Caring for the least of her brethren

There was no light on the road to Damascus or any great epiphany that set Dr. Luisa Venida on her crusade to help lepers and others disfigured by infectious skin diseases. Following the biblical exhortation to care for "the least of (her) brethren" was simply a choice to remain faithful to the Hippocratic Oath she took 30 years ago.

Venida, founding president of the five-year-old non-stock, non-profit Skin Research Foundation of the Philippines, Inc. (srfpi), is an expert in all types of skin diseases, particularly leprosy. But she admits that she is still learning the ropes about running a private charity organization and maneuvering through bureaucratic red-tape.

"Some may not believe it, but it is really just to help fellow Filipinos. It started when I first worked at the Dermatology Research and Training Center (drtc) of the Department of Health," says Venida, who is chair of the Department of Dermatology at the Jose R. Reyes Memorial Medical Center (jrrmmc) in Manila.

"With the right equipment and trained personnel, leprosy can easily be detected and treated. It’s still the stigma and fear–even among medical practitioners–that is contributing to the misery of the patients," Venida explains. "The DOH in coordination with international agencies like the World Health Organization (who) has an effective anti-leprosy program. But like in other agencies, funding is always too little for the task."

Leprosy or Hansen’s disease is a chronic infectious disease that affects the skin and nerves. The earliest sign is a patch on the skin that is lighter in color than the surrounding skin, with diminished to loss of sensation. Leprosy is still endemic in the Philippines and remains under-reported due to the lack of awareness among the general public.

Leprosy can only be acquired during early childhood or from zero to five years. It is also poorly communicable so there is practically no danger of doctors and nurses getting the disease from their patients. It takes several years, sometimes decades, before symptoms appear. That is why, Venida says, early detection is important.

Venida took up pre-med at the University of Sto. Tomas, majoring in psychology, and completed her medical degree at the University of the East in 1975. She did her senior internship at the Baguio General Hospital and in 1977, began work at the drtc, which she briefly headed after the 1986 People Power Revolution.

When the drtc was transferred to the jrrmmc in 1998, there was strong opposition owing to the nature of the center’s work. "Naturally, I brought my patients with me and hospital officials were afraid," Venida says.

Venida also found out the hospital had no dermatology department to speak of. So she began to set up the department and, along with some of her fellow medical consultants, undertook fund-raising for their patients, particularly lepers.

Their work was tiring but gratifying, although there were times when things hit hard like when some of her patients went insane or even committed suicide out of depression trying to cope with the disease and its side-effects. She recalls a 27-year-old patient who hanged himself because he simply could not cope with the pain of gastritis caused by the continuous use of steroids as part of his leprosy treatment.

"Majority of our patients are poor and we can only provide anti-leprosy medicines. So in order to help reduce the side effects, they should take antacids and eat more to allow their body to cope with treatment. But they don’t have money. There should also be some psychological support. It was one of the saddest moments of our work, and that could have been prevented if only we had a little more money to provide patient support," she says.

Patients who are employed often lose their jobs, contributing further to lack of finances to buy medicines. Symptoms of the disease strike during late school age to working age "when they are supposed to be most productive." In 2005, patients ages 16 to 35 accounted for more than half of the cases; males comprised 71 percent and females, 29 percent. Out of the 299 new cases reported last year nationwide, Manila registered the highest number of patients with 65 persons afflicted with the disease.

There are other stories. A high school girl kept her illness from her family and used her allowance to buy her medications until she finally got well. Fortunately, the disease was detected at an early stage.

An Army officer would often cry during visits to her center because his wife, who is a nurse, refused to talk or even go near him. Whenever she is at home, she locked herself in her room as she could not bear seeing her husband covered with festering wounds. "When I convinced both of them to come, I told her: ‘Bakit ka ganyan, nurse ka pa naman, alam mo namang hindi yan nakakahawa. Tingnan mo, hinahawakan ko asawa mo’ (Why are you like that? You’re a nurse so you know that this is not contagious. Look, I’m touching your husband)," Venida recalls.

On the other hand, there was a 75-year-old patient, a balikbayan, who had a wife less than half his age. Venida reports that the couple even had three children during the course of his treatment.

Deformities associated with leprosy happen only when the patients do not take any medication, Venida says, explaining that the skin sores that appear once treatment begins is actually a good sign, as it shows that the bacteria are already dying because of the medicines.

Venida has been conducting studies and tests on the use of squalene, an extract from shark liver oil, and virgin coconut oil as alternative medications to reduce the side effects of the drugs. The results are very encouraging.

Very little money, Venida laments, is allocated for dermatology in the government’s health program because of the common notion that it "is all about vanity." Her deparment handles about 33,000 new skin cases a year, including about 300 leprosy cases, most in the intermediate or advanced state already due to the lack of access to detection equipment. The srfpi was formed to fill the gaps in the government program against leprosy and other skin diseases, including those triggered by the human immunodeficiency virus (hiv).

The foundation needs at least P2 million annually for the purchase and maintenance of detection and laboratory equipment, patient support, research and training. Apart from leprosy, the foundation also seeks to take the lead in combating cutaneous tuberculosis, which is also prevalent among Filipinos.

"All of us Filipinos have a stake here in eradicating these diseases," Venida says. "We cannot turn a blind eye to them. We mingle with people who may be patients. Our children go around, what if they get infected? Shouldn’t we all be working to totally eradicate all these diseases for our children?"