 Magandang araw sa inyong lahat. Good day to all. I am Dr. Carmencita Padilia, one of the proponents of the newborn screening program in the Philippines. Join me in uncovering the wonderful story of the newborn screening program in our country. And together, let's zoom in on what makes newborn screening a comprehensive program for every Filipino here at newborn screening in focus. To ensure that newborns are truly healthy, they must undergo newborn screening, a public health program that helps determine if a baby is born with one of the more than 20 congenital disorders that can be picked up at birth. Its importance cannot be overemphasized. If any of the congenital disorders is left undetected and not managed immediately, it can lead to mental retardation and even death. It was integrated into the public health delivery system with the enactment of the Republic Act of 9288 or newborn screening act of 2004. Now, part of the PhilHealth newborn care package, newborn screening is being offered in more than 7,000 hospitals and birthing centers nationwide. It has also saved thousands of babies, now children and adults. This educational series is intended for health professionals who deliver services of the newborn screening program. Whether you're online or offline, this program aims to further enrich your knowledge in newborn screening and be able to apply the highest quality service to Filipinos, especially during challenging times. We will discuss the very process of newborn screening from the moment the baby is born and into the continuing care available for newborns found positive. We will also zero in on the features and manage and management in each of the conditions included in the newborn screening panel. We will also interview patients and their parents. And in keeping up to the challenges, talk over how facilities and centers manage to give quality service despite the limits brought about by the COVID-19 pandemic. This program is the newest educational platform for our newborn screening coordinators, one in every 7,200 health facilities throughout the country. We also hope that this series will also benefit the health professionals, physicians, nurses, midwives, nutritionists, medtechs, as well as the students in the health professions. So take a seat, get comfortable as you're in for quite an adventure here at Newborn Screening in Focus. I'm Dr. April Grace Burboso. I'm a pediatrician with a subspecialty in clinical genetics and I'm currently the newborn screening coordinator of Dr. Jose Fabella Memorial Hospital. Ang Dr. Jose Fabella Memorial Hospital ay naglilingkod sa mga nanay na nanganganakan, katiling usually sa Manila, Greater Manila area. So we have about 400 bed capacity. We have 30 newborns a day roughly. During the height of the pandemic, we had additional areas which include the areas for the suspect, for the COVID suspects and areas for the COVID positive mothers, for the COVID positive babies. So many areas were added. We had a number of trained staff during that time to do newborn screening sample. At that time, because there was increase in the number of areas that had to be serviced, there were times that we lacked the trained employees on the newborn screening collection. At that time, there were some delays in the newborn screening sample collection and at that time also there was an increase in the unsatisfactory and contaminated sample. So what we did was as the newborn screening coordinator, I talked to the staff, to the nursing staff, to the midwifery, to the newborn screening staff. And we looked at the problem and we saw that there were lack of trained newborn screening midwives and nurses at that time because of the increased areas. That's why we requested for skills training from the newborn screening center NIH and from the Department of Health newborn screening unit. Now we have more trained newborn screening staff at Josef Abela Memorial Hospital. During the time of the pandemic, we learned that of course the mothers will continue to give birth and babies will continue to come. Our newborn screening services couldn't stop. Also, we cannot compromise the quality of our newborn screening procedures and our collection methods. We learned that by coordination, talking to the staff and asking for help from the different stakeholders such as the newborn screening center NIH, the newborn screening reference center, will be able to overcome that problem and we got the answers naman in the response from the different units. Sa newborn screening, alam naman natin ang goal niya is to save the lives of babies. So timely newborn screening in order to save the lives and also to maintain quality of lives for the babies. So you shouldn't be complacent whether it's pandemic or not, which should do our best to do timely and efficient collection of the newborn screening samples. So we'll be able to screen the babies correctly and save them on time. For this episode, we will talk about newborn screening in the time of COVID-19 pandemic. The local transmission of the coronavirus disease 2019 or COVID-19 in the Philippines resulted in rate adjustments in the healthcare arena, including the newborn screening program operations, where timing is very critical. With a total lockdown, temporary closures, and modified schedules of the official courier partners, the transport of newborn screening samples to the newborn screening centers were halted. In this episode, we have invited two special guests to share with us the challenges they have experienced and how they address this to facilitate continuous quality newborn screening. Here with me to discuss this topic is our nurse from the newborn screening northern Luzon, Anthony James Almazan, program manager of NSC NL. And we also have Michelle Meg Gilaran, program manager of the newborn screening center in Mindanao. Welcome to newborn screening in focus, Sheila and AJ. Let's start our conversation. Let's start with how long have you been with the program? Sheila? Ah, hello ma'am. Magandang araw po to all the to-you-chancellor Padilla and to all the viewers of TVU screening series. Okay, I started newborn screening in newborn screening center Mindanao in 2009. So magde ten years na po ako sa programa. And I've been through many challenges na rin sa nil sa dito sa Davao. Ten years, ma'am. Actually, I don't have any body here. So talagang, adventure talagang up na ting sa Davao. Pero I'm not really new sa newborn screening. I have been exposed to the newborn screening program before 2009 at UPI's machine. Thank you. Thank you, Sheila. What about you AJ? How long have you been with the program? Hello daw, good afternoon and to all the viewers po. Though I've been with the program since NSCNL started in 2017. So I'm four years in service now po. Okay, so ang tanon po sa inyong ngayon ay. What is different in terms of your responsibilities? Maybe you can say a little about what is your overall responsibility in the center. And then how was it before COVID and now under COVID. I'll start with AJ. Okay, daw, I am the program manager of NSCNL. And our responsibility is to check on the proper implementation of the program in our jurisdiction, which is regions one and two. So with that po, we are responsible for monitoring, evaluating the program. And as to the difference po na pre-COVID and this COVID experience. Actually sabi ko ng first week daw ng ECQ parang it's been a month. So parang ang hirap ng COVID experience. Dahil unang wala kaming ming sample na na re-received. So parang hirap mag-received ng sample from the NSF. And also we have to think of the operation of the NSF also. So dalawa po yung iniisip namin. The NSF and also the NSC operation. Okay, so dalawa yung pillow problema nyo. Just for our viewers ang tinatawag ng AJ na newborns na NSF. These are newborn screening facilities. These are the hospitals and the birthing centers collecting the sample. Yung kanyang pinanggit naman na newborn screening center. This is actually the laboratory. And your laboratory is based where? Where is the center base, AJ? Doc, we are located po here sa Mariano Marcos dito po sa Patap City. Kailakos, northe po. And how many hospitals and how many facilities are you servicing? Total? We are servicing more than 700 hospitals po, in the regions 1 and 2. Okay, so thank you. What about Kenshila? Ma'am when I started in 2009, actually, covered ko po lahat ng administrative aspect of the program from the accounting to the procurement, to the human resource development, even to the program development. So medyo malarok talaga ang aking part. So meron kaming program at laboratory manager who handled the laboratory part. But as I said medyo malawak talaga ang administrative part. Challenging na noon ng wala pang COVID, pero naging medyo doble challenging ng COVID na. Kasi mahiap ng sa career, wala ng career, meron pa kaming ihandle ng human resource na hindi mo dapat sila. May mga working arrangement na may implement ang civil service to prevent COVID infection among the workforce. Tapos meron pa rin kaming mga laboratory procurement issues nung time niyan kasi wala ng career to transmit the sample, as well as we cannot procure the supplies and bring in the supplies. So wala kasing airline, operations airline. So medyo may hirap talaga. Presently, sa awan ng Jaws, hindi naman nag-close down ang center. Meron din ba ang positive cases nung time na yan nung juring kasagsagan ng COVID, pero so far hindi ko nag-close down ang center. Thank you Sheila. So just for the benefit of our viewers, I just want to share with you that the structure of the newborn screening program is such that the 7,200 health facilities are actually divided in terms of location and as to where they will submit the samples. So as you've heard from AJ, NSC NL, NSC Northern Luzon, received samples from the hospital working centers of Region 1 and Region 2. As for Sheila, who belongs to the NSC in the now, they covered the whole of Mindanao and actually they have about 1,800 facilities. Sheila is sitting there. I think 1,300 if I'm not mistaken. Yes ma'am. So this is something probably that most of our viewers are not familiar in terms of operations, but you can see that the operation of every newborn screening center is really very complex and now with the COVID became more difficult and that's going to be part of our discussion on how we were able to adopt the program. So let me just talk about the staff first. Before we go to the challenges for the program, kumusta naman yung staff nyo, AJ and Sheila when COVID struck a year ago because it's been a year now. How would you describe the feeling, the spirit inside the newborn screening center? Let's start with AJ. Yes. At first po, very anxious lad ng staff dahil takot silang infect ng COVID and what is good po is no one got positive ng COVID-19 from our unit and we remain operational all throughout the crisis and as of now po, staff are physically, socially and mentally healthy and we follow ating health protocols inside and outside of our hospital or work premises po. What about in India now, Sheila? When you said AJ, na dundin yung first few months of the COVID pandemic and dundin yung fear and dundin yung uncertainty, yung anxiety and yung worry then for the other than the staff yung program operations paano ipadala yung samples paano ipadala yung matanggap yung sako sa amin. So aside from the health ng staff namin, may program concerns din po ma'am. So we deal with it every day as the days passed by nung COVID-19 at nag-ahalap kaya yung solution nakaupakaming yung solution na nadoo na yung confidence and confidence and uncertainty nandun na rin yung hospital who has provided so much with the safety measures also management and si Minda now mismo administrative that provide safety measures. So medyo na bawas na naman sa ngayon yung fear and anxiety. Pag-usapan natin isa-isaya na Sheila. So na rin nyo, pareho si AJ and si Sheila na meron talagang mga agam-agam nagsimula ang programa at sabi ng AJ nung unangata walang sample dalulang courier. Yalangan natin naintindihan ang proseso para makalati ang sample sa laboratory ay the courier and nung nag-lockdown pag-imang issue. But I'd like to share with the audience that if you remember from episode one I explained in that lecture that the coverage of newborn screening in the Philippines actually only dip by 12%. So parang sinasabi ko dito na bago nag COVID ang coverage ng newborn screening sa buong Pilipinas nasa 92%. Nung after COVID, after one year of COVID we went down only by 12% and really that is really a that's amazing. Nakakatawa talaga hindi tayo mo siya dumubaba kasi yan dahil sa lahat ng ating newborn screening center ay gumawa ng paraan para mapaksilbihan ng hospital and boarding center. Jana atin magsisimula ating episode ngayon pag-usapan natin kumusta ang operations ngayon under COVID-19. So AJ, maybe you can share maybe what were the most challenging cases that you had in either Region 1 or Region 2 and give us the join me for these very specific challenges. AJ? I remember dog yung meeting namin with NSRC no March 17, 2020 that parang may advise na in case that NSC will not receive samples we might close temporality. So with that fear ko parang nagsip kami ng strategy how to facilitate ating receiving of sample from this NSF. So we experienced one time ang nareceab lang namin na sample is sample lang so with that number of sample parang inisip namin sayang your agent but still we have to test them so sa amin sa program with that issue ang inisip namin yung pang partners na pwede like the Philippine National Police who are having their duties at the provincial border sila po yung aming kinausap para i-allow yung mga newborn screening facilities nearby to send samples sa amin directly and also for the province of Ilocos Norte we talked to all the hospitals na magkarao ng drop of points among the area para yung mga malalayo na hospitals drop to the hospital near our area and then ipipikap po siya na aming mga staff doon so from there dun po kami nakapugot ng mga idea namas implement pa yung aming advocacy and also yung strategy namin na yung newborn screening by and hand strategy. So AJ sabi mo, you have drop of points so how many drop of points did you have in region 1 and then in region 2? I think for region 1 we have identified 6 for Pangasinan and I think 5 for La Union and also 5 kasi ang geographical area kasi ng Ilocos is pahabap po so dun din yung isang challenge sa amin especially that Ilocos implemented one of the most strictest community quarantine sa Luzon so ayun, kailangan nalagang aming mag accept ng drop of points among this area and for region 2 I think we have I think 16 po din na facilities na from different provinces po including those that are considered po na So Pangasinabi nyo where as before pinipicap sa Bawa to hospital this time yung hospital mismo ang nagdadala ng sample sa drop of points and with that we will go to 5. Yes po. So sa Mindanao, Sheila how did you handle kasi laki ng Mindanao and you have how did you what we did during the first few months is to address muna yung samples within the city so inuna na yung namin yung samples within the city we call we have several big hospitals so at least yun lang naman ma-address namin so continue yung operations na lang mga new birth screen dito sa malaking hospital like SPMC, our own dali lang so din na transport dinadala lang nila from the new birth screen collection ng hospital para saan malaking samples na siyang at 36 spot that time per day na-address namin within the city we ask the hospitals or the facilities inside the city to bring the samples to us fortunately din merong isa 2-3 years na operational pa at that time na they work within the city lang so yung na-address namin yung facilities within the city so okay na siya so we accept samples within the city then we go outside the city so pang nag-outside na kami like pijon 9, 10 11, 12 karaga and arm so na una actually nag-ask kami assistance from DOH regional offices so nag-response pijon 10 pijon 11 pijon 12 kasi di they can transport the samples via land so madali lang po nito mam so they use their own transportation first what they did was call at na ng aging may drop of hospitals then or points sa kanilang provinces so nagset nagset silin ang hospitals where they where the facilities can drop off their samples to these provincial hospitals na DOH will schedule pick up of the samples from drop of points then the regional offices the NBS team from this regional offices bring the samples to us so kung region 10 ka ang office ng regional office so they travel first they pick up the samples around the kanilang provinces then they will travel this to us sa Davao dito din ginawas karaga from butuan inikot nilang nearby facilities sa butuan so nabild nilang sa Davao the most challenging duns arrangement na yun was sambuanga kasi they have to fly we have to fly in the samples kung land trip kasi ma medyong matagal siya so what we did we tapped the Philippine Air Force to bring in the samples ang medyong difficult na dun kasi hindi araw-araw yung schedule ng pag-flying ng kanilang aircraft so meron talagang schedule ninsan pumaabotan isa sa isang lingo ninsan sang besi sa dalang lingo but we really try to bring the samples sa Davao yung regional office ng sambuanga pininsula nag-tap din sila ng mga drop of points at simbuanga pininsula para sambuanga city e-endorse yung samples sa Philippine Air Force ako sa Philippine Air Force if applying dito sa Davao ng mga samples so yun yung na-dress namin mga outside the city so from every week ma may delete reek kami ng regional offices yung arm mam yung medyo ang pinaka active nung time na yung isang may pop-up so they give the samples to kagayang dioro to si regional office region 10 si H-10 so si H-10 pinapadala dito sa amin meron din ng mga malalaking hospital mam like Subtown Kadarat Provincial Hospital na sila na rin ang nag-gather ng mga samples within the area ako sila na rin ang nag-pop nag-transport ng samples sa amin so yun mam ang arrangement namin before wala pa for a year thank you sila alam mo nakakatawa paking ganyong story nyo na kasi if I go back to 25 years ago nang nagsisimula pa lang ang programa ako ng tanong ng mga hospital e pa na dadalin ang samples sa laboratory and para bang it became part our responsibility to make sure that we pick up the samples kaya naging proseso natin yung courier service but I think itong COVID-19 pandemic has shown that this is a time when we just have to find ways together at takita natin sa dalawang example yung the society getting engaged in the solution identification of roughly points big hospitals bringing the samples for other hospitals and that para bang kailangan gawan ng paraan hindi pwede hindi hindi and puwede naman pala talaga kung talagang pagsasabasa mahi natin talagang examples and na rinig natin kaisila yung challenges every region as a challenge and the people will have to work together with the Department of Health and the Newborn Screening Center to come up with the solution at halo-halo na yung ka dila solution sa pinigay so na rinig natin ang police na rinig natin ang Philippine Air Force babalik ako ngayon k A.J. hanon yung hinandal ang batanis ay ganda sobrang hirap actually ni batanis seems talagang total lockdown for how many months so what we did po is to contact yung ating nbs coordinator sa batanis general hospital dahil three facilities lang po ang active doon batanis gen itubayat which is far from the main island ang batanis so sobrang hirap ko talaga kaya we have to connect also with the provincial DOH office and the provincial health office of batanis para lang makakukuhan ng solution and they gave us the idea na what if we contact natin ang Philippine Navy so with that po putin na lang po that time ay schedule ang Philippine Navy na pumukunta once a month so with that medyo medyo we felt we felt overwhelmed kasi parang we will may support kami na makakukuhan from batanis to test the samples from batanis and what is good pa doon is with the health ng DOH region 2 CHD2 mas na facilitate namin yung pag-receive ng sample kasi it's either Philippine Navy dadaan ang Santaana kagayan then the regional coordinator doon sa region 2 will have to go to Santaana kagayan and then isa-send niya yung samples through LBC doon yun yung isang way then the other way naman is si Philippine Navy will may may port sila sa Laon doon and then from batanis to Laon doon to CHD1 naman nang to pick up sa 4 point sa San Fernando Laon doon and then the NBS coordinator to region 1 will be the one through LBC or yung ating official career partner po then with that arrangement doon pa namin na facility yung yung sending ng sample from batanis it takes time pero nakakatawa pag-receive namin ng sample dito siya NSCNL kapag nakita namin na yung envelope is from batanis sa around 2 ang 2 ako kami dahil will have a chance to save the babies so ano po very nakakahapin na nakakapagod siya pero it's it's worth it naman po Thank you A.J. na-renid nyo na mo lang batanis hanggang sa buhangga in the new bursary ni program sabi ko nga ay we are in 7200 health facilities and with COVID-19 we just had to go back to the drawing table and find out paano ba natin pararatingin ang sample mula sa boarding center papunta sa laboratory yung pala ang pinagusapan natin ang unang asusunod natin tanong kasi pinagusapan natin yung sample mora sa hospital pukunta sa laboratory pagpunta naman tayong ngayong sa results meron ba kayong binago sa steelo niyo ng pagsabit ng results kasi ang na-renid nyo na both in northern Luzon and in Minta now in all of the laboratories ilaran nila ang samples no question about that so meron ba nabago sa pag-release ng results let's start with Sheila siyempre mga mo lang career so ginawa namin balik taran kami na DOH regional offices pag-mind na transports nila dito ng samples ibigay din namin nila namin yung results sa kanila so kung sino doon ang pwede nila nang madistribute na results una pwala din lap off nila sa mga drop off points so kung sino doon sa drop off point pwede nalakunin yung results doon mam mam kasama na kasama na po dito yung MBS kits kasi may mga orders pa nung time na yun eh so biditigay namin sa DOH regional offices sa kung kailas na kung puta dito i-exchange namin din dibigay din namin ng results normal results tumam ha and yung MBS kits nang procurement so balik taran kami ma kung ano ang tumating sa amin ibabrik namin sa kanila tapos nila rin nang didistribute doon sa kanila jurisdiction or provinces What about in Northern Luzon AJ How was it? Yes, in Northern Luzon naman po since may isang courier na talagang very workable with whole regions ng one Ilocos and kagayan what we did po is to provide tracking numbers and new board screening facilities and if may mga hindi dumating po sa kanila we advise them to call immediately yung aming result officer and then kung talagang hindi po makakatating sa NSF yung result ang ginawa po namin kinoordinate po namin siya sa provincial DOH office through our through the DMOs that are assigned to all the provincial DOH office sila na po ang nabibigay sa mga areas ang panilak responsibility po nila Thank you AJ I'm so happy to hear always the Department of Health being part of the picture because that is exactly the purpose of being part of the public health program It's a program ng DOH DOH is the lead agency in the implementation of the program at nakikita nyo naman dito kung papano napakasupportive ng ating mga regional office na maparati ang sample at madala naman ng result yung kanin ang binabanggit nishila na ito yung normal results kasi lahat ng result habinabalik namin talaga sa hospital so sinasabi nga nya pag nagdala ng sample ang DOH from the hospital hindi naman na result so ang tanong ko sa inyong ngayon what about the patients with a positive screen paano naman naging nahirapan pa kayo sa pag refer ng paciente because of the COVID-19 I'll start with Sheila may nagbago bakta process of referral nung umpisaman sa first few months of the pandemic mahirap talaga ma talagang i-recollect your patients lala na if the results need confirmatory testing so what we did was ginamin namin lahat namin na sa disposal namin like phone calls kung kailangan namin sa tawagan through mobile kung may positive form result unapot at nang tawagan talaga namin in hospitals kung ang result kailangan significantly elevated at kailangan nang confirmatory testing we also call the patients the mothers so kung further management we do tele consult or even videoconferencing with the parents and also we involve the hospitals and the health professionals at the patient so nung pang una talaga namin ginagawa initial recall of the patients with positive results yun mam dun sa mga hindi namin makontak kung geographically challenge ang kanilang area what we did again DOH regional offices parang very active talaga nila mam nung time ng pandemi so we refer these patients na hindi namin makontak through phone call sa kanila tapos dito the local tracing itatrace nila yung mga patients sa addresses nung mga patients so e-endorse din nila ito mam sa mga tinatawag nila na the patient nurse deployment project or NDP nurses na sa mga local barang guys health offices so ninyutilize nila ito mga nung nurses mga midwides local health barang guys officials or mga midwides nang nagtatrabaho local sa kanila so nila nagtatrack of patients para lang mag-recall ma-refer sa amin for management so at also mam nung sa management na nang mga patients for CH let me just mention ma for CH confirmatory test we asked the local in herbal hospitals na pwede mga accommodate nang nila patients kung very basic lang yung mga test for CH for gentle hyperthyroidism sa CH naman mam ito po yung kailangan so what we did was since nila nang isa lang ang confirmatory testing dito so napadala sa amin kung ang DOH merong schedule delivery sa amin nerequest na namin na nila kung pwede kuna nang NSF yung patient na kailangan of confirmatory testing yung DOH napadalini nila ito sa amin tapos kami na magpapadala dito sa dapa for those disorders na kailangan confirmatory testing yung maglopin nopati and metabolic disorders yung hold namin tumaw because we don't have careers at that time to send sa samples yung biological specimen tumanila kasi urgent dito tapos next day delivery so we know namin mam merong kami bakulag pero still urgently called this cases tapos in assess nang kunila immediate assessment whether attending practitioners so in assess ko talaga ng practitioners we still inform these patients that confirmatory test will be done when trouble restrictions access or at least allowed so sinasabihan pa namin yung paciente mam sa ngayon nili namin kayo makapuka na ng specimen for confirmatory testing pero later on mo balikan kaya namin para kuna yung mga specimen nito for metabolic disorders naman cases were managed based on clinical assessment by our metabolic specialist hence metabolic management was initiated immediately even without performing the bio chemical metabolic workup so for him maglopinopathy cases immediate referral to a pediatric hematologist were advised so that even if confirmatory testing was not done these babies would be assessed and managed appropriately by the specialist so yung pung kinagawa na namin mam habang hindi ko namin niyo ko confirmatory testing so I think recalling the patient for now this time for confirmation and further referral is as complex as bringing the sample to the center but about in your case AJ how did you handle the recall of the patients as well as the management sa amindok same with mam shila yun lang yung recall of patient naging double yung effort for doing that kasi akot yung mother na pumunta din sa hospital so first we have to counsel them the importance of that having the repeat sample having the confirmatory or being referred to a specialist we have to we have to counsel pa or the mother or ilang panami pagsabihin yung mga parent para lang mag-comply sila sa recall and also yung ano po the same din po dun sa ginawa nilang mam shila for the confirmatory especially kung yung patient is galing ng ilakos norte ang ginawa ko namin we ask for the assistance ng aming host ang Mariano Marcos to transport this samples to the confirmatory testing center in Manila para timely and para ok yung quality yung sample pagdating sa Manila kasi ang difficult dun is pwede yung masiray yung sample kasi may mga times na pagpinadala through courier late ng dadating ng Manila so the facility will have to collect again the sample so kaya yung po nag-request kami ng transport assistance for for the patient and ang isa po po is with the aid of the DOH pa din po na we requested for ambulance conduction to reach those patient na mahirap or malayo especially those located in geographically isolated areas thank you AJ no I think with your sharing both you and Sheila it was very clear that the COVID pandemic really affected the operations of the new birth screening program but you've shown that it is possible and you've actually tapped so many resources to make sure that you're able to perform to fulfill your vision and your mission for the program so we've tackled actually moral and how it's affecting the staff and we've discussed how samples how to reach how to reach the laboratory we've also discussed how to recall the patients and release the results what are other things that you would consider as additional challenges because I think we're here for another year na mga ako mga hindi naman tumagi-end siguro ka-agad mo so do you do you see additional measures that are needed to ensure that we will be able to cope for another set of months in running this program let me start with AJ AJ Doc if we all remember no November and December region 2 suffered also yung massive flooding so that's an additional challenge po sa amin noon so madami po kami late samples na nakuha from the province of Isabela and kagayan and of course hindi na namin mag-send agad-agad ng sample dahil hindi talaga possible so what we did po is to really come up with a regional contingency plan in order to in order to facilitate the sending of samples and your operation din na ating newborn screening sa region namin sa one and two po so yung aming regional contingency plan was drafted together with our partnership with the DOHT we also have our continuity clinic and also ating mga G-6P the confirmatory testing center so yung po yung sa tingin po is makakatulong sa amin to cope up with this challenge actually last kahapod po kahapod we had a meeting with our follow-up team we were planning to conduct sana I mean the follow-up long term and short term follow-up po so we are trying to collaborate na para ma-softend yung para ma-softend yung yung operation ng follow-up sa region dahil bumabapo yung aming return rate so with that kailangan talaga ng collaborative effort with from the different partners to address these issues sa amin sa center hindi talaga namin kakayanin ko kami lang po okay thank you AJ the realization that you cannot solve the problem alone is already a first step and the development of a regional plan with the other stakeholders is actually really planning for the future and as you said you just have the COVID pandemic you had the floods and you know the Philippines will always have disasters even after the resolution of COVID-19 pandemic but about minda now do you first see any other challenges with regards to the physical health or health mental and health status of our staff the vaccination program of the government really helps na mapanat ang kalooban ng mga staff na made in terms of risk exposure sa hospital tapos yung fear na when they get infected even outside at their homes and at their offices or outside their personal activities just na ma normal activities outside the office so yun yung welfare na our staff okay na yun ma with the full support of the hospital nagkakasakit ko kami in terms of COVID kumay symptoms like anong kami na ralang daman na mga sakit ang doon yung full support may meron kami PHS a personal health services na tele-consult na very very responsive sila kung meron kanong cases na kung bulang kung ting kating nang lalamunan pwede ka agad makakasult sa kanila via FB messenger so you don't have to go there physically so meron silang medium to assist us so yun yung sa health na our staff pangalawa medyo bumabalik na rin po yung operations ng career medyo di na ganong kakirap ang aming results mag-received ng results even confirmatory testing medyo may hiwanag sa tunnel mag pangatlo the online doing tasks online really helps us to connect with other offices and other partners outside the cloud so we use that to our most minamaksimize namin na online facility so na na online meeting kami consultative online DOH na kakondak activities online so at least meron din connection hindi nawa wala yung aming connectivity pa ang totoosend kasi due to the travel restrictions tapos merong isolation ang mga places hindi nga in dabao so na dun ma'am so hindi naman masyado kami affected emotional and physical medyo bumabalik na sababong normal hindi na gano sya ka kahira gawin yung mga tasks namin so yun ma'am napakansin namin kaya okay parang rinimind lang kainisila even we're succeeding in the operations of our program the mental health component must be still a priority so that the trust of our staff in the program will not diminish in the trust of the hospitals and all our birthday centers will be there just before we go to the final words I'll be asking AJ and she let to give the final words I do want to express my thanks to the Department of Health yun na kaka tabanan log itung pinagusapan natin yun na each time merong silang banggiting strategy sinasabi nila na kasama namin ng Department of Health I want to thank you and I'm sure it's happening in all of the regions maraming maraming salamat sa inyo at sa isang episode kaya naman nang kami interyuin para malaman kung how was it to run a program in the middle of the pandemic so let's go to some final words andami natin natutuna na dito ngayon and thank you thank you to AJ and Sheila but I'm sure AJ and Sheila will have some final words we'll start with Sheila maybe addressing our the other new board screening coordinators the screeners and then all the rest of the viewers but remember that all the coordinators are listening to you ano bang mensahe mo sa kanila Sheila take home message ko lang ma'am actually be resourceful and always stop others seek the help of your co-partners or stakeholders in the program kasi based on our experience namin meron kalagang tutulong matutulong sa'yo hindi ka nag-iisa sa ganitong and before or your journey mo sa pag-bigay ng quality new friends screening sa inyong kalayan o sa mga parents general public mangi inyongkala ng tutulong meron tutulong at tutulong sa inyong yan pumang and always be safe and practice the safety measures even not only in your workplace but also in your personal life and personal activities So that's the best way to stay safe in the COVID pandemic na umang. So we say always practice safety measures. Yanong umang. Naraming salamat, Sheila. What about you, AJ? Final words? Yes. Last year, daw, I requested my staff to write something sa isang paper. Two things that they miss and two, I mean one thing that they have learned from this situation. So in most of them, nag-answer na ang isang, ang isa talagang lesson na na kita nila with this kind of situation is yung closeness nila with the family, the funding, also the funding yun ko yung mga namin nila. And one year after, I made them write again, one thing they have learned, and mukhang the same po yung talk nila. And with that, para ang lesson naman na ang final word ko for this program is the NBS program yung main resilient. Parang mas naging inobative pang ang mga tao ng yung foreign screening. And with this experience, during this unprecedented global crisis, parang we still provided a lesson of hope and commitment to the program. So with this po, we are one for the NBS program. Thank you, AJ. Maraming salamat sa ating dalawang bisita, AJ and Sheila. Tutuono na ang COVID-19 pandemic ay naging isang malaking hamon sa ating healthcare system sa buong mundo. At dahil sa ating public health priority ay nag shift sa response sa pandemic sa ibang pagkakataon ay nakakaligtaan ang ibang programa. Pero sa araw na ito sa ating episode ay napakita na ang ating public health program na newborn screening na hindi na tinag. Dahil sa ang mga nagpapatakbo ng ating newborn screening center, ay nag-isip na mga paraan para matuloy ang ating programa. At sa mga nila, be resourceful, be hopeful, be innovative, at kung sama-sama natin sa sagutin itong mga problema ang ito, itong mga hamon na naririnig natin ay kakayani natin talagang mapatakbong ibang programa sa loob ng COVID-19 pandemic. Muli, maraming salamat kay AJ and Sheila. Managing the newborn screening operations at different levels was and continues to be a tough task. We heard from our guests how the newborn screening program leaders quickly stepped up to respond and coordinate mitigation plans effectively. Throughout the pandemic, newborn screening centers, regional screening teams at the Department of Health Centers for Health Development, newborn screening continuity clinics and newborn screening facilities in the country remain operational, facilitative and employed various creative strategies while observing standard protocols in continuously giving quality newborn screening services. With the COVID-19 pandemic, challenging healthcare systems all over the world, public health priority shifted towards response to the pandemic. The newborn screening program has also felt the effects of this equation and had to adapt to continue its costs. Through the innovative strategies, solidarity and resilience of the different stakeholders of the program, delivery of service and care for patients has continued in these trying times. To our virtual audience, please send us your comments, questions or the list of topics that you want us to cover in our succeeding episodes. Email us at info at newbornscreening.ph or you may tweet us at newbornph or also include the hashtag hashtag ENBSPH. Before we end, I want to again take this opportunity to present to you the new addition to our tools in learning, our ENBS mobile app. The ENBS mobile app is a one-stop hub for all newborn screening health workers on everything they need to know about newborn screening. It also features a rewards program that our health workers can use to earn points and use it to claim shop vouchers with our partners. If you have already downloaded the app, answer the question that we will send to your inbox to earn those points. We continue to improve our services as deemed necessary by the emerging challenges through an open dialogue that our experiences in newborn screening. It is our hope that through this program we extend the sharing of knowledge with greater reach, empower our frontliners, improve connectivity with the newborn screening coordinators and most importantly, provide unparalleled service to every family. For our next episode, we will start to focus on the different conditions included in the ENBS panel, starting off with congenital hypothyroidism. This and more here in newborn screening in focus. Nothing is more precious than seeing a child grow healthy and normal. Let's realize this through newborn screening. Newborn screening is a gift of life. Makalipas ang 24-hours, bak si baby lumabas. Go win natin ng ENBS alin sunut sa batang.