The Daring Innovator

The challenge of the Philippine health scene is that the greatest of our problems have remained to be the same for generations. In Noli me Tangere, Rizal talked about how people would drink holy water to cure illnesses that are still prevalent today. Alfonso Linares, Maria Clara’s suitor contending with Crisostomo Ibarra, died from dysentery. Diarrhea is still a serious family burden in the country. Past three colonizers, four Constitutions and two world wars, we have yet to be adjudged if we have made any progress in changing not only the stark scenery of diarrhea, but children’s health in particular and public health in general. Our history, nonetheless, evinces that sporadically, there are men and women who see beyond the illusions of currentness to take arms against what has before been merely gleaned upon. They accept the onus of changing a status quo we have acquiesced upon to our own disaster. In many fields of services, a few Filipinos have looked back and referred to the past, but instead of surrendering, saw in it their destinies and envisioned a common destiny for millions more. Visionaries like Dok Jimmy contemplate what we can achieve against what we have lost, or what continue on losing.

A comment-in-intervention was filed to the Supreme Court En Banc at the early days of Imbong v. Ochoa. The petition, consolidated with half a dozen others, form the legal obstacle against the implementation of a recently-passed (but more-than-a-decade formed) law. Dok Jimmy, intervening with fellow former-Department of Health Secretaries Dr. Esperanza I. Cabral and Dr. Alberto G. Romualdez, Jr. were fighting for the constitutionality of the controversial R.A. 10354. The “Responsible Parenthood and Reproductive Health Act of 2012”, or better known through its moniker ‘RH Law’, is set in an arena of clashing beliefs, information asymmetries and polar interpretations of social justice and national development.

They argue for the statute’s validity, “It is consistent with the constitutional right to privacy. It is in furtherance of the Philippines’s state obligations under international law. It does not violate the freedom of religion. It does not violate the right to life.” Through distinguished counsel, UP Law Professor Elizabeth Aguiling-Pangalanan, Dok Jimmy raised his official capacity as then-Health Secretary as locus standi, that is, he can validly assert a legally- demandable and enforceable right that stands to be impaired with the law’s non-execution, “Intervenor […] issued AO 1995-6 defining the roles and responsibilities of key DOH management personnel for the Integrated Family Planning and Maternal Health Project.” The fight, not yet concluded by the Honorable Court (although two status quo ante orders have been passed), promises to foment more discussions on the State’s police power among academic circles, the separation doctrine in broadsheet commentaries, the right to determination (as “ripened” by a health workers’ autonomy or a couple’s clinic visit) among shirtless street-side drinking sprees and incorruptible dogmatic morality in homilies. Beyond the arguments, the footnotes of case law and the snippets of the 1987 Philippine Constitution, however, the 35-paged paper evinces to an interesting history— one that Dok Jimmy has helped to create.

Among the legalese, the legacy of Dok Jimmy as an innovator for Filipino health and wellness stands bright. The man who “started and brought us Universal Health Care”, lauds 2013 Ramon Magsaysay Awardee Dr. Ernesto Domingo in a conference on Kalusugang Pangkahatan, who “without whom, we would not have this program”, (statement at the Health Secretary’s Cup 2013, 24 January 2013) has contributed greatly to the cause of planned and responsible parenthood. The contentious juridical, and even philosophical, arena rests on many bricks that Dok Jimmy had laid.

While serving under public trust, he introduced novel and pragmatic solutions to archaic problems of the Filipino health scene, catalysing programs that after his post would unfortunately gain momentum only years later. The family planning strategies of the DOH under Secretary Juan Flavier (who would later on become Senator) and under Dok Jimmy energized the efforts of the department since nascent policies for family planning in the 70s, so much so that the CBCP, called the former a devil’s handmaid, even threatening excommunication. Undaunted, the two sided with their conscience and advocated for a nation where every family can feed, clothe and educate their children.

Although the country is unlikely to meet its Millennium Development Goal on improved maternal health, modest efforts have been made by today’s government to stop 30 children from being motherless every day. Such actions do not veer far from the efforts that almost three decades from now have been strongly pursued by the DOH, with Dok Jimmy in its steer and helm. Despite what many has thought only as doomsaying, Filipinos would later on realize the value of this proactive response. According to the UNFPA, for example, “At this pace of reduction [of maternal mortality rate or MMR], by 2015 MMR will have only declined to 140 and the target of 52 will be unachievable” (UNFPA, Will Philippine women continue to die during childbirth?). Seeing yet again the redux of what he and the general public (through its duly elected representatives) feel as an insult to the cause of preventing further deaths, Dok Jimmy can’t help but be called to action. Perhaps the nation now, in acknowledging that “The target of universal access to reproductive health by 2015 is unlikely to be achieved” (NEDA, Meeting the 2015 Challenge: Philippine Progress Report on the MDGs, 2011), would have gathered from the past attempts of many like Dok Jimmy and succeeded, unlike what it now foreshadows to be an abject and regrettable failure.

Today, Dok Jimmy’s spirit for innovation continues to shape public health and welfare. Two of his advocacies hinge from the dynamics of human progress and health: sustainable development and rational health human resource management. The latter is a recognition of the under-utilization and institutional abuses to our health human resources: nurses, doctors, midwives, dentists and allied medical professionals. More intently, Dok Jimmy focuses on our Filipino nurses, whom he says he “has a big heart for” (her wife being a registered nurse). The brain drain phenomenon seems to be neglected in health policy circles and the country is tacit and passive to the fact that we are losing our nurses. Although we could not halt this exodus, providing the complexity of migration and oversees employment, he believes that “we can both benefit from this problem” (“Who can heal us now?” in Health Secretary’s Cup 2013). In effect, he tells us that we can transform the problem into a solution. Complicated as it may imply, Dok Jimmy has laid recommendations and frameworks for inter-country collaborations. Describing his study with a university in Canada, he calls upon the Philippine Nurses Association, the Professional Regulations Commission and many more stakeholders to the welfare of our nurses to improve their capacities and reinvigorate the profession through advanced practice and international exchange. He pushes for a one-nurse-one- barangay policy, a “golden” opportunity that the DOH should not miss. The policy, he believes, would drastically improve the public health in the country.

innovator

In a recent conference with the Philippine Nurses Association, where he introduced the one- nurse-one-barangay policy for the whole of Metro Manila, he asked, “Why don’t we have a nurse undersecretary of Health?” This rhetorical question, posed to members of the nursing academe and profession, hospital administrators and members of the PNA, echoed as a serious challenge. It was met with riotous applause. As history tells us, man works in a sort of punctuated equilibrium, generally living in a stable social environment until a crisis warrants it to change. Filipinos with their proverbial “resiliency” do not fall far from this stereotype. Dok Jimmy’s suggestive query has deep ramifications in shaking a status quo: a Department of Health composed absently of nurses, “the most populous health services providers in the Philippines.” He wanted the audience to see the ‘crisis’ that effectuates change.

In line with another present interest (among the many that he manages day-in and day-out), Dok Jimmy is pioneering sustainable development in the country. The state of our environmental health is observably depressing and many areas in the Philippines see a perilous tipping towards an ecological disaster. With injudicious exploitation of natural resources, with exponential urbanization especially in provinces contiguous to megacities and the stagnancy in many of our social services, we risk the health and livelihood of millions. Dok Jimmy, with a formidable team of doctors and scientists tries to answer a question posed during his term as Health Secretary, “How do we strike a balance between environmental protection, on the one hand, and the individual personal interests of people, on the other?”(Laguna Lake Development Authority v. Court of Appeals, Dec 1995).

Hinging from his orthodox styles in designing and actualizing community-based health programs, he resolves to once again revive participatory public policy development to wrestle the goliath task and solve the question. In Santa Rosa City, Laguna, he leads a team of researchers strongly partnered with lakeshore barangays for proactive discourse towards disaster risk reduction and watershed management. With a mixed top-down and bottom-up approach, the initiative, aptly called “Yaman ng Lawa” promises to be a venue for democratic exchange in policy formation. Once again, Dok Jimmy, with groundbreaking resolve, denies surrender to the past and present, and proceeds, with enlightened optimism, to guide, change or make history.

Ecological health rights are absolute and inviolable, Dok Jimmy reminds us that. Our nurses are not optimized to address the challenges of Filipino public health, Dok Jimmy gives a solution. The health of mothers and children are in peril, we must not fall passive. The Visionary remains unyielding to any sight other than his vision.

That comment-in-intervention in Imbong v. Ochoa marks the historicity of a man who cannot stop and cannot rest to acquiesce on a present that he feels he can change. He knows, as much as millions of Filipinos do, that we live in a country that does not have to let ten die mothers from childbirth daily. He knows that the contemporaneity that we are in leaves so much to be desired and in terms of health, the discouraging facts do confirm to us that we live in an ailing and injured nation. Yet more than knowing the shadowed cynicism of our collective fates, he knows that he must exercise his full capacity in contending with what we have. Perhaps it is what we can that matters and that in the grand scheme of things, we all have that locus standi to bring our suits, let our comments heard and “fight” that our actions may prosper. Dok Jimmy’s cause was always greater than himself and judging perhaps that trying (or knowing) is half the battle, having known and having tried leads us to half of victory. The other half has to be held and tried with constancy of purpose—coupled with the temerity to assert and the “itch” for novelty.