INAUGURAL SPEECH OF PAHPBS PRESIDENT DR. CATHERINE SC TEH

This year marks the 50th year of Apollo 11. The mission that first landed humans on the moon safely. This has inspired me with a “Moonshot Thinking” for our society, the PAHPBS. We needed both radical and breakthrough solutions to create a massive impact perhaps just like the approaching typhoon Tisoy.

Looking back, 10 years ago, it was a moonshot to create this society. Though a little late in our developments in the HPB field. The landscape has always been that of general surgery. Modern and advanced, scientific and responsible liver, biliary, pancreatic surgery has taken place only in the past 15-20 years. It was not perceived as a specialty at that time, in the eyes of Filipino surgeons. Even before PAHPBS was formally inaugurated.

In 2014, I organised the 1st HPB masterclass where I performed a Live demonstration of laparoscopic hepatectomy. The next 2 masterclasses followed in 2015 and 2016, following the same format of 1.5 days of didactic and live surgery on day 2. These were necessary to improve awareness and drum up the interest of surgeons to specialise, train and pursue HPB. Thankfully, this moonshot idea was shared by the same group of HPB enthusiasts and in 2015, we were inaugurated as the Philippine Association of HPB Surgeons graced by Prof Daniel Cherqui as keynote. There were only 21 founding members at that time. Today, 4 years later, we have a 22 associate members and 114 members with Prof Henri Bismuth as an honorary fellow. I believe, we are a bunch of people who believe in moonshots. We faced birth pains and growing pains in this first 4 years. Thankfully we have 2 wise men who lead us to unity and provided us the wisdom in carrying out the vision and mission of this young society. And for that I wish to take that opportunity to give my profound gratitude to both Dr Mon de Vera as the founding President and Dr Ernesto Tan our outgoing President. Let us give them a big round of applause.

THE PAST AND THE PRESENT

Many things have happened since then, And I thank the Board of trustees all for working with me. With that I urge you to give another round of applause to the Board of trustees who worked hard to realise our vision as the nationally recognised leaders in HPB care.

Last year, we held the 1st international symposium with 0% funding and 100% doubt. Not knowing whether there will be enough attendees, and many more concerns. I did not hesitate despite the odds. 9 Internationally known speakers came to support us with Norihiro Kokudo our IHPBA president elect as our keynote. Those who were there experienced the high quality scientific content for learning and mutual exchange. It was a roaring success!!! Indeed, I am a believer of moonshots.

And the rest is history.

Today, I stand here with tremendous honour and privilege as I accept the challenge as your President for the next 2 years, as a person who breathes, eats and sleeps HPB, I am much more inspired by moonshot thinking. The Lancet Global Surgery Commission found that nearly one-third of the global burden of disease can be treated surgically and that 5 billion people lack access to safe and affordable surgical care. That includes us!!! Philippines!

Locally, Liver Cancer is the 3rd leading cause of cancer related mortality in the country. In 2016, 8,580 HCCs were diagnosed, and the same number of 8, 230
patients with HCC died. We have got to do better than that!!! The lack of expertise, urban -rural divide, creating infrastructure contribute to this huge problem,
not to mention the lack of political will and unity amongst us. This is not the time to identify as I or you, but we and us, together as one. One HPB, One
Vision, One Goal, One Moonshot for the Filipino patients. Let us identify our needs, institution per institution, let us think of centralisation of cases because
we all know that high volume centers produce good outcomes. Not every hospital can be an HPB center, resources are meagre, whether human or infrastructure. We need funding and we need the government to align with our needs not only for the patients but for training. Understandably, without the volume, how can we train our younger colleagues to become experts? Capacity building is sorely lacking.

THE FUTURE

Let us take advantage of technology, for example telemedicine as a education & collaborative platform. Technology in minimal access surgery such as laparoscopic & robotic approach are here to stay, There will always be patients who will want to have those services. Again, not every institution is capable due to the high learning curve and high cost. What is necessary first and foremost is to have HPB surgeons in every region to take care of these needs,
whether open or lap. Technology is a must because pre-operative planning by radiologic assessment is the backbone of a good surgical outcome in liver, biliary and pancreatic surgery. Improving diagnostic and planning access & expertise alone will already change the landscape where unnecessary surgeries are done causing harm and surgeries / interventions needed are not given effectively and efficiently. Twinning with local institutions, partnerships with other specialties, with expert centers abroad, including humanitarian outreach are solutions right in front of us that we should take advantage of especially for the development of liver transplant program.

I am taking this opportunity to challenge everyone to be a game changer, to be inspired by moonshot thinking, let us all be one and improve these gaps…. Bridge these gaps and improve our training curriculum, improve access not only for patient care but quality surgical outcomes. Let us engage the government, unify as the Philippine Liver Transplant Program, provide opportunities for minimal access HPB surgeries through training, local and international partnerships,
please let us support and empower our your colleagues, make them shine, shine much brighter than us for tomorrow the landscape is for them to change and for us to look back.

Let us also take advantage of social media and create a place in the cyberspace, develop local and international representation and collaboration.

It is time we create expert teams and not teams of experts. For there will be roles to take by each one of us. Let us remember there is unity in diversity. Let us continue to grow and shine, so that by 2027, we can change this map of liver transplantation and Join the rest in turning pink!

REACHING THE MOON TOGETHER

Open our eyes and hearts to the current standards and advances – join the international community like the IHPBA 2020, APHPBA, ……
And I will continue to extend our network across the globe to be able to bring them to you , to us Come 2020, we will be hosting the 3rd ASEAN Lap HPB
conference here in Shangrila, and we hope to see you again and and be part of history !

Ladies & Gentlemen, All I want for Christmas is your support. Please sign-up in a committee, one in which you think you will and may have a contribution. Think of how you can give back, for giving back is the way to true happiness. Give back to our country and give back as a responsible global citizen. And Perhaps, soon, we can reach for the moon, together. I wish each one of you a very Merry Christmas and Thank you for listening.