nursing (PRCBON), Philippine Nurses Association (PNA), and the Local Government Units (LGUs) spearheaded a learning and deployment project for the increasing number of unemployed nurses that would improve the local health systems and support the countrys attainment of its Millennium Development targets. Thus, the Registered Nurses for Health Enhancement and Local Service Project otherwise known as RN Heals Project was conceptualized in response to the countrys constitutional mandate to make essential health goods and social services available to all Filipinos, especially the poor. Being part of the RN Heals Program was truly a huge twist of fate for me. Honestly, I was at the verge of giving up the nursing profession due to the global retrogression in which, the employment of the biggest workforce worldwide Nursing has been profoundly crippled. It seemed that all my hardships and sacrifices back then have become futile; that all my labors have resulted to nothing but grief and regret. Nevertheless, I never stopped believing that one day I will finally have a break and have the chance to practice Nursing while providing efficient and effective quality care filled with sincerity and compassion. Being one of those unemployed nurses who were given a chance to be employed especially, by the best known training hospital in the Philippine archipelago - the Davao Regional Hospital I could personally say that I was filled with gratitude that the government finally attended to the nursing predicament. For it did not only gave us neophytes a chance to taste the so-called Paid Labor but, it gave us a new hope to pursue our mission to

serve. Other than that, it gave us the opportunity to learn more and become the best nurse that we can be. As a former Volunteer Nurse in one of the respective health care facilities in the province of Agusan del Norte, I learned that every institution is unique and shouldnt be compared with others. I learned that various institutions have different policies and protocols regulated on the Nursing practice which should be respected. Errors, mistakes and lapses (for as long as the health status of patients is not compromised) may be encountered too. But I know that in time, I will be able to overcome these insufficiencies with Gods grace and with the aid of the bridging programs that DRH offers. However, the greatest thing that I have learned so far from these experiences is the fact that everything truly happens for a reason. That it has been planned in advance for us by the Almighty God. That everything would come on its place at the right moment of our lives. That rushing all things would result to nothing but anxiety, mental and emotional fatigue. Therefore we should have a stronger faith and keep ourselves yearning for new knowledge and continue to live our lives with hope and optimism. This is a great opportunity for us novices to become globally competitive and to be highly competent nurses by focusing on learning and development in spite of the limited time. Attending trainings, seminars, case-based group discussions, brainstorming, applying learned skills and applying tested techniques of colleagues and prayer will be the core for my personal and professional growth and develop the person I aspire to be - benevolent, modest, full of virtues, strong-willed, and proficient. I am looking forward to gain everything that I can and as much as I can in my journey through this RN Heals Program. full coverage for our countrymen suffering from dire illnesses, opening new doors to Filipinos in the margins, around the margins, of society. So if Aling Nena has been diagnosed with early-stage breast cancer, PhilHealth will pay for the entire course of her treatment in any of the government hospitals contracted to provide this package: from cardiopulmonary clearance and surgery, to the complete session of therapy and even radiation therapy if it is necessary. For 2012, PhilHealth has allotted three billion pesos for the Z-Benefit package, 1.3 billion pesos of which will be used for the treatment of 12,000 people afflicted with either breast cancer, childhood leukemia, or prostate cancer. That is 12,000 fathers, mothers, sons, and daughters whom we are helping directly and whose families need not become mired in debt. Before, the poorest of the poor could not even visit hospitals or see doctors; now, we have found a way for them to receive full treatment for the most debilitating illnesses, while sparing them most of the financial burden. If I may emphasize: this is only the initial implementation of that program. Just as PhilHealth has dramatically expanded their coverage in only two years, so too will they expand the coverage of this program in the coming months. This occasion represents the very goals of our universal healthcare: to ease the burden of our countrymen already struggling to put food on their tables by lending them a helping hand for their other needs; and to support Juan and Juana de la Cruz from beginning to end, in the most common of illnesses and in the most catastrophic. Just as fighting corruption and poverty are the means to ensure a healthier, fairer, and more prosperous society, so too will programs like these help improve our public health system, resulting in a society where the vulnerable are made strong, and the weak are empowered to contribute to the well-being and the happiness of the whole. With your help, we have already done so much. There will be many more challenges, both old and new, but if we continue to stand together, we will be able to strengthen not only our healthcare system, but also each and every Filipino. My congratulations, thank you, and good day. Source: www.gov.ph/official-gazette/republicofthephilippines

Journey

SPEECH OF HIS ExCELLENCY from page 5

will be vaccinated. This means that we will be able to protect 700,000 children from the poorest families in our country and give them a stronger, healthier start in life. And this is not the only way we are fighting to diminish the occurrence of diarrhea related hospitalizations and death. Lives can be saved through simple measures that have been in place for some time, such as the administration of oral rehydration salt solutions, which can prevent up to 90 percent of diarrheal deaths. But we know that these strategies work best when used with preventive measures such as breastfeeding and hand washingand this is also where the rotavirus vaccine comes into play. We are doing all these because we want to be prepared for this recurring threat; because we want to diminish the danger that this condition poses to our children; and because we want to lessen the burden on our people who should not have to worry about their children dying from a highly treatable disease like diarrhea. But we also know that there are illnesses you cannot necessarily prepare for and fight in the same way we are fighting the rotavirus. The worst of these are what we call the catastrophic illnessesillnesses that are literally catastrophic to ones health, to ones financial situation, and even to ones emotional and psychological well-being. Philhealth classifies them as Type Z cases. Our people should not try to overcome these illnesses alone, and this idea is at the heart of our universal healthcare program. So we are especially proud today to launch the Z-Benefit Package of PhilHealth here, and in hospitals nationwide. This will comprehensively cover catastrophic illnesses that can lead to death or disability. Among those for the initial implementation are: early stage breast cancer, standard risk childhood acute lymphoblastic leukemia, and low to intermediate risk prostate cancer. For the first time in its history, PhilHealth now provides benefits that can cover the treatment of diseases that cost roughly a hundred thousand to 200 thousand pesos. This represents a change in the way PhilHealth does business. Instead of focusing on one claim or one treatment alone, the focus is on the patient himself: from the surgery to post-operation care and even to therapy. The Z-benefit package provides

in F O cus
ISSUE NUMBER 3

DISASTER PREPAREDNESS
by: Brian Balan, RN

Rainy days are seasonal no more. We cannot really tell what a 30-minute heavy rain can do to us. We often hear flash floods on broadcast somewhere on the northern part of the country but not here far south. What happened in Davao City in 2011 clearly showed how fickle the weather condition is. While we were typhoon-free that before, we are no longer safe now from flash floods, and without warning properties, infrastructures are destroyed or even lives lost. Preparing for a calamity is something we should seriously consider. We are in the cyber technology era and electricity becomes a necessity; even mobile phones become an integral part of our daily activities. Should these things shut down in face of a calamity or a disaster are we prepared? If this happens, what do we do? We cannot stop natural disasters but is very important to know beforehand what to do during calamities. Knowing way ahead minimizes panic and last minute preparations. Ask these questions as early as now. Where do we start? What should we consider first? What supplies should we store? Questions like these may be popping in our heads. But worry not! Listed below are the things we need to know and do before disaster hits. LOGiSTiCS AND GO BAG A component of your disaster kit is your Gobag. Put the following items together in a backpack or another easy to carry container in case you must evacuate quickly. Prepare only one Go-bag with supplies enough for the whole family. You may not be at home when an emergency strikes so keep some additional supplies in your car and at work, considering what you would need for your immediate safety. Flashlight Radio battery operated Batteries Whistle Dust mask Pocket knife Emergency cash in small denominations and quarters for phone calls Sturdy shoes, a change of clothes, and a warm hat Some water and food Permanent marker, paper and tape Photos of family members and pets for reidentification purposes List of emergency point-of -contact phone numbers Copy of health insurance and identification cards Important documents/valuables (land titles, insurances and the like, jewelry) Prescription medications and first aid supplies Toothbrush and toothpaste Extra keys to your house and vehicle Rope (life line)

FiRE Remain calm and get out. If you see smoke under the door, find another way out. Feel the door with the back of your hand before you open it. If it is hot, find another way out. Drop to the floor to avoid smoke and fumes. Crawl to safety. If your clothes catch on fire, STOP where you are, DROP to the ground and ROLL over and over to smother the flames. Call emergency number from a safe location. Stay on the line until the operator hangs up. If you are trapped in a burning building, stay near a window and close to the floor. If possible, signal for help. Do not go back inside the building unless instructed that it is safe to do so. FLASH FLOODS Tune to local radio stations for emergency advisories and instructions. If water has entered a garage or basement, do not walk through it it may contain hazardous materials. Do not try to drive over a flooded road. If your car stalls, abandon it immediately. Attempting to move a stalled vehicle in flood conditions can be fatal. If you are asked to leave your property, disconnect all electrical appliances. Do not walk through moving water. Six inches of moving water can make you fall. If you must walk in water, walk where the water is not moving. Use a stick to check the firmness of the ground in front of you. Stay clear of water that is in contact with downed power lines. Do not allow children to play around high water, storm drains or any flooded areas. EARTHqUAkE If you are indoors when shaking starts: DROP, COVER AND HOLD ON. If you are not near a strong table or desk, drop to the floor against an interior wall and cover your head and neck with your arms. Avoid windows, hanging objects, mirrors, tall furniture, large appliances and cabinets filled with heavy objects. Do not try to run out of the building during strong shaking. f you are in bed, stay there and cover your head with a pillow. If you use a wheelchair, lock the wheels and cover your head. If you are outdoors when shaking starts: Move to a clear area if you can safely walk. Avoid power lines, buildings and trees. If youre driving, pull to the side of the road and stop. Avoid stopping under overhead hazards. Once the earthquake shaking stops: Check the people around you for injuries; provide first aid. Do not move seriously injured persons unless they are in immediate danger. Check around you for dangerous conditions, such as fires, downed power lines and structure damage. If you have fire extinguishers and are trained to use them, put out small fires immediately. Check your phones to be sure they have not shaken off the hook and are tying up a line. Inspect your home for damage. If you are trapped in debris: Move as little as possible so that you dont kick up dust. Cover your nose and mouth with a handkerchief or clothing. Tap on a pipe or wall so that rescuers can hear where you are. Use a whistle if one is available. Shout only as a last resort. These are just few of the procedures we are to do during calamities and disasters but all of these are nothing if not geared up ahead of time. Emergency drills should be sporadically adept in simulation in various situations to acculturate our system and ourselves. The more prepared you are the lesser tendency to panic. Staying calm leads us to focus and think right. One thing also we often forget during a calamity is to call ALMIGHTY. Again, when disaster strikes, HOW WELL PREPARED ARE YOU?

CREATE A COmmUNiCATiON PLAN It is important to have a communication strategy among your family members. Make sure that everyone has a complete list of all contact numbers from personal cell phones to office and school landlines, even contact numbers of places you commonly go to like the gym or a friends house. Dont forget to include the numbers of your local police and fire station. Dont forget to always stay calm! Remember, panic will not get you anywhere! Your family needs your undivided attention. Just stay cool and execute the plans youve discussed as a family. You have prepared for this, so theres no reason to be frightened.

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ISSUE NUMBER 3

Whats
with the Z

The New PhilHealth Benefit Package

The Philippine Health Insurance Corporation (PHIC) unveiled last July 2, 2012 the so-called, Z Benefit Package led by President Benigno C. Aquino III and Health Secretary Enrique T. Ona at the Malacanang Palace. The Z Package gives substantial financial risk protection and totality of care for the treatment of catastrophic illnesses, specifically childhood acute lymphocytic leukemia (ALL), breast cancer, prostate cancer, and kidney transplantation procedure for endstage renal disease. In order to give the PHIC member patients a better choice in receiving quality care and services, the Davao Regional Hospital (DRH) has joined forces with the PHIC in bringing Universal Health Care to all Filipinos, especially patients from the Davao Region and its neighboring provinces. As one of the eighteen (18) contracted government hospitals nationwide, DRH also did a launching event simultaneously with the Malacanang Palace led by the Assistant Health Secretary and the DRH concurrent Chief of Hospital Dr. Romulo A. Busuego. The event was graced by Dr. Ruben O. Lacuna of PhilHealth Region XI, Mr. Salvador Gaspar M. Deocampo of PhilHealth Davao del Norte Province, and Vice-Governor Joel Mayo Z. Almario of Mati. In the Z package implementing guidelines, all non-sponsored PHIC members are required to follow a fixed co-pay policy. A fixed co-pay is a negotiated fixed amount for quality care that may be charged by the contracted hospital as approved by the PHIC. The Davao Regional Hospital has once again proven its reputation as the most affordable specialized health institute with its favorable fixed co-pay policy. Likewise, those under the Department of Social Welfare and Development (DSWD) and Local Government Unit (LGU) sponsored programs could avail of the No Balance Billing or the walang dagdag bayad policy. Further details of this wonder package is explained below: WHAT ARE Z BENEFITS? Z benefit is a benefit for any catastrophic illness that requires prolonged hospitalization. extremely expensive therapies, or other treatments that can deplete a familys financial resources, unless covered by special health insurance policies. WHAT ARE THE ILLNESSES COVERED BY THE PACKAGE? The following illnesses are covered with their corresponding package rates: Acute Lymphocytic Leukemia - P 210,000.00 Breast Cancer - P 100,000.00 Prostate Cancer - P 100,000.00 Kidney Transplant Procedure - P 600,000.00 WHAT ELSE DOES THE PACKAGE COVER? The package covers necessary services that include payment for room and board, drugs and medicines, laboratory, operating room, and professional fees, and mandatory services for the entire course of treatment. WHO ARE ENTITLED TO THE BENEFITS? All eligible PHIC members including their qualified dependents are entitled to avail of the benefits. OFW can avail themselves of the mandatory and other services only when performed in the Philippines. IS THE NO BALANCE BILLING APPLICABLE FOR Z BENEFITS? The No Balance Billing policy shall be applicable to all sponsored members. This means that no other fees or expenses shall be charged of paid for by the member above and beyond the package rates. For non-sponsored members a fixed co-pay shall be applied. This means that a fixed amount will be shouldered by the member on top of the Z package but not to exceed the benefit payment being paid for by PhilHealth. For further information, please contact DRH PhilHealth Section at (084) 400-4674 or drh_phic@yahoo.com.

President of the Philippines at the joint launching of the DOHs rotavirus vaccine and PhilHealths Z-Benefit Package [Delivered at Heroes Hall, Malacaan Palace, on July 2, 2012]

His Excellency Benigno S. Aquino III

Speech of

Thank you. Good afternoon. Please sit down. Secretary Ike Ona; Dr. Banzon, president, CEO of PhilHealth; Dr. Dr. Soe Nyunt U of the World Health Organization; Dr. Willibald Zeck of the UNICEF; Dr. Francisco Duque, Chair of the Civil Service Commission; fellow workers in government; honored guests; mga minamahal ko pong kababayan: Magandang hapon po sa inyong lahat. In 2010, a single idea made our campaign a true peoples campaignand said, Kung walang corrupt, walang mahirap. If we can eradicate Before, the poorest of corruption, then we can end the poor could not even poverty. Today, this idea remains at the heart of our methodology visit hospitals or see to effect lasting and positive doctors; now, we have change in the Philippines. found a way for them to In the past two years, you have seen just how receive full treatment vigorously we have for the most debilitating pursued our anti-corruption and anti-poverty reforms. illnesses, while sparing So while we are cleaning up them most of the institutions and processes, and holding the corrupt financial burden. accountable, we are also focusing on the programs and projects that truly help Juan and Juana de la Cruz: from the Conditional Cash Transfer Program, to our recently implemented K to 12 Education Program. But to win this war on poverty, we must also turn our attention to public health. And, as we focus on the health of our country, economy, government, the overall health of all Filipinos also remains a top priority. We want our people to be empowered individuals capable of standing on their own two feetstrong, healthy, and skilled men and women who can take advantage of the opportunities that life affords them. And all of you in the arena of public health are vital to this goal. Those of you in the Department of Health faced challenges that seemed almost insurmountable. For example, around five million poor families were not covered by PhilHealth despite the four billion pesos spent by the national government and local government units in premiums in 2010. But you confronted these challenges willinglyfinding solutions, cleaning up the systems, and increasing your ability to provide more services, treatments, and medicines to our people. The goal: Kalusugan Pangkalahatan, a universal healthcare system that provides for the Filipino people quality and appropriate healthcare for Type A illnesses like diarrhea to Type Z illnesses like cancer, if we go by the PhilHealth classification. The rotavirus is the most common cause of severe diarrhea in infants and children below five years of ageor so Im told by Secretary Ona. We are aware of the dangers that diarrhea poses to anyone, especially in severe cases. For instance, in the Second World War, many more Filipinos died in the prison camps from dysentery, than from Japanese Soldiers during the Death March. If a strong and hardy soldier trained to withstand the most difficult conditions can die of dysentery, how much more our children who are among the most vulnerable in our population? Diarrhea is an illness that can be prevented given the proper care and environment but in the Philippines alone, thousands of children suffer from diarrhea each year, with over 3,500 cases leading to death. We can greatly reduce these numbers, and the effort to do this has already begun. Today, we launch the rotavirus vaccines, which are expected to contribute to our goal of safeguarding the health and well being of Filipino children. For this year, 700,000 infants from the families listed in our National Household Targeting System

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in F O cus
ISSUE NUMBER 3

Revolutionizing
the state-of-the-art digital medical linear accelerator, that has the following capabilities: Gantry +/- 0.5mm rotation difference (acceptable is 1mm) Multi-Leaf Collimator 82 leaf Integrated Treatment Planning System - Faster planning MOSAIQ software Upgradability to IMRT (Intensity Modulated Radiotherapy) Davao Regional Hospitals NUCLEAR MEDICINE & RADIOTHERAPY CENTER provides the most comprehensive services and affordable treatment for cancer patients not only in the region but also in the whole Mindanao.

Cancer ranks third as the leading cause of death in the Philippines. It is estimated that for every 1800 Filipinos, one will develop cancer annually and it is very common among Filipino patients to seek medical advice only when the disease is at advanced or terminal stage. It is with this premise that the Davao Regional Hospital took center stage in developing a P200-Million worth NUCLEAR MEDICINE & RADIOTHERAPY CENTER that was inaugurated by no less than the Secretary of Health, Dr. Enrique T. Ona and paved its way as an additional service to the public on January 8, 2012. The FIRST and ONLY government hospital in Mindanao with

A DRH Experience
On August 29, 2011, a 48-year old woman was admitted due to vehicular accident and sustained a severe head injury. The following day, she was declared brain dead and was referred for possible organ donation. Her husband and children agreed to donate her kidneys that were given to two (2) patients in Manila listed in the waiting list for over one year to be transplanted. Another gift of life was donated by a 30 year old man who suffered from severe head injury from industrial accident last March 20, 2012. After the family has been given a thorough explanation of the patients critical condition, they have agreed for organ donation. This successful deceased organ donation, is the FIRST for Davao Regional Hospital (DRH) and only the second time in Mindanao. The kidney recipients are neither rich nor famous, and their lives are marked by the same struggles we all face. But because of the donor familys decision for organ donation, they are given a second chance at life. Since kidney transplantation in humans became successful over five decades ago, the number of patients needing kidney transplants has exceeded the supply of donor kidneys. In Philippine data, 10,00012,000 Filipinos are diagnosed of End-Stage Renal Disease annually and this number has led to a critical shortage of organs available for transplantation and a long waiting list for kidney transplantation. In response to this, the Department of Health is spearheading the development of a national system of promoting organ donation from deceased donors. The potential of deceased donor organs is yet to be maximized where the estimated number of deaths due to accidents is about 8,000 per year (ADB-ASEAN Regional Road Safety Program, ACCIDENT Costing Report AC7:Philippines). A brain dead person can still feel warm to touch and the mechanical ventilator that pushes oxygen into the lungs may cause the chest to expand

DECEASED ORGAN DONATION:

FAQs
1 WHAT IS ORGAN 2
ANd TISSUE dONATION? Organ and tissue donation is a way to help others, after your death by allowing organs or tissues to be taken from your body and transplanted in someone elses body. It may save another persons life.

ON ORGAN DONATION

WHAT IS THE BASIS Of ORGAN dONATION? RA 7170 Organ Donation Act of 1991 An act authorizing the legacy or donation of all part of a body after death for specified purposes which is signed into law by President Corazon Aquino.

HOW IS BRAIN dEATH dIffERENT fROM CARdIAC dEATH? BRAIN DEATH The complete and irreversible cessation of all brain functions including the brain stem according to the usual and customary standards of medicine. Once a patient was

4
declared brain dead, he/she is clinically and legally dead. Mechanical ventilation and medications keeps the heart beating and blood flowing to their organs. CARDIAC DEATH The cessation of normal circulation of the blood due to failure of the heart to contract effectively. HOW dOES BRAIN dEATH OCCUR? When the brain is injured, it responds in much the same way as an injury like a twisted ankle - it swells. Unlike the muscles and tissue of the ankle, however, the brain is in a confined space the skull and has no room to swell. As the brain swells inside the skull, it pushes downward toward the brain stem blocking all upward flow of blood. Depending on the type of injury, this may happen within minutes or over a period of days. Even while the heart is still beating and supplying blood to the rest of the body, blood that carries oxygen cannot reach the brain or the brain stem, which controls heart rate and breathing. The result is that the brain and the person dies.

Health Care Service

For more detailed information on the Radiotherapy services, please contact us at: Telephone Number: 084-400-5614 Mobile Numbers: 0999-762-2544 / 0933-942-6431 email Address: drh_tagum@yahoo.com drh_cancercenter@yahoo.com

thus making them appear to be breathing normally. This can be mistaken as a sign of hope for recovery by most family members. But the sad truth is that no hope for improvement or recovery is possible once a person is declared brain dead. It is only during this time that the option for organ donation is being offered to the family, to hopefully convince them that death can bring life, that sorrow can turn to hope and that a terrible loss can become the greatest gift of all. (National Organ Donors Memorial) The table on the next

page shows the deceased organ donation data at the Davao Regional Hospital since 2010 until the first quarter of 2012: Davao Regional Hospital has had thirteen (13) deceased organ donor referrals since 2010 until the early part of 2012. 2 (15%) of those were successful referrals where the kidneys were retrieved and transplanted and 11 (85%) were failed referrals. 11 (85%) of the total referred donors were male and 2 (15%) were females. 4 (31%) were aged <20 years old, 3 (23%) aged between 21-30 and 31-40 years old, 2 (15%) falls between the age of 41-50 and 1 (8%) with no data. Most of the referred donors were single 8 (61%), 4 (31%) were married and 1 (8%) with no data. The two successful referrals were aged 48 and 30 years old. For the cause of death, 12 (92%) were trauma cases where 9 of this were

due to vehicular accident and 1 each due to fall, mauling and crushing while only 1 (8%) was from a non-trauma. Most of the referrals were made by the surgery residents 8 (61%) while the rest were by the staff nurse 5 (39%). Around half of the referred donors (7 or 54%) did not consent to organ donation, 4 (31%) consented but were medically unsuitable due to hepatitis B (3) and gonorrhoea (1). Despite the existence of the first organ procurement in the Philippines, the Human Organ Preservation Effort (HOPE) of the National Kidney and Transplant Institute, organ donation is generally still in infancy stage. It is for this reason that the government should lead the way in intensifying advocacy campaign, to provide logistic support to various Organ Procurement Organization (OPO) to fully maximize the potential of Deceased Organ Donation Program.
See table on page 9

WHAT CAUSES BRAIN dEATH? Acute neurological trauma, cerebrovascular accident, cerebral anoxia, brain tumor.

WHO dETERMINES BRAIN dEATH The potential donors Attending Physician determines brain death. The diagnosis shall be confirmed by a Neurologist or a Neurosurgeon. No member of the Transplant Team determines brain death.

CAN ANYONE WHO IS BRAIN dEAd BE AN ORGAN dONOR? Anyone who is declared brain dead can be a potential organ donor. The Transplant Team will decide through the screening of laboratory results if the potential donor is medically suitable or not.

WILL dONATION WHAT ARE INTERfERE ORGANS fUNERAL THAT CAN BE ARRANGEMENT? dONATEd Donated organs are removed surgically, Organs: heart, kidneys, pancreas, in a routine operation similar to other lungs, liver, and operations. Donation intestines. doesnt disfigure the Tissues: bone, body. Normal funeral corneas, skin, arrangements including heart valves, veins, an open casket funeral cartilage and other are possible. The donor connective tissues. is always treated with great care and respect. Bone marrow.

HOW TO BECOME AN ORGAN ANd TISSUE dONOR? 1.Indicate your intent to be an organ and tissue donor on your drivers license. 2.Carry an organ donor card. For possible deceased 3.Most important, discuss organ donor, your decision with family please contact: members and loved ones. Even if you sign a 0908-580-3585 donor card, it is essential (084) 400-5323 that your family knows kamp2228@yahoo.com your wishes. Your family drh_transplantcenter@yahoo.com will be asked to sign a consent form in order for your donation to occur.

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Every death, be it noble, random, painful or quick is like a tear in the very fabric of our consciousness. There is a void left where a person used to be, and no level of understanding will ever make that better.

Davao Regional Hospital (DRH) grieves on the tragic death of a promising DRH employee, Agnes Raceles Domingo. On July 16, 2012, many were on hand to pay tribute and her wake was filled with friends and family who came to pay their last respect to an achiever as most people described her. Though her life was short lived, it was evident that Agnes who was survived by her husband and an only son, lived a good life. It was really a time to recall the wonderful deeds of this woman who was shot at gunpoint while going to work last July 12, 2012 at 6:30 in the morning. Agnes started working at the DRH in 1999 and was promoted to Head Nurse of the Coronary Care Unit (CCU) in 2006; later she was transferred to the Medicine Main Ward until her tragic death. As a unit manager, she assiduously implemented rules of the hospital. Agnes rarely refused responsibilities and additional tasks as shown by her membership in various committees of the hospital and as a lecturer in staff development programs and trainings such as Intravenous Therapy Training, Basic Life Support, Nursing School Affiliation Program,

FRIEND
by: Ivy B. Ballesteros, RN
Nursing Documentation and more. She had a strong personality and yet was a very loving person. She gave so much to those she loved. Her family was the center of her life. Others may have perceived her as vulgar and rough. Yes, it is true, when shes angry she talks loudly and coarse. But beyond this toughness was a woman with a generous and compassionate heart. She may even sacrifice her effort and time just to help others. Agnes seldom walked away from a fight. She was brave and courageous. In fact, one of the bravest I know. When

REQUIEM FOR A
youre a friend to her, she will never leave you especially when you need her most. A friend in trouble can always rely on her. A very fun-loving person, Neneng as she was fondly called, love to sing and dance. She sung mostly classical, mellow and upbeat music. Although she may not have the best voice but she can definitely sing in tune. She danced in every opportunity with friends and she has danced publicly on stage too, just like on October 2010 when she, together with other head nurses offered a dance number as a birthday gift to Dr. Romulo Busuego. Soon after she was pronounced dead at 10:08 am of July 12, 2012, DRH employees expressed their sympathies and hoping that justice will be given to her.

Soon after she was pronounced dead at 10:08 am of July 12, 2012, DRH employees expressed their sympathies and hoping that justice will be given to her.
You always make me look forward to do better ..You taught me how to stand for my job..You became not just a mentor but a dear friend -Phoebe Cruz Rest in peace Madam. We will miss you.. Ram John Ruto Yangyang I love you, Maam Nes..Father God embraces you now.. Rest in peace..We will forever miss you.. -Jaybee Genobisa TIME passes, MEMORIES fade, FEELINGS change, PEOPLE leave. But HEARTS never forget. Klog, youre in my heart. -Ivy Ballesteros The angels are always near to those who are grieving, to whisper to them that their loved ones are safe in the hand of GodLet not Maam Agnes death be in vain. -Dr. James Paul Dumdum

Rest in peace, Maam Agnes Raceles Ate, may justice Domingo, We will miss prevail for youmay youHope justice your soul be in peace will prevail..You dont with our Savior. deserve to die that way. -Rochelle Lynne -Julius Basan This is really Sacramento sad and a great There are reasons Pahulay na, Maam loss indeed for all worth dying for but sa kalinawSalamat of us..We will miss certainly there are no ,Maam sa knowledge you, Maam A! I reasons worth killing for. and skills nga imong giwill cherish your -Faith Kristine Omega impart sa tanang nurses company. -Cindy sa DRH.. -Maricel Marie Aguinaldo Dungog

To our dear friend Agnes..We will always remember you..Not because of the sweetness of your smile but because of the principles in life that you have..We will miss you. -Engr. Ferdie Arnel Denaque

Ne..the last time nagkita ta, we were so happy.. Naulanan ta, na-flatan ta ug ligid, nakaadlawnan ta sa jolibee..I will cherish all those memories I had with you..REST IN PEACE my dear friend. -Loida Valderama

IMPROVED DIALYSIS LIfE

WITH ONLINE HEMODIAfILTRATION
by: Engr. Ken Saad B. Magallanes End-Stage Renal Disease is a continuing challenge worldwide with a projected 712,000 prevalent patients in the United States alone by 2015. In the Philippines, 120 Filipinos per million population per year are suffering the disease. The number of diagnosed cases worldwide keeps growing exponentially every year. In fact, renal dialysis centers all over the country are sprouting from everywhere and patients are filling up seats just as quickly. Hemodialysis is one of the forms of renal replacement therapy, the others being kidney transplantation and peritoneal dialysis, and it is the most popular form of therapy today. It has been for the last three decades, at least. Simply put, hemodialysis is the process of removing toxins and excess fluids from the blood (the two primary functions of the human kidney) through diffusion and ultrafiltration when a persons renal function deteriorates or fails. This procedure clears the blood of a good range of toxins such as urea and creatinine. Hundreds of dialysis centers around the country offer this form of therapy making it readily available to patients with chronic kidney disease. But as popular as hemodialysis has become, nephrologists are still confronted with several challenges. Aside from the ever growing number of patients with chronic kidney disease, many of them may come with other complications, like cardiovascular disease, hypertension, and diabetes. Bernard Canaud, a Professor of Nephrology at the Montpellier University Shool of Medicine in France, reported in his article Therapeutic Benefits of Online Hemodialiftration that inspite of major technical advances and many therapeutic achievements in renal replacement therapies there has been no significant progress in patient survival. This may be caused by several factors such as poor clearance of middle sized solutes that leads to accumulation of middle and large sized toxins and poor biocompatibility

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of the dialysis system that results in a microinflammation state. The key to further improve the patients quality of life now rests on how to manage these risks while making the most, if not more, of the clinical benefits of renal replacement therapies. Diffusive-based dialysis procedure, such as that of conventional hemodialysis, is limited to their capacity to clear low and middle sized uremic toxins and clearance of toxins with large molecular weights, such as the 2 microglobulin, is extremely poor. Online Hemodiafiltration is a form of renal replacement therapy where it not only clears the blood of uremic wastes through diffusion, just like in hemodialysis, but also by ultrafiltration of plasma water and uses a replacement fluid to keep the patient in fluid balance. The hemodiafiltration machine creates an ultrafiltered fluid from its own dialysis solution through its specialized filters that removes contaminants and infuses a certain amount directly into the blood circuit. An equivalent volume of plasma water is then filtered out as blood passes through the dialyzer. This results to a more wider spectrum of toxin removal, including those large 2 microglobulins, resembling that of a healthy natural kidney. Further studies have shown that with the use of ultrapure dialysate the behaviour of some sensitive markers, such as interleukin and albumin, remain stable during treatment thus reducing the microinflammation of the patient. The graph shows how the online hemodiafiltration therapy closely resembles the human kidney in terms of toxin removal.

A DRH Experience

DECEASED ORGAN DONATION:

from page 7
TOTAL NUMBER OF PATIENTS (n=13) Failed Referrals Successful Referrals 2 (15%) 1 1 13 2 (15%) 11 (85%) 1 (8%) 4 (31%) 3 (23%) 3 (23%) 2 (15%) 1 (8%) 8 (61%) 4 (31%) 1 (8%) 12 (92%) 9 1 1 1 8 (61%) 5 (39%) 11 (85%) 1 10 1 4 2 3 1 1 7 3

Referrals Gender Female Male Age No Data <20 21-30 31-40 41-50 Civil Status No Data Single Married CAUSE OF DEATH Non Trauma Vermian Tumor Trauma Vehicular Accident Fall Mauling Crushing Referrals made by: Surgery Resident Registered Nurse Consent Status Consented, Medically Suitable, Organs Retrieved Consented, Medically Unsuitable HBsAg (+) Gonorrhoea Unconsented Relatives divided over decision Relatives thought that the patient had suffered enough Relatives are concerned with the perception of others

1 1 1 1

1 8 1 1 0 7 4 1 1 1 1

2 (15%) 4 (31%) 3 1 7 (54%) 4 1 2

3 1 4 1 2

Professor Canaud further concluded in the same report that online hemodiafiltration enhances effective body solute clearances and improves the hemocompatibility of the dialysis system. Extended treatment time on online hemodiafiltration on a daily or nocturnal basis provides the best form of renal replacement therapy for patients with chronic kidney disease. Fresenius Medical Care, the worldwide leader in renal care products and services provider offers online heamodiafiltration as a standard to all patients through their 5008 Therapy System that delivers the highest quality of therapy, maximizes handling efficiency, maintains the highest safety standards, and optimizes operational cost through advanced technological efficiency to create a future worth living. For people. Worldwide. Everyday. Learn more on how Fresenius Medical Care can help provide our patients with the best possible quality of life through products and services with the highest medical standards. You may visit our website at www.fmc-ag.com or contact any of our representatives in your area for more information.

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SafeHandS
by: Ivy B. Ballesteros, RN

Davao Regional Hospital (DRH) is privileged to receive a grant from SafeHandS, an organization funded by Australian Agency for International Development (AusAID) that promote healthcare worker safety. The grant funded the project entitled: Safe @ Work Program: Safe Handling and Disposal of Needles and Sharps The project was implemented hospital wide under the direction of the Hospital Infection Control Committee. It aimed to improve the protection of healthcare workers from injuries by strengthening compliance in handling and safe disposal of needles and sharps through education campaign, review and update of hospital policies and procedures, surveillance and institutionalization of the concept of staff safety, and implementation of a Safe @ Work No Blame reporting strategy in order to encourage reporting and development of best practices. The project runs from 2010 to 2011. It was facilitated by a team led by Ms. Ivy B. Ballesteros, the hospitals Infection Control Nurse and team

members were Dr. Julmin T. Tapsirul II, Dr. Bryan O. Dalid, Dr. Rodel M. Flores, Ms. Jaybee M. Genobisa, and Ms. Agnes R. Domingo. Support group were Ms.Nenet Burigsay, Ms. Maritess Estrelloso, Ms. Christine Lourdes Tan, Ms. Charisse Booc and Ms. Jill Gonzales as auditors. This project enhanced the practices in safe handling and disposal of needles and sharps among DRH employees. Last March 2012, Ms. Ivy B. Ballesteros was invited for a project presentation in Bangkok, Thailand. Together with other foreign nationals, SafeHandS facilitated the symposium where the nine (9) projects all over the Asia Pacific Region were presented. DRH was the only hospital chosen from the Philippines, making the project team leader as the only Filipino among the delegates. Ms. Ballesteros presented the DRH experience in completing the project which was well received by the organizers and the delegates. Hail to Davao Regional Hospital, Ms. Ballesteros is now the reference person of the SafeHandS Australia in the Philippines. This achievement could further promote Davao Regional Hospital not just in the Philippines but across the Asia Pacific Region. Mabuhay!

PHiLiPPiNE NURSiNG
With numerous controversies surrounding the nursing profession and by the Secretary of Health, Dr. Enrique T. Onas cited words of discouragement to incoming freshmen to take nursing as a course, it was indeed, time to change directions. In response to the challenges, the Philippine Nurses Association (PNA) together with various nursing organizations in the country has created the Roadmap of the Nursing Profession Towards Good Governance in line of Executive Order No. 220. The roadmap focuses on the core values which consist of love of God, caring, excellence, integrity and nationalism. Its emphasis is on the Filipino nurse, collaborative partnership, service excellence, competency enhancement, linkages/networking and social impact. Utilizing a doable action plan, the PNA has lay down MISSION: We, the Filipino nurses, are committed to provide society with professional nursing service through innovations in education, training, research, and management that will improve the well-being and quality of life.

ROADmAP 2030
the following initiatives: VISION: By 2030, the Philippines shall be the lead in promoting professional nursing in the Asia Pacific Region.

Core Values Program Positive Practice Environment Nursing Practice Watch State Of Philippine Nursing Nursing Image Primary Health Care Independent Nursing Practice Competency Enhancement Program for Education Continuing Education Program for Service functional Integration between Education & Service National Management Information System (NIMIS) National Career Progression Plan Nursing Deployment Nursing Law Amendments Nursing Practice Standards Organizational Roadmap Scorecard & Alignment Office Of Strategy Management Resource Generation for Philippine Nursing Development This nursing roadmap aims for a total transformation, with an emphasis on leadership, research, professionalism and excellence in the standards of service utilizing the standards of good governance and responsible citizenship.

TARGETED OBSTETRICS SONOGRAPHY

Tunog ni Nanay, Tunog ng Buhay

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11

According to the estimates developed by World Health Organization (WHO) in 2005, almost 4,600 women die giving birth each year in the Philippines. Based on the data from 1993 and1998 National Demographic and Health Survey (NDHS), Maternal Mortality Ratio (MMR) went down to 172 deaths from a 1993 baseline figure of 209 deaths and declined to only 162 deaths in 2006. In Millenium Development Goal (MDG), the target reduction in MMR is 52 deaths per 100,000 live births in 2015 while also including the universal access to reproductive health services. In view of the fact that the decline is considerably slow, this goal has been identified as the least likely to be achieved for the Philippines. However, despite the negativity in achieving MDG 5, the Davao Regional Hospital has come up with Tunog ni Nanay, Tunog ng Buhay program. This 4-Million project proposal is directed towards the education and training of Municipal Health Office (MHO) and allied health professionals in performing basic obstetric ultrasonography skills which will aid them in prenatal and even postnatal care. We cannot deny the fact that prenatal ultrasound (also called fetal ultrasound or fetal sonography) has become necessary part of the childbirth process during visits to the obstetrician. According to Claude Lenfant, MD, by identifying high-risk patients, ultrasound would allow doctors to provide aggressive treatment early. Information obtained from prenatal ultrasound exam can help determine prenatal care. Moreover, it not only increases a womans chances of delivering a healthy baby but assures her of a healthier and safer pregnancy. Supported by the Department of Health and United Nations Population Fund (UNFPA), orientation on this project was conducted on June 16, 2012 with participants from the identified provinces of Mindanao with the highest MMR namely, ARMM, Zamboanga del Sur and Davao Del Sur. This 10-day training will start on July 16-25, 2012 to enable MHOs to be more adept in Targeted Obstetrics Sonography.

DRH
NUMBE

at its best

TOP Performing TRANSPLANT CENTER outside METRO MANILA OUT Of 32 TRANSPLANT CENTERS RA N k in the PHILIPPINES

DAVAO REGIONAL HOSPITAL as a DOH-retained Tertiary Teaching Training Hospital has provided a comprehensive, accessible and quality kidney transplant services to the people of Davao and throughout Mindanao since 2002. In the 5-year Kidney Transplant Census (2007-2011) of the Philippine Renal Disease Registry, Davao Regional Hospital was identified as the

The total number of kidney transplant at DRH from 2002 until the 2nd quarter of 2012 is 60, all of which were performed on FILIPINO patients. Over the years, the DRH prides itself for having the cheapest Kidney Transplant Package in the country. With the launching of the PhilHealth Z Benefit Package, DRH once again proves that quality medical and surgical services need not be expensive to be enjoyed by every Filipino.
REGION
NCR

TRANSPLANT CENTER
National Kidney & Transplant Institute St. Lukes Medical Center Capitol Medical Center Cardinal Santos Medical Center Victor R. Potenciano Medical Center - Polymedic Far Eastern University Hospital NRMF

NUMBER OF PATIENTS
2007 334 204 122 105 77 55 7 2008 368 44 52 31 63 17 30 2009 351 17 15 17 3 35 8 2010 257 38 21 30 0 1 8 2011 253 35 23 23 0 0 5

TOTAL NATIONAL
RANK
1 2 3 4 5 6 7 1,563 338 233 206 143 108 58

The Kidney Transplant Program of the Davao Regional Hospital is powered by the following dedicated team of experts headed by the Chief of Hospital, DR. ROMULO A. BUSUEGO:
ISMAEL G. CRISOSTOMO, MD, DPBS, FPSTS Transplant Surgeon FRANKLIN B. GUILLANO, MD, DPCP, DPSN Transplant Nephrologist MA. THERESA L. BAD-ANG, MD, FPCP Transplant Nephrologist ASTERIO M. RAMISCAL, MD, FPCP Transplant Nephrologist VICTOR D. ESPINO, MD, DPBU Urologist RENATO A. MARANAN, MD, DPBA Anesthesiologist HERNAN D. CANALES, MD, DPBA Anesthesiologist
For more information on the Kidney Transplant Services, please contact us at: Telephone Numbers: (084) 400-53-23 Mobile Number: 0908-580-3585 / 0933-942-6431 email Address: drh_tagum@yahoo.com /
drh_transplantcenter@yahoo.com

RANK
XI

University of Sto. Tomas Hospital, Inc.

1 1
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

DAVAO REGIONAL HOSPITAL

Davao Doctors Hospital Vicente Sotto Memorial Medical Center Manila Doctors Hospital St. Pauls Hospital Cebu Doctors University Hospital World Citi Medical Center UP-Philippine General Hospital UERM Memorial Medical Center Angeles University Foundation Medical Center Asian Hospital and Medical Center St. Lukes Medical Center Global City The Medical City Makati Medical Center Quirino Memorial Medical Center Southern Philippines Medical Center (Formerly Davao Medical Center) Our Lady of Lourdes Hospital Chinese General Hospital Delos Santos Medical Center Bacolod Our Lady of Mercy Dr. Pablo O. Torre Sr. Memorial Hospital Jecsons Medical Center St. Francis Cabrini Medical Center Chong Hua Hospital Western Mindanao Medical Center

12
21 17 15 3 5 27 6 10 0 13 0 1 2 0 0 5 2 0 2 0 0 1 0 0

3
9 12 6 15 10 0 3 3 0 0 0 4 2 3 4 0 0 0 0 0 0 0 0 0

10
8 6 7 11 4 0 7 2 0 0 0 4 3 1 0 0 0 0 0 0 1 0 1 0

15
0 2 2 1 4 0 5 0 4 0 4 1 1 2 0 0 1 1 1 0 0 0 0 0

3
2 0 4 2 6 0 4 0 9 0 8 1 1 1 2 0 1 2 0 3 0 0 0 1

43
40 37 34 33 29 27 25 15 13 13 12 11 9 7 6 5 4 3 3 3 1 1 1 1

8
9 10 11 12 13 14 15 16 17 17 18 19 20 21 22 23 24 25 25 25 26 26 26 26

VII NCR VI VII NCR III NCR

XI NCR VI III IV-A VII IX

Kidney Transplants Performed According to Hospital, 2007-2011 Source: Philippine Renal Disease Registry