PhilSPEN Online Journal of Parenteral and Enteral Nutrition


The practice of clinical nutrition in the Philippines: from the 1980's to 2010 | Back

The role of St. Luke's Medical Center: from 1980 to 2009

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The History of PhilSPEN: from 1995 to 2007

The practice of nutrition support started as parenteral nutrition use mainly by the anesthesiologists and surgeons in the 1960’s. Dr. Arvid Wretlind developed both protein and lipid formulations which were used throughout Europe, while through Dr. Stanley Dudrick's influence parenteral nutrition started to be widely practiced in the United States. The specialist who espoused parenteral nutrition practice in Europe was mainly the anesthesiologist while in the United States it was the surgeon.

As the value of nutrition in patient care became recognized worldwide, several specialists came together in Hamburg, Germany to report on their experiences and concerns and the International Society of Parenteral Nutrition (ISPN) was born. The practice became multidisciplinary in nature and the present nutrition support practice and nutrition support team came to be. Two similar societies emerged from this “mother society”, the American Society of Parenteral and Enteral Nutrition (ASPEN) in the U.S. and European Society of Parenteral and Enteral Nutrition (ESPEN) in Europe.

Nutrition support practice came to the Philippines with an “American” flavor when Dr. Antonio Limson and his group spearheaded parenteral nutrition use in the Philippine General Hospital (PGH), while Dr. Renato Reyes did the same in University of Santo Tomas (UST). As the dietitians, nurses, and pharmacists came to be involved several nutrition support teams were organized with the support of several medical nutrition companies in the Philippines. ASTRA was the first to fully push for parenteral nutrition practice workshops, followed by the enteral and/or combined parenteral nutrition workshops and postgraduate courses initiated and coordinated by Mead-Johnson, Nestle, Otsuka, and Abbott. The European influence came in with the involvement of Fresenius Kabi and BBraun.

The Philippine Society of Parenteral and Enteral Nutrition (PHILSPEN) was born in 1995 when the need arose to consolidate all activities related to nutrition support into one effort to promote its use throughout the Philippines. Dr. Bernardino Agustin was one of the key persons who initiated this with the support of ASTRA Philippines, which brokered the initial organizational efforts. Dr. Jonathan Asprer was the founding president with Dr. Luisito Llido as the Vice President. The Board members were: Dr. Samuel Ang, Dr. Cenon Cruz, Dr. David Dy, Dr. Antonio Limson, Dr. Fernando Melendres, Dr. Claver Ramos, and Dr. Renato Reyes. Dr. Juliet Sio was the secretary. Shortly the Parenteral and Enteral Nutrition Society of Asia (PENSA) was organized in Chiang Rai, Thailand with Dr. Jonathan Asprer as one of the founding members.

Two of the major aims of the society are: firstly, to enhance every physician’s awareness and knowledge on nutrition support in the Philippines and secondly, to help install a nutrition support team (NST) in every major center in the country.

The NST issue: an impossible dream? The second major aim of PHILSPEN, which is to help install a nutrition support team (NST) in every major center in the country grounded to a halt even before it fully started. Workshops, invited speakers, and seminars were done starting years 1996 to 2002 and attempts to organize NST’s were done supported by every major medical nutritional company in the Philippines, to no avail. Initial plans to have NST's in 10 major hospitals in the country were initiated with the sponsorship of Mead Johnson Philippines, but the teams did not live within one year of their organization. An NST successfully maintained its presence in Veterans Hospital in Quezon City (supported by Mead Johnson Philippines), but when its physician leader left it also fizzled out. A Total Nutrition Therapy (TNT) program initiated by Abbott Philippines hoped to jumpstart the process in 1999 and nutrition support teams sprouted in major centers in the Philippines, but again after a while they just became teams in name not in function. The only active NST’S are seen in the Luzon area (see Home page: Challenge) and they comprise 6/83 (7%) of the needed team presence.

The organization of a nutrition support program and team in St. Luke’s Medical Center (SLMC) under the encouragement of Dr. Ricardo Fernando was a key movement that helped in the revitalization of the society. The successful partnership of the SLMC group with medical nutritional companies through the TNT program, Aesculap academy, and later the FRANC Asia nutrition course made the nutrition support team and its faculty a key factor in providing the needed people to be involved in the education process on nutrition support. The establishment of the nutrition support fellowship training program in St. Luke’s Medical Center followed by the establishment of the Master of Science in Clinical Nutrition of Philippine Women’s University and St. Luke’s Medical Center further provided the education, research, and faculty base which makes the current PHILSPEN able to flex its muscles as it faces the 21st century. Currently, to further consolidate its multidisciplinary base the society has initiated the establishment of the Philippine Board of Clinical Nutrition (PBCN), which will further provide the necessary credentialing process of the specialists who have trained in, gained recognition, or contributed to the work in clinical nutrition practice (physicians, dietitians, nurses, and pharmacists). The goal of developing real nutrition support teams to be fielded in every major medical center of the Philippines is not far off.

The first PHILSPEN convention was held in Shangri-La EDSA hotel, Mandaluyong City, in October 2004 and after the third annual convention, the Philippine clinical nutrition society or PhilSPEN had the honor of hosting the 12th PENSA congress in 2007. The future holds a lot of promise for the society as it gains more recognition in the Asia Pacific region for its role in the continuing nutrition education program and the development of systems that will further enhance the nutrition support process and make it a reality in every hospital in the region.

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