Public health is essentially a field that requires engaging people. But in my years of working in public health I realized that engaging people does not only entail having to design policies and programs, and promoting them to the people who will benefit from them. Instead, I learned that I had to listen to the people, and cater to their actual needs.
These needs aren’t what you usually ask in relation to the programs one plans to implement. You don’t go out and ask people around their knowledge, attitudes and practices related to vaccination, for instance. What’s needed is knowing their context, their culture, and their daily life.
In my two years in the field, while implementing programs for preventing non-communicable diseases, I realized that the right question wasn’t about their attitude on taking maintenance medications. The right question to ask was what has been leading them to an unhealthy lifestyle. I’ve found that answers to this question come from precisely these: their context, their culture, and their daily life.
In the Cordillera region, for example, in my practice I’ve been seeing a lot of people with elevated blood pressure. I’ve come to know that this trend was not really attributable to the failure in taking maintenance medications. I also didn’t think that exercise was a problem: navigating daily the difficult terrain was more than enough. However, because of the Cordilleran preference for meat and salt, some of my patients not only develop hypertension, but also develop gout and kidney disease.
This is also similar to my experience with an urban poor health program, shown in the picture, where non-communicable diseases are related to food choices, as well as lack of safe spaces to conduct healthy lifestyle activities.
The clinical approach is usually to respond with medications. What appeals better to me is the public health approach: nip the problem at the bud.
In the case of my host municipality in the Cordillera, we instituted a program for monitoring blood pressure, blood glucose, and cholesterol, in cooperation with senior citizens and the local women’s organization. In turn, the municipal employees’ association and our nurses implemented a healthy lifestyle campaign that focused on increasing physical activity through zumba dancing. We launched the campaign in what would be the best date for cardiovascular health: Valentines’ Day, 14 February. The Department of Health has since implemented a similar approach nationwide.
Meanwhile, in the case of the health program with the urban poor, we trained health workers in monitoring blood pressure and vital signs, which is the first step in recognizing the presence of health issues in the community.
It’s a source of pride for me that my host municipality did it first in the province. I plan to go back and monitor its progress within the context of a research project, but with the pictures I see on Facebook, I’m happy the effort has survived after a few years. Similarly, the effort with the urban poor health program blossomed into a corps of community health volunteers. The long-term impact of our little training program remains to be seen and the efforts need to be sustained further, but I am happy it has impacted positively on the health-seeking behavior of the community.
All because of a genuine interest in the lives and well-being of people.
All because of engaging people.