A legend called ‘Alamat’

It was the start of a legend, one that speaks of how 72 newly minted doctors, initially apprehensive to carry out a campaign for better health in the countryside, eventually became its staunch crusaders. It is a legend that speaks of how a common experience of serving as rural health physicians turned these medical graduates into forces to be reckoned with.

This is the story of Batch 29 of the Doctors to the Barrios (DTTB) program of the Department of Health, which we proudly call “Alamat” (Legend) or, in full, “Alab ng Lahing Manggagamot” (Fire of the breed of doctors).

In October 2011, we were 72 graduates of seven medical schools nationwide who had just passed the licensure examinations two months prior and who were about to fulfill an obligation to serve in the DTTB after having been beneficiaries of scholarship grants. We had varying reasons to apply for the scholarships, but we had one thing in common: the passion to serve the country in our own way as physicians.

The DTTB program sends medical graduates to a geographically isolated, economically depressed, or densely populated municipality to serve as rural health physicians for two years. Most of us, however, were to become heads of the local municipal health office, for lack of doctors in our areas of assignment. Apart from serving as clinicians in rural health facilities, we were also tasked to become public health managers, with the duty to ensure the smooth implementation of ongoing changes in the health system, the accuracy of health-related data, and the strengthening of local government support for health programs.

It was a tall order.

We were apprehensive and anxious about where on our 7,107 islands the DOH would assign us. In addition, we soon realized that being deployed to a faraway municipality in the mountains, in the vast plains of the countryside, or in isolated islands would produce much stress, not only for us who were mostly city-bred folk, but more so for our loved ones. Heading a municipal health office, with much of the population old and mature enough to be our mothers and grandmothers, made up additional stress. On top of everything else was the necessity for us to work within the local political milieu while striving to maintain our idealism and values.

A number of times, many of us became disillusioned after encountering situations in our areas that challenged our ideals and principles. Some of us were even pulled out in the face of threats to our safety. Many times we wept and comforted one another. Many times we considered quitting. Facebook was on our side, thankfully accessible on our mobile phones; within the safe confines of our group page, it enabled us to vent our frustrations, to discuss various issues, and, on the lighter side, to exchange jokes and set up mini reunions.

We pulled through. And eventually, we realized that in spite of the difficulties hindering us, we needed to put first the people we were serving. Soon, the successes started coming.

Members of our batch who were stationed in Batanes and Isabela were able to launch a multisectoral effort to reduce the number of patients with high blood pressure and diabetes, and improve the health of mothers. Another assigned to a faraway island in Quezon managed to decrease the number of malnourished children. This approach was also used by one of us assigned to a vast municipality in west Visayas to address the alarming number of patients with mental disorders; by another assigned to Lanao del Norte to prevent the spread of bloody diarrhea; and by yet another assigned to mountainous Bukidnon to reverse the spread of rabies, improve the health conditions of mothers and infants, and improve the health indicators in her area.

This is but a subset of the many successes that all 72 members of Alamat were able to reap because, inasmuch as there were difficulties that surrounded us, we eventually found allies in our areas who shared our commitment to help improve the health of the people we serve. These allies were people in the local government, local people’s groups, and other agencies. We soon realized that involving these allies and the people in our effort to improve health in our areas was a sure ingredient for success as public health managers. These successes started as small steps, which became legendary achievements because of the love and support of the people we served in our areas.

Before we knew it, our two years were up.

The DTTB program was an experience that made staunch crusaders out of us 72 doctors initially anxious about embarking on a campaign for better health in the countryside. The experience turned us into forces to be reckoned with.

We will carry these experiences to the new areas awaiting us—our next mountains, islands and barrios. Some of us have decided to pursue further clinical training, with the DTTB experience enabling us to empathize with our impoverished patients and their needs. Some of us are finding jobs that will allow us to put this two-year experience to work in public health policy and research fields. Some of us have even chosen to stay on in their respective areas, to ensure the sustainability of health programs.

We all value this collective experience, which will continue to fuel the fire and inspire us to be the legendary batch of doctors we had unabashedly branded ourselves. DTTB Batch 29, or Alamat, may have ended its stint in the barrios, but the effort to promote health for all Filipinos continues. And we will continue to take part in this effort, in a way that shows our intense love for our country, that gives tribute to the people we have served in our areas, and that shall carry our legendary brand of service, as Alamat doctors.

Jaifred Christian F. Lopez, MD, was assigned to the municipality of Sablan in Benguet under the Doctors to the Barrios program. Along with his batch mates, he recently completed a master’s degree in public management (major in health systems and development) at the Development Academy of the Philippines. He is now looking for a job in the field of health policy and research. He is 26.