MAJ Ramon Sumibcay, retired Army nurse who was recently recalled back to active duty due to COVID-19. He is currently deployed in Germany. Ramon is also the past Western Regional Vice-President of the Philippine Nurses Association of America, 2018-2020.
Florence Nightingale, the Founder of Modern Nursing, would have turned 200 years old. In her honor, the World Health Organization (WHO) declared 2020 as the “Year of the Nurse and Midwife.” Florence is always best remembered for her strong sense of selfless service and her incomparable courage. Leaving behind an affluent lifestyle, she gathered about 40 women, trained them, as they joined forces to volunteer their services in Crimea to take care of British soldiers. Her first cold winter in Crimea could be traumatic. There were over 4,000 deaths. There were more deaths caused by cholera, dysentery, poor hygiene and sanitation, poor ventilation, and very substandard living conditions than from battle wounds. Those deaths as we know now are highly preventable. As a prolific writer and an astute mathematician, she was able to use data and statistics to convince the British government to respond to her plea for a better living condition. She implemented handwashing as a standard practice. By simply implementing preventive health measures, and improving hygiene and sanitation, death rate was reduced from 42% to 2%. Evidently, Florence pioneered in Public Health and nursing education. Nursing profession has strongest and most natural appeal from the Filipinos compared to other Asians. Filipinos have traits that are very well-fitted to the profession: compassionate and hard working. In return, Filipinos have found nursing profession as lucrative source of professional income. In almost every continent of the world, there is a Filipino nurse. In the United States, there are about 150,000 Filipino-American nurses. Many have taken different career pathways. Many have achieved highly specialized training, and many have attained higher levels of education. Leaders in the nursing profession have always promoted “Excellence in Clinical Nursing.” “Sometimes, I feel being less significant”, says Major Ramon, (MR) “because of the emphasis of excellence in clinical nursing practice as compared to public health nursing.”
CL: How did you start your career?
MR: Nursing was a second career. I left the military service to go to nursing school. Earning my bachelor’s degree at the age of 41 was one of the greatest milestones of my life. In the early years of my nursing career, I was a clinical staff in a busy unit - Renal and Advanced Med Surgical Unit. Based on patient medical histories and their own stories I often wondered why there were so many sick patients. Patients in that unit were mostly, ESRD, Diabetes, Kidney transplants, and Hemodialysis. I knew then that I would take a career pathway at the other side of the spectrum, the Preventive side. When I joined back the active duty component of the military, I was excited that US Army Nurse Corps offers Public Health Nursing as a specialty. Just like every Army Nurse, I had to start all over again at the bedside nursing. My first unit was the Medical-Oncology Unit. I could not get away from my previous question why there were so many sick people.
CL: In your opinion, what is pandemic and how were you involved in a pandemic, a term very often used now?
MR: Pandemic is simply an epidemic of infectious disease that’s usually spread from one country to another, becoming global.
In 2007, I finally saw my career as Public Health Nurse in the Army. Army Public Nurse is a member of the big Preventive Medicine Department. The intense Army Preventive Medicine Course is required for all the allied healthcare professionals. In that course, I had learned brand new set of terminologies quite different from what was learned in nursing school such as epidemiology, surveillance, outbreak, epidemic, pandemic, contact tracing, determinants of health, etc. More relevantly, I learned about epidemiological triangle of disease transmission: host (us), agent (microorganism) and the environment (hand washing, hygiene, sanitation and social distance (isolation), density. It is a basic understanding that if one of the parts of the triangle is taken away or done something, there is no disease.
CL: COVID-19 is not the first pandemic that you’ve have been actively involved, right?
MR: The outbreak of the 2009 pandemic novel H1N1 virus put my nursing career front and center. When the pandemic was detected in the country, all military bases worldwide were put on high alert. Each Public Health team in every military installation prepared and trained for the worst scenario. Guidelines were established and published. Basic and common-sense public health measures were imposed such as handwashing, hygiene, sanitation, covering the mouth when coughing or sneezing, and social distancing, a new terminology that altered people’s interaction with one another.
CL: Do you remember how it started?
MR: When the first case was confirmed under my watch, I rolled up my sleeves and went to work. I had to contact with the index patient and establish his circle of contacts right before he was experiencing symptoms. Contact tracing was a very tedious work, but this was the first step how to identity who could be exposed. People identified in the tracing were required swab testing. With full collaboration and cooperation from all the different agencies, military and civilian, and following the strict guidelines implemented, the case was easily controlled and mitigated. No other case was confirmed, at least in that particular installation. Obviously, it does not need a rocket science to defeat even the most virulent virus. As the pandemic corona virus (COVID-19) started to be transmitted in the country, it was a déjà vu and it brought back memories of the previous pandemic. In this COVID-19 scenario, more stricter guidelines were imposed such as banning of large gatherings, Shelter-in-Place, Stay- at-Home, Lock Down. The spread of the virus was far more rapid than we have reacted to it. If only every individual, every community, every community leader, religious leader, every politician, and every policy maker, reacted quicker to the pandemic virus, it could have been a game-changer. Maybe we could not predict or prevent the occurrence of an epidemic or pandemic, but when it happens, the basic public health measures that we should have been practicing such as, hand washing, covering mouth when sneezing or coughing, staying home when feeling, should be our first lines of defense. Older people and people with underlying health conditions are more vulnerable because of their weakened immune system. Healthier people have stronger immune system to fight against any virus or microorganism. The sooner the virus is controlled and mitigated, the need for Treatment is greatly diminished.