Leaders for Health Program: Sleepy Bohol town learns to tackle health problems

A town mayor in the Visayas and a doctor from Manila, brought together by a common interest in medicine and a desire to serve poor patients, have teamed up to actively involve the whole townsfolk of Catigbian, Bohol in the implementation of what is now proving to be an exceptionally effective program aimed at tackling health problems while at the same time developing community health leaders.

Catigbian Mayor Roberto Salinas, 55, who dreamt of becoming a doctor but only got as far as completing a pre-med course in Southwestern University in Cebu, and Dr. Allan Evangelista, 35, who left the Makati Medical Center to "try working on the government side," crossed paths through the Leaders for Health Program (LHP).

A project of the Department of Health, the Ateneo Graduate School of Business and Pfizer Inc. that sends physicians to remote towns, the LHP, begun in 2002, has become a school without walls, training doctors, politicians and community leaders to change the way people think, behave and feel about health and their well-being. At the end of a four-year service, the volunteer doctor receives a master’s degree in community healthcare management from Ateneo.

Salinas was starting his first term of office when the LHP organizers brought the program to Catigbian, a fourth-class municipality of 24,000 people. Evangelista, on the other hand, was coming from a two-year stint in a government hospital in Mindoro, a position he said he had personally applied for to find out how the healthcare system works on the other side of the health spectrum after a three-year residency in one of the country’s most modern private hospitals in Makati City.

Getting support and guidelines from the program, the two well-intentioned men and two barangay health workers immediately buckled down to work, urging residents of the town’s 22 barangays to involve themselves in the program and do away with their centuries-old, unsafe health practices through a vigorous health information campaign.

"Deprived of a clean water system and with eight barangays still without access to water up to these days, we always tell my constituents to boil water before drinking it," Salinas recalled. "Yes, the information campaign is focused more on ways to prevent diseases. At the same time, we also advise them to regularly visit the health centers either in the town or in their barangay."

Evangelista said that in his first month in Catigbian, he would only have one or, at the most, two persons visiting him at the main health center for consultation or check-up. "I had to go out and visit each barangay and enjoin the people to come visit me at the center," he said.

Now, he has his hands full attending to at least 100 patients daily, a measure, he explained, of the townsfolk’s changed attitude toward health as a way of life.

"When I came over here, I found the people preferring more the faith healers, the quack doctors and the manghihilot. By the time they turned to the hospital or to us for treatment, the patients were already in serious condition," he said.

Health statistics in Catigbian, according to Salinas, who, together with his two barangay health workers had taken certificate courses in healthcare management at the Ateneo as part of the LHP, speaks glowingly of gains achieved by the program and of how well the whole leadership in the town takes to it.

For instance, the town’s mortality rate in diarrhea was down from 65 percent in 2003 to just 15 percent in 2006 and from 45 percent to nine percent in tuberculosis over the same period.

Evangelista said the program won’t have a chance to succeed without the cooperation of the local officials. "It helps that Mayor Salinas is genuinely interested in safeguarding his people’s health. Not only does he allocate a large slice of the town’s budget to health, he also urges the town council to quickly pass all the resolutions needed to ensure an efficient delivery of healthcare services to the people," he said.

This year, Mayor Salinas has signed a health budget of about P4 million for the town, a hefty 50 percent increase from that of 2004. On Aug. 16 last year, the Sangguniang Bayan, at the instigation of their mayor, passed a resolution naming Evangelista as Catigbian’s new municipal health officer.

Evangelista has come to love his official position in the agricultural town so much that he plans to serve the people of Catigbian and the LHP as long as he is needed. He hopes as well that the LHP will be replicated in every town in the country.

Initially in August 2002, the program dispatched 20 doctors to pilot areas in the Visayas and Mindanao. In 2004 it expanded its coverage by sending volunteer doctors, including Evangelista, to 39 municipalities.