“REMEMBERING DR. JUAN M. FLAVIER, DOCTOR TO THE BARRIOS” in this week’s issue of the MANILA MAIL (Nov. 12-18, 2014) (Image courtesy of tumblr.com)

Pilipinasblitz Forever
A column by Bles Carmona
For the week of Nov. 12-18, 2014

REMEMBERING DR. JUAN M. FLAVIER, DOCTOR TO THE BARRIOS

When Dr. Juan Flavier passed away last Oct. 30 at the age of 79, he metaphorically orphaned many a physician and health professional who considered him as their inspiration for serving in the rural areas of the Philippines. Dr. Flavier was an early pioneer of bringing medical service to the far-flung barangays of the country, writing about his experiences with the Philippine Rural Reconstruction Movement (PRRM) in his first book, “Doctor to the Barrios.”

Dr. Juan Martin Flavier (23 June 1935-30 October 2014) was a senator from the Philippines (1995-2007), and before that he served as the Secretary of the Department of Health (DOH) from 1992-1995. Flavier was born in Tondo, Manila then moved to Baguio City where he studied at the Baguio City National High School. He obtained his medical degree from the University of the Philippines Manila-College of Medicine, and his Masters in Public Health from the Bloomberg School of Public Health at Johns Hopkins University in 1969. From 1978 to 1992, he was the president of the International Institute of Rural Reconstruction (IIRR).

In his first non-fiction book, “Doctor to the Barrios,” Dr. Flavier shares his experiences about his medical service to the village folk in the provinces of Nueva Ecija and Cavite, both located in the Luzon island. I read this book on my own when I was still in high school. His subsequent books feature certain individuals in the barrios with whom he has formed friendships, including many humorous anecdotes and “parables,” as well. In the follow-up book, called “My Friends in the Barrios,” here is an excerpt from his foreword:

“When I joined the PRRM, I did so without previous exposure to the barrios. All my earlier life had been spent in cities – Baguio and Manila. So when I began to visit barrios and meet farmers, the experiences were intriguing and fascinating – it was a new world. Their language was poetic and different. Their ways did not conform with many of my own. Their humor and values made strong impressions on me. The strategy of knowing the farmers as a starting point for rural reconstruction made me aware of their humanity.”

President Fidel V. Ramos appointed Dr. Flavier Secretary of the DOH in 1992. Flavier’s sense of humor and upbeat personality helped launch many a department initiative with nationwide impact: Oplan Alis Disease, Oplan Sagip Mata, Kontra Kolera, Yosi Kadiri, Doctors to the Barrios Project, Pusong Pinoy, Stop TB, Family Planning, Araw ng Sangkap Pinoy, and many others. Dr. Flavier resigned from his post in order to run for Senator in 1995, and then again in 2001, becoming the 21st President pro tempore of the Senate of the Philippines. Aside from a perfect attendance record in all Senate sessions, Dr. Flavier authored and sponsored landmark legislations such as the Traditional Medicine Law, the Poverty Alleviation Law, Clean Air Act, Indigenous People’s Rights Act, Anti-Money Laundering Act of 2001, Barangay Micro-Business Enterprise, National Service Training Program for Tertiary Students of 2002, Dangerous Drugs Act of 2002, Plant Variety Protection Act, Philippine Nursing Act of 2002, and the Tobacco Regulation Act. (Wikipedia)

In the Journal of Infectious Diseases (1997;175(Suppl 1):S272-6), Dr. Flavier co-authored a study with Rudolf Tangermann and Maritel Costales titled “Poliomyelitis Eradication and Its Impact on Primary Health Care in the Philippines.” According to this peer-reviewed journal article, “through good routine immunization, the incidence of paralytic polio has decreased to low levels in the Philippines even before the national immunization days (NIDs) were initiated.” Since 1992 and I remember this quite well, there have been NIDs for polio eradication, promoted by Dr. Flavier himself in television ads about the Oplan Sangkap Pinoy. He was able to mobilize not just the health sector in volunteering for these events, but also the government in general, the nonprofit sector, big business, the Boy and Girl Scouts, and even TV and film actors and actresses. The study abstract further says: “National Immunization Days had a direct positive effect on child health through supplementary immunization with oral poliovirus vaccine, measles vaccine, and tetanus toxoid for childbearing-age women, as well as through the distribution of vitamin A.” The bottom line was that with improved surveillance for acute flaccid paralysis (AFP) and virus detection, wild poliovirus has not been isolated since May 1993. In addition to AFP cases, neonatal tetanus and measles are now being reported through the AFP surveillance systems in several regions. This was just one of the many successful health campaigns under Dr. Flavier’s leadership at the DOH. On the DOH website itself, Dr. Flavier is described as “perhaps the most popular Secretary of Health.”

I was still a medical student at the UP College of Medicine when Dr. Flavier was appointed Secretary of the Dept. of Health. At that time, there was an explosion of knowledge about community or grassroots medicine, utilizing modalities of alternative medicine like the use herbs, acupressure/acupuncture, reflexology, ventosa (cupping), and others. I remember being interested in all of those and would have wanted to explore some of them further, but it was not to be. Meanwhile, Dr. Flavier at that time was a ubiquitous presence in the media, promoting one DOH initiative or another, and the common tao can’t help but adore his jolly and positive presence. It was inspiring to see him at work. His charismatic personality endeared him to the masa. Clearly, in this diminutive man (in height only, not in spirit), the masses have found a champion for their health concerns, the personification of the government’s concern for the health and wellbeing of all Filipinos. Because of Dr. Flavier’s can-do and caring attitude, the attitude of most Filipinos became less resistant toward the government’s campaigns for health preventive measures. True, Dr. Flavier did incur the wrath of the Catholic Church hierarchy in the country for promoting the use of condoms and HIV prevention, but even an informal survey of Catholics at that time would reveal that the faithful think that the Church’s stand against artificial contraception was a little bit extreme.

When I was researching for sources for this article, I was dismayed that I cannot get a hold of any of Dr. Flavier’s books. The only hard copy I was able to borrow was his second book, “My Friends in the Barrios” from the Cal State East Bay (CSUEB) library. I tried Amazon and Alibris, wanting to buy his autobiography but it was out of stock. Maybe you and I could request the publishers to reissue Dr. Flavier’s books, especially in the light of his passing. Those books are timeless and I believe that we can all benefit from knowing how it is to serve in the rural communities which comprise at least 70% of our native country. Here are the books authored by Dr. Juan M. Flavier:

1. Doctor to the Barrios, Experiences with the Philippine Reconstruction Movement (1970)
2. My Friends in the Barrios (1974)
3. Back to the Barrios: Balikbaryo (1978)
4. Parables of the Barrio: Vol. I (1988)
5. Parables of the Barrio: Vol. II, Nos. 51-100 (1989)
6. Parables of the Barrio: Vol. III, Nos. 101-150 (1991)
7. Let’s DOH It!: How We Did It (1998)
8. From Barrio to Senado: an Autobiography (2009)

Dr. Juan Flavier’s diplomatic approach to the novel things he learned as a newly minted barrio doctor all those years ago paved the way for those of us who wonder how to mobilize community support for our projects and initiatives. Among the community-oriented lessons I have learned from reading Dr. Flavier’s books are: Start with where they are and what they know. Seek out the authority figures in the community and find out if they would work with you. Do not automatically assume that what you learned in medical school is superior to folk knowledge. Form friendships, be respectful, and be approachable. Simple lessons, sure, but these are the foundations of Dr. Flavier’s success as a barrio doctor and informed his legislation later as a Senator. He leaves behind a legacy of a life simply lived but with maximum impact on the Filipino psyche. His wisdom and humility will be missed.

Rest in peace, Dr. Juan Martin Flavier. You said, “Let’s DOH it!” With your exemplary life, Dr. Flavier, you surely did it and more.

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