CCI-Unbound Pilot: Progress, Successes, and How You Can Help Us Move Forward

"Sometimes the work we do can seem so small, next to the size and scope of the challenges we face—poverty and diseases, and the social structures that can reinforce them. It can feel discouraging, like no amount of work we do will make a difference to the problems facing our patients. And yet, the most consistent theme we hear is gratitude—simply for being there, for caring enough to come from so far away. If something so small as simply showing up can seem so big to our patients, how can anything we do fail to make an impact, no matter how big the problem?” —Dr. Jeremy Howe, primary care physician, member of CCI’s team in the Philippines.

In 2023, CCI partnered with Kansas-based NGO Unbound to launch a three-year pilot program to improve health outcomes for older adults in the Philippines with diabetes and high blood pressure—two leading causes of preventable suffering and death.

• Phase 1 implements CCI’s proven low-cost care model to support 150 elders managing diabetes.

• Phase 2 expands the project with a research study involving 150 additional patients, exploring how Unbound’s sponsorship approach—rooted in relationships, community, and generosity—can positively impact the well-being of U.S. sponsors who also have diabetes.

  
  

Last month, as Year 2 of the three-year pilot progressed, a five-member team of healthcare professionals, education specialists, and administrators from CCI traveled to Quezon City in the Philippines to assess progress and address key needs.

Among the objectives addressed, the team:

• Evaluated healthcare staff and quality of care while providing targeted training

• Reviewed resources and assessed the second-year budget

• Checked the status of the peer support program called CARE groups

• Identified project challenges

  
  

Following the trip, I spoke with Dr. Hans Dethlefs, president of CCI and medical director, to gather insights on the progress made and challenges encountered. Here’s a summary of key takeaways from our conversation, with reflections from the CCI team:

Takeaway 1: Winning Progress

The pilot has reached significant milestones, particularly in team stability, training, mentoring, and overall quality of care. Clinical outcomes have exceeded expectations, and the teamwork between the clinical team and the social work team combined with steady funding and strong leadership has led to remarkable results in a short period of time—despite the challenges of poverty. A key highlight was the program audit, which confirmed high standards across healthcare practices, including effective adherence to workflows, retention of medical knowledge and skills, and patient care well above standard care.

With 158 patients currently participating, the program is demonstrating impressive efficiency while staying on budget.

“The Unbound medical team is incredible. They do it all—checking blood pressure, performing foot exams, educating patients on healthy eating and exercise, and, most importantly, taking the time to listen. They address every concern with care, and their patients genuinely look forward to each visit!"—Andrea Dethlefs, education specialist, board member of CCI.

Takeaway 2: Connected in CARE

CCI supporters may be familiar with CCI Patient Associations—or Groups of 5—which are organized groups of individuals with similar needs, fostering community and mutual support. In the Philippines, these groups are known as CARE groups—Compassionate And Responsible Ensemble—and they are at the heart of community-building in the pilot program. There are 18 groups, each made up of five to seven women, many of whom are widows. Each member fulfills a role, from leading exercises to offering medication reminders or tending a shared garden.

Some groups live close enough to meet regularly, while others face challenges due to distance. Still, they stay connected through WhatsApp—checking in, sending medication reminders, and offering encouragement. This connection strengthens the program’s impact, and CCI is confident in the vital role these groups play in patient care.

“Each group member takes on a role—nutrition leader, fitness leader, medication leader—building a strong sense of support and care. Their commitment to one another is truly moving” —Kim Roth Howe, consultant, training and facilitation, member of CCI’s team in the Philippines.

Takeaway 3: Beyond the Clinic

For CCI, home visits are a key part of its patient-centered approach to disease care. Seeing patients in their own environment provides valuable insight into the physical, social, and cultural factors affecting their health. During the February trip, for example, CCI along with Unbound’s social work team visited five patients whose diabetes or high blood pressure remained uncontrolled despite routine clinic visits. By observing their daily lives—what they eat, how they live—the teams gained a clearer picture of the root causes behind why their chronic conditions aren’t improving.

The social work team in the Philippines has played a crucial role in supporting patients, going beyond medication to help with transportation, education, and other essential needs. Their best practices offer guidance that CCI can apply to improve care for patients in other parts of the world.

“Every time we conduct a home visit; the experience is both motivating and humbling. We’re able to get a snapshot into the lives of our patients who struggle with the burden of disease and poverty”—Corey Lawson, manager of programs for CCI.

Takeaway 4: How You Can Help

Despite the clinical and collaborative success of the first two years of the Unbound–CCI diabetes pilot project challenges remain. The biggest hurdle has been recruiting sponsors for the pilot’s research study. Unbound is seeking individuals in the U.S. living with diabetes to sponsor elders in the Philippines who are also managing the condition.

Qualified participants contribute $40 per month to support their sponsored elder in the Philippines, helping them meet basic needs and access medical care. They also participate in at least three 30-minute surveys, either online or by phone, over a 12-month commitment. The goal is to determine whether this model of sponsorship can improve the well-being of the sponsors as well as the sponsored.

If you or someone you know has Type 1 or Type 2 diabetes and is interested in making a meaningful connection, please click here.

Even if you’re not eligible to participate, you can still learn more about how CCI is transforming lives in the Philippines and the Dominican Republic and contribute to its work. Chronic Care International is a 501(c)(3) non-profit organization that relies on volunteers and tax-deductible donations to make a lasting impact on communities worldwide. Ninety-one percent of CCI’s funding goes directly to programs like the one outlined above. Please consider donating.