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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 Medical Issues Medical Issues Medical Issues Surgery • Equipment Medical Issues Medical Issues Surgical techniques • MICROSURGERY Medical Issues Antivirals Interferon Vaccines Phytosorb DIM I3C PDT Retinoids Mytomicin 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 underdescribed 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 Thank You!