A Free Clinic for UP Athletes

The University of the Philippines (UP) Diliman has a dedicated team of professionals that provides the UP Fighting Maroons—the collegiate varsity teams of UP Diliman—the health care they need, before and during University Athletic Association of the Philippines (UAAP) tournaments. Directly under the UP College of Human Kinetics (CHK), the UP Sports Physical Therapy Clinic (UP SPTC) is the only accredited facility that primarily provides free medical consultation, physical therapy services, first aid and paramedical assistance, and rehabilitation programs to all UP enlisted athletes. The clinic also offers local and international certification courses, trainings and seminars for physical therapy student interns and professionals in the field of sports and orthopedics. These services are also available to the University’s students, faculty, administrative personnel, and the general public. Therapy in the field According to UP SPTC Director Maria Angela L. Borras, the clinic was originally a joint project of the CHK and the then UP School of Allied Medical Professions (now College of Allied Medical Professions in UP Manila). But it was only about a decade ago when the varsity physiotherapist then for the Maroons, Anthony Caguioa, reopened the facility and accepted student interns from UP Manila to be trained in sports, says Borras. When Borras took over the job in 2011, the UP SPTC was formally set up as an organization headed by the CHK dean. “Clinical supervisors, who are licensed PTs, were welcomed as consultants. The CHK provided an in-house physiatrist for medical consultation, and with a good number of PTs available, the clinic started to operate regularly during weekdays, from 8 am to 5 pm,” she says. “In 2012, the clinic developed a system that partnered student interns with licensed therapists, which allowed training and game coverage for all UP Fighting Maroons varsity teams, specifically for UAAP games. Therapy sessions have been done in the field to provide return-to-sports intervention and careful monitoring of the reintegration of recovering athletes to the team and sports,” continues Borras. According to Borras, the milestones of the clinic include “providing post-graduate seminars and certification courses for licensed PTs and other sports professionals (2014); hosting an international certification course for Kinesiology Taping and Instrument Assisted Soft-Tissue Mobilization techniques (2015); Commission on Higher Education accreditation as an internship facility (2016); graduates from UP SPTC serving as physiotherapists for both professional and non-professional athletic teams; licensed PTs who underwent post graduate training specialization working for teams here and outside the country; hosting international certification courses which cut the expenses for our local practitioners; staff serving for the Rio Summer Olympics (2016), FIFA Medical Emergency course, Anti-Doping course for healthcare professionals by Stanford University, and this year’s Russia World Cup; and, staff pursuing their master’s degree.” Personnel, equipment, and other services The UP SPTC aims to “give excellent physical therapy services for injury prevention, rehabilitation and performance enhancement of the UP Diliman Varsity Teams;” and “be a role model for all sports physical therapy clinics in the country,” among its other goals mentioned earlier. And to fulfill these aims, the clinic operates under the leadership of CHK Dean Ronualdo Dizer and in coordination with Prof. Oscar Santelices, chair of the Varsity Athletics Admission System (VAAS). Dr. Alberto Magpily serves as the resident physiatrist. According to Borras, the resident physiatrist and visiting orthopedic doctors from the UP Philippine General Hospital are in charge of “medical consultations and referrals for ancillary procedures and physical therapy intervention or other services, as needed.” The varsity physiotherapist, tasked with ensuring that the teams are “provided with necessary care, training, game, and clinic based rehabilitation” is Ma. Crisanta Prieto. Borras, as the director of the facility, adds that she handles “external matters involving the clinic, such as partnerships with other universities, seminars and workshops, and other non-patient related events.” Borras explains that they, together with other physical therapists, serve as consultants, and as clinical and field supervisors who guide and assess students’ performance during their affiliation period. Borras says that the clinic, located at the Ylanan Gymnasium of the CHK, makes use of equipment such as “therapeutic modalities like ultrasound and TENS, a traction machine, a LASER machine, and exercise machines for strengthening and endurance.” She adds that “the clinic also offers specialized services like instrument assisted soft tissue mobilization, stationary and gliding cups, kinesiology taping, and wellness programs for weight loss or competition preparation for recreational athletes.” The clinic’s UP spirit With only one physiotherapist in charge of all the members of the varsity teams of UP Diliman, of each and every athlete of the UP Fighting Maroons, and clinic personnel having no security of tenure as consultants under non-UP contracts that are renewed every six months, the UP SPTC harnesses the UP spirit of honor and excellence, and dedication and grit, to provide its services, fulfill its goals, and thrive. “Everyone else looking after the interns—10 to 12 students—and all the varsity teams, are compensated on consultancy basis. They enjoy no benefits and no papers despite their service to the University,” Borras reveals. “Our varsity physiotherapist is under a non-UP contract which is renewed every six months. Since the consultants and the varsity physiotherapist are not compensated and given benefits accordingly, dedication to the institution leads them to working multiple jobs to keep up with individual needs. Whenever a consultant is offered a more sustainable opportunity, the clinic has no power to make a counter-offer and ends up losing staff almost every academic year,” she adds. “The majority of the clientele of the clinic are the athletes, and since they are provided for free, the services, seminars and workshops, have been utilized to raise funds to compensate the consultants. Student-interns are also providing minimal affiliation fees and non-athletes are charged minimally as well. But these funds are not fixed and are limited to the number of enrollees for every year and on a periodic basis, and to the number of non-athletes referred to the center. In the end, the system, facility, and the services are always in limbo until job security for the personnel is provided,” explains Borras. Live healthy In closing, Borras invites everyone to live a healthy life. “‘Exercise is medicine’ has never been more relevant than at present when common mortality causes are modifiable conditions and non-communicable diseases. As an advocate of movement and believer of adding more years to life, the clinic welcomes everyone to take charge of their health through seeking the services of professionals” she says. “One does not need to get injured, be diagnosed with a disease, or be pressured by society before commencing to live a healthy lifestyle. Alongside the advocacy for movement, the Clinic aims to train more proficient and passionate individuals who will share their knowledge and skills with athletes and non-athletes, and UP and non-UP members alike,” concludes Borras. The clinic can be contacted via sportsptclinic@gmail.com for health and wellness concerns or sports-related services.

Wheelchairs for Empowerment

The sight of a wheelchair has tradition­ally evoked pity for the person sitting in it, often presumed to be powerless and incapable. But that perception is changing—as well as the reality behind it. Today, wheelchairs are seen as tools for empowerment, which could change people’s lives for the better. United Nations statistics suggest that 10 to 15 percent of any given population may be per­sons living with disabilities (PWDs) in need of some form of assistive technology, such as a wheelchair, visual aid, hearing aid, or other devices to help them with their daily needs, activities, and mobility. Given our population of just over 100 million, there could be about 15 million Filipinos living with a disability today. Given these figures, the supply of wheelchairs for Filipino PWDs could be far shorter than the de­mand, so the University of the Philippines has stepped in to fill the gap and raise the quality of life of PWDs. The UP College of Allied Medical Professions (UP CAMP) in UP Manila initiated a Wheelchair Service Program for indigents in 2012 as part of its Com­munity-Based Rehabilitation Program (CBRP) and the Clinic for Therapy Services (CTS). Dr. Ferdiliza Dandah S. Garcia, a speech pathologist and a medi­cal doctor currently teaching in UP CAMP, oversees the implementation of the WSP. More than a device Garcia says that the wheelchair should no longer be seen as just a device given out of charity or some­thing to transport a PWD with for him or her to get adequate exposure to sunlight. “Wheelchairs are tools for empowerment. Being among the leading therapy schools in the country, we want to be at the forefront of advancing knowledge and skills that could enable our fellow persons with disabilities,” she says. According to Garcia, wheelchairs enable PWDs to do what they can and want to do. Through the WSP, various organizations such as the Philippine Society of Wheelchair Professionals, Physicians for Peace, KAISAKA Foundation, the provincial gov­ernment of Bataan, Department of Health (DOH), and others, help them attend to the needs of PWDs. They are also able to impart to their clients and the public the necessary information and training for appropriate wheelchair service provision and access to services. Beyond securing wheelchairs, the WSP also provides services to their users. This new paradigm, Garcia adds, requires the service provider to determine with the PWD and his or her family the appropriate specifications of the wheelchair to make the device suitable to their needs. The wheelchair can then be semi-customized to suit the PWD’s condition, envi­ronment or terrain, and activities, whether it is to be used in a school or work environment, or for sports or other activities. In this way, an enabling environ­ment is created for the PWD. The WSP came out of a meeting among wheelchair ser­vice stakeholders years ago. Back then, it was estimated that wheelchairs were needed by only one in 100 Filipinos, with only 10 to 15 percent of that sub­group having access to a standard wheelchair. The group’s application for a grant was approved in 2015 and through it, they were able to acquire some equipment for teaching and training faculty and stu­dents in UP Manila on how to do wheelchair service provision at the intermediate level. From then on, they were able to assess and fit wheelchairs for low-income clients in UP CAMP’s CBRP and CTS. Not only for PWDs Garcia says she hopes the program can help the University acquire a steady supply of affordable wheelchairs, and to find other partners who can develop these. Most wheelchairs in use are imported and expensive. The need for wheelchairs, she stresses, is “not limited to the PWD. They also include the elderly, those with chronic illnesses, those needing dialysis, those with a temporary disability, such as a fracture. They all need some form of mobility.” Although the WSP already uses available tools and equipment for semi-customizing wheelchairs, Garcia says the country still needs to establish a viable do­mestic industry for appropriate wheelchairs because importing is expensive. “There are prototypes for new wheelchairs, especially in other countries. There are designs for low-resource and high-resource types. The wheelchair is just one part of a bigger set of as­sistive technologies. It can be an industry here in the future. The WHO and UN are pushing for assistive technologies. Later on, there will be funding for other assistive devices such as communication aids, hearing aids, and visual aids. Hopefully, other UP colleges can do collaborative work to develop these,” she add. The WSP now serves as a model for other organiza­tions. Through their partnerships with non-govern­ment organizations and local governments, about 90 wheelchairs have been given to children with dis­abilities. In the college-based CTS and community-based CBRP, more than 50 wheelchairs have been provided since 2014, and about 18 formal train­ing activities were conducted in UP Manila. Some WHO modules were integrated into their Physical Therapy and Occupational Therapy classes. Garcia says that UP CAMP is training students in basic wheelchair service provision and hopes to train other health professionals, especially from UP. The WSP also aims to promote access to research and documentation, and to put up a model wheelchair service delivery center in the Philippines.