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November 20, 2014

Why I Left The Philippines and Why I Came Back

Four years ago, I did what I never imagined myself would do as a medical professional: 'betray' my country. At least, that was how it looked like for me. I was one of those who would criticize fellow professionals- doctors, nurses, therapists, teachers - who would leave the country in exchange for better incomes. I would lambast them in my tweets and facebook posts, condemning them for bartering their patriotism for a better life. Traitors. 

I never expected that one day I would be placed in a similar situation. Worse. I never expected I would choose to leave rather than to stay. 

It must be said that I chose to be a doctor not only because I wanted to "serve humanity" as the cliche would go but of course to earn a more than decent living that would support my family. Doing the right thing and getting paid for what you love to do is not bad or wrong. But the economical reason took a far back seat from the personal aspiration to really make a difference. I got attracted to this calling even before I became a medical student. I was exposed to the social injustices and I could not accept the fact that people get less quality medical attention simply because they are poor. Thus, after I got my medical license, I immediately applied to become a doctor to the barrio. It was not a pay back or return of service. After all, I was no State scholar. It was my way of responding to the challenge. In the struggle for equity and social justice, one cannot simply stand at the sides and be a spectator. 

I did not consider myself a 'hero' but somehow I did thought of myself as a true patriot, not like those 'traitors' who left the country and worked abroad, serving foreigners who are more likely able to access and afford their health care unlike so many Filipinos who die without getting the needed health care. At least 6 out of 10 Filipinos die without even seeing a medical professional. 

For almost 3 years I served in a far flung poor municipality in the heartland of Negros Island. It became my home and my staff became my second family. There were ups and downs but things were manageable until that day came when I felt 'betrayed' by the government that I thought I have served best. 

Returning from the CME of the DTTBs in Manila, I soon found out that the town, out of nowhere, had appointed a new doctor who would now function as the new municipal health officer. This happened even after the fact that I already told them I would accept their initial offer to be absorbed as the MHO of the town. The fiasco was eventually settled but the hardships did not end there. Later, I found out that the move to replace me was really part of a larger political scheme and I was merely a collateral damage. 

When the new administration took over of the town, I knew that it was my time to go. So, before they could even humiliate me, I picked up whatever integrity was left of me and resigned. 

I resigned with a heavy heart. I never expected to be 'rewarded' with such ingratitude. My government did not protect me. I felt I was sold out. I felt I was forgotten. At the age of 30, I became a cynic. 

Unemployed, I started looking for other work. Teaching part time in a University was not providing enough resource to sustain even the most basic need of the family. I thought of applying for a residency training but somehow the emotional baggage was clouding my decision making. "What did I do wrong?"

I was then furious. Mad. Angry. I thought I did not deserve this. "If they don't want my service, then I will find some place where my skills will be appreciated." 

Then I saw an ad online about an opportunity to work abroad. It took a lot of internal struggle. But after submitting my application and three skype interviews later, I received an email bearing congratulatory remarks for being accepted to the position. Six months later, I saw myself standing outside of NAIA Terminal 1 pushing a heavy cart of luggage, with a ticket to the U.S., a passport with C1-D Visa and a seaman's book. I was going to be a doctor working on a cruise ship. 

I tried to resist and push away the image in my head, of me being an OFW. I could not bear leaving my family. I could not stomach the idea of "betraying" my country. I was supposed to stay, to serve in the countryside, in the frontlines where people are in need of my service, of any type of medical service. I was angry with myself. 

But perhaps it was the best thing to do at that moment. I had to leave. I needed to leave. So I boarded my plane burdened with unrequited love for country. 

The first three weeks on board the cruise ship was tough. Thankfully, my new support system was my 'Filipino mafia', an endearment I would call my fellow Filipino shipmates who have been OFWs for quite some time. I got front row seats watching what it looks like living the life of an OFW. I would hear sad stories of separation from and joyful tales of reunions with their families. At times I could hear them 'baby talk' over the phone as they call their children back in the Philippines, with their eyes glistening with tears. 

Eventually I was able to adjust and life on the ship became acceptable for me. Looking back, the months I stayed on that huge cruise ship were a few of the best and memorable moments in my life. I was earning better, way better. My family was loving it! Thanks to the internet I would skype with my kids almost every night and every time our ship would dock in Cozumel. I missed them. But I became 'happier' now that I was earning for my family. 

But the Ghost of The Past kept on haunting me. And just as I was beginning to be comfortable with my 'ship life', I heard the words loud and clear, "Quo vadis, Doc?" And they sounded like the voices of the people I met in the barrios. It sounded like the voice of a mother who walked miles and miles just to bring her newborn to my clinic because of bleeding. It sounded like the voice of a child whose father was murdered and had to take care of an older sibling who was experiencing weakness of both legs. It sounded like the young mother who brought her 1-month old child to the RHU asking if we knew of someone who would adopt her child because she was not ready to take care of it. 

"Quo vadis, Doc?"

I could not take it anymore. I knew I had to go back. There was an unfinished business to attend to. After deep reflection, I told my wife that I have decided not to renew my contract and instead go back to the Philippines to continue the work. I contacted some friends and was fortunate enough to find an opportunity to work for an NGO focused on health systems development. The irony of it all is that they do health systems devleopment through the political and health leaders of their partner municipal governments. I had to face again the very reason why I left in the first place. 

It felt like I had to give this love relationship for the country another chance. I had to undress the cynicism I wore upon myself and re-think the way I saw things in government and government leaders. Thus, a few months after I returned to the country, I started working again in the field of public health. It was a huge cut from my previous earnings. I had to relocate in Manila, far from my family in Bacolod. And I had to 'teach' -no, transform- mayors and health officers with leadership skills that would enable them to address their health challenges. 

I thought I would not last long in this NGO. 

But gradually, I met mayors and doctors who were genuinely for change and passionate to make a difference. Every after my lectures, one or two mayors or doctors would quietly approach me and tell me how they appreciated what I just lectured. Visiting them in their areas, I found myself "coaching" them, journeying with them in their struggle to improve the health outcomes of their own communities. I thought I was the one transforming them. Without them realizing it, I too was being transformed, renewed, by their own transformation. 

There was a time when I felt that changing the system would be a losing battle. But every time I hear the stories of these leaders I would meet in my work, I could not help but feel hopeful that "maybe, just maybe, some things are not impossible" 

It is this same hope that pulled me back to the Philippines. It is this same dream that keeps me where I am now. The work is tough, as it has always been, and there are days that I would think, "Did I make a mistake  in going back home?" And yet again I would hear an affirmation from a mayor who would say, "It was because of what you have told us that we were able to do all of these." Or from another mayor who would tell others in public after sharing her accomplishments in health, "that's because I have the best coach." Or from another mayor who would simply send a text message saying, "Thanks doctor!" 

One day, one of my medical students told me that while doing her rounds in a medical ward, she came upon a newly admitted patient. After asking the patient's history, she found out that the patient was a resident of the town where I served as a Doctor to the Barrios. So she mentioned my name. "She told me Doc that you were the only one who was able to diagnose her condition when you first saw her. She still remembers you," my student told me. I told my student that I was actually trying to recall her. "Isn't it nice, doc, that your patients still remember you? They still remember us." 

It's enough to say that it was worth the trip back home. 


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