But there are roadblocks on a patient’s journey to cleft surgery and rehabilitation. In Arvie’s case, it was his family’s circumstances and location.
“It’s unsafe here. It’s prone to landslides, especially during the rainy season,” commented Abigail Santilices, Arvie’s mother.
After a three-hour-long journey, it was noon by the time Roanne Puod, social service assistant from the Philippine Band of Mercy Foundation, finally reached her destination: a 20 square meter shanty made of bamboo materials and bare flooring. As she entered, a little boy with big round eyes in a faded purple jersey peeked into the dimly lit kitchen.
It was Arvie, the 4-year-old bound for cleft lip operation the following day. Arvie has cleft lip and palate, a condition that is estimated to affect 1 of every 500 to 700 live births globally. The condition is surgically treatable, improving a patient’s health and well-being.
Finding Arvie’s home required some level of detective work as it bore neither number nor street name. The only details Puod was given before she left the PBM Hospital that morning were the name of the village and the municipality where it could be found: Barangay Pinugay, Baras, Rizal, 38 kilometers away from the hospital.
After half an hour of searching, Puod finally made contact with community health volunteers from the Norwegian Mission Alliance Philippines, Lilibeth Oliveros and Siony Gebilaguin, whose efforts include identifying members of the community in need of cleft surgery. She was given additional clues to the puzzle: “We’re waiting by the highway bridge, next to Maximo High School,” they said in a text message.
Arvie Papa, his mother and sister make the three-hour-long journey to Quezon City for Arvie to receive cleft lip surgery, accompanied by community health volunteers Lilibeth Oliveros and Siony Gebilaguin. Oliveros and Gebilaguin spent a year trying to convince the 4-year-old’s mother to bring him for surgery.
Arvie’s family lives a kilometer from the bridge, next to a cliff that can be crossed thanks to a thin, makeshift bamboo platform made by Jurie Papa, Arvie’s father. The rest of the way is a hike to the top. When it rains, as it did that day, the terrain can be slippery.
But Oliveros said they have been trekking the route for almost a year, just to convince Santilices to bring her child for operation.
“Even while other [Barangay health workers] were telling us to give up, we didn’t ... [Arvie] still has a chance at a better life,” she said.
Arvie’s cleft surgery journey provides a lens into the country’s universal health care ambitions, revealing the gaps between policy and reality, but also of the role of community and partnerships.
Cleft lip surgery is a simple procedure that lasts just 30 minutes. Despite this, patients from low-income families face many roadblocks on the journey to surgery and rehabilitation. At the Philippine Band of Mercy hospital, patients can receive treatment for free thanks to a partnership with the nonprofit organization Smile Train.