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RRP in Developing RRP in Developing CountriesCountries
Arturo Avila Chávez MDArturo Avila Chávez MD
DirectorDirectorVoice Center MéxicoVoice Center México
IncidenceIncidence
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NOT KNOWNNOT KNOWN
Between Between 1500 – 2500 cases around 1500 – 2500 cases around the country the country
Main ProblemMain Problem
CULTURAL
MEDICAL ECONOMICAL
Voice as an IssueVoice as an Issue
Voice is NOT a Health IssueVoice is NOT a Health Issue People IGNORE the problem existsPeople IGNORE the problem exists
Dysphonia = AlarmDysphonia = Alarm
People receive medical care People receive medical care only only when they are completely dysphonic when they are completely dysphonic or with respiratory distressor with respiratory distress
Health ServicesHealth Services
Public Hospitals (subsidized by Public Hospitals (subsidized by government)government)• ISSSTEISSSTE• IMSSIMSS• SSASSA
Most of the general population Most of the general population Not all are freeNot all are free Different levels of medical attentionDifferent levels of medical attention
• 1st – 3d level1st – 3d level Very few centers for high specialized medical Very few centers for high specialized medical
attention in all the countryattention in all the country
Health ServicesHealth Services
80 to 120 consultations per day80 to 120 consultations per day
10 surgeries a day10 surgeries a day
6 -8 moth waiting for surgery6 -8 moth waiting for surgery
Some patients even have to wait to be Some patients even have to wait to be operated until they have respiratory operated until they have respiratory distressdistress
Health ServicesHealth Services
Public HospitalsPublic Hospitals Big gap between first consultation and day Big gap between first consultation and day
of surgeryof surgery Bureaucratic paper workBureaucratic paper work Time consumingTime consuming Centralized countryCentralized country
Private PracticePrivate Practice• The least amount of patients with RRPThe least amount of patients with RRP• Need an InsuranceNeed an Insurance
Otherwise…..Very expensive!Otherwise…..Very expensive!
Medical IssuesMedical Issues
RRP is a third level attention RRP is a third level attention problem! (Highly Specialized)problem! (Highly Specialized)
Some residency programs don't Some residency programs don't have a good laryngological training, have a good laryngological training, which reflects a wrong Dx and Tx. which reflects a wrong Dx and Tx.
• WHY?WHY?
Medical IssuesMedical Issues
Larynx is ENT´s the most hidden Larynx is ENT´s the most hidden structurestructure
Medical IssuesMedical Issues
EquipmentEquipment• DiagnosisDiagnosis
Medical IssuesMedical Issues
Medical IssuesMedical Issues
Medical IssuesMedical Issues
Medical IssuesMedical Issues
SurgerySurgery• Equipment Equipment
Medical IssuesMedical Issues
Medical IssuesMedical Issues Surgical techniquesSurgical techniques
• MICROSURGERYMICROSURGERY
Medical IssuesMedical Issues
AntiviralsAntivirals InterferonInterferon VaccinesVaccines Phytosorb DIM Phytosorb DIM I3CI3C PDTPDT RetinoidsRetinoids MytomicinMytomicin
Drugs AvailabilityDrugs Availability
MedsMeds• Very expensive $$$Very expensive $$$
InterferonInterferon CidovofirCidovofir
• Non AvailableNon Available No International Sale RepresentativesNo International Sale Representatives
RRP InformationRRP Information
Pt is not informed about RRPPt is not informed about RRP
• CauseCause• SymptomsSymptoms• Treatment OptionsTreatment Options• No societies or foundations to support No societies or foundations to support
RRP RRP • Patients are all by themselves Patients are all by themselves
Main ProblemsMain Problems
Cultural Cultural The RRP manifestations are almost certainly under-The RRP manifestations are almost certainly under-
described and non existent for general populationdescribed and non existent for general population Lack of Information (educational programs)Lack of Information (educational programs)
Health care systemHealth care system• CentralizedCentralized• Better training residency programsBetter training residency programs
Subspecilized DoctorsSubspecilized Doctors
• DX tools and TX equipmentDX tools and TX equipment• Drug AvailabilityDrug Availability
SolutionsSolutions
Take advantage of Take advantage of RRP IRS´s RRP IRS´s infrastructure as a plataforminfrastructure as a plataform
• Inform PeopleInform People Most of the affected people only know Most of the affected people only know
Spanish and don't have access to internetSpanish and don't have access to internet Language barrierLanguage barrier
SolutionsSolutions
• Expand activitiesExpand activities Create a supportive community network in Create a supportive community network in
Developing Countries. Developing Countries. Creat Creat groups of people, committed people, groups of people, committed people,
specially patients and Doctors to approach specially patients and Doctors to approach RRP IRS as a backup for multipurposeRRP IRS as a backup for multipurpose
Interaction with Meds suppliers for easier Interaction with Meds suppliers for easier access and cheaper pricesaccess and cheaper prices
Thank You!Thank You!