Something I am truly proud of

 

Dr. Alberto G. Romualdez, Jr.

Director, Health Services Development and Planning

World Health Organization

Regional Office for the Western Pacific

Manila, Philippines

 

 

(Speech delivered during the 10th Recognition Rites of the School of Health Sciences, University of the Philippines Manila, at the UPTC Student Center, Tacloban City, on April 21, 1990.)

 

 

Prof. Yabes, representing Chancellor Domingo, Dra. Koh, distinguished guests, ladies and gentlemen, and my newly recognized fellow health workers:

 

There are many things which I have done during my life which neither I nor anyone else will ever remember.  There are a number of things which I in fact regret, and would rectify if I could.  There are very, very few things about which I am truly proud of.  My involvement in the School of Health Sciences – the so-called “Tacloban experiment” – is one of them.

 

It is hard to believe that almost fourteen years have passed since 96 young men and women (Tony Tirazona among them) from the most economically deprived rural communities of this and other regions of the Philippines, with NCEE scores ranging from the 9th to the 90th percentile, were accepted as the first batch of BHW students of the then Institute of Health Sciences.  It is even remarkable that, despite a chronic lack of resources, recurrent official apathy, periodic desertion by some supporters, and sometimes hostile local, regional and national environments, the concept of IHS has endured.  And here we are again, giving recognition to a fresh batch of young people about to dedicate their lives to the service of the people of their communities.

 

My pride in having participated in the development of this program is actually enhanced when I recall that my own role was rather minor and insignificant, and that many individuals of very different backgrounds, temperaments and inclinations made contributions far greater than mine.  With your permission, I would like to mention just a few of these individuals in order to demonstrate what I mean.

 

In its initial stages, the top leadership of IHS consisted of two persons.  The spirit behind the movement and its conceptual leader was the late Dr. Florentino Herrera, Jr. – U.P. Medicine Class ’41, Diplomate of the American Board of Internal Medicine, Dean of the U.P. College of Medicine and, later, Chancellor of U.P. Manila.  The driving force of the movement and its operational leader was Dr. Amparo Banzon – U.S.T Medicine Class ’47, Master of Public Health, Career Executive Service Officer, and Regional Director of Health Region No. 8.  I hope that those of you on the faculty who remember Chuchi and Amparing – as we used to call them behind their backs – have been able during the course of time to recall to our new IHS batches the inspiring leadership of these two great health workers.

 

At my level, we had the IHS Committee, composed of basic scientists, high-powered medical and surgical specialists, social scientists and philosophers.  I am sure that all of you who know him will agree that, because he is all of the above, Dr. Augustus Damian, Jr., recently retired from the U.P. College of Medicine, is the quintessential IHS Committee member, whose teaching abilities were matched only by his musical talents.

 

Then there was the faculty.  A collection of local and imported talent whose faith in the idea, dedication to work and sheer tenacity, are the real reasons why the school is still here today.  I am afraid I will be unable to do justice to those originals who are still here if I try to mention all of them and list their contributions.  We all know who they are, and I think it is sufficient that your present Director, Dr. Isabel Koh, is one of them.

 

And then there are the field workers and staff of what was then the Ministry, now the Department of Health.  There were, and still are, many of them at various levels.  I mention as an example the group of the Carigara Study Area only because I myself worked very closely with them.  The work of individuals like the late Dr. Arturo Misagal, Municipal Health Officer of Capoocan – the”General” as we called him – has changed not only the national health system of the Philippines, with the integration of health services at the Emergency or District Hospital level, but has provided international agencies such as the World Health Organization with a model for an ideal meeting point between communities and official health systems.

 

I mention all these names and groups of individuals to emphasize that, although the IHS concept has value as an idea, in the end it is people who matter.  No one will disagree with the idea that we need a school for health professionals who will serve the disadvantaged rural communities of this region.  Today especially, few will argue with community orientation and service commitment as the primary values of health workers.  But to put these theoretical ideals into practice requires work and talent, patience and dedication, and the blood, sweat and tears of a critical mass of living, breathing human beings.  And in 1976, we obviously happened to have that critical mass who believed in a concept and had faith in the capabilities of deprived communities to help themselves.

 

This brings me to the most important component of the IHS program – its students and its products.  They are the true heroes, the real indicators of the program’s success – and to me there is absolutely no doubt about its success.  I shall not repeat the statistics because all of us know about them and they are easily available.  I shall simply assert with great confidence that the record clearly shows that the IHS student and graduate is the intellectual and academic equal of those from any school in the country, technically superior to most in actual health care skills, and certainly far above all in dedication and commitment to the service of the people.

 

Of course, the IHS movement has had a number of serious flaws and failures.  Among these, the most serious is the fact that it has not been replicated anywhere else in the country, and that in fact, even here in Leyte, it is challenged by the operation of conventional, discredited and irrelevant institutions.  But this is the fault not of those who are involved in the operation here, but rather of those who have access to the academic leadership and policy makers at the national level – that includes myself.  But today, I have had my faith renewed.  I believe it is only a matter of time before the ideas that were born in 1976 will eventually prevail, and our people will finally have the kind of health professional who cares about them and their communities.

 

However, in order to ensure that the idea remains constant to its goals and relevant to its environment, we need to be constantly on guard against those whose slavish devotion to old-fashioned standards of academic excellence of proven uselessness will continue to reshape this institution back into the old comfortable mold of irrelevance.  In order to remind us of this need, I would like to close this talk with a Taoist story by the sage Chuang Tzu.  (As an aside, I took this story from a book that was given to me by Prof. Armando Bonifacio, who many of you will remember, was “the” philosopher behind the IHS program.)  And the story goes like this:

 

“The South Sea King was Act-on-your-Hunch.  The North Sea King was Act-in-a-Flash.  The king of the place between them was No-Form.

 

“Now South Sea King and North Sea King used to go together often to the land of No-Form, and he treated them well.

 

“So the two consulted together.  They thought up a good turn, a pleasant surprise to No-Form, in token of their appreciation.

 

“’Men,’ they said, ‘have seven openings: for seeing, for breathing, for hearing and so on.  But No-Form has no openings.  Let us make him a few holes.’  As so they put holes in No-Form, one a day for seven days.  And when they finished the seventh opening, their friend lay dead.

 

“It is then said: ‘To organize is to destroy.’”

 

Thank you very much.