Sunday, May 3, 2009

FE DEL MUNDO

Fe del Mundo

Fe del Mundo (born November 27, 1911) is a Filipino pediatrician. Possibly the first woman admitted as a student of the Harvard Medical School, she founded the first pediatric hospital in the Philippines. Her pioneering work in pediatrics in the Philippines in an active medical practice that has spanned 8 decades has won her international recognition, including the Ramon Magsaysay Award for Public Service in 1977. In 1980, she was conferred the rank and title of National Scientist of the Philippines.

Early life and education

Del Mundo was born in Intramuros, Manila, her family home located just across the Manila Cathedral. Her father Bernardo served one term in the Philippine Assembly, representing the 2nd district of Tayabas. 3 of her 7 siblings died in infancy, while an older sister died from appendicitis at age 10. It was the death of her older sister, who had made known her desire to become a doctor for the poor, that spurred young del Mundo towards the medical profession..
Del Mundo enrolled at the University of the Philippines in 1926 and earned her medical degree in 1933, graduating as class valedictorian. She passed the medical board exam that same year, placing third among the examinees. Her exposure while in medical school to various health conditions afflicting children in the provinces, particularly in Marinduque, led her to choose pediatrics as her specialization.

Admission to Harvard Medical School and post-graduate studies

After her graduation from U.P., President Manuel Quezon offered del Mundo a full scholarship to any school in the United States for further training in a medical field of her choice. She accepted the offer and chose to go to Harvard, arriving at Harvard Medical School in 1936. She was unwittingly enrolled in Harvard Medical School, an institution which did not yet then admit female students. As recounted in her official Ramon Magsaysay Award Foundation biography:
[Del Mundo] humorously relates that when she arrived in Boston and went to the dormitory assigned her in a letter from the director of the hospital housing, much to her surprise she found herself in a men's dorm. Unknowingly the Harvard officials had admitted a female to their all-male student body. But because her record was so strong the head of the pediatrics department saw no reason not to accept her. Thus, upsetting Harvard tradition, she became the first Philippine woman and the only female at the time to be enrolled at the Harvard Medical School.

Some sources cite del Mundo as the first woman ever enrolled in Harvard Medical School, or the first woman to be enrolled at Pediatrics at the school, or even the first Asian admitted to the Harvard Medical School. On this point, del Mundo herself would acknowledge only that she was "the first [woman] coming from [as] far [as the Philippines]". However, Harvard Medical School began to accept female students only in 1945, some years after del Mundo was enrolled in the school.

Del Mundo remained in HMS until 1938, completing 3 Pediatric courses. She then took up a residency at the Billings Hospital of the University of Chicago, before returning to Massachusetts in 1939 for a two-year research fellowship at the Harvard Medical School Children's Hospital. She also enrolled at the Boston University School of Medicine, earning a Master's degree in bacteriology in 1940.

Medical practice

Del Mundo returned to the Philippines in 1941, shortly before the Japanese invasion of the country later that year. She joined the International Red Cross and volunteered to care for children-internees then detained at the University of Santo Tomas internment camp for foreign nationals. She set up a makeshift hospice within the internment camp, and her activities led her to be known as "The Angel of Santo Tomas". After the Japanese authorities shut down the hospice in 1943, del Mundo was asked by Manila mayor León G. Guinto, Sr. to head a children's hospital under the auspices of the city government. The hospital was later expanded into a full-care medical center to cope with the mounting casualties during the Battle of Manila, and would be renamed the North General Hospital (later, the Jose R. Reyes Memorial Medical Center). Del Mundo would remain the hospital's director until 1948.

Del Mundo joined the faculty of the University of Santo Tomas, then the Far Eastern University in 1954. She likewise established a small medical pediatric clinic to pursue a private practice.
Establishment of the Children's Medical Center

Frustrated by the bureaucratic constraints in working for a government hospital, del Mundo had desired to establish her own pediatric hospital. Towards that end, she sold her home and most of her personal effects and obtained a sizable loan from the GSIS in order to finance the construction of her own hospital. The Children's Medical Center, a 100-bed hospital located in Quezon City, was inaugurated in 1957 as the first pediatric hospital in the Philippines. The hospital was expanded in 1966 through the establishment of an Institute of Maternal and Child Health, the first institution of its kind in Asia.

Having sold her home to finance the medical center, del Mundo chose to reside at the second-floor of the hospital itself. As of 2007, she retains her living quarters at the hospital (since renamed the "Fe del Mundo Children's Medical Center Foundation"), rising daily at five in the morning and continuing to make her daily rounds even though she is now wheelchair-bound at 96 years of age.

As early as 1958, del Mundo conveyed her personal ownership over the hospital to a board of trustees. In July 2007, the Medical Center Foundation reported to the Department of Labor and Employment that it would cease operations after having incurred losses of more 100 million pesos.. Reports soon emerged that a joint venture composed of the management and consulting firm Accent Healthcare and the STI Colleges had offered to lease, manage and operate the institution, thus precluding it from shutting down. Concerns over the employment status of the rank-and-file hospital employees following the takeover led to a strike that forced the temporary closure of the hospital in August 2007.. In September 2007, the hospital announced its re-opening under the new management of the joint venture management firm Accent/STI Management, Inc. According to a statement released by the hospital, under the 20-year management lease agreement contracted with Accent/STI Management, Inc., the latter agreed to absorb the outstanding debts of the hospital.

Research and innovations

Del Mundo is noted for her pioneering work on infectious diseases in Philippine communities. Undeterred by the lack of well-equipped laboratories in post-war Philippines, she would not hesitate to send specimens or blood samples for analysis abroad.In the 1950s, she pursued studies on dengue fever, a common malady in the Philippines of which little was then yet known of.Her clinical observations on dengue, and the findings of research she later undertook on the disease are said to "have led to a fuller understanding of dengue fever as it afflicts the young". She authored over a hundred articles, reviews and reports in medical journals on such diseases as dengue, polio and measles.She also authored "Textbook of Pediatrics", a fundamental medical text used in Philippine medical schools.

Del Mundo is active in the field of public health, with special concerns towards rural communities. She organized rural extension teams to advise mothers on breastfeeding and child care. and promoted the idea of linking hospitals to the community through the public immersion of physicians and other medical personnel to allow for greater coordination among health workers and the public for common health programs such as immunization and nutrition. She called for the greater integration of midwives into the medical community, considering their more visible presence within rural communities. Notwithstanding her own devout Catholicism, she is an advocate of family planning and population control.

Del Mundo is also known for having devised an incubator made out of bamboo,designed for use in rural communities without electrical power.

Citations

In 1980, President Ferdinand Marcos named del Mundo as a National Scientist of the Philippines, the first Filipino woman to be so-named.

Among the international honors bestowed on del Mundo was the Elizabeth Blackwell Award for Outstanding Service to Mankind, handed in 1966 by Hobart and William Smith Colleges, and the citation as Outstanding Pediatrician and Humanitarian by the International Pediatric Association in 1977. Also in 1977, del Mundo was awarded the Ramon Magsaysay Award for Public Service.


BIOGRAPHY of Fe Del Mundo


FE DEL MUNDO was born in the old section of Manila known as Intramuros—the Walled City—on November 27, 1911. She was the sixth of eight children of Bernardo del Mundo, a prominent lawyer from Marinduque—a small island between Mindoro Island and Luzon—and Paz Villanueva. From their mother, who thought nothing of rising at 4 a.m. to do the family chores, the children learned diligence; from their father they learned the importance of high standards, independence and education. The four children who survived to adulthood were all achievers. FE’s brother Salvador, a Ph.D. in Chemistry, was one of the leading scientists in the country; his promising career was cut short by his death during the Liberation of the Philippines in 1945. Carmen, her older sister, also earned a doctoral degree and is a pharmacist and educator and Corazon, the youngest, a dentist.

DEL MUNDO attended Intramuros Elementary School and Manila South High School. Shortly before she graduated from high school (where she was always on the honor roll) her mother died and she went to live with her brother and his family. During those lonely days the person responsible for giving her guidance and moral support was her mother's sister, Mercedes Hilario. She remembers her aunt with great fondness because of her many words of wisdom which guide her even today.

At age 15 DEL MUNDO entered the University of the Philippines and received an Associate in Arts after the completion of two years. She then entered medical school at the same institution. Five years later (1933) she received her medical degree with highest honors in her class of 70 graduates. That year she was awarded a medal as the "Most Outstanding Scholar in Medicine" by the Colegio Medico-Farmaceutico de Filipinas.

Throughout her school days DEL MUNDO was recognized by her classmates as "conscientious, quiet and reserved," a student whose thirst for knowledge drove her so that she had little time for any social life. She was always extremely shy and in college was known to cry when asked to speak before the class. Even today she finds speaking before large groups of people a painful experience.

After placing third in the medical board examinations, DEL MUNDO went to work as an assistant clinical pathologist with her uncle Dr. Jose Hilario, who had his own pathology laboratory. But lab work was not enough for this young woman of boundless energy. She also tutored private students in mathematics, worked as a medical examiner for the National Life Insurance Company, lectured in medicine at Centro Escolar University and at St. Luke's School of Nursing and started seeing private patients.

As a medical student DEL MUNDO had often been told by her professors that, weighing less than 100 pounds, she was too small to handle patients. She decided therefore to go into pediatrics where the patients would be smaller than she. She also knew the tremendous need for doctors specializing in children's health care. As a young intern she had traveled through her family's home district of Marinduque with a rural health physician. Wherever they went and whoever they saw— whether the child was feverish, nauseated or had a runny nose—the doctor gave the same diagnosis: "Oh, that's worms—give the child a purgative!" This experience made a deep impression on her for she realized that there was a basic lack of knowledge, understanding and concern for the identification and treatment of childhood diseases. Since those early days Dr. DEL MUNDO has been consumed with a devotion to pediatrics—from the prenatal care of mothers to the health and development of children through adolescence.

High infant mortality in the Philippines has long been a matter of great concern. In a government commission report for the years 1900-1903, the first years of American occupation, there was reference to "shocking infant mortality." Most of the deaths occurred during the first year of life, frequently from tetanus as a result of the improper dressing of the umbilical cord. Smallpox, malaria, typhoid, beri-beri and cholera also took their toll of the helpless infants.
In 1910 another commission reported that 64.9 percent of the total number of deaths in Manila were of children under five years of age, 48.8 percent of them infants under one year. Compared to other countries, the report commented, this was high. A number of civic organizations devoted themselves to trying to bring about a decrease in infant mortality, but the reduction did not come quickly. It was not until the middle of the century that a decrease became clearly evident. Between 1926 and 1940, for instance, the infant mortality rate ranged from 16.5 percent to 13.6. Fourteen years later the rate had decreased to 9.4, and the decline continued to a low of 5.9 in the mid-1970s, in part due to the work and writing, of Dr. DEL MUNDO.

In the early years pediatrics focused almost exclusively on the care of sick children, especially in countries like the Philippines where there was a high childhood mortality rate. Slowly, however, the field expanded to include preventive medicine. Pediatricians began to recognize that their role was more than just healing the sick child; they had to encourage healthy lives and prevent sickness in the first place. One of the pioneers in the recognition of this expanded role for Filipino pediatricians was Dr. FE DEL MUNDO.

At a time when few doctors went to the United States to specialize DEL MUNDO sought and worked hard to obtain any grant to study in the U.S. Unexpectedly she was called by President Manuel L. Quezon who appointed her in 1936 for one of two fellowships offered by the Commonwealth government and was accepted at Harvard University Medical School for postgraduate work.

She humorously relates that when she arrived in Boston and went to the dormitory assigned her in a letter from the director of the hospital housing, much to her surprise she found herself in a men's dorm. Unknowingly the Harvard officials had admitted a female to their all-male student body. But because her record was so strong the head of the pediatrics department saw no reason not to accept her. Thus, upsetting Harvard tradition, she became the first Philippine woman and
the only female at the time to be enrolled at the Harvard Medical School.

After spending the academic year 1937-38 at Harvard DEL MUNDO went to New York where she continued postgraduate studies at Columbia University and Mount Sinai Hospital, subsequently taking up a residency at the University of Chicago's Billings Hospital for the academic year 1938-39. She returned to Boston for a two-year research fellowship at the Harvard Medical School Children's Hospital. Along with her research on children's diseases at Children's Hospital she found the time and energy to pursue a program of study at Boston University which led to a master's degree in bacteriology in 1940. She also took classes in public health at the Massachusetts Institute of Technology. Her five years in the U.S. were made possible by the scholarship grant from the Philippine government.

Early 1941 brought signs of the involvement of Southeast Asia in the Second World War and DEL MUNDO was summoned by the government to return home to Manila. During a stopover in Honolulu she was in a serious car accident resulting in a three-month confinement in Queen's Hospital and another month of recuperation outside the hospital. After her arrival in Manila in May she sought a government teaching position, for she hoped to pay back her government scholarship and also to pass on to future generations of doctors the knowledge she had acquired in her studies abroad. Unfortunately there were no positions open so she took up private practice. Dreaming of a children's medical center based upon those she had observed while working and studying in the United States, she proposed such a center to President Quezon, but just as plans were beginning to take shape war came. The President remarked: "You need not work in the government for I know that no matter where you work you will render valuable service to the community."

Japanese forces entered Manila January 2, 1942 and almost immediately some 5,000 American, British and other foreign nationals were herded into an internment camp set up at the University of Santo Tomas—which consisted of three buildings on one city block in the center of the city. Thinking that the internment would last but a short time, some of the parents left sick or convalescent children with friends or maids. Three such American children were DEL MUNDO’s patients and she asked herself how she could render some greater service in a field in which she believed herself qualified.
Lying awake one night, unable to sleep, she finally saw a way—taking care of internee children whose parents would be willing to leave them under her care. She had noted that many of the children were suffering from common childhood diseases and realized that their condition would only worsen if they remained cooped up in camp. The next day she presented her plan to Red Cross officials and they enthusiastically supported it. .

The first problem was to get permission from the Japanese authorities. With the help of Albert Holland, one of the most active internee leaders and one who had already established a good working relationship with the authorities, she was able to persuade the Japanese of the need for opening a children's home outside the camp. The second step was to gain the approval of the parents. Much to her surprise 17 parents fumed their children over to her the very first day.
After all the arrangements had been made she opened the Children's Home on January 10, 1942, in a small Red Cross building. The next day 12 more children were sent from the camp and the number kept increasing until the facilities were overcrowded. The Sisters of the Holy Ghost College, one of Manila's exclusive girl's schools, upon representations by the Red Cross and Dr. DEL MUNDO, agreed to house the internee children. The school had the advantage of being much closer to Santo Tomas and had modern, spacious facilities including a large playground. Occupying only the first floor in the beginning, the children and staff soon increased in number so that they took over the second and third floors as well. In just over three weeks the school was housing 130 children and a staff of 25. Three months later a wing of the school became an annex to accommodate 27 women internees who were either expectant or convalescent mothers, or mothers of children below the age of two. In the early months parents and children were allowed to visit each other at stated intervals. Health authorities made weekly medical and physical examinations and, at a time when vaccination campaigns were neglected because of the military occupation, the children in the home were among the few who received immunizations. Holiday celebrations, dancing lessons and drives to nearby perks were among the various activities by which she kept the children happy and healthy.

It soon became apparent that the Japanese planned to keep the American and European internees in camp throughout the war, and the Philippine Red Cross could not afford to sponsor the home indefinitely. Recognizing the usefulness of the facility the Japanese camp authorities decided to take over its management, keeping DEL MUNDO as director until February 1943. At that time they turned it over to women internees to run until 1944 when they ordered all women and children into Santo Tomas. Shortly before DEL MUNDO left as director she was given a "community service" award by the internees. In the space of one year and a half she had mothered some 400 children and ever since has continued to receive letters from her former wards and their parents recalling her wonderful work. One mother wrote at the time, "I hope you will be decorated for extraordinary heroism in action—but that isn't half of it—half of that had to do with a loving heart and a Pied Piper way with children."

After leaving the Children's Home in 1943 DEL MUNDO became director of the City of Manila's Children's Hospital, a 100-bed facility in what was once an elementary school. By this time the Philippine population, and particularly the children, were also suffering the ravages of war and occupation. During the liberation of Manila in 1945 she was asked by the U.S. military authorities to convert Children's Hospital into an emergency hospital because of the heavy civilian casualties incurred during the fight for the city, and by the end of the year it was known first as PCAU 5 (Philippine Civil Affairs Unit) Hospital and then as North General Hospital (NGH) and housed-about 550 sick and injured civilians. DEL MUNDO remained as director and senior pediatrician at NGH until 1948, the first woman to head a government general hospital. During this time she strove to achieve excellence in medical services and was also responsible for setting up a School of Nursing in connection with the hospital. The students graduating from there consistently ranked at the top in government tests. For her work at NGH "she was highly commended by the Government for her guidance, her vision, her loyalty to duty, and her superior grasp of administrative technique, and her tolerance and understanding." She invested not only her time and talents in the hospital, but so much of her own money that when she left in 1948 she had scarcely enough funds to pay for moving out her belongings.

While she was still at NGH she began teaching at the University of Santo Tomas. In 1947 she was the first Filipino to be certified by the American Board of Pediatrics as Board Diplomate and the following year spent some time in the United States. Traveling to New York City as a delegate to the Fifth International Pediatric Congress she also visited various medical schools and hospitals to study their facilities; under the sponsorship of the University of Texas child health program she made an extended visit to Galveston to gain firsthand experience in pediatric clinical and educational medicine.

Soon after her return to the Philippines DEL MUNDO became director for one year of the newly established Manila Children's Hospital. At the same time she set up her own private practice. Some of her patients needed constant care and mothers pleaded with the doctora (as female doctors are called in the Philippines) to care for them herself instead of sending them to the hospital. So, using her own home, she began taking in a few patients. As her "Little Clinic" took in more and more children she was driven not only from her own bedroom, but from house to house in the neighborhood in search of more space. And she began to consider once more her vision of a modem pediatrics center.

Encouraged by friends she decided to embark upon building a hospital—the first part of her dream to build a center for both curative and preventive care. She secured a loan of P400,000 (US$200,000) from the Rehabilitation Administration but paid it back when the Government Service Insurance System agreed to loan P800,000. With this she started construction of a building in Quezon City, which adjoins Manila to the east. In the summer of 1957 patients and staff began to use the first floor of the yet to be completed hospital. As new patients arrived they were assigned to the second floor while work was being done on the third. It was indeed a challenge to provide medical services amid the dust, noise and confusion of construction, but on November 26, 1957 the Children's Memorial Hospital, with a 100-bed capacity, was inaugurated and dedicated to the children of the Philippines.

Financing continued to be a problem and to raise money for equipment, as well as for the completion of the third and fourth floors DEL MUNDO had to sell the house and lot where her Little Clinic had been located and move herself and the staff members who were living there into the unfinished fourth floor. The income from this sale plus an additional cash of P15,000 made it possible to purchase an elevator.

In November 1958 DEL MUNDO formally signed away personal ownership of the hospital and fumed it over to a Board of Trustees Composed of civic-spirited individuals, the board pledged itself to carry on the work and aims of its founder and director, and registered the hospital with the Securities and Exchange Commission so that it could solicit funds as a nonprofit foundation.
A number of improvements were made in the early 1960s: a new X-ray machine was purchased and a new-loom nursery and nurses quarters were built. Obstetrical and gynecological services were added, as well as more pediatric specialties. Ten years after being established the hospital could proudly point to its numerous clinics: heart; neurology, epilepsy and cerebral palsy; ear, nose and throat; well-baby; preschool; teen-age; thyroid and breast for women, and a premature nursery. It had 100 beds, including a 30-bed charity ward. DEL MUNDO donates all her own fees to support the latter.

From early on the work and facilities of the Children's Memorial Hospital have been very favorably commented on by knowledgeable visitors. Dr. Victoria W Winnicke of the World Health Organization, Geneva, in 1963 remarked on the caliber of the hospital and on "the wonderful and dedicated work of its staff under the leadership of Dr. FE DEL MUNDO." The following year Dr. Helen Taussig, a world famous specialist on pediatric cardiology and professor emeritus of Johns Hopkins University said, "Your hospital is one of the most rightful children's hospitals I have ever been in and my admiration for you is unbounded." Dr. Taussig later donated US$4,000 representing an achievement award granted her by the Association of American University Women.

But DEL MUNDO’s dreams went beyond the hospital. She wanted to build a medical center which would focus equally upon preventive medicine and would include research facilities and a program for delivering medical services to the rural areas where most of the people of the Philippines live. In 1964 the Children's Medical Center (Foundation) Philippines, Inc. created under the same board of trustees an Institute of Maternal and Child Health (IMCH) which was inaugurated in 1966.

The IMCH, like the hospital, is a semiautonomous, private, nonprofit institution under the umbrella of the Children's Medical Center, and now occupies its own building in the common compound. There were times when it looked as if the IMCH building would not be finished, but through the determination and hard work of DEL MUNDO—who had to overcome the initial reluctance of the Board of Trustees and sold the residence built for her near the Children's Memorial Hospital to help pay for construction—the building was dedicated November 26, 1972.
When the IMCH was founded it was the first of its kind in Asia as a unit of a Children's Hospital. Dedicated to service, preventive medicine, training and research, the institute was divided into three units: 1) Maternal and Child Health, 2) Rural Extension and 3) the National Training Center for Maternal Health which includes family planning. There is a great deal of interaction among the three sections. DEL MUNDO is executive director of the Institute, and has also direct responsibility for the National Training Center. The other two units are each under a medical officer. Support for the IMCH came from the United States Agency for International Development (USAID) through the National Economic Council (now the National Economic Development Authority, NEDA) and later this assistance was channeled by NEDA through the Commission on Population. The IMCH has remained the most useful and effective private affiliate of the Population Commission and is now recognized both nationally and internationally for its MCH and family planning activities and contributions to the national programs.

The rural extension program sends pediatric teams, made up of hospital staff, out into the countryside. Traveling to farflung areas— from Cagayan in the north of Luzon to Jolo in the Sulu Archipelago, the teams stay at each locale from one to seven months depending upon the need. Team members stay in farmhouses and travel by local, often primitive, means of transportation. Hazards abound, but DEL MUNDO, who has often accompanied the teams, disregards such difficulties. Her staff follows suit.

Because of the lack of health service manpower in many underserved and remote areas, DEL MUNDO is a fervent believer in the team approach to health care. As early as 1962 she was sending Rehydration Teams to work with rural health units in several provinces to treat diarrhea and other debilitating diseases which are particularly life-threatening to children. By 1965 these teams had been strengthened by pediatric personnel. In order to establish the team approach on a nationwide basis it is necessary, she feels, to have a corps of trained individuals throughout the country. Training others has been one of the major functions of the teams sent out by the IMCH.

In the remote areas team members lecture and give demonstrations on modern methods of treatment. They instruct mothers on infant feeding and provide nutrition information for whole families, being particularly concerned with the regular weighing of children under five. Another of their tasks is to insure that periodic examinations of water supplies are carried out. Trained in immunizations, they carry out campaigns to provide polio and diptheria-pertussis-tetanus vaccines to young children.

An early project was on the island of Marinduque. Initiated by the IMCH, the project enjoyed the cooperation of the Institute of Medicine of Far Eastern University, the Department of Health and the Nutrition Foundation of the Philippines. One of the aims was to expose medical graduates and interns to the problems found in rural areas while at the same time extending health services to remote areas of the island. However, the escalating cost of air fares in the mid 1970s due to the rapid rise in the price of oil, made it impossible to continue using students and interns from Manila.

The National Training Center for Maternal Health was set up in 1967 by agreement among the institute, the National Economic Council of the Philippines and the United States Agency for International Development. Its purpose is to provide doctors, nurses, midwives and paramedics with information about the relationship among population characteristics, social sciences, economic growth, reproductive biology and physiology and family planning. There are also courses for lay opinion leaders. In its first year the training center concentrated on maternal and child health with integrated family planning. By September 1968 the center had trained a total of 1,520 medical and paramedical personnel, including 33 laymen, at family planning and MCH courses, both at the institute and around the country. Over 8,500 were trained during the first four years. There is a regular faculty and training staff of about 10 at the institute and there are some 20 to 25 lecturers on call—members of the clergy and legal profession as well as medical practitioners. The courses run from one to three weeks.

In 1968 the institute set out to establish 100 MCH clinics with family planning services in various provinces and to train 300 personnel to staff them. In spite of numerous difficulties in organization, and communication with and transportation to remote areas, it succeeded. Because the government had not yet decided on a population policy, the work in family planning was limited to advice about the rhythm method and abstinence. In 1969 the government created a Population Commission which readily recognized IMCH as a private agency qualified to receive its support. Thus enabled to expand its work the institute clinics now offer government approved and medically accepted methods of contraception.

Additional facilities were opened in 1970-71, bringing the total of MCH/family planing clinics to a peak of 350 in 43 provinces and 21 cities. To avoid duplication as other agencies began to sponsor family planning programs MCH clinics were gradually reduced to 280 by 1977. About 10,000 government personnel and private individuals in different disciplines have been trained by IMCH in family planning. In fact, IMCH trained government staff from different departments (now ministries) for three years (1968-1971) before the government became officially involved in a national family planning program.

In 1973, realizing the trend of maternal and child health concerns and thrusts to the family and community, DEL MUNDO changed the focus and broadened the scope of IMCH through a new Institute of Community and Family Health (ICFH). Besides the IMCH, which is a part of the new institute, ICFH includes the care of adolescents; an extension office for outreach health programs in four doctorless and underserved communities in Pampanga and Bulacan provinces, to render medical services and particularly for Primary Health Care (PHC)—to help the people learn to take care of their own health; training of medical and paramedical personnel in community health work; and recruitment and preparation of mother health workers, teachers and schoolchildren for some components of PHC. Dr. DEL MUNDO is now endeavoring to finance construction of a fourth building in the Children's Medical Center complex for the ICFH and her goal is to inaugurate it in 1980. Meanwhile the ICFH offices are in crowded space in the IMCH building.

In its four years of existence research has been a major activity of ICFH and prestigious international and national agencies have supported its various programs and studies: United Nations World Health Organization (WHO), Western Pacific Region; Rockefeller' Ford and Asia foundations; World Neighbors; International Development Research Center (IDRC), Canada; the Netherlands Organization for International Aid; the German Food for Hunger Agro-Action Program; and in the Philippines the Commission on Population, the Population Center Foundation and the Maternal and Child Health Association. The ICFH's team researches on hilot (traditional birth attendant) training and community programs on nutrition among children have been widely commended.

Dr. DEL MUNDO 's own scientific investigations range broadly from measurements of 10,839 newborn babies and commonly missed children's diseases to rheumatic infections and herpangina. During the 1954 epidemic of dengue fever—the mosquito-born virus that is endemic in the tropics—she was able to contribute clinical observations, and the findings of research she later undertook to characterize the pathogenesis of the disease at the clinical and laboratory levels have led to a fuller understanding of dengue fever as it afflicts the young. She has done studies on the immunization of children against major viral diseases like poliomyelitis, measles and German measles. Vaccines, she learned early, were chronically in short supply in the Philippines and the prevailing practice was to give immunization to every child who happened to be around when vaccines were administered. Concerned that resources were not being matched with general need, Dr. DEL MUNDO addressed the problem of how to allocate limited consignments of these antibodies-inducing preparations among the large population of underserved, disease prone children. The series of experiments she initiated in 1962 to determine who should be given vaccines and at what age has been her major research study, and her pioneering trails have been followed by other investigators. For such original research achievements as these Dr. DEL MUNDO has won two to five awards per year from the Philippine Medical Association and the Philippine Pediatric Society.

In 1977 there is still much to do in the field of children's health and family planning Out of a total population of 45 million there are 20 million under the age of 20. Even with 15 medical schools there are only 564 pediatricians—435 of them in Greater Manila, with only 129 in all the rest of the Philippines—1 pediatrician to 110,000 children. Seventy-six percent of all births are still at home and 38 percent are attended by hilots who have had no medical training. Malnutrition is the number one illness and its incidence has grown tremendously in recent years—in almost direct proportion to the growth in population. Communicable diseases continue to account for 42 percent of infant illness and death.

DEL MUNDO is still seeking the best means to reach the poor and underserved, but she has found that a health center works best when the people of the barrios (villages) ask for services and provide the land and build the center themselves. The ICFH will then send in a team which will train local residents in simple medical and family planning techniques. A successful example is Barrio San Roque, San Luis, Pampanga Province.

DEL MUNDO’s talents and energies have never been devoted exclusively to the ICFH or to the earlier institutions she created and managed. From 1956 until 1976 she was professor and chairman of the Department of Pediatrics at Far Eastern University and is presently Professor Emeritus at that institution. She also served on the boards of a number of Philippine organizations such as the Association of University Women, the Mental Health Association, and the University of the Philippines Medical Alumni Society. In 1946 and 1947 she was vice president and president respectively of the Manila Medical Society, and was three-term president of the Philippine Pediatric Society (1951-1953). She was founder and first president of the Philippine Medical Women's Association (1949-1954) and was the first woman to be elected president of the Philippine Medical Association in its 65-year history (1969-1970). She is presently on the National Research Council and the founding president of the Maternal and Child Health Association of the Philippines (1972 to date).

Her activities have not been limited to the Philippines. She was the first Asian elected president of the Medical Women's International Association, 1962-1966, and was on the Advisory Board of the International Pediatric Association from 1966 to 1970. She was on the Expert Advisory Committee, Maternal and Child Health, of the World Health Organization (WHO); a member of the WHO Technical Advisory Group on Dengue Hemorrhagic Fever in the Philippines; on the Medical Advisory Board, Foundation for International Child Health (New York); and an Honorary Fellow of the American Academy of Pediatrics.

In connection with these activities she has been a frequent delegate to conferences all over the world, attending on a regular basis and reading papers at the meetings of the International Congress of Pediatrics, the Medical Women's International Association (annual), the American Academy of Pediatrics, the American Pediatric Research Society, the International Pediatric Association and various WHO conferences.

Since 1941 DEL MUNDO has been a steady contributor—with more than 100 articles, reviews and reports on original research studies, cases and clinical trials—to medical journals, primarily in the Philippines but also in the United States and India. She has published regularly in the Journal of Philippine Medical Women's Association, Nutrition News, Philippine Journal of Pediatrics, and Journal of the Philippine Medical Association. She wrote a weekly column in the Manila Sunday Times Magazine for 20 years (until the newspaper stopped publication) called "Baby and You." In this popular column she gave advice and guidance to parents for preventing childhood ailments.

Concerned with the education of future doctors she is the editor-in-chief and major contributor to the Textbook of Pediatrics and Child Health, published in December 1976. Unique in its approach, it stresses the role of the community in the treatment and promotion of healthy children and adolescents. Pediatrics, she wrote, is concerned with the physical, emotional and social health of children and "includes a variety of health services to enhance optimum health at various stages of the child. The family and community background and even the conditions in the community, directly or indirectly affect the health and wellbeing of the child. It becomes necessary to provide conditions and an atmosphere which will enable children to live healthily and not just be free from disease."

The pediatrician must be community-oriented and community-involved, she emphasizes, if he is to achieve the best possible health care for the youth of the nation. Medical students must have as part of their study program some training outside medical school and the teaching hospital. They must go out into the provinces to see firsthand the problems that exist. Pediatricians must be able to translate medical knowledge into a language their patients will understand and pass on to them information concerning good hygiene, nutrition, and family planning. Only in this way can a doctor acquaint his patients with the importance of preventive as well as curative medicine.

DEL MUNDO’s contribution to the health of Filipino children and to the world's understanding of childhood diseases has brought her repeated honors. In one or another of her multiple roles as practitioner, administrator, organizer, teacher, scholar, researcher or as author of books and scientific papers, she has been the recipient of awards, citations, plaques and testimonials almost yearly since she graduated from medical school. She was given among others, an Award of Merit as "Founder and First Director of the North General Hospital" (1948); a Diploma of Merit for "Recognized Leadership as a Medical Researcher and Organizer and [for] Significant Contributions in the Field of National and International Pediatric Medicine" by the Philippine Federation of Private Medical Practitioners (1959); the Most Distinguished Alumnus for 1960 Award from the University of the Philippines Medical Alumni Society; the Presidential Award of Merit by the Civic Assembly of Women of the Philippines (1961); Award of Merit "for her lasting contribution to the art and science of medicine especially in the field of pediatrics" by the Philippine Pediatric Society (1963) and Distinguished Service Award by the Philippine Medical Association (1964).
In 1966 DEL MUNDO received the prestigious Elizabeth Blackwell Award presented to women doctors of world renown by Hobart and William Smith College in Geneva, New York. The award honors the first woman in the New World to receive a medical degree (1849).
The Blackwell Award came as a surprise to DEL MUNDO. She was in the United States to preside over the Medical Women's International Association conference and was informed that the first order of business was to attend the award presentation ceremonies. Beside finding herself the unsuspecting awardee, she had the delight of a reunion with Albert Holland, the internee who had intervened with the Japanese to allow her to establish her Children's Home. As the new president of the college, he presented her with the award which read: "Doctor DEL MUNDO, your extraordinary intellectual and professional abilities have been both proven and sharpened on two continents; your zeal transcends continental boundaries. Humanity looks to you and your kind to provide the massive solutions which alone will save it from itself. "
More recently she has been honored as the Most Outstanding Woman in Medicine by the Federacion International de Abogadas (1968), and the Most Distinguished Alumna of the University of the Philippines by the University of the Philippines Alumni Association (1972). She received honorary doctorates of science from Medical Women's College of Pennsylvania and Smith College in the United States, both in 1970. She was given the Ayala Science Award in Medical Science for 1974 and in 1977, she received the Most Distinguished Pediatrician and Humanitarian Award from the International Pediatric Association.
A deeply religious person FE DEL MUNDO, whose name means "faith of the world," begins each morning with a few minutes in church. She seems to gather from this spiritual exercise the energy needed to maintain a round of hospital calls, classes, lectures, meetings and patients' visits that would exhaust a lesser person; her custom is to rise at 5 a.m., return to her room by 11 p.m. and retire at 12. Throughout her life she has given her time and knowledge selflessly and tirelessly; her colleagues claim that the diminutive doctora survives on "black coffee and sick children." So absorbed is she with her work that she has not had a home since selling her second residence to build the IMCH. For a long time she lived in the Children's Hospital, moving from empty room to empty room. She now has a modest suite on the fourth floor of the IMCH building. Unwilling to take time from her busy schedule for bothering about food which she takes sparingly, she was eating only dishes from the meals prepared for hospital patients and staff until her associates insisted that the soup comprising her lunch must be a heartier one than is normally served with a full tray.

DEL MUNDO lives by the creed, "give to the world the best you have and the best will come back to you." For her the best has been to see her dream of a maternal and child health center come to fruition.


Siya ay nakatanggap ng mahigit na 80 medalya bilang pagkilala sa kanyang pag-aaral, pananaliksik na ginawa niya sa pagbabakuna sa mga batang may sakit. Kinilala rin siya sa kanyang inbensiyong incubator.

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