The municipality of Alfonso, along with its Municipal Health Office, made a significant impact on my understanding of how the public health system works. As a resident of Silang, Cavite, I’ve experienced some benefits from my own RHU, but this immersion allowed me to see that each municipality functions differently, depending on its capacity and available budget.
Through fieldwork in Alfonso, I gained deeper insight into the challenges, rewards, and day-to-day realities of public health workers. I rotated through various barangays, each with programs that differed depending on the day. At the start of each day, Dr. Elie, the Municipal Health Officer, gave us meaningful lectures on relevant health topics such as HIV, rabies, dengue, and tuberculosis.
I was able to visit nine out of the 32 barangays in Alfonso. These visits included staying at barangay health stations to observe how nurses and midwives deliver healthcare services like immunization, consultations, and family planning. I also had the opportunity to accompany the Zero Open Defecation (ZOD) monitoring team, which included a provincial health officer and a sanitary inspector. Furthermore, I witnessed how Dr. Elie personally visited evacuation centers following a week of heavy rain caused by successive typhoons.
What struck me the most throughout the immersion was the sheer volume of responsibilities assigned to each worker. With 32 barangays, most government nurses and midwives are responsible for 4–6 each. Their schedules are packed with daily visits, report writing, house-to-house monitoring of bedridden patients, and close coordination with barangay health workers. The unequal distribution of labor was eye-opening.
As a medical student, I used to think that doctors mainly stayed in hospitals or clinics. However, I learned that the role of a municipal health officer extends far beyond that. They do not just see patients at the RHU, they also handle environmental health, nutrition programs, emergency response, and sanitation issues across the municipality. While I had learned in class about the difference between a public health doctor and a clinical doctor, this immersion allowed me to experience that difference firsthand. Public health is not just about treating patients but ensuring they live in safe, healthy environments. It is a discipline rooted in prevention and long-term care.
To be a public health doctor is to be committed to conducting health education for children, responding to disasters, monitoring hundreds of patients a day, creating programs, drafting proposals, visiting barangays, and liaising with officials. It is not just a job in medicine, it is a multifaceted responsibility.
Working in public health also means working with a diverse team. I observed how essential respect and camaraderie are to successful collaboration. Everyone, regardless of role, is vital to the system. Of course, friction can arise. Not everyone may appreciate your methods, but it’s important to maintain professionalism and respect. Fulfilling your duties with compassion while building good relationships with coworkers can make all the difference.
This immersion gave me a clear picture of how public health truly functions. In class, we discussed systems thinking, the idea that one problem often affects multiple systems. During my RHU experience, I saw how issues like vaccine shortages and poor recordkeeping are not isolated problems but results of deeper systemic challenges. Public health is deeply intertwined with finances, logistics, politics, and human resources.
Despite these obstacles, the takeaway from Alfonso was clear: always provide care. Never let a patient leave without receiving some form of assistance. Even with limited resources, you must do your best. The principle of maximizing what you have and serving everyone, regardless of status, is at the heart of their health philosophy.
Public health is undeniably difficult. It faces many barriers, but perseverance, creativity, and smart decision-making are key. As a future physician aspiring to serve in public health, I know I must start preparing today by studying hard, being resourceful, and maintaining my compassion. I hope to someday help make RHUs more efficient, possibly by integrating technological advancements to ease administrative burdens. I want to be a "doctor ng bayan," grounded in truth, excellence, and a heart that serves.
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