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In their own words

Dr. Miriam Joy Calaguas

Philipines: Crossing the social divide to fight cancer

Miriam Joy Calaguas works in two worlds. The Filipino radiation oncologist treats cancer patients with state-of-the art radiotherapy treatment at a private clinic in Manila. But on Wednesdays and Thursdays, she leaves the pristine corridors of St Luke's Private Hospital, to work at the two main public hospitals in the city.

“I have the privilege to work at the premier hospital where cancer patients – who can afford it – get the best in radiation treatment. At the same time, I see what is going on in the government hospitals – the lack of facilities, the lack of equipment and manpower. Where patients line up to get a slot, sometimes waiting two to three months. By the time their turn for radiation treatment comes, the tumor has already grown so big or even spread. So our treatment strategy is totally different in the public hospital. We select patients with an early diagnosis and give them priority over the ones whose cancer already has advanced to late stages.

“You feel hopeless sometimes. You don't offer them the treatment because you know they can not afford it. It's bad enough already knowing that they are stuck with a terminal illness, without knowing that there is another kind of treatment that can extend their life but they cannot afford it. You have to be aware of the sensitivities.

“In the public hospitals we have only one machine, with about 100 patients to treat. It is used until 2am in the morning. The technicians are overworked and underpaid, unlike in the private hospital, where they pay overtime.

“It's frustrating because you know what to do, but there are just not the resources. The Government doesn't have the money for a cancer control programme; sadly health is not really in the top priorities. So we need outside donors like PACT. We have the people. We have trained staff in the Philippines who are capable and smart, that we train here at the University. But what can you do without the facilities and radiotherapy equipment? You cannot treat with your hands.”