An uphill battle

Over the last few weeks, “Doc Adam,” an Australian physician who makes YouTube videos on health education for Filipinos, became an increasingly prominent feature on my social media timeline. At 1.33 million Facebook subscribers and with most videos in easy-to-understand “Taglish,” Dr. Adam Smith’s YouTube channel enjoys reasonable popularity, both for health-related videos, as well as humorous, sardonic content where he responds back to his critics. He has called for a sense of responsibility among influencers and other social media personalities endorsing weight loss or whitening products. Recently, he became even more popular because of videos debunking a “detox” whitening and slimming drink, as well as the purported cancer cures (among other things) peddled by a well-known naturopath. His view count on Facebook and YouTube soared even more after he told his viewers that he had become the target of legal action and harassment because of those videos. He’s received an outpouring of sympathy from the medical community, but remains the target of threats and harassment from supporters of his two latest adversaries.

In watching his videos I had to set aside my own initial hesitations about possible white-savior complex, not to mention the fact that Smith is not Filipino. This is because, as we are often taught in community and social medicine, persons who are part of a community, and sensitive to its cultural and sociopolitical nuances, are best equipped to diagnose, plan, and manage deep-seated health-related issues in that community; in that respect, I think the YouTube channel’s mission to “make the Philippines more healthy” is a little flawed. Nonetheless, his advocacy to drown out health misinformation with correct information is a well-intentioned one, and to watch him come up against obstacles like death threats and legal actions only serves to illustrate how unrewarding it can be to be a health information advocate in the Philippines.

None of this is new. We’ve long known the challenges of pushing for correct medical information when it is contrary to products or ideals endorsed by the wealthy or powerful. One remembers the recent “tuob” debacle, where Cebu government supporters clashed with medical professionals about the risks and benefits of the practice of tuob. A pulmonologist colleague who made an infographic about it was inundated with threats and personal attacks. Mansplainers also filled my inbox, explaining why my medical knowledge couldn’t compare to government officials’ expertise. One comes up against poor education, sheer ill will, a disdain for professionals and experts, an ignorance of the levels of scientific evidence, and a host of conspiracy theories surrounding “big pharma” and lazy, money-grabbing doctors.

Also, depending on which fake news or fake medicine peddler one comes up against, one can get sued, discredited, or even physically hurt. It’s a battle of lawyer vs lawyer, money vs no money. What it doesn’t ever seem to be is a battle between science and evidence: for instance, Smith’s actual arguments have yet to be debunked with anything highly evidence-based.

I suppose that what’s new this time is the fact that Smith enjoys some protections that we, less influential health advocates, might not have. Not only is he not a resident of the Philippines; he also appears comfortable enough with the legislative process that, instead of folding, he says to his challengers, to go ahead and “Take me to court!” Perhaps, too, his practice stands to be less affected by this drama, compared to those of us whose practices are based in this country.

This is not to discredit the worthiness of his efforts, but rather to underline the challenges faced by other Filipino health advocates who have the information and the desire to improve health education among Filipinos, but who are frustrated by little audiences, by fears of legal retaliation, and by the endless hate that trolls can spew online. The fact that I was hesitant to name Smith’s most recent targets here also just goes to show how little faith physicians like myself have in any legal protection that can be offered to us should the need arise. The responsibility to loudly and unequivocally debunk false claims shouldn’t even be resting with the little community physician or vlogger, but with the regulatory boards and the concerned health departments. As it is, one can only hope that Filipinos hearing of Smith’s troubles can become more curious and more critical about health information.

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