Problem: What problem is this project trying to address?
Public hospitals lack the resources and manpower to meet the needs of indigent patients. For example, it is common for parents to buy their own medical supplies for their children such as needles and prescribed medicine; there are not enough bathroom facilities for the amount of patients that the hospital serves; beds are typically shared by two patients; and hospitals are understaffed with doctors seeing as many as 60-70 patients per day.
Pediatric patients suffering from illnesses like cancer can be traumatized by painful medical treatments and insensitive behavior of hospital staff. There is an absence of support for both the children and their families to cope with these anxieties.
Parents remain uninformed about their children’s illnesses because there is a lack of hospital personnel to thoroughly explain the medical conditions. Therefore, many parents continue to attribute their children’s sicknesses to superstitious beliefs. Parents also commonly misunderstand the doctor’s recommendations in medical terminology, which results in non-compliance of medical procedures.
Doctors experiencing burnout also need psychosocial support. Many doctors feel a sense of guilt and failure when they cannot cure their patient’s sickness. They do not have the means to emotionally process their experiences, as they struggle to meet the basic needs of patients in a volatile hospital environment.
Most government hospitals are resistant to change. Due to the broken system and poor conditions of these hospitals, the staff does not recognize psychosocial support as a powerful tool that increases patient survival. For some, the unfortunate reality is that the faster patients die, the more beds become open and available for newer patients. Typically, doctors see the integration of psychosocial support as more of a burden than a benefit, as it would require special time and resources to implement.
The field of psychosocial support is underdeveloped in the Philippines. Nationally, the government has not yet recognized the need for psychosocial support in public hospitals. Due to a lack of local evidence-based research, doctors are commonly unaware of the benefits of psychosocial support or do not make it one of their priorities. In many hospitals, doctors view Child Life Specialists merely as support staff that bring “play time” and entertainment to pediatric patients.
Solution: What is the proposed solution? Please be specific!
For terminally-ill children and their poor families, hospitalization can be extremely stressful between painful treatments and unmanageable medical bills. Psychosocial support addresses these emotional and social problems before they affect the child’s chances of recovery and the family’s ability to continue treatment. Child Life Specialists are equipped to deliver this support as trained healthcare professionals with expertise in child development and family systems.
In the Philippines, Fatima recognized the lack of psychosocial support in the healthcare system. She is creating a space and added value for the previously underdeveloped role of Child Life Specialists.
Fatima’s vision is to change the way hospitals think about psychological and social support: from a supplemental service into an integrated part of the healthcare field in the Philippines. The government and medical staff have viewed psychosocial support as an extra service taking place in parallel to medical care, but not really part of the formal treatment of a case. The practitioners—Child Life experts and their helpers—were seen as little more than outsiders playing minor, supporting roles outside the system. Fatima’s Kythe Child Life Program, on the other hand, is fully aligned with the hospital’s operations. Fatima is adamant that Kythe Child Life Coordinators become integrated into the ward and serve as members of the hospital staff that abide by the same standards and policies as regular employees and are respected as part of the ecosystem.
Kythe Child Life Specialists provide indigent pediatric patients and their families counseling and emotional support, from the point of disclosure to the very end of the child’s illness. Kythe prepares patients and families for medical procedures and also educates them about the illness. In order to give children an outlet from the depressing hospital setting, Kythe offers kids a safe space to play filled with toys and books, equipped with staff to initiate therapeutic play. In addition to the psychosocial support it offers, Kythe also helps fund certain medical treatments for indigent patients through a deep understanding of patients’ individual needs.
The benefits of psychosocial support go beyond the patients and their families. Fatima realized that this type of support was also crucial for the well-being of medical staff. Fatima and her team help medical staff and hospital leaders to process their emotions and recognize their needs as well as their patients’ needs. Kythe teaches doctors how to relate to their patients and how to manage difficult situations like disclosing bad news to a family. These are crucial skills which are surprisingly absent from medical education.
The mobilization of student-volunteer groups has been crucial to Kythe’s development. Through partnerships with universities such as Ateneo de Manila, Kythe has given students a life-changing experience through volunteer work with Kythe and its beneficiaries. As a result, Kythe has sustained long-standing support from not only their student volunteers, but alumni as well. When alumni move on in their professional careers, they champion Kythe and connect the companies they work for to sponsor Kythe’s initiatives. This serves as a sustainable approach that get stakeholders rooted in the cause.
To date, Kythe has reached over 8,000 patients and their families nationwide. As President of the Philippine Alliance of Patient Organizations (PAPO), Fatima is now gathering support from patient advocacy groups. In partnership with the Union of Local Authorities of the Philippines (ULAP), Fatima has been participating in road shows for PhilHealth, the national health insurance provider, to support disabled patients and give them access to healthcare. Through PAPO and her allies in ULAP, Fatima plans to convince PhilHealth to integrate psychosocial support in the national system.