(Published in the Philippine Daily Inquirer, April 24, 2004.)
PRESIDENT Gloria Macapagal-Arroyo might have visited and awarded the four police officers wounded in the March 17 raid of New People’s Army guerrillas on the town of San Juan de Buan, Samar, at a private hospital during her recent trip to Tacloban. But the medical personnel who gave post-battle first aid to these officers still suffer from war shock and the town’s health programs and schedules remain in disarray a month after the attack.
When a battle is fought between government troops and NPA rebels anywhere on Samar Island, chances are the gunfire and explosions are heard by a graduate of the School of Health Sciences (SHS) of the University of the Philippines Manila, who is assigned to a nearby health facility as a midwife, nurse, or physician.
Local-based SHS graduates heard the gunfire during the NPA attacks in Calbiga town in May 2002, in Motiong in November 2002, and in Quinapundan in June last year.
And when 20 rounds of artillery, 1,000 rounds of machinegun bullets and hundreds of rifle shots were fired from the government side during a four-hour battle to ward off guerrillas laying siege on the police station and an Army detachment in San Jose de Buan in the morning of March 17, three SHS graduates -- a physician, a nurse, and a midwife -- were cooped up inside their quarters in the town’s Rural Health Unit (RHU) building just 15 meters away from the besieged police station.
Wounded in the battle were four police officers, including the chief of police, and a soldier from the similarly besieged Army camp nearby.
Two civilians died from stray bullets, and another suffered a fatal heart attack.
Hardship assignment
The forest frontier town of San Juan de Buan is a hardship post. Located 133 km. north of Tacloban, it is more than 40 km. away from the nearest cemented highway.
Its population of about 7,000 is spread out in remote mountain barangays, mostly accessible by trails and footpaths on precarious mountain ridges or under a canopy of forest trees and vegetation, by fording or treading shaky footbridges across streams, by crossing neck-deep rivers, or any combination of these modes.
In such situation, it is easy for a person or a small group of silent hikers to be mistaken for guerrillas or soldiers on patrol.
Time here is largely reckoned by the hourly howling of an owl species. And since sunrise, noon, and sunset cannot be observed as easily as in the lowlands, the taking of medicines by the sick but less literate patient could pose some problem to the prescribing health personnel.
[NOTE: The following italicized text did not appear in the newspaper version. It could garble the sense of the rest of the article if not included.]
No doctor
San Jose de Buan has been "doctorless" for much of the past 20 years. A public health nurse headed its Rural Health Unit during most of this period.
Reynaldo Gacho, a nursing graduate of SHS from Lawaan town, headed the local RHU during the 1980s. After the first EDSA revolt in 1986, he also functioned as OIC-town mayor until the election of a new mayor in 1988. He has since relocated to Catbalogan with his family and now works at the RHU of the capital town.
Santiago Gloria, Jr., now 32, another SHS nursing graduate from Zumarraga town, replaced Gacho as public health nurse. Around the same time, Gloria’s batch mate, Adelfa Babalcon from Paranas town, who finished the SHS midwifery program, joined the RHU as rural health midwife.
Love blossomed between the two former classmates in that pristine setting, and they later got married. Both have served the town at least a decade now, but their two children live in the care of relatives at their residence in Paranas town, about 45 km. away.
In San Jose de Buan, they stay at the staff quarters (the old RHU building) adjacent to their new office building.
With the devolution of the health services in the mid-1990s, Santiago was retained as a Department of Health employee while Adelfa was devolved as a municipal employee. He still serves the town as its PHN but gets his salary from the DOH.
A doctor at last
The town had a full-time rural health physician for two years in the mid-1990s, courtesy of the Doctor to the Barrios (DTTB) Program of the DOH.
The department's gesture was much appreciated by the local residents because it brought external resources for health and medical care to the town and its hinterlands. But the first assigned doctor, a female physician who had worked abroad, was already middle aged.
Looking back to that DTTB experience, Santiago mused that both idealism and strong will were not sufficient for effective health work in this town. A younger physique that can withstand the rigors of hiking in a difficult terrain is also important.
In August last year, the town had a second DTTB physician. Dr. Phoebe de la Cruz, 31, belongs to the batch that followed the Glorias' batch at SHS. She went on to finish the medical course.
De la Cruz hails from the adjacent frontier town of Matuguinao, north of San Jose de Buan but is approached in a roundabout way via Gandara town.
She started her work with a bang, organizing 20-person expeditions to the remote barangays of the town to deliver medicines, health care and measles vaccines to residents.
Together with her team, she had literally climbed every mountain and forded every stream of the municipality and its hinterlands, a feat that she has not done in her hometown during her own "service leaves."
De la Cruz was appalled by the sheer preventive nature of the diseases that plague the town’s hinterlands -- measles, diarrhea, and ascariasis.
She was bothered by the delay of her team’s arrival in one barangay where three children had died of measles during an epidemic. When she expressed her disgust about what happened, she was simply told that 20 children had died here during a previous unattended outbreak.
A 1998 cluster survey showed only 26 percent of the eligible children had undergone complete immunization. The coverage has tripled since De la Cruz started her work there.
Coordination
De la Cruz was out of town trying to get in the day before the NPA raid. She had been warned not to go, but she forced herself to ride in a vehicle on a "special trip" to San Jose de Buan because of a symposium on drug abuse and immunization for children of Manobo tribes from the hinterlands, both scheduled for March 17.
The vehicle reached only as far as a destroyed bridge a few kilometers from town and she hiked her way to the staff quarters at the RHU.
Everything was set for the activities when gunfire started at around 3:30 a.m. There was a lull of only about 20 minutes in between until the firing finally stopped at around 7:45 a.m., or about four hours later.
When the battle began, De la Cruz rushed to the quarters of the Gloria couple who cowered together in that room. She asked and got permission to hug the people to calm her extreme fear while the ground shook with every artillery explosion from the besieged Army detachment a kilometer away.
They used an instrument tray as temporary urinal during the entire episode.
The RHU and its staff quarters were spared from the range of fire during the entire fight around the police station some 15 meters away.
"Our RHU building did not suffer a bullet scratch from the battle," De la Cruz said.
Post-battle
After the NPA attackers had retreated and the area was cleared by reinforcement troops, the question in every townspeople’s mind was: Was the doctor still alive?
To everyone’s relief, De la Cruz survived the ordeal. Her parents in Matuguinao were promptly informed about the good news through the Army’s radio facilities.
With the help of the Glorias, De la Cruz immediately attended to the wounded police officers and civilians, administering intravenous fluids and giving first aid with available supplies. Seven people were later brought by helicopter to Tacloban.
De la Cruz was too war shocked and scared to accompany the wounded to the hospital. She assigned the task to Santiago, the public health nurse, who was similarly shocked.
It was only in the helicopter that Santiago realized he was wearing only an undershirt, skimpy short pants and mismatched slippers. He had no money in his pocket.
After the wounded had been admitted to the hospital, Santiago proceeded to the DOH regional office to borrow fare money for the return trip.