The Mariano Marcos Memorial Hospital and Medical Center (MMMH&MC) was established initially as an Emergency Hospital by virtue of House Bill 1393 authored by Honorable Simeon M. Valdez, then Congressman of the 2nd District of Ilocos Norte in 1968. It was gradually transformed to what is now a 200 bed Tertiary Hospital and Medical Center. This is the only Medical Center up in Northern Luzon, about 200 kilometers north of the Ilocos Training and Regional Medical Center (ITMRC) in San Fernando City, La Union and 470 kilometers, North of Manila. It caters to the health needs of a wide area of Northern Luzon. Its primary mandate is to serve the indigents through provision of high quality low cost health care and engage in a high level of academic training for its medical, paramedical personnel and affiliates. Thus, it caters to the health needs of a wide area of Northern Luzon specifically to include the following provinces / areas with their respective populations:

Ilocos Norte (including Laoag City )            550,445
Ilocos Sur (Municipalities North of Candon
    City, including Vigan City)                     594,206
Northern Cagayan                                   427,536
Abra                                                     211,095
Apayao                                                 116,180
Kalinga                                                  154,145

 

Cancer of all kinds has been consistently ranked as the third leading cause of morbidity and mortality in our country in the present decade. Ilocos Norte statistics alone has placed Cancer of all types to be the 4th leading cause of mortality in the last 5 years. The Department of Health’s latest statistics have shown that there is a decreasing trend in communicable disease but increasing trends in both cancers and non-communicable or lifestyle-related disorders. For this decade alone, leading cancer sites/types are noted in the lung, breast, cervix, liver, colon and rectum, prostate, stomach, oral cavity, ovary and leukemia in order of frequency. 75% of all cancers occur after age 50 years, and only about 3% occur at age 14 years and below. It is estimated that for every 1800 Filipinos, one will develop cancer annually.  Filipino cancer patients seek medical advice only when symptomatic or at advanced stages: for every two new cancer cases diagnosed annually, one will die within the year.  A large contributing factor to this is lack of accessibility to appropriate health care facilities.
The Department of Health espouses a holistic approach from prevention to cure in different regions of the country at both hospital and community levels. Comprehensive cancer management should be established strategically all over the country. The comprehensive program does not only include community based prevention advocacy of different types of Cancer but also definitive treatments like competent surgical management, radiation therapy, chemotherapy, traditional and alternative therapies. Rehabilitation and palliative therapy like pain management, alternative therapies, as well as, hospice care are all part of this program. However, cancer survival rates remain relatively low due to lack of various treatment modalities available all over the country, of which; only a few are seen in major cities and are mostly privately owned.

Mariano Marcos Memorial Hospital and Medical Center, Batac, Ilocos Norte, has felt the burden of this national problem. There has been a steady increase of newly diagnosed cancers involving various body systems in the average of 150 new cases a year, which represent about 15 to 20% of the submitted specimens for histopathological examination. MMMHMC Cancer registry has tabulated an average of 334 new diagnosed cases annually for the past 5 years (2006-2010). The increasing trend can be attributed to the several factors like increased public awareness of cancer symptoms through advocacy and patient education, improved referral system among different health facilities through networking, increased diagnostic capability of the hospital, and increased number of medical and surgical oncologists consisting of 8 general cancer surgeons, 2 head and neck surgeons, 2 reconstructive surgeons, 1 thoracic and cardiovascular surgeon, 1 onco - gynecologist, and 2 medical oncologists among other general surgeons, internists and pediatricians – a clear effort of the hospital in strengthening its capability to face the challenge the Cancer is imposing to the populace.

At present, the nearest Radiation therapy unit to our hospital is in Baguio General Hospital, located 300 kms away equivalent to 6 hrs of public transport. Another one is located in Pampanga catering only to private patients. There are prolonged and delayed treatments experienced in Rizal Medical Center, Philippine General Hospital, and Jose Reyes Memorial Hospital due to the large number of patients flocking to these treatment centers. Cancer treatment is a race against time. In addition, cost of the disease has tripled for outside referrals. The increased cost includes transportation, additional laboratory work ups, unsubsidized diagnostic procedures, rental payments for accommodation for the whole course of treatment – since patients are treated as out patients, apart from the use of the radiotherapy equipment itself. The cost of dislocation from the support group like the family is inestimable.

The establishment of the Cancer Institute in Batac will definitely help in the better implementation of the Comprehensive Cancer Management Program by the Department of Health and will provide a positive impact in both western and eastern Ilocos provinces.  It will cater to the patients coming from Ilocos Sur/Norte, Abra, Cagayan, Isabela, Kalinga, Apayao, and Batanes and providing a strong support to the Radiotherapy Center in Baguio. It will serve as an alternative or back up in times of break down or maintenance period.  Financially speaking, the existence of a Cancer Institute in MMMHMC will cut the treatment and travel cost by more than 50%. MMMHMC is in the best position to carry out this Comprehensive Cancer Program, with its more complete line of cancer specialists, modern laboratory facilities for diagnosis, improved pharmacy, training programs for both doctors and nurses, palliative care initiatives. The only aspect lacking is the Radiation Therapy Unit – a critical component in the comprehensive management of this dreaded disease.

THE HOSPICE CARE CENTER – Towards Comprehensive Care System

Recent improvements in health care systems and delivery have led to increasing lifespan in our country. In addition, modernization has led to several lifestyle related illnesses like diabetes, cancers, hypertension, stroke, chronic obstructive pulmonary disease, and myocardial infarction. These diseases, if they cannot be totally cured, must be handled by tertiary hospitals.
The proposed 2-storey hospice and palliative care unit that shall be annexed to the Cancer Institute of Mariano Marcos Memorial Hospital and Medical Center aims not to cure but to provide a “better” quality of life during the remaining days of a patient. It is a program designed to provide a caring environment to address the physical, social, medical, psychological and spiritual needs of the terminally ill patients and their families and those afflicted with life-threatening illnesses - a relatively new concept of health care in our country. In addition, this Center shall be the home of training and provision of alternative health care like acupuncture, ventosa, massage therapy, moxibustion, pranic healing, and herbal medicine besides housing the Pain Clinic manned by Pain Specialists. A mixture of WHO recognized modalities of treatment involving terminally ill patients due to chronic, lifestyle-related diseases and cancer shall be done in this Center with the primary aim of easing the pain and prolonging life of these unfortunate patients. Moreover, the institution can provide hands-on training on care-giving and medical social works with good and wider exposure to hospice care system. This could be one of the initial ventures by the Department of Health for the Palliative aspect of health care.
This institution provides a venue to involve the community further in health care. Barangay health workers can then become a part of the multidisciplinary hospice team in their respective municipalities and cities. They will be trained as hospice volunteers to refer patients in their area and deliver hospice and palliative care services at the community level. This is the potential growth area for hospice care in the countryside and it is urgent that support be extended.
Bereavement support could be done in certain cases and the care givennot be persons in the medical field, although their participation is always required. It only needs people imbued with compassion to care for the sick and could be excellent hospice service providers after appropriate training. To deal with death openly, as one takes care of a patient, requires strength that can only come from a conviction for the noble purpose of accompanying a person on a walk to his or her new home as “midwife for the soul.”
This challenge can be met by strengthening Hospice training programs and networking with international organizations. There is a need to have more trainors and training facilities to hasten the formation of hospice units in the country. The proposed hospice care center could provide this.