Just came back from San Juan, Batangas. I worked on my reflection paper earlier today, and I think medyo naging OA ako with details. Ang haba tuloy ng paper ko. Hehe. Anyway, tinatamad na ko gumawa ng separate blog entry, so to imitate Lops, post ko na lang din dito. Ang haba masyado e, I think ieedit ko pa to. Wehehe.
Here goes.
Reflection Paper, Week 1
Cluster 7
(Calubcub 1.0, Calubcub 2.0, Abung, Subukin)
To say that I had my apprehensions before we left for Batangas would be an understatement. All orientations in the world could hardly prepare us for the reality that is San Juan. Despite what anybody said, we already had our own preconceived notions of what Community Medicine would be like, and I am sure we all stubbornly chose to stick to those notions until we saw for ourselves the real thing.
Coming to San Juan on that humid noon made a wave of nostalgia wash over me, as I took in the sights and the sounds that made up the town proper. Having grown up spending months at a time in a provincial setting, I felt like a little kid all over again, about to spend her summer vacation at her grandmother’s house. Stepping foot into the Rural Health Unit jolted me back to where I really was and why I was there. We were warmly welcomed by Ate Lani, Kuya Zandro, and Ma’am Arlene, who all gave us a preview of what to expect and what would be expected of us for the next 5 weeks. It was most likely that at this point, there were questions in all of our eyes, questions no one knew how to ask, questions that could most probably only be answered as we all began to immerse ourselves in our respective communities. After listening to them orient us as comprehensively as they possibly can, we then met Dr. Alidio, the town’s Municipal Health Officer, who basically told us the same things and more. He appeared to be an authority on what he does, and I do look forward to working with him more as we continue our rotation.
We couldn’t put it off much longer; the time came for us to finally be dispersed into the four different communities that would be our home for the next few weeks. Nervous but excited, we were pair by pair delivered on to the doorsteps of our foster family’s homes. Another wave of nostalgia washed over me as we trudged along the path that led to Tita Mayet’s house. It was a compound of houses that provided homes to several different families (who were all probably related one way or another), with a wealth of poultry animals and pigs. It was a sight to behold. Tita Mayet’s house was a pleasant surprise, as it was amazingly comfortable, luxurious, and more than enough to keep us satisfied. The house’s charm, however, could not compare to that of Tita Mayet’s, who was, as we fondly described her, as “cool” as foster mothers could most probably be. Not the doting or fussy type, she mostly left us to fend for ourselves, being an elementary teacher who was out for the greater part of the day. However, she would spend time with us in the evenings, making fun of our sore inability to cook, laughing at our anecdotes of the day, sharing with us her inspiring stories of victory (which is another story in itself), and endearing herself to us forever. Coming home to her house in the afternoons is something that I have begun to look forward to everyday.
On our first day, Ate Cecil (one of Tita Mayet’s neighbors) accompanied us to the Barangay Hall and Health Center of Calubcob 1.0. We met the Barangay Captain, who regaled us with stories of previous interns who had come to them. Joyce and I made up our minds right then and there that we would definitely make it our personal goal to establish a good relationship with him and the people of this barangay. We also had our initial encounter with Tita Sabel, the barangay’s midwife, and the Tuesday group of BHWs. They all smiled warmly at us and after brief introductions and talks of what we would be doing the next day. We immediately asked about the cluster meeting that was endorsed to us by the previous block. We knew we would be unable to start anything until after that meeting, so Tita Sabel decided to set a schedule for it as soon as possible (it is now set for Tuesday, Oct 28, 2pm). After saying our goodbyes, we went back home to rest up for the day.
As was agreed upon, we showed up at the BHC the next day for the ECG and Acupunture sponsored by the local congressman. After meeting more BHWs and spending some time with them, we eventually realized that we had no role to play in that particular activity, so we decided to proceed to the other barangays and get to know the people there. Remembering that Tita Sabel mentioned an EPI to be held at Calubcub 2.0 that day, we decided to make that our first stop. Two patients, both pediatric, came for consultation. We assessed and managed these patients, one as a case of viral URTI, and the other of lymphadenitis vs. parotitis. Tita Sabel expertly handled the immunizations and prenatal checkups. I learned about SLK (sampalok, luya, kalamansi) syrup, which I prescribed to our patient with the URTI for cough relief. It was at that point when I realized that we had to learn more about alternative and herbal medicines, since the center couldn’t possibly have a supply of all the medications that patients might need, and the nearest drugstore was not easily accessible to the townspeople. Western medicine can be expensive, and could possibly be an unnecessary expense if there are alternative but equally effective treatments available.
We wanted to go to Subukin and Abung, but was hindered in doing so when we were told that Tita Ditas, the midwife of these two barangays, was unavailable at the moment for she was handling a delivery (which, disappointingly, we were not able to come to – we wanted to meet her right away to tell her that we want to come along with her on her deliveries). The BHWs of Abung, on the other hand, were still in Calubcub 1.0 for the ECG thing, so we decided to put it off for another day.
The next day was spent holding clinics at Calubcub 1.0; however, only one patient, a case of bronchial asthma, showed up for consultation. The BHWs took care of the vital signs part of the examination, but failed to fill up the form for the danger signs. We were wondering how to respectfully tell them to fill it up, knowing that they’ve already undergone the training for it, but lacking confidence, we decided to let it slip this one time. However, we decided that we will be more firm in the coming days. The best way to gauge if the training they went through was truly effective is to see them apply it properly in their daily duties at the center.
We spent most of the day listening to the BHWs chat about their daily lives. Every once in a while, they would ask us to correlate medically the things they deal with everyday, such as stress, hypertension, and even pregnancy. They also gave much ado over this magnetic bracelet that was sold the previous day at the ECG and Acupunture (costs ranged from P2500 to P5000). They talked of choosing to buy the bracelet over buying maintainance medications for hypertension and high cholesterol levels, believing it to be more effective. It was disheartening. However, we couldn’t impose our knowledge on them since they didn’t ask. Personally, I am all for alternative medicine. I have practiced acupuncture in the past and believe in its therapeutic benefits. But to believe that a magnetic bracelet could become a substitute for other medications could only be detrimental to these people’s health. Health is a right – people, whether they are aware of it or not, actually do lay claim on that right by doing what they believe is best for them. But it is right knowledge that leads to right decisions. In part, it is our responsibility to share what we know with them, so that they may be able to make wise health decisions for themselves. Access to health care once they've made their decision is another issue altogether.
The rest of the week was generally the same – getting to know the people of the barangay, their health-seeking behavior, their lifestyle, and more. It feels much like being invited to take part in a play where all the parts have already been decided and we were just but mere additions to the already colorful exhibit. Cluster 7 is a fully functional group of barangays – but that’s not to say that there’s no more room for improvement. I still hold the same beliefs – the changes that might happen won’t probably be so drastic that concrete improvements can be seen immediately, but I sincerely believe that subtly, slowly, we are making progress in working together with the community for the betterment of the health and health care situation of the people of San Juan, Batangas.
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MOA ako kapag asa San Juan beh. Super! Mwah!
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