 as discovered as for today. Welcome po at sa alam po marami po kayo matutunan sa ating webinar for this week. In the captivating world of medical science where innovation is the guiding star, the Philippines shines brightly in the realm of eye banking and cornea transplantation. We invite everyone to uncover the latest advancements, surgical techniques and post-operative care protocols, revolutionizing cornea transplantation and enabling us to provide a glimmer of hope, especially for those who have impaired vision. We hope to be able to, especially yung ating mga healthcare administrators who steered their ships in the healthcare sea, find valuable insights on how to optimize eye banking operations. Very, very important matutunan po natin for today. That's within their own hospitals and institutions. It will be from logistics to donor recruitment strategies. Lat-lat po iyan ay pag-uusapan po natin sa webinar for today. And offering a unique perspective on the impact of eye banking and cornea transplantation for today. I'm Dr. Raymond Francis Sarmiento, Director of National Tehal Center, National Institutes of Health University of Philippines Manila. Always a pleasure to be with all of you during our regular Friday dates. Today, very, very special because my co-host will be none other than the special assistant to the Dean for External and International Dinkages at the UP College Medicine and also active consultant at the Philippine Jail Hospital, Dr. Angela Cison Aguilar. Mamangge, welcome po again. I think, Dr. Raymond, san ako yung lucky charm rather than the gym step and the technical difficulty. But good afternoon. Good afternoon, Dr. Raymond. Good afternoon, everyone. And welcome to all of our participants here in the Black Buster Always Live broadcast of the Zoom webinar. And to all of you who are watching live streaming through the TV UP YouTube channel, as well as on the UP System Facebook page, the TV UP Facebook page, and the Stop COVID Death Facebook page. So very viral po ating mga events. And of course, all of those who are watching from the TV UP signal channel 101. So we have panelists today. Raymond, can you guide us to the panelists? So our panelists, especially for today as we talk about the transformative power of i-banking and cornea transplantation in the Philippines, we bring you no one but the best po. Our main speaker is the founding president and chair and current ambassador at large of the i-bank foundation of Philippines. She also serves as the head of the association of i-banks in Asia and is active consultant and head of the Ocular Tissue Transplant Service at St. Luke's Medical Center, Dr. Mingita Padilla. And our re-actor for today serves as the chair of the Department of Cophitalmology at Angeles Medical Center, Angeles City Pampanga as well as a cornea and external disease consultant at the Paulino J. Garcia Memorial Research and Medical Center. I am very careful baka si Bama may makalimutang po ang word. In kabana tuan, Neva Eciha, Dr. Payus Acampo. The synthesis and closing remarks. Wow, that's very great. The synthesis and closing remarks will be delivered another by the head of the Office of Expanded Education and Training at PGH, Dr. Stella Marie Jose. Mamangge? Yeah, okay, so you've seen that in our opening billboard that we will still maintain the title stop COVID deaths but we will expand our discussions. Two current COVID problems of the CO, other outbreaks, V-viruses, eye infections, T-disasters. So, hence, our stop COVID deaths have already transformed. It levels up to take a closer look at the other emerging health problems here in the community. Now we are in the eye problems and while we keep an eye out, take note for COVID-19 developments here in the Philippines and the rest of the world. We are bringing you other topics as well. And since we know that you will like to be current at the latest news in health and medicine, here in abroad we have a new segment in the webinar called Web Updates. So, these are some of the stories that we are keeping an eye on and why they are relevant to you. We're still having technical difficulties to anong so we apologize but I'll start off with the very, very first news update po natin. So, I'll have one news update. Si Mamangge naman will also have one news update. For our news update for today, I will be talking about field health. So ano po bang alam po natin sa mga kailangan pumbayaran ng field health? According to the Philippines, I saw the private hospitals association of the Philippines pa or field health as yet to pay claims with private hospitals worth more than 10 billion pesos. And the said amount is based on the estimate of p-happy from three to four months ago. So medyo dumami na po ito, three or four months ago, one quarter ago pa po ito. Ang pinangahawakan po nila. So reports said that field health now owes hospitals in the countries around approximately 27 billion pesos. But promises to settle them in the next 90 days. And this is what current PCEO or President and Chief Executive Officer Emmanuel Ledesma of field health told the House Appropriations Committee that they will be rolling out soon the debit credit payment mechanism for that purpose. And the agency's more than 400 billion pesos in investable funds and over 68 billion pesos in net income is proof of its liquidity. So it liquid pa po ang field health and is able to meet its financial obligations. Kaya po na banggit na pwede po nilang there's this possibility that they'll be able to settle all of their payables within the next 90 days. So a very, very high percentage daw po according to PCEO of field health. I think it's attorney Emmanuel Ledesma. Mamangge, what's your news story for? Mayro na kalagay na WHO, WTO renew commitment to support integrated solutions to global health challenges. So very, look at this, graphic, very, very ambitious. And while acknowledging that there are issues with regards this integrated health solutions, they are trying to increase and broaden the support for more effective and sustainable use of these trips or integrated solutions to access health technologies. Nakawang sayo to Raymond, health technologies, parantel help to be better prepared for future pandemics and right now hindi lang pandemics na nakikita natin we have seen crisis upon crisis, especially working toward, especially with disaster. So for example, the people here that you can see in the graphic is that there are people who are Tedros Adhanom Gibresus, the director general of the WHO, WIPO director Darin Tang and W director, Dr. Ngozi Iuella, they recognize the challenges of this program to be fully implemented in domestic level so that the access to health technologies are available. Of course, COVID was one such issue. Now they're talking about communications, warning, disasters, multiple crisis caused by climate change, environmental degradation and human losses. And the issue there is that we have to have trilateral cooperation to be able to make sure all of the stakeholders will be able to translate this from policy to utilization. So very ambitious to and hopefully there's a time table and they will be able to carry this out and then come to medical technologies and innovation. So inabangan po natin yan. So go ahead, Raymond. Thank you. And those are the news that we're keeping an eye out on. Please keep watching us and keep an eye out for the news update for next week. Okay. So will ano po, tuloy-tuloy lang po tayo with our program for today. And I will be discussing po our topic very, very shortly, i-banking and corneal transportation. I'm not sure if we're able to play the POTS video, we'll take a stab at it po. POTS po is what we do in terms of trying to set our discussion into context. Kung ano po ang alam ng ating mga viewers, especially those who will be interviewed as part of the POTS video with regards to that topic. So the questions that we ask, alam nyo bang pwede kayong magdonate ng mata? Kung mamatay ka ba, ikaw ba ay willing na magdonate ng inyong mata? Bakit o bakit hindi? May concerns ka ba kung magdonate ka ng inyong mata, kapag ikaw ay pomano or na matay? All right. Sayang. Inaabang ako yan, Raymond. Actually it's the man on the street interviewer, the person on the street interviewer. Kasungan lang mayroon po tayong concerns, mayroon tayong iseskip na lang natin. So na sabi mo na rin na, lahat ng tao kailang malaman kung anong magagawa natin, just in case po manaw tayong di oras, may akadonate ba tayo ng anybody part in this time, cornea, and that is what we're going to talk about today. So, salamat and for those of you asking, Raymond, punish certificates nila of attendance. Okay. Thank you so much, mamang-guys. So for those who are asking, certificates of attendance will be provided to those who have attended at least 50% of the webinar duration. Those who have been asking as we have already sent out po our certificates of attendance for webinars 1-162 and after today hopefully will be able to send out for 163. For those who are asking, kasama na po dito si webinar, I think webinar 150, yung may kinelaman po sa climate change. So if you feel you should have received a certificate of attendance but did not, please let us know by e-mailing as a stop covid debts at up.edu.ph. Before we proceed to our webinar proper meron po kasi tayong fan quiz segment na meron din po tayong short video. I'm not sure if we're able to try that out also. Sige. No problem. So we're receiving instructions from our production team with regards to that. Can we have at least the fan quiz in zoom po at in-slido on the screen right now? Thank you. So mamaya kasi may standard panel discussion format. Pumasa pang fan quiz, go Raymond. Yes po, can we have also the slide on in dito po sa zoom para dun sa, thank you so much. Okay. So number one, first question po natin, but for those who are joining outside of the zoom, if you're seeing this, you should be able to see it po sa slido.com. So you can still participate in our fan quiz by open up your browser typing in slido.com and entering the code 6510096. That's 6510096 for you to be able to participate in our fan quiz segment. So first question po natin, a patient with cancer, diabetes or other conditions that are contraindicated. For whole organ donation can still be able to donate their cornea. Is it true or is it false? Yung po ang napaka mahalaga po natin na katanungan, is it true or is it false natin? So I would like to take this opportunity to greet those who are joining us locally. So maraming-maraming salamat po sa mga nanonood from the Orani District Hospital in Bataan. DSWD Haven for the Elderly in Tanay Rizal. The Department of Health Center for Health Development Western Visayas in Iloilo. From Sibu Provincial Hospital in Karkar City in Sibu. Sock Sergeant General Hospital in Surala, South Kotabato. Camp Navarro General Hospital in Zambuanga City in Zambuanga, Del Sur. Also those who are joining us all the way from Bataan, from Los Baños, from the Philippine General Hospital, from University of Rizal System Health Services, from Rodriguez Rizal, from Cavite, from RPS Annex One, Antipolo City, Dr. Menzi Ramos, maraming-maraming salamat po. Those who are joining us also all the way from, let's say, from Bulacan, maraming-maraming salamat po. From Deca Homes, Marilao Bulacan, thank you so much. Those joining us from, layupo ito, I think it's Mariano Marcos Memorial Hospital and Medical Center in Ilocos, Norte. So thank you, thank you po sa lahat. For our question number two, question number two reads, the most important factor in a successful i-banking program to encourage people to donate is ang tamang kasagutan. There are four items po na nakalista po dito. So we'd like to greet those who are joining us internationally from the Chonin Hospital in Taipei City in Taiwan, from Oman College of Health Science in Oman, from Los Angeles, California in the United States, the University of Haile in Haile, Saudi Arabia, University of Philippines Nursing Alumni Association, International Incorporated in Edison, New Jersey, USA. And those joining us na, maraming po na ating mga OFWs all around the world. So we'll not be closing this fan quiz po natin as we move on to our webinar proper and our main speaker will be introduced by Dr. Aguilar. Go ahead mam. Thank you Raymond sa nanakalang sagot kay sa quiz. So now I have the pleasure and honor of introducing our presenter of the topic for today. She is the founding president and chair and the current ambassador at large, i-bank foundation of the Philippines. She is the head of the association of i-banks in Asia, as well as an active consultant and head of the ocular tissue transplant service of the St. Luke's Medical Center. So we'd like to give the floor now to Dr. Mingita Padila. Ram, please. Hello, good afternoon. And thank you very much for inviting me here. Now without further ado, I'm going to share my slides. I heard about Mariano Marcos when you just opened some retrieval center there and they've had two donors na yata. So since we opened, so let me just share my slides. Go ahead mam. Screen share. Okay na ba? Yes mam, go ahead. So thank you for inviting me and giving me this chance to share about i-banking. And it stopped COVID deaths but COVID has had a very great impact on i-banking around the world. A negative impact as you can imagine. But let's get started. Well it is a non-profit organization. I have no financial disclosures relevant to this talk. So why did we put up an i-bank? Why an i-bank? Well it was in response. It was born out of a desperate need to provide transplantable cornyal tissue for those who needed it, for the cornyally blind. First of all, what is a cornyal? For those who are not familiar, the cornyal is the frontmost layer of the eye, crystalline, which must be clear and normal in shape to be able to refract light properly so that good vision is possible. This is the close-up of the eye. One of the eyes of my husband is hazel eyes. It's a perfect-looking eye. And this is the cornyal. Not everyone is this lucky. And what happens to some people who need cornyal transplants in the Philippines? Now for those who are little queasy, I'm sorry about these slides. But these are infections of the eye. The most common reason people need transplants in the country are infections, trauma, and complications following catalytic surgery. These are common. It can happen to anybody. This is a mutation who had fungal infection. He was just riding his motorcycle na poing siya. Ito nangyari sa kanya. Ito naman recurrent herpes infection of the eye. The other one below is trauma and improper use of contact lenses, bacterial infection, staphylobocan infection. Even if you treat the infection, it leaves a scar and you need transplants. Congenital opacities, chemical burns, cornyal perforating injury from trauma. These are also common. On the top is scar from measles keratitis. When we were in residency, we saw a lot of this because of measles and malnutrition combined. But because of the fortified vitamin A snacks and food, measles vaccinations, this went down a lot. When the vaccination level went down again because of all sorts of things and fallacies and misinformation, we saw them again. So, measles can cause keratitis which requires transplant. Post-cataractedema is another common reason for transplants. And so is keratoconus or a weakness of the cornyal which results in a conical shape of the cornyal instead of a sphere. Prior to the eye back, these people were virtually hopeless to be able to see again. And all we could tell them was, kailangan yung nang transplant pero wala ka nang cornyal. Balik nalang kayo pag tinawagan naman kayo. We put them in a list which got longer and longer and longer, some got married, some died. Wala pa rin silang cornyal. And the irony of it all is that the cornyal is such a small tissue. That's the front of the eye. It's about 12 millimeters in diameter. But we get about 17 millimeters because we have a rim and about 0.5 millimeters thick. So we'll answer a question later how many people can be helped with one cornyal and how many people can be helped with one eyeball. We store them in optisol which can keep the cornyal for two weeks in refrigeration. We have to go back to our history. We cannot move forward unless we learn from our history. So we don't repeat the same mistakes. So I always include the history of eye banking. And no one can do this better than Dr. Sargodor Salceda. And this was his Hemenyanodia Campo Lecture. He says the history of eye banking is a fascinating if not frustrating history. It failed because of due to general anti-donation culture and lack of dedicated leadership and raging professional rivalries among the ophthalmologists who put up their own eye bank in the past na kanya-kanya. And there was no public funding and lack of technology. He was my mentor. And almost every day when I was in residency and then fellowship for a while in the PERI and Institute of Opththalmology, he would tell me, you were not meant to do the extraordinary, you were meant to do the extraordinary. Put up an eye bank. Grabya presyo. Anong gagawin ko? Paano gagawin ko to? I called them my angels. At a certain point, I left PGH because I was disappointed even with other doctors. I saw the professional rivalries among the different consultants from different hospitals. We could not put up an eye bank. Everyone wanted it in their hot place, their telephone number, et cetera. I saw it with my own eyes. I went to Makati Med. I said, I can help better from outside. I said, Dr. Raul Forrest and the nuns of Mother Teresa. Why them? Because so many children were being brought to Makati Med. Who needed coronal transplants? And Dr. Forrest was the one who saw them. He saw the need. So when I told him I wanted to put up an eye bank, he said, he gave me, he opened his drawer and he got $500. Ito pohuna mato. Put up an eye bank. None of us knew what to do. Then Frederick Griffith put up the International Federation of IOT banks. And I wrote to him to help us put up our eye bank in the Philippines. But he had a very bad experience with Filipinos prior to that. He thought the Filipinos were personal ang grata to him. So he was not excited to come to that country. Mabuti na lang. Another angel came along. Khalid Tabara. Who happened to be a member of the board of the International Federation of IOT banks. And he saw here the need for an eye bank. So after that, Dr. Griffith came here, grudging me for a little bit more than a day. But all of us doctors got together to show him the need. So he was convinced. And these were the first people who believed in the cost. Some of them just humored me, but the others really believed. And then we had these other angels. The Venetia, Angara and my father and President Ramos who helped and here's Mr. Griffith. They really helped us have a law passed, which is the act to promote coronal transplantation in the country past in six months. My father was in the Supreme Court. Angara was Senate President. The Venetia was House Speaker and President Ramos. They were all friends. So everything fell into place. This was patterned after the Coroners Act of Baltimore and was quite progressive and aggressive. It allowed the medical legal officers to give the eye bank the cornyal tissue of dissidents who were unidentified and unaccompanied even with no explicit consent under special circumstances. And they passed it. And this was meant to jumpstart the eye bank. Just jumpstart because what was supposed to happen was that people by little, hospitals, the DOH, they would help in order to change the culture to one of pro-donation. Unfortunately, it did not happen. So we'll go back. We'll go to that later. We have been surviving on medical legal cases until 2021. Now, at least, balansa na. So we inaugurated the eye bank in the Makati Medical Center. So many of these people have passed away since then. And the eye bank trustees have changed through the years. And now we have some from Pisayas, from Indanao and Northern Luzon. This was her staff in the beginning, five regular employees. In 2019, we had 27. That was pre-pandemic. We had to downsize dramatically during the pandemic. What does the eye bank do? The eye bank retrieves, processes, stores, and distributes coronal tissue or even scleral tissue, eye tissue around the country. We have been partners with Philippine Airlines, Cebu Pacific, Victoryliner, Paragas, Sutra, and LBC. Philippine Airlines and Cebu Pacific transported tissue free of charge all over the country. Coronado Nation. Coronado Nation is much easier than whole organ donation. We do it within 12 hours after cardiorespiratory death, not during brain death, but after cardiorespiratory death. If refrigerated, we can wait up to 20 hours after death. Hence, it's usually done in the morgue or in the hospital room or even in the home of the donor. We don't need an operating room. Who can be an eye or coronado donor? Almost everyone. There are very few contraindications. I saw one of the quizzes canina at the questions. Old age, whole organ cancer, diabetes, malitus, and other systemic illnesses are not contraindications to becoming a coronado donor. And the cornya is immunologically privileged, as you say, as they say. But these are the few contraindications. If you've had eye surgery, we can still get your cornya. If you have high grade, pwede pa rin. Wag lang cancer sa mata. What happens to the cornyas donated? If we get only the cornya of the donor, we put it right away in optisol. If we get the whole eyeballs, we section them. The cornya we put in optisol storage medium. The sclera we will clean very well in the eye bank and put it in absolute alcohol. The cornya can last in storage for two weeks, but it never lasts long because the need is very great. The absolute alcohol, the sclera can last for two years. Tissue evaluation, gross examinations, slit lap examination, and specular microscopy where we count the cells and look at the quality and number of cells. And we do serology, like you would for a organ donor and organ recipient. Those who are suitable, the tissue that are suitable are transplanted. Those not suitable are used for education, research, and training. Very important to Filipinos is cornya donation, this degree. Ayokong pangit, gusto kung maganda pa rin ako, pagtina na nako dun sa aking ang aking labibun sa aking burul. There's even one who said, baka pagtawa na nako ang mga tawaway ko sa sabi ang pangit mo, nakalubongang matamu. Things like that. We want to look good even in death. And the answer here is cornya donation or even eye donation is not disfiguring. We replace the cornya with eye caps which actually has spikes, which actually gives the eye a very good shape and keeps the eyelid from opening. So it's even nicer. If we remove the whole eye while we also reconstruct or do and put an eye cap. So there's no disfiguring or disfigurement, okay? All our donors even na mga artistas had open caskets. And this is an example of a man who had trauma who after his cornyas were removed. So he looks very natural. Hindi lumugang mata. The recipients know the identity of the donor family. They are made anonymously and we keep the identities confidential. The only time you will know each other is if both parties agree to let their identities be known. How does the donor family benefit? One of our best advocates is Ali Soto who's son Niko. She donated his cornyas when he tragically died. He fell from a building and sabanya it actually gives you comfort. A mother who lost her son to know that part of your son still lives on and you were able to help other people. She has remained close to one of the recipients. She asked me. She was a little girl. I did her coronal transplant. She was six years old. Dalagan na nakatrabaho na. And she said her friends don't call her Esmi Esmeralda. They call her Mika. So my point is it's comforting. Part of your love what lives on and you're able to transform the life of a person or of persons and even just two it could even be more. From 1995 to pre-pandemic what it meant to have the eye back was people who needed transplants had hope to see within a reasonable timeframe. We don't have to wait indefinitely. We did not also have to depend on tissue from abroad that cannot find surgeons who will take them kasi hindi sila maganda. We had the pick of the best tissue of our countrymen or our countrymen. And we developed world-class coronal transplant surgeons because we had tissue to use. This is an example of a patient with mesoscleratitis is the post-transplant case two years after the transplant. Dinanggal na yung mga tahiya It's right after me mga tahiya. What types of coronal transplants do we do in the Philippines? We do the all, no? We do the penetrating or full thickness which is the classical and still the most commonly done in the world. La Mela where we can change just the front or just the back depending on the pathology of the cornea. So if you have you can use the back of the cornea from one patient and the front of the cornea for another. You can use the periphery of the cornea for other patients. We also do Bostocerat prosthesis. This is a artificial cornea embedded in a normal natural cornea and we'll show you some pictures of that as well. For penetrating keratoplasty this is the classical way, within a donor a sphere is is replaced or rather the abnormal cornea is replaced the central part with a healthy cornea from the eyebath and sutured into place. Okay. Then we also have La Mela keratoplasty where we can do endothelial keratoplasty wherein we change the inner part of the cornea. So you have, for example, pseudophagybulus keratopathy after cataract surgery or fuchs endothelial dystrophy. This is the normal part. Even if the other parts of the cornea become swollen it's because of this. We can just change this and replace it with healthy cornea with more high tech and we actually pre-cut the tissue. This is an example of a patient of mine two months after penetrating keratoplasty and cataract surgery and this is a patient two months after desec note. The transplant is just inside. No sutures. The eye is stronger. Recovery is faster and chances of ejection are also less. Now anterior La Mela naman, we also do wherein we change the front of the cornea and we leave behind the endothelium. Cases like keratocomus or else scars of the cornea which do not affect the endothelium. We can replace just the deep anterior La Mela portion. Again, this is technically or there's more tensile strength and less likelihood of ever having rejection. You can have it for a lifetime because your endothelium is still yours. Keratoplasty surgery is for eyes within traditional corneal transplantation carries a very poor prognosis of success. You have repeated graft failure, chemical burns, stem cell deficiency and anirigia and also if you have a strong heart in chosen cases of Stevens-Johnson syndrome that still have sufficient tears and can still adequately close their eyes. These are examples of patients. This is a patient who had limbal stem cell deficiency. This is the keratoprostesis with the backplate embedded in the human cornea. This is a more sort of extreme. Stevens-Johnson's syndrome patient wala na siyang to call this wala na nang sulpus but you were able to reconstruct his eye and then bucoby-costal graft from the cheeks of the inside and he was able to see 2040. So it's almost like a miracle but these are drastic patients who are at width's end desperate but we can still help them. Whole-eye donations and able us to use the sclera for other types of surgery and for example this is the sclera stored in alcohol, absolute alcohol. This is an eye again status post-keratoprostesis and you see that white patch is the patch from the sclera in the eye bank to cover the drainage device or the glaucoma drainage device which is there to treat the glaucoma. Nowadays because our corneas have a very wide rim what many glaucoma surgeons do is they partner with their cornea counterparts and then they ask them Pwede ba amin na yung retaso? So they get the rim and they use it for these types of surgery. We can even use the entire sclera to reconstruct the eye socket after the eye is removed so that that way it's cosmetically nice. So we have the know-how and technology to do various transplants but without the eye tissue to do so all this knowledge cannot be put to use. Hence we have been very busy with iBank and we are an NGO we are not government but we have tie-ups and various government agencies lectures, sports events, media, et cetera, et cetera and we have never stopped. Tuloy-tuloy ko it's necessary Advocacy is necessary. In 2005 we had a Grand Anvil Award winning campaign where 52 celebrities posed for June de Leon shedding tears of hope for the iBank Every Sunday inabakan ito ni mga pictures you name it A-listers were part of this novel campaign and we also worked with LTO in 2019 before the or 2018 before the pandemic when Phil Nyoz head with Dr. Sanyanto we really met with the LTO with General Galvante to make sure that the question of organization is really asked and now it is asked in online application problema sometimes the people in LTO themselves tell the people applying when they ask ano to ay ilagayin mo lang no aside from that the organization aspect is in the back of the license it should be in front nakapat nakalagayin bold letters organ donor but at least this is a start we have had tie-ups with celebrities remember J. Ilagan was a first celebrity donor and then we had Miko Soto in the early 2000s and later on AJ Perez the son of Cesar Montano whole corn whole aybolian we had a soap opera that featured a child we needed a trans I did a cameo role we've had so many media engagements but you cannot no one expect because every time a celebrity donates a cornea we make sure to really drum it up and awareness goes up the number of people signing donor's cards goes up becomes easier to ask but we can't keep relying on celebrities to die we have to have our own sustained campaigns late last year we had a beautiful beautiful documentary in eye witness Sandra Aguinaldo had it beautiful and I hope you can get to watch it sa mata ni Joel we still useless today when we go around the country putting up Trival centers see, but no matter what we do you can have as many PR campaigns as Medi media campaigns but unless you have a good hospital retrieval program everything is for naught this is the most effective tool for a successful corneal and i donation program the PR campaigns donor cards don't mean anything if at the time of death nobody asks about it in the hospital so it has to be a concerted effort it's the point of sale as the advertising people will say you have to ask. And this is where we really fall short. And aside from asking, in a hospital retrieval program, information about the i-bank, about corner donation, transplantation, in strategic locations is vital. The more the people see, the more they'll say yes, the more likely they will say yes when you ask them. Now this is the peculiar to the Philippines because of our Maryland Coroner's Act, which we did so well. Up to 93% of our donors from 1995 to 2021 were medical legal cases. They were young, yes. But the problem is, this advantage was at length complacency of the Department of Health in the hospitals. And none of them saw us at i-bank, um na natin, let's not anymore try to develop our hospital programs, retrieval programs. Now up to 2017, all our donors came from Manila and we just kept sending them out, Metro Manila and the environment is up to Gulakan, et cetera. But up to 2017, with the help of Phil Nos, we started really putting up more retrieval centers outside Metro Manila. And we had others in the pipeline there, no? Up to 2017. And then, sorry, up to 2019 rather before the pandemic struck. And we were doing quite well. Things were looking up, our waiting time was down to three months, imagine that, no? Then COVID struck. COVID struck. And what happened? Review. March 16, the whole of Luzon was locked up, locked down. PGH was the first hospital designated as a COVID-19 referral center. The i-bank is in PGH. Virtually all non-COVID admissions ceased. These were optomology residents, you know, on duty in the ICU and the COVID wards. Specialty departments refused into three teams. So everything close. The i-bank reopened in June 15, 2020. Now, even our dog couldn't walk. Remember that? Lockdown was so strict. So what happened to our hospital and funeral home partners if our lockdown? They all disappeared because they were all COVID centers, most of them. Then even the PNP morgs disappeared because of lockdown, people weren't going out, there were no accidents, no trauma, nothing. So it was really, really a standstill. But the impact was global. This is, for example, in Mexico. They had a very good program, but you see what happened after COVID. And it went down 88% reduction in coronal transplants in public institutions. Same in Brazil. They had a very good program, but again, bugs up. And until now, it's not the same. None of it is the same. So the sources of transplantable coronal tissue decreased due to the pandemic, but the number of persons needing transplants continued to grow. And programs in most hospitals and PNP also stood still. There are now 458 patients in the waiting list of the i-bank. This is better than January. January, we had 500. So, you know, seems that we're doing a little better now than last year and early this year. Waiting time was six months down from one year and more last January. So our efforts to educate and spread advocacy don't stop. And we are starting to see a slight increase in tissue retrieval this last month. Up to today, the coronal tissue yield around the world has not reached pre-pandemic levels. This is in Asia, United States, South America, Europe, and Africa. But especially, of course, in Asia. Wala pa. It looks dismal, di ba? Look at that. In 2016, it was even higher. 2017, we were okay, you know, above 800. Then year 2020, bumagsak ng content. 2021, 2022 was pretty bad. Now, 2023, we're starting to go up again. This is a very conservative projection. Hopefully, we'll reach about 400, hopefully more. And I want to look at that. There's a spike towards last month. And this is really hope. We are having hope, no? So I'd like to now concentrate on strategy, silver linings, and opportunities. What are we doing? We're renewing personal visits and fora to the hospital partners. And we are actually entering into more what's with new hospitals and LGUs. We are having wet labs as well. Bagay o hanggang marawi yan, tuloy-tuloy yan. If you see the ones in red, we're actually established during the time of COVID. And we have a pipeline for Zambales, sorry, sorry, for Batangas, Palawan, Iluilo, Sambuanga, Isabela, pipeline. We are renewing and strengthening ties with the PNP. We want them to be aware that their scene of the crime operatives must always look for donor cards in the possession of victims. If they see a donor card, tao kayo ka agad, no? Because we can still get that. We don't need the person hooked to a machine. Funeral home retrieval programs, we are also dealing with funeral homes, no? Because again, we can wait until before cremation, before embalming, up to 12 hours after death to get the cornyas or the eyeballs. And so hangkat puede, no? Until the last minute, pwede pang pominay. So we're doing this again, no? And so we're doing as much as we can to continue and to intend to grow. So i-banking is in crisis worldwide. But the Philippines definitely, no? But we are starting to see the light. As in every crisis, there are also opportunities. Silver linings. Now, more ophthalmologists have taken on the challenge of being champions for cornya donation in their hospitals and locales. More private organizations are donating to the i-bank. And for the first time, we have more hospital source tissue than we do the medicalical. And this is a step in the right direction. We are hoping for a strength and relationship with the DOH. And one thing they have to do, plantilia, plantilia, plantilia. How can you have a serious donation program if you have no dedicated hospital transplant coordinators in your hospitals? We need them. That was the common cry when we had our meeting last year. Kailangan may plantilia, may item. We want the DOH to issue an AO to make required inquiry and request the norm in hospitals to also make organization explicitly asked for in advanced directives for DNR. It is not, okay? We want also the DOH and the Bureau of Customs to make it easier for us to import cornyas from other countries like Sri Lanka where they have a lot of cornyas. And we need field health to cover tissue processing because they do not. And also, we need to have stem cell and tissue culture technology available for clinical use. They're stealing clinical trials in Japan and Singapore. Hopefully we can have them. And when that happens, one cornya with its endothelium can supply 30 eyes. There's 12 million people around the world in need of transplants. Only 150,000 are done a year. This will help a lot. And we can contribute to that in Asia if we just work together. So how can you help those who are watching, those who own hospitals? Encourage your own relatives to become cornya donors and consider donating your cornyas of your loved ones when they pass and sign up yourselves. Encourage your hospitals to put up their own retrieval programs. Little by little, they will all add up. Have advocacy campaigns in communities, organizations, or cornyal donation. And donate to the iBan. We are tax deductible. Reality check. Up to recently, our state was almost like we had gone back to 1995 because walang tissue and damning recipients lined up. There was desperation on the part of patients and frustration on the part of surgeons. Some even went to India to have their transplants. It shows how fragile our system is and how so much is needed to be done to institutionalize deceased organ and tissue donation. It should be in all of society, all of government approach. But there's a major difference between today and 1995. We have already planted the seeds in the last 28 years. We just need to water the seeds and fight the right fertilizer to allow iBan to flourish even more than it did before. And I want to put the spotlight on one hospital that gives us hope, which is the Paulina J. Garcia Memorial Research and Medical Center in Cabanatuan. And Dr. Pious is from there. If these are the seven satellite retrieval centers and look at them, they really stand out. So what are they doing right? And if they can do it, it's a government hospital in the central zone. Why can't the others? Others can certainly do it and we can talk about those strategies later. So 15 hospital retrieval programs, seven satellite retrieval units, nine nanmoba hospital, 16 marchawaris. If only six, if only each hospital would yield even three donors a month, we would wipe out our waiting list in half a year. Imagine that. So there is hope. If one hospital can do it, a government hospital at that, others can do it as well. So with that, I'd like to say that with perseverance, cooperation among stakeholders and God's grace, I believe we will be in a much better place in the near future and continue to be a leader in iBan King. Thank you very much. Thank you so much. Thank you so much, maming Gita. That was indeed excellent. I have a couple of questions but I'll reserve them towards the Q&A and really thank you so much for that wish list especially and other preparations especially for the hospitals to take care of. Mamanggay? Yes ma'am. Yes thank you. It's a very timely message na ko. It's really a big appeal to our impact country. So to put this up, but before we proceed to the open forum, we have our reactor. Tamabang Raymond? Yes ma'am. But you would introduce this one, men, national perspective si mamanggita about that iBan. And let's see how a regional center such as the PJG in Nueva Eciya is coping and how the efforts are translated in the periphery. So go ahead Raymond and introduce our panel. Thank you ma'amanggay. Thank you so much and thank you to mamanggita again an excellent excellent presentation. Before I introduce our reactor reminding everyone that for today's Q&A session, we encourage everyone to put in your questions already. So pagpag-baraipong questions will choose the most upvoted ones and we encourage everyone to start typing in your questions in the Zoom Q&A or in the comment section of Stop COVID-19 or to VUP Facebook pages or in the TV UP YouTube channel. Okay next up, our reactor who as I mentioned at the top of the coverage chair of the Department of Eftalmology at Angeles Medical Center in Angeles City, Pampanga. Also Acornia and Extral Disease Consultant at the Paulino J. Garcia Memorial Research and Medical Center in Cabanatuan, Nueva Eciya. Please give a warm virtual welcome to Dr. Payus Okampo. Hello, good afternoon everyone. Thank you for inviting me. Can you hear me sir? Yes sir, go ahead. So first of all I want to thank Dr. Padila for inviting me also to be our actor that was a very well-delivered talk by Dr. Padila. Well it started when I was in PGH where I did my training in Acornia. So Dr. Padila was one of my mentors there. So I was excited to start my practice here in the province to serve the community for Acornia Transplant. So I noticed that during my start around 2017 the waiting time for Acornia before I will be able to do transplants out three to six months sometimes it will take longer. So I tried looking for ways on how to lessen the waiting time for my patients, private and government. And I was so blessed that the PJG I was invited to be one of the Acornia specialists there and be active in the residency training program for PJG. So the first thing that I did is I asked my resident how many patients are dying in PJG. So that's the first thing that I did. I talked to my resident and do we have a way na maging Acornia Retrieval Center tayo here in PJG because I learned that in Manila pala, there are hospital partners by the Aiba like Isab that if they get Acornia there's like a deal that they will be able to use one Acornia for their institution and the other Acornia will be for the Aiba because what I noticed is that all of the Acornia specialists here in the Philippines are so dependent on the Aiba but we are not doing enough to help the Aiba in return. So in yun number one, the commitment of the Acornia specialist na mag-contribute sa Acornia Retrieval Program. Number two is the involvement of the residents. So in PJG, the one who harvests the Acornia are my residents. As early as pre-rest, first year they do it. For me, since I'm part of the training institution, that's surgical practice already for them. At least they're used to improving their surgical skills. Then the next thing is we are also blessed that my resident during the time had a friend in IM Department. Usually naman sa mga hospital sa IM and surgery, sila yung maraming yung mga naman matay, this is, no? So sila yung nandun natin makakuhay mga donors. So fortunately during that time, the IM resident was very enthusiastic na magkaroon ng transplant sa PJG. So I talked to her, sabi ko Acornia is very easy to do kasi wala na cross matching and there's Aiba is very active, so immediately we did the memorandum of agreement, then we immediately started. We started the program of Acornia Retrieval. So at first, for the first few months, hirap na hirap kami, parang nakakakuhak, wala kami isala, once every other month or twice now. Then I talked to Doktor Abadile, sabi ko anong ginagawa ng bagyo? Why are they successful? Since she told me that they have a transplant coordinator. Fortunately in PJG, the hospital is very supportive sa amin, then nagkaton kagad ng plantilin, transplant coordinator namin, then from there, direk-direk siya na, direk-direk siya na yung harvest. Then yung transplant coordinator, eventually na develop na yung skills on how to talk to patients kasi ay yung clincher yung skills ng coordinator para hindi mo of hindi mga patients, minsan kasi gano yung yung nagiging problem. Then information dissemination dun sa hospital lang mismo. Kasi if you imagine, PJG is a government hospital, thousands ang mga patients dyan, so you expect at least three to five deaths in a day's room. For sure makakarod nyan kung yung death rate, so mga ako ka lang sabi mo ng kung hundred fifteen patients yung mamatay do, thirty eyes kagad yun. So marami yun. That's why it's very important na yung apat na isinabi ko yung apat, core niya especially kailangan talaga magkumit sila na maging active sa retrieval number two, involve din yung mga residents. So what I did is sa mga residents ko, I make sure na merong isang gumagawa ng paper about banking. Kasi that will push the resident na maghanap mga donors kasi kailangan sa paper niya. Then yung IM department yung involvement ng other departments like IM and surgery ER kung saan nakakarod nung mga mamatay, dapat involve lahat sila dito and alam nila. So then of course yung most important thing yung makoko-ordinate sa lahat. So if I'm given a chance, I would encourage all institutions, yung mga may roc of tamology training programs, this will be very easy for all of us kasi we have residents to do it. So yung plantilia na lang dalaga yung plunger ng transplant coordination. Tapos of course you communicate with IM, which for sure they will be very, very willing to help. Regarding naman dun sa kung kakausapin mo kung open yung patients sa mga talga, being a donor, most of the relatives, hindi siya magliving issue. It's very easy kasi makakarumpan na legacy yung anilana. Then eventually, pag lahat ng mga training institutions na karunan niya, it will be easier na for other hospitals, even private hospitals to be part of this one. So I would like to thank Dr. Padilia already for starting, ay bang kasi it's very easy na lang on our part to do this. And it's also good na yung census ngayon kasi if you notice datay, ang nakukualang natin yung young patients, young donors, mayang kasi yung advanced na cornyal transplantation na yung taw din yung DMEC wherein it will be better kung ang donors natin yung mga older patients. So now, nakakarunan na rin tayo ng yung mga patients na matay of natural death. Okay, so okay, thank you. Do you have any questions? Thank you so much. Dr. Payus will have those questions later and will handle all of those questions later in the Q&A session. But before we proceed with the Q&A, meron lang puta, what do we have mamangit? Yeah, we have a quick break for our special public service announcement for today. So hope the video works, cross your fingers. Go ahead TV UP. Bulang sound. You the sound, it's the sound pa rin. Okay, sige. Dato po sila lang po natin. Sayang, bulang sound. Oh, I think that is supposed to be our vaccination push. Yes pa. Those who would have the birthday. But nevertheless, let's go and proceed with our Q&A session and go ahead Raymond. Yes, thank you so much, mamangit. But before we proceed lang po, just wanted to remind everyone that a COVID communication, public service announcement, just one of the many creative outputs that stop COVID at its team to push for COVID-19 vaccinations po. So obviously, if you have been watching our show po, there is a working yung po yung sound, no? A video clip for this one and we hope you'll be able to share that one in all of your social media accounts. Stay safe and stay well. Magpasama na po sa Bacuna Center. Okay, I'll start off with the very first question that we have for this one. We'll choose the ones that are up-voted. We'll start off obviously po kaya yung mammingita. This comes from Dr. Joseph Tortona. How many recipients benefit from one cornea donor and the age range recommendable sa pagiging donor daw po? Okay, great question. Because of technology, remember Payu said there's a DMEC, there's a there's antero lamellar na before. If you use the whole thickness of the cornea, it's one recipient for the cornea in the middle. But the periphery can be used by other people like for the sclera patch grafts which I said, which I said maybe five more people for that, no? And or the stem cells themselves can be used. So it depends what you use the cornea for. If you do an anterior lamellar and a DMEC, that's two people already in one central cornea button. Now if you have the whole eyeball, it's even more people because each sclera can be divided into five sections. So that's 10 people for the sclera and then at least two people for the cornea. So again, it depends on the surgery you're going to use it for. And with technology, we can use it for more people. It used to be the age range just from two years old up to first they put the age range at 65, but that upper age range no longer, limit no longer holds. Again, because of technology. As we said earlier, we can use the corneas even at have not very good cell counts. We can use them for anterior lamellar, but we don't need the endothelium. We can use them even for capro surgeon. We can use them for tectonic or patch grafts, no? And then for older donors, they do even better for the called as decimismembrane. So the lower age range of two years old was because the cornea is a little too thin and too floppy before that age. However, we have exceptions and I'd like to our youngest donor was a baby girl who was born with anencephaline. She died 14 hours after death and her parents decided even before she was born that they would like to donate her corneas to the IVAC. Beautiful story and her corneas went to a toddler and then who's now six years old and studying. So my point is we make exceptions for very young children. We can still give the corneas. So right now ayaw na namin magbigay nang youngest and eldest, but for the for the normal shape and rigidity of the cornea, it's two years old as usually, two years old. Okay. Okay. That's great. Yeah, that's an eye-opener maminggita because when you said anencephaline, I am an obstetrician and we practice also in many government hospitals. We have a lot of anencephaline cases that we were not aware that these are potential donors. I think that- You can still donate and we have infants because they are born with congenital corneal opas. That's right. Yeah. So that's a very important thing. Parang hindi kami na abot ng messaging. So now nga abot kan na nakaabot tayo sa isa. So I have another question from the audience. This is from Dr. Ish Ludan. Ito kasama ko to sa Cardinal. Dr. Ish, if a private hospital wants to participate in the retrieval program, how to proceed and coordinate? So maybe I can maminggita and also let's ask Dr. Ocampo what was his experience as well. So maminggita first, ma'am. Okay. We deal with private and government hospitals. Our biggest contributor now among the private is Asian Hospital and Medical Center in Alaban. And we have many partners, but they're the most, because they're the equivalent of counterpoint of Oliva J. Garcia in private. All you have to do is contact the IBAC and tell us you're interested to be a partner. Then we will already draw up. We have a template of AMOA. Okay. And then we will have your legal look at it. If it's okay, then we agree. Then we will teach your staff how to do the counseling, how to do the retrieval. We have wet labs, et cetera, et cetera. So we have already a template of what to do. Now, all you have to do is contact us. Okay. Contact the IBAC and the numbers are there in the slide. Or you can just go to our website. Or I can give you the number now, 0917-53995. That's globe, just text. Okay. You want to be a partner. You're interested. We will contact you. Same thing. Okay. Sure. So Dr. Payos, anong naging experience punin nyo sa AUF, siya ka sa PJG. Merong bang mga concerns? AUF is a private hospital. Yeah. Yung AUF, I'm talking to Dr. Andrew Redd, my partner in LASIC. Buhay namin. Dati kasi, I think they had them all ready ka lang. Medyo naging busy, hindi naging active. Sabi ko sa kanya, dapat active tayo para makanundin tayo ng for our private patients kasi we will share the one eyes for us, one eyes for the IBAC. Makakabawas na dun sa backlog natin sa surgery. At the same time, makakakadulong di tayo sa IBAC. So I will do it. It's very easy naman kasi the IBAC is very easy to call. Then they will teach, ang magiging challenge nang kasi pag yung nasa malayong lugar. So kailangan talaga matrain yung mga staff doon pag-private from the business nila lang. That's great. So Raymond, may questions po ba tayo? Ako magtatan ang din mamaya. Go. Yes, questions. One question, I think coming in from one of our lay people po na who is really, what I'm driving at is this is not the first time that I've seen this type of question coming in from Mamaribic. Does prolonged exposure to gadgets affect the healthy condition of our cornea though? Okay, usually it's dry eyes, gadgets. The most common complaint is dry eyes because we know when you're exposed to gadgets, you don't blink when you're always on the computer. You tend not to blink as often. You have to consciously blink and rest every, well they say 2020, no? Rest for 20 seconds every 20 minutes by looking 20 feet away 2020 or if you find a two cumbers on every hour I say rest for five minutes, close your eyes or look far away. Walk around is also better for your health. The blue light affects your sleep pattern, not so much the eyes but the sleep pattern. And of course UV rays also affects the vision and affects the macula, affects the lens. So what I tell them if you don't want to get insomnia before you want to sleep, shift, even take your eyes off the gadgets or put a blue light filter. So basically it's more the dryness and the eye strain. If you're astigmatic and you have correction errors which you don't correct, it can make things worse as well. And there are studies that show that children are always on the gadgets tend to be more myopic near-sighted than those who are not. So there's a suggestion also that you go out, tell your children to go out to play at least 30 minutes a day under the sun. It will help make their eyes less myopic, okay? Otherwise you'll end up with more myopic children. Let them play outside. Okay, mamang get your questions. Yeah. So nakalaging ito, do you have an honor walk or any acknowledgement, a little ritual to pay homage to the donors before their eyes are harvested? So that's something that we want to highlight. Mariano Marcos has an honor walk for the donors. It's beautiful. I think also the Eastern Visayas, so these are DOH hospitals, Eastern Visayas Medical Center in Tacloban. What they do is, the U.S. also some hospitals have this. So after any organ donor or tissue donor, after the donation, they bring them to the morgue. But there's like the medical workers, the nurses, the doctors, they line the corridors for them and give them an honor, like a final salute. It's beautiful, right? And you can see it in the website of the iBank and the website of Mariano Marcos Hospital. So they do an honor walk. Coming in the iBank, we always give them a certificate of donation that can be taken display. We give them snacks for the, what do you call this, for the week. And we give them recognition, definitely we give them recognition. There was a time, some hospitals have their own way of encouraging the nation. Some even say one member of your family will have three eye checkups for life. There are many ways. But that's why I want to dispel the fantasy that Filipinos don't donate. They do it if you just talk to them properly. And other, I want to try to get, remove this notion, especially the younger people now are more open to it. Kuminsan, sasabihin ng asawa ng namatay, yes gusto ko, pero nakikielo naman yung ganan, you know, the other extended family, but the younger people are more open. And you just have to tell them, mga katulong kayo at buhay pa yung mahal nyo sa buhay. Pabubuhi pa siya sa iba. And itanoy, tamang paraan lang talaga, lima payos sa inyo, at ang galing ng transplant coordinator ninyo talaga. You know, she lets, she makes life easier for the donor family. You know, all the paperwork, kinagawa niya. You know, they give them, they give them, premium, premium. It is her who does that. But they're all hospitals to make it a policy to give their donor something, some premium, some discount or something. Sana, di ba? Or the duration of having AORs. I don't know, but you see these are, kanya kanyang discarte. But yung donor, yung transplant coordinator nito Pauline and Jay, she tells us, tinutulungan ko pa yung mga nurses awards na mang bibigay ng donor. Yung she really goes out of her way. Talagang passionate siya. And like others, makihintay lang ng tawag ng living-related donation, yun lang. Ito talagang siya does for part. And that's why it's key. The transplant coordinator, the ophthalmologist, the residents, and the management of the hospital. Kailangan serioso sila at may plantilia. I tell you, I tell you, I tell you. I tell you. I tell you. Hindi po ay may multitasking, no? O siya, today, head nurse ka nito. Bukas, ok kaya kung may transplant, kung may donor siya punta ka, it cannot be like that. Kailangan may plantilia talaga. Yeah, that's very great, no? So ang concern namin, like incentiveization is one, you have highlighted that, no? Number two is that we are able to provide an infrastructure to support the donors that will help them, especially if it's in their time of believement. But what about general education of the public? We have a different culture, shall we say, compared with, say, our neighbors like in Thailand. I'm a practicing laparoscopies and we go to Thailand because they have more cadaveric availability because they are less mindful and they're very open to that. Do we have to make an educational pitch, put it in our curriculum to make us more open to this type of this type of donation program, ma? What are your thoughts? Definitely, definitely, it should start. That's why there has to be close relationship between the department of education and department of health on this because it has to start from a very young age. It should be part of the curriculum. We have to start changing the mindset as early as that because ma, we're just an NGO, we're an NGO for heaven's sake, we're not a wealthy NGO. It has to be all of government, all of society approach and government meaning DOH, depth-end, DICT, DILG, you know, kailang kami sa totality. It has to be, you're right, education is important, education. We have materials, we have materials from all the experiences, the donors are speaking, the recipients are speaking, we have beautiful stories to share, show it na lang in the schools. Pwede yan, bakita nyo sa mga school na para hindi sila, they will not have a bad or a wrong attitude or impression of the nation, organ and tissue, not just tissue but organ donations. Mas mahirap yun kaysa koy nyo, mas mwede liyang koy nyo. Doc Raymond, may tanong pa? Yes po, yes po. Question, I did that and I will post this to ma mingita kasi this is the same question that I posed during our planning meeting which is I got two questions similar like this. So if you have been a recipient of a donated po na cornia, when you die, pwede daw po ba yung maibigay din po? As of now kasi we don't accept the cornia but we can use it for training and research, definitely. But we can get your entire eyeball and we can still use your scale na. We can still use your scale. I'm saying now, we don't know in the near future, you know, tissue culture for example, tissue culture, we can still, you know, now the endothelial cells of cornia, mas na maraming, can be grown and cultured. And eventually what we're looking forward to soon is that you can get those tissues, those cells and inject them into the eye of a recipient. Tapos ihiga na lang yung tao napaganito to repopulate the endothelial. That's what's happening now in clinical trials. So we can certainly use the eyes of the person who has had a transplant but leave that up to the eyeball na lang. Ang message ko siguro sa latang tao, wung na yung isipin pwede kayo hindi, kaya ang muna lang kami mag-design. Ang impotante mag-donor kayo, mag-sign kaya ng donor card, you can let the eyeball decide na lang if you're okay or not. We have our ways to find out, one is examine the eyes. If we feel the cornia is ready, not really good enough, we'll encourage you to donate the eyeball if you wish because the sclerach can definitely be used. So it depends, it depends on many things. That's my answer. Technology is evolving. Thank you mam minggita. Question po will be, let me just read it po. Question that I got. Are there any support networks or organizations for recipients of, for cornia transplant recipients in the Philippines? Dr. Payos? Support. Yes sir. Support networks na pa in the Philippines. I think the eyeball network ko hat. The eyeball lang, eyeball kaya na tayong. Actually, actually wala pa kaming alam na support net for cornia transplant recipients per se. But there are support networks for certain diseases like aniribia, those people who need special help. But wala pa for transplant recipients themselves. Kasi pander so happy na ay. Parang kailangan ang support ko po hindi sa lahakita. But as soon as they can see, although the eye bank, what we do is we keep in touch with the recipients because we use them or we need their help, we call upon them when we need advocacy. For example, hijingin ang isang TV station, pwede mo maka-interview ng isang recipient ng bata, isang matanda na ganoa na para advocacy. Then the eye bank is the one that contacts them through their doctors. But support system itself for those who have been recipients wala pa eh. But maybe they might have some psychological thing. Because we have some businesses that say na, makikita ko yung ganito, they think that they can see through the eyes of the donor. I remember a patient said na, sinabi sa akin, nakita ko sa salamin, nakailangan yung pangganti ko yung paka matay niya. Maybe psychological support also, just to assure them that nothing bad will happen to them by receiving the kindness of somebody else. And if they have issues, maybe it's more psychological also, psychotherapy is necessary for some. But that's an exception. Very interesting. So Dr. Pius, baka you can share some case studies where you found it difficult to convince and then what were your methods or ways or approach so that you'll be able to overcome these barriers. As pa-comment natin si Mamigita, ano ba yung mga tips and tricks? Because definitely there are many barriers towards i-donation want to support that. So please share your experiences. Actually mam, I'm not involved in talking to the patients. But at first, may time may residents are the one talking to them. So I realize na naging problem sometimes if the transplant coordinator is young. Kasi minsan pag-young yung transplant coordinator, may authority ng konday yung mga, siyempre grieving yan yung mga relative. So nakoan namin si Mam Jasmine. She's, I think, 50s. She's more mature so she knows how to talk to the patients. I think that one will remove the problems na. Yun lang ang mga doktor ay. Parang kailangan lang makuha yung technique on how to talk to the patient, to the patient's relative. Parang yung hindi na makakaroon ng issues. Regarding sa ano naman ang problem kasi dahil nasa government kami, it's very difficult for the relatives sa asikasuhin yung paperwork ng patients. Napagginawa ni Mam Jasmine yung paperwork nila. Approved na kagad yan mag-donate. They will not even bother me. Wala emotional part, basta mag-uha-sell lang yung trabaho nila sa paglalakap ng papeles. That's a very important tip for government hospitals. Ang daming paperwork ang daming red tape, if by donating that will be handled by the trans non-coordinator, ang laking bagay noon. Tamay ang sinabi nipayos. Tamay nyo. One more. Tamay yung sabing mature yung trans non-coordinator. Hindi lang mature. The trans non-coordinator must be comfortable with death. Must be comfortable with asking. Must not be apologizing to the deceased's family. Always tell them, don't apologize for what you're doing. You can't go with them. Express your sympathy. But yung approach na, I think you're giving them a chance to leave a legacy of their loved one. That's sa ane-ane. That's how you present it. And show them all the good things that can happen because of that. Then you'll be helpful and be comforting. And do not rush them. We teach. We teach. We have a course for this. It's part of the workshop that we give. The web lab, the workshops is how to counsel. Our trans non-coordinators do that also. And the DOH hope. The human organ procurement effort. I also want to say thank you to them. The time you saw the dip in the tissue, wala kami. They also help keep us alive. Yung mga multiple organ donor. Special cry call out to Arlene Bukin. She was really helpful. Hindi na sila kidney centric. Kidneys, cornyas, liver lungs. So it has to really be a joint effort. So much of it. So apart from people on the ground that are very accommodating and facilitating. So that will help. I'm a fan of AI. So Doc Raymond, you know that. So can there be an algorithm? For example, if the criteria has for the organ donation fits, then the patient or the relatives are automatically offered. So will that work? Will help. That will definitely help. Because right now, what we tried to do with Phil Nos since 2017 was report all deaths. It's not happening because there's no strict. Nobody's cracking the whip in government. Report all deaths. And once you have that AI, report all deaths. Even in the hospital dapat report all deaths. Even the ones who are already near death. I mean, this is for the organ donation at a certain level, glasco score, they must be reported. I mean, it's not like your ghouls or vultures. No, it's just a matter of just being practical. Because who knows his people might want to donate, but nobody's even bothering. Want to donate, but we have many foreigners who sign donor cards abroad, but nobody asks them here. They want to donate. In fact, the common thing I hear is sayang. If only somebody asked me, I would have said yes. You see? Sayang. Because we're not asking. That's why the hospitals have to change their mindset. And yes, if the hospitals have AI, type mo lang ang pak, red light, for counseling na yan. I mean, the automatic, the required inquiry and required request will also help. If there's an AO for that. Because right away, you'll have it in your database. Wala ay. It's what made the U.S. It changed the landscape in the U.S. in 1988 when they passed that law. We don't need the law. We have an organization law. AO na lang yan. Required request, required inquiry. Legay mo sa DNR form. Ita asop lang ninyo. Simple things like that. Wala. Wow. I can really feel na we really a lot of work. But at least this is an eye-opener, definitely. So Dr. Imod, let's see how our audience were able to answer to our quiz. Yes, yes. Thank you. Thank you so much, mamanggen. Thank you to Dr. Mingita and Dr. Payos for an engaging discussion. We'll now go into the next item po, which is our answers to our fun quiz. So can we have it on the screen right now? Thank you so much. So first question po, will be, this one will be answered by Dr. Payos. The second one will be by Dr. Mingita. Patient with cancer diabetes or other conditions that are contraindicated for who organ donation can still be able to donate their cornea. Is it true or is it false, Dr. Payos? You can still donate even if you can't as diabetes or cancer, there are only infectious. Camdena it was presented by Dr. Padilla. You can still donate. Thank you so much. Here in the Zoom, 65% of those who participated said true and may 35% na nag falls. Dito po sa ating first question. So pwede pa rin po mag-donate kahit po may ganun conditions. For our second question from mamanggen, the correct answer po, the most important factor in a successful i-banking program to encourage people to donate is? An active corneal retrieval program in the hospital. That is the most important. As I said in the lecture, you can have all the media and all the PR that you can have. But at the time of death, you cannot expect the relative to remember. Somebody has to ask. Iba? If nobody asks, then you will lose you will lose the chance. And you have to have and then to help them remember also you have to have all the visuals, posters, et cetera, in strategic locations in the hospital. So it's better active corneal retrieval program. Okay, letter C. Yes, thank you so much. 57% of those who responded chose letter C active corneal retrieval program. Meron din po dito. 22% is public relations and media. And then 14% funding and then 7% po sa ating availability of the i-surgeon. So yun po, those are the answers to our two questions for today. Can we have our panel evaluation poll po be flash onto the screen? The other question po, not the fun quiz, but yun, there we go. So for those who are in the zoom, you'll be able to see this panel evaluation poll. Po natin. So maraming, maraming salamat po. Again, thank you so much sa ating mga oftalmologies, mamminggita, doctor Pios, maraming, maraming salamat po. Sa inyo. Please take the time as I read through the panel evaluation poll to think of your parting words to our viewers kung ano po yung what you would want the audience to take away from the webinar as I read through the list po na meron po tayo dito. So for number one, the panelists demonstrated thorough knowledge of the topic. Do you strongly agree? Agree, disagree, or strongly disagree? Number two, panelists were well prepared and organized. Number three, the panelists spoke clearly and audibly. Number four, the panelists used appropriate language with technical medical jargon as you can explain. And finally, the panelists contributed to new perspectives and knowledge on managing various key health issues. We will not be closing the panel discussion poll until the end of our webinar as we move on to the parting words from our speakers. Go ahead mamanget. Yeah, thank you. And despite us having a very brief eye-opening messages for this webinar, we'd like to ask your closing remarks, mamangita and doctor. Payus, what do we want to tell our audience for to be able to, as our take-home message about i-banking? Go ahead, mamangita. You want to say, Payus, you go first. So payus mo na, go. Okay. Parting words first for us cornyas specialists. We are the ones who know kung sino yung mga may kailangan tayo mga cornyas specialists. We get our cornyas from the IBA. So I think we should all be active as cornyas specialists in giving back to the IBA. Dapat tayo. We want to be active to look for ways para mapawasan yung mga backlog natin. That's for the cornyas specialists. For everybody else, there are two things that will never change sa buway natin. Death and taxes. We will all die. We want to leave legacy. So one way of leaving a legacy is to be a donor. So I think that's all. Thank you, Dr. Payus in our final words from Dr. Mita Badilla. Mamang? Aside from what Payus said, agree ako jan sa dahat mo. But everyone of each of us, everyone of us can be heroes in other people's eyes. You can be a hero in other people's eyes. But just donating our cornyas. It doesn't take anything from you. Nothing. We will not lose anything. We don't need them in heaven. We need them here. And a lot of people need them. So please consider resigning a donor card, donating your loved ones cornyas when they pass away. I think I already said so much about it. And help us, help others. See, cornyas is something that you don't think about until it happens to you. It's the fifth most common cause of disability and blindness in the Philippines and in the world. It can happen to anyone. It can happen to you, tomorrow. And sometimes you don't think about it. And often nobody thinks about it. People don't think about it until it happens. So please help the eye bank to help those in need. And again, everyone can be a hero in other people's eyes. It's easy. Diadoon, thank you. Thank you, Dokanyita that is a very inspiring message. So now, Raymond, we will share our panel discussion, evaluation. Sakit naman nabaka. And we have the panel evaluation paul po muna before we go into our synthesis and closing remarks. Okay, so far, tulitulay lang po yung mga sumasagod po natin, at least 94% at least 94% of our respondents indicated that strongly agree with each of the statements. So that's a testament both to the webinar topic and the quality of experts that we have had. So maraming-maraming salamat po again to Doktor Mingita Padillian, Doktor Payo's account for talking about transformative powers po with regards to eye banking and coronial transplantation. For our synthesis and closing remarks, speaker that will be introduced by Doktor Aguilar. Okay, so I will introduce my boss who got me here, Doktor Stella Marie Jose. She is our head of the office of expanded education and training of the UPPGH who will give our synthesis and closing remarks. Ma'am, please. Good afternoon, everyone. We had another excellent lecture from Doktor Mingita Padillian and Doktor Payo's account. What is the status of eye banking and coronial transplantation in the city? I want to review what she said because it can affect any of us. So the process is damaged to the cornea. It can be pungal infection after a traumatic incident, recurrent surface, bacterial infection, trauma and improper contact lens use. You can see that in some patients. Congenital corneal opacity, chemical burns, corneal perforation, scar from measles and keratitis, post-cataract edema and keratophonus. So these are the causes of corneal injury. Now, landmark law in July 1995 was the Republic Act 7885, which is an act to promote corneal transplantation in the country. So it's already a law. So it's a good thing that it was integrated. So upon discussion we transplantation in the country, about transplantation in the country, do the recipients know the identity of the donor? So donations are anonymous. So they do not know who the donor is. But some come out in the open and like the family, they feel comforted because at least they have helped somebody to be able to see. So that's a good thing for us. All right. Mom Stella. Yes. Sorry. I was so then it came along and everything was a chance here. So during the post-pandemic times according to Mingita the eye banking was in crisis. So there was hardly any donation. But at present, if I may say so myself, I think the status of eye banking is hopeful because now the numbers are again going up. So in her summary, in her summary, Mingita said, how can you help the eye bank? First, encourage your own relatives to become either cornyal donors and also encourage their hospital to put up a cornyal retrieval program of their own and we should have an advocacy campaign in communities and organizations or for cornyal donation and of course, can donate to the eye bank of the Philippines. Now, we have a very young consultant, Dr. Pius Ocampo, also a graduate of the PGH department of Ophthalmology and Visual Sciences and now he is the head of the Ophthalmology department in Paulino J. Garcia, Memorial Research Medical Center in Cabanatu and Nueva Ecija and he gave four points for us to improve our our cornyal donation. He said, commitment of the consultants, number two, the involvement of the residents, so they get donors from the IM department, the internal medicine residents, the surgery resident and the ER resident and you should have a transplant coordinator in your hospital and of course, information on cornyal donation. You know, after the talk of Mingita, I checked my license and it was written there that not, not to donate and I will change that. Thank you very much for listening. Thank you, Ma'am Stella. Next week, we will be featuring a video. Tama, Riman. Next week pa will hopefully will have the Department of Health Undersecretary Sooka Dumama po and our health programs in the Bangsamoro Autonomous Region of Muslim Mindana po. So hopefully we'll be able to get the confirmation and we look forward to your participation again, everyone for that webinar. In the meantime for this, for not just for this webinar, but for all of our previous webinars, you can still watch us on the playback at the TVUP YouTube channel and the TVUP Signal TV Channel 101 and we thank Ma'am Stella for capturing pa yung essence po na ating webinar and next week hope makita kita po tayo and before we conclude our program, all stop COVID-19 webinars are archived for viewing at the TVUP YouTube channel. So you just either you open your YouTube app or you go to your web browser type in YouTube.com forward slash TVUPPH for you to be able to see all 162 after today 163 webinars that we have had today. Also, we know that you are everyone very, very busy po. So we have selected and made short presentations but that we call SED shorts so you can watch them at your convenience also at the YouTube channel of TVUP. So this formally closes po our webinar for this week. Makita po tayo again next Friday from 12 noon to 2 p.m. It's a date. Thank you. 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