TABUK CITY, Kalinga (PIA) — In places with mountainous terrain like Kalinga, the Department of Health (DOH)‘s Doctor to the Barrios (DTTB) program ensures that primary healthcare services reach people in hard-to-reach areas.
Five physicians are currently deployed in Kalinga under the DTTB program, serving in the municipalities of Pasil, Lubuagan, Balbalan, Tinglayan, and Tanudan. Among them is 29-year-old Dr. Leonard Mien C. Banatao.
The young physician, together with other public health workers, go to remote villages in Balbalan – at times needing to hike four to six hours to get there – in an effort to provide healthcare to underserved communities.
Public health journey
Dr. Banatao or “Dr. Mien” to his colleagues at the DOH-Kalinga-got his medical degree as a scholar at the Cagayan State University in Tuguegarao City, Cagayan in 2021.
“I was a very big fan of medical movies and documentaries, and this gave me an idea of what a doctor is. And when I was in high school, Dr. Rey Aranca was the chief of hospital in the Western Kalinga District Hospital in Balbalan and he actually encouraged me to become a medical doctor, so that was the start of my medical journey,” he shared.
He worked as a job-order doctor at the Kalinga District Hospital in Lubuagan for six months before joining the DTTB program in June 2023 as his return service for his scholarship.
Under the DTTB program, Dr. Mien was assigned to the town of Balbalan where his parents come from.
“I was very lucky that I was deployed in my hometown. I studied high school in Balbalan,” he said.
The town center of Balbalan is accessible enough for public transport but further into its rural communities, mobility is a different story. But transportation difficulties are par for the course for the country’s doctors-to-the-barrios.
Embodying the ‘Serving the underserved’ motto’, Dr. Mien together with midwives and nurses from the rural health unit (RHU) and the DOH sometimes have to hike for up to six hours to reach so-called geographically isolated and disadvantaged areas (GIDAs.)
“Very challenging ang transportation especially sa barrios na maglalakad ng four to six hours just to give medical services. So challenging siya but it’s fun, it’s part of the DTTB services naman na dadalhin mo ‘yung gamot dun or ‘yung services dun sa barrios natin,” he said.
Dr. Mien spends most days giving medical consultations and performing occasional minor surgeries such as circumcision, cyst removal, and family planning services.
He also participates in information drives where they give lectures about important health topics. He allotts at least one week in a month to visit GIDAs to provide health services to residents who would not otherwise have access due to lack of paved roads.
While people go to him to get treated mostly for their physical illnesses (respiratory infections, cold, cough, UTIs are just among the common illnesses he encounters in the barrios), Dr. Mien also gives attention to that oft-neglected aspect of overall well-being – mental health.
He shared that his most special experience as a DTTB so far is treating mentally ill patients.
“So ‘yung isang patient ko sa isang GIDA area nakwento lang po nung isang midwife namin and nurse na merong pasyente na nakakulong for many years na. So parang sa akin naman, kawawa naman kasi kapag nakakulong, wala na siyang activities, most of the time malnourished po ‘yung mga nakakulong na pasyente natin so, nag-schedule kami ng visit. Binisita namin ‘yung pasyente,” Dr. Mien shared.
When he visited the patient, Dr. Mien had his fears confirmed as the patient was malnourished and living in less than hygienic conditions.
“’Yung goal po namin is lumabas siya sa kulungan nya kasi hindi na po siya healthy, pati ‘yung place niya, and siya po mismo is sobrang malnourished na,” he said.
For two months, Dr. Mien and his colleagues treated the patient, working on restoring the patient’s health, and managing the patient’s mental illness, all with the end goal to re-integrate him back into the community.
“Ngayon, okay na po siya. Last December po nakisali na siya sa mga angkas tapos nakiki-participate na siya sa mga activities natin sa barangay, so very good indication po ‘yun,” Dr. Mien said.
Care for the mentally ill
With the stigma and ignorance surrounding mental disorders, relatives and community members often resort to isolating the mentally ill to deal with their disruptive behaviors, something that Dr. Mien strongly opposes.
“Sa communities po, dapat hindi sila ina-isolate, ‘yung mga pasyente natin na may mental illness, full support po dapat ang family and the community kasi parte po ‘yun ng sakit nila. Actually, hindi sila aware na ganun ‘yung ginagawa nila, hindi sila na ganun ang behavior so dapat ang gagawin po ng community is to help them, huwag po silang i-isolate,” Dr. Mien said.
He advocates for compassion and support for those suffering from psychosis and other mental health conditions like his patient (“’yung mga tinatawag na baliw”).
He stressed that mental health conditions just like physical sicknesses are treatable and people, even those in barrios where mental health tends to take a backseat, should not hesitate to seek medical help.
“Pinaka-importante is huwag po silang mahiya na mag-seek ng tulong lalo sa Department of Health kasi ‘yun nga po ina-advocate po natin ang mental health. Kapag may mga unusual po na behaviors, unusual na thinking ang isang family member, huwag po silang mahiya o mag-hesitate po na mag-approach po sa mga healthcare professionals, sa akin, sa RHU, or sa hospitals natin,” Dr. Mien said.
Fulfillment
Dr. Mien said he enjoys being a doctor to the barrio for the fulfillment of serving his own people and also for the way it sharpens his skills as a physician.
“For aspiring doctors, ang gandang experience po ng Doctors to the Barrio program, maganda po siyang foundation,” he said.
“Sa DTTB kasi mahahasa talaga ‘yung clinical skills mo as a doctor kasi sa barrio walang laboratory diyan so kapag nandun ka, talagang magiging resourceful ka as a doctor. May mga gamot na wala talaga sa bundok, so you have to improvise, mapapaisip ka talaga, magiging resourceful ka so ‘yun ‘yung magandang experience kapag nag-DTTB ka,” he added.
National Health Workforce Support System
According to DOH-Kalinga head Lilia Rose Say-awen, the DTTB program is instrumental in augmenting health services in GIDAs in Kalinga.
Physicians under the DTTB program help doctors in RHUs and improve the doctor-to-patient ratio.
“With the DTTB, at least may kasama ‘yung existing na doctor natin to serve our kababayan kasi nga ang gusto talaga natin, if patients need doctor services, at least may doctor silang mapupuntahan,” Say-awen said.
Say-awen said the DTTB is just one way the DOH is supporting and strengthening primary healthcare in rural areas.
With the National Health Workforce Support System, the DOH supplements the health workforce of local governments, deploying nurses, midwives, dentists, medical technicians, and other healthcare professionals.
“The DTTB program is just one element, kumbaga maysa lang nga program idiay National Health Workforce Support System that the DOH is giving but we actually have a lot [such as] nurse deployment program, midwife deployment program, dentist, medtech, pharmacist. We have a total of 150 plus deployed in the province alone,” she said.
“They are deployed in the different municipalities, RHUs. [They] are helping dagituy permanent tayo nga nurses, midwives in the different barangays. This is in support also of ensuring that there are enough health workforce in the different RHUs,” Say-awen said. **JDP/IOS-PIA CAR, Kalinga
