Southern Cross

fatkatz

a crazed med student. 

no longer...

fatkatz

when we are free from guilt,
we see the world with fresh eyes.

these eyes see what others do not,
people long to see what these eyes see

clear as day, the dewdrops on a petal
the stark noght cannot rob the light

but now my eyes have been clouded
i wonder what people see
when they look into my eyes
because i cannot see beyond the haze

110209

fatkatz

October 28, 2009

Magcocommed ba ako?  Minsan feeling ko, niloloko ko lang sarili ko.

Is community medicine really the road less traveled?  Sometimes I think it nearly always turns out to be the road not traveled well.  The least appreciated, minimal impact. Is it really for me, I wonder.

Of course there are inspiring moments.  Like during the trainer's training, I truly wondered what it would be like if I were to be doing that for the rest of my life.  However, I think that it practice it feels less remarkable. I feel as though I'm always on my toes, never good enough.  Is wanting something enough?  Is an ideal enough? How I wonder

I wonder: Are we just making ourselves feel better?

fatkatz

October 23, 2009

Summing up the two clinic days we have found that all the bhw's do not fill up the classification portion of the IMCI form.  In Laiya Aplaya, the IMCI forms are filled completely except for classification. in Hugom, the forms are filled only up to the cough portion.  and some of the BHW's don't even fill up the Respiratory rate portion.. 

I wonder though what prevents them from writing down. Is it confidence? Is it skill? Perhaps part of it is skill and experience. Because if it was skill then they need to learn that skill comes with experience.

But how can we tell them something like that? How can we gently ask them to fill in the classifications and manage accordingly? 

I observed that it truly is difficult to correct or to ask for something on our very first meeting with the BHWs. 
The concept of "nahihhiya" is something very unique to the Philippine psyche.  It hits me though, and it irks me a little. This is a negative thing for me, on no uncertain terms. In English, it means shame. 
Truthfully, I consider this one of the very negative portions of our culture. Because this concept, in most cases, does not stem from a respect for the other person. No. It annoys me because it stems from a difficulty of receiving correction.
Plain and simple, we, as a people, don't take correction very well. We view criticism negatively instead of as a way to improve ourselves.  From this stems the delicate balance of dealing with any strange situation.  I hate how we have to walk on eggshells around each other instead of saying what is truly on our minds, like professionals.

Much as I hate it, that is the reality.  That is my reality in the community. And though I want to change it, and I know it should be changed, I know that part of our culture cannot be changed simply by willing it to be so.

I suppose my lesson here is Stephen Covey's Emotional bank account.  It truly is difficult to give any sort of feedback in any relationship if we are not in the position to do so.  Persons who give feedback have to be in a position where he or she is responsible over the person he or she is correcting. To have responsibility over a person is not only afforded by being in the position over them, but also by taking the time out to invest in the people emotionally.  In order to be able to work with someone, you have to be emotionally involved. THere is no such thing as "just work."
In order to obtain something (like a desired learning or behaivior) from the BHW's, I in turn have to invest in them. With time, emotion, getting to know them.  Without such a relationship, I would be in no position to have influence over them enough for them to receive correction from me.

Emotional investment will take time. As will being able to correct those whom we work with.  I suppose that is one of the great hindrances to our progress in the community.  There is no consistency. Every six weeks, a new batch of interns come in, and then they have to get reaquainted. Another cycle of emotional investment before something happens. But that's the reality. We have to make the best of it.

fatkatz

October 22, 2009

Today was thursday, our first day of clinic in Barangay Hugom.  Yesterday's clinic was easy. We got to know the BHW's of Laiya the day before the clinic and the people were friendly and accommodating.  Also there seemed to be a steady health system in place.  This is because Laiya Aplaya was one of the first barangays in San Juan to get organized.

Hugom was very different.  The people were less warm, for lack of a better term.  It's not negative.. It's just an observation. Maybe it's cultural, maybe the Hugom BHW'se just take a little more time to warm up.  But there I was, thrown  out of my comfort zone, with people who were not responding as I expected when I reached out.  And so I realized then and there, it was so much easier to sit and wait for patients.  That I was really grateful when a patient would come for a check up because I would have reprieve from the stony silence.

Then I realized, I was glad because I was relegated back to a role I was comfortable in. Perhaps the reason why the health provider role seems to be the one being taken on by most of the interns is because this is our comfort zone.  We have been trained to talk to patients and diagnose diseases and provide remedy.  We spent four years studying and training for that role.  But when have we ever trained to be social mobilizers? to be catalysts and community organizers?  In truth we are just people and the community, they are just people as well.  We don't get to be social mobilizers enough in the community because we haven't had the training. The on the ground experience. 
I would like to think that my background would provide me some sort of advantage: we have been having community immersions since high school, I belong to an organization where part of the day to day is reaching out to people and getting them to open up.  I was president of our Medicine Student Council, so I know how to negotiate. 
But no matter how much you prepare, no matter how much you think your past   experience has prepared you for this, you fall short.
There is no formula to people.  Perhaps it would take years for me to train in interacting with people to be comfortable in a community organizer's role.  Howe can I be a social mobilizer when I am not accepted.  Becoming accepted takes both skill AND emotional investment in the community.  No amount of training will prepare you for every commmunity you will immerse in.
I think training in Community, like medicine should be day to day.  We are in the hospital everyday for 730 days straight. We live we breathe hospital. We know hospital. So when we go to community, we take a hospital mentality with us. I suppose there is no middle ground for community medicine.  Either you're in the community or you're not. And when you can't live and breathe community, you can't really be effective

fatkatz

So finally, here it is: reflections on my community medicine experience. Hopefully in the future they'll help me decide

(these were submitted as a requirement for the journals for the San Juan Batangas rotations)

Community Medicine Journal


October 20, 2009
Day 1 Community Medicine Immersion

It's the first day of the immersion and we just finished settling in into Ate Edith's house in Laiya Aplaya.  To be more accurate, we're getting ready to sleep in a room prepared for travelers going to the resort.  Suffice to say, this isn't at all what I expected of my physical surroundings.  We have a two bed room with air conditioning and electric fan, tiled floors and a lock on the door.  A tiled bathroom with indoor plumbing.  The shoreline is literally steps away.

I found out a few hours ago that we would be staying in this place, and as I listened to people's descriptions (beach sila everyday, may bano, change of sheets, its a resort, parang nakabakasyon) I got to wondering, would I really get the community medicine experience that I was looking for.  We wouldn't be at all 'roughing it.'  Those were my concerns, and I did not whether I should be happy or sad.

But now, I realize, that the practice of community medicine goes far beyond physical surroundings. And that the community immersion is so much more than living in a house without the conveniences you are used to.  Community medicine is about people.  We have to involve ourselves with the people who surround us. Engaging our host to treat us as one of her own is still something we have to hurdle.  I don't believe that I have been deprived of the 'full commed experience.'  In fact, I exprience the community when I speak to Ate Edith and find her slowly coming out of her shell and being more at ease with me.  I find that I learn about the community, their history and their traditions when we sit down and have conversations with the neigbors. We sit and talk, unhurriedly. And I am engaged in their stories. We share ideas andn experiences.

As of now, Ate Edith offers us a separate gas cooking range, wash area and table. This is what she offers tourists, and really, most of the interns who have previously lived with her.  And when we ate, we ate separately in spite of our repeated invitations for her and her pamangkin to join us. It is my hope that one of these days, they will feel at ease enough with us to join us for a meal. 

katz.m.d.

fatkatz

I was going to post this on facebook, just to spur discussion, but Alvin started noticing. I don't know, I don't like getting noticed so much. I feel as though I may do things out of an ulterior motive.  Actually, the exact words were: "i'm elated at your post, i didn't expect it to come from you." 

It really just proves that we aren't that close, because anyone who knows me wouldn't be surprised at any sociopolitical whatever chuvanes that i bring up.  Sigh, it makes me wonder, in my cynical heart of hearts.. "Apparently, you really do think I'm daft."  Wla lang. I know it was well meant, but I suddenly felt as if I was talked down to. Which is why the best response is to say nothing at all.

so here it is, my turncoats article, for private consumption.. and multiply, soon .

Party turncoatism is a despicable trait. And no self respecting voter should support a candidate who is a turncoat.

Much of what is wrong with our electoral system today is a lack of political ideal.  A firm belief in an ideal is supposed to move an individual, a party, a country toward a political direction.  Sadly such a thing does not exist in Philippine politics.  Here, political parties are relegated to the ways and means in which politicians can launch their platform


Isn't it sad that our political ideology boils down to whether or not we agree with (or like) whoever is in the seat of power. Parties are 'adminiistration' or 'opposition' because of their relationship with the current president.   Both the relationships and the stances of politicians can bishbosh depending on the events that transpire during the administration. Even our Saintly Cory Aquino was guilty of such defection facing decisions she deemed unfavorable to her and her family during the present administration.  Such is what ails our country today.

In light of present events in the selection of standard bearer for Lakas Kampi CMD, Zambales Rep Ma. Milagros Magsysay said some administration party members were considering moving out unless the coalition drew up a complete slate from the presidency down.  She said she couldn't blame some members if they were "looking for other options"  This is what infuriates me. It seems that the culture is personality centered. If the candidate does not get what he wants, he seems free to change parties with impunity.

This is why party defection is rampant.  We do not know where we stand or why we stand where we do. It's a cancer of the common man and of the most educated politician. Sadly, even if you do know where you stand, you will have no place to do so. There is no political machine in place.


  Parties are political machinery, true, but they are not meant to be simply that. Parties are built on principles and values that do not (or rather should not) change.  
If a party member can easily switch sides, it means there is something inherently wrong with the system. It means either of two things.  First, that the person's ideals are so fluid that they can be changed when things don't go their way. Or second, much worse, that party lines mean nothing  except loyalty to a group. And when you leave you are ingrata and nothing more. Like leaving the kids on one side of the playground for the bigger kids who can give you more candy.

The late "Grand Old Man" of Cebu, Sergio Osmena Sr. once said: I have always held that loyalty to a party is part of the larger loyalty to th country.  Why is this so? because the aphorism: One's loyalty to the party ends when loyalty to the country begins is not only prone to abuse, it is a fallacy.
The truth is political turncoatism is more than disloyalty.  It is more than the complete absence of a political vision. It reveals that the basest instinct of he who would turn his coats, is to get what he wants above the interest of the majority. It is the embodiment of personage politics-- When you place your self interest above the party.  If a politician is unable to submit to the will of his party, how can you expect him or her to subject himself to the wills, needs, and clamor of the people who would elect him? 

Our political process is riddled with imperfections.  The personality politics radiates to the way we elect our leaders.  The voter will vote for any reason under the sun. From liking a person's hair, to a sense of loyalty to thinking the person is good, bad or his father's son.  We sink our own ship when we succumb to voting this way.  We as the electorate have the responsibility to be educated, not for the sake of being labeled an "educated voter."  It is to know where we stand. What is our political ideal? What do we want? Who will we vote for to take us there?  We must educate ourselves so that we do not spread the disease of candy takers, and turncoats.




READ:

Randy David: Hopes for modern politics
Solita Collas Monsod: THe statesman and the retreatant
editorial inquirer
Only the Savior can save us now.

fatkatz

Our better selves
EMOTIONAL WEATHER REPORT By Jessica Zafra (The Philippine Star) Updated August 07, 2009 12:00 AM

Most of you are probably too young to understand why Filipinos aged 35 and above are disconsolate at losing Tita Cory. To you, the EDSA Revolution is a distant historical event, an item on an exam. To old people like me who were in college at the time, it was the greatest thing that had ever happened, and the best part was that we were in it.

To you, Cory Aquino was Kris Aquino’s mom, the nice old lady who kept trying to stage People Power with smaller and smaller crowds. To us she was the symbol of the world we wanted: a world where people could speak their minds without disappearing, where public servants actually served, where leaders were honest, just, selfless, intelligent and dignified.

You don’t have to be 35 and up to know that that was not the world we got. These days when we speak of politics at all it is with indifference, anger, or “Please, could we talk about something that doesn’t make us nauseous?” But there was a time when we could discuss government with hope, pride and trust in our leaders, and that was when Corazon Aquino was president.

It did not last. We were cruelly disillusioned: “Pare-pareho lang naman pala kayong lahat.” The revolution had failed us, if it was a revolution at all. Later, whenever Tita Cory urged us to join mass protests against official corruption we still went, but many of us wondered what for. Massing on the streets would cause traffic jams, disrupt business, generate bad press for the country. We should be mature, let the democratic process take its course.

In other words we had resolved to suck it up. Grownups do it all the time.

So we did what was deemed pragmatic. We made compromises and dug in.

We didn’t want any trouble. We got by; some would argue that we did pretty well under the circumstances. But something rankled. If we were doing the right thing, why were we beginning to loathe ourselves?

We heard ourselves speaking with fond nostalgia about how orderly the city was during the Marcos years, how at least there was support for the arts. More and more we found ourselves throwing our hands up and saying, “Whatever.” Is that what being an adult is like, saying “There’s nothing I can do”? No more applying your imagination, just sheep-like acceptance? Because if that’s maturity, it is not a good thing.

When I heard the news of President Cory Aquino’s death I was surprised at how upset I was. I found myself getting teary-eyed when talking about her. Most times I will gouge your eyes out before I let you see me cry, but in this instance it’s all right — my friends are getting soppy, too. On TV, hardcore former coup plotters are weeping because Tita Cory is dead.

Thousands of people with nothing to gain lined up for hours at La Salle and at Manila Cathedral to pay their last respects to our president. They had nothing to gain but their self-respect and the feeling that they had a country. Politicians promise us everything, but sometimes all we really want is to feel that we are part of something bigger than ourselves.

On Monday morning on EDSA I thought it was 1986 all over again. Why this massive outpouring of grief and affection for a symbol we thought we had outgrown?

I think Tita Cory reminds us of our other, better selves — the ones who were prepared to make sacrifices for a noble cause. Politicians and governments have sorely disappointed us, but we never lost faith in Tita Cory the human being. She never mocked our aspirations or knowingly insulted our intelligence. She defended the Constitution from those who would bend it to their own ends; she rejected the idea of perpetuating herself in power. Say what you will about the missed opportunities and lost chances, Cory Aquino was decent to us.

She was a good person.

And after all our “growing up,” “learning to face harsh reality” and losing our illusions, it turns out that character does matter. Being good does make a difference. You will not receive praise or payment for it, and other people will mistake your goodness for weakness, but it resonates among people you won’t even meet.

We have no control over fate and history, but we can control how we conduct ourselves in this life. That’s what we learned from Tita Cory.

Even in death, she reminds us of what we could be.