butuan ramblings
Written by admin on August 4, 2010.
Butuan Ramblings!
07-29-10
Greetings All!
Usually I attempt to initiate these ramblings by focusing on how the fluctuation of the jewel that is the Agusan River parallels a particular issue facing our clime. I cannot conjure up an appropriate segue this week.
We have toyed with many issues, a community action center, a viable navigation entrance, Expat public conduct, Butuanon Yahoo group moderation failures, infrastructure issues, and tyrannical political hindrances to community growth. And yet, Butuan evolves, grows and disproves the mindset of the ‘fellowship of the miserable’, in their belief that ‘things’ will never change, and that, ‘that’s how things are done here’. Fallacies both, and entirely disrespectful to Butuanons who are demonstrating the exact opposite with their deeds and actions. To that end, I wish to laud Dr. Nery, who had the courage to repudiate conditions present in our city hospital, against a political stalwart. He did this outside of the political realm via a public letter explaining his position. Whether his position was right or wrong is/was not relevant. What was relevant was that he spoke up for those without said voice, at great personal financial risk. This man is a hero. Alas, he and I have had our internet disagreements, but he is genuine and proud. He and I still disagree, perhaps, but he represents all that is good about public service.
In a related mindset, and please forgive me for going off tangent, but importantly so, I wish to again explore the concept of instituting a palliative care/hospice unit in Butuan City. I have made considerable rounds within our local medical community seeking their opinions as to whether hospice would be accepted in this culture and how it would be funded. This is an emotional subject to state the obvious. In order to present a platform for discussion, it seems appropriate to define hospice, in laymen’s terms, so here goes;
Simplified, hospice is therapy designed to make a patient comfortable, rather than attempting to aspire to recovery. A person entering hospice care, recognizes that death is likely within 12 months, sans heroic medical efforts.
There it is. No religion, no fabrications and no miracles. It is what it is.
According to Dr. Amante, our new Mayor, cancer is prevalent in our clime. It has hit my family like a brick. Most cases are terminal in a practical and standardized medical sense. Herein lays the issue at hand. If a dying person is in gross discomfort, medical doctors do not have the option to ‘Kevorkian’ a suffering soul, due to legal and perhaps religious bent. Isn’t this unfortunate? Additionally, and most importantly, the loving family likely does not have the emotional skill set nor the financial capability to cope with such an event. This is where a hospice caregiver enters the picture. Not only are they trained to effectively communicate with the patient, but also can release the decision making burden from both the family and most importantly, the physician.
Currently I am the primary care designate for two Expats living here in Butuan. There is no other choice for them. One individual’s family kicked him to the curb, the other’s primary family is ill equipped to advocate for his comfort, because they simply feel ‘ashamed’ to question a ‘Doctor’! The result of this lack of advocacy is a decidedly uncomfortable patient, who likely is not in a condition to speak for himself. The former individual is the poster boy for growing old with a family unequipped for dealing with such a condition. The latter is afraid to seek medical care in Butuan and not well enough to travel. While people vilify those who abandon an elderly person, I choose to examine the culture and available services as they are, in attempting to understand the mindset of those who ‘take the old one to the jungle’. Who among us is trained to care for an elderly person? It is a tiresome exercise to say the least, given failing memory, mood swings and intermittent bodily functions. At some point, it pushes a primary caregiver to exasperation. Who really decides when an elderly person ‘loses it’? Given these parameters, how can Hospice be a bad thing?
To this end, Butuan is always searching for a niche. Medical tourism is huge biz in many developing countries, but yet few ‘assisted living’ facilities exist. As we explore growth opportunities for our region, beyond the Balanghai, a big tree and Bood 1st Mass discussion, (all niche interests), perhaps construction of assisted living facilities are a productive discussion. Butuanons appear to be a friendly lot, smiles abound, and we are located in a very advantageous location relative to ports, services and beaches. There is no shortage of nursing students. Heck, driving on the highway past Doctor’s Hospital is a game of ‘nurse pinball’.
Back in the 60’s the State of Florida in the USA became a thriving destination for ‘snowbirds’, and they brought their ‘fixed’ incomes, (at the least), with them. South Florida boomed. A decade later, Arizona and New Mexico followed suit, and in turn flourished also. Butuan has more attributes than either of those locales, and the cost of living is considerably less here. I am often asked about business opportunities in Butuan, and assisted living homes and a crematory are always in the top five of my suggestions. There is no shortage of the elderly and the dead, and the thought of being tucked away in a concrete box for eternity just kills me! (smile).
But back to Hospice. Would a Hospice unit function in this City, in this culture? After a fair amount of research in the local medical community, the accepted opinion is that the more financially settled families simply hire nursing care for their elderly loved ones, and the less financially capable simply do the best they can. I would offer that in both situations, neither truly has the skill set to assure the comfort of the patient, for the options available are quite limited. Sometimes those we love the most are too emotionally involved to make decisions in the best interest of the patient.
Hospice is expensive and exists only with insurance/health care benefits in more developed countries. This type of funding is not available in Butuan City at this time. I have been told that there is a Hospice unit in CDO, but I have not been able to locate it, if it exists. I would propose that a short term solution might be to invite a trained Hospice associate to Butuan, and conduct a series of seminars/classes, with the goal of training a population of ‘visiting nurses’. I think this type of direction is a more realistic approach to a very prevalent, yet silent issue. Your thoughts?
Café Caliente at 11am tomorrow!
Peace to all!
Greg May
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