Two years after being a First Gentleman Foundation Inc. (FGFI) scholar under the Doktor Para Sa Bayan Program and eventually earning our license as physicians, it's payback time. As beneficiaries to the scholarship, we are supposed to render service as community doctors through the Doctors To The Barrios (DTTB) Program of the Department of Health. Together with the Pinoy MD Scholars, we were deployed in the doctorless municipalities all over the country, from Batanes down to Tawi-Tawi, to fill in the lack of health specialists in geographically isolated and disadvantaged areas (GIDA). Entering the program is like hitting THREE birds with one stone. For one, I need not confuse myself after boards if I have to directly go on to residency or do some moonliting jobs. I already have a job at hand waiting for me with a relatively good compensation. Second, alongside with being a DTTB is a Master's Degree program at the Development Academy of the Philippines (DAP). Our Master in Public Management Major in Health Systems and Development (MPM-HSD) aims to prepare and mold us into the role of a health leader that we are in our community. Our classes at DAP occurs every six months for two straight weeks until the end of the DTTB program when we are expected to have an Action Plan and Project (APP) in lieu of the thesis required for a masteral degree in other institutions. Third, during the whole deployment time, I get to hold my own schedule leaving me a lot of time to spend at home, to be with my family and friends, and do the things I love. Had I went on to residency, I don't think I will consider getting married yet due to the incredibly tight schedule demanded by the training program. DTTB time is more like me-time for two whole years before proceeding to another phase of my career which is the residency training.
October 2012. First CME (Continuing Medical Education) at DAP before deployment. A photo of the Habagats (DTTB Batch 30. Us.) with Former DOH Secretary Dr. Alberto Romualdez and the academic officials of DAP.
With DOH Secretary Dr. Enrique Ona visiting the new members of his workforce. Driven by our ambitions, we were still full of idealism and vigor. We were so excited to be in the field, to impact changes, to educate, inspire and motivate people. We were yet to experience what is really happening down in the field.
After several deliberations with a huge twist of fate, I was assigned to the far-flung municipality of Talitay, Maguindanao. It seemed to me like I got into an another dimension with people who share the same religion but with a different culture and language. Everything turned out to be what I wasn't expecting. Being a DTTB in ARMM with a non-devolved health system is far from what was being taught to us at DAP. I cannot find a single hole to fit in what I had studied in the master's class.
With my PHN, Ma'am Rizza who accompanied me to Hon. Mayor Sabal's residence during the signing of my Memorandum of Agreement with the LGU. Yes, ako pa ang naglakad ng MOA ko. Something that should have been done and prepared for us by the DOH-ARMM or the IPHO at least. Well, this is how we roll here in ARMM. And yes, if you have something to lobby for to the local chief executive, don't go to the municipal hall. He's not there. He's at the comfort of his home.
January 7, 2013. First day at work. What I have highly appreciated being a DTTB though is the staff. They are a whole bunch of dedicated workers who, despite the meager salary and being taken for granted by the local government, they still do justice to their work. The RHU-Talitay now has one doctor, one public health nurse, three regular midwives, one RN Heals, two RHMPP and another two MECA (Midwife in Every Community in ARMM). We have also have Barangay Health Workers (BHWs) who work voluntarily without any allowance from the LGU.
Talitay is a 6th class municipality consisting of 9 barangays with a population of approximately 12,000. The main source of livelihood is farming and fishing. Poverty, similar to other ARMM municipalities, is a normal thing here. As far as I am concerned, I don't see how the local government or even the regional government is helping the people improve their livelihood. Parang kinalimutan na sila ng mundo. Seriously.
Houses are made of light-weight materials. You don't see a decent house here. Bahay lang ni mayor. I don't think this only happens in Talitay. I've been to several municipalities in ARMM and I have seen and observed the same thing.
This is our RHU, this is where I work. Most days of the week I only stay here. I don't do frequent barangay visits due to the unstable peace and order in the area. My staff are always on the look out for my safety. FYI, this was a former rebel den (I guess they still exist here) so a gunshot or two isn't surprising at all. Or even seeing a half-naked man with a rifle gun hanging on his shoulder.
In spite of being geographically isolated, we have a decent Rural Health Unit with a room for the MHO. That's me. :)
This is what we traverse everyday----unconcreted, bumpy and muddy road to Talitay. Um, I wonder where do the IRA goes? Isn't this a major project supposedly?
After six months of being here, I feel like I have been drained despite having done none at all except seeing patients at the RHU everyday. It's difficult to implement health programs in an area with an erratic peace and order, highly politicized, unsupportive local government and with people who are passive and contented merely by selling their coconut produce for a few cents. These are people who are being chased down by midwives and nurses to get their children vaccinated or to have their sick family members be seen by a doctor at the RHU. With mental passiveness comes poor-health seeking behavior. That is difficult to address but as health workers, we keep on giving them health education in our hope that maybe someday, their attitude towards their health will change.
After six months, I honestly have the urge to give up. I would either proceed to residency or fly to Nigeria to be with my husband. I seriously do not know yet. My life is at suspension at this very moment. Plus, there is a high probability that I will get transferred in Lanao del Sur (yay for that!! close to home!!) so I will be back to square one.
And oh, I missed the hospital. I missed having real patients. I don't wanna deal with politics or with politicians anymore. Le sigh. This isn't supposedly how I should end an entry on my supposedly noble work. But honestly, I cannot feel any nobility in what I do. I feel so strangled and limited in my work by a lot of factors that all the idealism in me vanished in a span of six months. I lost hope for the health system in the same manner as I lost hope for the country. Everytime I hear politicans speak, I hear all lies. I don't think I can stay here for long, I am only waiting for the passing of time so I can live the life of a real doctor saving lives and be a wife.
