Tiago Villanueva: Medical mission in the Philippines

Tiago_VillanuevaI’ve recently returned from a medical mission in the Philippines. Despite the frequency of natural disasters striking the country (typhoons, earthquakes, floods) and the reputation for being an extremely unsafe country, it has an enormous natural appeal to me due to my Filipino roots.

I was very eager to go this year since the demands and rigid timings of general practice vocational training never allowed me to take time off to go. But being a locum GP has a few advantages, and one of them is definitely the possibility of having more control over taking time off when I simply want to.

Apart from its bustling and vibrant capital, Manila, and world renowned tourist resorts like Boracay, the Philippines, with its more than 7100 islands, has many remote locations where it is extremely challenging to deliver healthcare. So I joined an organization comprised mostly of Filipino-Americans which target indigenous communities, who tend to live in far-flung areas where healthcare is scarce. In previous years, these annual medical missions targeted the Bajau people, in the South of the Philippines, but they have moved recently to the island of Palawan, and the focus has thus shifted to indigenous groups like the Tagbanua or the Tao’t Bato. The latter are known for living in caves.

One particular aspect of these medical missions is the vital role played by the region’s armed forces, who provided accommodation at their headquarters, logistics, transportation, protection and even healthcare provision. Travel to the mission sites took several hours usually through rough, unpaved roads in a military convoy.

Apart from being my first medical mission, it was also the first time working alongside military doctors and nurses. Many of the healthcare professionals from the armed forces have tremendous experience dealing with trauma in soldiers injured in the war raging in the South of the Philippines, where the country’s armed forces have been fighting for decades with Muslim terrorist groups who are seeking the independence of some Southern areas from this largely Catholic country.

This was also my first time practising medicine surrounded by heavily armed soldiers. I had to stop myself from thinking that I had a soldier with a granade launcher behind me all the time!

I worked shoulder-to-shoulder with a nurse (who also acted as a translator from Tagalog, the official language of the Philippines, to English), and saw hundreds of patients, who would line up in the scorching heat for hours without complaining. Most families I saw have at least four or five children, since contraception is not widespread nor very encouraged in the country due to the influence of the Catholic church (divorce is not even allowed). Many indigenous people don’t speak Tagalog, so I often required a second translator to translate the indigenous dialect into Tagalog.

I came back home thinking about the small children who have it really rough compared to their counterparts in the west. I saw many children carrying water containers by foot for hours in order to stock up at the nearest well, and who also walk long distances to go to school. Most patients walked for hours from their remote homes in the mountains to access the mission sites. Portugal may be facing hardships like never before, but its woes are those of a developed first world nation. Ironically, no one talks about “crisis” on that side of the world, and people seemed to me to be more cheerful and optimistic despite the fact that their health problems are often related to issues such as lack of sanitation, hygiene, and access to clean water. We take too much for granted in the West…

Tiago Villanueva is a locum GP based in Portugal, and former BMJ Clegg Scholar and editor, StudentBMJ.