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November 16, 2011

The Tale Of Two Towns

Today I arrived from Dipolog on what technically became my official travel-work with my new job. For what seemed to be only 1 day and a half, I traveled together with the President of the Zuellig Family Foundation to two municipalities which are "under the care" of the ZFF. These towns are the municipality of Mutya and the municipality of Siayan in ZamNorte. My role was basically to help gather insights from the experience of these two towns after they received some training and coaching from the foundation through the Zamboanga Health Alliance program. It wasn't my first time in Dipolog. The first time was actually almost one year ago when I was invited by ZFF to be one of their resource speakers for a training held in Dakak. I touched down in Dipolog and traveled to Dapitan. This time, it was my first to go outside of Dipolog and visit two towns and really go down the barangay level to visit and observe their own local health systems. While on the way, the President (former DAR secretary Prof. Ernesto Garilao) and I were discussing the things we would be expecting from this visit. Upon arrival at the airport, we were met by a fellow ZFF staff (Derkie) and the Assistant Regional Director of the DSWD. We were then rushed to the town of Mutya where the Mayor himself was already waiting for us.

Along the way, Derkie was kind enough to brief me about the place, being new to the ZFF. While traveling to Mutya, it brought a lot of memories while I was still working as a DTTB in Negros Occidental. It has been awhile since I saw myself in blue jeans and backpacking in the rural area, conversing with midwives and rural health workers. The town of Mutya is a 5th class municipality and its health picture is typical of a large majority of our municipalities especially in far flung areas. But despite the limitations in budget, the MHO (who is a former DTTB, Doc Felicita Sampul) together with her Mayor and health staff were able to initiate and sustain the health programs especially those geared towards Maternal and Child Care. While the statistics are still below the standard, the system is already in place. What the town needs is an augmentation in their resources. Speaking with the Mayor of Mutya, one can definitely sense that he was sincerely giving focus on health and he was definitely supportive of health. Perhaps what he needed was a little "coaching" on some technical aspects, the "how-to's" in improving his local health system. We spent a large amount of our time in the barangay health station in one of the town's far-flung barangay. Seeing the BHS midwife and her lone BHW (looking over at least 150 households all by herself!), it brought me back to my own experiences while I was a DTTB, when I would visit Brgy. Gatuslao or Brgy. Agbao (two of the farthest barangays in Candoni) or when for the first time I went to Sitio Nava, one of the farthest sitios in the municipality. It was heart-warming also to see the town's Mayor visiting these areas and looking receptive to the ideas and top-of-the-head suggestions that we would tell them on how to further strengthen what they have already initiated.

After spending the night in Sindangan, we left for Siayan early morning today to visit the Mayor of the town and her rural health workers. Siayan used to be the poorest municipality in the entire Philippines. It is now I think a 2nd or 3rd class municipality. The Main health center of Siayan was better-looking than Mutya perhaps because they have more financial resources than the previous town. But what caught my attention the most was how, after talking with the Mayor for a brief moment in her office, the Mayor was so genuinely focused on improving the health outcomes of her municipality. One intervention the Mayor did was to address the lack of health workforce in her municipality. Health workers are indispensable and it is important that our local chief executives recognize this. Because of this practical approach to addressing her health situation, the mayor was able to improve her town's health outcomes. There are still some areas that need to be improved further but just like the town of Mutya, Siayan's systems are in place.

We did a quick visit to one barangay health station in Siayan where we had tinanok nga saging. After commending the rural health workers for a job well done, we rushed back to Dipolog to catch our afternoon flight back to Manila.

I feel optimistic despite the predominating cynicism towards our local politics and health systems. It is definitely important to address the issue of leadership and governance. When our leaders are directed and guided towards prioritization of health issues, the local health systems will definitely improve. It takes a lot of transformation on the part of our politicians, most of whom are non-medical professionals, to own the responsibility for their health situation. I am a believer in the idea that to affect change, we must first and foremost intervene at the level of our leaders, make them more accountable and teach them the skills to communicate to those below them the preferred health realities.

It has been barely two weeks since I started with ZFF. I, just like our health systems, still have a long way to go.

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