The medical students, along with Cherry and Terence of VPHCSI, took the early morning bus ride from the Cebu City to Dumanjog port. From the port, they took the ferry going to the Guihulngan port of Negros Oriental. Upon arrival at Guihulngan, they went to visit the town mayor but apparently it was a holiday and the mayor was not in his office or residence. The group bought food at the market to take to the mountain clinic.

The group hired 3 “habal-habal” drivers to take them to a 2-hour uphill, downhill, paved and off-road journey to the small town of Banwague where the Kansalakan Mountain Clinic was situated. The habal-habal experience was scary since one motorbike had to accommodate 3-5 individuals while driving up the treacherous route – road was rocky, muddy, and even narrow near the mountain cliff. It was good to know that these habal-habal drivers had more than 10 years experience riding their motorbike on the mountains of Negros, and the drivers were confident to inform the group that the more people riding a single bike, the more stable and balanced it was for the drivers to take their habal-habal enduring the route to the mountains.

There were stopovers going up the mountain as the group was getting used to doing a balancing act on a motorbike. Sometimes the group had to get off their designated motorbike and walk instead because there were roads that habal-habal drivers can only traverse without the passengers on the bike. After two hours of riding, balancing, and walking the group made it to the Kansalakan Mountain Clinic owned by the Franciscan Friars.

The group met with the caretakers/healthworkers of the clinic and had their lunch there. After lunch, they had an orientation on their stay at the clinic and was given a brief background about the clinic. The day’s journey was adventurous, scary yet exciting.

The medical students went to Labogon to help in the discussion on history and PE taking to the volunteer health workers of different barangays. This was organized by the Visayas Primary Health Care Services, Inc. This was a 3-day seminar for the volunteer health workers and the medical students attended the final day. At the end of the seminar, the volunteers were given certificates of participation by the Barangay Captain and a medical student.

The group had an evaluation on their first week of stay in Cebu, especially their community diagnosis on Talamban and Pasil. Each student reported to Dr. Erlinda Posadas their opinion regarding their community immersion and if they have any other suggestions to share to the VPHCSI. They also evaluated the tuli missions in Inayawan and Lambangon, how each was organized and their areas of improvement.

One student reported that the health workers in Talamban needs regular skills training in taking vital signs and also to practice computation and conversion in taking the weight and height of children. About the students’ stay in their foster families, it was suggested that the foster families be informed ahead of time because some of them were aware that students will be visiting their community but was surprised that they were the chosen family to shelter these students. It was also suggested that the students visit the health center of the area which was not done. However, the students were able to walk around the community, visited and interviewed several families about their health problems in the community. Interviewed families in St. Mary Grace reported to the students that they do not have serious health problems, but what they need is to be educated on the basics of health – vital signs taking, nutrition for children, and treating the common illnesses like fever, cough and colds. Right now, the only problem in St. Mary Grace is land dispute. Other than that, they claimed they were able to manage well in their daily living.

The community in Pasil had more serious health issues than Talamban. Houses in Pasil were cramped and walkways were narrow, dark, wet, and dirty. As reported before, Pasil was similar to Pasay communities visited by the medical students during their community medicine rotation in UPCM. Pasil health workers organized a dengue brigade to make their area clean. Another problem they were encountering was that some houses near the waterway were pending to be demolished but the settlers near the waterway had no idea if they already had a relocation site.

As for the tuli missions, it was still an issue that sutures were reused up to 3 patients. Even if sutures were cleansed with lysol, there was still a health risk on transmission of infection and blood group incompatibility. Even the forceps and scissors were cleaned as if the nurses were dishwashing. This only showed that most communities lack medical supplies. The students were also hoping that tuli missions and other medical missions in the future will not be used for political purposes of those who organized them as was usually the case during election period.After the evaluation, the next schedule of activities and trips was discussed.

This tuli mission was more organized than that of Inayawan. There were more volunteer doctors and nursing students to help in the circumcision of more than 100 children. The patients were qeued systematically, and there were more appropriate tables and chairs to perform the tuli. Again, sutures have to be reused to more than two patients.

Pasil is a poor fishing community in Cebu. The medical students observed that this community is similar to some poor communities in Pasay, Manila. Roads were narrow, wet, and dirty. Houses were made of old wood and used cardboards. These houses were small and built with no space in between and even atop each other, similar to the apartment-style housing of Barangay 143 in Pasay.

The health problem in the area was sanitation and dengue, and so the women of Pasil organized a clean-up drive every week and formed a dengue brigade. These women need the manpower of the men and youth of Pasil if they wanted to make their place clean and healthy.

Aside from fishing, some women make puso (a coconut leaf wrap to cover cooked rice), earning them 5 pesos for every 100 puso they make!

Medical students Leah, Mabelle, Gillian, Lemuel, JM, and Kristine went to Inayawan to do circumcision to more than 50 children. This project was organized by Women of Barangay White Road, Inayawan. Medical supplies for the Tuli Mission were from Visayas Primary Healthcare Services Inc. and from a donation of a former healthworker.

Dr. Posadas supervised the group and taught some of the students who had not done circumcision before. The setting was different in the community. The Tuli Mission was done in a small market place atop the tables used to display raw meat. Old newspapers were placed on the table where children were to lay down to have their circumcision.

The medical students were surprised how unsterile the place for circumcision was. Scissors and forceps have to be rewashed to be used on the children waiting to be circumcised. Even the sutures were rewashed with lysol. The doctor told the medical students that this was usual in the setting wherein medical supplies were lacking and healthworkers had to use and reuse what supplies were available. Despite the few doctors and healthworkers as well as the lack of medical supplies, the Tuli Mission was a success.

The group lectured about nutrition for children, diarrhea and hypertension for the community members. The health committee was then taught how to compute for BMI, using their own heights and weights for practice. They also took the blood pressure of those who wanted to know if their blood pressure was elevated or not. They also assessed the weights of the children, which they have already done 2 months ago, and discovered 4 out of 19 children aged 0-6 years old have weights below normal.

The members of the health committee were familiar with BP taking but still need more practice. The lack of calculators also posed as a problem in BMI computation.

After the afternoon activities, the group was able to interview 3 people using the questionnaire provided by VPHCSI to aid in the Community Diagnosis of St. Mary Grace. Some of the residents then took the group on a tour of the community located further uphill where they were able to see the community of Tayong where the other half of the group (Leah, Mabelle and JM) was integrating. They were also able to visit and take the BP of one of the residents who is a known hypertensive and asthmatic, and is currently experiencing difficulty breathing. It was suggested that she go to the hospital for further work-up.

The group then proceeded to have dinner with their respective foster families.

The group of Gillian, Lemuel and Tine was accompanied by Ate Lina of VPHCSI at St. Mary Grace community in Talamban. They were introduced to Mr. Julian Libato, president of St. Mary Grace Neighborhood Association and to the members of the Health Committee.

Some were generous to offer their food for lunch but the group was not aware that they ate most of the food they shared with the family.

The group had a conversation with some members of the Health Committee. They requested from the UP medical students to lecture on hypertension and children’s nutrition. They were then brought to Lola Ellen Ngalis’ house where they would stay for the night, together with Ate Jessica (also from VPHCSI).

Good thing the community is located near a commercial complex for the students needed visual aids for the lecture. They also bought canned goods and rice for dinner which they prepared on their own. After dinner, they bought 3 gallons of water for Php 2.50/gallon which they used for dishwashing and bathing. Electricity was limited so that flashlights came in handy.

These UPCM students will be having their summer elective studying community medicine in Cebu, Bohol, and Negros Oriental. They will be observing the health conditions of certain communities and identify health issues that need to be addressed. Together they will work along with the health workers of the Visayas region to analyze what can be done in improving the health system of these regions and for the students to learn about the traditional health practices of the Visayas community.