Diagnosing the Future of Community Medicine in the Philippines

Our country is in dire need of doctors for the people. The starkest indicator of this dilemma
is the state of community medicine practice in the country and likewise the dwindling
number of community physicians.

BY PHILIP PARAAN
Bulatlat

Our country is in dire need of doctors for the people. The starkest indicator of this dilemma is the state of
community medicine practice in the country and likewise the dwindling number of community physicians.

According to the National Institute of Health, there have been more than 9, 000 physicians who have left the
country as nurses between 2002 to 2005. Likewise, the Health Alliance for Democracy said around 80 percent
of public health physicians have taken up or are enrolled in nursing. This year, it said, 90 percent of municipal
health officers (MHOs) are taking up nursing and are expected to leave the country. The number of
obstetricians and anesthesiologists are also fast depleting, followed by pediatricians and surgeons.

During the recent National Colloquium of Community Medicine: “Pearls and Perils in Community Medicine-
Issues and Challenges in the 21st Century” held Nov. 28, community medicine practitioners and advocates
met and discussed the state of the practice in the country.

Dr. Melecia Velmonte, chairperson of the Community Medicine Development Foundation (COMMED), said
that while community medicine is relatively a new field in the Philippines, it is best understood in the context
of health and development. It also represents state of the country’s health situation.

Among the measures identified that would help promote this discipline include integrating the concept of
community–based medical practice into the medical curriculum and also linking the Philippine health
situation to diseases as well as other subjects in the medical curriculum. Furthermore, there is a need for a
value re-orientation in the medical school-hospital support system to promote the viability of community
medicine practice while the medical academe should actively promote and advocate community medicine as a
career path among young doctors and medical students.

In the future, the best practices in community medicine should be documented and a strong system of
supportive mechanisms for community medicine practitioners both in the public and private sectors should be
developed.

“The health of the poor is a cardinal indicator of the state of people’s health,” Velmonte says. Among the
resolutions passed was the formation of a community physicians’ organization to advance the discipline not
only in the academe and medical community but also to gain ground in the promotion of health and
development for the marginalized sectors of society.

Anatomy of community med practice

Also called “social medicine” in western medical tradition, community medicine embraces the medical
philosophy of the distinguished German pathologist Rudolf Virchow.

He said doctors were supposed to defend the poor because of the impact of their social conditions. He said
poverty-related diseases are preventable.

It entails a process where health professionals become one with the people in understanding their situation
and in analyzing the root causes of ill health and disease.

Since then, social medicine proponents and advocates believe that the health of the population is a matter of
social concern where society promotes health, not only through individual means, but also through social and
collective undertakings. In this context, they uphold emphasis on the health of the poor as a cardinal indicator
of how well physicians are taking care of people’s well-being.

Global initiatives have been developed towards the realization of these noble principles. Among them was
the Third International Conference on Medicine in 1966 that described the first community-oriented medical
curriculum. Another was the 1978 Declaration of Alma Ata that defined the primary health care approach. In
1985, the World Health Assembly issued an official statement on community orientation. The Philippines
was a participant to all these initiatives.
Vol. VI, No. 43 Dec. 3 - 9, 2006 Quezon City, Philippines