Medical Mission in Cotmon, Albay

Have you ever read the Legend of the Mayon Volcano? It’s a wonderful legend (alamat in tagalog) depicting the theme of true love among Daragang Magayon and Panganoron. Both died of course and as all legends go, the people in the village saw the mound where the Magayon was buried slowly rising until it formed the Mt. Mayon. Legend states that Ulap, the antagonist in the story, angers Magayon in his attempts to recover his gifts to Magayon and she in turn spurts lava in retaliation to Ulap. Look for the recent pictures of the Mayon eruption and you’ll see some pictures showing Magayon and Pangaronon.

Being a first timer in Albay, it was thrilling to see the eruption first hand. For days prior to the eruption, we kept observing this red cloud forming over the top of the volcano similar to the eye of Sauron in Lord of the Rings. At around lunchtime of  Monday that week, news spread that the volcano has erupted. We rushed to the rooftop and saw this huge cloud-shaped eruption, similar to what we see in nuclear eruption pictures. Apparently, that was what PHIVOLCS call a “phreatic eruption”, an eruption due to contact of hot magma from beneath with water spurting not lava, but steam, rocks, and ash. That afternoon, it was declared unsafe for travel along  some of the roads of Camalig and Guinobatan as these were the municipalities which were severely affected by the ashfall. There was zero visibility along the roads after that eruption, but eventually, the order was lifted and travel was resumed. Citizens there were advised to wear masks and protective gear to avoid inhalation of the ashfall. Photos circulating the net that day was scary as it looked as though an ash tsunami was approaching the barangays. Everything was covered in white after, from the roofs, roads, cars, and plants. The eruption that lunchtime was not the last however, as after that eruption, several followed every 4 hours. School was suspended that entire week for the safety of the people. Citizens starting from the 6km danger zone were evacuated prior to the eruption thank God, but then it extended to 7km, 8km, and when I left Albay that week, even those from the 10km danger zone were advised to evacuate. As of today, as I’m writing this post, people from the 8km danger zone and above were allowed to return to their homes. This caused a decrease in the amount of evacuees in the evacuation centers but still, as up until now, Mayon is still erupting, although it has decreased to about once or twice a day as per NDRRMC text messages, thus, those from the 7km danger zone are still living in the evacuation centers.

The Association of Medical Doctors of Asia(AMDA) together with various partners and the BUCM-Sanggawad Organization manned the Medical Mission last Feb. 10, 2018 in Cotmon Elementary School in Camalig. Lo and behold and it was heaven sent that Cotmon was actually one of the adopted barangays of the second year community groups of BUCM. The evacuees in that school however, was from Cabangan, a barangay within the 7km danger zone. Most of the people there have been staying in the school for 1 month or more. The entire school was converted to an evacuation center. Portalets were installed near the entrance, faculty rooms were converted to make-shift clinics, and families were gathered in their assigned classrooms. Now the flow of the program was that our organization was to be the advanced party assigned to gather the needed data from the patients prior to the arrival of the doctors and their party. We left Daraga at around 9:30 am and arrived at Cotmon around 10:00 am. There was no time to rest as the AMDA people were expected to arrive by 1:30pm. Pairs were assigned as teams and given specific rooms to handle and gather data from. My partner was Irene and we were assigned Room 2. The people in the room was so friendly. While the coordinator was still explaining what was going to happen, they were already setting up a mini station by placing a folding table near the door, arranging chairs, and calling their family members. I explained to them our purpose, the program, and how we were going to proceed. Immediately, the citizens understood and allowed the people whom we considered as the priority to be interviewed first. The process went smoothly as the people were so cooperative. I asked why most of the people there were women and one replied that most of their husbands are out in the field working and that the housewives are the ones staying in the center with the children. In that particular room, there were only a few children. While we were interviewing, I saw how united the families inside the room were. Some mothers were cooking lunch outside the room as they had this gas burner and stove placed outside the room and all contributed to cook the food for the entire room. By the time we were finished interviewing however, this line of teenagers arrived, apparently they had their Saturday classes and are now returning home. It took longer than we expected as we had finished at around 11:45am yet we still had 1 more room to interview. We went to the covered court to report that we were finished and ask for the next room assignment but we were given 15 minutes of lunch break first. After lunch, we were assigned Room 14. Room 14 was located far from the main building. In the building where Room 14 was located, there were several little children outside the rooms playing. In fact, upon arriving at Room 14, I only saw 4 adults and the rest of the people in the room were children! So once again, I explained to them the process, etc. etc. There were only a few patients in that room but I was taken aback by one particular family. There was this little girl of 13 years old who had no accompanying adult who quietly took her seat in my chair and asked to be interviewed as well. I asked her where her parents were if they would also like to be interviewed but she said both her parents were working and that she was the only one left to take care of her siblings in that center. So I interviewed her, and after, she called her siblings and her cousins to be interviewed as well. She was a great “Ate” to both her siblings and cousins, setting a good example of not being afraid of us. By around 1:30pm, the doctors arrived and we went on to our next task of assisting them per room. We were assigned Room 1 & 2. Our main job was to dispense the prescribed medications, advise the patients, and health educate. It went by smoothly and by 3:30pm, the medical mission was finished. We then gathered in the stage near the covered court as the barangay officials manned the giving away of the relief goods brought by the AMDA people and their partners. Everyone was all smiles after, from the families, volunteers, doctors, and us, the medical students. The community expressed their gratitude by cooking baduya for us as our merienda. It was an awesome feeling when you see how grateful our kababayans were, from  the mothers to the elders, and even the children. They were all thanking us, and, though we did not deserve it yet, insist on calling us doktor/doktora. It was a great experience and a truly humbling one. How awesome were the volunteer doctors and health practitioners who traveled all the way from Manila and various cities just to provide unpaid service to their kababayans in Bicol. They are such an inspiration to us medical students. My hat’s off to you Sirs & Madames. Thank you for choosing my province as the place to share your blessings. I went to sleep that night with an aching body but a happy heart, thinking that at least even for just one day, we were able to provide support to our kababayans and tell them through our actions that they are not alone in this fight, that there are people who are watching them, caring and praying for them, and willing to extend a helping hand. All of which just underscores why I love this field.

INSPIRATION

 

 

Finally! Once again, I was in my element yesterday. It was our PD session and we had it at our affiliate hospital, the Bicol Regional Teaching and Training Hospital(BRTTH) just across the road from our building. The smell, the sight, the patients, how I missed all of those.

For second year, we were tasked to practice and master the skill of proper history taking and physical examination of actual patients. Since last week we weren’t assigned a patient, the group took it upon ourselves to scout for a patient the day prior to exposure.  Luckily, our preceptor that week was very willing to help us scout for a patient that she advised the surgery department to allow us to enter the ward and look for one. The training officer of the department accompanied us and semi-toured us around the surgery ward. It was actually a lot smaller compared to that in Bicol Medical Center. Usual sights of patients and beds along the corridor were normal.

We were directed to the Orthopedic Unit. The doctor introduced us as students from Bicol University College of Medicine and when we entered, we were greeted by smiles from the patients. One bed caught our attention as it was a pedia case with upper extremity fracture. However, when asked if they would allow us to interview them the next day, they told us that they had already packed their bags as they were given the signal that the patient can go home already. So we looked at the other beds and saw one patient with a cast. When asked if he would allow us to interview him the next day, he allowed us.

The next day was our actual duty in the ward. When we entered the department, I was a bit taken aback as some of the patients that were in the corridor yesterday were gone and replaced by new patients. Inside the unit, the same thing has happened, the little boy was gone and in his place was an adult man. The faces of the patients were different from those that were there previously. When we entered, we entered as a group, eh we were 10 in the group so all eyes were on us. Our preceptor was also with us and reintroduced us to the patient. The other patients, since it was a ward, heard what she was saying and they were all nodding and saying yes, that they would be glad to help us in any way. One patient even stated “Syempre tutulungan namin kayo. Kulang ang doktor ngayon dito. Kung hindi kayo tutulungan, sino pa ang magiging doktor?” We were all smiles when we heard that. Thank you Sir for your kind words of support.

This morning, the same thing happened. While waiting in line for the PRC to release my license, the guys in front initiated a conversation and the same line were also uttered by them. “Sana maging doktor kayo para mas madami kayong matulungan na tao. Kapag doktor na kayo, madami na kayong matutulungan. Kailangan natin ngayon ng madaming doktor. Sana pagdoktor na kayo hindi muna kayo umalis sa bansa. Dito muna kayo tumulong.”

It’s amazing that even though we are still only studying medicine, our kababayans are already rallying behind us to become mga doktor para sa bayan. To them I say, “Opo, para sa bayan, para kay Juan.”

 

Passion

Yesterday was a happy day for me. The night before was my official welcome to the book of Pathology, parting ways at 2 in the morning. I spent the entire night making a presentation for the next day on a concept that was very broad and interesting – Inflammation. I was already sleeping at 2 in the morning and it was only the third day since this schoolyear started! 😨 At least I got 5 hours of sleep on Day 2, I thought.

Yesterday morning was a morning of all praises, the preceptor congratulated me on my report, my groupmates were driven, and I can say that my 3 hours of sleep was worth it.

One question popped though, how on earth was I able to smile despite sleeping for only 3 hours, reading tons of pages from an unfamiliar boook, and delivering my report that morning?

A small voice answered – passion.

 When you love what you’re doing, you’re driven to do more. 😀

On Coconuts, Rivers, and Mountains II – What it takes to be a Doktor Para sa Bayan

February 20, 2017

I arrive at the Bicol University College of Medicine building bringing with me 4 bags – 1 for clothes, 1 for my laptop, chargers, and books, 1 small sling bag for my phone and coin purse, and 1 eco bag for the food from the dormitory(they converted my rent to food). 1 month before the departure, I was already buying stuff needed for my 1 month stay in community. I’m the type of person who likes to be always prepared, always with a Plan B, Plan C, looking at all sides of the picture before pushing through. Which was why I was carrying 10 kg load in one hand, 10 kg load in the other, and about 5 kg load on my back.

Now that I’ve mentioned my dormitory, let me trace back a bit by going back to February 1. In my dormitory we have 1 third year medical student, 2 second year medical students, and us 3 first years. Though they’ve already experienced it, the too were quite as excited as we were going to the community. I always ask them what to bring, what to expect, what they advise to do and such. Actually, now that I’ve thought about it, I think their answers were the reasons why I came overly prepared. Up until 3 days prior to departure, we weren’t informed as to what to expect, what to bring, and where exactly our community was so we mainly relied on what the higher years could advise us.

One of my second year dorm mate relates their experience in the community. Theirs was in Libmanan, Camarines Sur. To go there, they hired a van, then, a small boat to cross the river and go to their community.  Upon arriving they find out that the community was between the coastline and a sort of valley. They stayed in a Barangay Health Station, with running water and electricity. Every morning they would wake up early as the midwives and BHWs in duty would perform their work. This was when they were in first year, so their activity mostly consisted of community assessment. Now, the list of what to bring begins. She advised bring a jacket or that long black sleeves of a motorcycle driver, to prevent sunburn. Also bring sunblock, cap, shades, a bottle of water, and an umbrella. In their community, the river that they crossed apparently was dry in the morning and water rises up as the sun sets such that it becomes a river in the late afternoon. She advised to bring boots in case it gets muddy and it rains or to cross rivers and streams. As for sleeping, she uses a thin foam but recommends a sleeping bag, 1 pillow, blankets, Off lotion, PJs and the like. For food she advised us to bring lots and lots of canned goods. She relates of an experience on their last day when they literally had a shortage of food causing them to be creative and fit what they have to feed 11 people. And so the list went on and on until I created a master checklist for my things.

So many things to buy = So many things to bring

I bought everything good for one month thinking that we won’t go home every weekend and spend the entire month there. What if there was no sari sari store? What if there was no water? What if there was no electricity? So I bought coffee good for 30 days, shampoo good for 30 days, everything good for 30 days. I seriously considered buying boots but at the last minute thought maybe we weren’t going to a place that required boots so I didn’t but them. However, I brought my non-foldable umbrella, 2 jackets, a thick and thin blanket, 5 PJs, and 12 shirts, shorts, undies, 4 pants, 2 shoes, plenty of hankies, towels, facetowels, hangers and such.

Why that many? One higher year told us that there was a community with no water that they actually brought plenty of clothes to be presentable.

Don’t worry that’s just the first week. I brought half of everything back by the first weekend. LOL.

So that was the month prior to the actual community exposure. Sunday before the departure, we shopped for our food – egg, rice, dried fish, dried goods, a few veggies, as well the non-food items. We left them all sealed up in our building like the other groups so our baggage for the next day would be less.

Monday.

The group’s call time was 7 AM. Upon arriving, there were already a lot of pioneers in the building, with their respective preceptors, bringing their own things. I entered the room and the smell hit me right away. Almost all of the dried fish that we bought were lying on the floor, stolen, and eaten by a cat. There were cat scratches on the side of our basket. Hay…

Moving on, one by one my classmates started to arrive each bring their own luggage. Surprise surprise! Our boys brought wheeled luggage bags while we girls brought hand carry-type bags. Wow.

At about 8:30 AM, our van arrived and with a few sacrifices and a bit of physics, all 11 of us fitted in together with all our stuff, and the driver as well. The ride to Tabaco was quite smooth, though it was raining when we arrived at about 9:30AM at the City Hall of Tabaco and conducted the courtesy call to the city mayor.

The mayor of Tabaco City was so kind and supportive. She even divulged to us her secret dream of becoming a medical doctor if politics did not became her calling. Guess what her main problem in our barangay was though? The presence of nice people around. She immediately called her chief of police to inspect the place prior to our arrival to ensure our safety. At that time my groupmates and I were starting to get scared as the mayor told us that we would be moved to another barangay if there were news of those people. Once she assured us that the police were on their way, finally, we went back to our van to travel to Oras.

Surprise surprise! Our boxes were missing! Those were supposed to be placed under our sleeping bags to keep away the cold but a certain someone, left it out of the van and forgot to bring it back in. It’s gonna be a cold night then.

The van ride drone on and on and the driver kept mum. Finally, he asked us, “Where is Oras?” We all looked at him like whaaaat? We thought he knew. He kept talking about it on the way. So we stopped over by a sari sari store and asked some ladies there. Apparently, we were so far from Oras, we were already in the next barangay! Good thing at that moment, our preceptors called us and told us they’ll wait for us along the highway. So we turned back, found them, and continued our journey. WOW, we were like 20-30 minutes far from the supposed entrance to the barangay.

A road with no sign led the way inside Oras, away from the national highway. It was an uphill, downhill, curved road, but it was cemented. It took about 10-15 minutes to reach a wooden bridge and then you can enter the barangay. Upon our arrival, there was already the police mobile and it was raining heavily. We waited by a shed as we saw the policemen crossing the bridge towards us. They had just finished meeting with the kapitan and knew of the situation. There were no new sightings of the people and the area was declared safe. They initiated to hire tricycles for our luggage and helped carry them to the Barangay Hall.

It was an experience crossing the bridge. It had no railings but it was wide enough to fit a tricycle so it was sturdy. Under the bridge was a flowing river with many large rocks. The water was clear but strong due to the rain. We walked to the Barangay Hall with our preceptors, carrying some of our other luggage.

The place we were staying in was like a compound. It had a gate and walls. Inside the lot were two buildings, one was a one storey day care center, and another was a two storey building. The first floor was the barangay health center and kitchen, upstairs was the barangay hall. When we arrived, a kagawad, the kapitan, and her secretary were there to welcome us. They briefed us of the barangay, that it was relatively safe and there were no trouble. In terms of those people, the last encounter they had with them was 10 years ago so even they doubt that they were still there. It was around lunch time when we arrived so we cooked what was easily cooked – rice, noodles, and luncheon meat. Our preceptors left around 1:30pm.

First task: Clean everything.

There were 4 comfort rooms for use – 2 beside the health center, 2 inside the day care center, but only 2 had running water. Both had no light so flashlights were needed every time we went to the toilet. There was also a faucet outside near the comfort rooms with water. There was no faucet in the kitchen so everything has to be washed outside. Good thing there was a large wooden table outside the barangay health center. It was a non-functioning health center are there were no medical equipment available, save for 2 weighing scales and a height chart. During our first week, the children from daycare conducted their activities inside the barangay health center as the roof of the daycare center flew during the typhoon last December 2016, so the entire daycare becomes flooded every time it rains.

The barangay lent us a big cooking pot and a deep wok for cooking. They also lent us plates, glasses, spoons, forks, and cooking utensils. Di ba? Ang bait bait nila. For cooking, we brought a small gasulito with a single burner as well as various ingredients.

We also had a meeting for the committees to evenly distribute the work. Of course, I was on kitchen duties haha yey. There were the washing, runners, cleaners, and cooking team.

The cleaners were also busy, when we went up after lunch, the tables were placed beside the walls, along with our stuff. Then, of course, as per Filipino tradition(lol reasons), we had our siesta time.

When we woke up at 3 pm, we went out and conducted our first ocular assessment to Purok 3, the farthest Purok. It was a long walk, and it was raining. We only got halfway along the road and returned back due to the rain. During that time, school was let out, so children were walking back to their homes too. One group accompanied us and stopped when we also stopped. They didn’t talk, only stared. When we started to walk back they asked if we weren’t going to continue. We told them we’ll continue tomorrow.

In front of the the barangay hall were 2 sari-sari stores, one of which was owned by the barangay treasurer. His store was sort of like a mini mart since they also sell meat, fish, chicken, and vegetables. When we went back due to the rain, we bought meat and cooked pork sinigang that night. Mmmm… falling rain, cold wind, and hot pork sinigang made us all content for our first night.

The next day we conducted our first barangay meeting to meet all the barangay officials, introduce ourselves and our purpose in the barangay. We also informed them that we planned to conduct a stakeholder’s meeting the next day with the community people to introduce ourselves and for them to identify core leaders in their community.

Wednesday.

As soon as we woke up, wow. Men were coming in through the gate setting up a tent, some were bringing in monoblock chairs and placing them in the yard. Though the program was set to 2 pm that afternoon, the barangay officials popped in to bring speakers and curtains. Surprise, surprise. Come 8:00 am the power went out. With one click of a finger, one barangay kagawad immediately sent for his generator to be brought and used. No surprise, the entire group was extremely overwhelmed by the kindness and generosity of the people. And! Take note, they were living up to their name. Oras meaning time. They were so disciplined that the people started to arrive 30 minutes before the program! The vice mayor even dropped by to introduce himself but he couldn’t stay for the program due to previous arrangements.

At exactly 2:00pm, 100 people arrived, all the monoblock chairs were occupied, and there were representatives from every purok! The elementary school principal even volunteered her students to do an intermission number and they were so cuuuute! They arrived all in full get up and make up.

Meanwhile, I was given a new challenge. I became an instant host LOL. The first thing I did was what we always did during intrams, a roll call. Lo and behold, there was only one representative for Purok 3. A smiling old man. So I interviewed him, asked him his name and age. He was 82 years old! I asked if he came with anyone else and he said he came alone. Imagine! Purok 3 is the farthest barangay from the hall, about a 30 minute walk uphill and yet this lolo came just to attend our meeting. The entire audience expressed their amazement when they learned of his age and that he came alone. To lighten up the mood, I asked for a muse for lolo. I asked if anyone was of the same age group as him. An elderly woman raised her arm. I approached her and asked her name and age. She was 86 years old! Wow! So I asked the secret of her age and she stated she eats vegetables and rice, seldom meat. Then I asked her for her advice to the elementary students present. She told them to study hard and follow their parents. So with that, we had an instant muse and escort in the community! Hahaha LOL.

With that, we started our program. The usual invocation, Lupang Hinirang, welcoming message, and opening remarks. I went to the kitchen to help Ate Pam finish up her macaroni soup. We distributed them in cups along with a piece of bread while the elementary students danced and they were really so cute!!! After they danced I told the audience to look at the principal. She was smiling from ear to ear during the entire dance and looked so proud of them. I also told them that if there was anyone who would like to perform, they can approach any of us. Suddenly, two teens approached and told us they would like to perform. They sang and the audience asked for an encore. They sang another tune and the entire crowd went wild. Why? They were singing a song that depicts that being heartbroken. They were all teasing them after haha. Then the actual voting began and it went smoothly. A kagawad helped us talk to the audience and within 20 minutes, we were done! Kuya Pua initiated that we play some games as we were told that a representative from the City Health Office was already on her way. The games committee panicked as we didn’t have prizes to give away. They went up to our room, raided our stocks, and came back with the “prizes”. Hahaha. For the kids they brought back a large bag of chips and some biscuits. For the adults, they brought back 1 whole pack of instant coffee. I told them we were going to use the coffee for the meeting tomorrow so they panicked again and told me there was nothing else we can give. I told them to wait and raided my stocks from the dorm. I gave them 3 canned goods and told them that’s the prize for the adult. I also brought biscuits to give to the kids that didn’t win. When the games ended, we also ended the program. The community people immediately initiated the bayanihan effect. Each picked up his/her chair and brought it bakc to the elementary school. The men disassembled to tent and brought back the generator. At 5:00pm, the yard was clean, and we were all sitting and finally catching our breath. Suddenly, a woman entered our gate. She was the doctor we were waiting for! She advised us on how to deal with community people and told us that she was familiar with the area and that she knew that the community was safe. With that she left and we started dinner.

The next day we conducted our first focus group discussion with the core leaders to get to know them and discuss what they know about the community as well as confirm or oppose those that we observed during our ocular visit.

Friday.

One of our preceptors arrived bringing lots of bread and peanut butter. He asked us of our activities that week and our activities for the next week.

Finally, we were done with one week! 😀

 

To Hills, Lake, and Ruins

I’ve always wanted to explore Albay. However, all I’ve known about it is the famous active volcano with the perfect triangular shape. The pride of all Bicolanos and the so called “sister volcano” of Mt. Fuji, our very own Mt. Mayon.

Well apparently, there’s a lot of hidden natural treasures here. The beautiful places in Albay are made by Mother Nature herself. There’s Mt. Mayon itself, then Quitinday Green Hills, Hoyop-hoyopan Cave, Sumlang Lake, Kawa-Kawa Hill, and so much more! There are also some man made modifications that allow beautiful views of Daragang Magayon like Puro(Legazpi Boulevard) along the port of Legazpi and Lignon Hill near Legazpi Airport.

It was a spur of the momemt decision to go to Quitinday. My roommate Irene and I were bored and with exams and community presentations done, we had nothing to do. Originally, the plan was set to Friday but it was only Wednesday and we were bored out of our wits so she asked if we can go the next day. I agreed and called on four others who wanted to come. Only one also agreed so we set the call time to 6am the next day. Ha! As if! 6 am in my dreams hahaha. As per Filipino time tradition, we left Daraga around 9:00 am. The night before, I looked for directions on how to get to Quitinday and several websites told the same thing. From Daraga, ride a Legazpi-Polangui jeepney. Ask the driver to drop you off at the intersection to Quitinday. There would be tricycles waiting along that intersection. All they ask for is 500 pesos for a round trip service. Please don’t haggle. The ride is half cemeted and half rough road and it takes about 30-40 minutes to arrive. At first glance you’ll think that it was a wide plain with some bahay kubo sari sari stores.

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Entrance to Quitinday Hills

Upon arrival, we went to register and paid the entrance fee of 20 pesos. The lady at the stall stated that there were no guides that day but she had a tarpaulin depicting the bird’s eye view of Quitinday and it was actually very straight forward. Upon climbing the main hill, there will be a bahay kubo rest place. Two paths lead away from there, one to the north and the other south. The south path is steeper and higher and show you the rolling hills while the north path shows you Mayon in all its glory. Neri and Irene were quite excited to go that the moment the lady said we can climb up, they went straight to the parking lot hahaha. The lady laughed saying they were going in the wrong direction. Apparently, we were already standing on the foot of the main hill. At the back of the kubo was the “stairs” going up the main hills. “Stairs” because it was not man made in the sense that it was cemented or wooden but because it was dirt. Compacted dirt molded to form a stair-like formation with railings of bamboo.

So up we went. 5 minutes up and we were already catching our breath. It was very steep!IMAG9760.jpg But it was very compact. Good thing that the weather was perfect. I can’t imaging if it was rainy and the ground was muddy. There were some parts where the formation of the stairs were lost so you step on rocks while holding on to the railings for dear life. Note: Please look at the railings before you hold them. We were all victimized by holding what we thought was a strong bamboo but was hollow inside or was cut further along. 10 minutes later, we arrive at the bahay kubo rest place and immediately, we were given the whole 360 degree view of the gorgeous rolling hills of Quitinday.

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It was beautiful. To the north we can see the perfect cone of Mayon. To the south we can see another hill. Everything was picturesque. Long grass talahib were everywhere but in that area where the bahay kubo was, it was plain carabao grass. We rested a bit at the kubo. That 10 minute trek puts a toll on your lungs. Seriously. Note: Bring lots of water. Gatorade would be better. And snacks, don’t forget snacks BUT PLEASE BRING YOUR TRASH DOWN WITH YOU.

We decided to first go to the higher hill. But what we thought would be an easy climb was apparently an even steeper hill! And there was only half of the “stairs”. The rest were rocks and plain dirt, though there was also bamboo railings.

The climb took less than 5 minutes but upon reaching the top, you’ll need another 5 minutes to catch your breath and unfortunately, there were no chairs at the top. The view, however, was absolutely stunning. Note: At this point I’m running out of adjectives so bear with me guys LOL.

You can see the entire Quitinday Hills as well as the plains down below and it also shows you a beautiful view of Mayon.

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The sun and wind were also stronger there. We would’ve stayed longer but the heat was really strong so we went down. Neri and Irene went first as I was busy taking videos of the path and the view. I went down holding my monopod with the phone in it, no longer recording when whooosh! I slid down the hill. I tried to stand but slid down a few more inches. My monopod was on the ground but there was no phone! Aaaaah! I looked around and it wasn’t on the ground. I finally found it on top of the talahib. Good thing it wasn’t buried all the way down and I saw the aluminum shine. The ground pala at that point was literally dirt, and it was loose dirt so it was slippery. If there weren’t rocks I would’ve slid all the way down to the bahay kubo. Anyway I’m bookmarking that down in my unconscious as Experience so it’s all good, though my butt hurt a bit. Once again, we rested for while in the bahay kubo before proceeding to the next hill.

The path to the north hill wasn’t as visible as the one on the south. It seemed to be a steep path going downward and it was covered by bushes. It was also a dirt path with no bamboo railings. Past that however, is another hill with another set of steep path but with the stairs-shape like before. There was also bamboo railings on its side. It wasn’t as steep as the other hill so this climb was easier. On top you’ll be presented with the majestic view of Mayon with its perfect cone.

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Like the previous hill, there were also talahib that surround this area. Note: At this point offer a bit of prayer to thank the Lord for His creations. You’ll really feel relaxed here. The sun isn’t quite as strong but the wind gets stronger. My cap even flew away and once again, good thing it flew unto the tall grass. Once again, there are no chairs in that hill and eventually the heat got to us. We then decided to go down. The trike driver waited for us and even took us to the famous Let’s Pinangat for lunch.

Lake.

When we were riding the jeepney to Quitinday, Neri shouted out that she saw a sign pointing to the entrance to Sumlang Lake. It was only noon when we went down to eat. Since we still had a lot of time, she suggested we go to Sumlang Lake. To go to Sumlang Lake from Let’s Pinangat, ride a jeep going to Legazpi. You’ll see along the road a large sign saying entrance to Sumlang Lake. From the main road, you can walk towards the entrance, about 15 minutes. Entrance to the Lake is 10 pesos. You’ll be bombarded with native furnitures and instagrammable scenes. There are water activities available near the lake shore, most of which costs less than 50 pesos. We availed the boat? ride. They let you choose which boat? you wanted. There were different pieces of furniture per boat and two landmarks across the lake. A large Sumlang Lake sign with the majestic view of Mt. Mayon in the background, and a little island with a beautiful piece of native furniture you can sit on. We didn’t avail of the other activities but did take a lot of pictures.

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Ruins.

From Sumlang Lake, we rode a jeepney going to Legazpi once more and asked to be dropped off at Cagsawa. Along the road, there was a huge statue of the Cagsawa Ruins, that’s the landmark.  From there, you can ride a tricycle to get to the gate entrance of Cagsawa or you can take a 10 minute walk to the entrance. Entrance fee is 25 pesos.

Good weather and daragang magyon peeking out of the clouds means a crowded landmark. There were crowds of families and tourists visiting the landmark. It was quite different from when  first visited it.

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What a great day to start the summer! 😀

On Coconuts, Streams, and Rivers I – What it takes to be a Doktor Para sa Bayan

I believe that I am in an excellent school. Different from other schools, we take pride that we undergo community immersion as part of our MD-MPA program. Once a month every year for five years, we fully immerse in a community chosen for us. Usually our adopted community is one which is very far flung, often neglected in terms of health care and amenities. It may be along the coastal area, surrounded by mountain ranges or in a valley. The only condition, and one that is quite important, is that it should be safe, preferably with no Nice People Around, and with electricity and running water.

Now, the reason why we have this program is that we are being instilled the virtue of being a doktor para sa bayan. Being a state college, it is a given that upon graduating, one must serve his own people first before going abroad to serve others. This program actually is quite similar to what in nursing we call Community Organizing Participatory Action Research (COPAR) wherein the main goal, after five years, would be self-reliance of the community people to stand on their own in terms of handling, maintaining, and implementing projects for the good of their community. First years are limited to only performing community assessment – gathering data from all the households which would be the main basis for the community health programs to be proposed for implementation come the higher years. Come second year, the data gathered would be used to diagnose the problems in the community and also to be used to strongly back-up the projects come third year. Third year would be the time that the proposed programs and projects will be implemented along with the community leaders and the people themselves. Fourth year would continue the implementation of the community programs but slowly letting go of the programs themselves. Fifth year, the last year of studying, will be the time to fully let go of the programs, the termination stage, whereupon, the community people themselves would man the programs and projects and we, the students would simply be there to monitor and facilitate. At the end of five years, the goal of the program would be to develop an aware, active, and self-reliant community capable of handling problems within the community and finding solutions for it.

Our batch of 62 students were divided into 6 groups based on personality types, with 10-11 members. Each group was assigned to different communities scattered all around Bicol. Only one group went to Pilar, Sorsogon, the remaining five were distributed to barangays in Albay specifically …, Manito; Oras, Tabaco City; …Camalig. Ours was Oras, Tabaco City.

11 people. 1 house. 1 month of stay in that community.

Five years begin on February 15.

Promdi(s) go to Manila

Summer is here and for third year students, that means Manila Affiliation. Here is where we stay in a hotel for one month, rotating to a different affiliated hospital per week. For my batch, there were only four hospitals – Philippine Orthopedic Center, National Center for Mental Health, San Juan de Dios Hospital and Hospicio de San Jose where we had our duties. The week before leaving was a hectic one. Exams were moved earlier for our batch since we were leaving 1 month before holy week. For the research subject alone, we were bombarded by tasks for our defense. Two weeks earlier it was declared that we were going to have our defense in Manila but 3 days prior to leaving, the CIs suddenly declared that we were going to defend it the day before leaving. Thus, for two days, we scrambled to polish the research, double checking it, then triple checking before finally printing it to produce copies for our panelists. It was a good thing that we were fully finished with the paper itself. Thus, hours before leaving Naga, we successfully defended our paper and were marked free to join the affiliation.

We left early Friday morning and arrived in our hotel a bit past 9 pm. We were first called for a meeting where the staff explained the rules and regulations of the hotel as well as the CIs told us our schedule for the day. Even though we were only going to have an orientation from the different affiliated hospitals, I couldn’t sleep. Maybe it was being in a new environment, or being with roommates in one room. It was a good thing that in our room all five of us were group mates, thus no one will be left behind during duties. So what I did was I ironed my uniforms, all of them, though they were ironed prior to being kept in the luggage. OC, I know, but with that, I slept around 1am and woke up at 4am since we were scheduled to leave at 6:30 and there was one bathroom to be shared by all five of us. Since I only take 10 minutes to bathe, they ordered me to be the first one in the bathroom every morning.

Our first stop was in Hospicio de San Jose, an institution located in its own island (I’ll elaborate on this later). We were given a tour around the buildings and its surroundings. We traveled to San Juan de Dios Hospital next. It was a large, private hospital where we will conduct our clinical duties. We did not have our orientation in POC and NCMH until later during our first day of duty.

Let’s begin.

On Muscles and Inches

Hi there! I wanted to share with you my journey on using the 30 Day Shred. I have known and used this method in the past and I can say for sure that this is effective, safe, and best of all-NOT A QUICK FIX. I have heard of many diets going around, my auntie, for one is a fan of those. When the lettuce diet was a fad, she ate nothing but lettuce and a few viands. When those laxative teas were advertised, she used those to lose weight. Last September, she heard of the Skyflakes diet and she indulged in that too! Sure she grew thin but not a good kind of thin. She lost weight and inches because she starved herself. She deprived herself of the nutrients that can be found in a healthy diet. Guess what her answer is everytime I ask her why she keeps on dieting.

She believes that “being skinny means being healthy.”

And that’s just wrong. Being thin does not immediately mean one is healthy nor does being overweight mean one is not. There are several factors to consider with regards to being healthy and not just physical appearance. A few months after dieting, she gained back her lost inches and pounds. Why? Because it was the wrong way of losing weight.

That is something I vowed never to do, no matter how much weight I gain, I will never, ever, resort to quick fixes especially if it compromises health. Ask yourself. Is it really worth it? Will I not regret this decision? Can I not seek other activities to help me lose weight? How does this affect my body, not just externally but also internally? 

The use of laxatives alone is not recommended for those without any signs of constipation. Otherwise, your bowel will become “addicted” to your regular use of laxatives and instead of developing a healthy bowel movement, the more you promote constipation. Dehydration and loss of electrolytes are alarming side effects of the use of laxatives, which, if not properly managed, may lead to the hospitalization of an individual for forced induction of lost fluids and electrolytes.

Scared yet?

Alright, now, there are other alternatives to losing weight and the very first thing to keep in mind is that this is a process, not a one stop, one click fix. You gained those inches for several months so expect to work your butt off to shed.

The 30 Day Shred is a program by Jillian Michaels, a known trainer in the TV show The Biggest Loser. It is divided into 3 levels, increasing the load of exercise every level but all within 30 minutes. The only equipment needed are a mat and some weights. It is recommended that newbies follow 10 days for level 1 then the next 10 for level 2 then the last 10 for level 3 for a total of 1 month. I prefer using a different level everyday. I read somewhere that this method surprises the muscles leading to a more effective workout. This also promotes muscle growth and more muscles means faster metabolism.

I was my heaviest(70kg) during the PNLE and NMAT review days that once they were finished I vowed to shred off those added inches. Enter Jillian Michaels. Her videos are uploaded in YouTube by the way so check them out if you have time. After 2 months, I’ve lost 10 kg! Here’s the 2 months documentation:

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Happy workout! 😁

 

 

Welcome to Nursing!

First year nursing life went by so fast. For the first semester, there were only two nursing subjects. The first one introduced was Theoretical Foundations of Nursing, where the  favorite nursing theory was introduced to us(Environmental Theory), as well as our nanay in nursing – Florence Nightingale. Then the application through Fundamentals of Nursing. Here’s the fun part.

The USI nursing faculty has compiled a list of nursing procedures done in hospital and community settings. They have set a standard of steps which must be done in complicance to the procedure. After each theory taught, when applicable, we had a Return Demonstration to show our skills and application of the theory. Guess what the first return demo was? Simple handwashing. For the first return demo, I’m proud to say I got the perfect score. Thus, my momentum built up and my will to graduate with honors spiked up.

First year was the time that we were taught the bedmaking skill. The night before, I was so busy practicing it in my own bed that I slept wonderfully. Who wouldn’t when your pillow is all fluffed up and your bedsheet crease-free? Haha, okay so here’s the funny part. We were all partnered up to demonstrate bedmaking with a patient. So the first thing to do would be to ask the patient to move to one side, or assist him/her to one side and do one side of the bed first, then move the patient back to the done side and repeat the process on the other side. There are 3 layers of cloth placed on the mattress – the top coat, the rubber sheet and the draw sheet. Our partner, the patient was supposed to be independent and conscious but relaxed. Well apparently, my partner was so relaxed and a bit on the heavy side that when I pulled the rubber sheet underneath her, it ripped! It was so loud when it ripped too! Not a single eye was dry after that, even my CI was laughing. Lesson learned after my turn though, a skinny person was required to be the patient after that. Me? I sent the rubber sheet to the sewing room and paid to have it resewn.

Then we were taught how to administer medications through the oral route, intradermal, sub-q  and intramuscular. We were made to perform the return demonstration on a partner. The day before that, we were advised to practice on a tomato. So as a group, we went to a medical store nearby to buy syringes. All the while I was thinking how weird must they think we were that we were buying only one piece of tuberculin, 5cc and 1 cc syringes. I went home looking for a tomato and practiced, but goddarn it, I simply cannot perform ID on a tomato, the skin isn’t as pliable as a human’s. Anyway, the next day, I performed the procedures to my classmate and I found out my weakness – opening vials. I feel like opening them using a gauze or cotton ball would pierce my skin thus rendering the medication unusable because of blood contamination. So it would be a loss to the patient or hospital as well as mine as who else will pay the for a replacement? Anyway, that passed and I passed and it was my turn to be the patient. Everything was going fine, until my partner performed the intramuscular injection. She was about to push it but the CI noticed that she didn’t aspirate, so she was instructed to aspirate. Unfortunately, her aspiration means thoroughly removing the needle then reinserting it. “STOP!” yelled the CI. Haha I was startled as well but the situation was too funny. Therefore, instead of 2, I felt 3 punctures. I consider myself lucky, the next day there was word that someone from the other section repeated ID and IM on her partner, therefore, all her arms were punctured.

On White Caps and Photoshop

When I entered nursing school, I had no idea of the formalities entailed in the course. All I knew was that student nurses wear an all white dress, stockings and shoes, with their hair in a clean bun, all neat and pretty with their black duty bags, going to the hospital for their duties and what not.

Well apparently, I left out one of the most vital ceremonies in nursing- the Capping and Candle Lighting Ceremony.

In our school, the ceremony is a departmental affair. This was the day that second year students formally receive their nameplates, white caps and their Nightingale lamp. Yup, even boys get a white cap, the only difference was while we get ours “capped” by our dean, they offer theirs to a statue of Mama Mary set up on the stage.

Let’s go back to a few weeks prior to the event. A classmate named Nicole, scouted for people who can learn photoshop and were willing to volunteer as part of the invitation committee. So off we went, learning the ins and outs of Photoshop through YouTube and internet tutorials. As I mentioned before, this was the year that the clinical instructors left the planning of the ceremony to the students, from the invitations to the venue. I consider it a blessing that I was an officer in the Nursing Students’ Association at that time and our president was very adamant on helping us go through with the ceremony. With Kuya Jayson’s leadership, we had a photoshoot with Kuya Gau and the fourth year students became our instant backbone.They, together with the third year students also consisted more than half of the audience during the ceremony, as per the mandate of the dean, so the auditorium would not look empty. It was nice that my NSA ’12-’13 family voiced out their concerns regarding the CI’s decisions and immediately responded to the crisis at hand. Going back to the invitations, here’s the very first project that was forwarded to me by Nicole, the CI’s wanted Nightingale to be at the front cover of the invitation, as well as St. Vincent, as well as of course, the title, the theme, the venue, the time and it must represent the colors of nursing – green and yellow. Easy task no? Not.

FB_IMG_1463462526552Apparently, he had a meeting with our batch moderator and the CIs wanted those elements in the front cover and they wanted to see the cover as soon as possible. That night, he sent me his little project and asked for improvements. And that was when I first opened and started my photoshop project. Can you see her yeeeeett?

Hahaha, try squinting your eyes a bit, or increasing the brightness of your gadget. You’ll see that there’s a person there, a person named Nightingale. Yup, that’s her, or a sketch of her. Florence Nightingale, the mama of Nursing, the lady with the lamp. Get it? That’s why there’s such a thing as the candle lighting ceremony. Anyway, so that file was sent to me to include improve and add the required elements, and thus, I created the front cover as well as the back:FB_IMG_1463488057926

The CIs chose Nicole’s design for the front cover however, as the font in mine was, apparently, unreadable. But I got dibbs on the back cover, so all efforts weren’t wasted.IMAG5637_1

Now, the invitation was done. 14 pages in total, including the front and back cover, done in one month by two photoshop noobs. I’ll say holding that invitation was a very proud moment.

Next up, the day itself. The program, as you can see above, started in the afternoon. We walked to our seats to the tune of At the Beginning, a song that was “wasoy” during my high school years. Soon, to the tune of Sanctus by Libera, we were marching to the stage accompanied by a parent to obtain the pin, cap and lamp. During the mass, the priest blessed the caps, nameplates and the lamps, then the ceremony started immediately after. First task: The Pinning Ceremony. Our nameplates were a literal pin and most of the parents were nearing the 50’s-60’s years thus, there were some delays in the pinning. This was why the succeeding batch had magnetic nameplates oh di ba, less hassle. Then from that station, we moved on to the next ceremony: The Capping Ceremony. Basically, we kiss the white cap, then the dean simply pins the cap on top of our bun, congratulates us and the parents. The boys however, kiss the cap and offer it to the statue of Mama Mary before proceeding to the next station. Don’t worry, each cap has a name sticker inside so they wouldn’t get the cap with another boy’s spit, hehe. On to the third station, The Lamp Station. Here was where we received the mini lamp, and posed next to a big lamp for a souvenir photo. Then we went back to our seats, standing, as practiced, until the last person in the row arrived and we sat down altogether.

On and FB_IMG_1463462112073on the ceremony went until the fourth year students were passing white roses to the sophomores. Apparently, the NSA prepared a gift for the parents, to thank them for their effort and support that we were able to arrive in that stage in our nursing career.

We thought that was the last surprise, bu apparently, our babies(freshmen) also had a surprise for us! They gifted us with red, blue and black ballpens – much needed items for duty – for good luck. It was nice.

The ceremony ended not long after, with our NIghtingale pledge.

Time to go and celebrate! We were finally, officially, “Student Nurses”!

Duty starts Monday.