In the field, in reality, in danger
Last week, I hosted the first day of the research conference of my home school, Ateneo de Manila University’s Rosita G. Leong School of Social Sciences (RGLSOSS). Our keynote speaker was Dr. Cenon Alfonso, the dean of the Ateneo School of Medicine and Public Health.
His talk was aptly titled “Anatomy of Neglect: When Medical Education Forgets the People it Serves.”
Alfonso has long collaborated with different RGLSOSS departments to strengthen medical training so that budding doctors are taught to treat patients as people, not diseases.
With the exception of four institutions, most medical schools in the country prioritize laboratory and scientific training, leaving little opportunity for doctors to exercise their social skills, meet their would-be patients, and see medicine playing out in our many complicated communities.
We need to first ask, Alfonso said, what a community needs.
In the Philippines, we are in dire need of primary care, health promotion, and disease prevention—the most basic of all health care, as articulated by the World Health Organization. The absence of this basic need is felt in so many places in the country, where there are no doctors, or where patients have to cross seas and pay a fortune just to get themselves checked.
Instead, many doctors are trained to pursue critical illness and superspecialist career paths—paths that no patient should have to go through if the focus is strong on basic health care to begin with. Public health in the country, therefore, is horribly crippled: prevention takes a backseat to treatments later, and health centers have so few doctors while hospitals are bursting with specialists.
Medical education once focused so much on the science of health that it neglected the social determinants of health. Therefore, if medical education aims to holistically address health problems, then an equal partnership is required between the natural and social sciences.
This brand of medical education, inspired by the work of medical doctor and sociologist Julio Frenk, frames the medical school as a socially accountable institute, one that is responsive to society and people’s needs while still honing expertise in the medical sciences.
Alfonso’s talk resonated throughout the conference. At the plenary, a panel of social scientists spoke about their fieldwork and the research they had produced, where they treated participants as persons with lives, where they engaged and learned from them rather than using them to simply get data.
Research and practice, whether in medicine or the social sciences, are enriched by fieldwork. As a molecular biologist, I had to gather samples from the field to inform my laboratory work. As a science communication scholar, I have to constantly engage people in discussions to understand their complex lives.
Those of us who do research and use it to fuel practice have always lived in a universe of fluid knowledge, where information is never bound between books or encased in theoretical frameworks. We have always pursued fieldwork with questions and walked away humbled when we found our assumptions dismantled.
Those of us who engage in fieldwork love doing it because it is often in the far away, the dark, and the unexplored that we can most reliably discover answers to our questions.
Without our presence in the field, we cannot claim to investigate the natural world or study human nature. For many fields, it is indeed presence that defines the professional: the journalist who seeks out stories, the researcher who documents species, the doctor who treats patients, the social scientist who examines the struggles of the marginalized.
Last week, social media comments mocked the killing of a student and journalist, among others, in an armed encounter in Negros Oriental. One dared to scoff at the idea of fieldwork, implying that no one should be interested in stories of isolated communities unless they were also enemies of the state.
It was a polarizing argument, as usual, that assumed that anyone asking about poverty and disempowerment was automatically taking up arms— when they simply asked the age-old question: What is the truth beneath all that has been claimed, trumpeted, and assumed?
It is a question all of us ask: doctors, researchers, journalists. And to answer it, we must be out there, in the field. In any village that needs a doctor who understands how people live, so that they can determine how people can be treated. In any place that needs a social scientist to amplify the suffering whispers of the voiceless.
Every community needs the most basic health care. Every single corner deserves the illumination of research. Every person is a story, and every story deserves to be told.
This should be part of all education, where we are taught to speak to people rather than our assumptions about them, to acknowledge the richness of our culture and heritage, and to be better than pundits who blind themselves to reality and dare to call themselves patriotic.
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iponcedeleon@ateneo.edu
