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Among Hospitals and Health Care Institutions as Enabler for Surge
Capacity Management – Enhancing Service Delivery Network
Vice President for Luzon, Philippine Hospital AssociationDr. Jaime A. Almora
MUTUAL ASSISTANCE AGREEMENT
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PHA Mission:
L – lead
E - Enable
A – Assist
P – Protect
Enabling Hospitals to “continue serving
patients” in times of disaster through
MUTUAL ASSISTANCE AGGREEMENT
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PHA
L.E.A.P
LEGISLATIVE/POLITICAL/
REGULATORY COMMITTEE
Lead - Protect
DISASTER
COMMITTEE
Enable
PATIENT SAFETY AND
QUALITY CARE
Assist
COMMAND
AND CONTROL
MUTUAL ASSISTANCE
AGREEMENT (MAA)HEALTH CARE CONTINUITY
RESERVE CORPS (HCRC)
INFECTION
PREVENTION &
CONTROL
MAA
HCRC
Present Situation of
Disaster Preparedness and Response
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Not a question of “IF”, but a question of “WHEN”
http://assets.rappler.com/612F469A6EA84F6BAE882D2B94A4B421/img/7BF204D75AFD46418B2589BFE0023073/west-valley-fault-20150520.png
http://manila.coconuts.co/sites/manila.coconuts.co/files/styles/article_header/public/field/image/west-valley-fault.jpg
PRESENT SITUTATION OF DISASTER PREPAREDNESS AND RESPONSE
PRESENT SITUTATION OF DISASTER PREPAREDNESS AND RESPONSE
NDRRMC
LGUs RED
CROSS
BFP
DOHNGOs &
Industry
Leaders
RESCUE
AND
RECOVERY
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Current
Focus
Bring
Victims
To
Hospital
Department of Health (DOH)
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PRESENT SITUTATION OF DISASTER PREPAREDNESS AND RESPONSE
Organized the
Health Emergency Management System
(HEMS) - For Government Hospitals only
Disaster Risk Reduction, Recovery, Response
and Resiliency Management Council
(DRRRMC)
Capable of setting up field hospitals
Ability to come up with adequate services and access
to complete compliment of profession resource is yet to
be tested
Red Cross
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PRESENT SITUTATION OF DISASTER PREPAREDNESS AND RESPONSE
Rescue volunteers (REACT, Rotary, Red Cross,
NGOs, LGU’s, citizens, and communications
groups) expect the hospitals in a disaster area to
receive and deliver adequate services.
Some hospitals have given serious thought to
preparing for a sudden patient surge in times of
disaster and have done some preparation
DOH hospitals are mandated to have their own
Health Emergency Management System (HEMS)
Hospitals
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PRESENT SITUTATION OF DISASTER PREPAREDNESS AND RESPONSE
But majority of hospitals have not embarked on
serious preparation or their preparation is yet to
be tested. They are yet to organize themselves
into a common action plan that would pool their
strength and identify solutions for their weakness.
Because of spirit of competition, there is no
assurance yet that hospitals will assist each other
in a disaster situation in order to shorten response
time and deliver services quickly, efficiently, and
effectively in any form of disaster
Hospitals
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PRESENT SITUTATION OF DISASTER PREPAREDNESS AND RESPONSE
Reality of Disaster Preparedness
and Response
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Everything about disaster is a supposition and nobody can claim full
preparation or expertise. Anybody who would go into full preparation
would appear as ridiculous as Noah was in his time.
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
REALITY OF DISASTER PREPAREDNESS AND RESPONSE
From the disaster
preparedness point of view,
Noah could have saved
more people if the people
believed him and heeded
his warning.
He could have done better if
he people agreed to assist
him.
He was considered crazy
but eventually he was
proven right.
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
REALITY OF DISASTER PREPAREDNESS AND RESPONSE
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
In times of disasters
Incapacitated when
power and water supply
is damaged
Same Structural Damage
proportionate to the natural force Structural Damage
proportionate to the
natural force Equally incapacitated when power and
water supply is damaged
Isolated when roads, bridges or
transportation are cut off
HOSPITALSINFRASTRUCTURE
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Hospital Scenario
Hospital personnel are likely to have problems
of their own and inclined to help themselves
first and will not report to work
Hospitals who are lucky to have sustained
partial damage will be forced to work in a
chaotic and helpless situation
Trauma victims will surge to hospitals (as most
responders will concentrate in rescue and
provision of food and shelter to victims)
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
No known major occasion
where hospitals met and
organized themselves to
execute a common plan of
action to address anticipated
problems in a disaster.
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
HOSPITALS ALSO
NEED TO BE RESCUED
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
DELAY
UNCERTAINTY
NO PRIOR COMMITMENT
LACK OF ANTICIPATION
NO COMMUNICATION
LACK OF KNOWLEDGE ON
SERVICE CAPABILITY
NO SITUATIONAL REPORT
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
What can
hospitals do to
insure continuity
and resiliency?
Proposal
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Proposal
Hospitals will need to
organize themselves and
draft a plan to enable
themselves through a
“Mutual Assistance
Agreement”;
Better operation by
enhancing the existing
DOH program on
“Service Delivery
Network”, and by linking
with DOH HEMS
Facilitated by an
Information Technology
platform and;
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Hospitals will need to organize themselves and draft a plan to enable
themselves through a “Mutual Assistance Agreement”.
Proposal
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Proposal
Mutual Assistance Agreement
was the “MISSING LINK”
creates a pre-event formal
understanding
sets expectations
develop commitment, and
facilitate speedy response
for resource sharing
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Provisions of
the MAA MUTUAL ASSISTANCE AGREEMENT
1. Hospitals are the best source of assistance to other hospitals
damaged by disaster because they have the manpower, supplies,
medicines, equipment, and other resource necessary to continue
hospital operation
PREMISE:
4. There is a need to have reliable and committed
partners with common understanding and expectations
3. “Time is of the essence” in disaster conditions which
necessitate connectivity on a real time basis.
2. There is a need to link Hospitals for speedy identification
of services and capabilities available for resource sharing
during disaster
5. There is a need to agree on mode and manner of
financial recoupment.
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Provisions of
the MAA MUTUAL ASSISTANCE AGREEMENT
Hospitals agree to bind themselves and commit to:UNDERTAKING:
4. Provide on deferred payment to MAAG hospitals the
following services:
a. Medicines
b. Laboratory equipment
c. Diagnostic equipment
d. Other needs that a situation demands
3. Share manpower, equipment, technical, logistical assistance
when asked
2. Receive assistance
1. Volunteer assistance to members of Mutual
Assistance Agreement Group (MAAG) during disasters
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Provisions of
the MAA MUTUAL ASSISTANCE AGREEMENT
5. Lend for free such items as:
a. Non consumable items like instruments, generator,
tools, operating lights, operating table, etc.
b. Transport vehicles/ambulance except fuel
c. Professional Services
d. Other items that the situation demands
7. Pay promptly obligations as soon as able
6. Install a common incident management system to
facilitate communication and connectivity
Introducing AMSAdvance Incident
Management System (
AMS )
AMS is a comprehensive software
system for urgent tracking of
medical resources within a region in
near-real-time.
AMS was built on the positive
attributes of the Alabama Incident
Management System (AIMS) which
was developed within the University
of South Alabama Center for
Strategic Health Innovation (CSHI)
in Mobile, under the leadership of
Carl Taylor, Director for CSHI. This
was originally a research effort
which rapidly became the backbone
of the Alabama response to
Hurricane Katrina.
According to Federal and State
Officials, it is the best of those they
saw on a survey of tools available
for medical incident management
that they selected.
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
http://amsph.xchlive.org
Enhanced Connectivity thru AMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Asian Medical Management
System ( AMS )
Two-way Referral System
BHS/Clinics-
Birthing Homes
Service Delivery
Network (SDN)
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
BHSCommunity Health
Teams (CHTs)
Community/
District Hospital
Higher Level
HospitalS
hort
est
Tra
vel T
ime
Enhancement of SDNService Delivery
Network (SDN)
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Patient Referral (SDN) Resource Sharing
Enhancement
Connect with HEMS
Health Emergency
Management System
(HEMS)
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Health Emergency Management System
(HEMS)
Hospital based disaster response
Have the resource, manpower, training
Government network only
HEMS HEMS HEMS
HEMS HEMS
MAA
MAA
MAA
MAAMAA
MAAMAA
Mechanics of the
Mutual Assistance Agreement
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
being the organization of government and private
hospitals will do the organizational efforts, utilizing its
regular monthly Regional Conferences and Hospital
leaders Dialogue to forge a Mutual Assistance
Agreement among hospitals
will provide logistic support and
allow modification and
enhancement of its existing
program on Service Delivery
Network (SDN) and HEMS
AMS
PHA DOH
RESCUE
GROUP
SAsian Medical Management
System (AMS)
Philippine Hospital Association (PHA)
will be the nerve center to
provide real time situationers,
facilitate communication, and
resource sharing
Department of Health (DOH)
will network with other MAAGs
and with foreign hospitals and
health care institutions
Mutual Assistance
Agreement Group (MAAG)
MECHANICS
will augment sharing of
resources
Rescue Groups and
VolunteersMAAG
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
HEMS HEMS HEMS
HEMS HEMS
MAA
MAA
MAA
MAAMAA
MAAMAA
MECHANICS
INTERCONNECTIVITY
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
RESOURCE IDENTIFICATION,
BUILD UP, AND SHARING
1. VOLUNTEER MANPOWER
(HCRC)
2. MOBILITY
3. SUPPLIES
4. MEDICINES
5. EQUIPMENT
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
HCRC Initiatives
Pool of healthcare provider volunteers
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
HCRC Initiatives
EXPECTED RESULTS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Mutual Assistance
Agreement ( MAA) Expected Results
1. FASTER and ANTICIPATED RESPONSE to a
HOSPITAL faced with capability, logistics, and
manpower crisis
3. COST RECOUPMENT ASSURANCE because the
process of reimbursement will be provided for
in the Mutual Assistance Agreement. PHIC,
DSWD, NDRRMC and DOH is expected to help
insure cost recoupment
2. FREEDOM FROM UNCERTAINTY OR DOUBT in
requesting for assistance without worrying for
payment
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Mutual Assistance
Agreement ( MAA) Expected Results
4. REAL TIME INFORMATION because of
CONNECTIVITY by using an IT Software usable
during normal times and during disaster
situations (AMS)
6. High SUCCESS OF IMPLEMENTATION if it will
network with existing DOH disaster program
(HEMS) and two-way referral system (SERVICE
DELIVERY NETWORK)
5. ENHANCEMENT of SERVICE DELIVERY
NETWORK program and HEMS of DOH
THANK YOU.
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Sources
• Taylor, Carl. ND. Principles of Health Risk Preparedness-AMS as a Key to Surge Capacity Management, Situational
Awareness and Connected Response-Ability- Anywhere.
• DOH-AO 2014-0313: Guideline on Establishing SDN
• DOH AO 2014-0046: Defining SDN
• http://xchlive.org
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valley-fault-20150520.png
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References
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
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References
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Sources
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References
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Sources
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References
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
SUPPLEMENTARY SLIDES
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Major Advocacies of PHA
1. Legislative and political = Lead,---- Protect
2. Disaster preparedness and response =
Enable
3. Infection prevention and control = Assist
Overview Present Situation of Disaster
Preparedness and Response
Reality of Disaster Preparedness
and Response
Proposal for Mutual Assistance Agreement
Mechanics of
Mutual Assistance Agreement
Expected Results
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Department of Health (DOH)
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PRESENT SITUTATION OF DISASTER PREPAREDNESS AND RESPONSE
Not yet required all hospitals to provide isolation
facilities to handle new and emerging disease
epidemics
Advised builders of new hospital to incorporate
earthquake-proof structures -HSI
Embarked on logistics preparations for:
Vaccines
Medicines, and
Hospital supplies
Identified and assigned
Selected government trauma centers
Epidemic confinement centers
Organized the Health Emergency Management System
And the Disaster Risk Reduction, Recovery, Response and
Resiliency Management (DRRRM)
From the disaster
preparedness point of view,
Noah could have saved
more animals from the
worst disaster on earth if
only he had partners who
have known what he was
doing and willing to lend him
arks to save more animals.
If his ark capsized during
the flood because there
were no fallback options,
the earth would have been a
barren planet today. There
was nobody to assist him.
No Mutual Assistance
Agreement
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
REALITY OF DISASTER PREPAREDNESS AND RESPONSE
Framing the Service Delivery Network
DOH-AO 2014-0313: Guideline on Establishing SDN
DOH AO 2014-0046: Defining SDN
Service Delivery
Network (SDN)
Recently, with the help of JICA,
DOH rolled out its “Service
Delivery Network” program
which is to link hospitals and
health institutions of different
capability level into an interlocal
network of referral system to
help patients access health
services in a Health Zone.
This is designed to facilitate
access of patients to other
centers in normal situation but
does not include resource
sharing, and rescue mode
assistance from other hospitals
in emergency surge situation.
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Identification
of Priority
Population
Identification of
Service Providers
(Private and Public)
Set-Up Service
Delivery Network
and Forged
Partnership
Providers Facilities
Integration of Cultural Integrity and
Geographical Set-Up
Enhanced Connectivity thru AMSAsian Medical Management
System ( AMS )
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
DASHBOARDS
Enhanced Connectivity thru AMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
DASHBOARDS
Asian Medical Management
System ( AMS )
Enhanced Connectivity thru AMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
MAILBOX
Asian Medical Management
System ( AMS )
Enhanced Connectivity thru AMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
REQUESTS
Asian Medical Management
System ( AMS )
Enhanced Connectivity thru AMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
DISPLACED PERSONS
Asian Medical Management
System ( AMS )
Enhanced Connectivity thru AMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
VOLUNTEERS
Asian Medical Management
System ( AMS )
Enhanced Connectivity thru AMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
MAP & DISEASE SURVEILLANCE
Asian Medical Management
System ( AMS )
Enhanced Connectivity thru AMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Asian Medical Management
System ( AMS )
Neutrality
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Asian Medical Management
System ( AMS )
Freedom
Capability
Lightweight
User Friendly
Configurable
Enhanced Connectivity thru AMS
We recently added a displaced persons module
and can continue customization to meet your
needs.
- Carl Taylor, Director for CSHI
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Asian Medical Management
System ( AMS )
Scalable
Enhanced Connectivity thru AMS
There are two approaches-one full integration
with government efforts, much as AIMS does in
Alabama. The second, limited integration,
which is the goal of the Haitian Private Hospital
Association. They prefer AMS to be used to
support their members directly outside of the
government structure.
- Carl Taylor, Director for CSHI
Effective but not Invasive
Budget Sensitive
“We are happy to support your hospitals with
AMS at no charge and certainly happy to be
embedded into a Mutual Aid agreement.”
- Carl Taylor, Director for CSHI
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Service Delivery
Network (SDN)
Mutual Assistance
Agreement Group
(MAAG)
HDEC/
HEMS
HDEC/
HEMSHDEC/
HEMS
HDEC/
HEMS
HDEC/
HEMS
HDEC/
HEMS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
Mutual Assistance
Agreement Group (MAAG)
HOSPITAL DISASTER
EMERGENCY COMMITTEE (HDEC)
MAAG
(CHAPTERS)
COMMAND
& CONTROL
SEARCH FOR OUTSTANDING CHAPTER CRITERIA:
1.NO. OF MEMBER HOSPITALS IN THE CHAPTER WHO JOINED THE
MAA GROUP
2.PRESENCE OF HOSPITAL EMERGENCY AND DISASTER
MANAGEMENT COMMITTEE (HDEC) IN EACH MEMBER HOSPITAL
3. LIST OF HAZARDS AND RISK WITHIN THE GEOGRAPHICAL
LOCATION OF THE CHAPTER
4. PRESENCE OF DISASTER PREPAREDNESS AND RESPONSE
PLAN
5. PRESENCE OF VOLUNTEERS FOR HEALTHCARE CONTINUITY
RESERVE CORPS
6. NO. OF DISASTER PREPAREDNESS MEETINGS AND GROUP
TRAININGS
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PHA NATIONAL CONVENTION
November 15 – 16 – 17 – 18, 2017
Nov. 17- Plenary Session on Disaster1. Healthcare Continuity and Connectivity in
Times of Disaster
- Carl W. Taylor, J.D.
2. Disaster Risk Reduction and Management
in Hospitals in the Philippines
-Renato U. Solidum, Jr.
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
PHA ANNUAL NATIONAL CONVENTION
Nov.18- DISASTER PREPAREDNESS & RESPONSE TRAINING AND
WORKSHOP
1. TIEMS Worldwide Efforts Towards More Resilient Societies-
-Dr. Harald Drager (TIEMS President)
2. USAR Capacity Buildings and Disaster Responses in Asia and
Pacific Area
–Dr. QU Guosheng
3. HOSPITAL CONNECTIVITY – Installation of Software and Training
of Communication Officers and Disaster Response Teams
- Carl W. Taylor, J.D.
4. OVERVIEW OF MUTUAL ASSISTANCE AGREEMENT
-Jaime A. Almora, MD
5. OVERVIEW OF HEALTHCARE CONTINUITY RESERVE CORPS
-Ms. Angeli Medina
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
YOU ARE CORDIALLY INVITED.
THANK YOU!!!
Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement
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