| 25
June 2002
Filipino doctors
SOME of you know, from reading Ambeth
Ocampo, that Jose Rizal shouldn't actually be called "Doctor".
During the Spanish colonial period, the University of Santo Tomas was
the only educational institution offering medical training. If you
passed the examinations you got a "licentiate" but to actually
become a doctor, you had to go to Spain or Mexico to get additional
training, eventually submitting a thesis that allowed you to use the
title of doctor.
Rizal did go on to study in Spain but returned without submitting his
doctoral thesis. He returned to the Philippines and did practice
medicine while doing a hundred other things, including painting,
sculpting and, in Dapitan, developing the community's street lights,
educational system and water system.
Rizal's "flirtations" with medicine figure prominently in a
new book, "History of Philippine Medicine", written by three
Filipino physicians: Conrado S. Dayrit, Perla Dizon Santos Ocampo and
Eduardo de la Cruz.
The book traces the development of medicine in the Philippines from the
pre-colonial period to the present, essentially a listing of names and
medical discoveries of breakthroughs. The reading can become tedious at
times but there are interesting glimpses in between. I came away even
more convinced that medicine is more than dramatic surgery and cures.
What made a difference – the conquest or at least the quelling of
diseases – came about through massive social mobilization.
Even during the Spanish colonial period, we already find elements of
this mobilization. A newspaper called La Filantrofia published in the
early 19th century carried information on medical remedies. News about
health was disseminated through town criers.
"History of Philippine Medicine" didn't deal too much with a
historic campaign to bring vaccinations to the Philippines, one that
started in Spain with young children as live carriers of smallpox. The
children were transported from Spain to Mexico and eventually to the
Philippines, keeping the smallpox virus alive so it could be used to
vaccinate other children. I've wondered at times what happened to the
children after the expedition was completed, one that saved many lives.
The public health system under Spain was very rudimentary. When the
Americans came, there were only 66 physicians in the entire country (42
in Luzon, 18 in the Visayas and two in Mindanao), assisted by 22
midwives and 127 vaccinators. This was for a population of six million.
During the American period, the major public health challenge was
cholera. People were understandably suspicious of the Americans,
especially with the brutal Philippine-American War fresh in their minds.
The public health system was now stronger, with more Filipino physicians
and health professionals trained, but much of public health was a matter
of persuading people to adopt Western standards of sanitation. The
changes came gradually, through the combined efforts of the government's
health service as well as the public educational system.
"History of Medicine in the Philippines" reminds us that many
of the achievements in public health occurred before the era of
antibiotics. Diarrhea was treated first by purging the patient with
castor oil to rid the person of toxic substances and then using
paregoric, actually a tincture of opium, to stop the purging! There were
all kinds of prescriptions for tuberculosis, including intravenous
injections of calcium gluconate and pneumothorax, a surgical procedure
to deflate the afflicted lungs.
I sometimes think people recovered not because but in spite of those
treatments. Tuberculosis, for example, was treated at a sanitarium in
Manila's Santa Mesa district, which still exists today. Perhaps what was
most useful wasn't the medical treatment but the rest and fresh air.
My point is that a physician's healing capabilities depended too on his
being able to provide emotional support for the patient and the
patient's family, and mobilizing community resources to fight disease. A
moving example is found actually in an appendix to "History of
Medicine," a compilation of anecdotes from the Japanese occupation.
One of the stories referred to a patient, Edith Dizon, who had gone into
labor with her first child. She was alone, afraid and apprehensive,
worried about what would happen to her husband as he went off to fetch
some articles from their home. Suddenly, we are told, the music of a
violin "wafted across from the Intern's Dormitory." Dizon was
a pianist and recognized the tune: Massenet's "Meditation from
Thais". The music calmed her down and she delivered her baby
successfully. Many years later, at the age of 78, she went back to
school to complete a PhD in Music Therapy from the Michigan State
University.
We can see that the practice of medicine involves far more than
dispensing medicine, in this case, even the playing of the violin.
Seriously though, medicine in the last 50 years has shown how even
politics affects people's health. The most dramatic examples come with
medicines: we may have the latest drugs in the country but many of the
most essential medicines remain unaffordable to many Filipinos. There
have been many attempts to bring down the prices of medicines, from the
use of generics to parallel imports, but success here remains limited,
with too many obstacles posed by the drug industry and physicians
themselves.
Rizal may not have obtained his doctorate but in all he did-from the
community development programs in Dapitan to his writing of the "Noli
Me Tangere" and "El Filibusterismo" – he was practicing
medicine as it should be practiced.
|
