“While we do have other specialists who are capable of doing [cleft surgery] aside from plastic surgeons … [they are] far and few. They're distributed sparsely around the country,” he said.
The coverage also only covers one-third of the usual cost of cleft surgery in private hospitals, according to PBM Medical Director Santos.
“But I think it is enough for us to do it in a government hospital, to bring down the cost and to be able to serve more people. The one-third cost is better than nothing,” he said.
All four patients who underwent cleft surgery on the same day as Arvie were financially supported by Smile Train, an international nonprofit that helps provide cleft surgeries worldwide by partnering with local institutions and training medical professionals. In the Philippines, Smile Train has 50 partner institutions — a mix of both hospitals and foundations — that provide cleft surgeries in over 100 medical facilities in the country. PBM is one of its partners in the country.
PBM speech language pathologist Kelly Siy explains the importance of speech therapy for cleft lip and/or palate patients.
Some of the patients were able to use national health insurance to pay for the cost of surgery. But Smile Train covered additional patient needs, such as laboratory tests prior to surgery and post-operative care. The community volunteers also receive transportation and food allowance from the Norwegian Mission Alliance Philippines and their district each time they assist a patient for a check-up and surgery.
In addition, even if insurance coverage is provided, not all health care facilities have the necessary resources and doctors available to provide the required treatment interventions. There are only a few doctors in the country, for example, who are proficient in doing cleft surgery, Santos said.
Speech language pathologist Kelly Siy conducts a speech therapy session with a young patient, a service which the PBM hospital also offers for free.
This is part of the reason why the PBM Hospital in Quezon City has patients coming in from the provinces — such as Arvie.
But where gaps exist, partnerships fill in.
Arvie’s surgery was provided free as part of the collaboration between PBM and Smile Train, while the Norwegian Mission Alliance Philippines and local government helped take care of Arvie’s basic needs, such as food and transport. The volunteers were the ones who also found Arvie and referred him for surgery.
“Partnerships in the communities — through local governments, churches, other NGOs, and civic organizations — are extremely helpful in reaching more patients. They are the ones who live in the communities/barangays, so they know everyone in the community. They are also likely trusted by the members of the communities,” said Smile Train’s Flaviano.
Community health volunteer Lilibeth Oliveros went the extra mile before, during and after Arvie’s surgery.
In Arvie’s case, the community health volunteers went the extra mile.
Oliveros stayed with Santilices before, during, and after the surgery, assisting the mother with paperwork, and guiding her on Arvie’s post-op needs. She also accompanied them on Arvie’s first checkup two weeks after the operation.
Arvie still needs a second round of surgery to correct his cleft palate. He might need to undergo speech therapy later as well. She said she’ll make sure Arvie completes the full journey.
“It makes me happy just to see the kids I’ve assisted, and joke how good looking they are or share how well they’re doing in school,” Oliveros said.