Let's save the Asthma Treatment Institute of Misurina. 5 proposals for its relaunch.

Lake Misurina is home to the only center in Italy for the treatment and rehabilitation of childhood bronchial asthma. An Italian and European excellence in the healthcare field. The Pius XII Institute now risks closing forever. It is urgent to set up a working table with proposals, ideas and solutions to prevent it from failing.

Sad news reached Misurina last September 27, a press release from the Parma owners announces the end of an era with December 31, 2022. An inevitable decision, this is the comment of the Opera Diocesana San Bernardo degli Uberti.

"For some time - specifies its president Roberto Arduini - we have been forced to incur exorbitant expenses with an average of 700 thousand euros per year which in 2022 could turn into almost a million euros in deficit".

From the 70s to today, the health facility has hosted hundreds of children and young people for periods of treatment ranging from a few months to three years, establishing itself as a flagship in the treatment of breathing in the pediatric setting. However, nothing in recent years seems to have been able to save him from the announced fate. Collaborations with the Istituto Superiore di Sanità and the main pediatric hospitals (Gaslini of Genoa, Meyer of Florence, Bambino Gesù of Rome) were not needed. And not even the sums donated by the regional health system to support the structure. Unfortunately the mechanism seems to have jammed. Family doctors no longer prescribe a high-altitude rehabilitation program and hospitalization under the NHS is very complex due to bureaucracy. If the patient then resides outside the Veneto, the critical issues increase. The feeling is that the healthcare system prefers a purely pharmacological treatment approach rather than investing in hospitalizations where Nature, combined with Science, takes its course.

The Pius XII Institute cannot be left alone. A uniqueness of European value, second only to Davos (Switzerland), must be preserved, becoming a national priority where all possible stakeholders must sit around a table to discuss its relaunch.

"December 31, 2022 will be the last day of activity for the facility if we fail to find a plan B", announced its President. I say, let's do everything for this plan B! As an inhabitant of Misurina and founder of Bonel Misurina, in my own small way, I propose below 5 proposals for its rebirth.

1. The Davos model - multidisciplinary, international and for adults
2. Research and University - the key to innovation
3. Forest therapy - nature and medicine
4. Medical tourism - Project: Misurina “Heathy Destination”
5. Sport and competition at high altitude

PROPOSAL 1: THE DAVOS MODEL - MULTIDISCIPLINARY, INTERNATIONAL AND FOR ADULTS

Davos, Switzerland, is the perfect starting point for our reflections as it has a very similar history to Misurina on the clinical-environmental front.

We are at 1600 m. s L m , in an alpine context characterized by little pollution, low humidity and minimum concentrations of mites, pollen and spores. The favorable effect of the high altitude climate on asthma was first observed in Davos in 1879. At that time, tuberculosis patients went to recover. Among them, even asthma sufferers for whom there were no drugs available at the time.

Here many health centers were built. In 1950 Davos had 24 clinics, today only 4 remain. A decline comparable to that which occurred in Misurina. Perhaps this fate was inevitable for both, but Davos still remains a global point of reference in this field. The secret was to evolve, adapt to modern times, diversify and innovate, through a multidisciplinary and international approach.  

NOT ONLY CHILDHOOD and NHS

The first difference that emerges in the structures of Davos is the opening of the health service to people of age, unlike the Pius XII Institute which mainly treats minors. In Davos one does not rely exclusively on the national health system but the treatment at high altitude is recognized and financed by the medical insurance of the patients.

Here a separate chapter opens, namely the need to create a working table with insurance companies and with the world of corporate welfare. Let's talk about health policies and all the benefits that so-called B-Corp companies provide for their collaborators. In fact, virtuous companies are increasingly paying attention to guaranteeing a positive impact on their employees, on society and on the environment by reconciling their profit with ethics, sustainability and well-being. Well, establishing a dialogue with these realities becomes strategic to ensure a flow of patients intending to be treated in Misurina.

Returning to Davos, there are two excellent structures that I want to present, one 100% Swiss, the other 100% Dutch in Switzerland.

1. Hochgebirgsklinik Davos

State-of-the-art clinic, equipped with 190 beds (160 for adults and 30 for minors). Founded in 1901 as a sanatorium for tuberculosis patients, in the last 20 years, it has never stopped renewing and diversifying its offer of assistance by addressing patients of all ages and needs, from respiratory diseases to allergies, from cardiology until the very recent "long-covid" .  

2. Davos Dutch Asthma Centre 

Dutch healthcare facility in Switzerland, treats people aged 16 and over with asthma-related difficulties whose treatment is financed by Dutch medical insurance. Patients have at their disposal a room with bathroom and balcony, TV, wi-fi and a personalized therapeutic plan in a new environment, equipped with every comfort (gym, swimming pool). The waiting time for acceptance is 3 weeks. Below: a video of the structure.

DAVOS: MULTIDISCIPLINARITY AND TELEMEDICINE

The Davos high-altitude treatment combines a healthy environment with personalized care by a multidisciplinary team of medical, nursing, physiotherapy, exercise and psychological experts who are based on the holistic state of health of the patient. Considerable attention is also paid to improving general physical condition through fitness sessions, swimming, yoga, exercises and games in the gym, as well as numerous options for walking and exercising in the enchanting mountain landscape. In this regard, the town supports the clinics through a portal of all the sports and wellness activities to practice in the area: Davos Health 

Finally, in Davos, it is considered essential to maintain contact with patients beyond the therapeutic stay, making use of cutting-edge telemedicine tools and creating regular remote health consultancy sessions.

All of this could also be developed in Misurina but collaboration with research centers and universities is essential, as always happens in Davos. Let's find out in the second proposal.

PROPOSAL 2: RESEARCH AND UNIVERSITY - THE KEY TO INNOVATION

If Pius XII of Misurina boasts a recent agreement with the Department of Surgical, Odontostomatological and Maternal-Child Sciences of the University of Verona, around Davos, for decades now, it has been created a triad of excellence in the field of medical research on asthma and allergies. Three realities that deserve a mention here: 

1. SIAF Davos

Asthma and Allergy Research Institute - commissioned by the Canton of Grisons in 2020 to set up an extraordinary center dedicated to the "sciences of life", to proteomics (study of proteins in their structure and function). The project has a duration of six years (term 2026) with funding from the local government of 3.5 million Euros.

2. Allergy Campus Davos

Medicine campus, research space and spearhead of Switzerland in various fields (allergy, immunology, precision medicine, biomarkers, regenerative medicine). Various organizations are involved in his projects: Hochgebirgsklinik Davos, SIAF, University of Zurich.

3. CK Care - Center for Allergy Research and Education

One of the largest private initiatives in Europe in the field of allergy.  Themain focus of CK-Care today is the treatment of atopic dermatitis, recognized as a global health burden as the most common chronic inflammatory skin disease, especially among children. It has offices in Davos, Munich, Zurich, Bonn and St. Gallen.

Returning to the reality of Pius XII, we offer two last points in this regard:

• if the focus is to remain child care, the allergy dimension can be extended to the dermatology field. Among other things, the analyzes on the spring waters of Misurina found optimal values.

• A precious opportunity could concern the opening of a new CK-Care office in Misurina where, if the limit were the German language, the agreement could be established with the neighbor and German-speaking Autonomous Province of Bolzano and its University.

PROPOSAL 3: FOREST THERAPY - NATURE AND MEDICINE

A new therapeutic project has been involving the Istituto Superiore di Sanità in recent years with studies conducted by CAI and CNR in the field of "Forest Therapy".

Forests are in themselves therapeutic environments for humans as, through our senses, we absorb the benefits produced by nature both mentally and physiologically.

Forest Therapy means a deep immersion in nature implemented through an experiential methodology that stimulates the conscious attention of the mind, the 5 senses and the bodily sensations in relation to the natural context of the forest .

CNR and CAI intend, in the short future, to make the T prescribable by the National Health System. f in Italy (on a par with spa treatments) as well as train/inform professionals and citizens about the benefits of immersion in the woods.  

From June to September 2022, a research team was a guest of Pius XII in order to monitor the volatile compounds of the Misurina forests. The data collected are now a source of study for the CNR researchers of the Institute for Bioeconomy.

My proposal sees the birth in Misurina of an "Experimental Forest Therapy Station" - second to that of Pian dei Termini (PT) but the first in the mountain area with the opening of a research center that continues the activity of analysis on volatile compounds (B-VOC and A-VOC) and on them develops projects in the field of Psychology, Phytotherapy and Cryotherapy at high altitudes.

For further information, see my latest article: “Misurina - A forest therapy station for everyone”.

PROPOSAL 4: MEDICAL TOURISM - “MISURINA HEALTHY DESTINATION” PROJECT

If you want to experiment with a less sanitary approach and move towards new, no less virtuous trends, you can consider the theme of wellness stays or forms of light rehabilitation.  

The “Misurina Healthy Destination” Project promotes therapeutic stays in the uncontaminated area for guests who wish to improve their psycho-physical condition, alleviate asthma and ailments caused by insomnia, stress and smog.

In a nutshell, the guest stays in the clinic or in one of the partner hotels. Upon his arrival, he undergoes rapid non-invasive tests that monitor his physiological parameters (eg. lung capacity, spirometer, allergies, HRV). Once profiled, the guest receives a personalized program to follow during their stay. Upon departure, he undergoes a final test which will demonstrate the benefits of his stay in Misurina.

 

The project involves doctors, alpine guides, tourist and holistic operators and provides for the development of wellness programs tailored to the needs of the person. From the balsamic aerosol of the woods with forest bathing, to yoga, massage and mindfulness sessions, passing through long walks outdoors up to relaxation techniques regulating day/night rhythms for good quality sleep.  

“Misurina Heathy Destination” would be a one-of-a-kind case study, as well as an opportunity to bring the excellence of the territory into dialogue in the name of Wellness.

PROPOSAL 5: SPORTS AND COMPETITION AT HIGH ALTITUDE

According to the professionals of endurance disciplines, altitude training is the best tool for increasing one's sporting performance as the lack of oxygen, between 1900 and 2500 meters in height, makes its contribution -transport to muscles more efficiently, thus improving endurance.

Altitude training, being intensive, must be carried out under the supervision of professionals but in terms of performance it is highly recommended for competitive athletes.

My proposal envisages the adaptation of Pius XII to welcome and follow these sports training sessions from all over the world:

1. Official national teams (eg. canoe, ski, run)
2. Private sports club teams (eg. cycling, tennis, soccer)
3. Independent professional athletes (triathlon, freediving)

The plus would be represented by the presence just 10 km from Misurina of the Carabinieri Sports Center in Palus San Marco able to provide any logistical-organizational support .

CONCLUSIONS

This article aims to be simply a stimulus to give nothing lost and to open a constructive dialogue between the owners and all those who can contribute to the rebirth of Pius XII. In view of the imminent Milan Cortina 2026 Olympics, it is extremely crucial to bring together all possible efforts/funds in a plan for the transformation, redevelopment and relaunch of the Institute.

Finally, I invite Barilla and Chiesi, two large companies as well as Italian entrepreneurial families who have supported the non-profit organization Pius XII with important social responsibility contributions, to take a personal interest of the cause. Their masterful entrepreneurial approach and vision could have a significant impact for a strategic change in the fortunes of the Institute.

Chiesi Farmaceutici for its part has all the skills and knowledge to raise awareness of the issue in the field of health and research. Barilla can instead act as leader for an important project of rebranding and repositioning as a genius of communication as he is, finally starting together, first , a B-Corp plan in favor of Misurinasma.

The Pius XII Institute has saved many lives, now it's up to us to save him. In the hope that there is still hope for Misurina and her special aria… 

Chiara Bonel for Bonel Misurina