Lakbayan C+

Lakbayan upgraded me from D to C+! Haha! Most of my travel opportunities were attributed to medical missions during my DTTB stint which brought me to Davao Oriental (Typhoon Pablo), Leyte and Samar (Typhoon Yolanda), Zamboanga Peninsula (Zamboanga seige), and seminars in General Santos and Davao City. I hope I can visit a lot more places all over the country when I get back, doesn't matter if it is for work or plain leisure and I will definitely tag the little one wherever we go. Hihi. On top of my Philippine travel bucket list include: Ilocos Norte, Ilocos Sur, Surigao del Sur, and Negros Occidental.  In shaa Allah.  

How much of the Philippines have you visited? Check it here: http://forge.codedgraphic.com/lakbayan/ 

Robinhood

                        

I was browsing books at Kinokuniya earlier when I chanced upon this quote and suddenly, a part of my DTTB (Doctors to the Barrios) experiences came in a flash. At the time, I had a grasp at how politics is being played not only in my home province but in the whole country as well. I was able to answer some questions on the root cause of our country's corruption and consequent poverty. I found out that it is a mutual give-and-take relationship between the elected leaders and the voters. 

I remember one afternoon when I was backriding a motorcycle driven by a barangay captain in the municipality I served, we were on our way to his barangay to see a patient. Our ride was relatively smooth, thanks to the tire paths (see photo below) carpeting the narrow barrio roads. The captain was telling me how grateful he is to the local chief executive for constructing those tire paths making the transportation to and fro the far-flung barangay easier for his constituents. 

TIRE PATHS. Basically, two narrow concrete roads constructed to fit only the tires of vehicles. This is one of the PAMANA projects of the DSWD. I took this photo when my staff and I were on a convoy to one of the barangays. 

As far as I know, all the developments in that municipality, including the tire paths, are government projects through different agencies such as the DSWD, DA, DILG and DOH. None comes from the personal budget of the local chief executive. And yet, the community people think of it as personal projects of the LCE. I do not undermine the gratitude of the community people, of course we have to consider that without the consent and cooperation of the LCE, none of those projects would materialize. When I was there, I was also beyond grateful for the warm welcome and the kindness that the LCE and his family have shown me and my staff. But I also believe that they should not entirely own up to the developments, in fact, it is something that they OWE to their constituents, and the latter must also understand that being taxpayers (well, only a handful of them) they deserve each and every project in the municipality that alleviates their living condition such as concrete roads (which they majorly lack), educational reinforcement, agricultural/livelihood help, and health support and monitoring.

I have observed that, generally, in the fifth/sixth municipalities (poorest of the poor), most of the constituents rely solely (or shall I say, beg?) from the local chief executive. This starts during the election period where vote buying is not a secret to keep in our country. It is illegal but majority does it. We live in an era where a "clean intention to serve" neither qualifications matter. Money matters. This is where the give-and-take relationship I mentioned starts. The higher amount you give to the voters, the more chance you will get of being elected to the position you're vying. After election, the politician's financial resources is depleted and he now relies on the IRA and other government projects to "save up" again for the next election. Infrastructure and other major developments are compromised in this practice. Since services lack in the municipality, the constituents practically beg to the LCE for personal financial help. This is where the feeling of "helping the people" commences, and the constituents are largely "grateful" to the LCE for the help extended to them. Robinhood, eh?     

Basically, our nation's problem in corruption and poverty is a two-way process. We cannot isolate the politicians as blameworthy, if we have accepted their money when we voted for them, then we are their accomplices. We chose them, therefore, we must endure.

As the national elections come to a close, I fervently pray to God for enlightenment as we vote for those who are capable of leading us to progress and prosperity sans the sugar-coated words and "charitable deeds" while obviously stealing from the taxpayers' money for his personal gain. May God spare us from hypocrisy and following blindly. Ameen.

Words for 2014

Hello 2015!!!

This entry should have been written before 2014 ends but I procrastinated (yet again!!!!) on it that it has been sitting on my drafts for two weeks now. Haha! This is about reflecting on the year that went by. An entry on Rica's blog inspired me to do the same exercise. I contemplated on what transpired during the 365 days of the year 2014 and brought me to these two words: PATIENCE and GRATITUDE, which have been my daily mantra for almost everyday. 

PATIENCE 

People who are close to me knows how impatient I can get. Perhaps, it is something about physicians that we want things done ASAP at the exact right time, or else our patient's life is at stake. We cannot tolerate tardiness and any form of sluggishness. It manifests in the way we walk (we almost fly!), the way we speak (straight to the point, no flowery introductions), and in the way we deal with people. The biggest test of my patience this year was handling my RHU staff (haha! they might be reading this! I still love you girls!!), the nurses and the midwife who are almost always late when we go on duty to Tubaran. Tubaran is roughly around three (3) hours away from Marawi City without a regular transpo vehicle going there. A day before we go to the area (during Mondays), we already contact our suki vehicle owner to give us a ride. I instruct the staff that we meet as early as 6:00 AM (because I know they will arrive at around 7:00 AM anyway, Filipino time y'know) to gather the vaccines and everything we need for the week in Tubaran, and guess what? They usually arrive at around 8:00 AM or even later than that!!!!! And they make me wait almost always all the time!!! They make their BOSS wait!! (hahaha!) My friends, that happens almost EVERY WEEK of my entire tour of duty in Tubaran. What always irked me the most are those who would SMS me on the last minute that they will not come on duty due to selfish reasons they think are valid which renders them absent for the entire week. OMG. Staff problems. They really, really, really tested my patience. Nevertheless, I tried to be patient with them, I never shouted at anyone, I tried to make them understand the nature of our work and that we are not being punished by being assigned in a municipality forgotten by civilization but it is US who CHOSE to be DTTB and NDPs, and that we have no right to complain nor give our RHU clients lesser than our best.

Patience is a virtue that I have cultivated during my DTTB days~~patience with the staff, patience with the bumpy road, patience with some abusive drivers who think that they are gods because our life depends on them, patience with the kind of governance that we have, and patience with some impatient clients in the RHU who wants to be seen first without lining on the queue. My exercise on having a positive attitude helped me in a lot of ways to acquire patience in my daily life. Whenever I got stuck in a traffic in Marawi (traffic caused by irresponsible motor drivers and equally impatient vehicle drivers), I appease myself by thinking that it's ok, that there might be a few traffic knots somewhere but it will be over soon, that I need not complain about it. That eases my hot-headedness and impatience. Haha! Law of attraction, that is. 

GRATITUDE 

I mentioned in my previous posts about me practicing the gratitude attitude. It is the gist of the book The Secret that I told you about, and it is the biggest lesson that I carried on for the entire year of 2014. One of the exercise in the book is holding a pebble in your hand every night before going to bed, close your eyes and think about what you are grateful for for that day. Instead of holding a pebble, I did express my gratitude every salah, that's five times everyday. That also made me realize that as Muslims, we are encouraged to pray 5 times a day not only to ask God a favor but to count our blessings and express our gratitude to The One who provided us with everything in our lives. Alhamdulillah. When you have that gratitude attitude, it would be very easy to turn a negative occurrence into a positive one. That is by looking on the other side of the situation and thanking God that the worse did not happen. 

There were numerous instances during my DTTB days that I have escaped death. One afternoon when my staff and I were going home from Tubaran to Marawi, the FX we were riding was running at a moderate speed when we felt something underneath us went missing. The driver slowly went to a halt, we came out of the vehicle only to find one of our rear wheel was  missing!! Apparently, the axle (the Meranao driver said that the "aksol" went off so I am assuming that he meant the axle. Haha!) went off that's why our rear wheel flew almost 10 feet away!! Thank God it happened in Bacolod Kalawi where there were many houses and a vulcanizing shop nearby so it was easy for us to get some help. A former Vice Mayor in the municipality also passed by at us on his way to the nearby masjid (it was already 6:00PM maghrib time) and went out of his way to help us. He called the experts on car mechanics and after an hour, our wheel got back on its place and off we went. The people who helped us never asked for any monetary compensation whatsoever, a simple and genuine "Salamat ow"  was already enough. Alhamdulillah there were still people like them who are always ready to render a generous service without expecting anything in return. I have not lost hope in humanity after all. :)  I will always think of that experience with a full gratitude in my heart. We arrived in Marawi very late in the evening already, but come to think of it, we could have NOT arrived at all! Apparently, most fatal vehicular crashes are due to broken axles just like what happened to that vehicle we were riding. It could have happened in the darkest areas in Madamba or Madalum where seeking help would be an utmost difficulty. Subhanallah. Things could have been worse. There are plenty of things that I am grateful for, and when I think about those things, everything that I don't have disappears from my mind. That's the power of gratitude. 

Patience and gratitude are the two virtues that I will live through my entire life, in shaa Allah, because I have felt its impact on me and the people surrounding me noticed it too. I am less grumpy now. Occasional na lang. Haha!  

You, what are your words for 2014?

Quarter-Life Crisis

If you happened to read my previous post about The Secret, it has something to do with me undergoing "quarter-life crisis" pala. I just learned about it when I was reading an article and came across with the word. It summarized everything that I was feeling, I was going through a phase pala that I didn't recognize. What I knew was that I felt a lot of resentment about everything. It happened right after I was deployed in Maguindanao for my DTTB stint and eventually got married. Everything seemed to happen swiftly that I lost track to cope. I thought everything was perfect for me--- I had my license as a physician and earned respect from society, I have a fulfilling job, I married the kind of person I was praying for--- but I was feeling doomed. I dealt with a lot of emotional pains caused by too many factors and here, let me count the ways: 

1.) The hassles of being a Doctor to The Barrio
   
      Being pulled out from one province to another due to a rift with the local chief executive, going to the mountainous terrains, walking under the sun to reach barangays located in what seems to be the endmost part of the world, dealing with hard-headed and delinquent staff, seeing the miserable condition of the people in a municipality forgotten by civilization; and at the same time, witnessing the fabulous and glamorous lifestyle of the handful of people who are supposed to make life easy for those in the far-flung mountains. I was witnessing the irony in my own society. I was disillusioned. I cannot believe how money and power can rip off some people's conscience, rendering oppression to those in the lower strata and how the latter can all be purely innocent of the injustice lashed at them. For two years during my whole DTTB stint, I was in complete desolation. Yes, I have survived DTTB, I am in a good state now, but the people in the municipality I had left are still eating out from one powerful man's hand, struggling through their daily survival, waiting for a miracle to happen.

   For two years, I have witnessed how corruption from the lowermost level occurs and how the people from the grassroots suffer the consequence and worse, how they tolerate the powerful ones as if stealing the money rightfully owned by the mass is a normal thing to do. And the worst feeling is knowing that you are not, by any means, capable of doing something about it. I came to a point of wishing DTTB would end soon so I can get out of the loop to stop witnessing everything. 

2.) Long distance relationship

      Before my husband and I got married, he already talked me out of the DTTB stint and offered to pay back my scholarship so I can join him in his post in Nigeria. I vehemently refused because I was really looking forward to DTTB and I know I will regret it if I wouldn't join the program. I have already accepted our LDR set-up thinking that I have never been emotionally dependent to one person so it wouldn't be a problem. One month after we got married, he left for Africa and we were both back to our pre-marriage routine. Much to my huge surprise, I had a severe separation anxiety that I had occasional outbursts of crying!! Adjusting with the contrasts in our personality with a seven-hour time difference, it was one hell of a crazy LDR. Thanks to technology, but it wasn't enough to make up for the physical absence. Facetime or viber cannot detect the real mood or environment we were in so there were plenty of times when I would burst into outrage and he had no idea why, and then later on he would find himself profusely apologizing for something he did not understand. I was just PMS-ing lang pala. Hahaha! Thank God, he was/is very patient with me. Oh well, he now has a broad understanding of women and he had my mood swings to thank for. Haha!

3.) Pressure from attending to social obligations

      I was never a social butterfly as opposed to my own mother. Being labeled as "the physician daughter of *insert my mother's name here*" and immensely after I got married, I forced myself to pretend to be the social butterfly that I am expected to be and forced my brain to memorize family genealogy. It is quite difficult to be in the Meranao society, I tell you. You are forced to be who you are NOT because of  certain expectations coming from certain labels, and if you fail to live to that expectation then expect murmurs about you behind your back. Guess I will have to live with those murmurs and just shrug my shoulders as I live my life because honestly, I cannot live to pretend. 

4.) Pressure from the masteral classes

       The biggest perk (the ONLY perk actually) of being in the Doctors to the Barrios Program is being enrolled for free in a masteral classes in the prestigious Development Academy of the Philippines. The classes, which we call the Continuing Medical Education or CME, are conducted every six months for two whole weeks in the DAP Convention Center in Tagaytay City. CMEs are always being looked forward to as a breather and a refresher, it is what every DTTB loves. Upon returning to area, we were bombarded with assignments and action plan and projects (APPs) that needed beating a deadline. With the fluctuating internet connection in our place and with the impending works in the rural health unit, it was hard juggling my role as a student, head of unit and subordinate all at the same time. 

5.) The chaotic world

        Everywhere I looked at was chaotic--the core of the society I live in, my country, the whole world is in the verge of war. Natural catastrophes ground us to rubble because of man's own doings. My eyes opened up to the real world and how miserable it is. Negativity started to sunk into my being, it was eating me from within and my whole perspective about this world started to change. I was letting the happy girl in me slip into a hopeless being. Everything, including my own room, was in chaos.


It never occurred to me that the transition from my extended adolescence to adulthood would be a formidable one. I realized that I actually underwent a life-changing phase when I already emerged out of it. Haha! Yeah, it was quite late but I'm just glad that I managed to get through everything unscathed. I am grateful I'm surrounded by the positively-energized people who peppered me with relevant advice and it also helped that I read self-help books. I read all the three books of Rhonda Byrne: The Secret, The Power and The Magic, I read the entire Qur'an (the English translation) for the first time and tried to understand it by consulting some verses with my father who has better understanding of the Holy Book and of Islam and I listened to lectures of Islamic scholars particularly Mufti Menk and Yasmin Mogahed. Perhaps when you're conscious that something is going wrong in your life, it is a reflex that you try to bind yourself together by looking within you the purpose of your very existence. I clung to my faith and by counting my blessings, all the chaos and negativities hovering above me gradually disappeared. The greatest thing that happened to me while I was in crisis was accepting that what is happening in our lives is way beyond our control, that we can only do so much, and recognizing the power of The One Above who is The Best Planner, The Most Gracious and The Most Merciful. I believe I understood more things now about my faith than I do before, and there are still a good measure that I am yet to learn and understand.

I am grateful to three people who got my back while I was in crisis, the three people who made me see how blessed I am and who returned my positive outlook in life, they are the ones who I constantly talk to about my problems, who had awkwardly seen me crying, and despite my tantrums and everything, they still loved me unconditionally: my father, my husband and my brother J. I love you three!! 

The Arrival

We normally see a hanging signboard outside the doctor's clinic informing us that the "Doctor is IN" or if we are unfortunate enough, the "Doctor is OUT". But in my workplace where I am the Rural Health Physician, you don't see those signboards primarily because I don't have a decent office. Well, I SHOULD HAVE a Rural Health Center that constituents of other municipalities normally enjoy. So instead of seeing "Doctor is IN", you'd hear "The doctor has arrived!" and people would come swarming around us like bees. That happens on almost every duty day at Tubaran, Lanao del Sur as a Doctor to the Barrio.

                                 

I've been re-deployed for almost three months now, and apparently, according to the local residents, I'm the only healthworker assigned in the municipality who comes regularly.  The top reasons are:

1. Lack of a Rural Health Center 

    This lack of a major health facility creates a domino effect by hindering ALL health services which are supposed to be provided to the constituents as part of their natural human rights. There was once a functional RHU, according to folktown's tale, but was crushed down to rubbles more than a decade ago by the supporters of a political candidate who lost the election race to the present rulers. More than a decade later, the local chief executive who was sitting for more than three terms in the office, finally thought of building an RHU (as well as a municipal hall!). As of speaking time, our RHU is on it's way to the final touch. 

2. Lack of health workers.

    No health workers have been regularly going in the area for countless years already. The constituents would have the luxury to be visited by doctors only during medical missions, at least once or twice a year if they get lucky. They seek medical consult at the nearby municipality of Binidayan which they will have to hike for at least an hour because of the unpaved, dusty and bumpy road. No health worker coming from the IPHO (Integrated Provincial Health Office) is willing to be assigned in this place, only I and one contractual midwife dared. I always get raised eyebrows and shock on their faces whenever I mentioned the place where I am currently assigned. I don't know why but I'm fine with Tubaran, I like the heartwarming gestures shown by the people as well as the local officials. I personally feel welcome in the area. :) 

For the remaining few months of my contract as Doctor to the Barrio, I intend to maximize my time in the name of health care service delivery. I hope and pray that the local government speeds up the building of the RHU so we can settle where we should be settling. Presently, we hold our clinic right outside the Mayor's office in his own home. We feel at home din. Haha. 

People sometimes ask why I went into the DTTB program and endure of difficulty of going into the geographically isolated areas and (somehow) stagnating my medical knowledge when I can go into residency to be molded into the "ideal physician" everyone aspires to be. Serving the rural area has taught me to become a better person, my personality took a giant leap from the pushover medical clerk/intern to the one who makes sure that everyone is busy at their assigned tasks aka the "leader", the "head of the unit". I am still learning to dance with politics as it is already tied up tightly with my job. I failed at my first area of assignment, but I am learning here and I hope I get the rhythm of the dance. 

Howdy, Pablo survivors?

Our recent medical mission to Tolosa, Leyte wasn't the first time I laid my eyes on the aftermath of nature's wrath. I have seen it exactly a year ago in Cateel, Davao Oriental. I remember having a vivid imagination of how the end of the world would look like, but I pray to be spared from the destruction, my friends and family and down to the 10th generation of my future children. Subhanallah. Only a Great Force can do something like this in a matter of minutes to hours. 

Coconut trees were uprooted and were scattered like matchsticks. :'( 

I wonder how the super typhoon Pablo survivors coped a year since the massive destruction. the great thing about us, Filipinos, is the strength and resilience that we show to the world. We easily move on. Perhaps, God is just testing our character and how much we can endure. But oh, Ya Allah, no more calamities please. I don't wanna see something like this again. :( 

Haiyan/Yolanda

I was given an opportunity to see what looks like a post-apocalyptic scene at Tolosa, Leyte. The ARMM health contingent was the first to arrive in the area. We have seen the sadness in their eyes and heard the mourning in their voices. It was heartbreaking beyond words.

Bangon, Pilipinas. 

The Zambo Mission

What happened in Zamboanga City few months ago stirred the whole nation. Peace and order instability has a domino effect on the society, economy, and ultimately, health status of the people. Hence, when the crisis broke out in Zambo, the IPHO-Lanao del Sur set out for a Humanitarian Mission under the mandate of the DOH-ARMM. Zamboanga City does not belong to the jurisdiction of the Autonomous Region of Muslim Mindanao (ARMM) but it is undeniable that most of the affected are natives of the island provinces of Basilan, Sulu and Tawi-Tawi which belong to the ARMM provinces. Besides, we need not nit-pick to whom we should offer our help. 

After almost ten (10) hours of land travel, we arrived at Zamboanga City at around 6:00 pm. We had a short briefing with our bosses from the IPHO and with the DOH-ARMM and DSWD-ARMM. 

Some of the stuff we brought were lugged by no other than our big boss. 

When we arrived, some of the establishments in the city were already opened. We didn't feel the tension in the air just yet. Everything seemed normal. 

Our team was greeted by ARMM Regional Governor Mujiv Hataman on the first day before we set out to the barangays to do the works. 

We were treated to this tausug specialty called Satti. It's like the Javanese satay minus the peanut sauce. I am not familiar with the satti sauce. It was also served with cubes of rice.  

And then the mission began. 

This ambulance was our makeshift mobile pharmacy, so we can easily pack-up and ran if anything untowards happen. 

At Brgy. Talon-Talon. One of the barangays afflicted with the crisis. It certainly felt like a ghost town upon entering the vicinity. Most houses were locked, small sari-sari stores were closed and you barely see people on the streets. 

Our resident photog. Rocaya. Visit her at www.rocayaaa.tumblr.com because we're friends. Haha! 

While we were doing medical consultations, a smoke hovered above us. It was a signal that a house nearby was being allegedly burnt down by the rebels. We also heard loud exchange of gunshots which obviously signaled us to pack up and leave. Nevertheless, we were able to maximize our services by going from other five barangays in the outskirts of the city where evacuees sought shelter.

Our good friend, Racquel, spent her birthday during the mission. What a great way of spending an important milestone of your life in the name of service. Great job, Racqs! :D 

Doctors at your service. :)

Our experience was a mixture of excitement, fear, adrenaline rush and the strong drive to offer health services. With what was being shown on TV, it was understandable that our parents and loved ones were hesitant in allowing us to go to Zamboanga. But when unconditional service is in your blood, you are always ready to take a leap where you are needed. 

The Complainant

This is perhaps normal for people who extended their adolescent stage and woke up one day, forced to act like an adult, and thrown into the world of the unknown. It wasn't normal for me to complain for the things happening in my everyday life, I grew up to accept all the tiny bits thrown my way. And then all of a sudden, boom! the opacity of life disappeared and I got to see through it and saw the crippled form in everything. Here are the list of things I complain about almost EVERY SINGLE DAY.

1. My brothers' messy stuff thrown all over the house.

I hate it when upon arriving at home, they'd leave their bags at the sala, used (and smelly) socks on the floor, and leaving their shoes wherever they feel like taking it off. Why the hell can't they just bring their stuff inside their rooms because I seriously do not care if their rooms looks like a storm had came to pass. Just please spare the sala. 

2. The unruly pedicab drivers in Marawi City.

Oh, Marawi City. I love my homeland, no doubt, that's why I struggled and did my best to get pulled out from Maguindanao and transfer my area of assignment here in Lanao del Sur to be able to enjoy the cool weather and the company of my family. BUT, everyday I am bombarded with unpleasant sights and experiences making Marawi a loathsome place to live in. For one, the unruly, choosy and abusive pedicab drivers. Our main means of public transpo here are pedicabs and jeepneys. They know nothing of road rules and etiquette. Oh, almost everybody here including jeepney drivers and even owners of private cars. Pedicabs are like parasites that infested the entire city (the cityhood of this place must be revoked) and even creeping into my beloved MSU. There are NO traffic lights and NO policemen to regulate the flow of the traffic. Sometimes, you can see policemen standing under the shade, watching the cars go by or try to regulate the traffic by waving their uncoordinated hands causing more knotting of the traffic. 

3. No proper disposal and collecting of garbage in Marawi City.

 Wherever you go, it is impossible not to notice mountain of stinky garbage and even spewed on the roads catching attention. I sometimes wonder where are the people that we have voted for public office. Where are those who promised to give their public service? Why are they not doing something about this? And why are the people so irresponsible to be just throwing their wastes wherever they want to? No shame, at all?  

In my own home, my father taught us since we were kids to separate our trash into biodegradable and non-biodegradable (true!!!). The biodegradables are thrown into a pit at our backyard and the non-bios are either recycled, burnt or sold to junk buyer passerbys.  

Our beloved public servants, how do you feel when you go out of your house and greeted by the stench of trash at the corner of your street? Do you just look and drive past it? No concern at all? 

4.  About my job as a Doctor to the Barrio in ARMM. 

I can probably write a whole novel about my job but let me start on how the DOH central office made us contractuals instead of having plantilla items which was enjoyed by senior DTTBs. Being on a contractual status bereft us of the benefits that we deserve including hazard pay in which we are fully entitled of. Our workload has no difference with that of our seniors, the only difference is that we are being treated unjustly by the agency which is supposed to take care of us considering that we are being fed to the lions in the geographically isolated areas in the country. 

Being a DTTB is worse due to the mandatory political ties in implementation of  the health programs but it is worst in ARMM. I am sorry to say this and to frustrate each and everyone who, like me, was very hopeful in trying to initiate change in the community. It appeared to me how powerful politics is, not just in the political arena per se, but in public agencies as well. Life in the Philippines revolves around dirty politics but worst in ARMM.

Almost a year later, being a doctor to the barrio is far from the fulfilling job I expect it to be. I was pulled out from my area in Maguindanao due to the erratic peace and order situation (political war) and I was subtly ousted by the local chief executive himself (aka Mayor) after defending my staff on our absence at the RHU during the heat of the midterm election period where firefight encounters occur almost everyday. Truth be told, nobody wants to risk his life for a nonsense reason (read: political greed). That untoward incident deserves a whole entry. Nevertheless, I got transferred to Lanao del Sur (Alhamdulillah!) in the comfort of home and of my family. I am still waiting for my next deployment. 

One year left for DTTB and I can plan my life again with my love. :)

               

Doctor-ing to the Barrios

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.  

Meet and Greet with the Aetas. :)

One of our subjects in our Master's program at the Development Academy of the Philippines is Social Marketing in relation to Health Systems. We conducted a practicum in the form of a medical mission at different far-flung barangays here in Luzon. Two groups went to Bulacan and the other two at Pampanga. After the activity, we were tasked to submit a reflection paper. Here's what I wrote. 

The recently concluded medical mission as part of our HSD Practicum under Social Marketing was something I wasn’t personally prepared for. Per instruction, we were only told to bring our stethoscope, sphygmomanometer and diagnostic set. Nevertheless, being a doctor to the barrio and having conducted multitudes of medical missions in our respective areas, we somehow know already how to do about it. Upon orientation, doubts and queries as to the intention of the medical mission slowly dawned on me. The relevance of the activity in relation to social marketing was a bit blurry, especially the timing of the medical mission now that it is election time. My idea of a social marketing practicum would be that, we, the students are the ones who would create or think of an activity by coordinating with different stakeholders to partner with. In the medical mission that we did, everything was laid down to us requiring only our presence and our service so I don’t see the essence of doing a practicum when we’re already honed in doing medical missions. When the specific flow of the activity including deworming and vaccination were raised to us, people began grunting because those services were already being given by the RHU. But we still went with the flow by waking up as early as 1AM to go to our respective areas.

Our patients patiently waiting in queue. 

Our group was assigned to Brgy. Nabuclod, Floridablanca, Pampanga. I never expected the place to be that far, perhaps because of the idea that Pampanga is a nearby province. To my surprise, it took us almost four hours to reach the area and much more I was surprised upon seeing the Indigenous People (IP) we would be providing health services for. During the whole activity, I believe there was inadequate coordination with some partners. We were told primarily that we will conduct it in a school for proper compartmentalization, however, we were informed when we were already there that we cannot utilize the school rooms due to a prior commitment. We conducted the medical mission in an open space where there is, well, a perfect view. There were notable flaws but we were able to manage. The number of patients did not meet our expectation, in fact we were expecting more. In other words, our services were not maximized. 

A typical Aeta family. Most of them are farming their lands to sustain their  basic needs. Some of them are able to go to school but rarely finishes high school until they get caught up in what seemed as "natural course of life"~~~having kids. 

Doctors at work. 

I was asleep inside the bus for most of the travel time so imagine my surprise upon opening the curtain to see this body of water greet my sleepy eyes! Lol! Yes, we crossed a "little" river to reach the area. 

Doctors to the Barrios and a member of the army who made sure of our security in the area. Thanks, Sirs! 

During consultation, I asked my patients if they have sought consult at their RHU prior to our arrival. Most of them have not been seen by a doctor due to the distance, their RHU is located at the town proper which is quite a number of kilometers from them. I can relate their situation to the patients I meet at my area of assignment in Talitay, Maguindanao. It was my first time to meet the Aetas and was pleased by their behavior around us. Unlike with other med missions I attended, the Aetas are not demanding as to the services we offered. They listened to our health advisories and participated in our "dagdag kaalaman" games. They seemed to be compliant patients as well. :)

 We may have been "forced by circumstance" to do the mission, but being too rational made us overlook the positive impact of our presence among our Aeta friends. There are instances when we should put our personal clamors aside and look at things at different perspective. Only then we can fully understand what is going on around us from a macro level. At the end of the day, all of my doubts as to the intent of the medical mission vanished leaving me with a fulfilled heart and a sense of joy. It was really nice to meet our Aeta friends. :)

P.S.
I owe you an article on my DTTB (doctors to the barrios) experience. It's been six months since I signed the contract with the Department of Health. :)