Buddy Ostrea

Comes now the first Titan dancer: “Buddy”, Dr. Enrique Ostrea, Jr. Who’s he? Accomplishments? As a professional, Buddy’s list comes in 20 pages. Although, when we asked “Who is Buddy Ostrea?” we meant to know what kind of a man he is. Yet, it was not Buddy who would tell us what we know of him now. They were those who had worked with him and some whose lives he had touched.

The mere mention of his name at the Pediatrics Department of the Philippine General Hospital (PGH) opens doors and a curious welcome, “How did you know Dr. Ostrea?” Over a cup of coffee, one hears a string of stories on how he had helped an unnumbered young  doctors obtain scholarship grants, as well as on his life-long mission to share his uncommon expertise to Filipino medical professionals through a continuing lecture program in local universities and hospitals. And all these for free!
Awards? Let’s not be persnickety, lest we drown with the details. He must have received them all, including the Pamana ng Pilipino Award from the President of the Philippines.

Google him and you get back a list of 11,600 entries. Buddy is an internationally renowned Neonatologist. Right. A neo•na•to•lo•gist, a doctor specialized in the care of the newborn, especially the ill or premature infant. He is a Professor of Pediatrics in Wayne State University in Michigan, and was acclaimed five times as one of 500 Best Doctors in America.  Buddy’s name is etched as Number 35 on the Most Influential People in Science, 14 notches below Number 21, the legendary theoretical physicist Stephen William Hawking. Wow!

But look at him. The bigger he has grown, the firmer he has kept his feet on the ground. Picture him in a doctor’s trademark white jacket. One who, when he speaks, people listen. And see him at the high school reunion. Unshirted, his face glistening in sweat. His bulging belly deliberately displayed and painted with a hobbit’s face. To dance. As a titan. Like the frolicsome friend he was in high school. To give fun to his classmates gathered.

Are these the marks of greatness? To come down from Olympus and dance with the mortals?

We always think of him as a topnotch researcher, an expert clinician, an inventor. He is known for the Mectest, a testing kit to analyze an infant’s first stool after birth (called meconium) to find the infant’s exposure to drugs and alcohol while still in the mother’s womb.

His meconium drug-testing formula is now widely used by hospitals and pharmaceutical companies. The formula detects the presence of prohibited drugs – such as narcotics like morphine, shabu, marijuana and opium – in the baby’s meconium, which is a green matter. High concentration of any of these drugs or a combination of these drugs in the meconium shows that the mother had been taking the drugs while she was pregnant. There are several adverse effects of the fetus’s exposure to these drugs which include abnormal development, caesarian delivery and cerebral palsy.

The first of its kind to be used by the Federal Drug Administration (FDA), His formula can also be applied in other medical fields. His continuing clinical-chemistry research found that his formula can detect the presence of toxins, nicotine, non-narcotics drugs and other substances in the meconium. High concentration of toxins in the tot’s first stool indicates that the mother had been exposed to environmental toxic elements from insecticides and/or herbicides. Dr. Ostrea said that the exposure of a pregnant mother to the excessive use of home insecticides, like Baygon, may cause the abnormal development of the fetus’s motor system.

This particular finding seems to give credence to reports from the Philippines that some babies in localities in Mindanao, where there are large banana and pineapple plantations, were born with physical defects. These plantations have been extensively using insecticides, including DDT, to control pests. Doctor Ostrea said that a series of field tests he had conducted at the Bulacan Provincial Hospital in the Philippines validated earlier findings of the lethal effects of pesticides on children.

Likewise, the formula can determine the presence of nicotine in the meconium. A pregnant mother who is a heavy smoker is exposing her fetus to nicotine, which contains, among others, carcinogenic elements. Second-hand and third-hand cigarette smoke has the same adverse effects on babies, although in lesser degree. Dr. Ostrea, who is a professor of pediatrics at Wayne State University, advised parents that when they come home from work or parties where smoking is tolerated, they should change their clothes before they hug their baby. The cigarette smoke sticks to clothes, he said.

Today, the meconium drug testing formula that Buddy discovered and developed is widely used in hospitals and pharmaceutical industries, but did he receive large amount of money for it? It is sad to say that he is not profiting at all from his invention, which is the product of his 10-year-long research on meconium (infant’s first stool) and mothers who take drugs during pregnancy.

“Many people may think that I am now a rich man because of my patented drug testing,” he told a motley crowd who attended his recent lecture at the Philippine American Community Center of Michigan (PACCM) in Southfield. “The truth is that I am not rich because I’m not making any money from it.”

He had secured a patent for his very useful invention, but the infringement on his patent was widespread and rampant. If he goes after the violators, he would be caught up in a gargantuan legal tangle that would require much of his time and resources. Thus, he cancelled his plan to fight for his rights in court.

Did he try to find out how much money the people illegally using his invention are raking in? He said, “No, I did not because I do not want to know how much I’m missing.” This indicates that for Buddy, whose father hails from Balaoan, La Union, money is not everything. But he is happy in the thought that the product of his painstaking research for 10 long years at Wayne State University has become a big boost to the efforts to improve healthcare of people all over the world.

Buddy burns with passion to help his country by sharing his knowledge to Filipino doctors. He spends a quarter of the year in the Philippines, delivering free lectures to  health care students and professionals in medical schools and hospitals.

He also created a three-year fellowship in a number of medical institutions in the United States, where 10 doctors from Philippine provincial hospitals each year begin training in new specialties. Another two-month observership program provides opportunities for doctors and specialists to update their proficiency in new techniques and equipment.  Each of these scholars return to their home provinces armed with knowledge that could even be better than elsewhere in the world. Love of country and science just got a new name -- Buddy.

Together with a group of mechanical and electronics engineers from the University of the Philippines, invented the OstreaVent, an affordable, safe and effective ventilator.

About 15 years ago, Buddy was asked to make rounds in the nursery of a government hospital and in the course of his rounds, he noticed a 12 year old girl manually ventilating a premature infant with an inflatable bag. He asked the neonatologist on rounds with him, what the child was doing and she replied, "Sir, that is our ventilator!" I quickly asked, "What if the child gets tired or falls asleep?" She sadly replied, "Then, the baby dies". Dr. Ostrea eventually found out that it was a common practice in many neonatal in-tensive care units in the Philippines to hand ventilate an infant for an indefinite period due to lack of ventilators.

Dr. Ostrea said, “My most horrifying experience was when I saw four intubated, premature infants connected through a common tubing and ventilated with one inflatable bag by one person. I was therefore determined that this unsafe practice should end.”

There is a high incidence of premature births in the Philippines especially among the indigent population. According to a 2012 report of the UNICEF, the Philippines ranks 8th among the top 10 countries in the world with the highest premature birth rate! The mortality and morbidity of premature infants are high due to inherent underdevelopment of their organs (including the lungs) associated with prematurity, the lack of necessary equipment, such as ventilators and lack of appropriate care to address their medical needs in the newborn intensive care unit (NICU). Due to under-development of their lungs, about 25% of premature infants will need a ventilator immediately after birth to survive. However, in a recent survey of 10 NICUs in the Philippines, only an average of 5 ventilators are available in each NICU and an average of 5 or more ventilators are needed to care for the infants born or transferred to their units. In the absence of a ventila-tor, manual ventilation of the infant is the only recourse. A caregiver, usually a family member or hospital staff provides continuous, manual hand bagging of the infant by the use of an inflatable bag. This is a dangerous and relatively ineffective method of ventilation since the volume and pressure that are required to ventilate the infant’s lungs are not adequate nor uniformly delivered leading to complications and even death of the infant. The high cost of a ventilator is a major deterrent in providing the NICU with the adequate number of ventilators they need. In a recent inquiry from the procurement office of a major government hospital, the cost of a new commercial ventilator retails at a price ranging from ₱1.2 – 3.4 million.

Together with a group of mechanical and electronic engineers from the University of the Philippines and the Department of Science and Technology, Buddy developed OstreaVent - an affordable, safe and effective ventilator.

The OstreaVent device is a pressure limited, time-cycled ventilator which features a bar and waveform graphic display of the respiratory cycles and touchscreen controls for the ventilator rate, alarms and limits for high and low pressures and l:E ratio. Two knobs are used to vary the peak inspiratory and positive-end expiratory pressures. Data of the minute to minute performance of the OstreaVent are stored in its com-puter database and can be retrieved in Excel file format and transmitted through the Internet for analysis of the ventilator's performance. This feature of the OstreaVent is unique and is not found in current, commercial ventilators.

The OstreaVent is protected by a patent granted by the Philippine Government Patent Office in 2012. Its current cost is ₱300,000.00 which is substantially ¼ the cost of a regular, commercial ventilator for infants.

Impressed? You haven’t heard Buddy run his fingers over the piano keyboard. He is an accomplished pianist, a singer, a conductor and composer. He conducted the Philippine Medical Association of Michigan Choir in the premiere of theFilipino Mass of the famed composer Lucio San Pedro. The choir sang in Rome at the canonization of Lorenzo Ruiz, the first Filipino saint. Much as Buddy disdains the attention he gets, a swell of Ostrean hero-worshipers is building up a story of wonder and inspiration about this Titan from the UP High Class ’57. He would be Zeus if we were inhabitants of Olympus.