Thursday, December 25, 2014

Hospitality on Christmas

We went to a non-Christian country during the holiday season. There was a holiday spirit but not necessarily a Christmas celebration. People were coming from different places to have a vacation. We looked for a place where we feel welcome as visitors. But no one bothered. Everybody was too busy with their own stuff. Everybody was settled in their own comfortable places. We stayed in a backpackers inn as there were no more available hotels during this time.

It was quite an experience going to our inn. We had to walk for almost a kilometer from the nearest train station before we could reach the place. We walked carrying four big luggage plus our backpacks while tagging along 3 kids and walking on sore foot and broken ankle. When we reached the inn, the inn was full. We had to wait until late in the afternoon because the room still needs cleaning and the previous room occupant has not yet checked out. So we had to wait in the crowded lobby - standing. It was really a tiring but learning experience for me.

Our Christmas vacation made me reflect on the story of Mary and Joseph as they were traveling to Bethlehem and were looking for an inn that night. All the inn was full. Maybe they were as tired as we were, NO, much more tired as they had to walk and ride the donkey while we rode the bus and train. They had to walk for several kilometers while we only did one. We were fortunate to find an inn, although we needed to wait before we could settle in, but Mary and Joseph had no room for an inn. And so they settled for the manger. Our Christmas story this year was quite an experience that will change my perspective of the merry making holidays. Hospitality takes on a whole new meaning. The Christmas story of Mary and Joseph and the unborn baby changed the world. Do we have a room for them in our hearts?

Monday, December 22, 2014

Advent and Christmas

It's not yet Christmas. It is December. But it is still Advent.

December 25 is Christmas. Merry Christmas.

Below is an Advent Sermon I delivered during the Simbang Gabi on December 20 in Kamuning UMC leading to the Christmas Season.

Advent: Waiting for the coming
Luke 1:26-38

Who among you already had their Christmas party? How many of you opened their gifts already? How many of you have their gifts still wrapped? We are teaching our kids to also wait until Christmas. We already gave Christmas gifts to our kids as early as November, but they are not yet opened until now.  This will be the message for us this early morning.

We are on the third week of Advent. Advent is a season of waiting – hopeful waiting. I hate to break the bad news, but in the Christian calendar, it is not yet Christmas. It is still advent, the season of waiting – a time of anticipation and expectation… expecting for the coming of Jesus and anticipating for that day to celebrate the birth of Jesus on Christmas day, and hopeful waiting for the second coming of our Lord.

Our story this morning is about that anticipation period. The time before Mary gave birth. This is the time when Mary became pregnant and had to wait for that first Christmas.  This was about a little teenager girl. Imagine a girl – in a patriarchal society, she is considered a second class citizen. This is a child – in a society, she is innocent and without experience. She was given a task by God and the task is big – to bear a king.

Let us focus as our story tells us that Mary will be pregnant. She will be expecting. She will be waiting for nine months until the boy whom Israel has been waiting to be their messiah will be born. I remember princess Kate and prince William when she got pregnant with her baby two years ago. It was all over the news, people were excited, not only English people. People were waiting and anticipating, they even camped outside the palace and the hospital during the due month. She will be the mother of a future king. People asked, “is it going to be a boy? lalaki kaya? Healthy ba yung baby paglabas? Guapo ba?” How did the Princess feel? Ano kaya yung iniisip niya? Ano kaya yung pressure sa kanya to be expecting a baby king? But that’s for a princess. How about the commoner? Yung ordinary pregnant women?

What is it like to be expecting a baby and waiting for it to be born? I had a patient who became my friend (Gina) who wanted to get pregnant. They were expecting to get pregnant for years. They waited for the baby to be born. They got pregnant after more than 7 years of waiting. While they were waiting, they were also preparing. While waiting for the baby to be born, there needs to be preparation. As doctors, we help the family, the father, especially the mother to prepare for the coming of the newborn baby.  

Pregnancy is a time of preparation. “Nine months of preparation yan.” You need pre-natal care. We make sure the mother is healthy. Regular check up is needed to make sure no infection that will jeopardize the pregnancy. We need to provide nutritious food and vitamins to the mother. Also given is vaccine to the mother to make sure no  infection happens. Then we need to monitor the baby inside that it is healthy. We do an ultrasound. We check the movement of the baby and the position of the baby. We also tell the family to prepare a baby bag ready to be brought during the due date. We ask the mothers to prepare a duster during that day. We ask the father to prepare diapers, ready some medicines that will be necessary during the birth.

Pero hindi ko pa rin maintindihan hanggang ngayon, kapag may nanganganak at dinala sa ospital yung tatay wala pa ring tsinelas. Kapag hiningi mo yung lampin, yung mga gamit, dextrose, gamut wala daw. Wala din daw dalang pera pambili ng gamut sa botika. Emergency daw kasi kaya nakalimutan. Nine months siyang nagbuntis, they were expecting for this day for nine months pero wala pa rin preparation. Emergency pa rin. Hindi napaghandaan.

The Advent season is a time for us to prepare ourselves as we wait for the coming of our Lord Jesus. Most of us are unprepared for that coming of Jesus. As Christians we are like Mary, we are made pregnant by the Holy Spirit. That is the good news. The Holy Spirit has filled us. Within us, we bear the image of Christ. But many of us are not ready to give birth to the image of Christ.

We fear and doubt that great things will be accomplished. We cannot do it because we are too small, we are too weak. We are just simple people. The Nobel Peace Prize for 2014 winner is the youngest winner. She is a little girl. She is only a teenager, 17 years old. She is Malala Yousafzai. She is a Pakistani. She is advocating for women to be educated. She wrote a blog for this advocacy because the Taliban ban the education of girls in their country. When she became famous because of this advocacy, the Taliban tried to silence her and shoot her in the head. She survived it.

Educating little children and forming them in Christian values is a preparation for these children to become willing instruments of Gods plan. We need to prepare them early and properly to become willing instruments of God. The world will experience the saving grace of Jesus in feeding the hungry, healing the sick, pulling down the wicked, finding the lost, through the body of Christ today.

We join the anticipation of the pregnant Mary. She anticipate the birth of a child who will deliver Israel. Mary was told that his son will be the king who will reign over the house of Jacob forever. We anticipate that day when the hungry will be filled, the rich are sent empty, the sick healed, the humbled lifted. As Christians, we are made pregnant by the Holy Spirit with the image of Christ. We wait with hope, we wait with joy, we wait in solidarity with all who suffer. We wait knowing that it will come. As we wait, we know that God is with us as all of us are pregnant and filled by the Holy Spirit. The challenge for us, are we ready and willing to give birth to Jesus Christ in our life?

Friday, December 19, 2014

Welcome to the Children's Christmas Party

Welcome to the Annual Christmas Party of Joy Kiddy Garden Learning Center. 

This event is very important and special for our kids and for our family. It has actually become a sort of family tradition. We have been coming to this party every year for the last four years because my kids are here. Two years ago, my daughter Neya and her friend Ayela were the ones singing. This year my son Ken and his classmates are celebrating Christmas. Next year and the following years, my pamangkin will still be here so andito pa rin kami. So it is like a family tradition. Speaking of tradition, the Simbang gabi every 5 o’clock here in the church is another tradition that I invite you to attend. Lalo na bukas, because joy Kiddy is the host. Lalo na at guapo daw ang speaker bukas. Artistahin.

I would like to share a story as a reminder of what our Christmas party is all about...
Once upon a time, there were two siblings - a little princess and a little prince who was invited to a birthday party of a king. They were so excited to go to the party because they know it was going to be fun, with lots of games, singing, dancing, yummy foods, and they know that the prince will also give away gifts to those who will attend the party. The boy prince was excited what will be the games in the party? How will he win the games? Will there be good prizes for the games? The little princess was also excited with the party. She wants to wear her pretty dress going to the party. She wants to dance and sing. She was also curious what will be the gifts the baby king will give to them for attending the party. They enjoyed so much the party that they were excited for the party again next year and the following year and the following year.

At the end of the party, the king said he will give away special gifts to his friends who attended the party. The king said he will give mansion castle/house and lot to all his friends. And so the prince and the princess were excited because they participated in all the events in the party. They were pretty sure that they will receive the special gift from the king.

So, the king was giving away the gifts to his friends, and then the prince and the princess came to the king ready to receive their gifts of a new mansion castle. But the king, asked them, who are you? Are you my friends? The prince said, your friends are my friends. I joined them to celebrate your party and I also played the games and won prizes. We are friends. The princess said, I came to your birthday party in my prettiest dress and I dance and sing and had fun in your party, we are friends.  But the king said, I don’t know you. Even if you celebrate and join my party during my birthday, you did not bother to know me. You never talked to me, you never came to me and greeted me, you never played with me, you never approached me. How can I be your friend? Coming to my party and enjoying it does not make you my friends. You should approach me, talk to me, play with me, build a relationship with me, that’s what makes friendship.  A birthday party only becomes special celebration and fun if you are friends with the birthday celebrant.

As we have our Christmas party, I hope that each one of us here are friends with the birthday celebrant – the king of kings and lord of lord, Jesus. Merry Christmas and I hope we will all have a fun and special celebration with this Christmas party.   

Thank you and God bless.

Saturday, November 29, 2014

Why not medical mission and other Frequently Asked Questions

Every time I talk about having a better health ministry other than medical missions, people ask a lot of questions. Here are some quick answers to questions about why we should move forward and level-up from doing medical missions. Remember, we are referring to medical missions which are one time, big time events for purposes other than improving health. Again, medical missions are beneficial to a certain extent but there is a better way to do health ministry especially in resource poor developing countries – community-based primary health care. For suggestions on other health ministry visit this post.

First, would we rather allow people get sick or go to albularyo instead of giving medical treatment?

The question assumes that the albularyo is a quack and only western medicine is valid. This question also assumes that only medical professionals can help people get well. Traditional and Alternative Medicine is recognized by the WHO and the Alma Ata Declaration as an effective tool to improve health. The Philippines declared November as Traditional and Alternative Medicine month, just so you know. Now albularyos cannot address all kinds of illnesses but to dismiss them all as non-sense is wrong. And, NO, people need to be empowered to take care of their health. We know that health professionals are partners with their patients in improving their health. The short answer, NO, there is a better way than the messianic approach of giving the people good health vs. empowering the community to take care of their health. 

Second, this is our medical mission should we not do it our own way?

The NGOs, private groups and societies must partner with the government in giving health care. Medical services is a responsibility of the government, we do not compete with them. Rather, we work with them and complement their job. The quick answer, private groups must coordinate medical mission with the local government health unit.

Third, our medical mission targets prevalent disease in the community. Does it not help?

Yes, it helps. But it usually is just a temporary solution to a deep problem. One serious question needs to be asked about what makes that disease prevalent in the community? The common TB among Filipinos may be due to the poor sanitation and congested living condition of the area. Giving medicines is a temporary solution because after they are treated, they will still go back to the same living situation that caused the disease. Educating the community, empowering them to take responsibility of their health and helping them improve their living condition will better address the problem.

Fourth, cannot medical missions by religious groups plant the seed of God’s love for them to be transformed in God’s own time?

All of God’s reason for action is born out of God’s love. For God so love the world he sent His only son to heal the sick, feed the hungry and give them life. Medical missions as expression of one’s love to the other by making sure he gets healthy are praiseworthy. Health is the purpose of the health ministry. But if the mission is to persuade them to convert and become members of your church is another story. There is a big theological difference between the two, (something that I might have to write on a separate post.) Simply put, there is a difference between healing a non-Christian because you want him to believe what you believe, and healing a non-Christian because you want him to be healed – as an expression of God’s love.

Fifth, why not medical missions?

Medical missions have some benefits especially if done the correct way. But the point is there is a better way to do health ministry other than the medical mission. A way that is more cost efficient and sustainable. There is a method that improves not only an individual’s health but also that of the whole community. It is called the community-based primary health care. And it is time we have this kind of ministry. If there is a better way, why settle for less?

You might also want to read: Why doctors do not join medical missions?

Friday, October 3, 2014

What is a YPHEr? 3 Things You Need to Know about them

YPHEr is short for Youth Peer Health Educator. A YPHEr has been called other names like y-peers, ARK youth, young educators and other similar names. The YPHEr is part of a global movement that believes in harnessing the power of the youth to be social agents of change. Church groups and faith-based institutions can train YPHErs as part of their health ministry program. But what can a YPHEr do?

Here are 3 things you need to know about what a YPHEr:

1. A YPHEr is an educator.

He or she educates a fellow youth about health issues and concerns that greatly affects the youth today. The YPHEr has gained knowledge and skills about health issues affecting him/her. These health topics usually includes smoking and drinking alcohol; drug abuse; HIV,  AIDS and sexually transmitted disease; obesity and nutrition; and similar topics. The YPHEr can engage in casual conversation their peers about these common risky health behaviors and advocate for a healthy lifestyle.

2. A YPHEr is not a counselor.

Although a YPHEr has some skills and knowledge on health issues for the youth, they are not professionals that can give expert advice. However, YPHEr can always provide peer support and guidance to their fellow youth. A YPHEr is a friend ready to lend a listening ear to whoever needs it. If necessary, a YPHEr can assist his/her peer where to seek professional help when needed.

3. A YPHEr belongs to a group.

A YPHEr is never alone. He or she is part of a global movement of youth changing the health lifestyle of society. The YPHEr belong to the "good" pressure group as they advocate healthy lifestyle practices. They know there are many other young people that share their behavior and practices and they are part of that good crowd. With support from fellow YPHErs, the youth can better resist the temptations of risky-health behaviors.

A Youth Peer Health Educator program is one health ministry that you and your church can do. Ask around if there are workshops available for your youth group. You may also invite us to facilitate one for you.

There is one upcoming event in the next few weeks in Leyte.

Join us and be part of the YPHEr crowd.


Wednesday, September 24, 2014

Five Activities for your Health Ministry

Empowering the people to take care of their health is a great strategy for any organization or church health program. It is not like the one-and-done big time medical missions common today. This strategy focuses on prevention which is more cost-effective and has greater impact to the community.

Here are five activities that the church can do to improve the community's health status:

1. Health Forum and Workshops

The church can host a forum on pressing health concerns in the community. This can be an educational forum to teach practical ways on how people can take care of their health. During this rainy season, the church can sponsor a Dengue Information drive in the community with practical tips on how to search and destroy mosquito breeding grounds.

Capacity building workshops and trainings for BHWs, mothers and volunteer health workers can also be sponsored by churches. This helps improve the skills of the people in taking care of their own health. I saw this when I was invited to teach mother, newborn and child health to a successful community-based health care program in Compostela Valley.

2. Vaccination

The church can partner with the local barangay in its vaccination program. An example would be the recent campaign for a Nationwide Measles and Polio Vaccination where local churches and organizations provide the venue and logistical support in the campaign. Another example is flu vaccination. As this is not routinely given for free in the health center, the church can make this one of their annual programs. The church can offer this at a cheaper price. One church in Kamuning, QC even offered flu vaccination for free to around a hundred adult members of the community.

3. Advocacy Programs

Advocacy is an activity with the purpose of persuading leaders to make policies or allocate budget that will benefit the greater good. The church can lead in prayer rallies and advocacy walks that will involve the community in persuading their community leaders to choose what is beneficial for them. In one barangay in South Cotabato, the captain was persuaded to issue a Barangay Ordinance prohibiting minors from buying cigarettes in the store after the church led the community in several dialogues with the barangay leaders.

4. Regular Health Monitoring  

Non-communicable diseases are the new epidemic that affects even middle-class and low-income families. Free BP checks and quarterly sugar (FBS) screening can easily be done before worship service starts on Sunday morning. Mega-churches and big congregations can schedule this as a Saturday church program in the community. Many evangelical churches are doing this to benefit the community.

5. Food always in the home or FAITH.

This is the name of a vegetable garden program by a faith-based organization. It uses the backyard lot of a church as a community vegetable garden where the whole community is encouraged to plant vegetables in the garden and the produce is free for the whole community. The program also teaches backyard home gardening with the church providing the seeds for free.

The health spectrum ranges from preventive to curative care. Researches has been proven that the church can have a great impact in Primary health care and the prevention of diseases. (See my next post on this topic.)

What I listed are just five activities that any church or organization can do to improve the health of the community. I have seen this work in some churches, so it can definitely be done. What other health programs do you think your church/organization can do?


Saturday, September 20, 2014

Three Reasons Doctors Do Not Join Medical Missions

It is becoming difficult for organizers to get doctors to join them in their medical missions. I am not an advocate of medical missions. Before I give you the reasons why, let me clarify that what we mean of medical missions are the trend today of one-time events of medicals consults and surgeries with giving of medicines to patients as a tool for achieving something else. Med missions are sometimes beneficial especially during emergencies but other than that, it is an ineffective practice.

Here are three reasons why:

1. Medical missions do not address the health problem.

The medical management does not address the cause of the problem. A patient may come in with Tuberculosis due to the poor sanitation of the area, or poor nutrition, or poor hygiene habits. The current trend in medical management today is holistic approach wherein the doctor not only intervenes at the medical condition of the patient but also considers the other factors surrounding the patient. These factors include the mental, social and spiritual factors. Medical management also includes patient education on how the patient can improve her living condition, environment, lifestyle and other things more than just taking the prescribed medicines. This may not be possible as time is not a luxury during med missions. Also, some cases like TB needs further patient care which leads us to the second reason.

When Jesus healed the lepers, he restored their relationship with society. Remember, patient care is more than just treating the disease.

2. Medical missions do not provide continuing patient care.

Proper medical care is continuous and personalized. When medical missions are one time event, it does not allow for patient to follow-up with their health care provider for continuing care. Imagine the popular summer medical mission providing free circumcision to young boys. If complications happen to the wound, how will the boy get follow-up care from the healthcare giver? But a better example is chronic diseases like hypertension and diabetes. Continuous care is needed. Even if complications do not happen, the healthcare worker are ethically bound to continue care to the patient until they are well. This will not happen in one-time medical missions. Because of time constraints, personalized care are seldom given to patients.

When Jesus touched the sick, he touched their lives and they became his friends. Remember, the doctor-patient relationship is a contract of trust for care not for a one time meeting.

3. The ultimate goal is not patient well-being.

While medical missions looks into the health condition of the patients, the intent of the mission is not always the person's health. It is an open secret that politicians sponsor medical missions with the real intent of campaigning for people support. Churches sponsor medical missions as an evangelistic tool to persuade people to become Christians. Organizations sponsor medical missions as an outreach activity to gain prestige and recognition. There are other reasons individuals and groups sponsor medical mission but few are intent in addressing the health needs of the people. If the intent is to help people achieve good health, then they know that a one-time medical mission is not enough.

When Jesus came to heal the sick, his purpose was to heal the sick. In this context, health means a full life. Remember, health is an end not a means.

It is unethical for doctors to violate the principles of medicine. So, like most of my colleagues, I may decline invites in your one-time big time medical missions.

There maybe some benefits to the med missions but we can do better. I can name 5 health ministries churches can do. It is high time we level-up what we can do to improve the health of the community.

Thursday, August 14, 2014

Three Ethical Dilemmas on Ebola Virus Medicine

The Ebola Virus outbreak in West Africa has put the spotlight on ethicists. As the health world scrambles to address the problem, bioethicists are also facing ethical dilemma related to Ebola. It is a well known fact that the Ebola virus has not treatment and no vaccine available in the market today. But there are several pharmaceuticals racing against each other to develop a medicine against it. Last week, the US government tested the new drug ZMapp on two Americans infected with the virus. There was a public protest on why the medicines were given to the Americans and not made available to the general public. This raised several ethical issues.

Here are three of the biggest ethical issues that we all need to consider.

1. Is it ethical for us to use vaccines and drugs against Ebola that has not been adequately tested on humans?

So, here is the dilemma. The drug, as reported, is still on trial stage. There has only been the animal test phase. No human trial for its safety and efficacy has been done. The ZMapp given to the infected Americans, at its best, is a human research to its efficacy. Although, early reports showed positive response to the drug, there is no conclusive evidence to show it is effective. Would it be proper then to subject thousands of people to this medicine without knowing its effect to humans?

I will not even dare elaborate on another ethical if not racist issue behind this. Suffice for me to ask the perennial questions, why are experimental drugs done in third world countries? Why subject Africans to experimental drugs with unknown risks or benefits?

The WHO ethics panel agreed that it is ethical to use experimental, non-approved drugs to fight the Ebola outbreak. They reasoned that this outbreak is a special circumstance that needs special consideration. A research protocol needs to be followed in doing human research. Are we following the proper protocol in using these experimental drugs? Human research requires that the risks and benefits to the person should be weighed. Without knowing the gravity of the risk nor any benefits it can provide to the patients, would it still be ethical to provide these medicines to humans?

2. Who would receive the limited number of this new Ebola medicine?

The second, and perhaps the most difficult, ethical dilemma is sorting out questions on the principle of justice - specifically distributive justice. Who should receive the new Ebola medicine? Pharmaceuticals have reported that they have only more than a dozen of medicines available ready. Regardless of problem #1 being resolved, the medicines are now sent to West African countries. It's now time to give them to the people affected by Ebola. As of this writing, WHO has reported that more than 1 million people are now affected by Ebola. Who among them would receive the 12 or 15 or 20 medicines?

There are 4 countries severely affected by the Ebola virus - Guinea, Liberia, Nigeria and Sierra Leone. Who among these countries should receive the most of the available medicine? Should it be the closest ally of the western world? Should it be the country with the highest death toll? Where should the pharmaceuticals developing the medicine send their products? When they have settled that issue, more ethical questions needs to be raised. Who would be the blessed people to get treated first? Two Liberian doctors are going to receive the experimental drugs. Why the doctors? Why not the mother of 8 children whose husband recently died also of Ebola?

3. Why raise the ethical dilemma for the Ebola stricken West Africa?

The third maybe a little difficult for me to explain. This was raised by my Nigerian friend which I am now only beginning to understand. I will try my best to make it simple. When the ZMapp medicines were given to the infected Americans, there was no ethical question about it. It did not bother WHO to convene a panel of ethicists. In reality, experimental medicine are given almost anywhere. Here in the Philippines, stem cell therapy is on top of them. When a patient willingly consents to receive an experimental drug, no one bothers to stop them because it is still experimental. Yet, in the case of the Ebola virus outbreak, the world has to pause and reconsider giving the drugs. At a time where the affected people are crying out to give them anything - even experimental drugs - to stop Ebola, the world has to bring up ethical questions.

Yes, for some people - especially those who desperately need them - to second guess giving a "potentially" helpful drug is tantamount to withholding any hope of cure. Are there underlying reasons behind the hesitancy? Is money an issue? Does the financial gains and costs holding the world back? Are we really concerned about the efficacy of the drug and the safety of the sick people? Are we really being ethical about this?

Friday, August 8, 2014

Three Reasons Why Doctors are Poorly Compensated

Medical ethics tells us that "(T)he primary objective of the practice of medicine is service to mankind..." This principle has been abused to justify poor compensation for doctors with their work. There is injustice. This is specially true for young doctors who receives retainer fees or compensated for the number of hours rendered. But what is the doctor's service worth? If its value is measured monetarily, how much would it cost?

The first and most common argument thrown is that, "medicine is a service and should not be profit-oriented."

It seems to me that the assumption here is that only those that are cheap and free are considered a service. If you receive good money for a service rendered, that becomes profit-oriented. So doctors are made to believe that it is okay for them to receive little to no compensation for their service rendered. If doctors earn good money for their practice, they are not serving humanity.
This is where the professional fee for the professional service given becomes important. Of course, doctors are either compensated with either retainer fees or fee-for-service. But in general, what is a fair fee for the service rendered by the doctor? What will be a "just compensation" for doctors?
The PMA says the "(P)rofessional fees should be commensurate to the services rendered with due consideration to the patient’s financial status, nature of the case, time consumed and the professional standing and skill of the physician in the community."  They also explained that for self-employed professionals, there is no universal fee. It depends on the prevailing and acceptable fee among the practitioners in the community.

If there is an acceptable fee, why are doctors poorly compensated for their service? Again, this may not be true for fee-for-service doctors with good practice. But this is especially true for many young doctors on retainer fees/per-duty fee or resident physicians.

The second reason, doctors are told that the hospital can only afford to compensate them with a small amount for their service. It's either the doctor take it or leave it. Let me illustrate further:

I am looking to hire a helper in our house (pun intended.) She will help cook the food, wash the dishes, clean the house and wash the clothes. I will need her services to have a decent and clean place. For such services, the acceptable rate in our area for helpers is P3000 a month. (Don't ask me where I live.) I can only offer P2000. Although the acceptable rate is P3000, the prevailing rate and the most common rate offered is P2500. Well, times are tough. It's difficult to get a job. I know people need the money. If they don't want P2000 a month, then they don't have to accept it. I am not pressuring them. I am just offering it to whoever is willing to offer their service for that fee. Is it just for me to offer compensation for the service I know is worth more than that? Is it my fault if there are people willing to receive such compensation for their service?

The third and most important reason why doctors are poorly compensated is because NO ONE CARES. Not even the doctors.
Maybe because of reason 1 and 2. But this injustice perpetuates because no on is standing against it. A learned prophet once taught, "Learn to do good; seek justice, correct oppression... " (Isaiah 1:17).
The injustice must stop. People must do something against the unjust practices. Desmond Tutu famously said, "If you are neutral in situations of injustice, you have chosen the side of the oppressor." We must take sides now. No, one or two person cannot do it.  There needs to be a collective effort to stand against it. The government, the health industry, hospitals, doctors and even patients must do their share. Together, change can happen.

Doctors still do service to humanity. But what is its value to you?

Monday, July 14, 2014

Three Messages That Tells Me My President is Arrogant

Tatlong mensahe na nakuha ko sa DAP explanation ni PNoy. Three things that I heard from what PNoy said about his DAP explanation.

1.       “Presidente ako, kaya puede ko gastusin ang pera ng kahit sino”
-          The President can use and transfer the use of any savings from other appropriated budget according to the Administrative Order he has cited. It doesn’t matter whose money is it, the Philippine president is the most powerful person in the country and so he can touch and use anybody’s money whenever he wants to. It doesn’t matter if it was indeed appropriated and approved by congress, the president can appropriate the money according to his own budget. After all, DAP is not PDAF. According to PNoy, hindi naman pumunta sa NGO ni Napoles ang DAP kaya magkaiba yun sa PDAF. Regardless if the budget were diverted illegally, napunta naman sa mabuti kaya OK lang na i-manipulate ang budget appropriations.

2.       “Mali sila, dahil tama ako.”
-          The Supreme Court is wrong in their decision for the simple reason that they do not agree with the President’s interpretation of the law. It implies that only and only the President’s understanding and interpretation of the law is the correct interpretation. Any other interpretation by the 13 magistrates who have dedicated their lives in studying and upholding the law are definitely mistakes. I can even hear the threat to the SC, when he said “gusto nila ng personalan.” I will not wonder if another “Corona Impeachment” will happen to any of the justices sometime soon.

3.       “It’s okay to disobey the law, as long as your intentions are good.”
-          Obviously, for PNoy, the end justifies the means. Yes, even if it means breaking the law. Using the example of parking on a “no parking zone,” PNoy justifies that even if DAP was deemed illegal, it is still to be lauded for the good intentions of the program. We should not wait for another two years following proper procedure to use the money saved. Forget the bureaucratic procedure. It is okay to disobey the law, as long as one aims to help the needy. It is okay to beat the traffic light because you are rushing to help another. It is okay to steal, because you will give the money to the poor. It is okay to kill a person because you will save the innocent. I can hear PNoy shout at me saying, “Let us forget the law and order, and do what is convenient in the guise of doing good towards a matuwid na daan.”

Thursday, June 19, 2014

Para Kay Pepe sa Iyong Kaarawan

Pareng Pepe,

Isang maalab na pagbati mula sa mga bagong bayani. Oo, mga bayani daw kami. Hinahanay kami sa mga katulad mo at ilan pang nagbuwis ng kanilang buhay para sa ating bayan. Marahil tinawag kami ng gobyerno na mga bayani dahil inaaasa nila sa amin ang pag-angat ng bayan na dapat sana'y kanilang sinumpaang tungkulin. Ngunit ang liham na ito ay hindi pagpuna sa kakulangan ng gobyerno. Mahirap pag-aksayahan ng panahon ang hindi nagbibigay ng tamang panahon para sa iyo. Nais ko lamang gunitain ang iyong kaarawan bilang tanda ng pasasalamat sa Poong Maykapal sa ginamit niyang buhay bilang huwarang Kristiyano upang mapulutan ng aral ng kapwa Pilipino.

Ang iyong dedikasyon sa pagpapahalaga sa kapakanan ng iyong kapwa Pilipino ay tanda ng isang mabuting Kristiyano. Katulad ng isa sa mga mahalagang pangaral ni Hesus, "mahalin mo ang iyong kapwa katulad ng iyong sarili, (Marcos 12:31)" ang buhay mo ay naging halimbawa ng aral na ito. Hindi mo inalintana ang mga puedeng mangyari sa iyo, sa iyong pamilya at sa sarili mong buhay alang-alang sa ikabubuti ng maraming Pilipinong nagdurusa sa pang-aabuso at kawalang ng hustisya. Nagbunga ang iyong mga pasakit at nakalaya nga ang iyong bansa mula sa mga dayuhang mananakop. Ngunit nakalaya nga ba sila sa mga pahirap ng pang-aabuso at walang katarungan?

Ang tinuro sa iyo ng nanay mo na magdasal sa Diyos ay dala mo hanggang sa huling hininga mo. Hindi ka nakalimot sa iyong Diyos sa lahat ng pagkakataon lalo't higit sa mga panahong ikaw ay sinusubok. Ang tunay na Kristiyano ay laging inuuna ang kanyang Panginoon sa lahat ng bagay. Hindi ka nakalimot sa kung ano ang tunay na mahalaga. Nang ang simbahan ay lumihis sa turo ng Biblia, binatikos mo ito. Hindi ka lumayo, bagkos ang pag-ibig mo sa Diyos ang naging dahilan ng pagtuligsa mo sa mga mali na iyong nakikita. Hanggang sa huli, nananalig ka sa Diyos at siya ang iyong naging sandalan. Ang paglapit mo sa Panginoon sa huling sandali ng iyong buhay ay tanda ng mataimtim na pananampalataya na dapat tularan. Ang hinahon ng Diyos ay bakas sa iyong mukha bilang tanda ng lubos na pagsuko ng iyong buhay sa Kanya.

Ikaw ay bayani. Ngunit huwaran ka ding Kristiyanong matuturing. Nawa'y ang iyong halimbawa ay makita at maging inspirasyon para sa mga sisibol na tunay na bagong bayani.

Wednesday, May 28, 2014

A Daughter's Love for Her Mother: A Kidney Transplant Story

I just want to appreciate my sister who donated her kidney to our mother who has end-stage renal disease. God has a plan but we never saw it.

When there was too little option for a donor for our mother, we started looking for relatives. Although it may have higher chances of familial disease, we had to take the chance. Now there were only a handful of our relatives who were willing to donate their kidneys. You can count them on one hand. However, all of them failed the matching test. Then we started looking to those people beside us. We candidly asked ourselves, would anybody from the family would like to donate a kidney to mom?

How much does a child love one's parent when the child is not willing to donate a kidney? Would donating a kidney a test of a child's love to one's parent? Maybe not. But how much then does the child love the parent?

A child choosing not to donate a kidney to one's parent is not a measure of a child's love to the parent. But donating a kidney to one's parent speaks a thousand words.

People ask, why would a daughter donate her kidney to her mother?

She never answered it. She just did. Even the ethics committee never bothered to ask the question because they saw the answers in her eyes.

My sister is a social worker. She once explained to me why she loves doing good deeds. I always thought she would do good deeds because as Christians that is expected of us. I never understood what she meant when she explained that most people would imitate a movie star idol or an athlete. She was doing good to imitate Christ. Jesus sacrificed his body, his career, his future and eventually his life for other people's sake. I never thought my sister would go that far imitating Christ.

When it was time to have the transplant, every body was anxious. What will happen? Will it be successful? What if something goes wrong? What if the kidney was rejected by the body?

It was a test of faith. It was a simple pure surrender to God's plan. It helped that we are a God fearing family. It is cliché that "a family that prays together, stays together."

More than that, there were people, relatives, church family and friends who showed support. It was an outpouring of God's love through the people around us.

Then the time has come. The nurses and the doctor came to the room. There was silence. As the nurses prepared my sister, she was calm. Everything was set, then they started rolling her bed out of the room. There was one last thing that needs to be done. The family gathered around her... and Auntie Bing, who is a clergy, thanked God for a daughter's courageous act... The doctor assured her, the single kidney she will donate is healthy enough to support her mother. My brother squeezed my sister's hand and said, "it is all part of God's plan"... tears fell.

Tuesday, April 29, 2014

How to Celebrate a Birthday Away from Home

I have always emphasized the importance of celebrating birthdays. No, I do not mean that I love to party. Christians should always be grateful to God's goodness. Nothing more important to be thankful than to the life God has breathed on us. Our birth-days are a reminder of the gift of life God has graciously given to us. We ourselves celebrate in gratefulness to the life God has given us and the opportunity to experience life and worship God.

As Christians, our family members and friends must celebrate birthdays with us. They are the people God blesses through our life (I hope). Our family and friends show their thanksgiving to God for the blessings that flows through our Christian life. But what if we are far from our family and friends? How do we celebrate?

I am out of town to begin a new job - in the Middle East - with not too many Christians around me. How can I show gratitude to God? How can I share the celebration with my family and friends? To add spice, how can I praise God among non-Christians?

This is not the first time that I will celebrate my birthday away from the closest people in my heart. I have always wondered though how to celebrate my birthday if it was a thanksgiving for God's gift of life to me.  I did three simple ways  to celebrate my birthday perfectly.

- First, you've guess it right - I prayed. Of course, we talk to God and express our gratitude for our life and the blessings in the previous years. We also thank God for the opportunity to be a channel of blessing to more people in the coming years.

- Second, dine with your family and friends through Skype. While there is no substitute for physical presence - it is never the measure of fellowship. We Christians have long known that physical presence or absence does not define our relationship with our fellow Christians. Even time cannot be a hindrance to our fellowship with other Christians of old and the future we anticipate. As such, our fellowship can be spiced up by the social media available in our finger tips.

- Third, receive a gift. A gift is offered to show how special is the person. God gives us gifts because we are special to God. Birthday gifts for us are expressions of how meaningful and special we are to others. But more than that, receiving gifts is a reflection of how important we are to God. Now since, I am alone - I bought myself a gift that tells me I am special.

These three simple ways was the best way to celebrate a birthday away from home. It made me happy. I saw my family and friends happy as well. I am sure God is happy too.

Friday, March 21, 2014

Three Things a Former Secretary of Health Taught Me

The Dr. Alfred Bengzon, the former Secretary of Health now the CEO of Medical City, met to welcome us in the Medical City family. He shared his insights and thoughts in his 5 decades of being a medical professional. In our meeting, I learned three things from him:

1.       “Doctor’s should go beyond medicine” 
2.       “Heroes can come from the government”
3.       “Patients are partners”

I appreciated that Dr. Bengzon opened our meeting with a prayer from Bishop Desmond Tutu. He said it was something that he wants to be done in all other meetings. We were off to a good start.

The first thought that really had a big message for me was when Dr. Bengzon shared how he was able to appreciate being a doctor by going beyond the scope of medicine. He shared his story how a doctor like him ended up being a manager and taking an Master’s in Business Administration in Ateneo. But that “deviation” from the field of medicine allowed him to have a wider perspective and appreciation of medicine.  He was resolute to tell us that doctors must not only know medicine. He asked me who I was and what’s special about me and I told him that I am a doctor and a physician – the wholistic approach to medicine in person. Our talk turned to spirituality and I was impressed by his wide knowledge of the subject. He talked about Mitch Albom and his books and offered some of his insights on the topic of spirituality. He asked about how a loving God would allow unrepentant people to go to hell. He left it for us to theologize on it. He admonished the other doctors to also read Albom’s “Tuesday’s with Morrie” and not just be limited to their Schwartz, Harrison’s or del Mundo’s. He reminded us that doctors will be able to appreciate medicine better if they know other than medicine.

The second thing I learned from the good doctor is that heroes can still come from the government sector. The recent current events and forever have focused on how government officials and their cohorts have been stealing the people’s money. The inefficiency and ineptitude of the government to address the country’s problem has been an acceptable fact for many. But Dr. Bengzon told the story of an underpaid midwife in the mountainous typhoon-zone part of northern Luzon and her dedication to uplifting the health condition of her community. The midwife would travel on foot for several hours climbing mountains and crossing rivers just to be able to deliver vaccines for the children. Not even her surgical operation that required her to rest could stop her from performing her duty. It was no wonder that she died in the line of duty because she drowned when she was caught by a flashflood while crossing the river one stormy season. Some people in the government are still doing their best to improve the health condition of others. There are still heroes in the government. The field of medicine is like that – sacrificing more of ourselves for the health of others. Medicine is service oriented. He reminded us to help the government in serving the people because anybody can be a hero even in their own little way.

The third lesson I learned from Dr. Bengzon is in looking at the patient as partners in health. This concept has been taught to me in my residency training as a medical doctor and was not something new. But the experience and the examples he gave made it real and practical. It was no longer just a concept. He shared how one of his protégé applied the concept that patient are partners through the design of his clinic. The clinic did not have the traditional doctor’s table where the doctor sat on one side and the patient on the other side while the medical consult is ongoing. Rather, the clinic only had a couch and a center table. The doctor and the patient sat in the same couch to emphasize that the doctor-patient relationship was a partnership. The clinic structure allows the patient to look at the doctor at eye level and sit shoulder to shoulder to emphasize that both of them works in partnership and has equal role in the patient’s health. Dr. Bengzon reminded us how doctors love to go ego-tripping and that this culture must come to a stop. He challenged us new doctors that in our practice, we will treat our patients as partners who must also be given the responsibility and control of their own health.