Cancer care close to home

By Herman M. Lagon 

A call to action that is personal to many Filipinos has surfaced amid a global pandemic that has brought attention to healthcare inequalities: the localization of healthcare systems, particularly cancer treatment. The Iloilo Cancer Patients Forum, which took place early this week at the Park Inn by Radisson Hotel in Mandurriao, Iloilo City, focused on this expanding movement. Appropriately named “Strengthening Universal Health Care (UHC) Localization and Cancer Care in Iloilo City,” the event brought together a formidable mix of advocates, government officials, healthcare professionals, local caregivers, cancer patients, and survivors.

As a participant from a state university, I was most impressed by how resilient the cancer patients were. Their heartbreaking tales, full of suffering and hope, exposed the terrible truth about healthcare access in our country. For them, the path to care, support, or treatment has proven to be equally arduous as the illness itself, characterized by financial hardship, psychological exhaustion, occupational discrimination, and the immense distance they have to cover to obtain suitable medical attention. It was an honor to hear their stories during the focused group discussions (FGDs) and plenary sessions when the real significance of the issue emerged: having a community-based system that works for the people, not just hospitals or doctors, makes cancer care accessible.

Healthcare localization, particularly the decentralization of cancer treatment facilities, is not just an option; it is essential. For far too long, many patients undergoing surgery, radiation treatment, or chemotherapy have had to travel great distances from their homes routinely. Patients and their families thus suffer physically and psychologically and exhaust their financial means. A localized healthcare system would spread treatment facilities across regions, provinces, districts, and towns, ensuring everyone can access the care they need regardless of location.

Consider the patient narratives that were shared at the forum. Many mentioned how tiring, costly, and tedious the lengthy commutes to the closest cancer treatment facility in Iloilo City, or worse, Cebu or Metro Manila, have become. Their testimonies showed that cost-effectiveness would be a key advantage of healthcare localization. Grassroots-driven systems, such as optimizing referral networks and forging partnerships with regional pharmaceutical companies and healthcare facilities, have the potential to significantly reduce the cost of cancer medications and treatments, making them more accessible to everyday Filipinos. This point is particularly crucial given the high cost of cancer treatment. Resource speakers and organizers from the Department of Health, PhilHealth, Philippine Alliance of Patient Organizations (PAPO), De La Salle Univesity (DLSU) Jesse M. Robredo Institute of Governance, Iloilo State University of Fisheries Science and Technology (ISUFST), and Richard T. Clark Fellowship for Global Health repeatedly highlighted this during the open forum.

Early diagnosis is one of the main advantages of localization. Cancer patients made a point that rang true throughout the forum: late detection is frequently a death sentence. Community-based health programs can help in this situation. Early cancer detection can lead to significantly higher survival rates, which can be achieved through the implementation of awareness campaigns and routine screenings at the local level. It is a simple remedy with a lot of promise, particularly in rural areas with a shortage of healthcare infrastructure. Not only does localization facilitate better physical access to healthcare, but it also gets life-saving information to those who most need it.

One of the forum’s most moving moments was when the patients shared their journey. Cancer patients and their loved ones suffer significantly on a psychological and emotional level. This is why counseling and mental health services need to be a part of a localized system that works with the existing healthcare infrastructure. In community health centers, providing emotional support to patients and their families would be beneficial in addressing the psychological effects of cancer, which are frequently disregarded. It became evident during the FGDs that this kind of support is a need rather than a luxury.

One aspect of healthcare localization is addressing the stigma and false beliefs related to cancer. Cultural customs and beliefs can discourage or even postpone seeking medical attention in many rural communities. Localized health initiatives that provide education can help remove these obstacles and promote early intervention. By creating an atmosphere where patients feel supported and understood, we can start to shift the perception of cancer from one of fear and isolation to one of hope and resiliency.

Equally important is establishing palliative care centers that provide compassionate end-of-life treatment without leaving their homes. The geographical differences in access to palliative care services define one of the most apparent differences in our healthcare system. Localization would help the patients live out their last days in comfort and dignity with their loved ones by bringing these required services near them.

The localization of healthcare is essentially about empowering people. For example, a well-functioning referral system is essential to ensuring patients are effectively moved from community health centers to more specialized facilities when necessary. This saves lives by streamlining procedures and lowering delays in diagnosis and treatment. Cancer patients would have agency through a structural, localized, and efficient referral system, enabling them to navigate the healthcare system confidently, systematically, and securely.

The idea of a patient-centric approach to healthcare is at the core of all these initiatives. Dr. Jess Lorenzo, Senior Fellow at the Jesse M. Robredo Institute of Governance at De La Salle University, who was instrumental in setting up the forum, echoed this. He underlined the importance of having candid discussions to address social injustices in healthcare. He stated, “Community-based awareness is vital to bridging gaps in healthcare access,” and treating cancer patients is one area in which this is particularly true.

Localization seeks to create a system whereby everyone from all socioeconomic levels or geographic locations can get first-rate healthcare. It is about more than just increasing the number of hospitals or clinics. The main goals here are improving healthcare’s efficiency, lowering its bureaucracy, and raising its population-serving needs-oriented responsiveness.

Localized healthcare is ultimately a call for social justice, equity, and the recognition of every person’s inherent dignity. Living evidence that cancer can weaken the body but never destroy the spirit is provided by the patients who spoke at the forum and shared their stories. This movement thrives on the bravery, tenacity, and unwavering hope of those at its heart. While the road ahead remains long, every step we take today brings us closer to a future where others will not have to endure the same battles. My most profound admiration goes to the courageous patients who continue to fight, the dedicated medical professionals who stand by them, and the passionate individuals who have brought this vital initiative to life. Their collective strength and resolve light the way for a more compassionate and equitable healthcare system we all pray for.

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Doc H fondly describes himself as a “student of and for life” who, like many others, aspires to a life-giving and why-driven world grounded in social justice and the pursuit of happiness. His views do not necessarily reflect those of the institutions he is employed or connected with.