An article by ​Hannah jara

doing research fieldwork in cebu, philippines

Before the pandemic struck, I was doing research work with ​the National Institutes of Health, University of the ​Philippines Manila. The last project I was involved in was ​called the Focused Interventions for Frail Older Adults ​Research and Development Program (FITforFRAIL). This was ​a large study funded by the Department of Health through ​the Philippine Council for Health Research and ​Development. This was one of the many research projects I ​had with the same institute in the span of three years. In a ​nutshell, it was a study on the health of Filipino older ​persons in the community and the state of government ​hospitals for geriatric care. Since we needed to collect the ​health data of people, we physically went to different ​communities in Luzon, Visayas, and Mindanao to objectively ​measure health indices from over 400 senior citizens. The ​project spanned for more than two years, and looking back, ​that period surely gave me several perspectives that have ​shaped my outlook on life.

This blog will focus on three things: reflections from the senior ​citizens I interviewed, the state of healthcare in the country, ​and my personal journey as a health researcher.

The spectrum of senior citizens that we interviewed was ​immensely vast in terms of wealth, education, and outlook. ​However, there were some patterns in the majority that I can ​recall vividly. The first one was that older Filipinos were not ​prepared financially to retire. Although the government was ​able to provide some form of pension, it was not sufficient to ​combat inflation. Many did not have enough money to even ​buy maintenance medications. And yet despite this, many of ​them still support their children and grandchildren financially. ​It was a painful sight to see these children in their 30's and ​40's still rely on their aging parents for money. For many of ​those that I interviewed, they gave away the little pension ​that they had to help buy food for their households instead of ​buying medicine for their ailments. It was true love at work, ​but still painful to watch, nonetheless.

Likewise, the financial burden of medical treatment has led to ​many senior citizens not having themselves checked at all. ​They fear that upon discovery of illnesses they possess, this ​may lead to greater financial burden.

it was a painful sight to see ​these children in their 30's ​and 40's still rely on their ​aging parents for money.

Another pattern is that there is a feeling of being a burden to their children...

With the limited income that ordinary Filipino ​families also have, these were prioritized for ​basic goods. If there were any health ​concerns, there was a tendency to prioritize ​children over the elderly, which may also ​stem from the Filipino's culture of fondness ​for children. Hence, it was not uncommon ​that there was neglect for older people, ​especially when resources are scarce.

Another pattern is that there is a feeling of ​being a burden to their children, especially ​those who have their own families. Somehow ​their contribution through their pension was ​a way to compensate for that feeling of ​inadequateness, akin to a "membership fee" ​to give them the rights and privileges of still ​being part of the family.

Likewise, there were many who wanted some ​sort of contribution to their community or a ​bigger sense of purpose, either that they ​have not had in earlier years, or to relive their ​"glory days" of being one of the most ​important figures in their immediate network.

For those have had a successful career, ​raised successful children, had wonderful ​experiences with their spouse, or were well-​traveled, they were usually the ones who ​seemed happy and fulfilled. For example, ​there was this Vietnamese woman who had ​her PhD in the Philippines and eventually ​married a Filipino and settled down here.

She did not have a house nor was she living ​with her children (her husband already died), ​but she was filled with enthusiasm when she ​was telling her story because she told me ​that she lived a beautiful and fulfilled life. ​Even if her PhD did not necessarily translate ​to sufficient funds in her old age, she was ​happy. It was still a sad sight though, ​because she did not have pension so she ​had to sell vegetables that she grew in a ​small lot, earning as little as twenty to fifty ​pesos a day.

with the research team of upwise

For many of them, there seemed to be an immense sense of ​gratitude that someone even bothered to speak with them, ​research or otherwise. They did not mind whether their ​participation was rewarded with some form of compensation or ​not. Many simply want the feeling that someone bothered to ​listen to their stories, and there were some that were truly very ​interesting. It also made me realize how values have greatly ​changed since their time to ours. Cheating was greatly tolerated ​during their period, with one of my female interviewees reporting ​that she got a sexually transmitted infection from her husband, ​who used to have intercourse with prostitutes. However, they are ​still married and living together during the time of the interview.

I also realized how huge the gap is in geriatric care. There are ​very limited geriatricians in the country, which I suspect is ​because of the fact that many medical specializations already ​cater to different forms of diseases among the elderly. For ​example, there are cardiology, oncology, rheumatology, ​neurology, etc. It is also more difficult to get young doctors to ​specialize when opportunities abroad are more attractive. It also ​doesn't help when professionals in the country are only ​respected enough when they have studied or trained abroad at ​one point in time. There is a general perception that the training ​provided locally by the best universities still cannot compare to ​the training of a university abroad, even with equal footing as ​that of the former.

It is my hope that such a perception change in the near future, ​so that we can also prevent the insatiable desire of young ​professionals to go to other countries and end up staying there ​for good.

Of course, this perception can only change with an improvement in ​the quality of education as well. Especially in the context of ​healthcare, many of what is taught in foreign institutions are not ​necessarily applicable to the Philippines, given the difference in ​healthcare landscape and economic standing. A local training may ​be more appropriate in that case.

Lastly, as a researcher I have developed several useful skills from ​working in this sector. The first one is multitasking. Doing research is ​almost akin to creating a startup in the sense that you do ​everything–the accounting, the planning, the implementing, the ​monitoring, and the reporting. The only difference is how well you do ​the study may not necessarily affect how much budget you will be ​given, since this is mostly determined by your proposal to the ​funding agency.

It's also terribly variable in terms of experience. There are times you ​get fancy in conferences and travels, and other times that you need ​to cross muddy roads and swinging bridges to interview someone in ​a dilapidated shack. Over time, doing fieldwork is only something ​that the young can do and more seasoned researchers are expected ​to take the role of principals or co-leads given their experience.

Although in more recent years, I have veered away from doing ​research myself to venture in other areas but the lessons it taught ​me remain to be valuable even to this day. I am eternally grateful for ​the senior researchers who kept me under their guidance in my ​younger years. It is my hope that more Filipinos, especially in ​healthcare, explore research as a "road less traveled" as it gives so ​much fulfillment and richness of experience worthy of a lifetime.

An article by Hannah jara (2022)