REFLECTIONS: “The rewards are immeasurable when I see the babies that I have delivered thrive and become leaders themselves”

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I am Maria Natividad Marian (Naty) Silva Castro, Up Medicine Class 1995.

I have been working as a community doctor, public health practitioner and human rights activist in the Agusan Provinces since I started practicing medicine professionally in 1996.  

I worked with marginalized sectors in rural and urban communities, mainly with families of farmers, agricultural and mining workers, informal sectors in the urban poor and national minorities, helping peoples’ organizations build their capacity to respond to their immediate and long term health needs within the context of mutual cooperation and empowerment.

I worked with the Community-Based Health Program – Butuan Inc. (CBHP-Butuan Inc.) as a program physician while completing my Alternative Residency Program with the Community Medicine Development Foundation (COMMED) from 1996 to 1998.  I also completed my degree in Master of Public Health from the UP Open University in 2008.  

From 1996 to 2004, I worked part-time in the first two years and then full-time as human rights documentor and staff of the Alliance for the Advancement of People’s Rights (Karapatan) in Caraga, holding the position of Secretary General of the regional organization in its inception phase in the region until it has established itself as a regional alliance by 2008.  

In the same period, I worked as a referral network consultant of the Department of Health in Region 10 in its European Union-sponsored Women’s Health and Safe Motherhood Project and as program director of the Alternative Health Program of the Missionary Sisters of Mary in Agusan del Norte and Agusan del Sur and a health consultant of the Religious of the Good Shepherd Lumad Ministry in San Luis, Agusan del Sur.  

From 2004 to 2018, I worked full-time as Program Coordinator of the CBHP-Butuan Inc.  Since 2018, I started working with the St. Scholastica’s ENFIDE Institute as its pedagogy director in the field of public health as I continue to work with the CBHP in a consultant capacity as I am also helping to set up other community health programs in other provinces in Mindanao.

The early years of my community service were dedicated to providing vital health services to far-flung communities and teaching volunteer community health workers (CHWs) to educate and treat the basic diseases of their families and communities. 

I started in Agusan at a time when epidemics of cholera and measles were yearly cycles and malaria, schistosomiasis and tuberculosis were so rampant that our health services were vital in remote Lumad and peasant communities or else people died for lack of medical care. 

We organized CHWs to be frontline health organizers, teachers and health care providers.  We encouraged communities to organize walking blood banks, to explore and produce effective herbal medicines, to learn other modalities of treatment like traditional Chinese medicine and using indigenous Filipino herbal medicines.  We taught mothers and self-taught farmers to study and research their community’s health knowledge so that we can synthesize and learn what are appropriate and acceptable health practices in their communities.  

In the course of my work in the Agusan and Surigao Provinces, we were able to form more than 50 people’s organizations and train thousands of health workers.  

Long-time volunteer community health workers can examine and diagnose patients, give a combination of Western and traditional treatments to patients, perform minor surgery and dental extractions under professional supervision.   

Some of our CHWs are active as paramedical workers and frontliners in their communities in the time of COVID 19, teaching, organizing and caring for their neighbors and family groups/clusters.  

As a result of our work in communities and through cooperation and collaboration with government and non-government programs and projects, disease control programs for malaria, schistosomiasis and tuberculosis have effectively reached the grassroots level and epidemics of cholera and measles have become scarce in the past 10 years.

As I developed my health work in different communities in Mindanao, I also became involved in assisting the formation and coordination of peasant, workers, urban poor, women, youth and Lumad organizations so that they can develop their capacity to engage government and non-government institutions to complement their local efforts to develop.  I worked with local, national and international organizations to highlight the health and human rights situation in Caraga and the whole of Mindanao, especially during the height of the human rights violations in the time of Gloria Macapagal Arroyo, Noynoy Aquino to the present regime.  

As I gained a deeper understanding of the economic, social, political and cultural determinants of health by working with real communities, I became increasingly involved in “non-health” issues.

Issues such as killings of farmers, workers and Lumad for the sake of mining in the Caraga region and the whole of Mindanao, the widespread displacement of Lumad communities to clear the path for the foreign exploitation of non-renewable resources such as metals and coal, the declaration of large tracts of land with peasant and Lumad communities as special economic zones, rendering the people powerless to assert their right to land, livelihood and resources — these issues have become central to my work in the past 10 years,  I find myself working more and more with church people, people in the academe, media, the educated youth and other professionals to explain issues of environmental justice and human rights, how the basic sectors of farmers and workers should have a voice in the path to sustainable and just development, how the rights of the Lumad as historical and cultural stewards of their ancestral domain must take precedence over its destruction in the name of development.  

As representative of Karapatan Caraga and Initiatives for Peace in Mindanao among other socio-civic/ civil society organizations of which I have become part in the course of my work, I have brought these issues to national and international audiences, such as the United Nations and European Union Council among others, so that they may understand, engage and be part of progressive peoples movements to uphold these democratic rights in the Philippines.

My office has gone beyond the CBHP – Butuan office in Butuan City, Agusan del Norte.  A home, shanty or shed, a spot in the mountains or fields,  a vacant lot or broken down barn – I have conducted clinics and consultations, meetings and assemblies in these places at one time or another.  

The structures are not important; it is the people that have made my work worthwhile.  

I have seen death sown and life being rebuilt.  I take comfort in the sure knowledge that the struggle for peoples development will continue as surely as I helped develop leaders and workers with integrity and fire in their hearts for the poor and marginalized.

In my field of work, the money is scarce, job/personal security is poor (hahaha) but the rewards are immeasurable when I see the babies that I have delivered thrive and become leaders themselves, dedicating their lives to continuing the development work that I helped start in their communities.  

(This piece written by Dr. Naty Castro on September 11, 2020, was shared by her batchmates in the University of the Philippines’ College of Medicine Class of 1995 to give the public an opportunity to know the classmate they describe as “community doctor” and “servant leader.”)

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