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Zenny Palacios Gepilano, Founder, Urban Angels Medical Mission to the Philippines, SMH Toronto

The URBAN ANGELS is in its 8^th year, and continues to make a lasting and meaningful contribution  to the health and well-being of those touched by their Surgical and Medical Mission to the Philippines. A key underpinning and genesis for the creation of the Urban Angels was to provide free health care services focus on eye surgery and primary medical services, to those in need in the Philippines. Since its inception, equity and access are hallmarks of the annual mission which exemplify social justice in action.

ZENNY PALACIOS GEPILANO, the Architect of the Urban Angels (UA) is an OR Nurse from St. Michael’s Hospital. Zenny has spearheaded and led eight successful missions, providing medical and surgical services in the Philippines. Educated in the Philippines herself, Zenny has been all too familiar with the direct and profound relationship between poverty and quality of health.

Exemplifying the mission and values of St. Michael’s Hospital, Zenny set out on her humanitarian journey to address the need to increase access to eye surgeries and preventative care.

Her courage and conviction has inspired others within and outside the health care profession to embark on this journey with her. Over the last eight years, Zenny has gathered over 300 volunteers to part-take on this journey with her. Together they have donated countless hours of planning and fundraising to ensure successful annual missions abroad. Their level of commitment is second to none.  For more information visit their website at www.urban-angels.org.

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The KOL HOPE Foundation presented an Award of Distinction to Zenny Palacios Gepilano, Founder [of the] Urban Angels Medical and Surgical Mission to the Philippines in honour of her superlative voluntary contributions to the people of the Philippines and providing support to the voluntary sector.  – Given November 11th, 2011, Four Seasons Hotel, Toronto.

The June Callwood Outstanding Achievement Award for Volunteerism recognises individuals and groups for exemplary volunteer contributions to their communities and to the Province of Ontario.

The Congratulatory handshake from Dr. Eric Hoskins, Minister of Citizenship and Immigration.

Dr. Gordon Squires holding the certificate, Honourable Minister, Dr. Eric Hoskins of Citizenship and Immigration, Zenny Gepilano holding the trophy, and Dr. Robert Hyland.

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Recipient Values and Action award for Social Responsibility St. Michael’s Hospital 2005.

Feature Nursing Excellence through our Culture of Caring and Innovation and Scholarship. Nursing Strategic Plan St. Michael’s Hospital 2006.

Honoree- The Royal Tour 2010 – Canada. The Royal Highnesses Queen Elizabeth II and His Royal Highness Prince Philip of Edinburgh. HRH Prince Philip having a chat with Honoree Zenny Palacios Gepilano.

AWARDS: Honoree- The Royal Tour 2010 Canada. The Royal Highnessess Queen Elizabeth II and High Royal Highness Prince Philip of Edinburgh • June Callwood Outstanding Achievement Award Ontario June 2010  • Successful Women of Negros Occidental ABS-CBN Feature Philippines 2006  • Feature Nursing Excellence through Our Culture of Caring Innovation and Scholarship Nursing Strategic Plan St. Michael’s Hospital 2006 • Outstanding Citizen Valliadolid, Negros Occidental ’05 •  Recipient Values and Action Award for Social Responsibility St. Michael’s Hospital 2005 • Outstanding Staff RN Philippines Heart Center for Asia 1995 •  Service Award BScN Class of 1986, Riverside College of Nursing •  Award of Distinction 2011, Kol Hope Foundation for Children •

Urban Angels Medical Mission Team

That’s ZENNY PALACIOS GEPILANO- a true blooded Negrosanon from Negros Occidental, Philippines, who sees the world with compassionate eyes. Despite her tremendous successes and achievements in her charity work, Zenny remains humble, warm hearted and down to earth who continues to be an inspiration for everyone. She exemplifies extraordinary leadership in Social Justice effort —a mosiac of the Urban Angels Mission to the Philippines. The courage, conviction, commitment, compassion, kindness and love for her people in the Philippines. In all that she does Zenny continues to bear he heart and soul, her roots, native land and all the help she can give to it. A true hero…[sic]“

Urban Angels of St. Michael, Toronto Canada hold its medical mission in La Carlota City

Submitted by Jun delos Reyeson Thu, 02/23/2012 – 12:14

The City Government of La Carlota City spearheaded by Mayor Juliet Marie D. Ferrer facilitated more than 500 poor, indigent and less privileged family patients of different Barangays in La Carlota City which availed of the Urban Angels of St. Michael, Toronto, Canada osssssins its Annual Medical Mission Program with Free Medicines, eyeglasses, surgical operation among others, in coordination with Zeny Palacios-Gepilano and Company at the La Carlota City Gymnasium yesterday.

Dr. Kathlyn Therese Criste and Dr. Tammy Shaw of Urban Angels of St. Michael Toronto Canada facilitate the medical consultation with the poor, indigent and less privileged family patients of La Carlota City yesterday. * (Jun de los Reyes/NDB photo)

The Medical and Surgical Mission is in line with Mayor Ferrer’s priority program on Health in making La Carlota City a Healthy Family and Healthy City. She also thanked the efforts initiated by Doctors, Nurses, Volunteers under the supervision of its coordinator, Zenny Palacios Gepilano of the said medical mission.

Coordinator-Facilitator Zeny Palacios Gepilano of Urban Angels Medical Mission said,”There were about 56 doctors, nurses and volunteers in Toronto, Canada, U.S.A. and in the Philippines helping this mission. It is my dream to help my countrymen and we gave such help in February, the month of love. The people of La Carlota is enormous and very organized, Thanks to Mayor Juliet Marie D. Ferrer in accomodating us, We hope we can do this again next year. We started the Medical Mission since 2005. Doing it with your Heart is an easy task. We are here to help you with all the best we can and share with you the blessings of what we have for La Carlota City.”

Patient Morita Mallorca, 65, a housewife of Barangay Nagasi, who is also a sugar farmworker who suffered from swollen legs was very happy when the doctor attended to him, giving him medicines after consultation. “Salamat guid sa mga doctors sang Urban Angels Medical Mission kag labi nagid kay Mayor Ferrer nga nag patigayon sini nga mission, kabay pa kalo-oyan sang Mahal nga Dios kag magalawig pa inyo kabuhi.”

Larry Laos, 55, jobless with 4 children from Barangay Ayungon, who has a left hand cripple since l988 when he bladed his small cest on his left arm caused infection and was cut by the doctor, gave thanks to the Urban Angels Doctor who examined him and gave him medicines for its maintenance. “Salamat man kay Mayor Ferrer sa pagpatigayon sa amon nga pigado sa Barangay nga maka-pabulong man nga wala sang bayad kag may bulong pa nga libre. Anghel ka man sa amon, Mayor Ferrer. Madamo guid nga salamat sa imo.”

Urban Angel’s Medical Mission Doctors who performed consultations were: Dr. Dan Cass, Dr. Miriam Balitian Dill, Dr. Tammy Shaw, Dr. Ann Marie Mckenn, Dr. Kathlyn Therese Criste, and Dr. Lori Giovannetti. Nurses and Volunteers on Blood Pressure and Vital Signs: Linda Bruce, Patricia Vandegrift, Jerome Hidalgo, Jasmine Erret, Nicole Meleca, Norine Meleca, Leanne Jeffs, Shane, Robert, Cris and Kobi Dill, Art Bellosello, Millet Miranda, Rey Espiritu, Eduard Rosales, Jasmine Erret, Jusail Rodriguez, Evelyn Palacios, Gladys Belvis, Walter Reeh, Pauline Limsiaco, Leah Palacios, andJeff Chavez, Julie Flores. On Medicines and Eyeglasses: Jenny Lieu, Vivian Choy, Jean Paul Loa, Sue Fenwick, Christine Gordon, Sarah Fernandez, Rodner Advincula, Anne M. Flores, Tom Abada, Trish Wilson, Kristine Ann Serisola, Trish, Amanda, Anne Kat, Cheene, Belen. May Asentista, Maritess Ordinario and many others. La Carlota City Health Office headed by Dr. Edwina Frances Jalandoni personnel nurses and doctors, Corazon Locsin Montelibano Memorial Regional Hospital Riverside Medical Center, Collegio De San Agustin, UNO-R, USLS nurses also assisting.*

[ 2012 Roster of UA Volunteers. Physicians: Gordon Squires, Dan Cass, Mark Kataoka, Tammy Shaw, Michael Wan, Glenn Ragos, Anne Marie McKenna, Baseer Khan, Kwesi Mcguire, Paul Sanghera, Kathlyn Therese Criste, Phebe Luis. Nurses: Zenny Gepilano, Zita Abreau, Lianne Jeffs, Beth Rosenburg, Erica Kukucska, Ferilyn Jafariolia, Patricia Vandergift, Lori Giovanneti, Noreen Meleca, Jasmine Errett, Linda Bruce, Beverly Kataoka, Lorraine Ciccarelli, Rochelli De Juan, Lori Martin, Evelyn Palacios, Miriam Balitian Dill. International Volunteers: Christine Gordon, John Manrique, Trish Wilson, Sarah Fernandes, Alysandyr To, Tessa Tam, Ernie Castellano, Robert Danielsen, Amanda Semba, Darri Gepilano, Nicole Meleca, Kate Taylor, JP Loa Wing, Victoria Paz, Susan Fenwick, Marites Ordinario, Dick Gepilano, Zeny Lopez, Titus Lopez, Ernie Castellano, Kobi Dill, Art Bellosello, Shane Straiko, Millet Miranda, Rey Espiritu, Eduard Rosales, Jusail Rodriguez, Gladys Belvis, Walter Reeh, Pauline Limsiaco, Leah Palacios, Jeff Chavez, Julie Flores, Rodner Advincula, Anne M. Flores, Tom Abada, Kristine Ann Serisola, Anne Kat, Cheene, Belen. May Asentista, Ike Palacios, William Pasco, Kokoi Baldo, Mormon and many others.]

Article from Site: http://www.ndb-online.com/022312/business-economy/events-urban-angels-st-michael-toronto-canada-hold-its-medical-mission-la-ca

Photo by Walker Kitchens.

Well, for this year at least. The exact numbers are still coming in, but we have completed nine medical missions in nine different locations, seen more than 10,000 patients, given out 150,000 vitamins, and thousands of eyeglasses and medical supplies.

A clearly recurring theme throughout these two weeks both as I’ve sat down to write the blog and as I’ve spoken to others, is how to put this experience into words. Not an ideal state-of-mind for the person in charge of writing about the trip!

Photo by Walker Kitchens

But it’s true – the raw emotions we’ve felt, the weathered faces we’ve seen, the stories from the patients we’ve heard and the appreciation we’ve received – all seem to transcend our language.

Let’s not be fooled though; it was a lot of work, exhausting and frustrating at times, but as the missions wrapped up and for the first time we were given time to gain perspective of what we had accomplished over the last couple of weeks, the magnitude of this journey has begun to sink in.

I have realized on this mission how compelling and complex the human spirit is and how innate our desire to help others is. I took a moment to look around many times throughout the trip at the doctors, nurses, pharmacists and many other volunteers, and marveled at their true compassion for these people half way around the world. It was an amazing thing.

Photo by Walker Kitchens

Photo by Walker Kitchen

And similarly, just as I watched our team, I also observed the resilience and strength of the people we were helping. Despite lives wrought with many hardships and living without any of the luxuries – or even necessities – we are lucky to have in Canada, we were greeted with smiles every morning.

I have felt very privileged to be a part of the Urban Angels. Lead by Zenny’s unwavering dedication to make a difference to those that need it most in her home country, this is a very special group of people.

‘Til next year…

As members of our Urban Angels team begin to gather at the airport in Manila to fly home, it’s starting to sink in that this amazing experience in the Philippines is coming to an end. It’s hard to believe that we’ve only been here for two weeks – there have been so many amazing experiences, lessons learned and friendships made. I spent all nine of the mission days working with the eye-glass team. Our main job was to dispense reading glasses and sunglasses, but we also had some distance glasses and bifocals available. Our tools include a simple reading chart used to assess the strength of reading glasses needed. We have limited resources available to help those who need distance glasses.

It’s incredible to think of the impact that a simple pair of reading glasses can have on someone who can’t afford such a thing and has been living for years without them. Although a number of people we gave glasses to can’t read, they still require reading glasses as magnifiers in order to earn an income. We saw and helped several women who work as seamstresses and were having difficulty seeing the delicate stitches on the fabric.

The reactions of different people were all unique but all displayed an underlying sense of excitement and anticipation. Some people would read through the eye chart as far as they could for the initial assessment with a sense of desperation in their voices. When they tried on a pair of reading glasses and read through the chart again, you could hear an audible change in their breathing and a change in the tone of their voices as they realized they could actually see ALL of the numbers on the chart clearly now. To make sure it was true some would pick up different items on the table and see if the letters and numbers really were clear – their medical forms, a bottle of water, even the hand sanitizer bottles.

One of my most memorable experiences was helping a lady from the slums of Banago find distance glasses. She came to the eye-glass station during a rare quiet time, so I was able to spend a bit more time with her going through a trial and error process of trying on different glasses. Although the prescription is labelled on the glasses we have, we don’t have all of the necessary tools available to properly asses her needs – the best we can do is to try different pairs of glasses and see if she can see the signs in the distance clearly. After trying on several different pairs of glasses, she put on a final pair and her eyes began to light up and a smile grew across her face as she looked around and the signs came into focus. We had finally found a pair of glasses that worked – they actually looked really good on her! She was very grateful and said “salamat” several times, shook my hand and said a blessing to me as she got up to leave. As she stood, she removed her new glasses. I stopped her and asked why she was taking them off. Through our translator, she explained to me that she hadn’t been able to see properly for 8 years. She had come to the clinic with some friends and was ashamed to tell them she had needed glasses for so long, but went without.

Among the happy stories, we also experienced disappointment. At the mission site in La Carlota City, Kate spent some time trying to help a young girl who could barely see. They had gone through a number of pairs of glasses, but even the strongest pair we had didn’t seem to help. The girl was virtually blind, and although she and her mother were very appreciative of our efforts, they had to leave empty-handed. We also needed to make hard decisions about who can have a pair of our limited supply of sunglasses. They’re usually saved for people with cataracts or pterygiums developing – both of which we learned can be caused by prolonged exposure to sunlight such as that experienced by individuals working as labourers in the fields. The people doing these types of jobs are often very poor and the least able to afford sunglasses to prevent damage or the surgery to repair damaged eyes.

Through the ups and downs of this experience, we were very lucky to have the support of a group of Filipino nurses and volunteers from around Bacolod who joined us for the entire mission. Our volunteer translators were invaluable in helping us communicate with our patients, but also in keeping the team energized and in high spirits throughout the long mission days. Our translators provided a great reminder of how important it is to spend a couple of extra seconds to get to know the patient you are currently working with how powerful it can be to share a laugh with someone. Most patients walked away from the eye-glass station with a smile on their face, regardless of whether or not we could provide glasses – and that made it all worthwhile.

Tapos na. Salamat.

Drs. Ann Marie McKenna and Tammie Shaw work side by side (on bench with blue shirts) and assess their patients using translators.

We have now completed our ninth and final mission of our two-week sojourn to the Philippines.  After seeing hundreds of patients and witnessing the reality in which most Filipino people live, we are humbled and grateful for the life we are privileged to lead in Canada.  There are so many things which we now have a newfound appreciation for – our “top five” listed below!

#6) Azithromycin.  This one didn’t make the top five but is worth mentioning.  Without this antibiotic many of us would have been lost to traveler’s diarrhea…!

#5) A public sanitation system which provides clean, fluorinated water and diverts our waste from our public bathing and drinking waters.  In the Philippines we saw countless patients with chronic diarrhea, rotten teeth, and chronically infected wounds – all of which might be remedied with a clean water supply.

#4) A public education system which guarantees children will be able to read and write.  In the Philippines primary school (up to Grade 6) is publically funded, however parents cannot enroll children unless they can afford the cost of school uniforms, textbooks and other miscellaneous expenses.  These costs are prohibitive for the 51 per cent of families that live below the poverty line. Local Filipino Red Cross volunteers in Caticlan told us that most parents do not enroll their children in school, preferring them to work and finance household expenses.

Lack of education has a profound impact; for example, most patients who presented with classic symptoms of Tuberculosis (“Tb”) were unaware of both their diagnosis and the fact that the public health system in the Philippines will pay for treatment of this life-threatening disease. The ability to read Tb campaign signs and notices would be life-saving for many.

Not to be-labour the point, but a public education campaign on the risks of salt and Mono-sodium glutamate (MSG – banned from restaurants in Toronto) would also be of benefit. Every Filipino we saw with high blood pressure was an avid user of these ingredients.  The blood pressures (BPs) were on average 70 points higher than at home – one so high it exceeded the limit on the BP cuff!

#3) Allied health and nursing.  Our own medical mission was staffed by a team of pharmacists, nurses, nurse practitioners and other volunteers which enabled the delivery of comprehensive, and at times very creative medical care.

We saw a two-year old girl on our 8th mission who was in the throes of a severe asthma attack and she needed treatment emergently.  However, all of the inhalers we stocked in our pharmacy were designed for adults.  We did not have a pediatric “spacer” through which we could effectively deliver the medication to her small lungs. Luckily, our clever pharmacy team created a spacer using a water bottle and we saw immediate results!

The 2012 Philippines Mission version of a pediatric spacer!

Our mission was also staffed by a large cohort of volunteer Filipino nurses. These men and women are equally resourceful, constructing wheelchairs out of patio furniture and splints out of cardboard.  To our colleagues in IT reading along, we will officially stop complaining about the WiFi coverage at St Mike’s.  It’s pretty remarkable what we have at home, in comparison.

#2) Family.  On our first mission day we wandered about the local hospital and saw inpatients entirely being tended to by their loved ones.  From feeding to bathing, and even manually ventilating, family members were keeping the patients alive.  The role of family was also demonstrated in our outpatients, where we saw remarkable resiliency and support given by families to their ill loved one.  In our own Canadian hospitals many patients suffer alone – and we struggle in discharging those who have no supports at home.  The people of the Philippines are lucky in this regard – despite having no material wealth, they have true appreciation of what really matters most.

#1) Tommy Douglas and our amazing (yet widely criticized and under-appreciated) public health care system.  We cannot say enough about how wonderful and comprehensive our system is.  In the Philippines the majority of patients we met were seeing a doctor for the first time in their lives.  Most heart-breaking was a one-year old girl, born in a village to a teenage mother, who presented with hydrocephalus.  Her skull was swollen to thrice-normal size due to the buildup of “water in the brain” caused by a malformation of her brain at birth.  She was having seizures, could not move half of her body, and developmentally was severely delayed.  In Canada this condition would have been recognized in early infancy and surgically corrected, preventing the complications listed above and allowing her to lead a normal life.  This was one of hundreds of cases we encountered that might have been saved by publicly funded health care and education.

In stark contrast, a family member of Ann Marie’s was diagnosed with a benign brain tumour this year.  From diagnosis to operation date he was treated in under 28 days.  It really doesn’t get any better than that.

And so as we conclude our reflections on an unforgettable two weeks in the Philippines we would like to thank all of the fantastic Canadian and Filipino volunteers we worked with for an amazing experience.  On our return to Canada we face a busy month of cramming for our final licensing exams, but we will officially stop complaining about that too, as we are pretty damn lucky.

Patients wait to be registered.

As soon as the individual stations and supplies are set up each morning, the doors are opened for patients to register. This tends to be a chaotic process as often hundreds of people are waiting for us upon our arrival and the sign-in booths are quickly congested with people vying to establish who was first in line.

Once registered, each patient’s basic information including name, age, sex and location of residence is recorded and they are given a form to take as a record, and for our staff to refer to as they make their way through the necessary stages of the clinic.

From there, patients wait to see volunteers from local health clinics who mark down their weight, blood pressure and chief complaint, and then they are directed to the nurse triage stations.

Patients wait with their registration forms to see the next available triage nurse

On top of doing a head-to-toe assessment, specifically zoning in on their chief complaint, a pivotal role – and perhaps an unexpected one – of the triage nurses is to provide health education. Many of the benefits of proper dietary, lifestyle and hygiene choices that are obvious to us aren’t well understood or even known. For example, a child came in complaining of burning in their belly but after further assessment, the nurse discovered that they had six bottles of Coke that day and eaten only fried, or heavily sweetened or salted food for days prior. Many patients don’t have a choice but to eat what’s affordable and available.

Sugar is the number one export in the Philippines, and it is consumed at an exorbitant rate. Triage nurses say that there seems to be a disconnect in patient’s knowledge of the adverse effects of excessive sugar intake, with most people drinking Coke multiple-times a day, often with every meal, even at breakfast.  Coupled with the fact that there is no fluoride in the water and many of the patients we saw could not afford toothbrushes or toothpaste, this explains the alarmingly common cases of poor dental hygiene.

Unfortunately, it is not an exaggeration to say that the vast majority of the patients we saw had extreme dental decay. Most of the adults and a lot of children had some, if not all of their teeth fall out and there were many visible cavities.

When Jasmine Errett, an ER nurse at St. Michael’s explained the importance of dental hygiene, her patient said that it simply was not a necessity. Buying a toothbrush would mean choosing it over buying food – a choice with an obvious answer.

Triage nurses then send patients either to the eyeglasses station or to our doctors at the clinic based not only on their symptoms, but sometimes unfortunately, on our available treatment options. Given the mobility of our clinic and the limited resources we have to offer, patients who need a biopsy for example are referred to local social workers who often have a station set up at our clinics. Gynecological problems, although relatively common, can also not be treated as we simply do not have the resources to examine patients.

A man waits to be seen at the social welfare desk

What the doctors have been able to successfully assess or prescribe medication for is high blood pressure (common because of the excess salt consumed), bad and chronic coughs, worms, infected wounds, asthma and high fevers to name a few.

After seeing the doctor, patients needing to fill a prescription head to the pharmacy. In reflecting the types of cases the doctors are seeing, the most commonly prescribed medications are anti-hypertensives, inhalers, antibiotics, Tylenol and Advil.

The pharmacy team hard at work

We call it a kind of “organized chaos”, but at the end of a long day, once we have funneled thousands of people through our carefully crafted system, we realize how well it works.

Dickens’ words “it was the best of times, it was the worst of times” echo in my ear as I write this blog after 12 full days of our medical mission. Saying that what we experienced with our hearts and hands is as dichotomous as the stark contrast between those who have and those who do not have in this world was glaringly and painfully obvious. Every outreach day brought a different group of people seeking medical attention. And every day, there were moments of feeling we were making a difference, and there were moments of feeling utterly helpless to affect the fate and misfortune for our sickest patients that we served on our mission. Our team persevered through the sweltering heat, lack of sleep, dwindling supplies, and our patients’ health and living conditions with minimal or no access to health services.  We were struck by the resilience of people waiting to be seen who would try to queue the line or become aggressive at having to wait so long to see a doctor or receive their drugs.  Digging deep, I have to say that if the shoe was on the other foot and this was the only chance to have my child seen by a doctor this year or ever – perhaps I would have done the same.

There were a multitude of examples within and across our outreach days where we were able to bring smiles to people’s faces simply by providing vitamins, – dubbed, initially by Beth – a nurse from St. Michael’s Hospital – and subsequently referred to by our team as, “magic vitamins”. There were times where we were able to coordinate care for a patient by being collaborative without even knowing it.  One particular patient that stands out for me is an older breast cancer patient that arrived through our triage station at St. Joseph’s seminary near Iloilo. This patient’s chief complaint was pain on her left breast and upon being assessed by Tessa, a perfusionist and Linda, a nurse from St. Michael’s Hospital, it became apparent this complaint was not to be taken lightly. A more in-depth assessment revealed a deep open wound with several lumps surrounding on her left breast indicative of advanced cancer. This patient was quickly referred for assessment by one of the local doctors who prescribed wound care. We were fortunate to be able to provide wound care on that day as our surgical team who joined the medical team post Bacolod surgeries had set up a makeshift treatment area including two geriatric chairs formerly used at St. Michael’s Hospital’s hemodialysis unit. This was where I first encountered our patient, lying down having her wound being carefully and meticulously cleaned by two nurses, Joyce (St. Michael’s Hospital) and Bev (University Health Network). As I approached the treatment area, I looked at this women lying down in the chair who had a look in her eyes that will stay with me a long time. It was a combination of feeling some instant relief from her pain – both physical and psychological – yet knowing that it may be short-lived.   Consulting with the Joyce and Bev, she had not been given any medications for cancer or for her pain. Knowing that we had brought over Tamoxifin, a drug that is used to block the receptor site that can promote the spread of breast cancer cells, I ran down to pharmacy to consult with Jenny, our lead pharmacist around treatment options. Without hesitation, Jenny reviewed the patient chart and brought over a supply to last our patient a full year. As Jenny explained to our patient about when to take the medication and potential side effects, she looked ever so grateful.

Soon after this patient encounter, I had a chance to talk to my husband Dan, who was one of our physicians and medical lead for this year’s mission. As I started to tell him about this patient, a sinking feeling of helplessness and bewilderment came over me and tears welled up in my eyes. Although not perfect, we as Canadians have access to primary, acute and palliative care services which, if they  existed in the Philippines would have potentially enabled the diagnosis of breast cancer sooner, once diagnosed medical and surgical treatment options at no or minimal cost would have been made available, and as the disease progressed or spread – where our patient clearly was at – palliative care that alleviates and minimizes pain associated with cancer could allow a patient to leave this world with some quality of life.  I found as I had conversations with our team members over the next few days around this particular case, they also shared the same feelings, as Glenn, an anaesthetist from North York General Hospital, who has family back in the Philippines described the case as very sad as one can only imagine seeing the visible spread of cancer on her skin how much it had spread in her body.

There are several more stories to share by our team members, and this case is but one of what we saw in our days, which ranged from seeing 400 to over a thousand patients today. I am so honoured to been a part of Zenny’s Urban Angel  team this year – despite some challenging situations we tried our best to remain compassionate, collaborative and caring.

With nine missions each averaging more than 1000 patients behind us, we have come across thousands of stories of hardship and met many people who have inspired us with their resilience and resourcefulness.

In a place where a picture really is worth a thousand words, below are some of the most compelling snapshots from the mission so far:

An 11 year-old waits in line to have her three-year-old sister seen by a pediatrician.

Her little sister wears a breathing mask because she has told nurses there is blood in her sputum and she has been coughing for three weeks with a fever every afternoon.  The two come from a family with seven children and the oldest sister, pictured here, is in charge because their mother is in the hospital. They walked for an hour to get to the clinic.

A member of the Urban Angels team guides an elderly woman to the pharmacy to pick up antibiotics.

Zenny Gepilano Palacios, the head of the mission (right), with a patient from the 2006 mission.

When we arrived at the clinic in La Carlota this year, Zenny introduced one of the volunteers who was also a patient from the 2^nd Urban Angels mission in 2006. Whelyn had come to the clinic that year in search of reading eye-glasses. While waiting in line, Dr. Melinda Musgrave – a reconstructive surgeon at St. Michael’s who was on the mission that year – asked if any patients needed to be assessed for suspicious breast lumps. Whelyn was examined and Dr. Musgrave immediately recognized the severity of her case. She was in surgery the next day and had a bilateral radical mastectomy.

To prevent further growth of the tumor, Zenny has brought Whelyn a year’s supply of Tamoxifen every year since 2006. Last year, after five years on the drug, Whelyn remains in remission. She is now a local volunteer for the mission and as she posed for the picture to be posted on this blog, she said to make sure to write, “the Urban Angels saved my life.”

In every town there is a mission, banners line the streets welcoming the Urban Angels and inviting local people to come for a free medical check-up.

The feet of a patient we treated at the Poblacion, New Lucena mission outreach.

Her feet had become infected and blistered after she wore a pair of sandals that induced an allergic reaction in December. Without any resources to treat her foot, it has continued to worsen causing pain and making it difficult to walk.

A brother cradles his little sister as they wait in line to see a doctor.

A woman gets teary after she successfully reads through the entire eye chart.

The arms on her previous pair of glasses were melded to the frames with wire, and were so old that the prescription no longer helped her to see.

The eyeglasses team celebrates the arrival of a new shipment of reading glasses.

After giving out an unexpectedly high amount of glasses from day one on, our supply began to run dangerously low and it was clear we would not have enough to carry us through to the end of ten missions.

As a true testament to the type of people that are on this mission, two women stepped forward without hesitating to donate money to buy more. Sue Fenwick quickly wrote a note home to garner more funds, and combined with what she personally donated was able to raise more than $3,000. Beth Rosenberg, a nurse on the mission from St. Michael’s also generously donated her own money. With both of their help, we will not have to turn away a single person in need of glasses.

The crowded conditions of an open-air and over-heated Neurosurgery Intensive Care Unit at a Bacolod hospital.

It’s been a very busy couple of days as we’ve traveled from the rural town of La Carlota up to the village of Don Salvador Benedicto, which is located in the mountains. Each mission location brings a unique set of patients with new conditions. Environmental factors seem to play a role in the types of cases we’re seeing, such as less asthma in the mountains and symptoms more typical of farmers who are frequently working with pesticides more prominent in the rural areas.

La Carlota’s steel drum band greets us as we arrive to a large gathering of waiting patients.

Today we saw 776 patients and after the long day the team is having an early night to prepare for our 3 a.m wake up call tomorrow. We will catch the 4 a.m. barge to Ilio Ilio and head directly to our next mission location upon arrival.

The auditorium we’re stationed at in La Carlota begins to fill up with patients as soon as we arrive.

The surgical team has also been exceptionally busy. What should have been a normal day yesterday turned into hours of intermittent power shortages resulting in canceled surgeries, frustrated doctors and upset patients. To make up for it, all surgeries were pushed to today meaning the team performed 24 surgeries.

The long drive to the mountain village of Don Salvador Benedicto.

Dr. Gordon Squires, head of the mission’s surgical team, said that the majority of the cataracts they have treated here are huge and rock-hard. When asked if people with those kinds of cataracts have as much success with their vision afterwards, he said, “You mean the ‘wow’ factor?  Even more.  They walk in almost blind and leave the surgery seeing everything.”

The last few days have brought a rollercoaster of emotions as we’ve taken in the appreciative songs that awaits us in La Carlota, marveled at the far distances people traveled to see us at the mountain clinic, heard how a woman’s life was literally saved by the mission six years ago and maintained our purpose to do our best to help those in need.

Line-ups of people waiting to be seen when we arrive in the beautiful mountain town of Don Salvador Benedicto

Detailed accounts of these amazing stories and the continued journey of the mission to come once we settle in to our next spot. Stay tuned!

We arrived at our outreach clinic in Banago today and as expected, were greeted by lines of people waiting in the heat to see a doctor, be assessed by a nurse, receive vitamins or pain medication or be fitted for a pair of eye-glasses. Members of past missions have tried to prepare us newcomers, but the experience is difficult to put into words.

St. Michaels’ Chief Resident, Dr. Ann Marie McKenna works with a translator to assess an elderly patient in Bacolod

Without realizing the comforts we had at our mildly air-conditioned clinic yesterday, today we’re in the sweltering heat – the tight quarters of an open-air church is the only communal space in the neighbourhood big enough to accommodate us.

The space is instantly chaotic as the heat starts to intensify and it becomes clear to waiting patients that the lines will be long. Most of the women waiting have brought along at least two children, and many of them are mothers under 20 years old.

Dr. Dan Cass jots down a patient’s symptoms.

At the glasses station, eye cards are used as a guide to assess eyesight, and prescriptions are handed out accordingly. There are an unimaginable number of individual stories ranging from a woman who can no longer see but must continue sewing for her livelihood, to a little boy who has never been able to see the chalkboard at school to an elderly man who says he wants to be able to read the bible again.  Each story is a reminder that glasses are a luxury yet a necessity for so many.

An elderly woman admires her first pair of eye-glasses.

The personal tales give way to a dichotomous feeling that is becoming familiar here – the sadness in hearing of so many people’s struggles coupled with witnessing genuine joy at their improved vision.

The team of doctors at Bonaga saw a lot of infections and some very severe cases of TB. One woman in her 70s with TB had never seen a doctor before despite having a cough that had lasted more than 10 years and having lost almost 80 per cent of her body weight. Our team does not have medication to treat TB, but it is provided for free in the Philippines if you can prove that you have it.

A little girl dances out of excitement with her new bottles of children’s vitamins.

A lot of puffers were handed out for the high volume of children who came in with pediatric asthma caused by the pollution. Many of the children were also malnourished and also had worms, with one six year-old-boy weighing just 23 pounds.

Nurse Zita takes the temperature of a three-week-old baby who has come to the clinic with a high fever

Every morning as our medical team loads busses and heads to the outreach site assigned for the day, the surgical team returns to the Locsin Corazon Memorial Hospital to perform various eye surgeries. The patients have been pre-booked, and the team works long hours, performing an average of 20 per day. Most procedures are either to treat cataracts or pterygium’s, and after the first day wraps up, some of the nurses comment about the number of patients who started crying as they left after their surgery, filled with gratitude.

People line up in the pews of the neighbourhood church.

As the church pews filled up today with patients waiting to be triaged and treated by the ‘Urban Angels’, it was easy to feel St. Michael’s mission and values holding true even many miles away from home.