Hello Nasipit!

It's been roughly one month into my stay here in my new area, and so far, things are going well (*knocks on wood*).

My uncle who lives in town helped me set up these cork boards in my office, and now I have a nice cork canvas to get creative with.

I've also spent at least one day a week going around the different barangays, joining in on the house-to-house vaccinations.

It hasn't been easy. 

My previous job in Butuan mainly involved me staying put in a vaccination center. The people I dealt with were all willing to be vaccinated, even if in the tiniest degree, so it was not as much of an uphill battle.

But now that I'm working on the ground, I am more exposed to the proportion of people who don't want to get vaccinated. And it upsets me.

It hurts even more to think that we go through such lengths to bring vaccines closer to people - which can sometimes mean riding precariously balanced motorcycles on dangerous dirt paths deep into the mountains. 

What do we get in return? Resentment. Rejection. Redness (of the skin, from sunburn - lol I just had to find another "R" word). One person even threatened to file a case against me. Hay.

I fear the reputation of our vaccines has been irreparably tarnished by fake news. There have been too many unverified reports of kapitbahays and silingan who die after getting vaccinated, that now many people believe that vaccination is a death sentence (BY THE WAY I have to point out here that absolutely NOBODY has died from a vaccine).

These are the usual type of responses we get on the ground:

• Dili ko magpabakuna kay naa koy gibati / taas akong sugar / naa koy highblood. I don't want to get vaccinated because I have a sickness / my sugar is high / my blood pressure is high.
• Of all the vaccine responses, this is usually the easiest to deal with. 
• If there are med students reading this, please remember: THE ONLY ABSOLUTE CONTRAINDICATION TO A COVID VACCINE IS A PREVIOUS ALLERGY TO A COVID VACCINE. Everything else is relative. 
• People with high sugar and high BP can absolutely get vaccinated. But (sometimes just for show), when dealing with patients with these type of concerns, I pull out my trusty rusty stethoscope and listen to their chest. Once people see that they've been "adequately assessed", they're usually more willing to get vaccinated.
• However, some people will segue into this next point: 

• Namatay among silingan paghuman ug bakuna / Our neighbor died after getting vaccinated. 
• This one is very tricky to explain because it involves confronting a painful truth about human life: the truth that people die. All the time. From reasons that are completely UNRELATED to vaccines. People have died from heart attacks, strokes, sepsis, pneumonia, and cancer for as long as time can remember. 
• And the bitter truth is, in the Philippines, in poor municipalities with limited access to secondary and tertiary care, people in the past have often died without ever knowing why. Their relatives will just come to us in the Rural Health Unit, death certificates in hand, telling me their lolo died "of old age" or "stress," and I'll be left scratching my head, wondering how to translate that into a specific cause of death that I can write in the death certificate to be included in the mortality census.
• Nobody is immortal. People have died before the vaccines were a thing, and people will CONTINUE to die now that vaccines are a thing. 
• And because we have now vaccinated more than 50% of our population, we are seeing those deaths that would have occurred, WITH or WITHOUT the vaccine, now occurring at a time AFTER they've received the vaccine. 
• Again, just because B followed A does not mean that A caused B. Just because someone died after vaccination doesn't mean they died BECAUSE of the vaccine.
• I could probably explain this all in a better way if I gave it more thought but I'm lazy to edit now so meh.

• Dili ko magpabakuna kay dili ko ganahan. Basta. / I won't get vaccinated because I don't want to. Whatever.
• This is boss level resistance. Whenever I encounter patients like this, coupled with aggressive body language like huffed out chests and crossed arms, I don't spend too much time on them. They usually aren't ready to listen and to argue would just be a waste of time and energy.
• For these patients, I believe the best way to reach them is through non-healthcare worker sources. Be it pastors, parish priests, religious leaders, radio announcers, sari-sari store vendors, etc. They're more likely to listen to their friendly neighbor or family member than to me, and acknowledging that would save everyone so much time and energy.

This, aside from mounting pressure coming from DOH to meet the target of an 80% fully vaxxed population, can be endlessly frustrating. Covid is not just a health issue, it's a social one as well. Why does it seem like us healthcare workers are the only ones shouldering the burden of vaccination? Why are vaccination targets being imposed on us alone? We've reached that point where we've vaccinated most of the people who are willing to be vaccinated. All that is left are the people who are baseline distrustful of healthcare workers, the people who refuse to listen. No amount of convincing from a healthcare worker will change their mind. It's up to the other members of society to take on that task: teachers, priests, business owners, senior citizen leaders. 

I recently ranted to my Doctor to the Barrio friends Sarah and Albert about this, and they gave me a really cool idea. What if we could combat fake news with fake news? After all, fake news is what sells herbal capsules and supplements. What if we market vaccines the same way those herbal supplements are marketed?

If you live anywhere in Mindanao there's a good chance you've heard ads for herbal supplements like Panyawan, Shane, and MX3. These ads are so effective because they use a lot of testimonials from people who sound like your friendly silingan or kapitbahay. In the local language, they make big claims like, "So-and-so cured my cataracts and arthritis!" And, "Try it now! You won't regret it!" And then at the end of the ad you hear that voice going at 4x speed, "Noapprovedtherapeuticclaims.Ifsymptomspersist,consultyourdoctor." 

Can you just imagine the potential to reach people from the lower income segments if vaccines were marketed that way? "My eyesight was so blurry. I've tried everything... I took Vitamin A, tried Shane capsules, even asked my albularyo, but nothing worked... UNTIL I got PFIZER! In only TWO doses and ONE booster dose, my cataracts disappeared, my arthritis got cured, even my cancer went into remission! Try it na now na!" 

I feel obligated to tell you that I am, of course, just kidding. New readers might not catch that I have a weird sense of humor and might think I'm actually serious. Nah. I would never actually do that. That being, pay for an ad that spreads fake news but is for a good cause. Psh. It's absurd! It's ridiculous. It's crazy... But...

...Could it be crazy enough to work?