FJ Volume 21, Number 23
December 05-20, 2007
Magandang araw, mga kaibigan naman! Kumusta kayo?? Ay nako, it’s been too long—these last couple of months I’ve been “in hiding” a bit, finishing up my Master’s of Public Health Field Practicum and frantically writing up my project papers and presenting my findings to the Department of Community Health Sciences at the University of Manitoba. Phew! Pagod na pagod po ako dahil trabaho/pararalan! My last two columns sported reflections of my journey to the Philippines July 12th - August 10th. I first reported on the Ambassadors’, Consul Generals’, and Tourism Directors’ Tour (ACGTDT) and urged readers to respond to my Field Practicum questionnaire exploring the migration of Filipino doctors and health care workers to Canada. In Part 2, I then described my experiences at the Philippine Senate and Philippine National Red Cross with Senator Dick Gordon, with a cameo from the very charming former President Fidel Ramos.
My adventures didn’t end there, however. I was able to do/learn/see so much more during my time in the Philippines, particularly getting exposure to the different perspectives related to the Philippine health care system and the migration of Filipino HCWs to Canada. I got to interview many key players in this complex issue, including: Migrante International, a non-profit grassroots organization dedicated to the advocacy and wellbeing of OFWs; previous Secretary of Health, public health physician, and Pinoy HCW migration expert, Dr. Jaime Z. Galvez Tan; UP College of Medicine professors and students including Dean Alberto Roxas and Dr. Leo Cubillan; media station GMA-7’s Sandra Aguinaldo, who did a documentary on “Dr. Nurses”; governmental agencies including the Canadian Immigration Integration Program/Canadian Embassy, Philippine Overseas Employment Authority, Department of Labour and Employment; and numerous other physicians/residents/medical students/health care workers/stakeholders who proved very gracious in giving me their time and input. I also found myself in a position to take part in clinical/missionary work--Dr. Hector Santos and the rest of the plastic surgery staff at the Managed Care Clinic invited me to come to their Operation Smile mission where they perform free surgical care and rehabilitation (eg speech language pathology) to those in need who cannot afford the treatments. Not only did I get to interview the gang for my project, but I also observed cleft lip and palate surgery on young patients and listened to the surgical team serenade each other—what a happy musical bunch! After a very inspiring discussion about global health with Dr. Galvez Tan, he also invited me to experience a medical mission--this one in Tondo with the UP Family Medical residents, but unfortunately, typhoons prevented the mission. Sayang! Other major highlights include a trip to Subic to meet PGMA a second time around and an in-depth interview with President Ramos. I will have to write in more detail about these amazing experiences in an upcoming column/my blog. I did witness some of the unpleasant and downright scary aspects of the Philippines, such as my “undercover” research in the form of “kidney-shopping” with cabdrivers and the demoralizing Filipino “crab mentality” Dr. Roxas enlightened me of. I might even reveal some of my more candid reactions, culture shocks, and rude awakenings learning about the distinctly Pinoy way of life. These all made for a very rich and life-changing experience for me, and I consider myself blessed for being given the opportunity to experience it all.
This project also led me to experiences in Winnipeg with the WRHA/Manitoba Health/Department of Labour and Immigration (Physician Resource Coordination Office); IMG (International Medical Graduate) Program, Faculty of Medicine, University of Manitoba; College of Physicians and Surgeons of Manitoba (CPSM); University of Winnipeg, Global College; Philippine-Canadian Centre of Manitoba; Community clinics/organizations such as Welcome Place and ANAK; CBC; The Filipino Journal; and of course, key informants Pinoy and other IMG docs. I also went to Ottawa and learned much from the Philippine Embassy; Federal Government Departments (Multiculturalism and Canadian Identity; Citizenship and Immigration; & Health); and the Canadian Public Health Association Conference, where I got to hear from such notable speakers as environmentalist David Suzuki, Nobel Peace Prize Winner David Orbinski (Doctors without Borders), Public Health Agency of Canada leader Dr. David Butler-Jones, and Health Minister Tony Clement, among others.
Clearly, my findings from this field practicum are quite extensive and comprehensive. Some of my conclusions:
There is a massive unmanaged migration of Filipino health care workers, including physicians and MD-RNs, worldwide, including to Canada. There are many socio-politico-ecological factors which drive HHR (Health Human Resources) to move abroad, and the effects include a Brain Drain in the health system, an economy held afloat by the remittances, broken families, abuse/health problems of these workers, worsening health status of the Philippines, an increased disparity between the economic classes, and a disturbing culture perpetuated by the American Dream. Pinoy doctors/IMGs face many challenges in their migration, settlement, and licensure to Canada. Their integration success depends on many factors, particularly their ability to gain licensure to practice medicine. Despite a huge need for doctors in Canada, numerous barriers to licensure exist, including a complex web of stakeholders (eg federal, provincial, RHA, licensing bodies, medical educators, etc) with jurisdictional mandates/authorities that leave the IMG falling through the cracks; not well-known, unclear, variable pathways to licensure; competing interests of more aggressive destination countries; a resulting process that is blocked up to the point of paralysis; and the rigours of adjusting to a new lifestyle and culture. Certainly, the Canadian system has many areas of improvement but is definitely moving in the right direction. Canada should strive to address these gaps in the system in a collaborative, globally-sensitive way, including engaging in high-level discussions with the Philippines to come up with some Win-Win solutions, ensuring a consistent, fair licensure process for the various primary care workers congruent with immigration goals and practice, and still taking a proactive, ethically-minded role in the global HHR market. In this way, our country can proudly tap into the tremendous potential value and contribution of the Filipino physician.
I presented some of my experiences and conclusions to my Department at the University, and it was very nice to see mga kababayan attend my presentation. To the Filipino community and all involved with this project, thank you so much for your support, responses to my questionnaire, and much-needed input/advice! Talagang nagpapasalamat ako sa inyo. I plan to present my findings in more detail to the community, particularly for those who expressed regret in missing my presentation, so stay tuned for my next community meeting announcement. I plan to further much work in this area, so please contact me at my blog or email if you are interested in learning more or helping out.
So that wraps up this column for now. Please remember: health starts at home; your health (not just physical/body, but also emotional, spiritual, and mental health) is foremost in your own hands! Alagaan ninyo ang katawan at kalusugan ninyo! Until next time, take care, and mind your health!
Subscribe to:
Posts (Atom)