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RRP in Developing Countries. Arturo Avila Chávez MD Director Voice Center México. Incidence. ??????? NOT KNOWN Between 1500 – 2500 cases around the country . Main Problem. CULTURAL. MEDICAL. ECONOMICAL. Voice as an Issue. Voice is NOT a Health Issue
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RRP in Developing Countries Arturo Avila Chávez MD Director Voice Center México
Incidence ??????? • NOT KNOWN • Between 1500 – 2500 cases around the country
Main Problem CULTURAL MEDICAL ECONOMICAL
Voice as an Issue • Voice is NOT a Health Issue • People IGNORE the problem exists • Dysphonia = Alarm • People receive medical care only when they are completely dysphonic or with respiratory distress
Health Services • Public Hospitals (subsidized by government) • ISSSTE • IMSS • SSA • Most of the general population • Not all are free • Different levels of medical attention • 1st – 3d level • Very few centers for high specialized medical attention in all the country
Health Services • 80 to 120 consultations per day • 10 surgeries a day • 6 -8 moth waiting for surgery • Some patients even have to wait to be operated until they have respiratory distress
Health Services • Public Hospitals • Big gap between first consultation and day of surgery • Bureaucratic paper work • Time consuming • Centralized country • Private Practice • The least amount of patients with RRP • Need an Insurance • Otherwise…..Very expensive!
Medical Issues • RRP is a third level attention problem! (Highly Specialized) • Some residency programs don't have a good laryngological training, which reflects a wrong Dx and Tx. • WHY?
Medical Issues • Larynx is ENT´s the most hidden structure
Medical Issues • Equipment • Diagnosis
Medical Issues • Surgery • Equipment
Medical Issues • Surgical techniques • MICROSURGERY
Antivirals Interferon Vaccines Phytosorb DIM I3C PDT Retinoids Mytomicin Medical Issues
Drugs Availability • Meds • Very expensive $$$ • Interferon • Cidovofir • Non Available • No International Sale Representatives
RRP Information • Pt is not informed about RRP • Cause • Symptoms • Treatment Options • No societies or foundations to support RRP • Patients are all by themselves
Main Problems • Cultural • The RRP manifestations are almost certainly under-described and non existent for general population • Lack of Information (educational programs) • Health care system • Centralized • Better training residency programs • Subspecilized Doctors • DX tools and TX equipment • Drug Availability
Solutions • Take advantage of RRP IRS´s infrastructure as a plataform • Inform People • Most of the affected people only know Spanish and don't have access to internet • Language barrier
Solutions • Expand activities • Create a supportive community network in Developing Countries. • Creat groups of people, committed people, specially patients and Doctors to approach RRP IRS as a backup for multipurpose • Interaction with Meds suppliers for easier access and cheaper prices