Keynote Address
Manila Doctors College 25th Commencement Exercise
March 30, 2001

Reynaldo O. Joson, MD

Thank you, Dean Leonora Reyes, for the kind introduction.

Dr. Placido Mapa, Jr., President, Metrobank Foundation at the same time Chair and President of Manila Doctors College;

Mrs. Elvira Ong Chan, Executive Vice-President, Metrobank Foundation at the same time Vice-Chair of Manila Doctors College;

Mr. Aniceto Sobrepena, Executive Director, Metrobank Foundation at the same time Executive Vice-President and Chair of the Executive Committee of Manila Doctors College;

Sr. Estelle Marie Camagan, Member, Board of Directors, Metrobank Foundation at the same time Senior Vice-President of Manila Doctors College and also Administrator of Manila Doctors Hospital;

Mrs. Leonora Reyes, Executive Dean, Manila Doctors College;

Mrs. Jocelyn Ann Estable, Dean, College of Nursing;

Ms. Minda Reyes, Dean, College of Liberal Arts;

Other Officers of Metrobank Foundation;

Other Officers and Faculty of Manila Doctors College;

Parents of Class 2001 Graduates; and 

Class 2001 Graduates of Manila Doctors College.

Magandang hapon po at Mabuhay sa inyong lahat!

Before I go any further, I like to thank all of you for the honor and privilege that you have bestowed upon me when you chose me to be your keynote speaker in your Commencement Exercise this afternoon. I will reciprocate your invitation by fulfilling my responsibility as a keynote speaker to the best of my ability. 

Today is a day of graduation and a day of completion.  Today is a day of conferring academic degrees and a day of honoring people who have contributed to the task of health profession education.

The celebrants and honorees today are not only you, Class 2001 graduates of Manila Doctors College but also you, the parents of the graduates; you, the faculty and administrators of Manila Doctors College; and also you, the officers of Metrobank Foundation.

Thus, to all of you, I extend my felicitations and congratulations.

To you, Class 2001 graduates of Manila Doctors College,
you have successfully passed your respective courses and you have gotten your academic degree, which is now your asset and which can be a passport to more socioeconomic productivity, to better well-being, and which can be a stepping stone to something bigger in your life.  Your parents, your faculty, and the administrators of Manila Doctors College and Metrobank Foundation are all happy of your achievement. 
Also, with your academic degree, you now constitute additional, at least potentially, health manpower in the Philippines. 
Thus, to all of you, graduates, congratulations and best wishes on your future endeavors!

To you, parents of the graduates,
You have successfully supported, both financially and emotionally, your children to achieve their chosen profession.  You have now transformed at least some of your liabilities into asset.  Your children are all happy for what you have done and will forever be grateful.  I can hear them say “Thank you, mom and dad.”  “Maraming salamat po, itay at inay.” 
Also, with the graduation of your children, you have somehow, at least potentially, contributed additional manpower to the health development in the Philippines.
Thus, parents of graduates, congratulations and more power to all of you! 

To you, administrators and faculty of Manila Doctors College,
You have successfully provided formal and quality education for the graduates.  The officers of the Metrobank Foundation, the parents of the graduates, and most important of all, the graduates themselves, I am sure, are all happy with your accomplishment.  The graduates will forever be grateful to you and I can now hear them say “Thank you, teacher.  Thank you, Mam. Thank you, Sir. Maraming salamat sa inyong matiyagang pagtuturo.  Hindi namin kayo malilimutan.”
Also, with the graduation of Class 2001 students, you have somehow, at least potentially, contributed additional manpower to the health development in the Philippines!
Thus, administrators and faculty of Manila Doctors College, congratulations and keep up the good work!    

To you, officers of Metrobank Foundation,
You have successfully provided opportunities, through the Manila Doctors College and through your scholarship program, for the graduates to pursue their chosen profession.  You also have successfully supported the faculty and administrators of the Manila Doctors College in providing quality education for the graduates.  Without you, there is no Manila Doctors College. Without you, there is no quality education in Manila Doctors College.  I am sure the graduates, their parents, and most especially, the faculty and administrators of Manila Doctors College, are all thankful for your vision, mission and support.  I can hear all of them say: “Thank you Metrobank Foundation for your  philantropic vision and mission.  Thank you, Mr. And Mrs. George Ty, the people who are actually behind Metrobank Foundation and the Metrobank Groups of companies, for your sense of social consciousness and for your corporate social responsibility.  
Again, with the graduation of Class 2001 students, you also have somehow, at least potentially, contributed additional manpower to the health development in the Philippines!
Thus, officers of Metrobank Foundation, congratulations and continue your role as a  guiding light and a model for social responsibility to all foundations and business corporations in the country!    

After the greeting, expression of gratitude, and congratulatory remarks to all stakeholders of this Commencement Exercise, I will now proceed to my main task as a keynote speaker. 

The tasks that I have to do as a keynote speaker were spelled out in the letter of invitation.  The gist of the letter contains the following:

Graduates will embark on a new crossroad in life
Need a special person who has embraced life to inspire and guide them
Whose reflections, counsel, and advocacy to achieve will spur them to welcome and “seize” life not only for themselves but also for others
				
I shall be guided by this letter of invitation when I perform my main task.  

I hope you will NOT mind if I address NOT only the graduates as specified in the letter but to ALL the stakeholders of Manila Doctors College.

This diagram more or less outlines the reflections, counsel, and advocacy which I going to share with you this afternoon.

Citizenry
Parents
Institutions with CSR

Health Care Professionals
MDs, Nurses, etc.

Health Profession Educational Institutions
Medical, Nursing Colleges

Health Status

Health Development 

in the Philippines

Health Care Provider Institutions
Hospitals, Clinics

 

Health Care Governance
Institutions
DOH, CHED, LGU

The outline of my talk will be as follows:

Health Status of the Philippines
Health Development
	A Never-ending Process
	Direction of Health Development in the Philippines
	Important Health Development Areas in the Philippines
	Goal of Health Development in the Philippines
Why and How to Contribute to Health Development in the Philippines

The Health Status of the Philippines

I will describe the health status of the Philippines side by side with the global health status to give you a proper perspective of where we stand.

Based on the 1998 WHO Health Report, most people died before the age of 50 half a century ago.  Now, the great majority live well beyond that age.  Global life expectancy at birth at present is 68 years.  The projected global life expectancy at birth in 2025 will be 73 years.   A good news, isn’t it?

In the Philippines, the present statistics show that the life expectancy at birth for males is 67 years old and that for females is 71 years old.  Not bad, compared to global statistics, isn’t it?

The WHO report stated that the explanation for this increasing life expectancy trend lies in the social and economic advances that the world has witnessed during the late 20th century - advances that have brought better living standards to many, but not all, people.

The other health indices, such as infant mortality rates and maternal mortality rates 
also showed improvement, both globally and in the Philippines.  In the Philippines, however, according to the DOH report, the improvement was not as significant as that in the other Asian countries.

It is said that the war against ill-health in the 21st century will have to be fought simultaneously on two main fronts: infectious diseases and chronic, noncommunicable diseases. Many developing countries will come under greater attack from both, as heart disease, cancer and diabetes and other "lifestyle" conditions become more prevalent, while infectious illnesses remain undefeated. Of this latter group, HIV/AIDS will continue to be the deadliest menace.

In the Philippines, although we still have more infectious diseases, chronic noncommunicable diseases are on the rise.  HIV/AIDS is also increasing in incidence.

Overall, the health status of the Philippines has improved and can be said to be at par with most other developing countries in Asia and in the world.  However, there are still a lot of improvement to be done and problems to be solved.  

We need the helping hands of the health care governance institutions which are primarily represented by DOH, CHED, and the Local Government Units; the health profession educational institutions, represented by the medical, nursing, dental, and other paramedical colleges and their faculty; the health care providing institutions, represented by the hospitals and clinics; the health care professionals, represented by the physicians, nurses, and other paramedical professionals; and last but not the least, the citizenry, which can include you the parents and the people with social consciousness, like the officers of the Metrobank Foundation.

Health Development in the Philippines

Health Development: A Never-ending Process

Before I describe to you the health development status in the Philippines, I would like to state that health development is a continuous never-ending process.

Remember there will be NO end to the health problems in the Philippines and in the world for that matter because of the inherent nature of LIFE itself which will always end up in DEATH.  By medical parlance, all deaths will be preceded by a disease or a health problem.

Also, take note that improvement or eradication of one disease will always be replaced by another disease in the annual listing of top 10 causes of morbidity and mortality. A very clear example of this statement is the replacement of infectious diseases by heart diseases and cancers in developed countries as the leading causes of death and disability.  Thus, it can rightfully be said that there will always be a list of top 10 causes of morbidity and mortality, and therefore, there will always be health problems for all communities and countries.       

Because of this never-ending process of health development, we need the helping hand of everybody listed in this diagram.

Direction in Health Development in the Philippines

In the Philippines, we strive to reach the status of developed countries. In doing so, health wise, we end up with the same health status and health problems as in developed countries.   

The WHO Report states the following in this regard and I quote: “Infectious diseases will still dominate in developing countries. As the economies of these countries grow, non-communicable diseases will become more prevalent. This will be due largely to the adoption of "western" lifestyles and their accompanying risk factors - smoking, high-fat diet, obesity and lack of exercise.”

The exchange for a longer life expectancy will not only be heart diseases, cancer, and diabetes but also mental disorder because of the more stress in living the extended life span.  With such a trend and projection, anybody can rightfully ask the philosophical question that runs like this: “Which one do you prefer, a shorter life span dying of infectious disease or a longer life span dying of heart disease, cancer, diabetes, and mental disorder? Take your pick!”

Important Health Development Areas in the Philippines

There are still a lot of areas in health that need to be developed or improved.  If you want a detailed description of these health development areas, it is contained in the DOH’s latest Health Sector Reform Agenda and National Objectives for Health.

The Health Sector Reform Agenda contains policies and strategies for achieving the national objectives and goals for health through reforms in health financing, local health systems, public health programs, hospital systems and health regulations.

The National Objectives for Health contains the objectives for disease control and prevention, health and promotion and protection for 1999-2004.  It emphasizes partnership and shared responsibility for health among various sectors.  It can be used by by health service providers from local governments, non-government organizations, professional groups, private sector and the academe

For our purpose this afternoon, I will just list down five (5) health development areas which you can use as a reference when you decide to help, which I am enjoining you to:

1.	Inequity in health care in which the poor and the marginalized sectors of our community are still NOT getting adequate health care.  We all know that we have a lot of poor people and far-flung underdeveloped communities in the country.
2.	Increasing cost of health care which affect all citizens of the country regardless of economic status.  We all know that the citizens in the lowest income level will be affected most and this will further aggravate the inequity in health care.
3.	Need for better quality health care delivery being provided by health professionals and hospitals and clinics, especially in terms of rationality, promptness, and cost-effectiveness.  We are all aware of the left and right prescription of drugs and laboratory procedures, most of which are without sound basis and most of which can be substituted by equally effective yet less expensive ones, without sacrificing the result or quality of management.  We are also all aware of the long-waiting time for health service to be rendered by health professionals and hospitals and clinics in the country.   
4.	Need for better quality of health profession educational institutions in terms of more relevant curriculum and tangible impact on quality health care delivery in the Philippines.  Most, if not all, present health profession educational institutions are merely contented with production of graduates and board passers. We all know they should go beyond that.
5.	Need for increasing “health” literacy rate of the citizenry so that they will NOT be too dependent on health care professionals and health care providing institutions and it will fast-track achievement of the HEALTH FOR ALL goal.  “Health” literary rate is a phrase that I coined and it has a concept analogous to that of “computer” literary rate.  Health literacy can be achieved through an educational process and the ultimate indicators consist of the citizenry possessing unconscious competency in living a  healthy lifestyle.

Goal of Health Development in the Philippines

Before I go to why and how you should contribute to health development in the country, allow me to state in simple terms the goal of health development in the Philippines.

The goal is Health for All Filipinos with accessible, quality yet affordable, and cost effective health care services when needed.  

Allow me also to emphasize the concept of HEALTH.  It is NOT merely the absence of disease but it includes social, spiritual, and mental well-being as well. In other words, health is TOTAL WELL-BEING, LIVING A QUALITY LIFE, and BEING SOCIOECONOMICALLY PRODUCTIVE THROUGHOUT LIFE.   

Why and How to Contribute to Health Development in the Philippines

With the goal and areas of health development needing improvement having been spelled out and outlined, I will now try to convince you to help to contribute to this endeavor.
  
Why should you all contribute to the health development in the Philippines?  You may ask.

Simply put, because if you don’t, you will be affected by the ill-health of your countrymen.  In any community, there is almost always a mixture of sick and healthy individuals and families.  If we who right now constitute the healthy individuals and families of the Philippines do NOT help the sick ones or sick sectors of our community, eventually we will be affected or contaminated with disease. Just to cite one example.  We may not have Tuberculosis or AIDS right now.  If we don’t help control Tuberculosis or AIDS among our countrymen and in our community, our risk of acquiring these diseases will be higher compared to that in which we help control or even eradicate the diseases in our community.  

Just for this reason and example alone, without having to invoke the virtues of LOVE and CHARITY, all of us should contribute to the health development in the Philippines.  All of us should contribute to the HEALTH FOR ALL goal.
 
How can I contribute? You may ask. 

1.	Look at the five (5) health development areas and see where you can contribute most effectively considering your present status and competency.
2.	You can do it either on an individual basis or together with a group of concerned citizenry.
3.	You can do it by advocacy, role modeling or by actual hands-on.
4.	The minimum is to be “health” literate by living a healthy lifestyle – avoid excess in anything and everything (indulge in moderation only) particularly stress and food/fluid/drug intake; avoid toxic substances and chemicals, particularly smoking, prohibited drugs, and alcoholic drinks; work, exercise and relax regularly; live a balanced variety life; most important of all, learn how to be contented and always feel happy.

Class 2001 Graduates, if I may, here are some more advices, suggestions and pakiusap:

1. Continue to be self-directed learners to increase your competency as health professionals so that you can improve the quality of health care delivery services especially in terms of rational and cost-effective management and promptness and help decrease the cost of health care. Go for higher learning if you must.

2. You can join the health care governance institutions, health profession educational institutions, and hospitals and clinics.
 
I hope it will NOT be presumptuous on my part to say that you are most welcome to join the Manila Doctors College as faculty or the Manila Doctors Hospital as practicing health professionals.

Parents of graduates, if I may,

1. Encourage your sons and daughters who are graduating today to contribute actively in the health development in the Philippines.

2. Strive to be “health” literate yourself and try to help others also be “health” literate. Live a healthy lifestyle so that you can serve as a role model for our other countrymen to follow. 

Faculty and Administrators of Manila Doctors College, again if I may,

1. Don’t be contented with mere production of health professionals and board passers.  At present, such an output has NO impact on the health development in the country. 

2. Develop a more relevant curriculum in which the college, faculty, and students join hands in solving some ACTUAL health problems in the country.  Document your contribution in the form of an action research project.  Use it as model for your students as well as for other health profession educational institutions.

Officers of Metrobank Foundation, again if I may,

1. Don’t be contented with mere establishing and maintaining Manila Doctors College and Manila Doctors Hospital as an educational institution and as a hospital. Go beyond these goals and objectives. Ensure that these two institutions have tangible impact on health development. Then use this strategy as a model for other foundations to emulate and to follow.

2. Among the 5 health development areas, I think you can contribute most in decreasing the inequity in health care.  Please look into this.

Looking again at the outline of my talk, I suppose I have covered everything.

I hope I was able to share to you CLEARLY my reflections, counsel, and advocacy.

Most important of all, I hope I have inspired and guide you on why and how you should and can contribute to health development in the Philippines.
 
May I ask one last favor from all of you.  At the end of my talk, please give me a BIG and LONG round of applause if you believe I have inspired you to contribute to health development in the Philippines.  If not, just give me a SMALL and SHORT round of applause.

On that note, thank you once again for the invitation to be your speaker.  Congratulations again on your completion or graduation day.  Have a nice and healthy day, today and in the days, months, and years to come.  MABUHAY to all of you.