Poverty is a call to action --- for the poor and the wealthy alike --- a call to change the world so that many more may have enough to eat, adequate shelter, access to education and health, protection from violence, and a voice in what happens in their communities. (from The World Bank)

Poverty is a call for each one to recognize the basic human rights of other individuals. This recognition can only be comprehended by looking at another person like oneself with the same right to have food for bodily nourishment, shelter for protection, education for intellectual progress, and so on. In as much as an action, whether big or small, by any individual, that has contributed to unequal distribution of resources, we all are responsible for the offset of such inequality that has resulted to the sad reality of poverty.

No change of state is necessary in order to heed this call. So long as there is conviction to uphold humanitarian rights and good will, one can provide the springboard to participate in the worldwide concern to eradicate poverty in his place.

For the medical professional, promotion of health is a primary concern. It is precisely in this context that a doctor can best fulfill the call to fight poverty. Joining volunteer groups, organizing medical missions are great feats. However, these opportunities don't come by the day. A doctor spends most of his time in the clinic seeing a variety of patients, diagnose, treat, and most importantly, give advice on how to prevent another disease episode or a possible complication. With such daily routine, it is not at all surprising to overlook that part we usually reserve at the last segment of a consultation --- patient education on wise health-care practices. We could get lost in merely treating one patient after another so that we could finish seeing all those waiting in line. Or we could succumb to the satisfaction of having 'given aid' to those patients dwelling in city slums or remote road less lands where access to health is a hundred miles away, without even correcting misconceptions on health and hygiene, without giving cheaper yet valid alternatives for healthcare, without emphasizing the value of simple preventive measures such as eating more fruits and vegetables and less of fatty foods, using slippers, throwing away stagnant water, and other ways of healthy living which in the long run would be much more costeffective.

Recent statistics of the causes of morbidity and mortality in the Philippines are communicable diseases; examples are pneumonia, diarrhea, bronchitis, influenza, and tuberculosis. Other causes include cardiovascular diseases and hypertension. While such preventable diseases apparently affect majority of Filipinos, family expenditure on medical care has risen from 1.9% in the year 2000 to 2.2% in 2003. What does this imply? More medicines, more laboratories, more check-ups, more hospitalizations. All that in spite of endless campaigns organized by the Department of Health (DOH) to promote healthy lifestyle. It would be very easy to throw back at DOH that their programs are not enough, that they do not reach as much people that some healthworkers are inefficient, that they don't fight to increase the government budget in health, that they do not advertise often. It would be very easy as well to attribute the situation to the common people who seek consult by the time their sickness has gotten worse, who do not attend health classes after a door-to-door invitation by volunteers, who invest their little money on small-time gambling or texting while they complain of having to buy maintenance drugs, who lack the eagerness to transform their lifestyle into a healthy one. The list is endless. Numerous factors are put into play. Yet what does this whole health situation tell? What is the root of it all? Perhaps we have forgotten to look at the key figure…

A patient comes to us because he or she noticed something atypical from the structure or functioning of the body. We in turn see to it that we have gathered enough information about it before giving proper medications and advice. Then the more challenging part comes. Does the patient understand what I have mentioned? Will there be compliance in the medication? What keeps him from doing so? Can he afford all the work-ups? If he needs to be assisted in some activities, is his family willing to sacrifice time for that? What will make him be convinced that preventive means would lessen his tension and worry? These examples are just a handful among the many things we have to consider in approaching our patient holistically. We won't be able to treat our patient properly if we do not know the circumstances around him.

As much as we are responsible for the management we apply in a particular patient, we have the duty as well to make another be responsible for his own health. By advocating wise healthcare practices to our patients, there would be fewer expenses to deal with morbidities. Less money would be spent on medicines. Children could now go back to school after working in a factory or sell retail goods because father and mother are now healthy for their jobs. The savings of a poor family would fortunately be allotted to more food instead.

Enumerating to our patients all the healthcare practices, however, is not yet the end. Going beyond that will make us much more participative in our role to eradicate poverty. It is the concern for how these people would be able to fulfill those practices we have advised. It involves looking at the situation of each patient, giving them abundant encouragement not to depend too much on aid given by numerous organizations and to strive to take the effort in putting priorities in place. It means helping the patient fix not only his body but also his life. Such undertaking may sound distant fromthe customary role of the modern physician to diagnose and treat. But it is actually whatmakes up a true and humanitarian physician.

We entered medical school with the sincere desire to 'serve humanity'. We hope to utter the words of the Hippocratic oath with that same longing. As soon as a patient enters the clinic door, may we commit to mind always: Many mouths await for nourishment. Many ears await for learning. Many eyes await for our example. Poverty is a call to action…the world awaits for us to heed that call.

Beverlee Mante is Theme Advisor for this issue of Medical Student International. A student from the University of Santo Tomas Manila, she is an advocate of women's health, youth development, and environmental awareness.

References:
Understanding Poverty. Poverty Analysis: Overview. The World Bank. www.worldbank.org/poverty
Philippine Health Statistics and Field Health Service Information System. National Epidemiology Center, Philippine Department of Health. www.doh.gov.ph
Family Income and Expenditure Survey. Income and Employment Statistics Division, Household Statistics Department, National Statistics Office-Philippines.