 Nong did evening, episode number 53 of our Stop COVID Deaths webinar series brought to you by the University of the Philippines. Maraming-maraming salamat po sa inyong pagkatend at pagdalod dito po sa ating webinar. Masayang-masayap po kami that you are all able to join us today as we continue on with our fifth season of our COVID-19 learning journey together. So alam naman po natin na kamakailan lang po, a few days ago, a fire raised arguably the biggest COVID-19 referral center in the Philippines po. And it's fortunate that we did not sustain any loss of lives. In comparison, last month po in the city of Baghdad in Iraq, at least 82 people died in a COVID hospital kasi medyo wala po silang fire safety system ano po. And then in India, a spate of hospital fires also claimed more than 50 lives due to a lack of required fire safety measures. So today, alam naman po natin na napagusapag po natin last week that we promised that we will give you ako, on a virtual grandstand. So we had to recalibrate just because of the urgency of the matter and we wanted to be able to discuss the lessons learned from the Philippines General Hospital's experience. What can we learn from the experience po na in the incident and how do we apply it to our own clinics, medical facilities, health centers lalo na po panakon po ng COVID-19 na pandemya. Magandang hapon po alet. I'm Dr. Raymond Prandi Sarmiento, Director of the National Telehealth Center at the National Institutes of Health University of the Philippines Manila. It's always a pleasure to be back as co-host po, co-hosting this webinar po with my partner in crime and my mentor during our regular Friday lunch date. She is also our adjunct faculty at the National Telehealth Center and the Special Envoy of the President for Global Health Initiatives, Dr. Susie Pineda Mercado. Dr. Susie. Hi, good afternoon Raymond at Magandang hapon po sa inyong lahat kung sanman kayo na ron ngayon. We're just so happy that you're here with us in the webinar. I was just noticing, Raymond we have our friends from Sambuanga, from Surigao and the Metro Manila hospitals are watching. I just wanted to point this out, Raymond na malaki po ang natulong ng mga katabing hospital ng Philippine General Hospital. Mamaya siguro mabab mag-git na natin mga speaker yan. Na ako hindi din po sa tulong ng bayanian spirit ng mga hospital. Hindi po matutulongan ang mga pacienting nilikas sa Philippine General Hospital. So we have a very interesting story. PGH is here in full force. Lahat po ng mga more on the scene are here to share their experience but they're here mainly so that we can all learn and I know that many of you are watching from different hospitals. All over the country from Bagu, Cavite, Porta Princesa ko saansan po. Marami po tayong matututunan sa nangyari sa PGH. Hindi po natin na iiwasan, meron din talagang sako ng nangyari kahit na may COVID pero ang importante po yung handa tayo. So thank you everyone for joining us today. We hope you will enjoy the webinar and we will all be learning from you. Raymond over to you. Okay, thank you Dr. Susie po. So for those who have seen our poster po, you will notice na medyo special po ang episode po natin just because marami po tayong mga speakers for today. I think we will be numbering nearly 10 speakers po all in all for the Q&A format but before we do that, I would like to let everyone know just because of the success born out of the Q&A format po na ginawa po natin nito naka ang linggo, we have decided to switch to some sort of hybrid structure po for this webinar. So after all of our speakers have presented, we will go straight to the Q&A panel with questions from our moderators then proceeding to the Q&A session with Zoom and Mentimeter questions from our audience po. But before we start, I think Dr. Susie has a few announcements. Dr. Susie. Okay, so we have two announcements for today. Some of you are already asking for the Mentimeter so maybe we can flash that slide. We hope you've been enjoying the Mentimeter and this is because we want to include all of our participants on Facebook and YouTube to be able to contribute to the discussion. So here you will be able to participate in the opinion poll. All you need to do is open your browser and go to www.menti.com and then code in the following numbers. Seven two four four zero five five and we'll put that in the chat box as well. Seven two four four zero five five and if at any point during our webinar you have any questions please feel free to use the Q&A box. I'm sure menong kayong mga katanongan, marami laging mga tanong and sometimes you're not able to answer all your questions but we definitely will try to do that. So get ready for the Mentimeter. And the next announcement is coming from Raymond. Raymond go ahead. Thank you Dr. Susie just because we are talking about the PGH FIRE for today. We'd like to discuss po the call for donation. So on the screen you will see the different contact information, online cash donation details, cash donation details, food and non food donations. Specifically for emergency donations because related to the recent fire incident in PGH. Kami po ay nangangatok sa inyong mga mabuting puso po for emergency donations for this recent fire incident. And for other concerns we would like to ask you to contact the Bayanihan na operation center at one five five two hundred that is one five five two zero zero yun po ang official na numero ng Bayanihan na operation center. From the bottom of our hearts we are thanking you all of you po in advance for your generosity and for your continued support. Okay, before we go on po Dr. Susie, I'll take this opportunity to thank the very hard working team behind the stop COVID-19 webinar series if we could get that on the screen po. Right about now there we go. These are all well essentially the teams that comprise the production team po na every week. Very very hard working in terms of coming up with the concept, the roster of speakers, how our program pro will go on especially making sure that this learning series is very very possible po. So maraming-maraming salamat po sa lahat ng ating mga well team mates po Dr. Susie. Over to you. Yeah Raymond, it's webinar number 53, can you imagine? It's the 53rd webinar already and I just like to give a special shout out to those of us who are watching from outside of the Philippines. So I saw some new places Raymond, Bangkok, did you see that? Somebody is watching from Bangkok, we have from different parts of the world, we just want to thank you. So sometimes we're going to do some English translation for what, kasi nagtatagalong tayo ng sa Raymond dino. But we just want to greet all of those who are watching from outside of the Philippines and we hope that somehow we are able to also help you in your service to people who need help during this pandemic. So Raymond, I think you're going to talk about the certificates. Okay, thank you so much Dr. Susie. Just to mention po, we have already sent out all the certificates po for the previous 52 webinars. And for this webinar po, as always we will be requiring at least 50% duration spent in the Zoom webinar po. For you to be able to be eligible to receive a certificate of attendance along with a copy of the presentations po. There are those that still ask, as mentioned po in regards to changing the names. Very, very quickly we would like to reiterate that how you have inputed your names po in the registration using the registration link will be how it will be reflected. Kasi it's an automated process po. So be very, very careful when you are trying to put in your names kasi how it is written po. Uliting ko na po. Kung paano po siya nakasulat sa registration po, it's automatically transferred po to if you are eligible to receive the certificate. So please be very, very careful lang po. And for those who are joining us, I know a lot of you, we are now numbering a little over 1,100. But there are a whole lot more of our masusugid na tagapan nood watching us in the live streaming channel sa YouTube po na TVUP. Dundin po sa mga Facebook accounts na na-live stream po para po sa stop COVID deaths, para po sa University of the Philippines patin na rin po sa ating TVUP. So maraming-maraming salamat po. I'd seen a whole lot more of our international attendees e-mailing. So we'll give a quick shout out later on but before that I'll turn over to Dr. Suzie for the introduction to our opening remarks later. Thank you very much Raymond. So I think it's fitting that we open our webinar with the Chancellor of UP Manila. Of course this has affected the whole of UP Manila this fire. But so you know her very well. We'd like to welcome Chancellor Kamensit Padilya, Nenshit Padilya. Nenshit, welcome to the webinar. Hi Dr. Suzie. How are you? Oh, how are you doing Nenshit? Kamusta ka na? Well, we're still recovering from the fire. Of course everybody was caught by surprise but you know PGH, I don't worry about PGH. PGH is always ready. And I think you know COVID told us, taught us to be ready all the time. Parang every day is disaster day. Yeah, you mentioned to me when we were talking the other day Nenshit na. There were other hospitals that really stepped up and helped PGH at this time. Maybe we can, before you go into your welcome remarks, we can mention some of the hospitals that it really took our patience. I think GAP will be in a better, for instance, for me as a pediatrician, I can say that Santa Ana actually accepted our patience from the nursery. That was really so heartwarming, for the director immediately responding and saying yes we can take in the babies. It's hard when you have a newborn baby caught in the middle of the fire. But there were other hospitals that took our patience. And I think that's going to be part of the sharing of director GAP. At first always a fire and I was sharing with you before we started that on a personal note. Of course, I wasn't worried about PGH, but I went to work my son was my son was a resident of OB. I had no idea where he was. And I think it's part of the calling of a doctor that you just have to be where you have to be. And on that particular day, I was actually admitting an 89 year old uncle for amputation. So in other words, I'm sure that there are other patients like me who was actually in the middle of getting admitted to PGH. But we just have to move on and look for other ways. So in my case, I had to move my uncle to another hospital. But everything, there's also a curse for everything. So I think again, this point, thank you to the whole of PGH. Hindi ko talaga pinoproblema PGH ever since. It's always ready. And I thank the management for that. Okay, go ahead Chancellor with your opening remarks. Go ahead please. You know, Dr. Susie, I actually entered the College of Medicine in 1977, making my stay in this compound for 43 years. And in those 43 years, I have personally witnessed three fires at the Philippine General Hospital. One, the first one was in the 80s when it burned down the Upma's auditorium. A second one in one of the operating rooms just a few years ago. And the third one just last week. In all of these fires, they all happened at night. All of these fires warranted an evacuation. And in all cases, there were no casualties. Evacuating a hospital is a nightmare. For doctors, nurses and staff, every evacuation is an offering of life. The priority is always to be able to bring out all the patients and staff into open ground without casualties. The goal is zero casualties. And today, the PGH team will present how they survived the recent disaster, the fire, in the midst of COVID disaster. One can never be prepared for any disaster, whether fire, earthquake. Of course, now we have COVID. The investment of PGH management on preparedness is bearing fruit with the sharing of our presenters and panelists. In disasters, there is no overpreparedness. Back to you, Susie. Thank you very much. That's UP Manila Chancellor Menchit Padila. And we're going to have Menchit on the panel. And also to do our closing remarks. Okay. Thanks so much for that, Menchit. Over to you, Raymond. Okay. Thank you po for really just very, very succinct opening remarks. We will be having our Chancellor, our dear Chancellor, as part of our panelists and also for our closing remarks po, no? But before that, I think we'd like to take this opportunity to do a short opinion poll which we will be doing via Menchit meter, if I'm not mistaken. Okay, there we go. Ouliting ko lang po ang sinabi ni Dr. Susie Kanina for those who are joining us for the very first time or for those who are joining us ngayon ngalong palam po nakapasok, please go to www.menti.com. That is www.menti.com. Paglagay, pagpunta niyo po doon, may gagoyin pa ko kayo. I-enter niyo po yung code na nakalagay dito. It is an eight digit code, 72444055. I repeat, 7244055. So it's the first question that we have here is it reads, a hospital internal event could be one of the following. We have five options here. Fire, earthquake, bomb, hostage taking and all of the bomb. So we are seeing po na marami po sa ating mga attendees who have logged in to Menchit Meter, although we are only seeing less than 200 po, ayandami po natin. Lagpas po tayo na 1,200. Talap po yung on the other 1,200 will be joining us sa ating fun poll or quiz. Okay. And then we move on to our second question. Okay. There we go. Our second question is all about the stay and defend concept. So meron po tayong, maydumalit lang po yung pagpapakita dito sa ating screen and we are seeing only less than five attendees, or less than ten attendees answering it. So I will just give a very, very quick shout out po for those who have signed up and registered all the way from Kagayan Provincial Health Office from the Senate of the Philippines. Okay, wow. Pasay City in National Capital Region, the Provincial Government of Pabita, Entrez, and Marteres, LG U Mapanas in Mapanas, Northern, Summer, Eastern Visayas, and South Kutabato Provincial Hospital in Coronadal City in Sok Sargent. As mentioned internationally, tayo po ay napapanood from Taipei City, Taiwan, another colleague from Bangkok Thailand, Medan Indonesia, Bandar Seribigawan, Brunei, Singapore, Salmiya Kuwait, Muskap Oman, Betaya, India, Najsran, Saudi Arabia, Dubai, United Arab Emirates, and our regular from the Niagara Falls, Ontario, Canada. So the five options po for this question reads construction barriers to block fire spread between zones. Option two, location and condition of design doors and windows to block fire spread between zones. Option three, space between different buildings to prevent fires, spread between buildings. Option four, existing system for heating, venting, and air conditioning to prevent transfer of smoke and gases into uncontaminated occupied areas. And then number five, all of the above. So yun po. As mentioned, please join us in our mentee meter, www.mentee.com. The code is 724-44055. Okay, so I think while a few of our folks attendees are putting in their answers po, no? I think we'd like to take this opportunity. There is a very, very brief video created po by TV UP. So if we could have that po be shown on the screen po right now. If I broke out at the Philippine General Hospital. Pasado, ating gabi, Karina. Lasunog ang sterilization area ng operating route kung nasanggina mga linet. Mga 11 pas, mga quarter, mga bakit Dr. Roddy Gabita ating inform ako sabi niya kung mong puno pa OR. When I first knew about it actually parang hili po ako na niliwala pa na nangyari yun. But when I went outside and I saw that the patients are already evacuating, I realized it's real, it's really happening. At hospital yan, you have to evacuate the patients tapos meron tayong COVID situation at the same time, nagkarun pa nangapire disaster. So marami tayong ikaw consider niya pa priorities in time. Ang pinakasunog na nakita namin sa third floor, sa May Orsa, sa May Anesthesia Care Unit doon sa mga supplies po ng OR. Pinariwanan ko sa kanila yung papasukin namin usang area ay sanitation area kung saan gun ginagawa ang pag-ease o yung mga ginagdamit ng mga doctors, patients and mga iba pang team na mag-operat is ang patient. Ang objective doon, surprise immediate need of fire. So hinahanap namin kagad yung mga saanagsisimula at kung saan niya maging extension ng sunog. Hinalam namin kung dga ano ba talaga kalaki yung na sunog doon pa part ng Orsa, in sanitation area. Hindi natin, hindi natin alam kung gano ka kalala yung sunog on that moment. So we need to evacuate that is the part of the protocol na pag meron tayong alarm sa isang hospital we need to evacuate lalo na kung nearby ang sunog sa isang lugar. So we were given instruction by the chief resident to evacuate. Kaya even before that when the fire alert was already given, nabigay naman na ng alert yung mga patient and nurses to be ready. Tuna namin nilict us yung mga baby. Then yung mga baby naka nusubate pa. Then asunod namin pinababa yung mga adult natin nakusahan tayong mga ambulatory patients na hibigabin mga nakakalakad makaisapaano. Then ang third namin ginawa ay yung mga COVID patient. The small ones who are not on oxygen kinagalang na mga magulang nila at nailabas. But those patients na nakaswero na may important thing medication sa swero nila or those na kailangan ng oxygen nakatubo. On that those are the patients na ngilapan po kaming ilabas because we need to look for oxygen tank na merong wheels. Yung mga ganyang classroom situation may mga nakalatag na pang mga protokol. In case of fire ito yung dadaanan para sa COVID ito yung dadaanan pa sa non-COVID area. So hindi natin silang paghaloin yung mga lugar na yun. Alam na rin nila kung kaano namin isisegregate yung COVID and non-COVID. Pero sa umpisa siyempre yung biglang bugso pero naiseparate naman sila. Sabay-sabay silang yung sang area. Pero pagdasing nang naka-assemble na kami sa labas na pagiwala-hiwala na namin sila actually pinasok na namin sila dahandaan sa mga COVID dahandaan na namin sila namin sila sila namin sila namin sila namin sila namin sila namin sila namin sila namin sila namin sila namin sila namin sila namin sila mga kami bumidang ko sayang covered kailap ko sayang COVID na e n交易 mo gumakikin ito Best Sabay namin pan sa ceiling para mag-circulate yung hangin. Very disciplined nado talaga yung mga pasyente. Accurally nakakapraod silang makita na sumusinod sa instruction, walang reklamo. They just needed some equipment para mailabas sila. Pero nung nabigay na yun, nabigyan din ang instruction, sumunod sila agad. Napakako-operative nila. They are following the orders properly, especially sa mga staff ng PGA, sa mga nurse, sa mga safety officer, sa amin, sa mga volunteer. Kasi binibigyan namin sila lang instruction kung sang sila lulugar. So iniiwas din namin, chaka iniiwasan din namin silang matapot. It really pays to be prepared and to follow the instructions given by the department head and those people in authority na alam nila yung ipapagawa sa amin. Ang PGH kasi ay meron kaming kinakandak na every month na eye drill. Ang lesson naman dito, nagdagdagan na namin ng 20th an awareness. And nakakasawa na makita na tulong-tulong talaga lahat para gawin ito. Yung pagmamahal at selfisho sa mga paciente, nandoon hindi nawawala na sa ganito mga saka na ang unang iniisip ay yung ibang tao sa bat-paligid hindi yung salili. So I think that it's also the quality of most if not all of the Filipino healthcare workers. And I think it's something that we are really proud of. Okay, thank you very much TVUP for that eye witness interview. And I think just gives us a bigger picture of what really happened. And now we're going into the main event. We're going to take a close and intimate view of the response. And it's my honor and my pleasure to introduce our first speaker who I've known for many, many years, Dr. Rodney Dofitas, who is head of the manpower support of the PGH COVID crisis team. Rodney is a surgeon. And Rodney, welcome to the webinar. I just wanted to say that, you know, I've known Rodney again for so many years for the longest time. He's a very calm and composed person. And I think in time of an emergency, you couldn't have a better person at the site of the scene than Rodney who will be able to think it through calmly. And I think this is exactly what happened. So welcome Rodney to the webinar. Good afternoon everyone. Nice to be invited here. Salamat po. I'm honored. Thank you everyone for inviting me. Okay, Rodney, go ahead with your presentation. First of all, good afternoon. I'd just like to say that this is the same shirt I wore. Of course, it's already been... It paralang ano, medyo, feel ko pa rin. I was wearing my Philippine college. I'm a surgeon so I was wearing... We had the board meeting actually, the whole day with the Philippine college of surgeons. And I was doing my board meeting at the bedside of my aunt. My aunt was admitted for a couple of days already. So that's why nakagani ito po ako. And then I was at the bedside the whole day. So Rodney, you just happened to be in PGH at that time, right? Nakatao lang. You were there because you had a patient, right? So that's the same shirt pero Rodney nilaban mo na yan, di ba? Ay laban ko na. Bale, di naman namin malalaman sa zoomin. Sige, go ahead. Go ahead with your presentation, Rodney. Go ahead. I'm just a slideshow. Yeah, go to slideshow. There you go. Sige. So stories from Ground Zero. So thank you Chancellor Menchit Padilya and Dr. Suzy Mercant. Talagang ayaw ako when they invited me when I heard the invitation. Nabi ko ayaw ako ngayon. I know me. If not for Chancellor Menchit because I've known her also since I was still a medical student and she was the chief resident of PEDIA. Suzy, of course, for the longest time. So parang sabi ko it had a family feel and I had to make the story of PGH headed by Dr. Goplegaspil. He was also my classmate. So parang sabi ko I could not resist the invitation. And as I have been saying po, naihiya po ako because as I will say that it was yasandali lang po yun eh. It seemed like an eternity. Pero parang minutes lang po yung nagampanan ko. I don't know if you can see. I'm speaking in English and Filipino because I know our audiences are all over the Philippines. I hope you will indulge me. Sa tingin ko po ang, sa nakita ko talaga, ang true heroes po yung PGH healthcare workers na 24-7 na na sa hospital. And I will say my story why. Ang isa po po yung mga firefighters po na buis-buhay talaga po sila. Nakita namin niri. Director Gop pa ano sila lumusob and halos mamatay palabas. And ang true heroes din ang systema ng Dr. Gop at siya kaya yung lahat ng pamunuhan ng UP Manila ay Dean Charlotte, ay Chancellor Menchit. Mula nagsimula yung COVID crisis na ito. And I will again show you why later. There are a lot of personal angles na I would have wanted to keep pero hindi rin sila matago sa story na ito. Nakah-admit ko yung aunt ko, anti-medico na parang mother Korean for the longest time since I lost my mom, Amalia, many years ago also. And na sa picture po siya at siya kaya yung at 10 p.m. she passed to the better, to the great beyond, the better life. And ang kasama ko po, napakahirap itong COVID, wala kang mas maida lang family pero buti na lang po. Ang dun yung anak ko si Dr. Anthony at siya kaya yung daughter in law ko po si Dr. Rapparla. At lupo kami ang dun, kasi na sa mind ko laki as a cancer surgeon when patients pass to the great beyond, it must be in the care and comfort of the people who love them parang danon. But we were marveling, hindi kami biglaan umales because pinagusapan namin yung napakaplesant ng stay ng anti ko sa PGH. Alam mo naman mga 90 years old, very snooty na sila. But all the time she was very pleased with the service, room yung pag-ayos sa kanya na mga doctors at saka yung lalo na yung mga nurses and I observed them. So we lingered for a while, sabi ko nga angel din siya kasi if we would have left by 10 pm umalis na kami and I would have missed the boat. So nag-uusap lang po kami sa napakaplesant na experience ng anti ko, mahal na mahal din po niya yung PGH. And may mga make a few phone calls. Wala po kami masyald, wala ng iyakan na to because napakapis, wala napakasaya din namin. By 11.30, alis na po sana kami pero na upusan po na mata yung battery ko. So I had to stay a little longer to charge and by 12 midnight, 12.30 we were already bringing home her body po. Sa gurney, actually 8 pm pa lang inayos namin yung body niya kasi kami rin nga ayos ever since the COVID crisis yung mga namatay sa PGH. So inayos na namin sinong kupuha and my arrangement was she'll have a we brought to the funeral parlor and pibihisa namin and then eventually have her cremation around, we will be starting at 6 am up to 8 am also kaya magmamadali din kami in a bit. My aunt was in the elevator din naan siya. Kami naman, actually ako kasi na una na yung anak ko mga 10 o'clock at si Karla. Sa elevator po ako dumahan kasama ko yung caregiver ng aunt po. 12.30, 12.00 Dun ko po at the third floor na merong commotion parang nga away or nagsisigawan and ito actually po yung nakita ko talaga na for those who are familiar with the OR OR lobby my elevator dun para bago ka pumasok sa operating room may napakahabang hallway siguro mga 300-400 meters sa dulo po may team na smoke ang wala pung sunog na sinasabi it was all smoke po talaga and the smoke was getting bigger and bigger ang security guards po natin and hindi ko lang nasabi sa aking paningin heroes din po. Nakita ko po may mga nagtatakbuhan na nagtadala ng fire extinguisher may nagtadala ng tubig at saka nagbasag ng water hose dun sa wall yun yung mga nangyari sa ganapan. Ang mga andun nakita ko talaga mga personnel sa orsa kasi silang andun pero patakbo sila sa labas papuntang labas kasi sabi nila napaka may sunog at saka nakapalakas yung uso yung mga nurses po because katabinon is the OR andun po yung mga nakatingin ng OR personnel sa scene of incident hindi ko nga masyado nakita pero andun yung paco personnel yung IW nila na bumabalek na andun mo at saka andun lahat na mga security guards marami po sila. So kung titing na natin may duty ba when the fire broke out sa ito na po yung ni reconstruct ko rin hindi ko rin maano yung orsa personnel na yun sila yung unang nagpatay ng sunog yung nagsumubok na patayin ng sunog inoluman sila ng mga guardja since inutusan yung paco IW may kuning siya dun sa orsa since it's a supply room tumakbo siya in inform niya yung OR at siya paco nurses ang sinasabi natin na talagang may sistema na sa PGH na so sa ininterview ko rin sila operating room nurse siya yung tumawag sa operator pag may sunog pala anywhere in PGH siyang SOP nila is to call the operator na tumawag ng fire department yung mga paco nurses naman kasi dun po katabi ng paco andun na tutulog yung anesthesiologist at yung surgery resident sinabihan na nila at yung inibakuate nila yung isang patiente dun sa paco yun ng unang nangyari andun po ako nakadungaw sa hallway tinatingnan ko yung usok lumalake hindi namin makita yung sunog sabi ko malaki siguro and controllable na ito yung sunog na ito sabi ko sa sarili ko parang bumalikta na ako sa OTAK naman yung simulan ng COVID crisis ng March 2020 ang isa pang vision ang naisip ko noon na ko napakalaking problema pero na mas malaking problema nung ng COVID nagsimula yung COVID and wala talaga kung hanlinlangan sa OTAK kasi malaki siyang problema sabi ko kailang-kailangan malaman ni Director Gap by all means at siya ka na niniwala ako talaga sa chain of command nasa OTAK kong ayung anoy nung nagsimulat kami nun sa COVID crisis kaya parang natawa pa ako sa sarili ko kasi tinapanong lagi anong organization yun doon napakakomplikado na operation ng COVID crisis nakakuha kami ng picture noon ang dinadrawing ito ha sulat kamay ni Director Gap napakasimple lang eh meron siya line organizational chart and yung nasakanan was the regular PGH operation and the left was the COVID crisis and involved lang doon was Doctor Ocampo was in charge of the operations si Doctor Denis Serrano kasamahan ko nang surgeon silang dalawa in charge of the logistics at siya kawa ako ay inampanan ko yun ang manpower kami yung sumusupportan nung kay Director Gap ito talagang nakapicture may systema na kami sa and after informing Director Gap sabi ko natatawarin ako sa sarili ko sabi ko may trabaho na naman may gagawin na naman ang PGH COVID crisis pero tingin ko kaya ang kaya nito yung isa pa na tama po yun na naggano din sa akin na may disaster and evacuation plan na rin ang PGH kasi lagi kahit ako saan sa department ko sa OR lagi ko makikita kung saan magibakway tanong gagawin so may knowledge din ako na may systema na in place ngunit may I had the one big big problem remember may phone died at the OR then after so many phone calls and charge ko lang siya once it lift up umalis na rin ako kasi kailangan ko samahan yung anti ko I needed one phone para nito na money was imagining I was in a sinking ship because I'm from the province laging lulu po kang par ko or sabi ko sa Titanic or out plain fall oh you only have one call in your life sabi ko one chance only so sabi ko ito lang I'll call Dr. Gap one call only and fortunately Dr. Gap answered my call and I told him there's really no napakalaki problem at ito ang tawang tawangan and he said and I was confident because he said I will be there because I know since magkakalasi kami malapit hindi naman kalayuan sa makati lang si director Gap and he will be there soon enough so sabi ko sa sarili ko ako na napakalaki nabundot sa tiniko because I'll just be feeling that time while Dr. Gap is making arrangements and he will be here soon natakot din ako mamata yung phone ko I only had one viber message left so na isip ko sabi ko wala na iba kundi yung COVID crisis team so na hiya I wanted to avoid any panics ka whatever will happen that's why I said dear team very sorry to say there is a fire in PGH right now it started that format showing where it was alert everybody please on this team and in seconds sumagot ka agad si Dr. Herbos doon ako na makasang log ko sabi ko mas wala na ko ng battery may nakakaalam na tapos si Dr. JJ and then si Dr. Jonas nagsaguta na sila and may nagtanang sabi ko we have to evacuate everybody to the front because the area of the fire was in the central block evacuate natin sila sa harap in front of PGH in the atrium of PGH and then yun lang yung message ko dun sa kana so 1% one phone call and one viber message ito po yung PGH team na talagang I was very very confident that we've been through crisis any sort of crisis kami nina Dr. Berba sa HIKU as I've said Dr. Campo Dr. Serrano Dr. Berberabe and all Dr. Jonas kung ano-ano na naging problema na sabi ko makakayaan na namin itong fire laging apang nagtatakbu ako na sa mantra din nasa isip ko rin yung laging inaano namin sa team na mas kiyanong problema kalmakala stay the course believe lang sa systema that we've set up and we are one team we have so many photos po yung COVID crisis team kung saan saan kami sa atrium dun sa dietary kung saan na we're all together I mean of course with social distancing na one team lang lahat may systema tayo and we just stay the course naman siya so as I've said I felt I was filling up the shoes and bidding the time so mga actions ko na personal na na tawa na rin ako sa sarili ko e kasi sa umakyat ako ay node at room 508 because I was the attending doctor but Dr. Monroy ang kailopes did robotic surgery and dun si Mr. Joel Santiago was the safety officer ang sa simula apapok ng COVID crisis kami rin yung magkatasama and nung 8am dumaan pa ako sa kanyang kwarto but ngayon mga past 12 I went into his room na tatawang ako yunigising ko siya kasi yung sabi ko sir, patient na may trabaho ka actually pag pasokorp along the way nakikita ko alert na rin yung mga nurses sabi ko siguro they were calling each other by phone and they were asking for instructions so I told them to the nurses out of the station sa 5th floor right and left wing I told them to evacuate to the front and I distinctly remember yung the A-ball and ambulance patients yung makakababa ka agad takbu kami ulit pa bababa sa 3rd floor and at this time my phone conked out si Dr. Joel Sanchago sabay-sabay kami dumating na mga bumbero hinanap, sino yung safety officer so ito, ito safety officer to so he worked with the fireman and did his work sa mantala since wala akong po na security guards doing the radio so ang gagaling po ng security guards po namin so tosan mo lang we have to evacuate 4th, 5th, 6th and 7th they'll radio the area may mga guardya din po which provided the marshal and the escort para wala nagpapanik yung po talaga yung 2-9 na nangyayari apang nakatingin kamera sa suno kasi di pa siya controlled paano siya evacuated tapos sa sabihin san sir namin idadaan yung mga COVID-19 di doon hiwala yung sila san namin dadaling doon sila sa A3 yung may cohort doon yung sila sir yung mga, ibabanya yung mga baby so may umakiap sa kanila na makinform doon sa mga nurses yung mga intubated po sir ibabanya yung sila pero ipabang yung gamitin yung elevator baka matrat kayo doon kailangan sa dami nudan sabi ko kung kaya yung kargahin ibabanya sila so yung po yung mga actions namin at that time ito po yung very first kasi ang unang na ano isda paku and if the residents were asleep they would have been suffocated and I thank Dr. Grace Arbosa kasi yung tech message niya na ang mga residents are all accounted for so it gave me an idea to account for the residents each and every resident so yung enough ba what department po were accounting for the resident staff already and if they were already evacuated director gobson arrived po he told me he assessed the situation very well ining na namin yung potential doon action area he said I will establish a command post at the director's office and sinasabi ko nga kasi nagkatataksa isip ko talagay he was worried sabi niya bakit ka lang nakano wear ng ordinary mask kasi sa talagang initial I was wearing only an ordinary kasi yun yung ginagamit ko na unay kaya hindi ko nga napansin yung wearing of ordinary but when he reminded me about it doon na tupataksa isip ko that's why sabi ko nga doctor gobsaid my life and saved PGH at the same time and he also after establishing command post helped with us in the firefighting effort at the third floor so as I've said yung heroes talagar firefighters they are the first responders volunteers lang po sila hindi sila magkakilala doon lang sila nagmimit sumigaw sila kami lang will deal only with the safety officer walang iban na lahat ng civilian dito sa floor umalis kayo including yung nakaggreen sabi ko hindi ako ales kasi ako dito yung command sabi ko taga PGH admin dito ako sabi nga sige dalawa kayo may iwan mga residents po willing to mulong ang doon sila sa far left everything out so talagap pinalabas natin lahat ng mga civilians yung nagustuhan ko sinabi ng firefighter ang unan nilang hinana po sa floor plan sabi nga sinang may floor plan saan ang maintenance so sisi gaw kami itawagin yung OETS they cordoned off the area all civilians and then they said na evacuated na po sabi ko two teams sab niya isa saka liwa isa saka umakiap kayo bawat floor and search every room baka may na-iwan pa parang grave yung effecto no nung narimig ko sabi ko grave pa lang mga to and then doon na namin pinlano paano y approach ang fire sobrang hirap po kasi usok lang talaga siya hindi mo mapasok halos ihimatayin sila there are three passageways na tinuturo namin because parang bahay ko narin yung orsa sa right alley sa left alley eventually pa kami sa likod sa science hall kasi may daanan doon na pero we were pushed back by the intents po ito po si doctor si mr. Jules Sanchago in action siya na yung namamahala doon sa firefighting effort sabi ko ay trabaho mo yan na naglalokahan kayo and ito po yung sinasabi ko na um I was oblivious kasi gabi yun hindi ko rin nakikita chaka yung anak po si Anthony tawag na rin ang tawag sa akin inahanap ako but I couldn't answer eventually he found me and again I also owed my life to my son because he brought with him N95 mask at chaka respirators kung wala siguro na ano kasi wala rin I was oblivious dun sa initial bakt nakaganyan ka lang siguro na smoke inhalational injury na po so ito yung face mask kung anong effect doon ng smoke yung N95 po sandali mo lang gamitin itim na itim na ito isang ginamit kay doon na gabi sa saa amin iti isa kami and at the same time since may mga supportan na tinatawagan din ako ng wife po ng family ko na ano ng plano na atin dun sa kay auntie shall we meet you at home or are we meeting up with at Loyola Memorial Commonwealth so sabi ko na lang meet tayo doon there's fire in PGH and of course my wife thank you Belen always for being taking care of the home front sabi niya yung mga other anak namin kasi sabi namin itong COVID na pandemic will take care of each other e joses and kasi mat na mga graduate na soon ilang araw na nang ang tapanang nasa na daw ako so sabi ko lang I'm okay I'm in a fire commanding area don't worry so I'll show you a video short video yan po yung fire wala ka po makita kaya subod tapo anong gagawin nila sobrang ano na po yung ano dyan nakakapalpo ng gusto mas kaya ano po ang gagawin nilag ang hirap na hirap si that was the situation the lights were out they have it was very dark ito po yung area naman we were watching the operating room sa kanan unti-unti yung smoke nagdadala ng suit nag-re-ready po yung mga firemen nagbabantayin sila sa ito po yung sagit na if you go straight that's the new surgery room and you go left that's the ENT room dyan po ang simula ang malaking usok dun sa operating room and binabantayin din namin there's a situation since this is a fire I'll just show you a short video of the actual fire that eventually the firefighter shared with me was very small they were already in the ormato they contained it but lagi nila sinasabi it's the smoke that kills it and they were very careful kung anong patayin nila anong panda at what direction so sila sa akin that's why sila talaga ang tunay na bayani and ito po because there was a thick smoke daat ng pinto sa OR pinagbabap, pinagbubuk sa namin kaya hindi rin sila magbubukas hindi rin sila magbubukas or magsisira kung hindi sila nagpapahanan po hindi galing din so we were trying to save the operating room si Dr. Ghaap Dr. Angkoy my son in some residence were saving the operating room microscopes ito po yung mga c-arm mga robot so it was not we were saving also property at the same time ito po yung napakagandang video chaos paano binidip yung mga iba-iba OR equipment yan kami si Dr. Ghaap mantutulak ng mga microscopes at dakaabang apartment helping lahat ng mga Anthony were pushing the anesthesia machines kung ano-ano na lang po chaos this is the S3 to the ortho this is Dr. Angkoy pushing the precious robot thank you Dr. Angkoy nung dumating na yung mga suporta yung if you see their houses may mga tubig na so it was a matter of containment but it's very very difficult kaya from almost 12 up to 5 yung action tinago po namin yung mga equipments na valuable sa hallway sa likod atyaka talo sa side ng TGP these are the additional fire scenes makikita nyo as we can see sobrang dilim lang talaga po siya it's very very very difficult by the morning actually for me because dumating na yung I was going down back and forth to the director's office yung Jonas was doing at round of operations sa lupo si Marju na sabi kay was very pleased that's why I said ibang iba talaga PGH COVID team pero ito ay mga pictures on myself I went down the PGH because it was almost 6 o'clock and I had done to cremate tinignan ko sa ano yung ano na nangyari da patience there were patients at the oblation iba sila I think there are 6th floor may patients doon sa flagpole area mga 5th floor nurses dito sa kaliwa mga nakita ko yung mga nag-take care sa hanko ng gabe ito po ay yung chapel sa kanan sa baba and nakita ko yung andun yung mga babies at saka elevator and nakita ko rin yung mga nurses already ready these are I thought they were post duty nurses pero ito na po yung mga bagong nurses napapasok na sila they are there at PGH by 5 a.m. yung iba so we are ready sila sabi na in 4 by 5 41 was out ready na po kayo kasi papasok na kayo maglilinis na po kayo so yun lang po yung ano ko yung kwento ko po thank you very much po hanggang yan lang po yung kwento po thank you very much sa inyaya thank you very much that's Rodney DeFitas from the Department of Surgery and a very powerful story I think about how he just happened to be there at the moment to look at the chat box our audience offering their condolences to you you were dealing with the death you told us your aunt is like your mother she was your second mother and yet you were there you had to to be in charge until gap arrived and we just want to thank you and to thank everyone in the Philippine General Hospital for your courage and your focus and your dedication to service so Rodney please stay we're going to have a panel later on so thank you so much Rodney I'm turning over to Raymond who's going to introduce our next speaker Raymond go ahead please thank you Dr. Suzy we'll just be very very brief with our introduction given that our time limit our next presenter po is one of my mentors over at the Philippine General Hospital hindi na po siya kaila sa akin he is the director of the hospital himself Dr. Gap Legasti director Gap sir magadang happen po good afternoon good afternoon everyone can I just share my slides are they up Raymond go ahead sir up up wait well you know everything that's been happening with us here in PGH and I guess in the rest of the country it's all about telling stories I think now we've gone through a lot of difficult times we've we've faced challenges and I think today's narration of Dr. Dopitas is really a tale of the human spirit and also to speak to quote the book of UP Manila it's amazing how people react to situations were life their own lives are at stake and those of others so we can never say thank you enough to Dr. Dopitas who I think fate brought to the scene of the fire and eventually paved the way for a smooth handling of this crisis we are indeed always reminded that the biggest and the best asset of the Philippine General Hospital are its people and already prove that but let me just add a parang eto yung corny part eto yung dry part ng whole event which is the admin part because this is what we were trained for and this is what I think what ties everything together is when the incident command has been established so this is the fire that we saw in the third floor and Thomas Rodney the dedication of the Bureau of Fire personnel the volunteers one of our nurses atin also was there and it's amazing how they actually risked their lives for people they didn't know for a place they didn't really have any adherence to but still it's a part of their job and they did it very well I think so when I got there as Rodney narrated the first thing I did was after getting the call from Rodney I arrived in PGH I went to the head of emergency medicine which is also I think a vital cog in the operations here Dr. April Lanetta and got a briefing from her I saw that the emergency room patients were already well situated in the surrounding open area and we were placing them in the new emergency room OBAS area so that part of the that's the back part I had to park in Pedro Hill I knew that it will be very difficult I parked in Pedro Hill so I was approaching PGH from the back and after talking to Dr. April Lanetta I went straight up to the operating room in that scene of the fire was what welcomed us or presented to us so we had discussions with Rodney and I was happy to note that the evacuation plan has been rolled out through the help of the Mr. Joel Santiago and also the firemen on duty then so after securing the into the site and having a direct feel of how it was ongoing I went on to establish the command center I think one realization here is that all our fire drills were done during office hours so as I was leaving the fire site I realized it was I was not equipped to establish a command center because a command center needed information for for you to be able to roll out the plan so having no one beside me my trusted aid Pablo who always feeds me a lot of information anywhere I go in PGH was not there of course in the middle of the night so I think for anyone wanting to set up a flow of events what I did is I went up to the seventh floor and then walked down through the different floors of PGH until I reached the ground floor so that gave me a feel of how many people were still there how thick was the smoke was the fire getting to the other areas was the radiology department going to be threatened were again billions of pesos of equipment were present will we have enough areas for us to evacuate if we need to move other people so the quick scan of the central block was done and then I went to the areas of the patients and saw the how organized they were in the corridors and eventually in the we had to open the still unfinished emergency room of PGH and once we have scouted around the the different areas that needed to be evaluated I went to my office to establish the command center but having done doing that it is again a multi-tasking effort as Dr. DeFitas has done I've called the cavalry also I have first one I call this Dr. Terebin Indicto deputy director for admin whose office handles a lot of the possible services related to this especially engineering I already also did a call to Red Cross thinking that if you need to evacuate patients our four ambulances will not be enough and a formal pay-up was established to there before 2 o'clock I already got in touch with the engineering people and they started sending people to to PGH just to give us an idea on how electricity and plumbing and gases would be affected the chief of the division of clinical nursing operations Ms. Gloria Almariego was there early at I think 2 a.m. and nurses being the biggest and the most vital component of an event like this being both clinical having a role in clinical part of taking care of patients and in the organizational part of moving patients and things around was there to take the orders for us to be mobilizing the different units I also called up the dietary at 2.17 a.m. to make sure that it's going to function because I knew all of these people will be needing food in the near very brief shortly after this event because it's going to be breakfast time and the babies and the people needing their special meals so that's why at around 2.17 a.m. is Emi Labilia was already starting to prepare contingency plans and that's why I think that's the first thing that the people heard over social media is the food and water because we were not sure if we were able to open the dietary I called up added Mr. Bernadette Ijaw of property because knowing that the patients hitting oxygen in the different areas of PGH most especially those outside the hospital confine in the parking space and the oblation plaza in front needing oxygen will have to be replaced will have their tanks replaced soon so the supply chain for oxygen tanks are also established upon going around the wards the different wards I thought that the difficult task of bringing them will be bringing them back to the wards will be made even worse by the smoke that's there so early on at around 2.45 p.m. a.m. I already called up people who could help us with industrial fans and was able to get in touch with the renting company that would send fans early in the morning for us to use to dive away the smoke so having done all of that we established the command center in my office and I think the different calls that came in mentally paved away for the succeeding events that happened thereafter but while I was in the office I started to think about controlling further damage by the fire now that the patients have been secured and secured very well at that asset management was the first step the next step that I was thinking of so I went back to the Regiology Department after endorsing the command center to Dr. Linnetta at around 3.00 a.m. I went back to the Regiology Department seeing it's not too much affected I went back to the OR being a surgeon about the operating rumor all of those equipment are and I think for the it's just fair that I should share that we've been positioning PGA should be the most advanced surgical center in the country private or public hospital wise and we've been acquiring a lot of advanced equipment instruments in the last six years and as a director of the hospital the asset management came in as or risk reduction or reduction of losses also came in as a concern after the more important the other important concerns were already handled so we went up and in my mind I know I know everything that costs I know all the equipment there and how much they cost because I signed all the purchase request and the checks that pay for them so that's the picture that Dr. Adolfito showed we were pushing out microscopes that were worth 30 million pesos the robotic system that has worth 120 million the interoperative radiotherapy unit that was just delivered three weeks prior to this to this fire it's 110 million so the the fear or the panic that struck my mind not only as a surgeon but as a as an administrator of a hospital that we were really pushing to be on top of the surgical specialty kicked in and this prompted us to evacuate them as well upon the advice of the firefighters we put them in relatively safe areas away from the smoke and the dust that's piling up in the operating room so again this all happened spontaneously maybe unplanned at the start but of course to assess the situation on hand such considerations come in play after the lives of the patients and the other personnel have been secured so part of asset management part of the management also of the situation is knowing when to bring back the patient to the wards and as we were going to the fire the signal for this will be of course coming from the bureau fire personnel and at 245 they said that the fire was under control but there is still some smoke coming out of the area burnt area at 541 I got a text from Dr. April Danetta and she said that the fire was deemed controlled already so after two hours again which areas will be safe and clear of smoke for patients to return these are all identified and we started bringing back the patients the PGH central block has two floors three floors of COVID patients so this was a big challenge also and I'm happy that when I arrived this was already well managed and so we even had go up to the pay floors first because obviously there's more smoke than the ground floor we moved all of them first of the OBAS where COVID positive obstetric patients were being handled so we had a big space two areas there enough to secure the accommodations of our COVID patients from the sixth floor so slowly in from the outside and from inside to the inner side as the days as the hours progress and I think by around midday all of the patients already back in their specific areas so the first thing we did after everything has been secured was to call a post event briefing and even on a Sunday the executive committee and the COVID crisis committee as well as the personnel from the different services of PJs were there I think for us handling this situation we should have an immediate assessment of what happened because this will be a very important step in the planning for the event of resumption so from then on we planned further smoke clearance and evacuation and to my surprise again to show you what the Bayanihan spirit of our people from PGH is I think very early on not even 7 o'clock the PGH pantry was put up already headed by Dr. JJ Hermar and the obstetrics and gynecology residents and interns and people tired from the experience had an occasion to have some meal and some water during that morning so these other events that were were spontaneous and unplanned but dim very significant in the operations came up because of the nature of the kind of people that we have here so the plea for electric fans and industrial fans to blow out the smoke was heard all over the country I think so we had the deluge of fans by the middle of the day and we and Dr. Angkoy Lopez in charge of the wards started deploying them and bringing his own donors giving us commercial industrial fans we had the scene of the fire cleaned this is already this is around lunchtime or 2 o'clock and it's as if nothing happened to that area and if you remember the picture prior to this now this is already 2 o'clock so really amazing operating room personnel doing this the donated fans to us were augmented by the Red Cross Emergency Response Unit who brought in smoke evacuators to take out the smell and the toxic gases away from the area early on so I think the last step for that day was the officials of the university all the way to the president conception the dean Dean Sherlock Chung and Chancellor Padilla on hand to do personal ocular inspection and evaluation of the situation so I guess the management of this crisis rolled out as events have shown in a way that made the the whole process safe and also effective in managing the situation I am deeply indebted to all the personnel of PGH and all the and all the heroic measures that were instituted without being told so explicitly so Dr. Dofitas has been the cornerstone of that management and I also like to take personally for that so here on we are rebuilding and it's overwhelming for us all the support that we're getting from the public and government as well and I think the only way to really respond to this kind of support is to do better service for our people in the future so thank you very much everyone and Susie nice to see you again thank you very much that's Dr. Gaple Gaspedi director of the Philippine General Hospital for your leadership gap I know you've been going through so much because of COVID and now a fire but through all of this you emerge as a very strong steady and calm leader and I think this is what what we all need in a time of a disaster on top of a pandemic so maraming salamat gap I think our audience you'll see in the chat chat box really appreciates your leadership and it's one thing to respond to a fire and it's another thing to rebuild so hearing your story about the equipment the property that serves the poorest of the poor in this country I think is one that we should continue to share with our audience that we are trying to build here a facility that gives even the poorest patients the best medical care so more power to you Gap we've got us our next speaker the head of the disaster risk assessment and management program of UP Manila doctor Carlos Primero Charlie Welcome to the webinar as you know and as both Rodney and Gap have described there was a very calm evacuation there's a system in place and that's because there's somebody in charge of planning and preparing so I'm very pleased to welcome doctor Charlie Charlie Welcome Thank you mam Susie so let me share my slides and let me start my time I think I have 15 minutes to do this and I'll try to deliver this as fast as I can Hello Charlie take your time I think you've got a very important presentation Okay so my objectives for today is to identify or describe to you types of incidents in hospital disasters and to give you a brief definition of what disaster is and then through the presentation may be impart to you the value of a hospital incident command system the value of drills and then give you some action photos and videos so there are two types of hospital incidents one is external one is internal when we say external these are events disasters or incidents occurring outside the hospital and basically the role of the hospital here is to accept the mass casualty or the victims or the injured victims brought to the hospital while the internal disaster is an event or incident occurring mismo sa hospital natin so for example itong fire so mismo hospital ang affected so this is an internal incident or internal disaster another example is bomb threats earthquake na basta yung hospital natin ang involved chemical incidents hostage taking those are all internal hospital disaster incidents and what we should remember in internal incidents in events is that there is a principle of what we call a stay and defend concept sabi sa WHO sa safe hospitals sabi nila hospital should be the last building standing in a community and that's why in disasters we have to make use of the hospital as soon as possible we have to stay and defend and keep it functional for the community okay so what are the stay and defend concepts for fire specifically talking about fire we need to construct barriers to block fire spread between zones like for example meron tayong seismic fire seal dito sa paghitan ng building this is a picture we have to locate and condition design doors and windows to block fire spread between zones and then spaces between different buildings should be in place to prevent fire spreading between buildings and existing systems for heating or ventilation and air conditioning to prevent them from from serving as mechanisms to transfer smoke or fire in uncontaminated or occupied areas so one example is this may makikita kayo this powerful electric fan di siya electric fan actually this powerful ventilation system once na magkaroon ang sunoog sa building nasa ano siya nasa evacuation stairs ano yung purpose hihigupin yung pahangin sa labas magpuprovide siya ng positive pressure sa loob ng stairwell para yung usok hindi makapasok sa stairwell para yung ma nag-evacuate hindi sila masusufokit so these are one of your one of these are some of your measures that you can do to your building or your hospitals now let's define what are the characteristics of a disaster we know that in disasters there is a mismatch scenario which means mas marami ang problema natin kesa sa capacity natin tumulong so in short higante ang kalaban natin overwhelming ang needs limited lang ang resources available tayo kaya ang kinoko di tung picture is isang higante nilalampaso ang isang bata di ba wala kang laban wala ang match mismatch and that is the scenario always in a disaster and next is chaos one characteristic of disaster is chaos ano yung ibig natin sabihin chaos yung nagkakanyakan niya tayo in disasters ang principle natin is gusto natin tumulong di ba everyone does what is right in his or her own eyes tama naman yung ating principle pero kasi kung nagkakanyakan niya tayo ang problema is kung magkasalongot yung ginagawa natin in this natayo in makatulong tayo pa ay nakakadagdag sa problema di ba example dun sa takloban nuhayan lahat ng tao gusto ang pumunta sa dun sa takloban sa mantaling yung karating barangay wala naman silang wala tumulong wala nabibigay na suporta so kung gusto ko lang gawin yung gusto ko yung takloban yung isa redundant na yung support yung karating na napapabayaan di ba so that is chaos in natin naman maanid siya naman ayos yung available resource na tendo sa nangangailangan and that will also lead to a disaster so important in disaster is dapat organize tayong lahat dapat nakakasundu tayo hindi yung ay tamaring ginagawa ko kasi maganda naman yung aking hangarin so hindi dapat ganoon and how do you organize pano tayo makakaroan ng organization or government di ba meron tayong tinatawag na hospital incident command system datay ang tawag sa kanya is hospital emergency incident command system pero ngayon ang latest ninya is Hicks na hospital incident command system which meron tayong five primary management functions meron kang command meron kang operations meron kang planning meron kang logistics and meron kang finance ano ang role ng bawat isa command is the boss or decision maker operations ito yung mga doers ito yung firefighting ito yung medical ito yung search and rescue ito yung salvage planning siyempre siyempre sila yung nagpaplan magugutong yung mga yung mga nagrespon mamaya anong po hindi natin gawin dito so inuunahan na nila inanticipate na nila yung mga darating na problema kaya ano nagpaplan na sila para pagka nangyari ito meron ang naka-ready logistics paano natin gukunin yung kailang pagkain and finance siyempre siyempre magbabayang so importante ang incident command importanting ito sa isang incident so ito naman yung sa ating sa PGH meron kang incident commander meron kang information officer liaison officer safety officer and then operations planning logistics and finance and then dito sa operation dito pa pasok may yung ating tinatawag na emergency response teams or disaster brigade team natin which is meron kang first aid medical fire suppression evacuation team search and rescue and so on and so forth ngayon again chaos is a characteristic of disaster diba to avoid chaos we have to unify what we think is right hindi yung ito yung alam kung tama ito nalang ang gagawin ko kailangan unify lang isip natin lahat isang maganda example ito is si napolyon bonapart dumating yung pagkakataon sa panahon napolyon bonapart nung general siya ng france na nagsite ang directorin na i divide ang army ng france into two under kellerman at sa kanya ang sabi ni napolyon bonaparte hindi natin dapat i divide ang ating army ibigay nyo nalang kailerman lahat mas mabuting isang bad general kesa dalawang good general na nagtalotalo sa ganitong principle anong principle anong inachip niya naging emperor siya ng buong mundo di ba so merong value ang unified command sa mga incidents and yun ang gusto kung iemphasize dito kailangan meron tayong unified command hindi tayo dapat naglalaban-laban now regarding sa disaster plans ng PGH I would like to show you paano siya nagsimula so dati pa years ago meron nang mga orientations siyempre yung mga staff inorient natin na nabeng disaster plan ng PGH paano ito patakabuhin saan ang evacuation areas I would like to show you nang map ng PGH ang PGH kasi masyadong malaki we divided it into 12 different zones kasi ang hirap i drill sabay-sabay so for the sake of preparedness din divide ang PGH into 12 different zones ngayon meron zone one hanggang zone 12 and then makikita nyo dito ito yung mga buildings with the different zones ito yung PGH dito sa paligid is UP Manila yung mga colleges naman so we are just focusing now on PGH this was a drill done nursing home 2006 so makikita nyo meron na tayong working relationship with Bureau of Fire sila yung tumutulong sa atin ito yung modules paano mag evacuate kung walang madaanan paano gagamitin yung fire ladder nila paano bit-bitin o isalvate yung mga important nating gamit saan ilalagay yung mga paciente paano sila ititrik kung sa kasakaling meron and then paano tayo gumamit ng fire extinguisher properly hindi po kaya may fire extinguisher ibig sabihin alam na natin gamitin ito like for example dito tinuturo natin yung pass bull, aim, squeeze and sweet so this is important para pagka nangyari tunay ng scenario mas efficient tayong lahat 2011 so makikita nyo naman sa picture na ito meron tayong mga patient treatment areas and then meron tayong triage areas or treatment areas na color coded red, yellow, green and black red is of course toxic na paciente agaw buhay yellow is serious green is walking wounded ngayon meron tayong actually ng drill na ginawa na kailangan natin isara ang taft avenue so ito sinaran naman namin yung taft avenue hindi natin magagawa basa-basa ito kailangan natin kaausapin ang local government ang police at saka ang baranggay para tulungan nilatay dito so responding in disasters actually hindi lang tayo we involve all the agencies na importante at kailangan natin makilala sila para makilala din nila tayo para in a real scenario mas maganda na yung ating interaction so paron ko ba nag-build ka ng relationship at networking during these drills and kung wala kang evacuation space actually isasaran namin yung mga kalsada sa tabi ng UP Manila Campus kung kina kailangan and then kung titing na ninyo ito meron victim na nakita and kung mapapansin ninyo yung victim ay sinusulat masyadong ambitioso actually yung drill na minomonitor namin yung response nung mga nag-rescue at saka nagtitrate kung ano yung ginawa nila so actually may evaluation na buhay ba siya or na matay and kung makikita ninyo dito sa last picture sa right lower quadrant ito yung evacuation ang dun yung mga evacuees and then ang dito yung yung mga nakakulay blue ito yung mga observers at saka actors so do sa drill sila yung katulong ko para magpatakbo rang drill and then so makikita ninyo and dito si Dr. Legaspi siya yung isang part ng drill sa 2011 drill is there to test kung functional ba yung ating mga plans I will show you one drill kasi once na nag na karon ng fire aning isang procedure it's either mawala na kuriante or papatayin ng power alarm or gas lines person yung power so kung meron ka kailangan e-search and e-rescue paano mo nga yung makikita kung walang window at source of light yung yung building at hindi gumagana ang e-mergency lights dito kasi ako ang may dala flash light kung wala akong dala flash light paano nila paano nila gagam panangyanyong role nila so after this nagkaro na sila ngyanyong flash light yung ma-search and e-rescue so ang ang drill actually is not there for show your drill is there to test if functional actually yung planning nyo it's there to test kung applicable ba or practical ba or words lang at hindi naman pala applicable it is there actually to improve our response para kung dumatingin tunay na scenario hindi na natin ma didiscover during the drill scenario na ay hindi pala posible ay wala pala tayong flash light kaya na matay na yung mga tao so yun na principle drills are there not for show but to test the functionality of your plans so ito may pang victims ay hindi na kikita I'm just documenting para ipakita later on pag nagdebrief next drills involving patients so ito naman rehab medicine and kung makikita ninyo pati yung nanambulatory sinate so na do sila sa evacuation area kung mapapasin nyo pawis na pawis siya pero masaya siya dahil nagpapparticipate siya do sa safety procedures at drills ng PGH para sa kabutihan nila kung makikita ninyo dito sa right lower quadrant eto yung firefighting team medyo madaya kasi hindi pa nagsisimula yung fire nakapuesto na sila dalala nila yung fire extinguisher nila pero at least alam natin na merong firefighting team na alam nila ang gagawin nila in case of fire ang warning nila nang saka nila dito next time sana magsimula kayong mag magsama-sama at kung mo ang firefighting extinguisher kung meron ang alarm na naring na cancer institute so merong mga identification bracelets ang problema disaster confusion confusion chaos chaos delay delay morbidity mortality and death di ba so in order to manage disaster kailang efficient ka para one one way to be efficient is dapat kailal mo kung sinimong team members kung sinubah ang medical sinang search ratio sinify firefighters so dito nang mga identifying risk bands dito sa right upper quadrant meron tayong mga pacienting ready to evacuate again hindi pa nagsisimula ang drill inunahan nila which is na didific naman actually in purpose and drill kasi gusto natin malaman gano ba ka tayo kabilis magreact in case magkaroon ng alarm dito sa left lower quadrant makikita natin na merong mga police nang kataon ng drill na ito merong rally so we did not cancel the drill and we nagpatulay pa rin kami sa drill kasi hindi mo naman pwede ng sabihin sa sakuna wag muna kasi kasi may COVID-19 pandemic tayo hindi ka pwede ng magkasunog which is kaya ready ka sa lahat ng scenario dapat yan ang mga challenges and then do sa may padrefaura naman sila nag tayo ng evacuation area at saka ng treatment areas another drill sa nurses home 2012 ito puro PGH kumakikita nyo may X mark ang pinto para saan yung X mark niyan ang mga search and rescues pag nagahanap sila na mga nawawalang victims pag na clear na nila ng room kailangan nilang markahan para yung susunod na team napadating hindi nang mag-aaksay ng panahon na tignan ulit para wala ng repetition or duplication again efficiency mas efficient tayong lahat di ba mas mabilis natin naahanap yung mga hindi pa nahanap na areas and din dati ang ginagawa namin nagpupprovide talaga kami nang tunay na fire at usok ang problema namin ito later on is ang bahu kasi ang sakit sa ilong toxic fumes yung nasusulog na papel and then tinitig na namin kung paano gamitin yung fire extinguisher ng mga firefighting team later on ang ginamit namin is smoke machine na para safe naman yung fumes this is another drill sa zone 1 ng PGH in 2013 ito dito namin na discover na yung fumes ang hirap again wala silang flashlight so yung tunay na sinari yung maraming challenges 2013 zone 5 so anong gagawin mo pag hindi makalakad syempre wala kang choice kung wala kang rampa paano mo ibababa yung paciente so meron tayong training on how to move and lift patients or non-ambulatory victims right upper quadrant meron tayong host ang problema during this drill nakita na discover na wala ng host yung brass nassel na host and then sabi ng bureau fire yung ang problema ng mga brass nassels brass kasi siya mahal kasi siya nina nakaw so ito wala na siyang brass nassel nina ako na pala so paano mo yung gagamitin niya sa tunay na fire incident kung wala ka ng nassels kasama din dito sa drill na ito dumating mismo yung nakita ng ang journalist huy nakisama siya do nakikuwa siya ng picture and then part kasi ito ng ating drill hindi dapat di ba ak monfiden siya nang mga paciente so dapat hindi mo pinapabayang nakukuna ng video or picture ang mga paciente mo at the same time hindi ka nag-release ng unofficial information sa media kasi meron talagang tagapagsalita ang hospital kung saka sa kaling kailangan mag-announce ng statement sa media ito naman paano gamitin yung firehose dapat pala ginagamit natin yung firehose kundi magiging brittle siya zone 9 pwita natin may buwat sila mga babies mga bata nang nakakatawa sa ating mga paciente isna ko kooperate sila ito nan ambulatory patient naka stretcher hindi hila din siya mga naka wheelchair bakit tayo mayroong tao dito naka tayo in our deals anong ginagawa namin sa ang instruction ko sa mga volunteer na observers yung pinakahuling lalabas gawin yung victim itinago nila ito ang nagiging challenge sa head count sa evacuation area wala bang nawawala ang walang nawawala lahat accounted for saka ako ilalabas ito kung walang nawawala sino ito para mag-ihimates mo yung mga validate mo kung accurate nga ba ang head count which is important kasi kung hindi mo alam namin nawawala hindi mo ahanapin e kung agaw buhay na siya mamamatay ang ka 2014 nakaruntay ng central block drill and kung mapapansin ninyo dead malahat walang nagreact ang laki na na improvement natin yan after this pag na sa ibang bansakan na rinig mo yung alarm anong automatic nagagawin mag-evacuate na yung kaya ka nagpatunog ng alarm is that is the sound for evacuation wala pa sa kultura natin okay part ng drill na ito siyempre naslusunog ng building hindi mo papapasukin yung mga visitor na ipon ang mga visitors ng PGH sa main lobby sa entrance actually na paka hirap ng role ng guard dito kasi nagagalit na iba ay mayroon tayo on-going drill mayroon fire kung makikita ninyo ito yung mga nasa nursery and niku pano nila in-evacuate yung baby mayro pa sila mga manikina baby mayro sila mga aprons na pwede mo paglagihan ng 2 at 3 or 4 na babies and dito sa right Lower Quadrant makikita ninyo yung orderly evacuation maykanya kanya yung zone sila this naman pano mo yung i-evacuate yung hindi nakakalakad na pasyente ito this was done in manilamet on-going OR tapos mag-diklare ka na evacuation kasi naslusunog yung OR pano mo ibababa yung pasyente soang ginawan o manilamet dito nagprepair talaga sila Nag-dedicate talaga sila ng OR, nag-dedicate talaga sila ng OR staff, nag-dedicate talaga sila ng lappack, binuksan talaga nila para lang ma-subukan ang exercise na ito. So, habang nag-ihintay ng alarm, kunwari nag-orbo na sila, nag-pahid sila ng betadine, nag-appendectomy sila. On-going herniorapy, on-going x-lap. Actually, dalawang ng table ito. Sa tagal, bago nag-declare ng evacuation, actually, na-inip na sila kaya nag-selfie-selfie nalang sila. But finally, nung nag-declare na, na kailang mag-evacuate, so procedure is. Cover, close, transfer to stretcher, and then babasa-hadda. So, kung makikita na yung 1, 2, 3, 4, 5, 6. Anim, anag-bubot na paciente, sinimag-dadala ng monitor, sinimag-dadala ng oxygen tank, marami ang kailangan mo. Pero nag-gawa nila ito, from the top floors, hanggal makarating sa, huy, hanggal makarating sa kalsada. Na-wala ya tayo ang aking picture sa kalsada. Okay, besides that, meron ding mga ibang-classing crisis sa hospital. Like, for example, itong bomb threat drill. So, iba naman ang nangyayari sa bomb threat drill. Kailangan ang alisin mo silang lahat. Meron tayo ang tawg dito. K9, Bump Sniffing Dog. Merong tao na naglagay actually ng bump dun sa basurahan. And then, naka-received ng call, merong bomba dyan. So, nag-hanap ngayon yung Bump Sniffing Dog. And then, nung dumaan siya sa may tawg dito, dito sa basurahan, umupu siya. That is a sign na nandun yung IED. And then, siyempre, pasok na si Bump Squad na naka full protection gear. And then, nakuha niya ang bomb and dun niya dinidis arm. So, matagal ang bomb threat drill. Inaabot siya ng 1-2 oras. Kasi kailangan maingat ka para hindi sumabog. Meron din tayo ang code gray drill. Ano yung code gray, pagka merong violent na pasyente na nagwawala. So, meron tayo actor. Eto si Ayron, Canadian siya. Siyang kinuhan natin para maging violent person. So, sinusubukan niya lahat ng pasensyan ng mga staff, actually. Maggaling, actually, mga residenti natin nating mag-diffuse. Kaya, na hirapan si Ayron na mag-build up para mag-galit siya. So, inabot niya na kami nung mga more than 30 minutes. So, hanggang tinawag na nilang ngayon. Hindi na nila makontrol si Ayron. Tumawag na sila na security guard. Tinawag na yung mas senior. And then, dumating na yung mga security guards. And then, kinoconfront na nila si Ayron. Talagang hindi kasi, binibigay si Ayron. Talagang mangugulu na siya. Paano ka mag-subdue ng isang violent person? Andamin nila. Actually, mamiya, ituturo ni Ayron. Paano mag-subdue na dadalawala kayo isa ka lang? So, pag nangpatawag na co-grey, handang ating security guards to go at this point. Okay. So, ito naman, tinuturoan ni Ayron. Paano ba kayo mag-subdue? Dapat hindi siya makatayo. Dito sa second, tinuro ni Ayron kung paano. Dapat yung paano paciente hindi sa likod niya. So, hiharong niyong mga paano. Nakaharong niyong mga paanila, hindi siya makatayo. So, marami actually, crisis or incident sa nangyari sa isang hospital. And then, UP Manila, we divided UP Manila into clusters. Isang cluster lang ang PGH, which is nag-bibilong siya sa tough cluster. Sa Pedro Hill Cluster, ito yung mga buildings, sa Padre Fauro Cluster, ito yung mga buildings, and manong patayong SHS cluster na composed of the SHS colleges outside NCR. And then, during headcounts, during big drills, nag-re-report lat ito. Lat na mga zones, na-account mo. So, manong tayong headcount sa Padre Fauro, 121, Pedro Hill 810, SHS ang nag-report 36. This was actually the last NSED drill. Nag-headcount lang kami. And then, isala yung nireport na nawawala, na pumasok lang pala sa PGH. So, importante is, lahat ng buildings, accounted mo, alam mo kung ilan yung headcount, irereport mo sa team leader. Team leader irereport sa cluster leader. Cluster leader irereport sa overall incident commander later, which is the Chancellor. So, ito makikita ninyo, nag-re-report sila kay Chancellor for the final situation reports. And ito yung example ng evacuation during our drills. So, ang purpose ng drills, bakit ay nag-didrill? Para malaman natin kung alam ng staff natin yung plan. Para kung applicable, or magagamit ba natin yung plan natin kung saka-sa kalimang yari incident? And then, tama ba, tama ba yung pagkaka-apply natin sa plan? Do we know how to apply it? Pagsinabing, orderly and efficient calm evacuation, tama bang calm evacuation no nagtatakbuhan sila. Or later on is, pwede ba natin improve? Ano yung pwede natin improve sa plan natin? Pwede pala, hindi pala tayo pwede mag-evacuate dito ang ilaw, hindi natin makikita. So, pero tayo action point. Either lagi natin emergency light or dapat may flashlight tayo in these instances. So yun ang purpose ng drills. Drills are there to test functionality and para may improve natin para pagdumating yung tunay na event may ibsan natin ang casualty at yung injuries. So, moving forward, part ng challenges natin ngayon kailangan ba natin mag-conduct ng drills pano tayo mag-evacuate kasi may COVID-19 restrictions? Yun ang bagun challenge natin yun. Conduct drills now including the handicap of observing the new normal. Pano tayo mag-evacuate? Observing social distancing dapat nakamaskin PPEs and hygiene. So, pano tayo mag-evacuate? Mayan tayong open spaces. Siguro kailangan natin i-identify ang area na open space and then i-compute natin ilang tao ang kayang hawakan ito for evacuees and then, multiple evacuation sites para masunod natin yung new normal. Ganyan naman talagay. Ang pandemic, mukhang hindi na siya mga wala. So, hindi po kailangan tayong pandemic yung hindi naman susunod na hospital. Kailangan natin mag-handa. So, we can still conduct drills following the new normal. Added handicap, added challenge, pero kailangan natin. Kasi kung hindi natin gagawa ng contingency plan ito, tayo din ang magsasafo in the end. So, my references for this presentation, yung manual ng UP Manila DRM, Hospital Preparedness for Emergency Course, yung ICS Philippines Field Operation Guide, FEMA ICS course, yung PGH drills from 2006 to 2018, the Manila Bed On-Going OR Evacuation Deal, and the UP Manila DRMH Center Command Training Module. And my last message is time and chance happens to them all. Pagsinabi natin risk, it is the chance of a negative or positive event okureng. Kung negative event, yun yan, fire. So, time and chance happens to us all. So, oras lang actually hinihintay natin ay. Kung malas tayo at nangyari sa atin hindi tayo kawawa tayo. And I think hanggang dito lang po ang aking message. Thank you very much. Thank you very much. That's Dr. Charlie Gondran, who is the head of the disaster risk management program of UP Manila. Thank you, Charlie. I mean, now you can take a look in the chat box and you will see how people are appreciating your presentation. Nangita natin, yung response ng Rodney Chanigap that courage and leadership is very important, but also equally important is preparedness. And for a hospital to be prepared or a area to be prepared, you've got to have somebody who is Charlie, who is focused on the preparedness. Sabi nga niya, kahit na may COVID, kailangan parin ng drill. I think this is a very important message because it doesn't mean we have no earthquake risk. It does not mean we will have no flood risk or fire risk or any kind of any kind of disaster or emergency. So the preparedness is just as important as the dedication and the leadership of our people in the hospitals. Now we're going to call back everyone. So Rodney, Gap and Charlie, but PGH is here in full force because we have some specific questions that we are going to ask. So I'd like to call on Nina Berba, Nina, PGH Hospital Infection Control Unit. Doctors Stella Marie Hose PGH Deputy Director for Operations. Dr. Jubert Benedito. PGH Doctor Care Unit. Doctor Scarlett Tabunar Lead of the UPPGH COVID-19 Bayanina Operations Center and Jonas Del Rosario who is spokesperson of PGH. Now they're not all going to lecture, don't worry. We have one question each for them but there were very specific questions that we wanted to ask. Anticipating what the audience was thinking and we'll pull out a few questions from the audience as well. But before we ask them the questions maybe it's fitting that right after Charlie's talk we go to the mentimeter. So Rima, let's go to that and let's get the answers to the questions from Charlie. And Charlie, look into the chat box. You'll see how many people go. I'll have to. Yeah. Okay. Go ahead. All right. So we have a little less than 250 people who think that for the first question which is on a hospital internal event could be one of the following. The options stated here are fire, earthquake, bomb and hostage taking for wala pang nagtake obviously nang bomb and hostage taking on its own. Specifically all three above ang marami po nga pinili ang pinili po na karamihan ng ating sumagot sa ating first question. And then for our second question ang ating second question naman po has to deal with the stay and defend concept. Oditi ko lang po ang options po ulit although most of our attendees who answered and participated here numbering more than 300 those of them chose all of the above. The options put forward are construction barriers to block fire spread between zones, location and condition of design doors and windows to block fire spread between zones, space between different buildings to prevent fires spread between buildings and existing system for heating for HVAC, heating, venting, ventilation and air conditioning to prevent transfer of smoke and gases into uncontaminated occupied areas. Okay. So any comments po with regards to the answers given maybe we could call on our last speaker, Dr. Goon Brand dun po sa mga sinagot ng ating, ating attendees sir. Hi. Actually all the answers is all of the above, lahat sila all of the above. So I think after the lecture na laban na naman nila na everything yung ni tamagsagot na. Okay. Thank you very much. Thank you. So the answer is all of the above for both questions. We're going to go really quickly into one question for each of our other resource persons coming from the Philippine General Hospital. So we'll start with Dr. Nina Berbaho is our infectious disease specialist and Nina, were there any risks for COVID spread during this evacuation? Go ahead Nina. Hello everybody. Thank you for inviting me here. So I think yung talaga yung fear and anxiety that's going through the minds of everybody na baka naging super-spreading event. But fortunately for us with the leadership of Dr. Dofitas nga and actually katabi ko po si Joel Sanchago yun. He's one of the heroes. He was the one that Rodney was describing kanina inside the third floor. So kasi mga ano na sile mga disciples of infection control. So even when we were not there buti na lang, they were there. They saved the day, they saved the night, they saved the whole PGH kasi very logical yung naging approach nila. They started off evacuating the the non-COVID patients first and then later the COVID patients. So there was really no mixing so if some of you listening to us right now thought that there was a lot of mixing. They described the scene talaga as very organized. People were following instructions. Tapos immediately na nasegregate nila yung highly infectious COVID patients sa ibang part ng open space. So there's some semblance of control, infection control. So we're still carefully watching what's going to happen. Pero so far, there's been no reports of COVID-19 happening among the watchers among the patients na non-COVID patients. So wala pang nag-convert to positive in today's already parang the 5th to the 6th day post the event. So we hope wala talagang anju events na nang mga yayada. Thank you. Thank you very much. That was Nina Verba who is the head of the PGH infection control unit, infection unit obviously living general hospital. We also have Dr. Jubert Minidikto who's head of the critical care unit management team of PGH. And Jubert, we wanted to ask also about the effects of smoke. Rodney and Gap showed us the thing smoke that went through not just the area where there was a fire but the rest of the hospital. So, Jubert, you're a pulmonologist. What is the what were there any risks for smoke inhalation for patients and for those who are evacuated and for the staff of PGH? Good afternoon everyone. Definitely, there is a risk because anytime there's smoke especially in closed spaces when someone goes in definitely there will be risk of smoke inhalation injury. So ang pinagusapan po natin dito ang init po ng apoy, kasama rin yan pati ang smoke mismo, ang init po or the heat itself medyo upper airway po ang effect niyan tapos ang ibang combustion by products medyo lower airways. Ang kanilang end result inflammation of airways can occur so that may lead siyempre sa hypoxemia or low oxygen and of course ang difficulty of breathing po. Kaya napaka important yung mask I think Rodney realized that proper wearing of mask and of course establishing yung ventilation din kaagad ay I admire the firefighters na talagang they prioritize na di ba pinapalis nila yung mga wala naman kinalaman dun sa area and in fact they were encouraging the residents who were there who were trying to help to go outside and then to aim for well ventilated space. Yung po ang main problem namin ang isa pang problem yan siguro is that yes it can specifically exacerbate underlying pulmonary conditions. So yung mga non-covid po namin na let's say mga may asthma mga may COPD po di po talagang atakihin yan because of the smoke and not just of the heat but the smoke itself na ma-inhale nila kahit na malalayo nila napaka sensitive pa naman ng airways nila. So I'm glad this was handled well lalo na pinunta sila dun sa well ventilated areas and I really commend yung mga respiratory therapies medical and paramedical staff na talagang maskin yung critical patients namin naunahan nila na dapat may oxygen doon sa pupuntahan na doon na dapat nakastanba yung mga ventilators namin na fully charged yung battery. Thank you po for the time. Thank you very much, Juebert. So that's Dr. Juebert Benedicto who is the head of the critical care unit management team of the Philippine General Hospital. Okay, we're going to call now on Dr. Stella Marie Jose who is the deputy director for hospital operations and Stella, you were working on logistics. Yes. Finding people with Yes. So go ahead. Go ahead, Stella. So for our residents or first for our interns we decided to send them all home to keep them out of danger but some of them still volunteered and then later on for the two to ten we asked them to come in to help out in the cleaning up operations and as mentioned by the other speakers really the PGHs really our healthcare workers really are I would say dedicated and they are really they're very helpful and just like for example the nurses in the NICU they had to go up and down the stairs five times to bring down all the babies so we really appreciate their efforts and there's no words to express our gratitude to all our healthcare workers we have seen the pictures in the chapel and the nurses were supporting all the patients there we have cancer patients pedia on co-patients and they were all very appreciative of the nursing staff as to the logistics we offer health operation that's our part mainly and we after the par has been controlled the OR was checked and the instrument and we're taking into account all those damages and for example we need an autoclave and there's an organization the Father Barbero Foundation who's helping us procure the autoclave machine there are many other things that I can cite but I don't think we have that time so thank you for giving me this chance to speak thank you thank you very much Stella and I think actually providing for the needs of all our nurses and their staff who were there on the scene I mean this is a high traumatizing after it we can talk but it's quite traumatic to remember going up and down the stairs Stella has described five times to rescue babies this is not something that does not affect people so I know you're taking care of all your health workers Stella so keep up the good work I think it can happen to my health workers yes and if I may add going up the stairs the fire was still ongoing you can be blocked off and you cannot anymore go down so each time they go up the stairs they're risking their lives for the patients they're really ang babay talaga nila and they're so dedicated to their duties thank you to all the nurses and the nursing aides and all the IWs who are helping the evacuation thank you very much Stella okay we've got Scarlett Dr. Scarlett Miya Tabunaru who is head of the Bayanihan operation center and just quickly Scarlett I understand there's some from all over the world from all over the country how are you managing this? yes po na I'm in charge po kasi of the donations but coordinating the donations coming in for PCH and also the Bayanihan operation center as what director Gap showed earlier there was really an outpouring of donations right at the very first few hours after the fire so we really had to coordinate and make sure that all the donations would go to the proper channels and BNOC also offered its services to the PCH to be a channel or to do it for the donations to come in so right from the very start we can feel that a generous nation is really waiting to give us a helping hand so from the start po we were swamped by food non food everything that PCH might need at that time po so we managed it like before in COVID para po nadejabu kami so from our experience from COVID we were managing the donations and putting up the right channels where we would give the donations and who are the recipients from the I think it was overwhelming but it was a happy problem for us that people are really generous and supporting us it's just that we know there are a lot of well meaning people who are making initiatives and calls for donation and we know that the public is now doing their due diligence in asking and verifying if all the donations donation calls or initiatives are coming from us so we thank you we're really grateful for your help our only request po sana is all the individuals group of people who want to make an initiative for our calls for the nation to coordinate with us all the donations for our welcome is just that people and the public and the community are asking us to vouch for some donation dives if the drive or the call was not coordinated with us I hope you understand that we cannot vouch or verify for this cause but we are really grateful and appreciative of their efforts because I know they are all well meaning and I can't say anything else but to be thankful to our Kababayans for the Bayanian spirit they have shown our hospital once again if somebody needs to call what number do they call? the Bayanian center is 155200 I think earlier you showed are the official pjh infographics on where to call whether they're donating food non food non food in kind cash online infographics were already shown earlier and if you need what to call pjh directly rank line is 8554 8400 okay thank you thank you Scarlet we're gonna post that in the chat there's a jpeg of the poster that was posted on the chat for those who would want to download a copy para lang ko they have ready reference for it yes sir okay thank you last but not the least one of your favorites the audience loves Jonas Jonas how are you doing in terms of communication and media I think of course there was a lot of news coverage but I understand that people were taking pictures and photographs were being circulated without permission from people who were from patients or from staff how are you doing now with communications and media malaking bagay po yung media so the first thing I did was when Rodney sent that alarm at a message cap and malamang sigap did not get my message so I said malamang this is a big incident of me being the house and asking what's going on sabi ko tulong nga lang din po anyway just like pgh style kung kinong pwede kumunta so I went there I was there at the scene and I know Gap and Rodney were busy in the operating rooms sabi ko I'll try to help sa atrium, sa chapel I'm a pediatrician so I know the kids were in trouble making sure that the residents know so at least being there help me understand what's going on, get a big picture and eventually I have to talk of course to Gap and we discuss ano bang ilalabas natin making sure as always that we will have to be timely in sending out the messages we have to be truthful what are the things that are really happening where the fire happened ano ba ang mga detail I think we lost did we lose Jonas? I think so I can't hear him anymore okay Jonas ang jampasha okay I think we lost Jonas for a moment there maybe when he comes back he can finish but you have two short questions from the audience Raymond let's take those now we're past the top of the hour so let's take the questions first question we will call in someone who is also not unfamiliar with us he used to be a vice chancellor also very prominent in the OBGYN community may we call on Dr. Mario Festin if he is on the call already to ask his question live Dr. Mario thank you Raymond thank you hello Susie and congratulations to all our colleagues in PGH my question is well many years ago I was there in one of the fires in PGH and I helped in the evacuation and it was really very difficult to transport patients carrying them down the stairs over using stretcher by stretchers is it time to probably try to make some ramps incline drums in between floors so that we could use natural energy rather than relying on elevators so it's not only for disasters but for everyday use for easier transport of patients it will also be it was really very difficult to help to carry patients at that time thank you okay thank you maybe maybe that's for Gap Gap what do you think? yes the current building code requires all hospitals to have ramps already but the building of ramps in our current setup could be very difficult because of space constraint so I think this is more for new buildings but nevertheless in the planning taking all the lessons from I think at least we could just learn from it in fact the initial discussions I had with the architects that are doing the master plan for PGH ramps are being considered but I think in a modified way maybe it will find ways to make the manual carrying down of patients easier and we will leave it up to the experts to make suggestions on this the usual ramps are outside the building they run across the walls of the whole building and that will provide a big challenge that will give us a big challenge to do that but we will see how this could be incorporated in the near future thank you Gap thank you Raymond do we still have one more question or I think we were supposed to have one from the nurses sector I believe we might have lost him in the call but Dr. Jonas is back so we could hear from him again Jonas you might want to finish yours go ahead I think what is important is in terms of having a crisis is really being able to be available to connect with the public but making sure that whatever information we are getting out there should be factual and then as always I have to ask the director what messages he wants me to put out because I am representing PJ so nothing coming personally from me so usually every day at the start of the day ako po ang nangungolit sa operations team may bago ba, may run bakon dapat sabihin because where is from the media kung mo sa napo ang PGH the usual questions kung mo sa napo PGH kung mo sa inyong operations may run bako kailan baka yung magbubukas clearly this disaster was very impactful we had to close the operating rooms the ER right now is closed the issues about how does it affect our COVID operations usual questions of the public that we have to address every day usually I eventually will have to ask our boss kung dapat kung sabihin and then buck also lagi kami nagubuusap behind doors kung ano ba dapat may address because PGH I just realized that parang marami talagang interesado kung ano nangyari sa PGH and lastly because of also being out there in the public I think it it created a lot of noise and then really the outforing of so far just like what Mia was saying kung po ang isa sa mga nagsabing dahil nandong nang gabi na yon nakita ko na hulang yung pagkain so bumili kami but I also nagpadala na rin ang messages and so sabi sa akin daw ang dami po nagpupunta dito nagdala ng breast milk I think this is probably one day na ang umayoko na yung PGH na sa dami po na nagdonate ng breast milk you just imagine that PGH is like a magnet of good will of goodness so dahil nga po doon I think it's very important that we thank you so that's Dr. Johnas de Rosario is the spokesperson of PGH and we're out of time I think Raymond we're going to launch our evaluation but while we're doing that which will flash on your screen we're going to ask for some parting words we'll start with Charlie what's your message to our public it's better to be prepared anticipate, prepare and especially work together be unified kailangan natin yung unified command in answering or responding to disasters thank you very much Charlie Gap go ahead if I may have some time just give an update on what's happening I think people are all wondering what's happening now well the damage has been estimated and the damage is mainly on a lot of equipment and instruments for surgery so that's going to be very challenging for us to replace and we're working on that of course the other challenge is how to prevent this from happening again as we speak Meralco is already checking our lines for loading the Bureau of Fire is already here conducting their assessment on how to improve better and they have advices on what we call first aids in a situation like this where the first thing we do is improvise on our ability to respond to the fire simple as getting the right fire extinguisher I think that those are very simple maneuvers that they advise us from here on I think as Churchill always said never let a good crisis go to waste we have learned our lesson we have shared I think we share these lessons with all the other government hospitals who are very who have difficulty maintaining old buildings like ours so from here on we look forward to a bigger and better PGH and better to serve all of you of course thank you very much Thank you very much who is the director of the Philippine General Hospital Rodney, your last words to our audience Thank you for your sincerest words of condolences from all the audiences I'd like just to mention that simple as pay the course work as one team and work together I've just failed to acknowledge all of us were working since the start of the COVID period ang unan namin hinanap at the start of COVID period were nurses to mandate COVID words sa first volunteer was Mr. Kintin Bagay and nung kasansagan ng suno among the first one to volunteer he is a fire volunteer so yun din siya yung tumulong how to direct all the volunteers but where to go at siya ka anong hindi isisarain sa PGH talaga salut to all the firefighters and all the security people hindi natin sila napapansin pero salamat sa mga dina thank you very much to everyone thank you very much Rodney Raymond did you want to say something about the evaluation or we can go forward with mention just a very quick update po we have well more than 700 of our attendees who were able to answer our evaluation poll marami salamat po these are the results and mostly it's on the strongly agreed na po in terms of thorough knowledge of the topic well-preparedness and organization being able to speak clearly and audibly the use of appropriate language with technical medical targets adequately explained and most important of all the panelists contributions to new perspectives and knowledge on managing barriers for COVID-19 health issues. Over to you Dr. Suzy okay thank you we're going to close with UP Manila Chancellor Menchit Padiria Menchit please correct me to our speakers and panelists we thank and commend the PGH management under director gap the PGH health workers the firefighters and the security guards and we do have some few take home messages become don't panic know the protocols for evacuation stay the course follow the instructions believe in the system disaster preparedness and response is a community effort must be a one team so the next time there is a drill please join it can save your life and your patients lives back to you Suzy thank you very much that's Dr. Menchit Padiria the chancellor of UP Manila okay next week what we were supposed to have today was a grand rounds on COVID in a young adult and I think there's a lot of interest in that because from the very beginning we've been talking about serious COVID mainly in older persons but we are now seeing young people with severe and moderate COVID so we're going to take that up next week don't miss it so yeah over to you Raymond thank you so much Dr. Suzy and thank you for that very succinct again po na closing remarks really it's all about preparedness and mitigating all of the risks para po tayo ay magpatuloy pa rin po with our daily lives and our work flows and obviously continue to care for our patients and next week we will be tackling on a more clinical perspective po no a patient that was previously healthy naman po and because of COVID there were complications na lang po that the patient has to deal with please stay tuned at magkita po tayo ulit next week Friday from 12 noon to 2pm it's a date together we can stop COVID dance keep safe, keep healthy and see you online do I have strength to carry on my God, how long was this gone and if you're here to keep me strong I'm here to hold the line I'll keep my head worth till my head's dying my fears the others laugh before my tears but right behind at mass I'll look into myself and ask do I have strength to carry on but if you're here to keep me strong I'm the same before my fears pushing on the spite of tears please stay through another day