Without the White Coat
By Florentino P. Alerta II, M.D.

Free medical missions… supporting the “dole-out” system?

One of the reasons why physicians and doctors alike volunteer for any medical or dental mission is a self fulfillment of sharing and giving their services back to their communities. The wonderful feeling of joy and self contentment that cannot be brought about by any financial and monetary value makes one being lifted up by his/her feet. For the physician it may just be the fulfillment of his/her hypocratic oath of “ service to humanity ”, but the feeling of a C hristian service to your fellow human being is thus attained.

Medical mission has its own joy and experiences. People's perception coming from the urban area are totally different from those rural folks—their attitudes and views on medical missions are totally different. The “dole-out” attitudes may have been imprinted in our subconscious mind when it comes to medical or health mission, some medications aside from the free services given by the doctors. I observe that Filipino people never place importance on his health, 'cuz for the one peso he earns just a minimal amount or none at all is spent on his health care needs the 50% of the peso is spent on food, cigarettes and alcohol. The “ common ” Filipino tao will seek medical assistance and consult his physician when he is on the “ last straw ” of his medical condition, meaning when his condition becomes worst after a lot of “ disponering ” and “ quack ” consultations. This may be one reason that our dear country and people will never be a progressive nation, since our negative attitudes and traditions still hold us back. If we all look up at the health care system of our country it seems that everybody is so dependent on what it can deliver especially the needed medications. As Filipinos we never look upon the preventive aspects of diseases, we always deal on the curative and treatment stages of illnesses.

It has been years that I have been going around from one medical mission to some free medical and dental civic action in Metro Iloilo either sponsored by an organization or some association. I couldn't help to notice and do some observations of my own. Urban folks tend to be “ free-loaders ” and are the products of a “ dole-out ” system. Just hearing some folks around, the first question uttered by some and usually the most popular phrase I heard “ may mga bulong sila? ” , seeing none or the mission is purely a medical consultation this folks will start “ evaporating ” slowly. It could have been fine if the government subsidizes medicines and services. The urban folks that come to the “ free medical mission ” are all equipped with some chief complaint that will render all the free medications and in some instances will dictate on the examining physician what to give them. (a suggestion when sponsoring a health or medical mission be sure to bring or arm yourselves with a lot of supply of multivitamins for either the adult or the children populations.) A funny thing they won't leave your consultation table if you cannot prescribe some free medicine to them, even though your findings are all normal, but to satisfy them and support the “ dole-ou t” system, you “ kindly ” just prescribe the available “ free ” vitamins.

Sometimes deep inside I just have a smile in my face when one patient will bring in tow all her children, all with the same chief complaint and will demand medications for all of them. As Filipinos we will never forget our good neighbors in which times we ask free medications for them. You will see patients that will demand or will “ kindly ” ask the doctor for all the medications that will cure all the illnesses in this world from cough, nasal congestion to fever. The folks and the patient will thus be satisfied or will have a sense of fulfillment that on his way home he will have a plastic bag full of “ free ” medicines. Unless we all change we can never correct this “ dole-out ” phenomenon pulling down the Filipino people. I know we are a country of hard working Filipinos, a very resourceful country, but the blood of “ freebies (someone that like everything that are all for free)”, graft and corruptions still runs deep in our veins.