Filipino caregivers deserve better

The Economic Partnership Agreement that Japan has with some countries, especially the Philippines, has placed many Filipino nurses and caregivers working in Japan in a miserable situation where they are subjected to unfair labor practices, extreme pressure to pass licensing exams in Japanese within three years, cramped living conditions and poor salaries.
With net pay (monthly) of only around ¥60,000, an often unsupportive work environment because of the lack of programs, and constant comparisons between the local and foreign workforce, employment in Japan has become a nightmare for many foreign health workers. The Japan International Corporation for Welfare Services has not done anything to remedy the situation. Nor has it transferred foreign workers to fairer and higher-paying hospitals. Yet, it is getting ready to recruit the second batch of unsuspecting nurses and caregivers.
Japan must stop hiring overseas workers only to subject them to extreme poverty and unfair labor conditions. If it values the service that these devoted health workers provide to Japanese society, nurse licensing exams must appear in an easier format that includes furigana phonetic guides for kanji so that the workers can pass them in three years. An effective Japan nurse orientation program for newcomers would also help.
The opinions expressed in this letter to the editor are the writer's own and do not necessarily reflect the policies of The Japan Times.

Nurse to Stand Trial for Reporting Doctor

KERMIT, Tex. — It occurred to Anne Mitchell as she was writing the letter that she might lose her job, which is why she chose not to sign it. But it was beyond her conception that she would be indicted and threatened with 10 years in prison for doing what she knew a nurse must: inform state regulators that a doctor at her rural hospital was practicing bad medicine.

Michael Stravato for The New York Times
Anne Mitchell, right, and Vickilyn Galle wrote the letter to regulators that drew felony charges.
Michael Stravato for The New York Times
Sheriff Robert L. Roberts Jr., who investigated the case against the nurses, voiced confidence in it.
When she was fingerprinted and photographed at the jail here last June, it felt as if she had entered a parallel universe, albeit one situated in this barren scrap of West Texas oil patch.
“It was surreal,” said Mrs. Mitchell, 52, the wife of an oil field mechanic and mother of a teenage son. “I said how can this be? You can’t go to prison for doing the right thing.”
But in what may be an unprecedented prosecution, Mrs. Mitchell is scheduled to stand trial in state court on Monday for “misuse of official information,” a third-degree felony in Texas.
The prosecutor said he would show that Mrs. Mitchell had a history of making “inflammatory” statements about Dr. Rolando G. Arafiles Jr. and intended to damage his reputation when she reported him last April to the Texas Medical Board, which licenses and disciplines doctors.
Mrs. Mitchell counters that as an administrative nurse, she had a professional obligation to protect patients from what she saw as a pattern of improper prescribing and surgical procedures — including a failed skin graft that Dr. Arafiles performed in the emergency room, without surgical privileges. He also sutured a rubber tip to a patient’s crushed finger for protection, an unconventional remedy that was later flagged as inappropriate by the Texas Department of State Health Services.
Charges against a second nurse, Vickilyn Galle, who helped Mrs. Mitchell write the letter, were dismissed at the prosecutor’s discretion last week.
The case has been infused with the small-town politics of this wind-whipped city of 5,200 in the heart of the Permian Basin, 10 miles from the New Mexico border. The seeming conflicts of interest are as abundant as the cattle grazing among the pump jacks and mesquite.
When the medical board notified Dr. Arafiles of the anonymous complaint, he protested to his friend, the Winkler County sheriff, that he was being harassed. The sheriff, an admiring patient who credits the doctor with saving him after a heart attack, obtained a search warrant to seize the two nurses’ work computers and found the letter.
Both sides acknowledge that the case has polarized the community, and the judge has moved the trial to a neighboring county.
The state and national nurses associations have called the prosecution an outrage and raised $40,000 for the defense. Legal experts argue that in a civil context, Mrs. Mitchell would seem to be protected by Texas whistle-blower laws.
“To me, this is completely over the top,” said Louis A. Clark, president of the Government Accountability Project, a group that promotes the defense of whistle-blowers. “It seems really, really unique.”
Until they were fired without explanation on June 1, Mrs. Mitchell and Mrs. Galle had worked a combined 47 years at Winkler County Memorial Hospital here, most recently as its compliance and quality improvement officers.
The nurses, who are highly regarded even by the administrator who dismissed them, said the case had stained their reputations and drained their savings. With felony charges pending, neither has been able to find work. They said they could feel heads turn when they walked into local lunch spots like El Joey’s Mexican restaurant.
“It has derailed our careers, and we’re probably not going to be able to get them back on track again,” said Mrs. Galle, 54, a grandmother who is depicted around town as the soft-spoken Thelma to Mrs. Mitchell’s straight-shooting Louise. “We’re just in disbelief that you could be arrested for doing something you had been told your whole career was an obligation.”
It was not long after the public hospital hired Dr. Arafiles in 2008 that the nurses said they began to worry. They sounded internal alarms but felt they were not being heeded by administrators.
Frustrated and fearing for patients, they directed the medical board to six cases “of concern” that were identified by file numbers but not by patient names. The letter also mentioned that Dr. Arafiles was sending e-mail messages to patients about an herbal supplement he sold on the side.
Mrs. Mitchell typed the letter and mailed it with a separate complaint signed by a third nurse, who wrote that she had resigned because of similar concerns about Dr. Arafiles. That nurse was not charged.
To convict Mrs. Mitchell, the prosecution must prove that she used her position to disseminate confidential information for a “nongovernmental purpose” with intent to harm Dr. Arafiles.
Mari E. Robinson, executive director of the Texas Medical Board, has warned in a blistering letter to prosecutors that the case will have “a significant chilling effect” on the reporting of malpractice.
The nurses’ lawyers, John H. Cook IV and Brian Carney, have filed a civil lawsuit in federal court charging the county, hospital, sheriff, doctor and prosecutor with vindictive prosecution and denial of the nurses’ First Amendment rights.
Nonetheless, the sheriff, Robert L. Roberts Jr., and the prosecutor, Scott M. Tidwell, express confidence in their case.
“The only side of the story that the town has heard is that these are sisters of mercy, missionaries of peace,” said Mr. Tidwell, who is trying the case because the district attorney is in poor health. “The town has not heard the whole story.”
Dr. Arafiles, 47, who attended medical school in his native Philippines and trained in Baltimore and Buffalo, said his lawyer had advised him not to talk. “I’ve been brutalized and abused,” he said. “I’m the victim in this case, and that is all I can say.”
Several Texas laws would seem to enshrine a nurse’s right, and perhaps duty, to report a physician when he or she believes that patients are at risk. Lawyers on both sides agree that the case will hinge on whether a jury believes that Mrs. Mitchell reported in good faith. In civil whistle-blower cases, the Supreme Court of Texas has held that good faith requires only a reasonable belief that the conduct being reported is illegal.
The hospital administrator, Stan Wiley, said in an interview that Dr. Arafiles had been reprimanded on several occasions for improprieties in writing prescriptions and performing surgery and had agreed to make changes. Mr. Wiley, who said it was difficult to recruit physicians to remote West Texas, said he knew when he hired Dr. Arafiles that he had a restriction on his license stemming from his supervision of a weight-loss clinic.
In a surprise inspection last September, state investigators found several violations by Dr. Arafiles and concluded that the hospital had discriminated against the nurses by firing them for “reporting in good faith.”
But Sheriff Roberts, who has held the post for 18 years, said the state would show that the complaint had been filed in vengeance. “If it’s made to destroy somebody’s reputation or forcing them to leave town,” he said, “then I don’t believe it is good faith.”
Sheriff Roberts called Dr. Arafiles “the most sincerely caring person I have ever met.”
Mr. Wiley said he believed that the nurses had acted in bad faith because they went to the state despite his internal efforts to discipline Dr. Arafiles. But, he said, “I don’t believe they did it on a personal vendetta.”
Mrs. Mitchell said all she saw at the hospital was delay.
“The medical staff needed to make a decision on him,” she said. “You don’t get a second chance to save somebody’s life.”

Cdn health advocates nervously eye Obama reforms, fear another exodus of nurses

TORONTO — U.S. President Barack Obama's health-care package, although in political limbo, has nursing experts in Canada concerned about another exodus in their profession if provincial governments aren't vigilant in retaining nurses.

Canada will be short almost 66,000 registered nurses by 2022, says the Canadian Nurses Association. As of 2007, the country had 217,000 registered nurses delivering care but needed about 11,000 more, it added.
"We're always very concerned when we see potential of a renewed migration," said Rachel Bard, the CEO of the association.

"What is happening in the U.S. is a potential threat, because we already know that the United States is (going to be) short over 750,000 registered nurses (by 2020)."

House and Senate Democratic leaders in the U.S. are scrambling to see if they can salvage Obama's ambitious health-care plan, which Republicans almost universally oppose.

If it passes, the U.S. could embark on a renewed search for nurses abroad, Bard said.

The country's emergence from the recession could also play into a demand south of the border for nurses.
The worldwide recession has reduced inpatient admissions and decreased the demand, but Linda Aiken, a professor of nursing at the University of Pennsylvania, said her country will see a surge in the call for nurses as the economy improves.

"The U.S. Department of Labor estimates that over the next decade more jobs will be created for RNs than in any other job category," Aiken said.

Health-care stakeholders who have fought for almost two decades to keep nurses in Canada say that find those trends troubling.

In the early '90s it was called "nurse poaching," as recruiters snatched up health-care professionals from Canada looking for better opportunities in the U.S.

Doris Grinspun, the executive director of the Registered Nurses Association of Ontario, said the change happened quickly in the province. Nurses would simply "take their luggage and go," she said.

At the time, about 70 per cent of the positions for nurses in the U.S. were full-time, but in Ontario and several other provinces many nurses could only get part-time or casual work. They were often commuting between two or three different employers to make ends meet.

"We lost tons (of nurses)," Grinspun said, lamenting the years that the association spent trying to lure them back home.

Slowly, some provinces bounced back. The Ontario government introduced the nursing graduate guarantee, which secured full-time employment for young nurses. From 2003, Ontario increased the full-time employment of nurses to almost 70 per cent.

"The ghosts are there all the time," said Grinspun, as she compared recruitment agencies to vultures. "They are ready to find the weaknesses to poach the nurses for other places, because - remember - it's a business."
Plastered to the walls inside a Toronto subway platform a giant advertisement from a recruiting agency encourages nurses to work in Saudi Arabia.

For Grinspun, that's also a worrying sign.

"Always we will need to be very vigilant in Ontario," she said. "The moment that we let our guard down in terms of ensuring that our new graduates have full-time work, is the moment that we are opening the door for them to go somewhere else."

This is already the case in Alberta, where only 40 per cent of the graduating class this year will be able to find work. The remaining 60 per cent are searching outside the province for employment, said Mary-Anne Robinson, the executive director of the College & Association of Registered Nurses of Alberta.
The health regions cut budgets significantly last year and, as a result, there are less RNs available for patient care, she said.

"When you have a graduating class coming out that has student loans to pay they're going to look for a job and they need to find one," said Robinson.

Nurses in Alberta have become accustomed to seeing ads in newspapers enticing nurses to work overseas or in the U.S.

"Our concern is: Can we get them back?" Robinson said.
"The track record isn't good on getting them back."
Alberta has forecast a shortage of 6,000 RNs by 2012.

The nursing shortage in Canada is also a global nursing shortage, said Ivy Bourgeault, a professor at the University of Ottawa.

Bourgeault, who holds a research chair in health human resource policy at the university, said although she's not as worried as she once was about the effect of Obama's plan, she is still concerned.

"When we implemented medicare here in Canada there was an instantaneous shortage of physicians and so we had a huge influx from internationally educated countries," said Bourgeault.

Obama's initial push for universal health care has since been watered-down and likely won't have the explosive impact on the nursing shortage in the U.S. as once feared, she added.

Saskatchewan has sought out international nurses to fill its shortages. The province and the Philippines have signed memorandums of understanding to allow these nurses to come and work in Canada.

Nursing home sexual violence: 86 Chicago cases since July 2007 — but only 1 arrest

Rape allegations were reported in a quarter of city's 119 nursing homes in those two and a half years, records show

"I just broke down," says Dorothy Foster, recalling a 2008 visit to her daughter, a nursing home resident, shortly after another resident told staff he had raped Foster's daughter, files and interviews show. No one was arrested. (Tribune photo by Zbigniew Bzdak / January 12, 2010)
Authorities have investigated at least 86 cases of sexual violence against elderly and disabled residents of Chicago nursing homes since July 2007, but only one of those cases resulted in an arrest, a Tribune investigation has found.

Allegations of criminal sexual assault, or rape, were reported in a quarter of Chicago's 119 nursing homes during those 2 1/2 years, government records show.

State law requires nursing homes to notify police immediately when they receive an allegation of sexual violence or abuse. However, no police reports were filed in connection with at least nine alleged sexual attacks reported by the state Department of Public Health, according to Chicago police records released to the Tribune. In a 10th case, the allegation was reported to police months after the incident.

Police and state investigative reports depict the terror endured by elderly and disabled women in some city nursing facilities where predatory males troll through common areas and unlocked bedrooms with little supervision.

Almost all of the 86 cases the Tribune examined involved residents attacking other residents. Only a handful of the alleged attackers were employees or visitors; the lone successful prosecution was of an orderly.

The frightening atmosphere is another consequence of Illinois' unusual reliance on nursing homes to house younger psychiatric patients with sometimes violent criminal records. Many understaffed facilities are ill-equipped to treat these residents or monitor their behavior.

Government records show that the 30 Chicago facilities where rapes were reported were roughly twice as likely to house convicted felons and mentally ill patients as the 89 city nursing homes without a sexual assault allegation.

At Rainbow Beach Care Center on the South Side, a 61-year-old woman said she was afraid to fight or scream and could only say, "No, no, no, please," as she was allegedly raped by a schizophrenic 47-year-old man with a "history of inappropriate sexual behavior toward females," according to a state health department report. When a police report was filed months later, it said the woman had called the sex "consensual."

A physician had previously ordered that the alleged attacker be given periodic shots of the drug Depo-Provera, a form of chemical castration used on male sex offenders. But state health inspectors found no medical record indicating those shots were given. State investigators also said the facility failed to conduct a "thorough investigation" to determine whether the same man had raped a second woman.

A few miles away at All Faith Pavilion, a female resident was hospitalized in a "catatonic state" with a swollen black eye, broken nose and human bite marks, state records show. She told authorities she was raped by a schizophrenic48-year-old male resident in the facility. The woman remained hospitalized for at least a month, a state report said.

No charges were brought in the Rainbow Beach and All Faith cases.

The owners and administrator of All Faith declined interview requests. Eric Rothner, a co-owner of Rainbow Beach, issued a written statement saying: "Every day, we confront a unique set of challenges and we deal with them realizing that if it were not for our facilities, our residents would be living on the streets. All of us caring for this population are keenly aware of these issues and work to overcome them 24 hours a day, seven days a week."

'Something hidden'

Most of the 30 city homes with alleged attacks had substandard staffing levels, which experts call a key indicator of patient safety. Of the 23 homes that federal authorities have rated on a ratio of nursing staff to residents, 21 were rated "below" or "well below" average on staffing levels, while two others were deemed average, the Tribune found.

In addition to 48 reports of criminal sexual assault, which is a felony, Chicago police records show 28 allegations of criminal sexual abuse at city nursing facilities since July 2007. Those sexual abuse cases, which include charges of molestation and groping, can be misdemeanors under some circumstances.

One of the nine alleged attacks that did not turn up in police records released to the Tribune came to light in May 2008 during a state inspection of Rothner's Sheridan Shores Care & Rehabilitation Center on the North Side. Three "alert and oriented" women described "the fear they were experiencing at night time" when they awoke to find strange men in their rooms, sometimes standing over their beds, according to the state inspection report.

One woman said: "It scared me to death!" Another recounted staving off "2 attempted rapes during the night when male residents entered her room using the stairwell," the state report said. A facility investigation confirmed one woman's allegation about a male intruder standing over her bed, but Sheridan Shores' administrator denied to state investigators knowledge of any attempted rape.

Although both police and state health inspectors investigate allegations of sexual violence in nursing homes, the Tribune found that the two agencies rarely communicate with each other about the incidents and do not typically share reports on violent incidents or pool their expertise and resources.

The extent of the violence in Chicago nursing homes was unknown to the state ombudsman's office, which fields abuse complaints from nursing home residents and their families. That agency investigated only two sexual abuse allegations in Chicago homes during a recent 12-month period, according to its records, while police listed 27 reports of sexual assault at city nursing homes during that time.

"We believe the reports are less frequent than they should be — we think there is something hidden here," said Karen Roberto, a Virginia Tech professor who studies sexual assaults against the elderly in nursing facilities.

The small number of arrests related to recent rape allegations in Chicago nursing homes — 48 rape reports, one arrest — sharply contrasts with figures on sexual assault allegations citywide, official figures show.

Last year, Chicago police investigated 1,446 criminal sexual assault reports and made 450 arrests. Though some rapes can involve multiple defendants and some arrests can be linked to reports from the previous year, that amounts to roughly one arrest for every three reports.

Similarly, the FBI estimates that nationally there were 89,000 rape reports to law enforcement agencies in 2008 and 22,584 arrests.

Prosecution pitfalls

Experts say a variety of factors can interfere with investigating or prosecuting sexual assault reports in nursing homes. Often the victims suffer from dementia or appear delusional and can't describe the attacks in enough detail to assist investigators.

In December 2008, for example, a health care worker found evidence of sexual trauma on an elderly female resident of Warren Park Health & Living Center on the Northwest Side. The woman, who was hospitalized after the alleged attack, said a man came into her room and sexually assaulted her, but she "was unable to provide any further (information)," according to a Chicago police report.

Some facility residents are afraid to speak out because they live alongside their alleged attackers, others are anxious about alienating their caregivers or being moved from the only homes they have, and many simply feel too weak to face the ordeal of police questioning and forensic examinations.

"When they're at the end of their life, a lot of times people give up. It takes a lot of strength to go to police," said Karla Vierthaler, outreach coordinator at the Pennsylvania Coalition Against Rape.

Some cases become compromised because residents delay reporting the alleged attacks until they are visited by a relative or trusted caretaker. By then, any DNA or forensic evidence can be lost.

A Tribune review of police and state health reports found that although many facility operators responded immediately to rape allegations, some unwittingly cleaned up crime scenes rather than properly preserving evidence.

Others downplayed the incidents as consensual sex. They "act in their own self-interest rather than the interests of the residents," said Holly Ramsey-Klawsnik, a Massachusetts-based sociologist and mental health clinician.

For their part, police sometimes drop their investigations too quickly when faced with the host of obstacles from both victims and facility employees, said Ronald Costen, a former criminal prosecutor who directs Temple University's Protective Services Institute.

"You have to treat these cases of sexual assault in a long-term care setting like coming across a dead body on the side of the road — you have to look for hard, forensic evidence," Costen said.

In addition, experts said, police sometimes decide that mentally ill perpetrators lack the intent needed for successful prosecution and may have a better shot at treatment in nursing facilities rather than prison.

Only one of the 48 Chicago cases involving the most serious allegation, criminal sexual assault, was referred to the Cook County state's attorney's office for felony review, according to a records search done for the Tribune by prosecutors.

Chicago police say they vigorously pursue every sexual assault allegation. "We're not real quick to drop investigations ... that's not the case," said Thomas Byrne, chief of detectives for the department. "Sexual assaults are something we take very seriously."

In April 2008, police were summoned after midnight to Somerset Place on the North Side after a mentally ill 28-year-old resident told staff that he had beaten, then raped a schizophrenic 53-year-old woman after forcing his way into her fourth-floor bedroom, records and interviews show.

The man told police "he wanted to make a confession," and a police report said he sexually assaulted his female housemate "without the victim's consent." Sent to the emergency room with a blood-filled and swollen black eye, the woman told police and Somerset employees she had been sexually assaulted.

The victim's mother, Dorothy Foster, of Bolingbrook, saw her daughter at the facility the next day. "I just broke down," Foster said. "It was so bad."

But in the end, no arrest was made in the case. According to a police detective's report, the victim refused to cooperate with officers. She and the male resident now live in different facilities.

Somerset, another Rothner nursing home, sent a description of the incident to the state Department of Public Health as required by law, and the facility has not been accused of wrongdoing in the case.

Somerset has had seven reports of alleged sexual violence since July 2007, more than any other Chicago nursing home, records show. Federal and state authorities this month moved to revoke its state nursing home license and cut off its federal funding because of citations for abuse, safety breaches and other problems. The facility is contesting those actions.

Tribune reporter Anne Sweeney contributed to this report.

Woman left on operating table is suing North Shore University Hospital over no-show docs

Jennifer Ronca, who was left out cold on an operating table after her surgeons failed to show, at her home in 2009.
The State Health Department let a Long Island hospital off the hook for abandoning a patient in the OR - even though it found the hospital broke a host of rules.
North Shore University Hospital faced fines as high as $28,000 after Jennifer Ronca was left out cold on an operating table after her surgeons failed to show.
But state officials declined to fine the hospital.
Ronca "was not harmed by the medical staff that day," Health Department spokeswoman Claudia Hutton said yesterday. "Inconvenienced, certainly, but nothing rising to the level of harm to her health."
"Our goal is compliance, not revenue. The plan of correction from North Shore gives us compliance with their own policies, regs and what our standards dictate."
Ronca, a 33-year-old mother of three from Pennsylvania, was put under anesthesia and prepped for brain surgery on April 10 to correct her Chiari malformation - a condition that causes terrible headaches and other debilitating symptoms.
Unbeknown to her, Dr. Paolo Bolognese was en route to a family vacation in Disney World the morning of the procedure, and Dr. Thomas Milhorat, his partner and the chief of neurosurgery, refused to cover. Milhorat told OR staffers he was busy and directed them to wake Ronca up and reschedule.
North Shore suspended the two prominent neurosurgeons for several weeks. Milhorat, 73, was forced to step down after the Daily News exposed the incident.
The Health Department slapped the hospital in September with 14 violations of the public health code, including its no-show surgeons, an anesthesiologist who put the patient under with no one to operate and lying to the patient.
In North Shore's plan of correction, which was accepted and released by the Health Department yesterday, the hospital disagreed with seven of the state's 14charges.
The hospital dismissed the surgery mishap as "a result of an unfortunate confluence of a few errors, not a 'systemic' failure resulting from the absence of bylaws or policies."
The department's decision not to fine the Manhasset institution was another slap in the face to Ronca, who is suing the doctors and North Shore's Chiari Institute.
"I cried again," Ronca told The News when she learned the hospital got off without a fine. "The Health Department never called me to hear the facts from me. It's just another betrayal."
Ronca said since the ordeal, she has suffered recurrent nightmares and pain that plunged her into a deep depression, for which she was hospitalized in October.
"I've had a lot of issues trying to come to terms with what they did to me. The Health Department just assumed there was no injury," she said.

Doctors Using Herpes To Kill Cancer

This year, 70,000 people will be diagnosed with melanoma in the United States. Almost 9,000 will die from it. There hasn't been a treatment for melanoma in a decade, but now, doctors are using an STD to kill it."It's just like you're right there but they don't even know it," said Ira Dickstein, a melanoma patient.Dickstein has spent the last seven years trying to find a cure for his cancer.

"I found a significant black and blue area on the inside of my toe. It was hidden. It was big enough when I could see it, when I looked at the bottom of my foot. That's when I knew there was something wrong, but I didn't know it was melanoma," Dickstein said.From one toe, the melanoma spread above his knee."It's under the skin now," Dickstein said.Dickstein is taking part in his third clinical trial, but it's the first time he's seen his lesions disappear."My melanoma actually retracted a bit," Dickstein said.The lesions started to disappear when doctors injected them with a sexually transmitted disease."It can be engineered to specifically target cancer cells," said Dr. Gregory Daniels, a medical oncologist at the University of California, San Diego.Daniels injected a form of the herpes virus directly into Dickstein's melanoma lesions.When the body recognizes a virus is in the body, it increases a patient's immune response."Our body automatically recognizes that as a dangerous situation and attracts a response to it," Daniels said.It's working for Dickstein."The lesions that were directly injected shrunk, and one disappeared completely. The others were going backwards," he said.It's a good sign that his search for a cure is endingMelanoma is more than 10 times more common in whites than in African-Americans. It occurs more in men than women and, unlike many other common cancers, melanoma has a wide age distribution. It occurs in younger as well as older people. In fact, it is one of the more common cancers diagnosed in teenagers. 

MELANOMA: Melanoma is a type of cancer that begins in the melanocytes, cells that produce pigment melanin. Melanoma can also begin in other pigmented tissues such as the eyes or intestines. In 2009, an estimated 68,720 new cases of melanoma were diagnosed and about 8,600 deaths were accounted for, according to the National Cancer Institute. 

TREATMENTS: The standard surgical procedure used to remove melanoma tumors is excision, or surgical removal, according to the Mayo Clinic. The procedure can be a complete cure for most patients with thin melanomas.Another procedure used to treat melanoma, specifically on the head and neck, is Moh's surgery. Moh's can be used when the cancer has not yet spread to other areas of the body. During Moh's surgery, the surgeon removes the cancer layer by layer, guided by a microscope, until the whole tumor is gone.Other options for treatment are radiation therapy, chemotherapy and experimental treatments such as immunotherapy. Immunotherapy is a popular experimental treatment that encourages the body's own immune system to seek out and kill melanoma cells. 

HERPES IN CANCER TREATMENT: Researchers at the University of California, San Diego are testing a type of immunotherapy for melanoma using engineered herpes viruses. Using a needle similar to that used for the flu vaccine, researchers inject the herpes virus into a melanoma lesion. The idea is the presence of the new virus alerts the body's immune system to attack the cancerous area. Daniels said the virus is engineered to be safe for non-cancerous cells, and the idea of using viruses to fight cancer has been around for hundreds of years.

Interview of caregivers, nurses bound for Japan ongoing

Interview sessions for the second batch of nurses and caregivers under the Japan-Philippine Economic Partnership Agreement (POEA) has started, the Philippine Overseas Employment Administration (POEA) announced.

According to POEA, the interview will run until February 6, 2010 at the POEA’s head office at Ortigas corner EDSA in Mandaluyong City.

POEA said its counterpart in the recruitment of nurses and caregivers, Japan International Corporation of Welfare Services (JICWELS), will fill in 77 nurse positions and 101 caregivers for deployment to 82 Japanese health and caregiving institutions.

Last week, applicants drawn from POEA’s online manpower registry system underwent Pre-Employment Orientation Seminars to prepare them for their jobs and new life abroad.

Meanwhile, POEA urged JICWELS to consider holding part of the language training in the Philippines.
“The move is expected to benefit our nurses and caregivers as it will give them more time to be with their families as they learn the Japanese language at the same time,” POEA Administrator Jennifer Manalili said during the courtesy call of JICWELS officials.

Qualified candidate nurses and caregivers need to complete a 6-month Japanese language training in Japan and undertake on-the-job training at their respective hospitals.

Nurses should be able to pass the licensure examination in Japan before they can work as registered nurses and are given 3 chances to take the licensure examination. Caregivers, on the other hand, are required to complete at least 3 years on-the-job training before they can take the national examination for caregivers and work in Japan for an indefinite period after passing the examination.

Manalili is set to fly to Japan this month to visit the various health care institutions where Pinoy nurses and caregivers conduct their trainings. She hopes to meet with her counterparts to discuss the arrangements for the entry of Filipinos in the health care sector as well as to negotiate for better terms and conditions for them. - via