“Everyone has a place under the sun; it’s just that one should make it his or her goal to find his rightful place,” said Dr. Charles Y. Yu, the vice chancellor for Lasallian Mission and Linkages of the De La Salle Health Sciences Institute (DLSHSI) in Dasmariñas City, Cavite.
The good doctor must be talking from his own experience. A product of public-school education and the University of the Philippines (UP) School of Medicine, Yu ended up spending his expertise at the DLSHSI for the last 30 years.
According to him, it was in post-Edsa revolution when he was active at the Philippine General Hospital (PGH), including being a leader of the physicians’ association, which marched the streets in protest of the past administration. Eventually, he received an offer for a small part-time position at the UP Pharmacology Department.
But then in December 1987, he said he was asked by the late Dr. Jose Esteban to practice as a pulmonologist in Cavite. “Esteban said: ‘Charles, we need a pulmonologist. Walang pulmonologist sa buong Cavite.’ Initially, I agreed as a reliever to a very busy clinician Dr. Ra. Ang dami-daming pasyente at natutulog na ako sa ICU sa sobrang toxic ng schedule. Then, they like me. Kahit wala akong application for the position, pinatawag ako sa office ni Dr. Gonzales. He said we like you, the patients like you and the people here like you. After two weeks he said, ‘Kunin ka namin as school physician,’ but I said, ‘May offer na ako sa UP,’” Yu recalled. He also mentioned to Gonzales that it was his life-long dream to teach in UP.
At the end he said he decided to accept DLSHSI’s offer, and the rest is history.
“Well I remember to this day, Gonzales said, ‘Fate brought you here. If I were you, I will follow what I did [and] take a leap of faith and a bolder step, leaving the UP. Come here, and you will never regret it. You can be a small fish in a big pond, like UP, or you will be like a big fish in a small pond here at the DLSHSI.’”
“And so I felt it was my destiny to be here at La Salle. I was involved in research, and I was provided with a building. So ’yung naging path ko dito in the early 1990 was to build a research center. Gumanda na yung building, lumaki na. Eventually, we expanded the hospital. Until now I take pride that out of the network of La Salle in the whole world, ang DLSHSI lang ang institution na may hospital,” Yu beamed with pride.
Today Yu is an internationally recognized expert on tuberculosis (TB), particularly on public-private mix DOTS (PPMD) and has personally directly treated thousands of TB patients over more than 25 years of practice, often without financial gain, and indirectly influenced the practice of hundreds of other physicians through trainings, guidelines and advocacies. He was a member of the core group of the World Health Organization (WHO) DOTS Expansion Committee, PPMD Subgroup; the WHO consultant on TB-PPMD and the immediate past president of the Global Alliance for TB Drug Development Stakeholders Association, which seeks to develop new TB drugs that are affordable, accessible; and is a much sought-after authority by WHO and developmental agencies as well as the Philippine Department of Health. He is also a member of the International Union Against Tuberculosis (IUATLD) TB Education Working Group and was recently hailed the cochairman of the TDR/WHO/UNDP TB and the Leprosy and Buruli Ulcer Disease Reference Group.
He was the senior TB adviser, and the training and certification adviser of the Philippine TB Initiatives in the Private Sector (Phil. TIPS), where he played a pivotal role in convincing key stakeholders (six major professional societies, association of medical schools and allied health schools) in getting involved in TB control and integration of DOTS in their training. In particular he worked closely with the Association of Philippine Medical Colleges in the integration and teaching of TB and DOTS in the medical curriculum. Likewise, the curriculum for teaching of TB and DOTS in the medical technology, pharmacy and nursing schools were also created.
Know more of the country’s TB expert from this Q& A with the BusinessMirror.
You seem to have always been fascinated with fighting the disease. What made you passionate of it? I was misdiagnosed to have TB in my younger years. Natakot ako, ’di ko sinabi sa magulang ko, and I self-medicated. Masuka-suka ako sa gamot, only to find out later that I didn’t need the medicine, because it turned out I had primary complex. But then I felt the stigma of being labelled as a TB patient or carrier—ikinahihiya mo talaga. And so when I took up medicine, I told myself if there’s a disease I am going to concentrate on kapag ako ay naging full-pledge doctor, it would be TB. That has been 30 years ago, at sa tingin ko naman, nakatulong ako.
Also as a clinician, ’yun isang naging drive sa akin kung bakit ako pumasok sa field ng pulmonologist, was because I thought there was something to be done. Ang motto ko sa buhay ay “mamili ka ng isang worthy cause to fight and completely dedicate your life to it.” Early on, when I finished medical school, dinibdib ko na ’yun. That includes correcting the socioeconomic conditions of the society, like having jails and even having squatter areas that are TB-free. Kasi, kung ’di mako-correct [ang stigma], matatalo ang laban against TB. Moreover, we also had to fight the stigma of having TB. Millions have been stigmatized. In fact, I heard some patients who were happier having cancer than having TB.
Can you say that the battle against TB in the Philippines has already been won? Worldwide, nung time nag-start ang efforts versus TB, No. 7 ang Pilipinas. The last survey I remember, No. 9, so malapit na tayo lumabas sa top 10 countries with most number of TB cases. And the good thing is ’yung mga pinakanakahahawang cases of TB, which is ’yung WHO goal of detection, na-achieve natin more than 6 years ago.
You ask me, problema pa ba ang TB? We are a victim of our own success. Yung ordinary drug-sensitive TB, medyo natalo na natin, but not yet 100-percent panalo. Pero ang lumalakas ay ’yung multidrug-resistant TB (MDRTB), ’yung mga patients na naputol ang gamutan or nahawa ng isang patient to another. Di pa alarming ’yung case pero marami na, mas nakakamatay ito. An ordinary TB will infect 10 persons in their lifetime; itong patient, ang mortality rate ay tumataas ng almost 40 percent.
Pero may mas grabe na kaso, ’yung extremely drug-resistant. Ito ’yung walang gamot na tumatalab, ito ’yung meron sa South Africa. Ito ngayon ’yung tina-target ng TB programs sa mga preso. So, controlled na ’yung TB, but the battle is not yet won.
You are in the medical practice, and you are also involved in the academe and in research at the same time. Yes. And I’m still active in research. The ongoing largest research now is called The Newton Fund, a recent award na joint project ng United Kingdom, ’yung British Medical Research Council, and the Philippine Council for Health Research and Development, under the Department of Science and Technology. Named after Isaac Newton, it’s now called Newton Agham Program or the UK-Philippines Joint Heath Research Grant for Infectious Diseases launched two years ago. Sa umpisa, science lang s’ya, and then a year ago naging health ang emphasis. We do research proposals on the most pressing diseases in the Philippines, like TB, dengue, HIV, malaria, meron ding naligaw na leprosy. It’s like a competitive bids from universities. Kailangan mag-link, for example, we, at DLSHSI, have to partner with another university in the UK. Tapos naglaban-laban kami, parang over two dozen universities bidded for it. So, kami ang nanalo dun sa TB work, so it’s a three-year project. So, malaking project ’yun—field work gathering actual data, may health economics, parang nangungolekta ng gastos ng patients, halimbawa, sa hospital.
According to Yu, the entire research program will cost more than 50 million pesos to support activities of two groups of researchers. Aside from the DLSHSI team, there is also the counterpart team from the Liverpool School of Tropical Medicine in the UK.
The projects, titled “Impact Assessment of Diagnostics Tools for Multidrug Resistant and Drug-Sensitive Tuberculosis in the Philippines” is touted as an important component of the Philippines’s fight against TB.
“It is important that we develop appropriate strategies that will help health practitioners provide patients with cost-effective options for diagnosis. We should have some preliminary results this August, which we should be able to present at the stakeholders’ meeting in Manila, but the full outcome will probably happen next year,” said Yu, the project’s primary investigator.
Basically, what is the duty of a vice chancellor? What does the vice chancellor for mission and linkages do? I’ve been the vice chancellor for 10 years; it’s still a work in progress. Basically, I do link and partnership for DLSHSI. And why did I become the vice chancellor? I dont know. Maybe, it was my fate. Kasi mahilig ako to go where no one wants to tread. After my stint as a medical director, ’eto na ’yung offer for mission and linkages. I saw this as an opportunity, so I could expand what I wanted to champion at. I wanted to be on health promotion. I wanted to have links for La Salle to other institutions here and abroad. I wanted to be on poverty alleviation and community health. So, becoming the vice chancellor was an opportunity and to also expand the TB work I’ve been doing all these years. DLSHSI is now one of the leading centers for TB research, whether it’s training health workers or doing the Newton fund, or the high tech. ’Yung gusto matuto about TB, DLSHSI ang port call nila.
On the side, ako ’yung unofficial doctor sa maraming La Salle brothers na nagkakasakit. On call ako, eh internist naman ako. I take care of our own brothers who are sick nang ‘di na sila pumupunta sa kung saan para magpagamot.
But the most important part of my job is values formation. Napansin ko, if you want to change and improve the health situation of the country, you have to change the way we prepare our health professionals. Kasi many of them go abroad for greener pasture. So, the country becomes exporter of the best and the brightest. So, they are in other parts of the world. The best nurses in the world are Filipinos. The thing is, you cannot compete with money. If they have been planted with the right values, maybe they could have stayed.
Moreover, I want our young doctors today to consider their patients as friends at hindi dapat pagka-kwartahan. Huwag sila magmadali. ’Wag tingnan ang patients as peso or dollar signs to pay off their loans. They became doctors for noble reasons. Their goal should be that, as they prosper, tulungan naman nila ang community sa paligid nila. Doctors can change the world. Mataas ang tingin sa mga doctor sa ating bansa.
Are there still things that you want to accomplish? I strongly believe that the way to transform society is through education. I-angat mo ’yung mga tao sa estado nila through education. Poverty should not be a hindrance. At DLSHSI napi-pick up namin ’yung mga poor, yet talented and deserving students. And we held them along the way, just like this young man that despite being poor, malapit na maging doctor. Kahit nasa private sector kami, we realized the value of why we are here.
The La Salle brothers now realize the value of health education. So, we wish to transform the health landscape, kasi we produced thousands of doctors already. 30 years na kaming nagpo-produce ng doctor.
So, whenever I have the chance to speak to young people, I always tell them to never give up. Kahit anong itapon sa ‘yo, tine-test ka lang para bumangon. It’s not the number of times you fall. Never give up and always accept the challenge. Don’t close your door to new challenges. Never say no and consider every defeat as an opportunity.