This month, the Department of Health (DOH) opened the first urgent care and ambulatory service center in the Philippines.
Named the "Bagong Urgent Care and Ambulatory Service" or the BUCAS center, the DOH stated that this endeavor marked a significant step towards ensuring access to quality healthcare for all Filipinos.
“As we unveil this pioneering BUCAS center less than three months from conceptualization, we focus on our goal of establishing 28 primary care centers to serve the 28 million poorest Filipinos by the year 2028,” said DOH Secretary Teodoro Herbosa.
The center is envisioned to address the ambulatory medical and surgical care needs of Filipinos, especially for the poorest of the poor.
To date, the BUCAS center offers surgical services and has laboratories with comprehensive diagnostic capabilities.
Moreover, the DOH said efforts are underway to begin providing additional services, including ambulatory services in ophthalmology.
Shedding light on an emerging threat
The Philippines is no exception when it comes to diabetes, as it continues to emerge as a pressing health concern worldwide.
As a significant portion of its population is affected by diabetes, the country faces various complications associated with this disorder.
One such complication that often lurks in the shadows is diabetic retinopathy.
In a media forum on DOH Modernization for Equity last January, Herbosa underscored the importance of detecting retinopathy among diabetes patients as soon as possible.
“Kapag na-detect agad ang retinopathy, hindi mabubulag ang pasyente (When retinopathy is detected early, the patient will not go blind),” Herbosa said.
Diabetic retinopathy is a leading cause of blindness among adults --- both here and abroad.
Affecting the retina's blood vessels and the light-sensitive tissue at the back of the eye, diabetic retinopathy can lead to severe vision impairment or even blindness if left untreated.
“Diabetes is one of our highest burdens of illness, and retinopathy, which leads to blindness due to damage to the eye lens, its main cause is diabetes,” Herbosa explained in a mix of English and Filipino.
While the condition is primarily driven by prolonged high blood sugar levels, other factors such as high blood pressure, cholesterol levels, and lifestyle habits can exacerbate its progression.
In the Philippines, where diabetes prevalence is alarmingly high, the incidence of diabetic retinopathy is also a significant concern.
When asked to provide data on diabetic retinopathy patients in the country, Herbosa noted that population-based surveys showed a prevalence of 1-2 to 10 percent. “In hospital-based surveys, it goes up to 60 percent, which is high,” he explained.
Given this, Herbosa said the DOH plans to adopt best practices from other countries. “In Thailand, they utilized a methodology that involved the use of artificial intelligence for primary care clinics,” he explained.
Leveraging technology to facilitate remote diagnosis and monitoring of diabetic retinopathy, he noted, can also help bridge the gap between urban and rural areas --- ensuring that all individuals with diabetes have access to essential eye care services.
To further strengthen ophthalmology services in the country, Herbosa said that eye health will be among the priorities in DOH’s urgent care and ambulatory centers.
“Iyan ang gusto kong gawin, itatag ang mga pasilidad para madetect ang retinopathy, at kapag agad itong nadetect, hindi mabubulag ang pasyente (That's what I want to do, establish facilities for detecting retinopathy, and when retinopathy is detected early, patients won't go blind),” Herbosa said.
Challenges experienced by diabetic retinopathy patients
The interplay of genetic predisposition, lifestyle factors, and limited access to healthcare exacerbates the burden of this sight-threatening complication.
Asked about the challenges experienced by diabetic retinopathy patients when receiving medical care and obtaining medication and how DOH is addressing these, Herbosa once again underscored the importance of early detection.
One of the primary challenges in addressing diabetic retinopathy in the Philippines, according to DOH, is the lack of awareness and routine eye screenings among diabetic individuals.
Many people with diabetes may not realize the importance of regular eye examinations or may face barriers in accessing eye care services, particularly in rural or underserved areas.
Moreover, the shortage of trained eye care professionals and resources further compounds the issue.
Herbosa noted that while DOH offers eye services, having a small number of specialists also poses a problem.
He noted that eye specialists, particularly ophthalmologists, are rare --- especially in remote areas.
While urban centers may have relatively better access to eye care facilities, rural communities often lack these essential services, leading to delayed diagnosis and treatment of diabetic retinopathy.
Herbosa said that around 30 percent or three out of 10 patients have “some form of retinopathy,” and about 10 percent will need treatment.
“We have data on the severity distribution of retinopathy, and we use these statistics with the assistance of the private sector,” he explained.
DOH, Herbosa said, is in constant coordination with specialists such as those from the Philippine Academy of Ophthalmology, the University of the Philippines (UP) National Institutes of Health, and the Philippine Eye Research Institute.
“They help prevent blindness, and retinopathy is one of the causes of blindness, so I am going to make sure that our specialists will assist in our centers,” he added.
Prevention is key
While DOH strengthens efforts towards early detection, Herbosa underscored the importance of addressing the root cause of diabetic retinopathy which is diabetes.
“We need to prevent people from having diabetes, and if they develop diabetes due to hereditary factors, they can be treated. If they are treated, retinopathy can be prevented,” Herbosa said.
He also noted that what is very important in preventing retinopathy is the ability to control the sugar levels of diabetic patients.
Addressing diabetic retinopathy
To combat diabetic retinopathy, DOH said the Philippines must focus on multiple fronts.
Apart from increasing awareness about the importance of regular eye screenings among individuals with diabetes, there is also a need for healthcare providers to emphasize the importance of early detection and timely intervention to prevent irreversible vision loss.
Herbosa stated that under his leadership, the DOH will prioritize primary care, as seen in other countries that have heavily invested in primary care to ensure the well-being of citizens.
“We will focus on health promotion, disease prevention, and early detection – that's what we'll implement in our new urgent care and ambulatory centers,” Herbosa said.
Overall, the DOH recognized the pressing need to expand access to comprehensive eye care services across the country to address various causes of blindness such as diabetic retinopathy.