Going rural
By Jacqueline Majella R. Uy, MD
Philippine Daily Inquirer
First Posted 02:44:00 12/02/2008
Filed Under: Healthcare Providers, Human Interest
I was an undergraduate scouring Recto Avenue for used books when I came upon a tattered, thin book written by Dr. Juan Flavier. It was about his “Doctors to the Barrios†program, about young doctors being sent out to the rural areas. It was all the push I needed to decide to become a doctor of medicine. I was inspired and I thought that going to the barrios was a great way to give service where I was needed.
During five years of medical school, I got my fair share of grueling exams, hospital grime, sleepless nights, overcrowded emergency rooms, 24- to 36-hour duties, summary rounds, community immersions. It was a good educational experience and also a lot of fun. Despite everything, being a doctor is still a fulfilling vocation.
In medical school, I also realized that there are many opportunities open for a doctor. The temptation to go abroad is very strong; more than half the members of our class are going abroad. Specialization, up-to-date medical technology, research, and big salaries await those who go outside the country.
Almost everyone goes through this train of thought, and I was sorely tempted. I had a US visa, and my parents had always dreamed of me going abroad and they were willing to spend for it. But what about this idealistic voice in my head, the push that made me decide to go into Medicine in the first place?
It is always best to follow our dreams, because if we do not, then we might regret it. I did not want to live a life full of regrets, so I decided to stay on the path less taken. I submitted my application for the Doctors to the Barrios program. It was a crucial step for me and I heaved a huge sigh of relief as I handed over my application to the Department of Health’s Human Health Resource Development Bureau Office. All I needed to do was to wait for the call.
But call, they did not. It was one of the worst disappointments of my life. I could not believe it was happening. I thought the Philippines needed doctors to stay and serve.
I found out later that they had lost my application. But when I look back and think about it I am left wondering if submitting it was a mere figment of my imagination. I did not get a copy stamped “Received†but I’m sure the logbook in their office would show that I was there. Did I lack follow-up? But I did go to the provincial office of the DOH to follow up my application and submit some additional requirements. Still, it happened. I have to live with the inefficiencies of our government offices.
With my father’s help, I got a job as acting municipal health officer (MHO) in a small town. Basically, this is what a doctor to the barrio does; he or she is the rural health physician in a municipality.
My starting salary was P15,000 a month. I found out later that this was much lower than the standard pay of a municipal doctor. This has made me realize, that for the government health care has a low priority. No wonder many health workers opt to go abroad.
My stint as an MHO has taught me many things and brought many changes to my life. Every morning, I wake up at 5 so I can take the bus that leaves at 7. It is an hour-long drive to the town where I work and I have to ride a non-air-conditioned bus that passes through some unpaved and bumpy roads. I get to the clinic at 8 and see patients the whole day. Market days are busy days and I see between 50 and 100 patients then. These are usually simple cases, but many times I have wanted to do some diagnostic exams or treatments but couldn’t because of the lack of resources.
Sometimes, I get medico-legal cases—mostly rape or mauling. I have signed many death certificates for persons I had not even attended to.
Sometimes, we go to the villages to give lectures or immunizations. I have to deal with staff members who are older than I am and who have been working in the rural health unit for a long time. Fortunately, the people I have encountered are very accommodating and welcoming.
I am still learning to adjust, to deal with my issues, to know when to speak out for what is right, to be conscious of the hierarchy in government offices, to live without my peers, and to make do with what is available.
My bus trips are usually times to ponder over so many things. On my way home one day, the bus was full. As I stood there, holding on to the handrails and watching people still forcing themselves into the overcrowded bus, I kept hoping we would not have an accident. “What the heck am I doing here?†I asked myself.
Some of my friends and relatives are laughing at me for choosing this job. They say I should seek greener pastures, go somewhere for my advancement. And sometimes I am tempted to follow their advice.
Every day I have to remind myself of my purpose in life: service. Repeating this like a mantra helps me cope with my issues and focus on my goal. It gives me great joy to know that I am somehow doing something to make the lives of my fellow Filipinos better. I believe in destiny. I believe God has a great plan for my life and that He has put in me this stubborn desire to serve in the countryside for a reason. I am sure I will end up a better person after this experience.
Jacqueline Majella R. Uy, MD, 25, graduated from the University of the Philippines College of Medicine in 2008. She is the acting municipal health officer of Catigbian, Bohol.
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