After what seemed like an endless journey of about 2 days, I was picked up by my team at the small airport of Tuguegarao Citiy on the Philippine island of Luzon. From here we drove another 2 hours to Conner, where our German Doctors house and office was located.
When I arrived at my new home, I was warmly welcomed with a welcome sign and a traditional Filipino lunch, home-cooked of course by our housekeeper Johna.
After that, I was only allowed to recover briefly from the exertions of my journey, as swimming in the nearby river was on the agenda for the afternoon. After a short ride in a tuk-tuk, I was faced with my first test of courage: in front of me was a not-so-stable suspension bridge made of steel rods. At this point, I had no way of knowing that this suspension bridge would be the sturdiest one I would have to dare to cross. After summoning up all my courage and turning a blind eye, I finally reached the other end unscathed. Below me, a few local children bathing made fun of my hesitation, but I only had more eyes for the well-deserved cooling off. So much for my first day …
After a short introduction by Regina, my German colleague for the next 3 weeks, we started the rolling clinic the very next day.
My first week only included day trips. The well-known barangays (communities) were eagerly awaiting us.
Every day in the morning, after a welcome, a prayer and a visit to the Barangay Health Workers (BHW), we gave a short training on taking pulse and blood pressure and repeated the most important rules of the Rolling Clinic with our volunteers. Meanwhile, the patients were already gathering in front of our clinic. Sometimes there were more than 50, but sometimes fewer due to village meetings, election or school events. In any case, the number of patients was easy to manage in pairs and I was occasionally grateful for the occasional piece of advice from my experienced colleague.
Frequent symptoms were whole-body, back and headaches from the hard physical work in the fields. Dizziness, mostly due to the very low blood pressure and insufficient fluid intake, as well as all kinds of infections with flu symptoms, shortness of breath (asthma and COPD due to the open fires in the houses for cooking), diarrheal diseases (due to the poor hygienic conditions) and occasionally special patients with cancer, thyroid nodules, but also with fresh or old injuries.
I remember one case in particular: a patient who was probably over 90 years old was brought to us at the Rolling Clinic by her son. She was very thin, emaciated, but with strikingly pronounced leg edema up to the thighs and massive shortness of breath. Although very rare, we immediately thought of heart failure or probable pulmonary edema. We gave her the few emergency medications we had available for such cases and tried to make it clear to the family and the patient that she needed to go to hospital. Initially, this seemed impossible. We were in a village that was only accessible on foot, the son who had previously brought the patient to the rolling clinic had already gone back to work in another village, and the last bus to the next town did not leave until the next day. Finally, we gave the patient sufficient diuretic medication and medication for respiratory distress, spoke to other family members who promised to take the patient to the bus the very next morning (presumably piggybacking again) and drive her to the hospital. In the end, the agreed plan seemed to be the best option we could think of. With a sinking feeling in our stomachs, we packed up and began our walk back to our vehicle.
Fortunately, we rarely faced such challenges, and even if someone had to be taken to hospital, there was always someone from the family or the community who could help.
When we were on tour with the Rolling Clinic for longer periods, we slept in the villages (with sleeping mats on the ground under a mosquito net), washed in the rivers and were usually cooked for by families in the villages. It also happened that someone from the village would come and take us on an excursion, for example to a waterfall or another village.
The locals were usually very excited and curious (especially the children) but always very helpful, courteous and hospitable when the German/Austrian Doctors came to visit.
We had to walk up 700 steps to a village with our daypack and medical luggage. Here, a woman in her 60s helped us carry our medical rucksack, which weighed at least 10 kg, up the steps by our heads. She hopped over the steps with such ease that I couldn’t stop being amazed.
I also found it very exciting that we treated many patients with epilepsy and psychiatric patients. To do this, we often made house calls and walked to other villages after our usual working hours.
I couldn’t get the psychiatric patients in particular out of my head, as many of them had to live in cages before the German Doctors came to Luzon. Due to psychosis, they were often aggressive towards other people. The state gave the families money to build cages, some so small that the patients could not even stand. Thanks to the long-term doctor Dr. Gerhard Steinmaier, the patients were given antipsychotic medication so that many of them can now live normally in the village community and are no longer feared.
To summarize, I can say that my assignment on Luzon was much more instructive, amazing, exciting and better than I could ever have imagined. In particular, however, I was most impressed by the joie de vivre, warmth and hospitality of the locals on our tours.
I would also like to take this opportunity to highlight the team on site. Thanks to them, I felt incredibly comfortable and in good hands the whole time. There was never a lack of fun and banter, which was a good distraction, especially after difficult days.
