The topic for the blog rounds this week is why we continue to love the Philippines and what our reasons are for staying.

From a purely material perspective, there is very little to stay behind for. Educational opportunities are dwindling, security is tenuous, wireless internet service is spotty, the cleanliness of bottled water is suspect, gasoline will only become more expensive, there is a looming rice shortage, traffic and its twin children, pollution and waste of time is ridiculous, the beaches in Thailand are less costly, shopping in Hong Kong and Singapore is infinitely better, Haagen-Dazs is more expensive in Manila compared to Tokyo!

You leave our country and find that much of the world has left us behind. You leave our country and your desensitization to poverty and bad governance disappears, you begin asking questions once again. It does not have to be this way and this is the fundamental reason why we can’t leave our country like this.

We need to love our country and give as much as we can because of those we leave behind. We become a nation only when we recognize our responsibility to help these desperate millions of Filipinos who by the looks of it, have no chance to improve their lives.

We need to keep this love for our country burning because we are the last hope, or so must we frame it in these dramatic terms because if we give up and cede our country’s future to all these politicians who have been presenting themselves all these years, then all becomes lost.

We will be telling our children we had a country once.

In a very disturbing development, the Philippine Supreme Court upheld the disqualification of an elected mayor because he is a United States permanent resident as shown by his possession of a green card. In a glaring display of ignorance, the Supreme Court ruled that US permanent residents are deemed to have abandoned and renounced their status as residents of the Philippines.

A few facts rankle. First, the disqualification emanated from resigned and disgraced elections commissioner Benjamin Abalos. While the elected mayor chose to return to his country and participate in rebuilding it, Abalos was busy sealing the deal that would have allowed him a big portion of a $135 million kickback.

Second, the Philippine government strongly encourages Filipinos in the US to send money back home, invest in real estate and business ventures and return frequently as tourists.

Finally, in order to work in the US and become productive Filipinos who can potentially contribute to our country, we need to legally adjust our status by becoming permanent residents. There is not an iota of love lost for the Philippines in this process. Every remittance reconnects us to our communities. Unless our government prefers us to hang around the corner store and drink beer and gin and sell our votes to all these traditional politicians who control the political process from whence they make their livelihoods.

In all seriousness though, I think this is the preference of the government.

It used to be, during the last year of medical training we would be sent to some far flung barrio and we would get “immersed” with what was truly out there. We would treat hypertension with native herbal concoctions delivered with an enormous dollop of patient education, detailing the pathophysiology of the disease and suggest numerous lifestyle modification techniques that 20 years later I now fully realize was a total waste of time.

What Filipino medical students need is a different rotation, to a healthcare system that works. We should be sent to countries like Japan, the US, Cuba, South Africa and learn about methods that work. What is happening is we are producing generations of Filipino medical doctors who are fully aware of the almost-absent healthcare system but are unable to think differently from the reliably failed nostrums of the preceding generation of public health policy makers.

Philippine healthcare system? System denotes order that promotes efficacy. We are certainly not a healthy people. We are woefully malnourished, our diets depend on sodium to acquire a semblance of palatability, clean water is hard to find and the vast majority of the poor are intentionally kept in the dark regarding their healthcare choices.

We Doctors must find it unacceptable that the government places very little importance to healthcare. And this comes about because many politically connected physicians actively co-opt this tragic lack of foresight. We must understand that there is no way for an unhealthy population to rise from dehumanizing poverty and corruption.

What can we do? We all know the situation is not getting any better. We all have our opinions and solutions, most of which will never be heard because we choose to be quiet and uninvolved. It is easier to allow all these wonderful technocrats and healthcare experts to continue charting this disastrous course while we comfort ourselves by participating in medical missions and contributing assistance towards the medical needs of a few unfortunate souls.

It is simpler and safer to be part of the problem.

Easy entry, this one is. Last summer, while you were all over the world visiting historic sites and gawking at national treasures, I ran for the senate. 90 intense days. I didn’t campaign for one day more, one day less than the prescribed period. I never bought a single vote and I never appeared in a paid television or radio commercial. I spent a little more than a million pesos of my own funds even if the biggest financial consideration came in the form of the lost income in the 100 days of that unforgettable experience.

Can’t say I didn’t have a good time. Went around the country, met many people. Knew it was a hopeless battle but kept on, knowing it was but a beginning.

Looking back, while working in my clinic in Oklahoma once again, there are no regrets. Did the best I could. Somebody needed to put up a fight. Worst mistake in my youth was to give Marcos, Ponce Enrile, Ver and company a free pass. Everyone was simply so afraid to resist.

Can’t say I’d do it all again. I watch my kids having a wonderful time, reconnecting with old friends. My patients are happy and I am no longer working as hard as I used to. We’ll see.

I’ll have a less exciting summer this year, that’s for sure.

It’s close to midnight here and I am rushing this post in solidarity with my fellow Filipino physician bloggers. I guess the longer you remain in this business, the more you realize that we are able to continue practicing in fairly good health solely because of some special grace. I am not old and yet I know of quite a number of classmates and batchmates who have died, contracted metastatic cancer, undergone angioplasties and bypasses, and the like.

While I really should be more conscientious in meeting my health screening milestones (at least an annual lipid profile, diabetes screening, colonoscopy, etc) I have only become more cavalier with time because let’s face it, the time allotted us is truly very short and the more we think we can beat that aneurysm growing in our brains with a monthly cerebral CT angiogram, the less importance we give to why we are alive in the first place.

Introspection as to what this is all about needs to take precedence over finding ways of prolonging life for the hell of it. Some old folk have this nasty habit. Much like those self-important geniuses who devote countless hours musing about the existence of God.

Get over it. We are all patients. Our illness is our inability to fully appreciate the exceptional blessing bestowed to us of being able to leave this world a better place.