She originally wanted to become a family physician, but Penny Robredo Bundoc, who is visually impaired, sort of stumbled upon rehab medicine. It was an accident of fate that had meant a world of difference to Filipinos with disabilities.

When Bundoc applied for a residency in Family Medicine at the UP-PGH, she learned that it was no longer offered as a specialty. On her adviser’s suggestion, she went into Rehabilitation Medicine instead.

That decision ultimately meant that PWDs (persons with disability) in the Philippines no longer had to be shut in, but could instead stride out of their homes to go to school, earn a living and otherwise have fuller lives.

“Coping with poverty is hard; (more so) when a family member has a disability,” mused Bundoc, who has become a staunch advocate of PWDs.

“Poverty is magnified and multiplied for such families,” she said, explaining that an able family member is usually designated as the caregiver, which means one less member contributing to family finances.

The emotional and psychological trauma adds to the burden, said this medic. “Our society values physical beauty so much. Those with obvious physical disabilities are pitied at best, and at worst, are mocked and ostracized, even abandoned or abused by their own families.”

Bundoc’s own family knows disability firsthand. Through their father, Jose Chan Lim Robredo, the Robredo siblings inherited the gene for retinitis pigmentosa, an incurable or degenerative eye disease that causes severe visual impairment and, often enough, blindness.

During childhood summer vacations, Bundoc recalled how the entire brood would travel to Manila to be thoroughly checked by a renowned eye specialist, although their parents never told them the reason for the annual check-ups.

“We just thought going to an eye specialist was part of our summer vacation routine,” this rehab doctor recounted. “It was only when I was much older that I realized my father had become blind by the time I was born and that he never actually saw me. But he was such a can-do type of man, very much the head of our family that I didn’t realize he was in any way impaired until I was much older.”

By the time Bundoc was born, her father was no longer a practicing accountant but had gone into lumber trading, and later, the fishing trawl business. He was self-taught in the latter. A toy tug boat among his children’s playthings was the model for the fishing trawls that the woodworkers used on Robredo’s instructions.  Each boat was named after one of his children.

“My father is physically small—like me,” said Bundoc who stands under 5 feet tall. “He remembered the layout of the Naga City port from when he could still see, so although his vision had deteriorated to the point of him being legally blind, he would still go to the pier by himself to supervise the fishing trawls every day. He was not afraid to stand up to the big burly fishermen who worked on his boats. When he got home from work each day, he would bathe and change, then ask our mother to smell him now that he had washed off the odors of the fish, the sea and the engine exhaust.”

Although Bundoc is very near-sighted, she needs only prescription lenses and does not have retinitis pigmentosa so the gene had not been passed to her sons either.

But the second and fourth Robredo siblings, Jose Jr. or Butch, and Jeanne Robredo Tang, inherited the gene and have since gone blind. Like their father, they are not defined and limited by the disability.

Sadly, in the Philippines, the visually impaired (VI) are especially dependent on others and marginalized. The SPED (Special Education) Centers in many public schools are ill-equipped, with overworked teachers unable to give PWDs the individualized attention they need. Jobs for the visually impaired are generally limited; most of them end up being massage therapists, street musicians or beggars.

The non-profit Adaptive Technology for Rehabilitation, Integration and Empowerment of the Visually Impaired (ATRIEV) has attempted to help the visually impaired to use computers and break into the BPO industry as call center agents, but its success rate is uncertain. The few who have made it through college usually have a shadow teacher or, thanks to technological advances, cope through computers with special programs for the blind.

“If Butch were in college now instead of 30 years ago, he could have become a lawyer,” said Bundoc. Because of his failing vision, Butch Robredo, as a UP Diliman undergrad, used to sit near the doorway as the sunlight streaming in through the wide windows along the corridors helped him see a bit better. A teacher, not realizing his medical condition, however accused him of cheating.

Blindness forced this Robredo sibling to give up his dream of going to law school so he became a businessman instead, Bundoc added. He has since retired and lives in the Robredo family home in Naga City where he helps care for their elderly parents. Fortunately, he did not pass on the retinitis pigmentosa gene to his only child, a dermatologist.

Josephine (Penny) Robredo Bundoc is the second doctor in the family (the other being Jocelyn Robredo Austria, a neonatologist in Philadelphia), and is married to her college sweetheart Rafael or “Pipo,” an orthopedic surgeon. They have two sons.

The most famous Robredo, middle child and late Interior Secretary Jesse, had always supported the PWD sector and was instrumental in setting up the Naga City Resource Center for the Blind, the first of its kind in Bicol. Here, the blind learn braille and are taught Mobility and Orientation, or how to use a white cane to get around so they can be more self-reliant. The well-loved former Naga mayor was also there to support his youngest sister when the cornerstone was laid at the UERM School of Prosthetics and Orthotics three years ago, the fruit of her advocacy.

After becoming chief resident at the UP PGH Physical Medicine and Rehabilitation Department, Bundoc trained further in prosthetics and orthotics at the Moss Rehabilitation Center and the Shriner’s Hospital for Crippled Children, both in Philadelphia.

(Prosthetics refers to artificial body parts, mainly limbs but also eyes and teeth. Orthotics are external devices like braces and splints that are used to modify the structural and functional character of the neuro-muscular system.)

During her US observation trips, Bundoc realized how deprived indigent Filipino PWDs are in terms of adaptive devices, mobility aids and even therapy services. “Inggit na inggit ako (How I envied them),” she said of her experience. “American PWDs don’t have to be rich to get the kind of high quality care that most Filipino PWDs only dream of.”

Bundoc also noted how public transport in the country is nearly impossible for PWDs. Many cab drivers won’t stop for PWDs on wheelchairs because these mobility devices can nick the paint on the edges of the cab trunk or might not even fit inside the trunk. Most wheelchair ramps are usually too steep, are abruptly cut short or too sharply angled and narrow at turns.

But the start of the new millennium was auspicious for Bundoc, who was introduced to the visiting Scotsman Carson Harte, a prosthetist-orthotist and CEO of Cambodia Trust, a charity started 20 years ago to help landmine amputees in Cambodia and later, throughout South Asia. The meeting strengthened her vision to offer programs in Prosthetics and Orthotics at UP Padre Faura.

Though the curriculum was disapproved by the UP Board of Regents, Bundoc was undaunted. Her faith was rewarded when she met Dr. Juan “Ace Doc” Montero, a successful thoracic surgeon in Virginia USA, who has been going to the country for medical missions. His business card proclaims that “Friendship and In-kind Barter (i.e., round of golf, fishing trip)” are accepted in lieu of professional fees.”

It was through Ace Doc, one of the original members of Physicians for Peace (PFP) in Norfolk, VA, that Bundoc met PFP Founder Dr. Charles Horton, whose credo is a variation of the multiplier effect of teaching a hungry man to fish. PFP programs worldwide focus on training, supporting and empowering healthcare professionals working with the world’s under-served populations.

Soon the group was sponsoring provincial medical missions specifically for Filipino amputees, aptly called “Walking Free” that Bundoc joins every year.

The group’s full service missions include “Seeing Clearly” which trains public elementary school teachers to identify who among their students might need help from volunteer optometrists or ophthalmologists, and a free pair of prescription eyeglasses. The PFP also sent a PGH technician to train abroad. (Medical professionals may find out how to volunteer with PFP on www.physiciansforpeace.org/ph.)

When Bundoc’s husband, Pipo, became an Eisenhower Fellow in 2007, he brought her along as the grant allowed side trips for the accompanying spouse. The couple crisscrossed the continental United States, visiting universities and hospitals with a Prosthetics and Orthotics program.

During the Eisenhower Fellows farewell party in Philadelphia, Washington SyCip (founder of the Philippine accounting firm SGV) who was on the Eisenhower Foundation Board of Trustees, asked the two doctors: “Now what are you going to do for the Philippines?”

Bundoc told him about the plight of Filipinos PWDs, particularly the mobility impaired, and her dream of a prosthetics and orthotics training program. SyCip committed his support right away.

“I immediately saw that this was in line with my deep interest in public health,” he declared. “There are three causes that I strongly advocate, that I believe, have the greatest impact on eradicating poverty in the Philippines. First, is to enhance public education so as to eliminate illiteracy. Second, is to provide the poor with access to credit through micro finance. And third, is to uplift lives with improved public health programs. We can only have a strong nation if our people have a sound mind and body.”

Back in the Philippines, the philanthropist donated P500,000 of his own money to help set up an Amputee Ward at the PGH Rehabilitation Medicine Department where indigent amputees and an escort from the provincesmay temporarily stay for free while the patient gets fitted and undergoes therapy to get used to the device.

SyCip was also among the supporters of the Walking Assistance and Learning Key [WALK] Unit set up in the Rehabilitation Medicine Ward to help stroke survivors, amputees and others regain their ambulatory skills.

The quest to help the indigent Filipino mobility-impaired has been blessed with other similarly serendipitous meetings and partnerships. During PFP Walking Free Missions, Bundoc often encountered indigent amputees who had made their way to the mission site from their remote rural homes, accompanied by their family and at great expense, only to learn that their type of amputation cannot be fitted with a prostheses. Their disappointment was shattering.

Fortunately, in 2008, the Ateneo Java Wireless Competency Center came up with Amputee Screening Through Cellular Networking (ASCENT). Smart Telecommunications donated the app for this which enabled a barangay health worker, armed with a smart cell phone, to do the initial screening and data gathering for prospective prostheses recipients. The same program has been adapted to help barangay health workers to screen those with cleft lips and palates (bingaw or ngongo), or with more serious facial clefts and other cranio-facial defects. Again affordable and available technology was serving the marginalized PWDs.

The dream of having a Philippine Prosthetics and Orthotics center finally materialized in 2010 or nearly 10 years after that first meeting with Carson Harte and the Cambodia Trust.

Bundoc’s alma mater, the UE Ramon Magsaysay Memorial Medical Center agreed to host the center in partnership with the Nippon Foundation and Cambodia Trust. Again, SyCip helped pave the way for the UERMMC Philippine School for Prosthetics and Orthotics (PSPO), the first in the Philippines and only the 12th of its kind in the world. The Tan Yan Kee Foundation generously donated the building.

“The PSPO provides training and services in orthotics and prosthetics that essentially result in more affordable artificial limbs and other mechanical devices,” the SGV founder said, adding that the facility “directly benefits and improves the lives of over 4 million disabled Filipinos.”

In 2011, the PSPO admitted its first 13 enrollees who are expected to graduate in three years’ time, or by 2014. Otherwise, this is a five-year course. Scholarships for the deserving are available and each batch is small as the training is intensive.

Unlike nursing, there is no glut in the field of prosthetics and orthotics, as the course can be difficult and has both medical and engineering subjects, including robotics. It also requires fine and superior motor skills to be able to craft devices.

In the Philippine setting where many patients are poor, PSOP applicants must be service-oriented, if only to give back to the institution that gave them partial scholarships and lab supplies in their third year.

When Bundoc received the Apolinario Mabini Presidential Awards in September last year, she reminded President Aquino of how Filipino PWDs have been asking for an audience with him to discuss, among other issues, the Philippine Magna Carta for the Disabled, that would require that 5 percent of all emergency or contract hires in government be from the PWD sector.

It has not happened yet, but Bundoc is undaunted. With her father and brother Jesse as her models, one could say that like that gene for retinitis pigmentosa, dogged persistence runs in the family.