Service Leadership Reflections from the Philippines
Written By: Jenssy Crystal Rojina
November 2009

 

I peeked out through the window of the plane. Floating islands were scattered all around the glistening water. This picture alone had me in awe. After more than 24 hours of travel, my excitement was bubbling over the brim for the journey on which I was about to embark. The airplane pilot had just announced that we'd soon arrive at our destination in Cebu, Philippines, where I would be joining a group of 18 other university students from around the world to fulfill our service mission, Project Philippines, under the direction of the Southeast Asian Service Leadership Network (SEALNet).

It is estimated that 7 out of 10 pre-school children in the Philippines suffer from gastrointestinal (GI) worm infections - an illustrative example of the global burden of these diseases, which collectively rank first among all communicable and non-communicable diseases in the school-age population in developing countries worldwide . Intestinal worms are acquired through the ingestion of parasite eggs from contaminated food or water. Once inside the body, the eggs develop into adult worms, which circulate in the body until they become lodged, particularly in the intestines. The worms suck nutrients from a host's body and cause abdominal pain and diarrheai. These infections in children result in reduced cognitive development, hampered concentration, and increased school absenteeismii. Project Philippines attacks the problem of high worm prevalence - action that will result in increased productivity and improved quality of life across the country. Our project aimed reduce the number of children infected with GI worm infections by leading an education campaign in Alaska Elementary School that targets students and parents. The education campaign focuses on changing behavior and encouraging hygienic practices in addition to emphasizing the importance of medication.

A person's health is influenced by the interaction between social and environmental factors. If we want to improve the health of our globe, we do not only need physicians to diagnose health conditions and provide treatment, we also need other professionals such as engineers to help provide access to safe water and adequate sanitation systems to the nations of the world. We need government officials to support public health initiatives aimed at improving health, and we also need community health workers to relay important health messages to the community. In the same manner that the human body needs specialized organ systems to interact with each other for a fully functional body, the world needs diverse groups of people talented in different ways and areas to work together to address the problems of today and of the future. In my own career as a physician, I have a vision of improving health globally by fusing a practice in medicine with public health approaches and policy. My time in Cebu, Philippines this past summer allowed me to discover what a public health strategy to alleviating a community problem might look like.

Project Philippines mentees and mentors in an Alaska Elementary classroom giving a presentation as part of the education campaign where approximately 2000 students were targeted in Cebu, Philippines. September 2009.

Prior to our first tour of the Alaska community, I remember our team of volunteers standing in a huddle, resembling a football team. Time seemed to stretch on for hours. Water bottles in hand, we discussed our "game plan". We waited for a representative of Save the Children, our NGO community partner, who would be giving us the tour. I was not used to the humidity and scorching sun blazing down on me. Minutes ticked by, and I could feel more beads of sweat trickling down my neck and my shirt sticking to my skin. I took this time as an opportunity to absorb my surroundings.

I was standing outside the headquarters of Save the Children. A gap through a barred window let me know that the headquarters was a small one-room space. As students in the community roamed around, it appeared to me that it was their break. I saw elementary-aged students walking in groups, notebooks and pencils in hand. Other preschool-aged children played keep away with a ball.

Homes near the ocean in the Alaska community located in Cebu, Philippines. The community is comprised mostly of squatters who are not legally allowed to live in the area, lacking access to safe water and a sanitation system. August 2009.

Elderly women stood at posts selling nuts and candies to the children walking by. Every couple of minutes, men cycling pedicabs and carrying passengers passed by. I remember seeing a woman make her way past our group, walking barefoot across the uneven dirt pathway. She carried a child in one hand. I heard children laughing and speaking excitedly in their native tongue, Cebuano. I wished I knew what they were saying. An unpleasant urine-like odor permeated through the hot summer air.

My observation was interrupted when a member of the project announced that our tour guide had arrived. Finally, our tour would begin and I would be able to see more of the community I would be working with. One by one, like school kids lining up for recess, the project members followed the tour guide. As our tour continued and more time passed, a pang of mixed emotions rushed through my body like lightening. I felt like an invader, a trespasser. I was walking through the very area that the children I saw playing before the tour began, called home. Everything was transparent. This community's way of living held no secrets. Like a trespasser, I walked directly into situations where mothers bathed their children, fathers weaved fishing nets, women collected shells to make jewelry, men proudly displayed small dry fish to sell, babies napped, and neighbors interacted.

Before coming into the tour, I knew that residents of the community comprised mostly of squatters who were not legally permitted to live in the area. I understood that residents lived in temporary homes built near the ocean. I realized that living conditions were less than sanitary, and it was these living conditions and other factors that contributed to the acquisition of GI parasite infections and other diseases. I had studied several aspects about the Philippines in school, focusing on global health in my major. I knew so much, and at the same time knew very little. The more I saw of the community on the tour, the more I felt overwhelmed. All around me it was easy to see the reasons the majority of the children in the Philippines had GI worms, and as I walked, my faith that I could make a difference in the lives of the children and adults in the Alaska community by running an education campaign was shaken.

Project Philippines high school mentees showcasing the tower they built during a service-leadership workshop in UP High School Cebu, Philippines. August 2009.

I had to take a step back to reflect and gain a new perspective. True, there were many problems that the Alaska community faced, and all of these problems were to some degree part of the equation in disease propagation. One of the main problems behind high GI worm infection rates was inadequate access to safe water and lack of a stable sanitation system. Project Philippines was not in a position to implement an entire sanitation system in this community, but what we could do was address the behavioral aspects of disease acquisition that might help reduce the high infection rates. In this respect, we could make a difference. But most importantly, we could make a difference by allowing the future leaders of the Philippines, its youth, to take responsibility and ownership for their communities by empowering them and giving them the service leadership tools they need to improve their own nation's health.

A huge aspect of Project Philippines was working with a group of students in University of the Philippines Cebu High School. The university team was responsible for mentoring 26 high school students who would help lead the education presentations in Alaska Elementary. The university team worked hard to create and implement service-leadership workshops that would challenge and allow the mentees to grow as leaders. As the mentees learned how to strengthen their skills in the leadership workshops, the mentors had an opportunity to gain a better understanding of how the mentees viewed their own community and the Alaska community. For example, we learned about the perceived barriers the students saw when combating any problem within their communities such as stereotypes and financial resources. I was thankful for the opportunity to learn more about the community because I realized that in order to effectively carry out any public health campaign, it was imperative that we understood the community we wished to impact very well. In general, understanding a target community not only helps one meet the needs of the target population more adequately, but it also helps one be a better advocate for our communities.

The most rewarding aspect of my experience in the Philippines was interacting with the high school students. Through the time we spent together, I was able to gain a sense of the wonderful country they are proud to call home. The students understand that their country, like every other country in the world, is not perfect. Despite the corruption in politics, the country's financial debt, and other factors that hinder the development in many ways, the students are optimistic and hopeful of a better future. In a way, I saw a lot of myself in the mentees. Their passion to improve the health and living conditions of their community and its surroundings was palpable. Their enthusiasm for wanting to learn how to become the best leaders they could be, giving every activity 110% of their energy and full attention, was truly inspiring. In the end, I discovered that we were all simply a group of students and teachers to each other. Together we were dreamers, believers, and inspirers. We dreamed about improving global health for a better future, believed in our potential and ability to make a difference, and inspired others to discover that they too could be vehicles for positive change.

It was a surreal experience to see the high school students grow in their confidence with each passing day. When they stood in the classrooms delivering our health messages and engaging their audience, targeting a total of about 2,000 students in Alaska Elementary along with 200 parents, I felt proud. No matter how they choose to lead their lives in the future, the mentees of Project Philippines are prepared to change the aspects of their society that they dream can be different. For this reason, I left the Philippines feeling confident that my efforts would reach far beyond just my stay. I no longer felt overwhelmed by the many problems I had seen during my tour in the Alaska community. I had helped the students who would continue to fight for healthier communities in their nation, and my belief that a small group of dedicated people can make a difference was reaffirmed.

In the future, I strive to be simultaneously a physician and global health leader. Along my journey, I know I will encounter many obstacles. Despite the obstacles that I encounter in my path, I will not be disillusioned. I will look back on my experiences in the Philippines and be inspired. I will remember the words of another dreamer: "Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has."

About the Author

Jenssy Rojina is a senior and premed student at Stanford University majoring in Human Biology with an Area of Concentration in Global Health. She went on a service project in Cebu, Philippines during the summer of 2009 through an organization known as the Southeast Asian Service Leadership Network (SEALNet). In the future she plans on attending medical school and addressing children and women's health issues as a physician. She can be contacted for questions or comments at jrojina@stanford.edu.

References

1. Maclang, Amor. "A Helminth Stricken Society." Janssen Pharmaceutica 6 Oct. 2005. Belizario, Vicente, Alexander Mallari, Anna Javier, Poul Dizon, and Marilyn Anastacio.
2. Baseline Assessment for School-based Control of Common Intestinal Helminthiasis in Public Elementary Children in Cebu City. Rep.No. National Institutes of Health, University of the Philippines Manila. 2006.