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.  

On another news, I miss my person. :)

Caught unaware at BenCab.

It's been two weeks since he left. I cannot believe that my first ever relationship would be a long distance one. An enormous test of strength and character. We need to keep ourselves busy to become oblivious of the passing of time. So long, my love. Be back soon. :)

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. :)

The Best Half

Hello there. Yes, I'm still here constantly thinking of blogging and after countless attempts, I finally mustered the courage to gather photos and hit the keyboards. Now don't blame me if this post consumes your time because I shall post a lot of photos to make up for my absence----uncollaged photos, these are. Heehee. Well, nothing philosophical, just some what's-going-on-with-my-life entry. My relationship with this blog is like an old friend with whom you kind of lost in touch with but you perpetually think how they've been but preoccupation with current important stuff eats your time and then you accidentally bump into each other somewhere down the road and go back to being good friends again as if time never passed. :)

So, since this entry is mainly about how my life has been and to give a sequel to my recent post about my wedding frets, well....here. Yes, I got married last March 9!! *insert kilig smile here* One of the most enormous mystery of my life is now revealed. 

Officially misis. (c) Doc Saino

With our families. (c) Val Candole

Back in my singlehood days, the man I'm going to marry has always been a mystery I never knew when to happen. Never did I expect that he will come around the time I was reviewing for the board exam, the most unlikely time to flirt around. Haha! It was a typical Meranao parental set-up, but lucky us, we find each other suitable for a spouse. Well, primarily I didn't think of it THAT way when I met him. We have a common first cousin (we are also blood related, his father is my third degree cousin on my Mom's side) who introduced us. But apparently, prior to our personal introduction, he met up with my parents first to subtly ask if he can  visit me. They (him and my cousin) visited me at the review center after a long negotiation, I was so much under pressure of passing the boards I need not anyone to bother me. But I give in to my cousin's plea, I sure didn't know he's with him. We had a relatively good conversation over dinner that our first meeting didn't end there. I learned that he's a CPA who works with the Philippine Embassy in Abuja, Nigeria as a finance officer. Since he was on a vacation and was scheduled to go back to work few days after our meeting, he frequented his visits without my cousin. No resistance came from me thinking that he's leaving soon and I must admit I enjoyed his company. I thought his last visit would be the last and when he leaves, no further communication will occur. I was wrong. Even we were continents apart, his overseas phone calls became persistent and regular until I find myself expecting it almost always. I kind of get used to it, and while I was driving myself crazy studying for the biggest exam of my life, he acted as a shock absorber listening to my rants and, in his own little ways, comforted me. While those things were happening, his parents were also communicating with my parents about the two of us getting married. It took time before everything was settled and I had to ask myself a hundred times if I want it too. Our parents obviously do. I prayed hard and asked for signs, and when I felt that my questions were answered, I wholeheartedly accepted the marriage. Choz. Andami ko pang chorva e 'noh? Obvious naman na like ko din siya. *winks*

In retrospect, I love our lovestory. Yes, I'm a fan of my very own lovestory. Haha! We are not boyfriends/girlfriends, but we allowed fate to work everything for us. There wasn't too much obstacles along the way making our story run smoothly. Everything I was praying for were answered. Alhamdulillah.

After the wedding, we had to make the most of our time together because he would be leaving again for Nigeria. We traveled around Mindanao from Marawi City (our home base) to Cagayan de Oro, Bukidnon, Davao City, Cotabato City and back to Marawi. During those travels, we slowly revealed the quirky and fun sides of each other. In him, I found the best travel buddy! :) 

Sipping his durian frappe in a non-beachy outfit under the sun at Samal Island, Davao City. 

Who goes to Davao without devouring durian, huh? Good thing we both love durian!! 

A month later, we fled to Manila to work on some of his papers at DFA main office while I also took a leave from my work to be with him. During one mundane afternoon, he suddenly thought of going to Baguio, telling me that he's been living in Manila most of his life but never had a chance to go the Summer Capital of the Philippines. As wanderlusts that we both are, we took the bus and off we go relying only on the internet for directions.

Overlooking the City of Pines at the terrace of SM Baguio.

The first name of the hotel that appeared on the search engine was Casa Vallejo which is located at the Upper Session Road. We checked in without thinking twice and off we walked down to main Session Road until we reached Burnham Park. I'm the kind of traveler who keeps an itinerary either in writing or in mind, while hubby goes for absolute spontaneity. We walked around wherever our feet brought us. 

Burnham River at night. 

Night market. 

We woke up to this chilly environment. I felt like I was in a non-tropical country. 

Waiting for our breakfast at Hill Station.

Energizing ourselves in preparation for a loooong day ahead.

Typical Baguio sights.

Our first stop was the Strawberry Farm at La Trinidad, Benguet. We were both excited to hand-pick strawberries that we did it like it was not our first time. Haha! 

From there, we went straight to Camp John Hays for lunch and did some window shopping. 

Since it was his first time in Baguio, it's a must for him to see Mine's view Park. 

Another must-have is a photo with the Igorot natives at Baguio Botanical Garden. Look at the oldies so cute with their peace-out hand sign!! :) 

Per Ate Diane's suggestion, we visited Tam-awan Village which reflects the culture of the different northern tribes. We had a lot of fun taking each other's photos. Haha! 

A typical Kalinga hut.

From the native Tam-awan Village, we drove to another mountain called Tuba in Benguet to visit BenCab Museum which houses modern sculptures and paintings. 

Our eyes feasted to these beautiful works of art contemplating on how they were made and the emotions of the artists who did them. 

"WAG MO DAMDAMIN ANG MGA BAGAY DAHIL ANG MGA BAGAY WALANG DAMDAMIN". 

Terracota.

I'm sorry I have a bad camera. :( 

At the basement of BenCab is a cozy restaurant called Cafe Sabel....

...which opens to this magnificent view! The most romantic place EVER.

What we loved about Cafe Sabel is that their food were purely 100% organic. They're preparing their herbs from a nearby garden that they maintain. We had minty pineapple frappe and mouth-watering basil pesto pasta which were both absolutely delicious! :)

From BenCab, we hurried to the bus station and went back to Manila. It was just a quick but worthwhile trip. We visited most of the must-see places in a day and a night. Greeaaaat!!! Looking forward to a lot more travel sprees with you, Jab! :) Inshaa Allah. 

Alhamdulillah for all the blessings that God has given me. I am truly grateful beyond words. Ya Allah, thank you for my family, my friends, my work, the travel opportunity with my husband, and thank you for bringing Jabar in my life. Please shower us with more of Your blessings as we walk Your earth worshipping You alone. With him, there's nothing I can ask for (handsome and intelligent children na lang. haha!). 

As of speaking time, he's now back in Abuja immersing with his work while I also do the same to shun missing his presence. I can only pray for God to give us strength to stand the distance and courage to face our future together. In God's perfect time, we will be together again. :) For now, BBM and Facebook na lang muna kami. Hehe.