The lights beyond Ticao Pass
The day began before sunrise and showed no intention of ending. By the time the rural health unit opened, patients were already waiting—mothers carrying infants for vaccination, farmers seeking blood pressure checks before returning to the fields, elderly patients lining up for maintenance medicines, and pregnant women settling in for prenatal consultations. The health team moved without a pause.
By evening, exhaustion had settled not only in the body but in memory itself.
I walked back to my small blue-walled apartment, a space less lived in than endured, quietly holding fatigue, small victories, and the weight of another day of service.
That night, I could not stay indoors. The breakwater was only a short walk away, yet it felt like crossing into another world. Behind me, the clinic dissolved into sound—monitor beeps, hurried footsteps, the soft urgency of illness. Ahead, the sea erased it all.
Wind replaced noise. Salt replaced antiseptic air. Silence became physical.
A weathered concrete bench faced the water. I sat and looked toward Ticao Pass.
At night, the sea flattens distance. The horizon disappears, and darkness is broken only by scattered lights from fishing boats and distant communities.
One light held my attention—faint, fragile, almost imperceptible, yet impossible to ignore.
Above it, the sky opened into countless stars. Below it stretched the dark sea. Between them was a single point of light. In that stillness, gratitude arrived without invitation. For a moment, it felt like arrival.
But it did not stay that way.
In public service, distance is never abstract. It has names. Faces. Consequences.
I remembered a child brought to the clinic late one afternoon after hours of travel from a distant barangay. He did not cry. His lips were dry. Limp in his mother’s arms, he had been sick with diarrhea for days. We stabilized him, arranged a referral, and did what we could. But what stayed with me was not the treatment—it was everything that came before it: the road, the waiting, the delay, the hours lost before care could begin.
Illness had begun long before he reached us. So had the barriers to care.
The stories are not rare. They are routine.
The light was no longer a symbol of how far I had come. It became a reminder of how far health care still has to go.
Across Ticao Pass, access often depends on boats, fuel, and weather. From that bench, the gap between policy and reality was no longer theoretical. It was visible, immediate, lived.
Then came something I could not ignore. I was not there to save everyone. I was not there to be a savior. I was there to serve.
And there is a difference.
A savior centers the story on themselves. Service does not. It understands that the story was never ours to begin with. It means showing up when resources are thin, listening when time is short, teaching when knowledge must travel farther than medicine, and staying present when leaving would be easier.
That night, the sea made its own kind of teaching clear. Change is rarely dramatic. It does not arrive in sweeping moments. It is built slowly—patient by patient, family by family.
Over time, the scattered lights across Ticao Pass began to feel different. They were no longer just distant communities flickering in the dark. They were signals—of lives continuing, of needs still unmet, of care still making its way across water and weather.
In an archipelago of more than 7,600 islands, care is never only clinical. It is logistical. It is social. And it is political.
The farther I moved through the island’s communities, the clearer this became. A consultation depended on whether a boat was available. A referral depended on fuel. An emergency depended on the weather. Every layer of care was shaped by forces beyond the clinic walls.
For decades, the Philippine health system has tried to close these gaps through reforms in financing and primary care. The Universal Health Care Act was a step forward. But in places like Ticao, universality remains uneven. What is written in policy does not always reach the shoreline.
Among the country’s longest-running efforts to bridge this gap is the Doctor to the Barrios Program, created in 1993 to bring physicians to underserved communities. As part of this program, I joined that continuing effort—so that distance would not decide who receives care and when.
Looking again toward Ticao Pass, I realized that the lights beyond it were never meant to be admired from afar.
They are signals.
Signals that somewhere, a family is still waiting for care to reach them.
In a country that has committed itself to universal health care, those lights should not remain distant.
They should be within reach.
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Raymond Martin Ajero Corpus, MD, MPM-HG, is a Bicolano public health physician and former doctor to the barrios (Batch 38) who served in the island communities of Ticao, Masbate, from 2021 to 2024. He is currently a medical officer IV at the Department of Health–Bicol Center for Health Development.
