By Nathaniel S. Orillaza Jr., MD

The early stages of the pandemic closed the doors of so many hospitals to non-COVID-related consults. In anticipation of the surge of cases that will need the facilities and require intensive care, Orthopedics, like most other times, is low priority compared to more life-threatening conditions. It seemed natural to think that hand surgeons will take a long relaxing break from the elective carpal tunnels and trigger fingers or even some complex wrist fractures. Paradoxically, or maybe as should be expected, the decrease in hand injuries was not proportionate. Staying at home brought out the secret desires of many adults to be chefs, bakers, gardeners or even home restorers. Children who are used to running free outside in the neighborhoods were kept inside the houses filled with many heavy objects, and freely swinging doors. Combining the limitation of most hospitals in accepting patients and the consistent flow of hand injuries, the already few hand specialists of our entire archipelago marched on to deliver.

Instantly, our national society, currently of less than 50 members, organized to traffic patients to appropriate centers. Having serendipitously launched a social media campaign in late 2019, H.A.W.A.K Kamay (to hold hands in Filipino, the unabbreviated name translates to Bringing Proper Care and Awareness of Hand Problems) channels were used to reach patients and triage concerns to avoid panic and unnecessary trips to the overwhelmed health facilities. From an average of 1-2 queries per month, the messages increased to having at least 1 weekly question from fellow Filipinos across the thousands of islands and even from overseas workers concerned with the well-being of relatives at home. An official website was also launched to help connect patients and colleagues while most clinics and offices remain closed or with limited hours.

Working in two reputable tertiary government hospitals, one gallantly accepted the call to be one of the initial three COVID-referral centers in Metro Manila while the other, perpetually on stand-by to be similarly delegated, continued to accept all patients in need of urgent care. For many weeks during the strict lockdown, the hand service topped the department census, consisting mostly of injuries, common and unusual and a few infections. Serving in both gave me the unique opportunity to practice the specialty, to help decrease the impending rise of inadequately managed injuries potentially affecting the livelihood of the already burdened population. One would hardly consider a hand surgeon as a frontliner in this long exhausting battle, but in our country of more than 100 million people and only a few specialists, I proudly know that it is true.