Access to Life: RC Passport One Marikina’s AV Fistula Creation Medical Mission

When the world shut down in 2020, the Rotary Club of Passport One Marikina (RCPOM) did not. As COVID-19 spread and elective surgeries ground to a halt, a new need began to loom large, a need that would reveal the resilience of a community and the power of partnership: the life-saving creation of arteriovenous (AV) fistulas for indigent dialysis patients. What started as a response to a crisis has grown into a high-impact medical mission, one that has changed the trajectory of hundreds of lives and the narratives of families who once faced the unthinkable: a chronic, life-sustaining treatment blocked by the absence of accessible vascular access.

The start of RCPOM’s AV Fistula Creation Medical Mission lies in urgency and collaboration. The pandemic laid bare a troubling reality: an increasing number of dialysis patients were dying due to complications arising from the lack of specialized surgeons who could perform AV fistula creation - a vital step in long-term hemodialysis. An AV fistula, surgically connecting a patient’s vein and artery, provides a durable, lower-risk access for dialysis treatments. When this critical procedure is unavailable or delayed, patients face repeated needle sticks, infections, reduced dialysis efficacy, and, tragically, higher mortality.

From this painful observation, RCPOM conceived a bold, structured solution. The project forged a triad of partnerships with PATACSI (Philippine Association of Thoracic and Cardiovascular Surgeons, Inc., not limited to its actual initials here but representing a network of PATACSI-affiliated surgeons) and Taytay Doctors Multispecialty Hospital. The arrangement was simple in principle but profound in impact: surgeons from PATACSI would waive their professional fees to perform the AV fistula creation, Taytay Doctors would offer the operating rooms, and RCPOM would cover medical supplies, medications, and all operational costs for the patients. In a time of economic strain and healthcare scarcity, generosity collided with necessity to birth a lifesaving program.

The per-surgery cost, ranging from Php35,000.00 to Php65,000.00, reflects the nuanced realities of access needs and the resources required for each case. For many indigent patients, this figure would have been impossible without the mission’s subsidized framework. The beneficiaries are the indigent hemodialysis patients from Rizal Provincial Hospital Systems in Taytay, Binangonan, and Rodriguez—communities that, until now, bore the extra burden of navigating a healthcare system stretched thin by the pandemic and geographic barriers.

The mission unfolds in a carefully orchestrated sequence designed to safeguard health and maximize success. It begins with a pre-surgery medical examination and consultation, a critical step to assess overall health, comorbidities, and suitability for fistula creation. Vein mapping follows, a non-invasive imaging process to identify the healthiest vessels and tailor the surgical approach to each patient’s anatomy. Only after this thorough preparation does the actual surgical procedure take place, conducted by PATACSI surgeons headed by RCPOM's Service Project Director, Dr. Jay Alejandre, who brings years of specialized expertise to the operating room. In the days after surgery, post-surgery medical examinations monitor healing, detect potential complications, and ensure the fistula matures properly for dialysis use.

Preparation is substantial - about two weeks, to ensure the health and safety of each patient. This window allows clinicians to optimize nutrition, manage diabetes or hypertension, address anemia, and arrange post-operative care and rehabilitation. It also creates an opportunity for families to learn about fistula care, care for catheter alternatives if needed, and understand the signs of potential complications that require timely medical attention.

The impact of the RCPOM’s AV Fistula Creation Medical Mission is measured not only in the number of surgeries performed but in the transformations that follow. Since its inception in 2020, the project has saved the lives of over 500 dialysis patients who continue to live productive lives. That figure reflects more than a single medical intervention; it embodies a continuum of care, stability, and hope. For many families, a successful fistula means predictable, efficient dialysis sessions, improved quality of life, and the ability to plan for a futureeducation for children, return to work, and the restoration of daily routines that had been disrupted by dialysis-related unpredictability.

What makes this initiative especially powerful is the human value it carries for patients and their families. When a patient finally receives a fistula and can resume regular, safe dialysis, the relief is palpable. Spouses regain sleep that had been stolen by worry about medical costs and treatment interruptions. Parents regain confidence in their ability to support their families without the constant fear of financial collapse. Children return to school with fewer tensions about their parents’ health and the family’s financial stability. In many households, the fistula is not just a medical device; it is a bridge to a more ordinary, meaningful life.

The story behind the numbers is equally compelling. PATACSI surgeons, volunteering their expertise, carry a professional dedication that transcends fee-for-service models. Their decision to waive professional fees speaks to a community ethos: that life-saving care should not be determined by a patient’s wallet. The Taytay Doctors Multispecialty Hospital contributes the physical space—the operating rooms, where the delicate work of fistula creation takes place. RCPOM, bearing the project’s operational responsibilities, orchestrates the supply chain of medical materials like sutures, sterile equipment, imaging consumables, and medications, and covers the costs of pre-operative testing and post-operative medications that keep patients’ experiences humane and dignified.

The project’s financial model, while transparent in its intent, is anchored on generosity and sustainability. The cost of a single AV fistula creation procedure, while significant, becomes manageable when a diverse base of donors and corporate partners shares the burden. RCPOM has positioned the mission not as a one-off charity event but as a scalable program with expansion potential as more individuals and corporate donors express interest. This is essential in a region where demand for reliable dialysis access will continue to grow, given population trends and the steady need for ongoing renal care.

Beyond the clinical and financial aspects, RCPOM’s AV Fistula Creation Medical Mission highlights a broader truth: high-impact service is achievable through structured collaboration. The project is a blueprint for how non-profit organizations, professional societies, and private healthcare facilities can align toward a singular, humane objective. It demonstrates that when specialized skills, clinical infrastructure, and philanthropic resources converge, patients who were once invisible in the health system gain visibility and agency over their health outcomes.

The ongoing commitment of RCPOM to sustain the project is both a tribute to the donors who have backed the mission and a pledge to the communities that depend on it. With the interest of more individual and corporate donors, the program has the potential to reach more indigent patients across the Rizal Provincial Hospital System (RPHS), expanding to other municipalities in need and reducing treatment disparities that persist in low-resource settings. Each new partnership strengthens the pipeline of care - from pre-operative assessments that ensure patient readiness to post-operative follow-up that guarantees fistula maturation and durability.

The human stories behind the statistics are the enduring memory of this mission. There is the patient who arrived with compromised energy and a mounting fear of dialysis-related infections, who, after surgery, could once again greet dawn with a renewed sense of possibility. There is the mother who described the fistula as a “second chance” for her child’s future - the chance to attend school, to participate in community life, and to dream without the constant reminder of medical fragility. There are families who learned to navigate the health system with greater confidence, no longer overwhelmed by the costs and complexities of life-sustaining treatment

As the project moves forward, its leaders and partners are calling for continued community involvement. The call to action is clear: help more dialysis patients access life-saving AV fistula creation. Contributions enable pre-surgical optimization, surgical capacity, postoperative monitoring, and sustained medical supplies. They empower surgeons to volunteer their expertise and healthcare facilities to allocate space for essential operations. They enable families to keep faith that a loved one can lead a productive life despite chronic kidney disease.

If you envision a future where no patient dies because they cannot access a vital surgical procedure, you are already part of the solution. This continuing RCPOM service project stands as a powerful reminder that when compassion meets expertise and resources, lives are transformed, families are steadied, and communities become more resilient. The mission is not only about saving lives—it is about enabling lives to be fully lived again.

Closing with conviction, the impact is undeniable: more than 500 lives saved and counting, a network of surgeons and hospitals united for a common good, and a model for sustainable, high-impact medical philanthropy. The project has proven that a crisis response can become a lasting lifeline. Now more than ever, it invites further support, greater participation, and broader advocacy to ensure that every indigent dialysis patient in Rizal and beyond can receive the AV fistula creation they so urgently need.

Unite with the Rotary Club of Passport One Marikina in this essential mission. Donate, volunteer, or advocate - because every fistula opened is a doorway to a healthier, more hopeful life. Let us come together to save lives, restore livelihoods, and reaffirm the universal promise of care without barriers.

Written by: PP Ben Calderon