“Health” and “being healthy” may mean a lot of things to Palauans. To many of us, it means to be physically active, to eat healthy foods, and to drink lots of water. We are reminded to maintain a healthy weight and to pay attention to our blood pressure and levels of sugar in our blood streams. We are encouraged to avoid foods high in fat, cholesterol and, and if you are unfortunate like some of us, protein is also restricted in your diet. Above all, we are reminded to avoid sugary drinks and foods at all costs. Ministry of Health staff reminds us constantly about healthy lifestyles and healthy eating habits. We eat the fish we catch, the taro we plant, and the vegetables we harvest. However, we are often told what needs to be done, and seldom get to have our say in what our health needs are. Last year, a prominent local man was asked to speak on what health means to Palauans. This man, although, not associated with healthcare services is familiar with the needs of these services and he gave the following speech before health service providers and hospital personnel from various countries. This is what he had to say:
“Thank you for the privilege to address this conference. I would like to speak to you as the voice of the people in the villages and in the outer islands. We are not sophisticated people. We do not have nor understand modern machines and equipment. But we are many, and we are the people who need your help the most. The service ends of the programs you discuss here should begin to trickle down to us, not five years from now but as soon as possible. It would be the height of irony if our medical people could talk to theirs colleagues thousands of miles away at the push of the button, but would be unable to bring urgently needed medical assistance to someone who lives on an island only a few miles away. Reliable transportation must be a factor to be considered and planned for in all of our medical outreach programs. Take advantage of our attitudes and beliefs. Most people in the villages and in the outer islands view medical procedures as something similar to rituals. A patient would take his medicine religiously – morning, noon and evening – not because he understands the workings of the drug but because it appears to him like a ritual. We may not understand modern technology, but we are certainly familiar with natural phenomenon. We know that tides are affected by the phases of the moon, what plants flower at certain times of the year, and we know the direction of the prevailing wind for each month of the year. For best results, we suggest that you schedule your projects or visits so as to take advantage of these natural events. An immunization project scheduled for an island during its rough weather not only would appear foolhardy, but would also affect the credibility of the medical workers and the drugs they plan to administer. Don’t laugh at our superstitions. Get to know them and, where applicable, use them to enhance your work. For instance, a scientific explanation of disease, virus, and germs would go over our heads because we have not seen any of them. But if you were to tell us that they were like evil spirits, invisible but very bad, we would know exactly what you mean and would do our best to stay away from them. Finally, we have seen many instances where good programs did not take roots in the villages and in the outer islands simply because they never left the planning offices. We urge you to make sure that when decisions are made, the implementation part should follow immediately. It doesn’t do anyone any good if the levers of authority are pulled at the head office, but nothing happens in the villages and in the outer islands.”
These are wise words from a very intelligent man, my father, Bonifacio Basilius’ view. Health care providers should take the advice from the very people they service, incorporate their own professional knowledge on what the services should be, and bring the health back to the people. Bridging this gap helps patients trust in the health care system, and ultimately benefits the health of the community as a whole.
By M. Ebil-Rois Lawrence