August 2007
All about Eba

Woman of many firsts

FRAIL BUT feisty still at 95, the diminutive doctora is proof positive of her own prescription for longevity: “Leave the dining table a little less full, a little hungry, and you will live longer.”

NOW 95 years old, Dr. Fe del Mundo remains the doyenne of Filipino doctors, whose many accomplishments have changed the lives of millions of people. [photo by Fides Lim]

The black bouffant wig nods on her tiny, spare frame as she ticks off a simple diet mostly of fish and vegetables with little rice, plus a fondness for cheese. Yet there is more to this admittedly “lazy eater” who eats, she says, “because it’s there.”

Fe del Mundo, doyenne of Filipino doctors, is a woman of many firsts, whose many accomplishments have changed the lives of millions of people.

Married only to her profession, she however counts a multiple brood from generations down that she has variously embraced and they, her. They include not only those who were entrusted in her direct care, but also those whose lives she has touched and strengthened through rural rehydration and health centers, immunization campaigns against polio, measles and chickenpox, anti-tuberculosis programs, and a diarrhea treatment called BRAT (banana, rice, apple, tea) that has benefited and saved millions of children around the world.

There are also the hundreds of students who came under her tutelage — from the nursing school she set up at North General Hospital after the war, to her long teaching stint at the University of Santo Tomas (1943-1974) and chairing the pediatrics department at Far Eastern University (1956-1976), to the training centers and health institutes that she shepherded.

Then there are the 400 youngsters who became her special wards during the Japanese Occupation. The offspring of U.S., British, and other foreign nationals who were imprisoned upon the outbreak of the war, del Mundo with the help of the Red Cross set up a “Children’s Home” to care for these sick children in enemy-occupied Manila.

“I’m glad that I have been very much involved in the care of children, and that I have been relevant to them,” says del Mundo, in tones so soft one has to strain to hear her. “They are the most outstanding feature in my life.”

IT HAS been a life marked by both tragedy and triumph. The sixth of eight children of Paz Villanueva and Bernardo del Mundo, a prominent lawyer from Marinduque, the death in childhood of four of her siblings influenced her decision to take up medicine.

It was particularly the memory of youngest sister Elisa who died at seven years old from peritonitis, an abdominal infection, that firmed up her resolve to become a doctor. “She kept a little notebook where she wrote that she wanted to take up medicine,” recalls del Mundo. “When she died, I decided to take her place.”

In 1933, 22-year-old Fe graduated valedictorian from the University of the Philippines’ medical school. Financial problems nearly prevented her from finishing but a relative came to her rescue. In school, she observed that those who had textbooks hardly read them, while those who were hard-up like her would borrow and study the books whenever possible. But she says, “Monetary aspects have not been important considerations in my choice of direction or targets.”

The extremely shy girl who was known to cry when asked to speak before the class chose pediatrics as her field of specialization. Barely five feet and weighing less than a hundred pounds, she had often been advised by her medical professors that this was the best option as the patients would be smaller than she is.

THE hospital she founded and which bears her name unfortunately had to temporarily close down this week, hit by a strike. [photo by Fides Lim]

But it was her research work as an intern in her home province of Marinduque that sealed her decision. “I saw how many children were not receiving medical attention and how many were dying,” she recounts. “There was no doctor for children and the provincial health officer had no background at all about pediatrics.” She was dismayed when the health officer always gave the same diagnosis and advice for every sick child: “Oh, that’s worms. Give him a purgative!”

Those experiences sparked a serious interest that would develop into a lifelong commitment in the identification and treatment of childhood diseases and its prevention. She was to pioneer in this expanded role of pediatrics — from the prenatal care of mothers to the health and development of children through adolescence. And her grassroots immersion in Marinduque would lead her to further reach out to poor children in other doctorless remote areas.

She had to be creative in the struggle to save lives in a country where babies die from the most common yet preventable diseases. She is credited with devising an incubator for use in rural areas without electricity, as well as a cloth-suspended scale to weigh infants and a radiant warmer made of bamboo to regulate the body temperature of newborns with special care needs.

The makeshift incubator consisted of two native laundry baskets of different sizes placed one inside the other. “I put in hot water bottles all around between them. I put a little hood over it and attached oxygen for the baby,” she says. “We had to do with whatever was available.”

Driven by a thirst for knowledge and to expand her horizons, del Mundo sought and worked hard to obtain a study grant to the United States. In 1936, through an unexpected scholarship offer under President Manuel Quezon, she was accepted at Harvard University Medical School for postgraduate work.

She recalls with a chortle that when she went to the dormitory assigned her in Boston, she found herself in a men’s dorm. Unknowingly, Harvard — which would open its doors to women only in 1949 — had admitted a female to be part of its all-male student body. But because of her scholastic credentials, the pediatrics head saw no reason to send her back. Thus, she became the first Filipino woman and the only female at the time to be enrolled at the Harvard Medical School.

POSTGRADUATE STUDIES in pediatrics at Harvard, Boston, and Columbia Universities led to a residency at Billings Hospital in Chicago and a research fellowship at Harvard Medical School. But on the eve of World War II, despite attractive opportunities to remain in the United States, del Mundo returned home. “I told the Americans who wanted me to stay that I prefer to go home and help the children in my own country,” says the doctora. “I know that with my training for five years at Harvard and different medical institutions in America, I can do much.”

BANNER displayed at the hospital enumerates its founder’s legacy of excellence and commitment. [photo by Fides Lim]

This would become the pattern in her life. Between returning to the Philippines and staying in the United States, which she would revisit many times after the war for study tours and conferences, she always chose readily to go back home, where she wanted to do much more. She considered her trips abroad more as learning missions and for fund-raising to realize her dream of setting up a full-fledged pediatric center for both curative and preventive medicine.

Before that dream was realized, though, she first came to be called the “Angel of Santo Tomas” for her work with women and children during the Second World War. Initially housed at the Red Cross building near the University of Sto. Tomas (UST) internment camp, the “Children’s Home” she set up transferred to bigger quarters at the nearby Holy Ghost College (now Holy Spirit) when the number of patients grew to include expectant, convalescent, and nursing mothers. The makeshift hospice lasted from 1942 until 1944, when it was shut down after the Japanese ordered all the women and children back into UST.

After the war, del Mundo received commendations from the former prisoners and the U.S. government for extraordinary heroism in action. She would continue to receive letters and visits from her grateful wards for her courageous work.

But her one big dream became a reality at last on November 27, 1957, her birthday. With an P800,000 loan from the Government Service Insurance System (GSIS), some donations, and the proceeds from the sale of her first house, the 100-bed Children’s Memorial Hospital finally opened to serve the public. She patterned the hospital set-up after a facility she had admired in Chicago.

Just as she had moved into a new house, she sold this to build her hospital’s adult wing. She again had to sell yet another home to fund the construction of another unit of the hospital, the Institute of Maternal and Child Health. Inaugurated in 1972, this was the first of its kind in Asia dedicated to preventive medicine, training and research, and rural extension work.

Years before, in 1958, she had signed away personal ownership of the hospital and turned it over to a board of trustees. She was able to pay back her loans.

She continues to donate the fees from her own practice to support the 30-bed charity ward — much in the same way that she had invested much of her own money along with her time and talents in all the previous hospitals she headed. In 1948, when she left the North General Hospital as director and senior pediatrician, she had scarcely enough funds to pay for moving out her belongings. But as she once said, “While the specialty of pediatrics is far from rewarding in terms of financial returns, the satisfaction derived from guiding and serving children is worth much more than a check for services rendered.”

THESE DAYS, a wheelchair aids del Mundo’s movements. But it has not constrained her from fulfilling a tour of duty that has lasted 70 years — and still counting.

Every morning, barring the worst of weather or a rare bout of illness, she still rises at five to catch the early mass at Sto. Domingo or nearby churches. Then it’s back to the hospital she founded that was recently renamed after her in recognition of her innumerable contributions to pediatric and maternal care.

The hospital compound along busy Banawe St., Quezon City is also home to del Mundo. She lives in a modest little suite at the east wing of the second floor of the main building. She still remembers the early years when she had to move herself and the staff members who were living with her from floor to floor as the hospital was being built.

Today the once dizzying spin of lectures, hospital calls, conferences, and yet more meetings has come to a pause, along with the once endless cups of black coffee. But the line of young patients has not shortened as parents or grandparents that were former patients still ask for her personal services. And the doctora still prepares the “history of the day” and makes her rounds.

“I’m glad I never got married,” says del Mundo. “I believe that I’ve been able to do what I’ve longed to do because of this.”

A COMMENDATION from her alma mater, the University ofthe Philippines, hangs on one of the hospital’s walls. [photo by Fides Lim]

She remains forward-thinking and open-minded, even when it comes to population issues. A devout Catholic born and raised just beside the Manila Cathedral in Intramuros, she ranks religion as “the greatest influence” in her life. But she sees no conflict between practicing her faith and pursuing family planning programs that are opposed by Catholic church elders.

Apparently, she shares the belief that improving the quality of life of the poor means addressing the problem of unregulated birth rate. Even before the government began encouraging population control in the late 1960s, del Mundo had rural units in distant Palawan and Marinduque teaching family planning, reproductive and sexual health, and proper nutrition.

“I think that we can control population but still remain true to our religion,” she says simply.

Del Mundo is an avid believer as well in harnessing the role of the community and the importance of the team approach to primary health care. With her rural extension teams, she has traveled far and wide, enduring often primitive conditions, to instruct mothers on breastfeeding and to undertake the regular weighing of children under five and periodic examinations of water supplies.

Her own clinical studies include 150 scientific papers that range broadly from the measurements of 10,839 newborn babies and commonly missed children’s diseases to the pathogenesis of dengue fever and on immunization.

To her, the pediatrician must be “community-oriented and community-involved,” if they are to achieve the best possible health care for the youth. “Medical students must go out into the provinces to see firsthand the problems that exist,” she insists. “Pediatricians must be able to translate medical knowledge into a language their patients will understand. Only in this way can a doctor acquaint their patients with the importance of preventive as well as curative medicine.”

She notes that most pediatricians are women, proving that they have assumed this role well. “Women make good pediatricians and they can very much influence parents in the care of children,” she told the Medical Observer. “I feel that if you give the world the best that you can, the best will always come back to you.”

DEL MUNDO’S manifold services to children everywhere have brought her repeated honors. These numerous awards, citations, and plaques are proudly showcased all around the hospital she established, which will retain her name even though it was sold just last month to Accent/STI.

One award close to her heart is the Ramon Magsaysay Award for Public Service she received in 1977, in recognition of “her lifelong dedication as a physician extraordinary to needy Filipino children.”

“It came to me as a big surprise,” she says of the award. “And I’m very grateful.” An admirer of President Magsaysay, she recalls meeting him, but almost very casually. “He talked to me more than twice, saying that my brother (Salvador) was his former professor in chemistry, and my brother was very strict and almost failed him,” she says. “I told him I’m sorry, but I’d no idea.”

But the heaps of honors and praises have not turned her head or made del Mundo lose sight of her purpose. “I had the opportunity more than others,” she says. “Why should I be proud? It does not make me feel different. I have remained the same in my daily life.”

A lifetime of achievement has also failed to make this “medical stateswoman” consider casting her stethoscope into the murky world of politics. “Never,” she quickly replies. “I do not love to talk, or say more than what is expected of me. I’m very quiet.”

She was probably upset when her beloved hospital was hit by a strike last week, forcing doctors to double as clerks and cooks just to keep it going. (They still had to send most of their patients home, and by last Monday, the hospital had to temporarily close down.) But what really causes great concern for the woman whose name translates to “Faith of the World” is the impact on the marginalized of the increasing number of Filipino doctors and nurses leaving for abroad. “The work I’m doing here in this hospital serves very few,” she says. “It does not reach the hinterland where most help is needed.”

She adds wistfully, “I wish I could still go out into all nooks and corners of the country and bring better care for children.”

That, she says, is her only regret at 95.

Fides Lim also wrote Dr. Fe del Mundo’s profile in the forthcoming Great Men and Women of Asia Volume 7, a Ramon Magsaysay Award Foundation publication that is due for release at the end of August. The book is part of a series honoring Magsaysay awardees.