Dr. Michael Hoffman, a pediatrician with and Chief Executive Officer of Elmhurst Clinic, has been making medical mission trips to the Philippines for 10 years. The most recent trip was in February 2020 to Borongan in the province of Eastern Samar. In this Q&A, Dr. Hoffman talks about the participation of other Edward-Elmhurst Health doctors and nurses, the motivation behind his mission work, and a special memory of the care he provided for a 9-year-old girl.

Q: Is this effort part of an organization or are you doing it as a group from Edward-Elmhurst Health?

A: The organization that sponsors the mission is the Diocese of Joliet Partnership in Mission. There are people from Edward-Elmhurst Health as well as many others from the Chicago area, the United States and many other countries, including Canada, Spain, Australia and the Philippines on the last trip.

Q: Who else from Edward-Elmhurst Health took part in the most recent mission trip?

A: On the last trip, Dr. Armando San Juan (an OB/GYN with Elmhurst Clinic) and Susan Smith, APN (an advanced practice nurse with Elmhurst Hospital) were the other Edward-Elmhurst Health participants. Dr. Salil Doshi (an ENT surgeon with Elmhurst Clinic) and Josephine Mulvihill, RN (a pediatric nurse with Elmhurst Hospital) have also gone on mission trips in recent years.

Dr. Moeen Saleem (an independent cardiac electrophysiologist and member of Edward Hospital’s medical staff) and Dr. Matthew Smith (an independent gastroenterologist and member of Elmhurst Hospital’s medical staff) have participated in other missions, but not the trip to the Philippines.

Q: When did you start making mission trips to the Philippines?

A: This is the tenth year I have participated in the mission to the Philippines, seventh as Medical Director. 

Q: How many people make up the mission group and what are their roles?

A: The team that goes to the Philippines usually includes 45-50 people who participate in one of three areas of outreach.

• The first is the medical team, consisting of surgeons (general surgery, ear-nose-throat, ophthalmology, OB/GYN), medical specialties (internal medicine, family medicine, pediatrics), anesthesiologists and CRNAs (certified registered nurse anesthetists), RNs (registered nurses), dentists and physical therapists.
• The second is the construction team that helps local people construct houses or other structures.
• The third team is our social outreach team that works with local nuns and support people from the Diocese of Borongan and the Eastern Samar Provincial Government to provide food, housing and other needs of daily life to those who are poor and in need.

Q: How has COVID-19 affected your efforts?

A: The most recent trip occurred just before the COVID-19 crisis and did not impact the trip while we were there. However, it has impacted our ability to follow through with activities after the mission. As surgical test results have come in or follow-ups have been needed, the COVID-19 quarantine has prevented us from getting our patients taken care of outside the Eastern Samar province. We would usually have some patients seen and attended to in Manila or Tacloban (large city in neighboring province), but this has been restricted and healthcare has been delayed.

Q: Why do you do this?

A: I go on mission to help the poorest of the poor. Mission is a calling and my abilities to practice medicine give me an opportunity to give back as I have been given so much in life. Mission isn’t a location. Some might be called to give of their time or abilities in their local area. I commend all of this service. Some can’t give their time or ability but can support financially. This, too, is a gift and can greatly help those in need. I receive so much more from the fellow mission participants than I can ever give to them, and that’s especially the case for the people I go to serve.

Q: How do you do this (i.e., where does funding come from, where do you get supplies, how do you/supplies get there)?

A: Each mission participant pays to go on mission (around $2,800 for the 17-day trip), which covers the cost of airfare, lodging, food and transportation while in the Philippines. Some people pay their own way and others may raise the money through their local churches and other organizations. We get supplies from all sorts of organizations and by donation. Some we have to purchase (e.g., anesthesia meds, narcotics, antibiotics, IV fluids), which is also defrayed by the $2,800 per participant. I also run a fundraiser and solicit donations from sources like the Elmhurst Hospital Medical Staff and administration, who have generously donated $10,000 multiple times.

Q: Describe the challenges in taking on this effort.

A: In doing anything this far away and this large a scale you can see that there lots of areas that are challenging. We bring all of our supplies, which requires them to be procured, packed and transported. They need to be inventoried here and on arrival. This takes hundreds of hours and thousands of dollars that need to be collected by donation and other means. You have to recruit a team to provide all the levels of care including doctors, nurses and support personnel. This has to be done over the course of a few months and then secure transportation and lodging. The team is multinational and everyone needs temporary licenses to practice medicine in a foreign country, something that’s required every year, even for return missioners). It takes many volunteers to make this happen.

Q: How many patients do you treat during each visit?

A: Our team sees well over 1,000 patients every trip, which is about 11 days of mission work and five days of travel. We perform 100-150 major surgeries and at least that number of minor procedures. Our dental team sees 500-800 patients and performs at least one procedure on each, from cleaning to extractions. The outpatient medical teams prepare patients for surgical procedures, provide inpatient and outpatient consultations, and the range of medical visits and follow-ups. The pediatric team sees 300+ outpatients over the course of the mission and the pediatric surgery team will perform 15-30 surgical procedures on the two days they are in Borongan. The internal medicine and family medicine team will see around the same amount, but see many more patients who require surgical intervention and have longer-standing chronic disease.

Q: What are the most common conditions/diseases you encounter?

A: The adult population has a large need for cancer treatment and surgery, thyroid disease and all manner of infectious disease management. Similarly, you will see congenital problems in children that have gone undiagnosed and untreated due to lack of access to care. Children also require a lot of infectious disease treatment. Adults and children have pulmonary and non-pulmonary tuberculosis that needs diagnosis and treatment.

Q: What’s the biggest healthcare challenge facing the people who live in these areas?

A: These people are truly the poorest of the poor and their biggest problem is access and inability to receive care based on finances. There is a large discrepancy in the third world to access based on finances.

Q: What’s the most meaningful memory from one of your mission trips?

A: I saw a patient (9-year-old girl) who was unable to speak and was having seizures every day. I was able to diagnose her with a parasitic infection (schistosomiasis) that played a role in her symptoms. We treated the infection and used anti-seizure medication. When I saw her 10 days into the trip for a follow-up, this girl, who had not talked in a year, said, “thank you.” The joy on her face and her mother’s face will be enough to keep me going back forever.

Q: How can people help?

A: People who are interested in mission or supporting mission can reach out to me at Michael.Hoffman@EEHealth.org or Bruce Carlson at the Diocese of Joliet Partnership in Mission, bcarlson@dioceseofjoliet.org.