Milestones in the Life of Philippine Leprosy Mission

1945- The US liberation forces brought in with them several representatives of major Protestant denominations to revive work in the country.  Each appointed a representative to be with the PHILIPPINE EVANGELICAL LEPROSY MISSION (PELM) which was to  be the   conduit of the American Mission to Lepers (now American Leprosy Missions) for the spiritual and material help of Protestant leprosy patients in the four major leprosaria.  Soon after, Filipinos were invited to join the committee. Thus, from the beginning of leprosy work, the American Mission to Lepers, was the main support of the leprosy work.

1945-1960s – As the PELM identified and addressed the most urgent and vital needs of patients, help for different aspects of their lives was extended through coordination and cooperation of churches in the area where the leprosaria were located.

In the 60s, Elizabeth Hessel, wife of the pastor of Ellinwood Church was able to work through the Department of Health and given permission to work in the Central Luzon and Culion leprosaria where most patients were.  Buildings were constructed, local committees organized to oversee the work needed, relief goods were distributed.  Local doctors were sent for training in India. An American Physical Therapist, Judy Corot, with the newly trained doctors, started training staff in new aspects of leprosy care in these hospitals.  The operating rooms were updated and surgical wards renovated to conform to modern standards.   At the same time, Filipinos started being active participants within the committee and with the patient work.

April 10,1962 – The Philippine Leprosy Mission was incorporated through the efforts of Atty. Miguel V. Gonzalez, who became President and Chair of the Board of Trustees for several decades.

Six Filipinos and three American missionaries were signatories of the incorporation papers.

1968- Our Research Paper on “Utilization of health activities by leprosy Patients” was accepted for funding by ALM.  The Department of Health in turn, accepted the recommendations and this led to the organization of the Resource Center for Training in Leprosy (RCTL) and the allowing of PLM to have an office a DOH building within the compound of the department.  This also became a training room, library for literature in leprosy and a place for out of town leprosy workers to do their work while in Manila.

Volunteer specialists in ophthalmology from the Philippine General Hospital and the East Medical Center have traveled to leprosaria to operate on eye cases.  PLM in partnership with Soriano enterprises (which provides transportation by air) make these biannual sorties possible.  Reconstructive and difficult surgical operations were made available to the leprosaria with good operating rooms.  On the same arrangement:  volunteer surgeons, also traveled at least bi annually to do the major surgery not possible with the leprosaria doctors.  Subsidy of the activities: Air transport courtesy of Soriano enterprises and funding of the miscellaneous expenses by PLM, and the hospitals provided board and lodging to the surgical teams.   This practice has been discontinued since the DOH organized well-equipped secondary and tertiary hospitals in the regions  in the late 90s and early 20^th century.

In the late 60s, the PLM, in cooperation with Sasakawa Memorial Health Foundation (SMHF), Sovereign Military Order of Malta, and with the permission and cooperation of the Department of Health , initiated the Multi-Drug Therapy (MDT) in selected areas together with local health staff.  The selected areas were hard to reach and had very high prevalence of leprosy, the islands of Butanes and Munikani off Samar province. Public health workers were trained to do the distribution of drugs (at that time, still dispensed in loose form) and treatment and monitoring of patients.  PLM staff visited every quarter with DOH doctors to evaluate progress.  These two initial efforts were effective even before the nationalization of the National Leprosy Control Program using MDT as an approach.

1970s – PLM expanded so that therapists could give service to different leprosy units to act as the core of the training activities, with doctors and other specialists from the DOH.  Concurrently, Physical Therapy Units were equipped and added to the four major sanitaria: Central Luzon, Culion, Cebu and Iloilo.  At the same time, Family Planning Units were established in these same hospitals to service the communities around them. Leprosaria staff trained sub rosa while they went on leave. Note that this was a pioneering activity, because, at that time, DOH did not allow any form of Family Planning services.  Activities designed to educate the public regarding control, prevention and treatment and rehabilitation were launched in cooperation with interested NGOs and regional offices, with PLM funding activities and DOH providing staff from public health agencies.

1973- Tripartite agreement with the University of the Philippines to provide consultancy and training services in Rehabilitation with volunteer Instructors and Physical therapists of UP School of Allied Medical Professions.

PLM arranged for the licensing and retraining of Physical Therapy Technicians in the sanitaria so that the leprosaria/sanitaria could have permanent trained PT technicians in the leprosy hospitals.

Cooperation and coordination with the Sasakawa Memorial Health Foundation (SMHF) started with DOH an exchange of doctors and leprosy workers.  SMHF funded training for leprosy doctors in Karigiri Schieffelin Leprosy Research and Training Center for about three decades.  In exchange, doctors and workers from Japan and other Southern Pacific and Asian countries were hosted (and trained as necessary) to   observe leprosy work in different areas of the country.

1977-Sasakawa Memorial Health Foundation  requested the Philippines to host an International Chemotherapy Conference in Manila.  Because DOH did not have funds to initiate this activity but was desirous of the privilege and honor of hosting the first conference of this sort, the Secretary of Health asked PLM to be partner in the enterprise.  Thus, PLM became the lead agency in the organization and implementation of the major international activity.

1978 – The General Secretary of the International Leprosy Association, ILEP, convened all the stakeholders  (NGOs) working with leprosy patients to organize the Philippine Leprosy Coordinating Committee (PLCC)) and thus avoid duplication of effort and economy of resources.  For years PLM was the major correspondent and liaison for the organization until majority of the members opted to change the direction of their activities

This period also marked the expansion of relationships with other global international welfare organizations:  Church World Service, World Vision, Christian Children’s Funds, Pathfinder, The London Mission, Sovereign Military Order of Malta, World Neighbors and Interchurch Commission on Medical Care.   We have to include local relationships with the regional Medical Associations, Medical and Nursing Schools and the major Protestant universities and churches

Networking with other government and private organizations enabled PLM to offer corollary assistance to leprosy patients so that they can learn how to access their services regarding alternate ways of earning additional resources to alleviate their financial conditions.  Among these:  the Department of Social Welfare, Bureau of Labor, Department of Agriculture, National Council for the Welfare of the Disabled, Philippine Foundation for the Rehabilitation of the Disabled, Philippine Band of Mercy.  The Catholic Charities, Philippine Sweepstakes Office    Agricultural Colleges like UP Los Banos, and  Arpanet volunteered their expertise to help.  The Presbyterian Church established a farm in Cavite to train pastors in agriculture and animal husbandry.  PLM was able to send patients or family to access the training provided.  Northern Motors Inc., a big car company, provided free training in car care and maintenance to some of our patients.

1980s- Marked the major role of PLM in the organization and implementation of the National Leprosy Control Program (NLCP) whose major approach was the use of Multidrug therapy through domiciliary care.  The advent of MDT with its major advantage of rendering a patient non-infective after a month of treatment allowed the World Health Organization and governments to adopt the program.  The Philippines was one of the first countries to start this program and pioneered the use of the blister pack to encourage patient compliance.

1983 onwards- Training of health personnel started. First, in two pilot provinces and later, in others with high prevalence.  Implementation followed right after the training so that the same trainees did the advocacy and coordination with local officials as they implemented the treatment program.

The National Leprosy Control Program

Based on the results of the  pilot area leprosy control program, the Secretary of Health Dr. Alfredo Bengson directed the  Bureau of Medical Services  to nationalize the MDT program as soon as possible.

A National Advisory Board composed of the major stakeholders with DOH as the lead agency was organized.  A National Task for Training and monitoring was instituted for each region.  The Technical Working Group sat together to produce a Training Manual and a Manual of Implementation for the use of the health services.

Training seminars and workshops with world specialists in leprosy were invited to train   leprosy consultants and private doctors from interested hospitals.

By 1985 (in two years), the whole country had integrated the program into their health services.  At the start of the program, Registries had a tentative number of 56,000 patients.  After careful screening out of the dead, cured, or lost, the program started with 38,000.  In addition to the regular health units, special action projects for elimination of leprosy  (SAPEL) for remote areas with no access to health services were implemented.  Community Action Projects (CAPEL) was organized in high prevalence endemic areas to maximize the effects of the NLCP.

The goal of WHO for every country implementing MDT program was to attain the elimination goal of leprosy prevalence less than 1/10,000 population.  The Philippines, after a decade of intensive implementation, reached the goal in 1998 (on a national level.)  At this time only about 3,500 patients were on the registers.  It still means however, that much has to be done in small pockets of high prevalence and infectivity and that the health services cannot sit on their laurels or else the prevalence will shoot up again

1987- PLM appointed a new Executive Director, Enrico E. Griño who was with the Board of Trustees, and more importantly was with PLM in which his wife was Executive Director, to be the all around helper, in accounts, administration and many times as financier in the early days when ALM did not yet give an annual budget for PLM operations.  He took the place of   Soledad Griño who was seconded to the National Leprosy Program Technical Working group as Consultant to the NLCP at the early stage of its inception.  During his incumbency, the then ALM President. John Sams allowed ALM to remit two year’s budget for NLCP.  Griño’s experience and expertise in administration and finance enabled PLM to invest these funds wisely, so that ALM did not have to send any more funds for the next three years.

1990s – saw an expansion of work by the PLM and the government in the direction of addressing other problems of leprosy patients: community organizations were established, continued training of new health workers and staff of NGOs involved in leprosy care and welfare, intensive campaigns to promote acceptance of leprosy patients into the mainstream of society.

Continued support to leprosy agencies regarding the treatment and prevention of deformities and disabilities in the form of assistance with materials for their PT departments, shoe projects, and occasional training of PT and health personnel in the leprosaria with many disabled patients.

PLM shift in program focus to include problems of patients apart from the medical: (1) scholarships to needy patients or former patients and children to the first level of consanguinity. Selected patients are given high school and even college scholarships. These of course are subject to agreed upon guidelines; (2) local organizations are helped to establish pre-school and feeding programs among their clientele;  (3) small family helper projects have been established to address continuing problems among the leprosy patient families.  Livelihood projects have been encouraged with PLM helping to contact other helping organizations so that the leprosy patients can take advantage of their programs.  Habitat for Humanity allowed PLM to enroll former leprosy patients in the program.  Eligibles have been given low cost houses that they can afford.

1998- PLM Executive Director, Enrico Griño and his wife, Soledad, then seconded to DOH as Leprosy Consultant and Technical Working Group for NLCP, retired but were retained as consultants and members of the Board of Trustees.

At the turn-over, Norand Pepito, then the Assistant Executive Director, took over as Executive Director and Teresina Posis, formerly co-worker in NLCP, became the Program Director.

Norand Pepito’s background was mainly on community organization and development.  The staff remained essentially the same although there was an expansion to  community development projects in addition to the original mission to help cure the leprosy patients.

2000 and beyond

The new leadership intensified the focus on community-oriented projects. While the projects oriented to treatment continued, PLM took the role of enabler of this new thrust, leaving the bulk of prevention, treatment and physical rehabilitation to the DOH partners.  Partnership with the sanitaria churches flourished.  Local organizations in the leprosy satellite communities were organized to implement livelihood projects.  The focus towards advocacy was intensified. The Executive Director’s expertise enabled PLM to organize and strengthen 17 organizations around the Philippines composed of persons affected by leprosy and their families. More small churches became more active in their orientation to helping leprosy patients.  Randy Pepito resigned after about 8 years to join an international organization.  In his absence, an Executive committee had oversight of PLM with the Administration under the responsibility of Jenette Callada, the Finance Officer.

2006- Dr. Gemma Cabanos was hired as Executive Director.  She had previously been with the Department of Health doing leprosy work, first, as Rural Health doctor, then Skin Clinic physician, then Regional consultant of the World Health Organization in Geneva.

When she resigned to take care of her ill mother, PLM took her on board to be Executive Director.  She continued relations with the DOH in the different

treatment and control and training activities.  In answer to the need for focusing on endemic areas that could be helped through innovative leprosy control strategies, she organized PLM-initiated Leprosy Activities (PILA) in Ilocos Norte and Sur, known endemic areas of leprosy.

The operations were mainly the responsibility of the local health unit staff, with PLM working with them at the onset, for the orientation, provision of materials and enabling activities. The PILA pilot project was envisioned to last 3 years per province, time enough for local units to find patients and put them under treatment.  This innovation in case-finding proved successful.

School children and their families were taught the early symptoms of leprosy. Then, they would just encourage going to the health center for proper diagnosis and treatment.  This strategy seems to have better results because the families and community were involved in the case finding and because they learned basic facts about treatment and control. She had been often asked by WHO to go on temporary assignments to evaluate programs in other countries.  Dr Cabanos resigned as Executive Director in January 2012 and was seconded by the American Leprosy Missions to the WHO Western Pacific Region Office.

2012 – This year, WE ARE IN ANOTHER  TRANSITION PERIOD.  The Board of Trustees appointed a management committee of three members: Dr. Belen Dofitas, Emmeline Huang, and Soledad Griño to oversee operations until conditions have stabilized and more concrete plans for the future are in place.

It is our prayer that PLM can continue to serve as Christ’s ministry to leprosy patients and their families, even in the face of the lack of the main support for operations, which has been our mainstay for the last 50 years.  We entreat each member and supporter to continue helping in this endeavor.

SSG-January, 2012