[Speech] Commencement Speech - UP Baguio 2025 Commencement Exercises

This speech was delivered at the Baguio Convention Center on the occasion of the 2025 Commencement Exercises of University of the Philippines Baguio, on July 22, 2025.

Distinguished university officials, chancellors, deans, representatives of our different campuses, esteemed professors, dear guests, colleagues, family, friends, and of course, the 526 graduates that we celebrate today, a very pleasant afternoon to all of you.

On this momentous occasion, I also want to honor our ancestors and pay respect to the Indigenous heritage both across our archipelago and here in Baguio, to the Ibaloi and Kankanaey, to all the peoples of the Cordilleras, to the generosity of their land, and amid histories of injustice, their enduring legacies of agency and resistance.

Finally, I also want to acknowledge that we live in a more-than-human world and recognize the
plants, the animals, all the species with whom we share the space around us, as well as the
bodies of nature, which our ancestors rightfully saw as living beings. And of course, the Creator, the author of life. Being closer to the heavens, surrounded by the Cordilleras, the mountains of my youth gives me strength; may they remain forever green, and may our rivers, our lakes, our seas, and our oceans remain forever blue.

In my life’s journey, I have seen many rainbows, many wonderful things, but perhaps the most
magical thing that I have witnessed is the possibility of change, change for the good and
change for the better. That within each living thing lies the potential for growth.

And that in our broken world, there is the possibility not just of build, build, build, but of repair, of renewal, and of regeneration.
And so the first message I would like to share is this:

Give others a chance.

Who among you has been let down by somebody? Maybe in a group report—someone didn’t make the slides, didn’t make it on time, didn’t make it at all.

Or maybe you became disillusioned by someone you looked up to. Hurt by someone you cared
for. Disappointed, even disgusted, by the political posts of someone you know.

Today it is easy to block, unfollow, cancel someone in response to what we think of as their
failings. But human are complex, imperfect beings. Someone you think is lazy in class might
actually be a working student busy at work. Someone who seems unfriendly might just be shy. Once, I had a classmate who never joined us for lunch—only to realize, years later, that he
simply couldn’t afford to.

When we see the life stories behind the IG stories, we might be inclined to understand instead of judge, to support instead of punish. It actually costs less to support someone through
school than to keep them in jail, but our society is good in rewarding success, but not in
supporting people so they can succeed. Can we recognize that maybe our education can allow
us to understand others better, and to support them more?

I know that this is not always easy or advisable, and there are times when you have to stay
away from toxicity or negativity. But in this age of cancel culture, be someone who gives others
a chance.

Secondly, give yourself a chance as well.

How many of you have fallen asleep in a lecture with 30 people people? 10 people? 5 people?
Well, once, I fell asleep in a small group discussion during our pediatrics rotation, and there were only three of us. “Do you feel refreshed?” The professor asked when I finally woke up.

We’ve made many mistakes, and I’m sure if you look back in your years in UP, you wish you
could have done things differently. Perhaps you wish you studied more. Or perhaps you wish
you studied less, and that you tried out new things.

Giving yourself a chance means recognizing your privilege and your potential, your capacity to
learn from your mistakes, improve yourself, and never give up on your dreams despite pressures,
artificial milestones, and the weight of expectations.

Speaking of expectations, there’s the understandable desire to meet our parents' expectations and so to the parents here, I want to ask of you, in behalf of our graduates, please give them the space to follow their path, they’ve made your dreams their own, please make their dreams yours as well.

Since I was a kid my dream was to climb mountains. Memorably, I climbed Mt. Pulag when I was 17, back when it took three days to climb Ambangeg Trail, and I cannot forget that it was
dog named Chica who guided me to the summit.
After Pulag my next big target was Mt. Apo, and I felt that I needed to climb it before I turn 20.
Even when my companions backed out, I decided to go, accompanied only by two Bagobo
brothers who served as my guides.

When I finally started hiking, I was so happy, because I was finally about to realize my dream.
But it started raining, and very soon I was soaking wet. We were taking the Kidapawan trail,
and we had to cross the river many times, by just walking on coconut trunks! It was nerve-wracking and although managed to not to fall, I
was exhausted.

Finally, we arrived at the campsite, and I managed to pitch my tent and fell asleep out of
fatigue.

But when I woke up in the middle of the night, my Boy Scout tent was wet, and I was shivering
in the cold. And to make things worse, I could hear the sound of even-heavier rain, and I could
even see flashes of lightning. I felt angry and miserable. There I was, alone, inside a tent, so far from my dream.

But I needed to pee.

At first, I tried to sleep again, ignoring the call of nature. But I couldn’t do it, and eventually, I
gave up and unzipped the tent, bracing myself for the cold and the rain.

To my surprise, there was no rain. What I thought was the storm was just the sound of the river
that we had crossed. And what I thought was lightning, turned out shooting stars. Above me,
there was the Milky Way, the brightest, most vivid night sky I’ve seen in my life, and the next
day, I reached the summit.

Sometimes, we give up on our dreams too soon—because we misread the signs. We mistake
fear for failure. Discomfort for defeat. Detours for dead ends.

But if we give ourselves a chance, if we step outside of tents, our comfort zones, then perhaps we’ll see the stars and surely we’ll be on our way to reaching our dreams.

Thirdly, give our country a chance.

I know that it is not easy to feel hopeful about the country, especially when you see the corruption, the impunity and the injustice. The roads that take forever to build. The traffic, the lack of green spaces and quality public transport, the slow Internet.

In the name of development, we quarry mountains to build new cities. In the name of progress, we cut pine trees to build more malls.

Alas, we are still far from being a country where Kian de los Santos can freely study, and where
Chad Booc can freely teach.

But the Philippines is not a small country, and our country is larger than all of the above. We are not a poor country, either. Saying that the Philippines is a poor country runs against our
heritage of wealth and richness, which is why we were colonized and exploited in the first
place. Saying that the Philippines is a poor country naturalizes the fact of our people’s poverty, obscuring the violence of its provenance. It is like saying that someone “is dead” when the more accurate way to put it is that “he was murdered.” Saying that the Philippines is a poor country sets low expectations for our government, serving as an excuse for incompetence, negligence, and corruption.

Actually, other countries have the same challenges and frustrations too. When you hear people say “only in the Philippines”,chances are, it’s actually not true, and in fact, I’ve heard the same expression in other countries, like Solo en Colombia and Unik Tiada Tara in Indonesia. Realizing that many of the problems we face are actually shared by others, can pull us from the despair of imagining ourselves as innately flawed and fundamentally hopeless.

What gives me hope is our long and living legacy of resistance. Macli-ing Dulag and Ama
Lumbaya who defended the Chico River. Pascual Pocding, who fought against the construction of a dam in Itogon. The people of Sibuyan Island, who blocked mining trucks with their bodies and successfully blocked a mining project. When I asked the forest guards in Mt. Kitanglad how many trees they’ve planted, one of them said “around five” — and when I incredulously repeated my question, he said, “Yes, five. Hectares.”

What gives me hope is the kindness I’ve encountered across the archipelago, the hospitality, of the people of Babuyan welcoming us with lobster. Hikers in Sulu sharing their best coffee. Friends, classmates in med school, opening their homes, opening my heart to what country is all about. Once, I lost my cellphone in a jeepney in Maguindanao. I had given up on ever seeing it again, until I got a call from a family who found it and wanted to return it. When I offered a reward, they refused. “We’re just being good Muslims,” they told me.

What gives me hope is you and all the talent, all the energy that you can bring to this country.
When I say give the country a chance, I do not mean passively watching it change, but actively
participating in making the change possible.

We need the arts, literature, and the humanities to open our hearts and minds to the beauty,
diversity and richness of our country, and at the same time remind us of our shared humanity.
We need communications to bridge our differences and empower communities.

We need the sciences - biology, ecology, physics - and mathematics to help us understand the
universe more, to take leadership for the challenges we face today. And in this age of AI, we need computer science not just to harness future technologies but to make sure it will not only benefit a select few.

And yes, we need social sciences - history, economics, sociology, anthropology, development studies, Indigenous studies - to help us understand each other, to ground us in a past is deeper than colonialism, and to guide us in a present that is full of challenges are not just
technical but political and social. There’s actually enough food to feed the world, but problem
is distribution.There’s enough information, each of us have more information in our smartphones than Rizal ever dreamed up. But there’s also disinformation, and the challenge is learning and critical thinking, which is why we need to work together, from different fields,
different perspectives. With all our efforts, our country has a fighting chance.

But what you do not know, you cannot appreciate, what you cannot appreciate, you cannot love, and what cannot love, you cannot fight for. Perhaps what gives me the confidence to say these things is that I’ve known this country, I’ve immersed, I’ve put my heart in it, and I encourage you to do the same. For me, it began with traveling - hiking, going places. One of my sidelines, when I was a student, was as a mystery shopper for Cebu Pacific. I had free
flights, but I had to pretend to have a headache each time, to test the flight attendants, so it
also required some work.

But it was a lot of fun, and even today, having been around the world, having lived in different
places, I can say that I love the Philippines, and I am happy to invest my time and my energy in
this land. I do not know how many countries you can visit without a visa, but I know of 82
provinces. And each can inspire you to give this country, our country, a chance.

Fourthly, give the planet a chance.

Today, we face overlapping crisis. Even as we speak, a genocide is being live-streamed from
Gaza, and many look away, as hospitals are bombed and children are gunned down. Before
the pandemic, I had the opportunity to visit the Rohingya camps in Bangladesh and alas, it is
just one of many examples of how much cruelty and suffering humans can inflict on one
another.

And then there is the climate crisis. We face the specter of hotter, more inhospitable world, with
worsening storms, not to mention the ever-present threat of eruptions and earthquakes, like
the one that shook the very place we’re gathered in, twenty five years ago.

Even as we have finally overcome COVID-19, the threat of future pandemics looms, alongside
emergent hazards to our health, from ultra-processed foods to microplastics and anti-microbial resistance.

At the heart of all this is inequality: inequality in who gets to benefit from progress, and who
bears the brunt of its consequences. On the same planet, billionaires can afford to go to space while billions cannot afford a meal, go to a hospital, or send their children to school.
And yet, humanity has also achieved so much. And though our challenges are daunting, we
can build on those achievements.

In the 1980s, scientists discovered that the ozone layer was thinning because of
chlorofluorocarbons and other ozone-depleting substances. Thanks to activism, research, and
international cooperation, those substances were banned and today the ozone layer is healing.

Also in the 1980s, HIV/AIDS was a death sentence, shrouded in fear and stigma, and I want to acknowledge Dolzura Cortez, the first Filipino to come out as HIV positive. Today, thanks again to scientific research but advocacy, including from people living with HIV, it is a
manageable condition, and people with HIV can live as long as people without, as long as they
have access to treatment. Smallpox, once a dreaded disease that scarred people for life, is
gone. More and more people today are surviving cancer, and there are bright prospects for
better treatments, diagnostics, and cure in the coming years.

Even in the most repressive regimes, there has been resistance, and all repressive regimes
have fallen, resistance has endured. Dictators have been toppled, despots have put behind bars. And thanks to culture bearers and
activists, there is renewed pride in Indigenous heritage, a renewed appreciation for Indigenous
wisdom. I am heartened by the emergence of a multipolar world, of Asian, Latin American, and
African countries breaking free from colonial divisions and forging new forms of solidarity.

We can take part in these efforts, not only as participants, but as leaders. With our collective
experience, we have so much to share with the world. But we can only do so if we give the
planet a chance.

So give others a chance, give yourself a chance, give the country a chance, give the planet a
chance, and finally, give life itself a chance.

Alam ko marami sa inyo, pagod na, at sa loob ng magagarang mga kasuotan, marami są atin ay
may pinagdaraanan. Maybe you have been burnt out by all these years, and even though this is
an occasion for celebration, maybe some of you may not be looking forward to what lies
ahead.

It’s not gonna be easy; it’s not gonna be easier. I think I speak for all your faculty, your parents,
that for me to reach this point from where you are meant facing the challenges that come with
life, from rejection and disappointment to sickness and pain, including perhaps the most
painful of all, the loss of your loved ones. It’s been years since I lost my both my grandmothers and I miss them so much.

But speaking of our loved ones, the people you will miss in life are the same people you want
to live for, so you don’t miss out on them. There are people worth living for.

People like your parents, and those who stood as your parents. your siblings, relatives,
kasambahays, those who worked hard for this moment. We often think of our parents as the
pillars by our side—but don’t you want to be by their side, too, as they grow older?

People like your teachers and professors, the people who the subjects that you took come
alive. Orgmates and teammates, mentors and mentees, the people who you’re fighting for, the
people you’re fighting with.

There are people worth living for.

And there will be moments that make it worthwhile, from something as big as graduating from UP to the small things in life, like a gust of wind that refreshes you on an uphill climb. A sip of coffee that awakens you to a new day. Being with your beloved pets, the Hachikos of your life.
Receiving a message of appreciation or encouragement, from a student, a teacher, a stranger, a friend.

There are people and there moments that make it worthwhile.

So live for your past self who dreamed of this very moment!

Live for that high school kid wondering which course to take. The college student working on their thesis, not sure if they’ll finish on time.

Live for the people you have yet to meet. The people you have yet to love.

Live for the music yet to be composed. The art yet to be imagined. The books you have to
read, the books yet to be written.

Live for the next episode, the next series, the next chapter, the next level, the next stage.

Live for the problems yet to be solved; the discoveries yet to be made.

Live for the races yet to be run, the mountains yet to be climbed!

Once, I was hiking up Mt. Sicapoo in Ilocos Norte, the highest mountain in the Northern
Cordilleras. To climb it, you have to cross Gasgas River several times.

We were already on the way down when a sudden flash flood swept me along the river, and for a hundred meters I was being carried by the current, trying to the dodge the rocks that would
have knocked me out and drowned me.

My life was saved by our Itneg guide, Tatay Emilio, who had the quick thinking to run to the
narrowest portion downriver. With all of my strength, I swam towards his outstretched hand,
and I can still remember the tight grip with which he held my hand, and the tight grip that I also
gave, to hold on and avoid being swept away.

I want you to hold on to life as tightly as I held on to that hand that saved me.

And this, at last, is the lesson I have been privileged to share with you:

Our vocation is life itself. Through our work, through education, research, community
engagement, activism, we can defend life, we can enable life to flourish; we can empower
people not just to survive but to thrive, to realize their full potential, and that we too, can find
meaning, purpose, and fulfillment in our own lives.

And for as long as we hold on to dear life, as long we give life a chance, the possibilities remain
alive, not just for ourselves, but for our country, and for the planet we share.

And so, dear graduates and friends, I say to you “Mabuhay”, not just as a greeting but as a call
to action.

Live! Mabuhay! Live!

Baguio City

July 22, 2025

[Plenary Discussion] Regen Asia Summit - National University of Singapore

On July 4-5, 2026, I participated in the Regen Asia Summit at the National Univeristy of Singapore (NUS) and joined a plenary discussion titled "Ouroboros: Decay, Collapse, and Renewal in Regenerative Systems" on the second day. The panel included Thiri Dawei Aung, Executive Director, Biodiversity And Nature Conservation Association (BANCA) in Myanmar, Farah H. Sanwari, Co-founder, FiTree and The Futures Collective in Singapore, and moderated by F. Merlin Franco, Assistant Professor of Environmental Studies, Institute of Asian Studies, University of Brunei Darussalam. 

Below are some of the notes that I shared during the one-hour discussion attended by several hundred students across Southeast Asia: 

On regeneration 

Breakdowns, crisis, sometimes forces upon us the recognition that things can be otherwise. The pandemic, for example, illustrating how remote work, online classes, and so on is actual possible, thereby serving as a transformative moment for how we work. In my own field of public health, the withdrawal from development and global health s forcing us deep rethinking.

But at a more fundamental, if we are to regenerate, we have to rethink the hidden assumptions in our societies, the things we take for granted, and we can begin doing this by rethinking basic concepts like “nature”, “development”, “native”, “indigenous”, “normal”, “ideal”, “traditional”. 

One important concept to question is notion of what is “natural”, as opposed to what is “cultural”. Humans have always been tinkering with the environment. The cherry blossoms you see in Japan are products of hundreds of years of cultivation and almost all of the sakura trees around the world came from just four trees in Ueno Park, in Tokyo. What country in ASEAN has the spiciest foods? Many Asian countries are proud of their spicy food, but chili peppers came to this region only in the 16th century, as part of Colombian exchange. Many of us eat rice, but even rice-eating is not “natural”; especially eating rice three meals a day. Our communities, especially our communities, have a had of food diversity and root crops used to form much. The moment we started to eat rice, we surrendered our food sovereignty at the family level, and pushed us to a cash-based economy, relying on social and political organizations. 

Once we realize that nothing is truly “natural”, and the nature of humanity is change, then it opens up possibilities for imaging a different future. 

On coping with grief 

As a medical doctor, I have seen so many people die, and it's one of the most challenging. As much as we want to think of life is circular, death imposes a kind of linearity to life - and a seeming end to it.

One of the things I’m most proud is one when I was mustered enough courage to tell the family that. 


This is where the arts and the humanities come in, to allow us to make sense, for us to share in the collective of humanity. There is power in solidarity, which is rooted in empathy.  

I was in Boston in the October 7 attacks in Israel 2023 and the ensuing War on Gaza, and I happened to be watching a concert of the Boston Symphony Orchestra a few days later. I would like to read out what I wrote that day: 

Before playing “Cello Concerto No. 2” he spoke about the year of its composition—1966—as being at the height of the Cold War; he recounted how Shostakovich used his music to challenge Joseph Stalin and his idea that “a single death is a tragedy, a million deaths are a statistic.” He then invited the audience to listen to the music in the same terms with which he committed to perform it: as a way of speaking truth to power.

He then launched into an emotional performance of the concerto. During the performance, some of the musicians were visibly in tears, as the cello’s music—at times screeching, at times mournful, never dying—became the personification of the human spirit amid the fearsome percussions that became, at least to me, as though the reverberations of gun and rocket fire. When the final strum of the cello lapsed into silence, the audience burst not so much with rapturous applause, but with a somber appreciation for such a profound performance.

So music, and various forms of art, and offer us a sense of solidarity and empathy; a realization of our shared humanity. 

Societies that have embraced cyclical time hold intimacy with nature, and this is another way for us to cope with the changes in life. Today, we are seeing what  some scientists have called “extinction of experience”. How many species do we interact with everyday? Being immersed in the rhythms and cycles of life gives us a different perspectives by which to see ourselves and the changes, crises we face. 

[Keynote Speech] 2024 Graduation of PGH Residents and Fellows

Keynote speech delivered at the University of the Philippines—Philippine General Hospital Specialty Training Graduation” on Dec. 11, 2024, at the Fleur-de-Lis Auditorium, St. Paul University.

Good day to the faculty, consultants, colleagues, and dear friends: One reason I came here today is to thank you. Your support over the years has been invaluable. Some of you were here when I first set foot in PGH, and it’s been a privilege to witness your growth and careers.

Alongside acknowledging our most illustrious guests, I also want to honor those who cannot be with us, including our heroic COVID frontliners, our mentors, and those who’ve gone before us. To our residents and fellows, if you have family and friends who are not here with you, but was part of your medical journey, I want you to take a moment and spiritually bring them with you; bring your significant others into this special occasion.

My message for you today is simple: resist three things as you move forward.

First, resist comparison. We live in a world of extreme contrasts, where rich kids can spend P100,000 for a dinner in a Japanese restaurant, but poor mothers cannot spend P100 for their kids’ medicines. We live in a world where powerful politicians have billions of intelligence funds but there is always a shortage of funds when it comes to supporting our children’s intelligence. In the course of my travels, I’ve met crypto millionaires, and heirs to untold fortune, who don’t need to work a single day in their lives, but I’ve also met so many people who cannot afford not to work even for a single day, which is why they can’t go to the clinic, or are lost to follow up. 

Closer to home, comparison often defines how we see ourselves and others. You may have felt it in med school, watching high school friends build careers and families while you were still a student. Or during residency, attending weddings or events where your peers seemed to have "more freedom."

In medicine, comparisons are everywhere: publications, H-indices, the number of patients, clinics, awards, recognitions. Even the time it takes to reach a milestone becomes a yardstick for success. Social media only amplifies this, offering polished versions of others' lives and making comparison unavoidable.

But this rests on a flawed assumption: that people can be compared or quantified. How can you compare a year spent caring for a loved one with a year in fellowship abroad? A career in a rural municipality with one in a teaching hospital?

Remember this: comparison is a choice. External judgment only has power if you give it power. You can draw inspiration from others, but don’t let comparisons undermine your confidence.

Having reached this point, you are already among the privileged. Financially and professionally, the worst that can happen to most of you is better than the best that can happen to many others. Embrace the value of your journey, unique and incomparable, just as others' lives are.

By resisting the trap of comparison, you free yourself to find contentment, fulfillment, and true happiness.

Second, resist the inertia of life. Many of you went straight to residency from med school, then into fellowship. Others may have taken detours or entirely different paths. Regardless of your age or timeline, remember: it’s never too late to seek new experiences and embark on new challenges. 

In my own journey, I knew I wanted to be a medical anthropologist even before finishing med school. But that decision meant many more years of study and unconventional choices, leading others - and sometimes even myself - to question my path.

The road has been long: seven years to get an MD, another seven for a PhD, and yet another seven to fulfill my childhood dream of becoming a historian by finishing a master’s in the History of Science. Yet every step, every detour, had value. Along the way, I lived in different places - from Mexico City to Bogota, to Amsterdam to Puerto Princesa, each enriching my life and making me a better person. 

If you’re hesitant about pursuing something new, remember: you don’t need to feel 100% ready. Sometimes 51% is enough. I’ve climbed almost 200 mountains in the country; probably more than anyone else. But honestly, I’ve often woken up for a hike feeling only 60% motivated—but I go anyway, and I’ve never regretted it. 

This applies to your career and your life. If you’ve been dreaming of something—running a marathon, writing a book, pursuing further training, starting an advocacy—take the first step.

One major factor, by the way, is that my parents were very supportive of my decisions, and to the proud parents and loved ones who are with us today: I ask you: Please support our graduates in their plans; give them space, the support to chart their own paths; free them from the weight of expectations. Just as they made your dreams their own, make their dreams yours as well.

Even with your loved ones’ support, it won’t always be easy. There will be rejections, setbacks, delays, along the way. But as Gabriel Garcia Marquez said: “It is not true that people stop pursuing dreams because they grow old; they grow old because they stop pursuing dreams.”

So, graduates, don’t let inertia hold you back. Resist it, and embrace the unknown.

Thirdly and lastly, resist hopelessness. The world can be daunting, filled with crises—political, environmental, and social. In the medical field, we face challenges from corruption to the rise of AI and the threat of future pandemics. At the global stage, it is discomfiting that with a single flick of a finger in your smartphone, you can see images of dogs, and cats alongside images of genocide.

But even in the face of these challenges, we’ve made progress.

When PGH was opened in 1910, life expectancy in the Philippine was just around 35-40 years, but now it’s 71 years for males and 76 years for females. 

Also in 1910, there were 150-200 deaths per 1,000 live births, but when I entered med school in 2005 it was 26 and today it’s 17 or 18.

Just a few years ago, we were at the mercy of COVID-19, but thanks to vaccines and revolutionary progress in making revolutionary progress, we are back to a beautiful gathering like this.

Of course, disparities remain. Life expectancy may have risen, but not for everyone. Kian de los Santos only lived to 17, not 71. How we can even talk about clinical practice guidelines for places where hospitals are bombed, or where, closer to home, health activists are red-tagged? 

Some things have also not changed much. When PGH was opened in 1910, the average height of Chinese and Japanese males was 5’2-5’3 and now it’s 5’7-5’8. In the Philippines it was also 5’2-5’3, and it’s still 5’4. This is not just genetics alone, but nutrition, quality of life. Hopefully there’s nowhere to go but up but we still have a long way to go.

And yet, change can happen on many levels, and you have a role to play in all of them. Structural reforms are crucial, but so are individual contributions.

Yes, we need streets and communities that are inclusive for people with disabilities and chronic illnesses. But we also need rehabilitation medicine specialists, ENT specialists, and ophthalmologists to help patients regain their quality of life. Likewise, neurologists, geriatric specialists, palliative and hospice care experts, are essential to support our growing elderly population. 

Yes, we need UHC. But we also need more physicians in Family and Community Medicine, as well as Internal Medicine, to guide individuals, families, and communities, through their health challenges. We need more oncologists that people can trust so they won't fall prey to those who seek to profit from their struggles. 

Yes, we need all kinds of expertise to expand prevent future pandemics, and finally end the burden of TB, malaria, HIV. But we also need IDS to manage each individual case.

Yes, we must ensure safe and healthy childhoods, with more parks and better schools. But we also need pediatricians to treat children, one patient at a time.

Yes, we need reforms to improve occupational health and safety, and yes, Filipinos must learn to swim to prevent drownings. But we also need emergency medicine specialists, toxicologists, general surgeons, orthopedic surgeons, and anesthesiologists to respond when accidents happen.

Yes, we need to advance reproductive rights, promote gender equality, and address teenage pregnancies. But we also need obstetricians, gynecologists, and specialists in adolescent medicine to care for these populations.

Yes, we need to address the structural and social determinants of mental health. But we also need psychiatrists to provide care during personal crises.

Yes, we must build a society where physical appearance is not a basis for judgment. But we also need dermatologists to care for skin conditions and improve patients’ confidence.

Yes, public health is too important to be left to doctors alone. Yes, we must empower nurses, allied health professionals, social scientists, and patients themselves to take leadership in health. But we also need doctors in public health and more specialists across the country, including radiologists, pathologists, and all the other specialties and subspecialties represented here today.

Hold two truths at once: that health is socially determined, yet also deeply personal.  The lesson of “Kuwento ni Rosario” is not just there were so many interlocking reasons for her death, but also that there were many points where she could have saved. Each patient you treat, each day you improve their lives, is inherently valuable. 

Each of your own life journeys, including the chapter of your lives in PGH, is also inherently valuable. Don't forget to take care of your own happiness, your physical and mental health. 

And what I’ve just told you, I believe, is part of this self-care: Resist comparison. Resist inertia. Resist hopelessness. Instead, embrace the uniqueness of your medical journey. Embrace life as an adventure. And lastly, embrace hope! There is so much we still can do for ourselves, our loved ones, for our patients, for our beloved  country - and for a world that may yet be redeemed.

[Keynote] 16th Annual Conference - International Society for the Study of Drug Policy (ISSDP), Leuven, Belgium

On June 1, 2023, I delivered the closing keynote for the 16th Annual Conference of the International Society for the Study of Drug Policy (ISSDP) in Leuven, Belgium, as the inaugural winner of ISSDP's "Excellence in Research Award". In my lecture entitled "Between global and local: Drug policy reflections from Southeast Asia" and held on the last day of the three-day conference, I talked about the Philippine drug policy situation, the emergence of drugs as populist tropes in the region, as well as regional influences and their roles in drug policy. 

The paper that was the basis of my lecture can be found here.

[Public Lecture] The 59th Dr. Jose P. Rizal Memorial Lecture - Philippine Medical Association

On May 18, 2023, I delivered the 59th Dr. Jose P. Rizal Memorial Lecture of the Philippine Medical Association, in a ceremony held in Manila Hotel. My lecture was titled "Rizal’s Enduring Relevance for Medicine in the Philippines: Nature, Culture, Innovation, and Empowerment" and reflected on lessons from the Rizal's medical practice and way of life that resonate with the experiences and challenges faced by medical practitioners today. The abstract of the talk is as follows: 

Jose Rizal (1861-1896) was an ophthalmologist and general practitioner who, by virtue of his exemplary medical career, is often invoked as one of the pioneers of health care in the country. Less examined, however, is the relevance of the Philippine national hero’s broader ideas for medicine and public health. In this lecture, I survey the life and works of Rizal to identify four major themes - nature, culture, innovation, and empowerment - in which his philosophy and practice hold resonances and valuable insights for the country’s heath care system. Taken together, Rizal’s vida y obra gestured towards a holistic, ecological, culturally-sensitive, and modern approach to medicine: one that viewed patients not as passive recipients of charity but as agents of their health and well-being. 

The lecture was attended by PMA officials and recipients and nominees of the Dr. Jose P. Rizal Memorial Awards including DOH OIC Maria Rosario Vergeire and PMA President Maria Minerva Calimag. Previous Dr. Jose P. Rizal Memorial Orators including Ambeth Ocampo, Michael Tan, Antonio Oposa, Howie Severino, Xiao Chia, among others. 

[Public Lecture] Medical Populism in Asia - La Trobe University

On May 12, 2023, I delivered a virtual lecture organized by the Philippines-Australia Forum of La Trobe University in Melbourne on medical populism in Asia. In my presentation, I shared three case studies of medical populism in the Asia Pacific, namely (1) the controversy surrounding the Dengue vaccine (Dengvaxia) in the Philippines in 2017; (2) the war on drugs by Prime Minister Thaksin Shinawatra in Thailand in 2003, and; (3) the COVID-19 response in India under the leadership of Prime Minister Narendra Modi. 

The video of the event can be viewed here. Thank you to Dr Raul Sanchez-Urribari, Director of the Philippines-Australia Forum, and Rei Fortes, for organizing it! 

[Plenary Speech] International Harm Reduction Conference #HR23 - Melbourne, Australia

On April 16-19, 2023, I participated in the 27th Harm Reduction International Conference (#HR23) that was held in Melbourne, Australia and organized by Harm Reduction International. Gathering harm reduction advocates, scholars, and policymakers, the conference brought together over 1,000 delegates from 80 countries - including over a dozen from the Philippines.

Together with Kirsten Han (Transformative Justice Collective, Singapore), Gina Jackson (Return to the Heart Foundation, USA) and Kassandra Frederique (Drug Policy Alliance, USA), I was part of the opening plenary entitled "Challenging Systems of Oppression". In my address, I talked about the role of activism, advocacy, and scholarship in the Philippines during and beyond Duterte's drug war - as well as the need to "decolonize harm reduction". Here are some of the concluding thoughts I imparted: 

This is message that we send you from the Philippines: That even when our leaders suppress our rights and oppress our communities, there are good people in government, in the private sector, civil society, people who use drugs who work for change, pursuing activisms both loud and quiet, advocacies both urgent and enduring. 

That even when society as a whole think that drugs are evil, even when they support leaders who echo that view, there are academics, artists, various allies who try - in their own ways, to erode that view, slowly and patiently, pointing out its many contradictions.

And even at the darkest moments of oppression, there are pockets of resistance that are spelling the difference between death and life.

Inspired by the conference, I also wrote a column in the Philippine Daily Inquirer entitled "The case for harm reduction". 

[Symposium Presentation] Coping with COVID-19: A Comparative Study on Cultural Immune Systems - Osaka, Japan

On March 4-5, 2023, I participated in an international symposium titled "A Comparative Study on Cultural Immune Systems" in Osaka, Japan, hosted by Japan's National Museum of Ethnology. As the organizers put it, the symposium aimed "to compare and analyze the ways in which the “cultural immune system” has been activated in response to COVID-19 in various Asian countries such as Japan, China, South Korea, Mongolia, the Philippines, and Bangladesh, and also consider other regions like Europe."

In my presentation, I talked about the ways in which certain COVID-19 cures figured in the ways political actors in Asia responded to the pandemic, in what I call "pharmaceutical messianism", with the following abstract that builds on my work with my research associate Vincen Gregory Yu on the subject: 

This presentation surveys some of the miracle cures or wonder drugs that were touted to treat or prevent COVID-19 in Asian countries - and analyzes the ways in which politicians and other prominent public figures in the region promoted them. While the phenomenon of ‘pharmaceutical messianism’ (Lasco and Yu 2022) has been described all over the world, this presentation also reflects on the particularities of Asian contexts that lead to the social and political efficacies of these products, regardless of their biomedical efficacy.

I would like to thank the organizers in Minkapu, including Ippei Shimamura and Sohee Che, for organizing the event and for inviting me to be part of it. 

[Presentation] - Seventh Global Symposium on Health Systems Research #HSR2022 - Bogota, Colombia

On October 31 to November 4, 2022, I attended the Seventh Global Symposium on Health Systems Research in Bogota, Colombia and delivered a presentation entitled "Enabling Youth Equity in Drug War-Affected Communities in the Philippines". 

The presentation was part of a panel organized by Equity Initiative on "Increasing the voice of the unheard – south-south learning and sharing to address power imbalance and health inequity in marginalized populations" and included other Atlantic Fellows: Shehnaz Munshi (School of Public Health, University of the Witwatersrand), Lance Louskieter (University of Cape Town) and Somporn Pengkam (Community Health Impact Assessment (CHIA) platform in Southeast Asia). Piya Hanvoravongchai chaired the session.

In addition to presenting in the panel, I also attended the panel organized by my colleagues in the RESPOND project on "Patients on a journey: understanding the individual, social, institutional barriers to effective and people-centered hypertension care", in which my research associate Jhaki Mendoza presented about our paper on 'therapeutic itineraries'; also presenting in the hybrid session were Lia Palileo-Villanueva, Martin McKee, Maureen Seguin, Alicia Renedo, Nafiza Mat-Nasir, and Nasir Ismail.

As with the previous in-person HSR in Liverpool, it was a great opportunity to connect with international colleagues and the growing Philippine community of public health practitioners:

[Plenary Talk] 6th Filipino American Book Festival - San Francisco

On October 15-16, 2022, I attended the 6th Filipino American Book Festival in San Francisco organized by the Philippine American Writers and Artists (PAWA). During the first day, I joined a plenary panel with Ani Rosa Almario of Adarna House, the novelist Gina Apostol, author Reine Arcache Melvin, and the historian Vicente Rafael in sharing my thoughts about "Writing Towards the Future". Journalist Troy Espera moderated. Notably, Gina Apostol delivered a powerful keynote speech about the socio-political conditions in the Philippines:  

Only a few lead comfortable lives in the Philippines … it is a small minority whose lives are threatened with change. But it is also they whose myth-making and golden promises manufacture majority consent to their violence and their greed … It is satisfying to blame the voters, but is a problematic response to fascism’s power. I lay the blame unequivocally on the structural oppression that has produced the voters’ economic condition, which leads them to the desperate hope that Marcos will, with his absurd and incredible lies about his family’s Tallano gold, lift them out of despair.”

Overall the entire book festival was a very enriching experience, which I chronicle in my column in a piece entitled "Partaking of Filipino American experiences". I am grateful to the organizers especially Edwin A. Lozada and Christina Newhard for organizing such a meaningful activity! 

[Panel Discussion] Author on Author: Creative Doctors - The Write Treatment

On April 22, 2022, I joined author and neurosurgeon Dr. Ronnie Baticulon in an informal dialogue on medicine, public health, and creative writing, as part of the "Author on Author” webcast by the National Book Development Board. The occasion was also held to mark National Literature Month with the launch of the 13th Philippine International Literary Festival (PILF), a celebration of reading and literature. 

The dialogue mostly involved a sharing of our respective literary, professional, and personal backgrounds, our creative process, and future plans. I had the opportunity to talk about my book, “The Philippines is Not a Smal Country”, while Dr. Baticulon shared about his essay collection, “Some Days You Can’t Save Them All” - for which I also wrote the foreword. We also fielded questions from the audience about the challenges and rewards of being a physician-writer. 

The recording of the event can be viewed here.

[Public Lecture] Virginia A. Miralao Exellcence in Research Award (VAMERA) Lecture

On March 2, 2022, as the recipient of the Virginia A. Miralao Exellcence in Research Award (VAMERA) given by the Philippine Social Science Council, I gave a lecture for my winning work entitled “Living Together in Precarious Times: COVID-19 in the Philippines”.  The presentation was based on the essay which was published a book chapter in Viral Loads: Anthropologies of urgency in the time of COVID-19 (UCL Press, 2021) edited by Lenore Manderson, Nancy J. Burke, and Ayo Wahlberg.

In the presentation, which I updated to reflect changes that took place in the country over the past two years, I charted the enduring role of other species in our experience of the pandemic, as well as how the pandemic continues to affect various species and entire ecosystems. 

The awarding ceremony and lecture can be viewed here.

[Public Lecture] Medical Populism and the Covid-19 Pandemic

On December 6, 2021, I gave a public lecture entitled "Medical Populism and the Covid-19 Pandemic” to the Institute for Asian and African Studies, Humboldt University of Berlin. The public lecture was organized by Dr. Andrea Fleschenberg and Dr. Rosa Cordillera A. Castillo as part of the "Covid Governmentalities in Transregional Perspective - Public Guest Lectures.

In the lecture, I provided an overview of the concept of medical populism, and used its framework of spectacularization, simplification, and division to make sense of the politics of COVID-19 pandemic. I also introduced the concept of 'pharmaceutical messianism', which I argue is one of the most prominent manifestations of medical populism today.

[Book Launch] Drugs and Philippine Society - Part I

On November 24, 2021, we held an online book launch for Drugs and Philippine Society (Ateneo de Manila Press, 2021), the collection of critical essays that look at drug use; drug wars; and drug policies in the Philippines from different angles. It was a privilege for me to have edited and written the critical introduction to this volume, which features the perspectives of scholars; social and cultural workers; artists and activists present and past.

The book launch featured Filomin Gutierrez, Mary Racelis, and Ica Fernandez, all of whom contributed important chapters in the volume, particularly focusing on “interrogating the drug war” (also the title of the second part of the book). All three asserted the importance of eliciting the perspectives and positionalities involved in the drug war, from police officers to people’s organizations and of course the people themselves who are living in communities affected the most by the so-called war.

[Speech] Message to the students of UP College of Public Health

Speech delivered virtually on October 6, 2021 on the occasion of the 2021 Welcome Ceremony and New Students' Orientation of UP College of Public Health 

*

First of all, I would like to express gratitude to the College of Public Health not just for this invitation but the support I have received, moral and otherwise, from people like your Dean, Dr. Jun Belizario, my Universal Health Care Study Group colleague Dr. Emer Faraon, and my contemporaries in the UP College of Medicine, like PM Hernandez and Jimjim Lopez - who I have known since our Intarmed days. I do not say this just to mention people in your college; I say this because I really feel so much at home in UP Manila because of the support I have received in my various activities. Someday, I look forward to collaborating with your college and I hope I get to meet you. 

But of course, I also feel at home in UP Manila because it was literally my home for several years, from the time I was an Intarmed student to the time that I finished medical school. I lived across Taft for three years, and in a dormitory in Orosa Street for another four years, I have seen shops and restaurants come and go - Sala Thai near PUP, Iseya in Padre Faura, Cyma our long-time favorite in Rob Manila. Gone is the computer shop where we used to play DOTA; gone even are the buildings where we used to have our lectures. But of course Robinsons in still there, and I’m sure you’ll get familiar with its every detail - including the escalators and restrooms that are out of service.

Today, with a pandemic upon us, my student days seem to belong to the remote past. But just because things have changed doesn't mean that we have to let ourselves bogged down by the thought of that change. Leadership involves rising to the occasion, and while I do not underestimate the personal challenges we all face today, I believe that by being here, and by choosing public health, you have what it takes to be leaders, whether in scholarship, community-building, teaching, or public service. Once, when I was hiking in Japan’s Mt. Hiei - the site of Ruruoni Kenshin’s epic battle with Shishio, it was foggy I couldn’t see anything, then suddenly a monk appeared, and asked me: “Why are you here?” And I said, “I want to climb Mt. Hiei”, but he repeated: “Why are you here?” And I realized that what he really asking is “Why are you here in this world at this moment?” 

I still think about that question from time and time, but today I am convinced that the reason why we’re here is because we refuse to accept that the pandemic has defeated us. We refuse to accept a future where public heath is a privilege, not a right. We refuse to accept that we have stopped growing as individuals. We are here, whether as teachers or students, because we believe that we can make the future better than the present. 

 But we cannot be future-looking all the time. Being in college, or taking that master’s degree, is not just a step in a ladder, it is a chapter in your life that is as important as the previous and the next. I think that I speak for the faculty in saying that your happiness, your sense of fulfillment and meaning with your life today matters to me much just as much as your service to the country, even as I also know that the happier you are, the better you will be able to serve. Aside from wishing you success in your future career, my hope is that you will be able to make the most of your student experience, in academics and beyond. And so, in 10 minutes or so, let me share some advice as you embark on your college journey on this time of great uncertainty. 

First, never allow yourself to get envious of the past, never think of your student experience as inferior or incomplete because of this pandemic. I know that it is disappointing, and even depressing, to start college or grad school this way. I know that it’s almost two years, and the lockdowns upon lockdowns are increasingly unbearable. But don’t think that this virtual platform will make you any less of a student. Focus instead on what you can do, from learning from the pandemic itself. Like a volcanologist who does not welcome a volcanic eruption but will nonetheless use it as an opportunity to apply and grow their field, we can learn from this pandemic, and we can evolve our way through it by developing our skills in independent learning, in online teaching, in virtual fieldwork, and so much more. 

Second, use your privilege wisely. Not everyone will have this opportunity to learn. Not everyone will have fast enough Internet; some are struggling to have Internet access at all. Even before the pandemic, studying has been a privilege. This is no need to feel guilty about this, but aside from acknowledging it, one way we can respond is by maximizing our opportunities and using it to improve ourselves so we can better help other people. 

Now one of the nice things about being a UP student is that you get to meet people from all over the country. My love for traveling was developed with my visits to my classmates during sem breaks and summer vacations - including my first trips to Mindanao. I’ve learned so much from my travels since, andI would advice you to travel whenever there’s an opportunity, with the caveat that, in this age of Instagram, I hope you will travel but not for the world to see you, but for you to see the world. But of course today we cannot even go out of our homes, we cannot even go to campus, which brings me to my third advice: Read. Read. Read, because books can also take you places. Books allow your imagination to travel, and it can be as rewarding as traveling itself. When I was in med school I used to go to the Booksale in Robinsons Manila and I made it a point to read one a book every week. I think it helped me a lot, and I think it will help you too: To the graduate students in particular, I must say that you that if you want to write your thesis of dissertation easily, you must learn not just to read but to enjoy reading. 

Fourth, I hope you realize that “ambitious” is is not a bad word. In the Philippines, “ambisyoso” has a negative connotation, and even “trying hard”, but If public health is grow, then you must be confident in your ability to expand the field. I think we have to celebrate a certain degree of bibo-ness in all of us. A few years ago, I told myself that in terms of productivity, my goal will be to publish one tweet a day, one column a week, one journal article a month, and one book a year. At that time, it seemed unreachable, especially the one journal article a month and one book a year. But this year, I’m happy to say that I’m on track to meeting this goal - I will be launching a book on “Drugs and Philippine Society” later this month. With practice and perseverance, I realized that one’s goals, no matter how ambitious, can be realized. I think we in the Philippines have much to share to the world in terms of public health knowledge and experience, and we must be ambitious in taking leadership in global health. 

Fifth, do not be afraid to question experts, including your professors, but do s with humility, with the acknowledgment that you could be wrong. During the pandemic, I have found myself at odds with some of my own professors. For example, I was one of the first to question the value of face shields especially outdoors. But I have continued to engage with them privately and I have refrained from personal attacks. Public health can be divisive because it is not an exact science. But there is far more that unites us than divides us - from the importance of vaccination to our demand that health care workers and researchers get due benefits. I hope that you will join us in trying to make public health a true community: one united by shared goals, shared experiences, and shared values. 

Sixth, never let go of who you are. Sometimes, especially in the health sciences, we think of our careers as a series of steps towards increasing specialization. From health you become a doctor, then you become an internist, then a cardiologist then an interventional cardiologist. But while we cannot be a jack of all trades, we don’t have to let go of our backgrounds, the things that make us unique. You can be plural in your career, in your professional identity. This applies to non-academic stuff too. In college, you will meet people from all walks of life, and sometimes you cannot help but wish you had some of their abilities, talents, looks, and lifestyle. Some will be effortlessly good in public speaking. Others will be physically fit and toned no matter how much they eat. Some will have so many Instagram followers, others will have the best condo. Never let go of who you are, because without realizing it, you also have something unique that can enrich you even further if you pursue it. I really loved mountain climbing, but when I was in college I had hardly anyone to climb with. I didn’t realize that mountain climbing was also a key to making so many friends, and I’ve climbed with so many people from all walks of life because of the mountains. I’ve also learned so much about our country and our world - having climbed in all kinds of places. The mountains have been a source of strength which is why I have been a steadfast environment advocate, it’s the least I can do for the mountains that are dear to me. 

Seventh, be generous with your time and your emotions - but reserve them for people that matter. I remember recently this celebrity saying that she could get by with 100 pesos a week as a student in La Salle, we were all students before and most of us will feel at some point that we never have enough. But while allowance is limited, your emotions are boundless. Do we look at our emotions as something can be generous about? It is frustrating to see all the problems of our nation and the world, but there is already so much good you can do at an individual level, from explaining vaccines to engaging relatives and friends, on matters of politics. However, I’ve also learned to reserve my emotions for people who matter. Because of my column and my tweets I get trolled a lot, I’ve even faced legal harassment, and it can hurt. But I don’t hate these people. They don’t deserve my love, but they also don’t deserve my hate. I don’t have time or space for hatred. There’s so much to do, there’s so much good we can do. Expand your concept of generosity to include time and emotions, and you will enrich the people around you. 

Finally, this is a moment of overlapping crises in our country and I’m sure you’re thinking about where you want to be in the future. I for one don’t believe that you necessarily have to be in the country to be of service, but do not lose hope, because there’s so much we can do in our lifetimes, and of course there’s no place like home. Remember - we are not a small country and there’s so much diversity and beauty within us. We are not a poor country and with better leadership, we can do so much with our wealth of knowledge, creativity and solidarity. A poet once said: “Don't stay where you are needed. Go where you are loved.” In the Philippines, you are both loved and needed. And so always reserve a space in your heart for our beloved country. With those thoughts, I conclude this message and I wish all of you the best in your public health journeys, with the hope that we will see each other along the way.

Mexico City, October 6, 2021

[Panel Discussion] #PHCON2021 - Indigenization of Public Health

On September 23, 2021, I participated in a virtual panel discussion on the "Indigenization of Public Health" as part of the #PHCON2021 organized by the Philippine Society of Public Health Physicians. Joining me in the panel were Dr. Renzo Guinto, Dr. Meredith Labarda, and Dr. Ryan Guinaran. 

I highlighted the importance of looking at structural barriers to participation as well as the value of long-term engagement with indigenous peoples as a way to facilitate inclusivity in times of crises. I also underscored the importance of the social sciences in helping bridge medical and local knowledge. 

[Speech] Message to the students of UP Manila College of Arts and Sciences

Speech delivered on the occasion of UP Manila College of Arts and Sciences' Araw ng Pagkilala 2021 on August 20, 2021

My esteemed colleagues; my friends in the UP Manila community; and our dear students: 

I was a young and naive 17-year old from UP Rural High School in Los Baños when I went to UP Manila. I was an Eagle Scout who of course knew how to use the compass and even at some point how to build a fire, but the first time I used the LRT in Pedro Gil I got lost and ended up in the opposite direction. On our first week, two of our blockmates had their cellphones stolen in Padre Faura, and learned early on that the thieves can smell who the newbies were from a mile away. Back in those pre-iPhone, pre-Netflix days, Pedro Gil was filled with vendors selling VCDs, and the most introvert-friendly way to make friends is to add them on Friendster.

Diliman, they said, was much better campus, but we eventually warmed up to UP Manila, including our favorite part of it - Robinsons Mall. I visited the Booksale every week hoping that I would be lucky enough to find good books, encouraged by the Haruki Murakami novel - Norwegian Wood - that I bought for 50 pesos. I usually did, and I made my policy to read one novel every week. 

As an Intarmed student, I actually spent a lot of time in AS, which during our time had the strictest security guards ever. I don’t remember what my grades were, except for 2.5 in Calculus. We had colorful, unforgettable professors, like the legendary Ma’am Gavino, our History instructor Sir Esguerra, our Humanities Ma’am Achanzar, and many more. Now that I’m a UP faculty now myself, I realize that when you’re standing in front of the class you can see everything that students are doing - from watching NBA games to scrolling their Twitter and reading books totally unrelated to the course. And all I could do is to tell myself: Karma is real. 

It would be nice to continue my reminiscence because I want to impart to you a glimpse of how your college memories can be a source of strength, joy, and even laughter, in the future. Maybe today, you know even the student number of your crushes, but someday, it will feel like an achievement to remember your own. 

But at the same time, I know that we are faced with more pressing natters today, amid this pandemic and the seemingly endless cycle of lockdowns. When I graduated in 2010, a new president was about to take office, but we did not have the sense of uncertainty we have today. Certainly, we did not have this pandemic that has changed every aspect of our life, including this ceremony during which I cannot even see you face to face.

And so I cannot be a guide for what’s going on today, the way a mountain guide knows the way and takes hikers up the summit. Some might use the metaphor “we are on the same boat” and that’s quite apt since the word ‘barkada’ literally means the same: people of the same barko. But I also know that the pandemic has divided the privileged and the under-privileged, and has exposed the inequity of the world - including in your personal lives. Many of you have struggled greatly over the past one and a half years, which is why surely, this moment comes with a mix of emotions, and I do not feel adequate to the task to giving justice to all of them.

Even so, along my journey in UP Manila and beyond, I would like to remind you of three things that I learned along the way that might be of help as you continue your journeys through and beyond this pandemic. 

First, always remember that you are plural. Do you remember that UPCAT application form when you had so many choices but in the end you can only take one? Life is not like that. You do not have to choose just one thing. You can choose two. Or three. Or more. Of course you have your chosen career path but don’t let your life be limited to that. Don’t let your career define you. Some of you are singers, dancers, writers, actors, activists, leaders in different fields. Do not let go of your hobbies and passions. Hold on to them like a child misses their blanket. Nothing is too petty or unimportant if it means so much to you. My mountain climbing has sustained me throughout of my life, giving me so much confidence and strength. I refuse to downplay it. It’s an integral part of my life, co-equal with my writing, with my research. They all make me who I am, and none is less important than the other. Because I loved medicine and the social sciences, I tried to find a way of combine them and I’m so happy with my career as a medical anthropologist. There are ways to mix and match your strengths, talents, passions especially with today’s technologies that have enabled you to pursue more. I actually composed songs for the musical we produced as part of Ma’am Achanzar’s Humanities 2 class and maybe someday I would like try that again too. 

Plurality, by the way, can extend to identity - you can be a proud Mindanao, Bicolano, Palaweño, Filipino, Asian, and whatever else you end up, all at the same time. At a time when we are forced to choose between different identities - race, ethnicity, gender, or even professional affiliation - we can be all of the above - or none; we should welcome plurality not as a threat, but as a fulfillment, of our individuality. I. 

Second, always remember that as individuals, you are promising, and you continue to be. No matter how prestigious your university is, no matter how big your achievements are, it is easy nowadays to feel incomplete and inadequate. Maybe today you feel that you’ve underachieved, especially if you compare yourself to others. Maybe you felt that because of the pandemic you didn’t learn enough. 

But let me tell you that the best way to look at achievement, and at ourselves, is not as a product, but a process. The UP education did not take you to the top of the mountain, it did not even take you to a certain trail, but it taught you some skills how to climb, how to find your way, and if needed, how to find your way back. And along the way, learning has to continue, like a Final Fantasy character that keeps leveling up. How can you live up to that promise, in ways that avoid what BTS calls an “imaginary swamp” of worries and expectations? In my experience, aside from the medical training itself which taught me so much about life and death, traveling has given me perspectives that I needed to know myself and to understand the human condition better. Once the pandemic ends, travel as much as you can - but do not travel so the world can see you, but so you can see the world. There are different ways to travel - you can travel to Japan and just eat matcha and sushi all day. I don’t mind that! But you can also go to the country and learn about its history, its society, not just their technological marvels but also their societal challenges. 

Aside from traveling, I would add reading, which is like traveling with your imagination.

And then there’s practice, which is essential for any endeavor in life. When I started writing a column, it took me four days to write one piece. Nowadays, it takes me around four hours. When I started writing academic papers, it took me over a year to write one piece. This year alone, I've published 12. Keep practicing, and you will get there.

Finally, you are not just plural, you are just promising, but you are powerful. I know that this is hard to say in the middle of a pandemic, it might come off as naive.

But only if we define power in narrow terms. There are things we can do, both as individuals, and as communities. I have not solved the vexing problems of vaccine inequity and hesitancy, but I’ve managed to convince at least 13 individuals - family and friends - to get vaccinated, by giving them information and vouching for the safety of vaccines. As UP graduates, you have the power to influence the people around you. On whether or not to take a vaccine. On who to vote. On even what to eat; how to leave healthy, non-toxic, positive days. To those of you who will be pursuing health related careers, you have a special power to help other people. We will not always be able offer cure, but we can always offer care. 

Sometimes, our power lies in the most underrated life skills, like encouraging people, introducing them to new experiences, and mentoring them. Somewhere in your high school, or hometown, there’s a kid looking up to you, and your words can mean so much to them. Somewhere in your community there’s a pantry, a local initiative, and your support can mean so much as well. 

Remember, you are powerful because kindness is powerful. 

And you are powerful because science is powerful and those of you who will pursue the track of research can improve people’s lives. The very fact that it’s possible to protect yourself with vaccines today speaks of the power of research to improve people’s lives and we should never take that for granted. By science, of course I also mean the social sciences, which can diagnose the ills of society, and point out to the structural barriers to our people’s health and happiness. Science can be used in the service of authoritarianism, of corporate greed, of human vanity, but with moral courage, it can also be used to challenge them, by pointing out its weaknesses, contradictions, and harm - and pointing towards sustainability and equity in our ways of life.

Finally, you are powerful because arts are just as powerful and important as the sciences. During the lockdown, when medicine failed, it is the music, film, TV series; the stories and songs that kept us going, offering the beauty and hope that reminded that the world is still worth fighting for. UP Manila is the health sciences university, and AS fits right in the middle because the arts can heal. The arts can heal, and again with courage, they can also heal our nation. 

And so, our dear students, my colleagues and friends, fellow learners, let me end not with a challenge, but with a benediction: 

May your plurality allow you to maximize your life and realize your potential.

May your promise translate to the betterment of your families, communities, and our beloved country. 

And may the power that lies within each of you lead to a better, safer, fairer, and more inclusive world. 

Amherst, Massachusetts - August 4, 2021

[Panel Discussion] Asia and the Pacific Youth Symposium - Health & Wellness

On August 18, 2021, I moderated the Knowledge Session on Health and Wellness as part of this year’s Asia Pacific Youth Symposium organized by the Asian Development Bank. Building on the first-ever APYS last year, the session was envisioned as part of an intergenerational dialogue for the exchange of knowledge and experience on pressing matters involving the region, in ways that mobilize young people as partners. 

In the event, Shruti Mehta discussed how can we reduce NCD prevalence through MYE in sports investments, as well as through youth-led behavior change on harmful habits, diet and exercise and Trisha Lamban, a 19-year old mental health advocate from the Philippines, talked about engaging her peers both online and offline. Meanwhile, Rui Liu, a health specialist with ADB’s Health Sector, shared lessons learned about youth health during the pandemic and some insights how we should approach this topic amid a so-called ‘new normal’, and Prof. Susan Sawyer provided an overview of the state of young people today - as well as the current and potential opportunities for meaningful youth engagement. 

[Speech] Medicine as a Journey: Commencement Address to UP College of Medicine Class of 2021

Speech delivered on the occasion of Salimbay: UPCM Commencement Exercises 2021 on August 8, 2021

Let me begin my saying that I am greatly honored by this privilege of being able to address you, Class 2021, this year’s new batch of doctors, and that my only regret - one that I’m sure you all share - is not being able to do this with all of us gathered together. We have taken it for granted, but now we know that something is lost when we do not see each other face to face. Something is lost in this brave new world of social distance, when we could not even gather together to celebrate this moment; a moment that recognizes all that you and your loved ones have labored to realize.

And yet, at the same time, we lose even more when we refuse to make the most of what is available to us. Whether it’s telemedicine, a Zoom lecture, a virtual gathering like this, learning must go on, healing must go on, and we are here today because we refuse to accept that this pandemic has defeated us. We are here because we believe that there are many forms of togetherness, including that involves not so much being in the same place, but sharing the same principles and values. And we are here because we believe through medicine, a future where humanity can thrive remains possible. And that the dawn for our country remains within reach. 

But what kind of medicine? In addressing you today, I wish that I could afford myself the privilege of reminiscence and reflection; of assembling some anecdotes and words that can hopefully inspire you and make you feel good about yourselves. But I know that doing so will not do justice to a ceremony that is being held amid the most devastating health crisis in our lifetimes. And doing so will not do justice to where your thoughts dwell today. And so, even as I still want this speech to be about you, as new doctors and as more-than-doctors, we must grapple with these questions at the outset: What kind of medicine can allow us to overcome the crises of our time? What kind of medicine can give people the dignity that they deserve, empower them, and actually improve their lives? What kind of medicine can you, Class 2021, offer the people? 

If we are to answer these questions, the first step is a willingness to acknowledge that while our profession has shown remarkable heroism, some of our paradigms have been problematic even before the pandemic. 

Despite paying lip service to the value of preventive medicine and the social determinants of health, the view of health as primarily a matter of individual responsibility has led to a focus on individual, mostly pharmaceutical, interventions. Healthy environments. Protected forests. Good housing. Access to quality public transport. How many times have we prescribed these human needs that are both preventive and therapeutic? Predictably, this is the same paradigm that has been applied in the pandemic, with individuals being told to do all kinds of things, wearing face masks and face shields, getting themselves vaccinated, even as what we also need to prescribe more forcefully is government action on various aspects of the pandemic - testing, supporting communities, reasonable. and as result, the burden of the pandemic has been borne by the Filipino people. 

The view of medicine as top-down, and quite frankly, authoritarian, has led to disempowering discourses, and again, this has been the case even before COVID. Convinced that all the patient has to do is to comply and follow instructions, we have not emphasized communication skills, medical humanities, social sciences, in our curricula; we have not recognized the value of therapeutic alliances with families and communities, and we have neglected empowering and encouraging individuals to take charge of their own health. As a result, we would rather trust a drug to lower people’s cholesterol instead of working with them to change their lifestyles, instead of demanding for environments where such lifestyles are possible. Again, predictably, we see this reflected in the pandemic with people, including doctors, telling the public to just listen to us, just follow us, sumunod na lang kayo.

Finally, our view of medicine as separate from politics has led to abandonment of our role as attorneys of the people, most especially the poor, and we have not heeded Jose Rizal when he told his students in Dapitan that “knowledge without courage is useless”. And so, as institution, as a profession, we have avoided hard questions of people in power; we have been quick to reprimand the powerless, but slow to call out the powerful. Is this because of another pathology in our field, which is that we are too hierarchical? Regardless, and again predictably, we see this during the pandemic, where - despite the good intentions of many of our colleagues - what we see is policies-based evidence instead of evidence-based policies. 

 Thankfully, I think that you can see through these paradigms, in pat because I know you are critical thinkers who can fact check your professors not follow them blindly. And also in part because our alma mater has no shortage of people who have asked the same critical questions; we come from a university that activism as a form of public service; and we come from a country that demands that we ask those questions if we are to survive. 

 But perhaps what you’re wondering is how you can adhere to these principles without being burnt out. And apply them in ways that actually make an impact. And, perhaps most importantly, how you reconcile them in your life, which you also want to be enjoyable as it is meaningful. 

Today, I want to contribute to your thinking by suggesting that to be effective in your medicine, you need to strive not just to be good doctors, but to be more-than-doctors. Even though medicine will be a big part of your identity, I do not think it should necessarily define you. I hope you remember that there are far more letters in your name that than the MD that you can now add to it. 

And so, please allow me to return to one of our TRP songs, for inspiration. Not just because I composed it, but because in this rare honor that you have bestowed upon me, I feel that I speak for my batchmates in Class 2010, and our collective experiences. The song’s name is ‘Paglalakbay’ and today, I would like to speak of medicine as a journey. 

The journey is more important than the destination. 

 Thinking of medicine as a journey reminds us of its uncertainty, of the risks involved, our Austronesian ancestors who sailed across the oceans, like the traditional healers who trekked through mountains in search for medicines; like the doctors of old who braved disease to bring about cure. Of course, there’a also the sense of adventure, the sense of wonder, the curiosity that can lead us to pursue research; the curiosity that can lead us to better. And the excitement that can keep us going.

But one of the things I would like to emphasize is that like all journeys, the journey itself is more important than the destination. In fact, the root of the word journey means “day”, emphasizing our daily activities - not our lifelong goals.

Doubtless, today is an important milestone. But milestones are literally reference points to see how far we are in relation to a certain destination. I love climbing mountains and I must admit that I used to think of hiking the same way, always looking at how far I am from the summit instead of looking around me for the beauty that’s already there. To just give you one example, I missed a once-in-a-lifetime opportunity to see a Philippine eagle in a mountain in Bukidnon because I was such a hurry to reach the peak and I wasn’t paying attention the trail. 

How many more years before you finish medical training? I know you’ve been asked this question many times, and you will be asked it many times more in the future. Many of you will have different answers to that question. Many of you won’t have a definitive one.

Regardless, don’t just count how many years there are before you reach your dream. Count the days and the moments you have with your family, your classmates, your friends. If your grandparents are still alive today, spend time with them. And of course, the same is true with your parents, mentors, loved ones. Life is not a mountain, or a career ladder, that you require to climb. It’s a long distance trail. Can we look at each chapter in our life - college, medical school, residency, fellowship, as equally important independent of where they lead to? 

This insight is applicable to our patients as well. Can we think of our encounters with our patients as curative acts in themselves, regardless of whether they can lead to treatment? Chemotherapy might lead to cure, but a reassuring tone, an empathetic explanation, can ease the anxieties and the pain of the moment. In a profession that’s increasingly based on numbers, we need to remind ourselves that words can heal. Words can heal, and their effects can be both immediate and everlasting. I remember a friend of mine once tell me that the reason he became a doctor is because once when he was in grade school, his teacher told him that “I think you can be a doctor” and that sentence was imprinted on his mind, giving him confidence and faith. Mindful of the value of each moment, do we recognize the value and the power of our words and actions?

This is not an invitation to disregard the future. In fact, living in the moment prepares you for the future too. If you invest in your mental health today, you can be better prepared to deal with the stresses of tomorrow. If you look at yourselves as more-than-MDs today, then you can better doctors in the future. 

And so, do that 5k run! Take that yoga class. Learn that language you’ve always wanted to speak. Climb that mountain. Play that piano piece. Write that poem; write that essay your reflections on the health care system. Pursue that research, that project, that business, that advocacy. Dance. Bike. Live! And be generous with your emotions. Open your heart to the possibilities of each day. If there’s anything that medical school should have taught you, it’s that you can never be too busy for the things and the people you love. 

This includes your own body, too, and you must be a good doctor to your own self. If I can give pragmatic advice in the middle of this address, it’s that you take care of your bodies. This is hard to do because we too are subjected to the same structural challenges that undermine our people’s health. At a personal level, what’s going on in our country can stress us out. And at a personal experience we experience the bad policies, the lack of access to public spaces. All we really had in med school was Rob Manila, which I could navigate with my eyes closed. Because of the stress and the lack of other options we loved to eat a lot and I still remember the post-duty breakfasts when we ate to our heart’s content. But you all know that by now you are reaching the age when metabolism slows down, and you have to start thinking twice before you order extra rice. Looking back, I wish I had run along Roxas Boulevard more, that I had gone to the swimming pool in Vito Cruz more. But it’s never too late to mind your own wellness. Be kind to your bodies, because you need them to be healthy and strong if your journeys are to be long and winding. 

Detours are welcome

So far, I've talked about how journey that’s more important than the destination. The second insight is that we must be open to the possibilities of detours; of itineraries that keep changing; of a journey that may look completely different than the one that you envisioned. In other words, while we have our dreams, we should also open our hearts to the world and to whatever possibilities or opportunities will come. 

When I entered medical school, I never thought that I would be a medical anthropologist. Because of all the science fiction that I read I thought it would also be cool to study neurology and be at the forefront of exploring whether the mind can ever be connected to computers. Later on, because I excelled in doing ABG and inserting IV lines in infants, even neonates, I thought I could do emergency medicine. But I’ve always been curious about cultural practices, and in fact, I think I was the first student to take the Ethnopharmacology elective in LU 5 which involved going to an indigenous community and documenting their herbal medicine. I dragged along our class president, Dr. Beverly Ho, we went to Ifugao, and we really enjoyed the experience. In succeeding years, in LU 6 and 7, I got introduced to the work of Prof. Michael Tan - who became my mentor - and other anthropologists, I realized that I could combine my passion for the social sciences, and my medical training, while being able to pursue a lifestyle in line with my other passions, like climbing mountains and writing essays. 

 Importantly, I was convinced that by articulating the cultural determinants of health; by exposing the political pathologies that hold back our nation and our people, medical anthropology is both diagnostic and therapeutic. It is diagnostic because it unearths the sources of illness, from corporations that profit from selling unhealthy food to politicians that benefit from touting populist responses to the pandemic. And it is therapeutic because it promotes empathy towards our people while demanding accountability from those who exploit people’s health and illness. 

As you can imagine, it must have been disappointing for my parents and grandparents that I would not be the doctor they might have envisioned - wearing white coat in his clinic. But they were supportive of my decision, and I do hope that you will have loved ones who will be equally supportive of you as well. Please never take their support for granted. I have to also say that I’ve experienced incredible moral support from our faculty in UPCM and I am so grateful for that.

Ultimately, though, it is still your decision. Take your time to decide. Do not count a year off as a loss, view it not as delay but as a detour. Whether it’s getting married, having kids, being a consultant, gaining a fellowship, buying a house, or reaching a certain achievement at a certain age, never allow your life’s journey to be defined by milestones set by others. Take your time to achieve your dream specialty. And to those of you who will not pursue a clinical specialty, never ever feel incomplete. Take not that precisely because of the flawed paradigms of our profession, pursuits like activism and community service may be perceived as “prestigious” as other tracks. But we can always resist and reject such ideas. And regardless of what stage of life you’re in, you can always do something else, or something more. Like the board exam that you’re about to take, and for which I wish you all the best, "all of the above” is often the correct answer. Remember, again, that you are plural; you are more-than-MDs. We are encouraged us to be five-star physicians who are decision-makers, managers, communicators, community leaders, health care providers. And I agree that within medicine, you can do so much. But at the same time, the constellation of things you do can go beyond medicine itself; you can be five star persons too.

Part of the problem is a comparative paradigm that we end up applying to ourselves. However, you can also end up setting milestones for others, including your classmates. Class 2021, if there’s anything you can do for your classmates is that you build a supportive, non-judgmental environment that will empower them to pursue their dreams. And of course, please recognize that the people, including your classmates, who have been part of your journey.

Is it worth continuing this journey?

Finally, if medicine is a journey, then like any other journey, there is the possibility not just of detours, not just of side trips, but of stopping, or even turning back. After all, being a doctor is not just an identity; it’s also something that you choose to do every day. Indeed, you may already be doctors, but it’s still a decision whether to answer that call for help, to go beyond your call of duty, to pursue advocacies, to speak out, to be involved in community work, and to do more for your patients, not just treating their illnesses but trying to address the reasons why they get sick in the first place. 

 The pandemic has made it even harder to make these decisions. COVID-19 has arguably increased the stature of heath care workers in society, but at the same time the pandemic has increased the hazards of our profession. Aside from being in the medical frontlines, some doctors are finding themselves in the political frontlines too, and it’s not just the virus that can deal us harm, but our fellow humans - especially those who are addicted to power. 

And so we ask: Is it worth continuing this journey? Is it worth pursuing a medicine that not only looks at individual patients but looks at the environment, at our politics, economy, culture, to uncover the structural determinants of health? And is it worth fighting for a life that is determined to go beyond medicine in order to fulfill your other dreams and passions? 

These are questions that only you can answer. But if we find ourselves willing to continue in this journey, but lacking confidence or hope, then there is no shortage of people whose footsteps we can follow to take it step by step. 

If an ophthalmologist named Jose Rizal can open his people’s eyes to the oppression of colonialism by using his gift of writing, his creativity, his courage, then so can we keep going. 

 If a medical graduate named Bobby Dela Paz can push for a community-based health program even if such a program is deemed an act of subversion, even at the height of Martial Law, then so can we keep going. 

If doctors to the barrios like Dreyfuss Perlas, Sajid Sinolinding, Rose Sancelan, can choose to stay in their communities despite the risks involved, they so can we chose to stay in our places of calling. 

If a pediatrician named Karen Senen can sing songs even amid COVID, determined to live a full life, determined to keep serving others, then so can we carry on, amid the crises of our time. 

If nothing else, then it’s worth taking to heart that our vocation is important because people are important, every life has value and is worth saving. When you chose the word ‘salimbay’ to christen this moment, I felt that it applies not just in illustrating your own promising, exciting careers about to take flight, but the kind of medicine you can offer: With your knowledge and skill, you can actually give people a chance to soar in their lives. Indeed, there are wings in the anatomy of hope, but at its heart is empathy, and the conviction that human life has value. 

This is why we are hurt and rightfully enraged when people, including our own leaders, trample on human rights. This is why we protest when people reject the knowledge, the evidence, the science that could save people’s lives. And this is why we speak out when we realize that we are treating patients only to send them back to conditions that make them sick. If our journeys can somehow advance this mission of saving lives, while giving you the fulfillment of living your own life fully and meaningfully, then I say it’s worth taking. 

And so in the name of all is that good, all that is true, all that is beautiful, and all that is worth fighting for in this world, I exhort to journey on, to keep soaring, to keep dreaming, to keep climbing; and to keep healing, inspiring, and uplifting others along the way. 

Mabuhay ang Class 2021. Mabuhay ang inyong mga paglakakbay. Maraming salamat sa inyong lahat.