Dr. Natie Castro: The ‘Misyonera’ Doctor
Being a community doctor is already difficult. But this doctor is taking on more challenges, engaging in paralegal and human rights work.
From rallies to communities
Dr. Natie Castro and Dr. Caguiat were both from batch 1995 in medical school. They were the only doctors from their batch who went into community service.
Natie also joined COMMED. She had her exposure in a farming community in Nueva Ecija and in a tribal area in Mindoro.
Since her graduation from medical school, she has practiced and lived with the people of Butuan, Agusan del Norte.
Living and working with the poorest of the poor was not hard for this Manila-raised woman. During her pre-medicine days, she was very active in political rallies and met a lot of people from different walks of life with varied concerns but united in one struggle.
“Dismal” government health care delivery
Her first experience in delivering a baby at the patient’s home was the most challenging experience for her. Six out of 10 Filipinos are born at home, she said. But doctors like her are trained to deliver babies in the comfort of the hospital.
Alone and with only a stethoscope, she was uneasy during her early years in the community because of her fears of encountering complications in the birthing process. But confidence comes with experience, she said.
But not all medical cases could be ensured by skills.
She remembered her child patient with pneumonia. After a hospital refused to accept the patient because the parent is incapable of paying the deposit, Natie decided to do the treatment in her clinic. She instructed the mother on what to do while her son was confined in the clinic. The boy was already recovering. But the mother fed her child who was in a lying position. The child vomited and inhaled food particles causing his death by aspiration.
“Pag hindi handa ang community sa panahon ng krisis o catastrophic illness, walang ibang matatakbuhan,” (When the community is caught unprepared in times of crisis or catastrophic illness, there is nowhere to run to.) she said. “Kahit gaano namin kagustong makatulong, limitado lang ang aming resources at walang suporta ng gobyerno” (Even if we want to help, we have limited resources and we do not get government support.)
Natie is the only community doctor in the two Agusan provinces, and one of only two in the Caraga Region or Region 13.
“Yung state ng health care na doctor-oriented, city-centered, tapos curative lagi, ‘yun rin ang pumapatay sa public health delivery sa community” (The doctor-oriented, city-centered and curative-oriented state of health care is what kills public health delivery in the communities), she said, assessing government support as “dismal.”
She also criticized the Philhealth, saying it is not sustainable and does not cover all the costs of treatment, especially out patient expenses.
Learning and unlearning
In community work, she did a lot of unlearning of many things taught in school. On the other hand, she learned from the people she serves.
Through her training under COMMED, Natie acquired skills in organizing, social scanning, social investigation, networking, communicating with patients, and developed the attitude of unlearning unneeded and irrelevant interests.
“Mas gina-ground ka galing du’n sa prestige na meron ang medical profession” (You are trained to be more grounded in contrast to the prestige and air of respect that the medical profession has), she said. She said she could be a doctor with special skills but she is not apart from or higher than the people she serves in the community.
There was an instance when their program was running out of funds. To cope, they all received the same minimum allowance regardless of job description and training.
“Sa CBHP (community-based health program), hindi naman hiwalay y’ung doktor sa overall kahirapan ng lipunan kaya dapat i-simplify ang buhay para umabot man sa gano’n, hindi gano’ng kabigat (tanggapin ang pagbabago),” (In the CBHP, the doctor is not immune from the overall poverty of the community, so you have to simplify your lifestyle so that if worse comes to worst, it would not be too difficult to adjust) she said. This, she also said, is especially true for her who is still single and does not need much.
“Hindi ko naman maatim na sumusweldo nang mas malaki e single naman ako, kesa du’n sa may pamilya” (I’d be ashamed if I earned more than those with families, when I’m single), she said. “Malaking bahagi ng community health work in general ang pag-i-involve ng buong community sa ginagawa mo”(A good part of community health work in general entails getting the whole community involved in what you do.)
But oftentimes, medical students treat community service as a vacation, she said, that’s why their minds are also at break. This thinking has a great effect on the students’ preparedness to go to community service, she added. They then experience difficulties in organizing the community; and in making health services and programs adequate and appropriate to the community.
For Natie, it is easier to work in an “organized” community where people’s organizations have been established and the people in the area are united. In areas where no people’s organization is formed yet, the task of delivering health services is accompanied by organizing.
“Mobilizing through health programs makes the people aware of the bigger societal problems they face and makes them realize the need to unite through creating their own organizations,” she said.
