Wednesday, October 5, 2011

Prognosticating the Last Frontier

(This is my attempt to justify my frequent gallivanting to the Philippines' last remaining Paradise - Palawan, I love! I was assigned by the Philippine Heart Association to make an article about Palawan, which is a cross between a travelogue and a medical eye-opener. Here it is.)

It is known among Filipino travelers that anyone who visits Palawan can never resist its charm. This phenomenon is called Kambak-Kambak syndrome, where visitors to Palawan inevitably fall in love with the place and invariably desire to come back. Some would even choose to stay there for good. This is not surprising since Palawan is definitely one of the most beautiful places in the country, perhaps even the world. Touted by the National Geographic as one of the Top 20 Best Trips for 2011, Palawan boasts of pristine beaches, secluded lagoons, magnificent limestone karst cliffs, lush rainforests, and coral reefs with the highest biodiversity.

My addiction with Palawan began in 2010, after witnessing a number of my friends acquire the legendary Kambak-Kambak Syndrome. At that time, I had already roamed around perhaps half of all the provinces of the Philippines, but I’ve never set foot in Palawan. Being a low-budget traveler, I had this notion that traveling to Palawan was expensive. My friends convinced me otherwise. While there are some luxurious, extravagant, and ridiculously expensive resorts in Palawan, there are more budget-friendly, rustic accommodations that cater to backpackers like me.

So in 2010, I brought my backpack and my camera and decided to experience Palawan. My first trip was to Puerto Princesa, to explore the famous St. Paul’s Subterranean River (also called the Puerto Princesa Underground River), chosen by UNESCO as a World Heritage Site, and the Philippines’ only bet for the selection of the New Seven Wonders of Nature that will conclude at the end of 2011. True enough, I went back to Palawan after barely three months, and then came back again, and again.

Palawan is the largest province of the Philippines, with a total land area of almost 15,000 square kilometers. It comprises almost 2,000 kilometers of coastline stretching across 1,768 islands. Because of this huge land area, Palawan is the 2nd province in the Philippines with the lowest population density (the number one being Batanes). Notable destinations in the province include the Calamianes Islands, the biggest of which are Busuanga and Coron. Also famous, especially among foreign travelers, is the Bacuit Archipelago located in the town of El Nido in the northern part of Palawan. The town of San Vicente, midway between Puerto Princesa and El Nido, has picturesque white-sand beaches that stretch for miles, perfect for the world-weary soul who needs to rest from the stresses of the city. South of Puerto Princesa are the towns of Narra and Aborlan, with verdant rainforests and unspoiled waterfalls. Other interesting destinations include the southern towns of Brooke’s Point and Bataraza and the quaint, mysterious island-towns of Cuyo and Cagayancillo over the eastern side of Palawan Island.

The city of Puerto Princesa, despite being a bustling metropolis, is an ecotourism destination by itself. It is the 2nd biggest city in the Philippines in terms of land area (next to Davao), and is consistently among the cleanest and most peaceful cities in the country every year. Dubbed as a “city within a forest”, it has a charming mix of the energy of urban life in a laid-back, leisurely pace. There are a variety of activities that would suit any kind of traveler – Ugong Rock climbing for the adventurous types, dolphin-watching, island hopping and beach-bumming at Honda Bay for those who just want to relax, hiking across the Monkey Trail toward the underground river in Sabang for those who want to rough it up, banca ride along a mangrove swamp in Poyuy-Poyuy River in Sabang for those who want some peace and quiet. I recently watched the fireflies along Iwahig River (it was a surreal experience) and fed the fishes at Pandan and Snake Islands at Honda Bay (which was awesome in a giggly way). Definitely, I’m coming back for more!

During my last visit to the province, I had the opportunity to meet doctors from the Palawan Provincial Health Office. It was then that I learned that despite the many accolades bestowed upon the natural wonders of the province, much remains to be done in terms of improvement of the health situation of the Palawenos. Because of the sheer magnitude of Palawan’s land area, the number one problem remains to be the lack of access to health services for a significant portion of the population. The province of Palawan has 23 municipalities (including Kalayaan town in the Spratlys Group of Islands which has a population of 300). Some of these towns remain doctorless, with health facilities being manned only by a town nurse or a lay barangay health worker.

According to Dr. Louie Ocampo, Chief for Planning and Research of the Palawan Provincial Health Office, Palawan is considered by the Department of Health as a Geographically Isolated and Disadvantaged Area (GIDA), where the most common health concerns are still communicable diseases such as malaria and infectious diarrhea. While the incidence of non-communicable and lifestyle-related diseases is increasing particularly in the more urbanized areas, the main focus of the government is still on basic problems such as maternal and child health and malaria eradication. The lack of skilled manpower and the sparse population spread over a great distance prove to be the biggest hindrances to improvement of health services in the province.


One of the islets in El Nido town. Tour packages are standardized, and these include a guide, boat trip to a specified set of islands, and a sumptuous lunch of seafoods by the beach. El Nido, November 2010.


A fisherman faces Ulugan Bay at day break. Sabang, Puerto Princesa, Palawan. Palawan’s fishing grounds are among the richest in the Philippines, supplying more than 30% of commercial fish output in the country.


Experimenting with 30-second exposure while watching the fireflies along Iwahig River. Not as pretty as the fireflies but pretty enough for posting. Iwahig, Puerto Princesa. October 2011.

A long beach at Snake Island, one of the destinations included in a standard Honda Bay tour. Just a few meters offshore, visitors can feed the fishes with bread. There are also excellent snorkeling sites.


Sunset at Roxas town. Roxas is a 1st class municipality north of Puerto Princesa. Aside from being the urban capital of the north of mainland Palawan, it is also considered as the “Cashew Capital of the Philippines”, being the primary producer of cashew nuts for the country.


Even in urbanized Puerto Princesa, there is still a relative paucity of doctors. There is only one tertiary hospital and there are several secondary hospitals. A number of medical subspecialties are still not available and patients with diagnostic and therapeutic dilemmas would frequently travel all the way to Manila for medical consultation. At present, there are only two practicing cardiologists in Puerto Princesa: Dr. Josefina Goh-Cruz and Dr. Gilbert Paa.

With Palawan’s beauty and diverse possibilities of adventure and exploration in an ecosystem that remains relatively undisturbed, Palawan is indeed the Philippines’ Last Frontier. Sadly, this may also be true in terms of health care. Hence, the challenge lies not only in preserving Palawan’s ecology, it is also in sending brave frontiersmen and women who will change the health landscape of the province. For doctors who still do not know where to go or what to do with their lives, try Palawan. And then kambak-kambak, dare to make a difference.