When I was first asked to be keynote speaker for this very important event, the first reaction was to cringe in embarrassment. Second, third, and fourth was still to cringe in embarrassment, because really, I don’t think I have done anything special with my career as a doctor to deserve this honor. I have not specialized; I have not even finished my MPH degree, for crying out loud! My claim to greatness, such as it is, is that I survived for so many years in the jungle. But then again, this is not rare; the country has thousands of rural physicians.

But, in the 24 years that I have known him, I have never really learned how to say no to Dr. Cristobal. I don’t think I will start now.

SERVICE, in whatever capacity.

My parents, by their actions if not their words, have taught me and my siblings at an early age that we are all put in this world to be of use to others. My career in public health might have started right after college, but I think the disposition was embedded in my DNA, and it was nurtured by the example of my parents. My family is not well-off, there are 7 of us, I was 3rd. My father was a government employee; my mother had a small pharmacy to augment the family income. As children, we were expected to contribute to the family economy: the eldest was in charge with running the household, the second with running of our store. I took it upon myself to be in charge of my younger siblings, especially in the area of personal hygiene, specifically before bedtime ablutions. My 10-year-old self decided that this is the area where I can help my mom.

Thus, my very first health campaign was conceptualized and implemented. The goal was to get my 4 younger siblings to brush their teeth and take bath right after dinner. The strategy was to establish a fun after-dinner activity, an exclusive, invitations-only night club for kids where gleaming white teeth and squeaky clean hair and skin are requirements for admission. Dress code was strict: pajamas and nighties only. We sang, we danced (I choreographed, imagine that!), we put on puppet shows, story-telling sessions, it was loads of fun, and it ran on for a couple of years. Like any self-respecting health implementer, I gave the health campaign a catchy name: we called it Pajama Jam!!!!

The strategy is a marriage between facilitate and manipulate, which i will call facipulate in later years.

My inspiration was Mark Twain’s Tom Sawyer. I am sorry, my dear millennial graduates to reference an American classic, I am just showing my age, but the story went this way: Tom Sawyer, a rascal of a kid, was punished by his aunt because he played hooky at school. He was told to paint their fence. So while his friends were playing, Tom went about his job very seriously. Soon his friends noticed, started to convince him to stop working and play with them. Tom purposely did not mind them, made a great show of concentrating on his job. He told them its delicate work, not to be entrusted to just anyone. Of course, because people in general, and children in particular, being contrary creatures, everyone wanted to try his hand at painting fences. In the end, the fence job was done, with outsourced laborers who bartered various treasures and toys in exchange for a chance to paint!

That kid club became my prototype for health campaigns. Look for health gaps; look for ways things could improve. Public health, for me, means influencing a group of people to behave in a certain manner, with a health outcome in mind.

I guess what it all taught us is that everyone is called to serve, in whatever capacity we can, with whatever talent we have. So, the question is how does this apply you as new graduates? While I am here to talk to you about my experience as an MHO, this is not to convince to take the same path I did. While we are all called to service, it is up to us in what manner we can serve others best. Which, brings us to the next item on my list: Now that I’m grown up, what do I really want to be?

A number of people have expressed surprise that I have spent all this time as a rural physician. Sometimes, in admiration, other times, in disdain. I have always believed that I deserve neither. My work, my career choice is an expression of who I am, who I think God wants me to be, and so deserve neither praise nor scorn. It’s like praising a bird because it can fly, praising a fish for how well it breathes underwater, or praising a frog because it can croak. The bird, the fish and the frog has nothing to do with what their nature is; same is true for me and my work. I was once asked by a first year medical student for tips on how to love working in rural community. She is a scholar, expected to payback her scholarship with service in the community. I didn’t quite know what to tell her. Choosing a career is a lot like looking for Mr. Right and One True Love. And just like Mr Right and One True Love, career options, especially those leaning towards public health are often either romanticised or looked down on. In truth, public health like any career paths, have its advantages and disadvantages. Well, actually, there are more disadvantages mainly on the financial aspect. But when one is called to it, one should consider what it entails before committing fully to it.

Actually, we get a lot of PF in public health. People may not pay us in money but still we have a lot of PF:
1. Professional fruit
2. Professional fowl
3. Professional fish
4. Professional flowers, especially if you’re single