Saturday, November 10, 2007

Six days of community medicine in an urban poor community

by Gideon Lasco

(Note: This is a reflection of our experience as volunteer health staff in Brgy. 143, Pasay City, as part of our medical training. I was a third year medical student then)

On our first day, we were excited to see our barangay. Ate Nene, the prominent BHW of Brgy. 143, fetched us from the LRT station. She told us that our first stop was the local health center, where we are to pay a courtesy call to the doctor. However, when we arrived there, he didn’t show up in spite of our waiting for him for over an hour. We then proceeded to the walk through the Barangay. We passed by the “Tunnel” where we saw for the first time the grim realities of the area. The tunnel’s walls and roof were patched-up shanties, stacked on top of each other; on its 1-meter wide floor the women washed their clothes, the men took their baths, the children roamed about. Everything was done in the footpath which is also the social area of the neighbors. We began to notice how politics is a significant part of the BHWs’ concerns; they introduced us to the new barangay chairman, and the outgoing Kapitan Ong, who seemed apathetic to our presences.

On our second day, we were again asked to drop by the local health center first, to pay a courtesy call to the doctor. Once again, he didn’t show up, and we insisted that we proceed to the barangay hall already. There, Dr.Portia Marcelo followed and a Barangay Health meeting was held. Foremost in the BHWs’ minds was the recently-concluded elections; they had supported the losing candidate and they were suddenly insecure about their position as BHWs. Because of these, they seem paralyzed and unmotivated. What came out of the meeting was a need to engage with the new officials, and it was agreed that they ought to make a report to present their accomplishments in the past few years. As ICCs we did virtually nothing but observe the proceedings. Only four or five BHWs were present on this day.

On our third day, we went straight to the Brgy. Hall. We checked up around 18 kids to track their health and nutrition. They are enrolled at the Supplemental Feeding Program (SFP) but due to the elections this program has been put to a halt, and it was the first time in two months that a check up took place. We found many of the kids malnourished, with dental carries, scabies infection, among others. We identified some of them for follow-up.

On our fourth day, only two BHWs were present: Ate Babes and Ate Cynthia. We were supposed to help them make their report to the new barangay officials. Perhaps their poor attendance can be related to their feeling of being ‘paralyzed’ due to, again, politics. We taught Ate Cynthia how to use a computer. Moreover, we conducted home visits to 5 kids whose special health concerns we identified the day before. Meanwhile, Kapitan Ong continued his tong-its sessions with his friends.

On our fifth day, again only two BHWs were present. Ate Babes was there, too, and we continued to help them in making their report.

On our sixth and final day, we came to help the BHWs present their final report. It was also supposedly a feedback/conclusion session. Again, very unfortunately, only Ate Babes was there.  She was disillusioned too, because she felt that she was being left alone in the struggle. It was only Ate Babes who accompanied us when we rode the jeepney and bade Brgy. 143 farewell.

From these six days, it is very apparent that the BHWs lacked motivation. Unfortunately, down to their level, political intrigue is rampant even though their positions are actually minor and petty.

Probably they are beginning to feel that their efforts are futile. However, negative attitudes are like infectious diseases, they are communicable…honestly I felt unmotivated too sometimes because we were going all the way from PGH only to meet with one or two BHWs…there wasn’t much accomplishment in that. Hopefully, when the political dust settles, the BHWs can get back to work again; there is so much that needs to be done.

It is also unfortunate that the barangay officials don’t seem to care. The Brgy. Captain just loitered around his office. How can he expect others to work if he is as lazy as that? The local health doctor exhibited a similar attitude: how can he inspire future doctors, or even his constituents, if he’s always late and doesn’t take his job seriously?

I realized also that it is not enough to see the poor from a distance, or read about their plight. Actually being there inside the tunnel and palpating the body of poverty is an experience that gives me a clearer picture of Metro Manila. There are realities within the tunnel that do not see the light of day, and these things you will never see unless you really go to these people and listen to their stories. Beneath those high-rise buildings, below those modern roads are dark tunnels. Hopefully, in the future, the people of Brgy 143’s tunnel will find their way out.

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