The Good Doctor

Dr. Rainier is by no means a large or intimidating person; his eyes light up at the prospect of discussion and his passion for health care permeates from his every word. I met the good doctor outside of Aluna Bar in Alona Beach, Bohol—after spending the evening together, he told me he had not “partied like that since med school.” How he made his flight to Manila is a mystery which I will never be able to solve.

At the young age of 34, Dr. Mozo Ranier is one of the youngest medical directors in the Philippines. Quickly we realized we were kindred spirits and our friendship began. He invited me to the island of Cebu where he was scheduled to visit the newly opened clinic for Derma Clean skin. During the visit, I asked to interview my friend; he was elated talk about Filipino health care.

During my time in the Philippines I have witnessed a good bit of medical difficulties and met several doctors with whom I have discussed the common ailments which afflict the Filipino people. Unsurprisingly, most of the problems are preventable, but worsen to a critical state as health issues are usually left untreated. However, the severe number of deaths on the road is another large problem, but road safety is another topic.

Over drinks one night I spoke with another friend of mine, Bal, about my upcoming interview with Dr. Rainier—Bal quipped, “health care? Ha! ’Just bag em’ up, but don’t worry— we use recyclable bags.” Although my friend was half-heartedly joking, a certain sense of sad truth emanated from his dark humor. The frustration of the Filipino people is palpable; nearly every person exhibits frustration at the lack of ability and cost of health care.

Most Filipinos simply can not afford the cost of health care on their salaries, on average about 7$ a day. The cost and lack of funds leads people to opt to let that tumor grow, or ignore that heart murmur instead of attempting to treat it. Problems which could be solved by an initial visit to the doctor become life-threatening and then the care required is completely unaffordable.

HIV and Prominent Diseases

The country’s wet and humid climate creates a breading ground for diseases such as dengue, typhoid, and malaria. In addition to climate, the religious atmosphere promotes abstinence only education in schools. The lack of sex education leads to copious amounts of women’s reproductive issues ranging from ovarian cysts to families of unsupportable sizes.

Sexually transmitted diseases are common as well; the HIV rates are some of the highest in the world. Coupled with Catholic shame of condom use, lack of access to information, little care available in rural areas, and stigmatization of the disease enables HIV to take many more lives than necessary.

One friend of mine has put off having an HIV test for weeks simply because he is afraid to know whether or not he is infected— the priority of safe sex and health care is a second thought to the fear of the disease. This mentality is common in the Philippines, it is better not to know what is wrong.

Religion in the Philippines

Culture is the most difficult aspect to change when a shift in society needs to happen. The stranglehold of Catholicism ensures proper sex education is unavailable and the proven ineffective method of “abstinence-only” sex-ed is the only source of instructed information

The lack of education leads to reproductive issues and STD rates being some of the highest in the world. These are problems which require a paradigm shift for the Filipino people and government. However, the inaction of those in charge is challenged by social which helps inch people in the urban areas towards the modern and more sustainable direction proper sex-education. But at the same time, large amounts of misinformation flood the internet. However, rural areas are left out of the discussion as the access to internet and communications is drastically limited in the less populated regions.

As I stood at a beauty pageant this past month, I leaned in closely to hear what the girls had to say to a “hot button” hasthtag prompt. The two questions which were the most poignant for me were “#HIV” and “#PremaritalSex”; the response to HIV was “HIV is a disease and it is bad for our community.”

The response to “premarital sex” was even more saddening, the contestant beamed, showed off her legs and proclaimed, “premarital sex is a sin and we should not do it.” As the pageant contestant exhibited her scantily clad body—in all its irony—to the crowd, each member audience looked down to the ground shamefully.

The sex education, or lack there of, is exemplified perfectly by these answers. A people who—due to the lack of education promoted by archaic religious views on sexuality— recognize their own problems. Based on many discussions with Filipinos, the overall sentiment is helplessness to make any change in a system so entrenched.

A cultural aversion to discussing sexuality leads to copious amounts of problems for the friendly and loving people of the Philippines. A joyous and hospitable people who have a tendency to celebrate with rum, a lot— and we all know what happens when you have liquor, music and sun…in the great words of my friend Paul: “oh ya! They’re gonna make a boom-boom!”

As a woman who has spent time in several Catholic developing countries, I have noticed HIV rates and unplanned pregnancies are at their highest in these areas. My observations only solidify my notion that religion adversely affects medical availability, STD rates, women’s reproductive rights, and access to education. With that said, many people in the Philippines would like to see change and do not have an aversion to discuss sexuality, but the foundation needed to fully understand the science of sex is just not in existence for most people.

Unconventional Approaches to Health Care

For many who live in the poverty draped areas of the Philippines, it is more probable a patient goes to a witch-doctor and uses local, ineffective remedies instead of seeking professional medical advice. The lack of medical providers in addition to a population inclined towards superstition facilitates an unchecked environment for disease and preventable ailments to thrive.

An example which comes to mind is a friend’s wife feeling faint for several days; she went to her witch-doctor and was recommended to bury a placenta—a placenta of what I have no clue— under her house. A few days after performing said ritual the woman said her symptoms were gone. Placebo effect or not, many Filipinos trust an affordable local—mythical— remedy to the expensive words of a doctor.

Diet

The diet of the people also fosters many medical problems; consuming foods with high salt levels such as: salted fish, sardines, and pork. The high-sodium levels int he local diet promote high blood pressure which leads to heart disease and a myriad of other delightful problems. The unhealthy foods swarm the aisles of grocery stores, meanwhile young children’s teeth rot as they guzzle soda. When you consider most Filipinos do not have the money to afford a healthy diet or visit a doctor, Bal’s analysis of “bag em’ up,” is far too realistic.

The Future

However, as problematic as things might seem, Doctor Rainier is optimistic about what lays ahead for Filipino health care. A universal health care bill is in the works and PhilHealth already exists for people to enroll. However, the costs and bureaucratic maneuvering keep most Filipinos out of the system and paying out-of-pocket; which just means those poor people are fucked if any health issue arises; destined for the “bag em’ up” section of the hospital.

The problems which face the Philippines for health care will in no way be solved over night, but better health care will become an option as long as efforts are made to ensure better pay for doctors and nurses, mitigate corruption in health fund management, offer more affordable access to health care, ensure the availability of comprehensive sex education, and begin to tackle the momentous task of traffic management. Traffic might not be a concept most people would equate to health care, but hours in unmoving traffic leads to people in ambulances dying in heavy traffic; no one moves out of the way of the blaring sirens. Health care which is needed as soon as possible comes second to rush hour traffic, and every hour is rush hour in the cities.

The Philippines is certainly faced with an arduous task to reach modern standards in its availability of medicine; but with that said the doctors are very well trained and educated. When given the necessary tools, the medical practitioners are very knowledgable and able to provide great health care. Foreigners— specifically Americans, because ya know, our health care system is fucked— find health care is much less expensive. However, health care is miles away from being affordable to the average Filipino.

Singapore is a role-model to which the Philippines esteems to emulate; although it might take time to get to that status, the dedication of people, like Dr. Rainier, will take the Filipino people far in their journey to become a healthy country.