In the hilly farming barangay of San Agustin in Gerona, Tarlac, a cheerful man visits one house after another. During stops, he flips a blue clearbook then proceeds to take the blood pressure of residents. He cracks a joke to the delight of the families and Barangay Health Workers (BHWs), and plays games with the children. As a Community Health Nurse (CHN), Dominique Madayag untiringly performs his usual routine for Barangay San Agustin (with a population of 1,924, as per 2020 Census) whose residents could only express thankfulness for the presence of this jovial health professional. Aside from providing health services, Dominique also empowers the community to achieve an improved, efficient, healthy, and organized locality. Deployed as a CHN through the Alay sa Ginhawa at Kalusugan (ALAGA KA) of Health Futures Foundation, Inc. (HFI), Dominique came into grips with resource constraints and governance issues characteristic of low-income municipalities. Health and environmental concerns, including solid waste management, emerge as population grows and agricultural lands in the barangay are converted into residential and commercial areas.
Through the Community-Based Health and Wellness Program (CBHWP) of ALAGA KA, Dominique tries to close the gaps brought by these challenges. He coordinates with the Barangay Captain (village head) and health workers of San Agustin to orient residents and households about the program and elicit their participation. With his skill in building relationships, Dominique ushers the BHWs and Health Cluster Leaders (collectively referred to as Community Volunteer Health Workers or CHWs) into a collaborative relationship, working together and with him in providing basic health services and organizing the community for self-help. The past few months saw Dominique doing initial house-to-house visits with the BHWs in San Agustin, conducting meetings, organizing the households into cluster groups, and facilitating the election of cluster leaders. In the coming months, Dominique will conduct capacity-building activities by training and mentoring BHWs and Cluster Leaders on health and wellness topics.
Dominique had been a CHN before, working for almost two years in Brgy. San Vicente, also a marginalized barangay, in San Manuel, Tarlac. He is applying the lessons he learned from his past assignment to his present work in San Agustin. Dominique shares his experiences in addressing challenges from emerging health problems, climate-related health risks as well as from misunderstandings, and differences in culture and relationships. He recalls how the searing heat in the summer and the perennial flooding during the rainy season caused delays in program implementation. He explains that “When there is flooding, the children get sick, especially with skin diseases. In worse cases in the past, some drowned.” (Kapag bumabaha, nagkakasakit po ang mga bata, lalo na sakit sa kanilang balat. Dati may nalunod.)
Meanwhile, in San Agustin, Dominique encounters cases of snake bites due to wildlife habitat loss. The unhygienic environment in poultry farms also brings occupational and community health hazards. He recognizes that so much can be achieved with the active involvement of trained CHWs, and he wishes that they don’t have to leave in search of jobs, here and abroad, to have better lives. Dominique also shared communication barriers among Ilocano and Kapampangan-speaking residents. Despite being skillful in communicating with these dialects, he experienced conflicts and misunderstandings with patients due to ethnolinguistic differences.
Reinforced by experiences from his previous assignment, Dominique remains steadfast in his belief that it is still possible to build a community that strives towards the health and well-being of its people with the resources available to them.
“Being a Community Health Nurse (CHN) is not an easy job. We need a long patience. We must build enduring relationships in the community. We should be flexible in any aspect and circumstances. We must know how to give ourselves to the community.” (Ang pagiging Community Health Nurse ay hindi po isang madaling trabaho. Ang kailangan po natin dito ay mahaba-habang pasensiya. Dapat marunong tayong makisalamuha sa komunidad. Dapat maging flexible o nakikibagay po tayo, kahit anong aspeto po, anong kalagayan… Dapat alam po natin ibigay ang ating sarili sa komunidad.)
Dominique also emphasizes the importance of being physically fit and healthy as a role model to the community. As a basketball player, he uses his skills in sports to take advantage of opportunities to teach people in the community to live healthier. “A lot of patients’ lives were changed… That is why I want to continue being a CHN here in San Agustin to help our community. We are not only helping one person. They can be self-reliant, and they learned how to use herbal medicines, acupressure, and advise on how to prevent and manage non-communicable diseases.” (Marami po akong naging pasyente doon kung saan ang kanilang buhay ay nabago… So yun po kaya gusto kong ipagpatuloy ang pagiging CHN sa ibang lugar para po matulungan ang komunidad natin. Hindi lang po isang tao lang ang tinutulungan natin. Maging self-reliant po at marunong na po silang gumamit ng herbal medicines, acupressure, at maalamin kung paano umiwas sa mga non-communicable diseases.)
Just like in San Manuel, Dominique has already endeared himself to the residents of San Agustin. With his cheerful mien, the residents are confident there is now someone they can easily consult for their health concerns. Yet, Dominique reminds them that his tour of duty in the barangay is just for 18 months, and that he needs their support in transforming San Agustin into an empowered community of wellness. How to bring this about is something Dominique, the CHWs and the residents will have to learn by doing.
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Written by: Lizette Abibuag
Edited by: Pedrito dela Cruz and Nina Coronel
Read other CHN stories here.
