Remote Island Medicine
Comprised of over 7,100 islands in Southeast Asia, the Philippines is an archipelago filled with natural beauty and rich culture. Along with its rich biodiversity, white sandy beaches, mountain ranges, and tropical rainforests, the country’s colorful history is filled with a unique blend of cultures. Known for their warm hospitality, contagious smiles and delicious food, Filipinos truly make the Philippines a very special country to visit.
While experiencing the cultural diversity and natural beauty of the Philippines, learn about the organization of its primarily devolved health system and the various challenges in providing adequate healthcare in the context of its peculiar geography. In many remote, hard-to-reach islands, otherwise known as geographically isolated disadvantaged areas (GIDA), hospitals and health care clinics strive to deliver quality health services despite the often inadequate infrastructure, investment, supplies and personnel. Experience first-hand the daily healthcare challenges faced by “barangays” or villages, on remote islands.
Visit premiere urban public and private health facilities in the capital city of Manila prior to the remote island immersion for a better appreciation of the dichotomies between public versus private and rural versus urban healthcare systems. Meet local health professionals at the Department of Health and the WHO Western Pacific Regional Office Headquarters and enjoy cultural lectures and excursions led by CFHI's on-site partners.
This program offers life-changing firsthand exposure to the struggles and triumphs of local people working together to achieve better health outcomes for their communities.
Clinical Rotations & Public Health Placements
Remote Island Medicine Immersion Sites: Quezon, Lubang, and Romblon
Rural Health Unit (RHU)/Clinic– The RHU is the main public health care facility that provides health services in these remote areas. Its operations are supervised by a medical doctor called the Municipal Health Officer (MHO), who will be your local preceptor, assisted by nurses and midwives. The clinic offers primary care services such as general consultations for patients, prenatal checkups, live birth deliveries, vaccinations/ immunizations, health education sessions, dental services, and selected laboratory services. It is also the principal implementing unit for public health programs on maternal and child health, reproductive health, communicable and non-communicable diseases, nutrition and sanitation among others. Join the MHO and the rest of the RHU staff and learn more about public health program implementation and health service delivery networks at the grassroots level.
Barangay Health Stations (BHS) – The BHS is an extension of the RHU located at the village or “barangay” level. It is usually manned by a nurse and/or a midwife, assisted by local community health volunteers called barangay health workers (BHW). Participants will have the opportunity to shadow BHS staff engaging in primary care consults, prenatal check-ups, actual vaccinations/ immunizations, health status monitoring and health promotion activities at the barangay level.
Philippine Health System Exposure Sites: Metro Manila
Department of Health (DOH) – The Philippine DOH is the national health agency responsible for ensuring access to health services for all Filipino citizens. Participants will learn about the basics of the Philippine health system through lectures, visit to key offices and informational interviews with select DOH staff.
University of the Philippines-Philippine General Hospital (UP-PGH) – The PGH is a tertiary state-owned hospital administered and operated by the University of the Philippines Health Sciences Center. It is generally considered as the largest public tertiary hospital in the country with a 1,500-bed capacity and is the principal end referral hospital for mostly indigent patients from all over the country. Participants will be exposed to various departments and service areas, from the outpatient department to the emergency room and the service wards for a glimpse of the current realities that define the Philippine health care system.
Urban Health Care Facilities – Participants will do walkthroughs of selected urban health facilities, particularly a tertiary private hospital offering comprehensive specialized medical care services and an urban public primary care center to provide a frame of reference for analysis of the country’s rural versus urban health set-ups.
World Health Organization (WHO) Western Pacific Regional Office
Headquarters– The WHO Western Pacific Regional Office in Manila, Philippines is the headquarters of the WHO in the Asia Pacific, representing 37 member states. Its primary purpose is to support all countries in the region in their quest to achieve the highest attainable level of health. Participants will learn about the supporting role of the WHO to countries through lecturettes, visit to key offices and informational interviews with select WHO staff.
The program begins with a weeklong introduction to the Philippine health care system and visits to key exposure sites in Metro Manila. This is followed by a 2.5-week immersion in a remote island site as determined by the CFHI Philippines team.
Metro Manila - Also known as the National Capital Region (NCR) of the Philippines, Metro Manila is composed of sixteen cities and one municipality, whose overall population is estimated at 12 million. It is considered as one of the most densely populated cities in the world. NCR is the center of culture, economy, education, and government of the Philippines, which makes it the country's hub for finance and commerce.
Alabat Island – Alabat Island is located in the province of Quezon and is one of the program’s original sites. It is located about 250 km (155 miles) southeast of Metro Manila, situated between the Pacific Ocean and Lamon Bay. From Metro Manila, Alabat Island is reachable by 6-8 hours land travel plus one hour boat ride. It is composed of three municipalities or towns: Perez in the north, Alabat in the middle and Quezon in the south. Participants who will be assigned to Alabat Island will be specifically placed in the town of Quezon, working closely with the Rural Health Unit staff.
Tablas Island - Tablas Island is about 367 km (228 miles) south of Metro Manila, situated between Tablas Strait and Sibuyan Sea near the geographic center of the Philippines. It is the largest island among the 7 islands that comprise the province of Romblon. From Metro Manila, Tablas Island is reachable by 2-3 hours bus trip to the Port of Batangas, followed by an 8-10 hours travel by passenger ship to the Port of Odiongan. It can also be reached via a one-hour plane ride from Manila. Participants who will be assigned to Tablas Island will be specifically placed in the town of Alcantara, working closely with the Rural Health Unit staff.
Carabao Island - Carabao Island in the Municipality of San Jose is located off the southernmost tip of Romblon Province. It can be reached via passenger ship (10 hours) from the Port of Batangas to Caticlan Jetty Port or by plane (1 hour) from Manila to Boracay Airport in Caticlan, followed by an hour boat ride to Said Port in San Jose. Participants who will immerse in Carabao Island will experience working with local health workers in the Rural Health Unit and Barangay Health Stations around the island municipality.
Gigantes Islands - The Gigantes Islands are an island chain located 420 km (or 260 miles) southeast of Manila. These islands are part of the municipality of Carles, the northernmost part of Iloilo province. Carles is made up of 33 barangays, 15 of which are in the mainland and 18 are scattered throughout 6 big islands and 19 islets. From Metro Manila, Carles is reachable by a one hour plane ride via Roxas City Airport, followed by one and a half-hour land travel. The Gigantes Islands can be reached by a one-hour, fast-craft boat ride from Bancal Port in Carles. Participants who will be assigned to the Gigantes Islands will work closely with the staff of the Rural Health Unit of Carles at the Gigantes Island Health Station and Birthing Clinic.
Marinduque Island - The town of Torrijos is the primary immersion site in the island province of Marinduque. Located 249 kilometers (156 miles) southeast of Manila, it can be reached via a 45-minute flight from Metro Manila, or a passenger ship from the Port of Lucena City in Quezon Province. Dubbed as the “Heart of the Philippines,” Marinduque is composed of six municipalities all reachable through a three-hour trip around the island via the Marinduque Circumferential Road. Participants who will be assigned in Marinduque will be specifically placed in the municipality of Torrijos, working closely with its Rural Health Unit.
Things To Do
CFHI participants have free time during most evenings and weekends. A weekend trip in the remote island site is organized by the local team to nearby destinations in and around the program sites.
Metro Manila - Metro Manila, with its 16 cities, is a crowded, fast-paced environment with much to offer. The city of Manila has a reputation for being a concrete jungle where you can eat, drink, and shop 24 hours a day. Explore Intramuros, the old walled city showcasing the preserved architecture during the Spanish era and watch the world famous Manila Bay sunset. The nearby business districts of Makati and Taguig, with tall skyscrapers and fine restaurants, are known for their cosmopolitan and upscale vibe. Pasay City, where the international airport is located, boasts of one of the largest malls in the world, the Mall of Asia, and various gaming and entertainment establishments. Embrace all that the rest of the metropolis has to offer while immersing yourself in the vibrant Philippine culture and mouth-watering gastronomic delights.
Remote Island Sites - Unlike Metro Manila, islands in the provinces of Iloilo, Marinduque, Quezon and Romblon offer a much slower paced life. However, these islands are excellent locations to appreciate the Philippines’ natural beauty and biodiversity.
On Alabat Island, enjoy picnics by the beach and lazy sun-kissed afternoons. Make sure to try the local delicacies, most notably the exotic mangrove-inhabiting crustacean known as “takla”. For the more adventurous, hike to the falls of Barangay Sabang or visit the nearby islet of Pulong Pasig to enjoy it pristine waters and white sand beach.
On Tablas Island, you will find secluded white sand beaches along its vast coastline. You can visit the nearby town of Looc to snorkel and to feed the colorful fish at the Looc Fish Sanctuary. For the more rugged and outdoorsy types, you can hike the various trails to discover hidden waterfalls. And if this is not enough, you can do island hopping to the island municipalities of Romblon and Carabao Island, or even go to the Philippines’ most famous island destination, Boracay.
Carabao Island is named after carabaos (or water buffaloes) that inhabit the island. On Carabao, one can find powdery white sand beaches and crystal clear turquoise water, comparable to that of neighboring Boracay. The island boasts diverse geography, with an irregular coastline and pockets of secluded beaches. Explore underwater tunnels at Koding-Koding Point or go spelunking in Ngiriton Bat Cave, Bunayag Cave, or Angas Cave.
The Gigantes Islands in Carles are becoming a prime tourist destination because of the many beaches, sandbars, caves, and century-old lighthouses. Popular attractions include Cabugao Gamay island, which was ranked by Forbes Magazine in 2017 as one of the Most Beautiful Places in the World. You will also want to visit “Tangke,” a saltwater lagoon known for its crystal clear water. Carles also has an abundance of seafood, such as the locally known “tikab” (scallops) and “wasay-wasay” (rock oysters).
On Marinduque Island, you will enjoy white sand beaches in Torrijos or go island hopping at the smaller islets of Santa Cruz to find a pristine sand bar and beautiful rock formations. You can also go hiking at the mystical Mount Malindig. Make sure to go round the heart-shaped island and visit centuries-old Catholic churches, and then watch the sunset at the Luzon Datum of 1911, the base of the first modern geodetic survey in the Philippines.
Accommodations & Homestays
For the first week and towards the end of the program, participants will be lodged in a three star hotel in Manila with basic amenities such as hot shower, air conditioning and internet wifi connection. Accommodations will be in a twin-sharing room, separate beds, with males and females in separate rooms.
For the weeks in the remote island sites in Quezon, Lubang, and Romblon provinces, participants will live in identified local lodging. This can be either in a homestay or in an apartment/dorm-type lodging, depending on availability and as chosen and screened by the CFHI Local Coordinators. Please note that the accommodations do not include facilities like air conditioning, internet, telephones, showers and hot water bath.
Accommodation in Metro Manila and in the remote island site includes two meals per day. A local prepaid cell phone will be provided to each participant upon arrival. For official CFHI activities, all transportation will be arranged and covered by the program.
Eligibility: Who Can Apply?
This CFHI program is ideal for students and non-students of all levels and health disciplines. Anyone interested in and passionate about global health and medicine is welcome to participate. However, program applicants should be physically, mentally and emotionally prepared to step outside their comfort zone and brave the peculiarities in a remote island and low-resource setting. In particular, this program will focus on challenges faced in providing adequate medical care in both urban and rural settings and deepening understanding of health inequities. For more information, please read CFHI's general eligibility requirements.
Language Required: English
The Philippines is a multicultural and diverse country with approximately 175 different languages. The two official languages of the Philippines are Filipino (Tagalog) and English. Over 90% the Philippine population speaks English and it is one of the primary languages of instruction. English is widely spoken by most professionals and used frequently in many business and academic settings.
CFHI staff in the Philippines and healthcare professionals at the various clinical and public health sites you will interact with communicate effectively in English. However, you will find that daily communication amongst locals and community members will be in Filipino (Tagalog).
Participants should arrive in Manila, Philippines on the program start date and will be picked up from the airport by a CFHI representative and taken to their on-site lodging. As much as possible, participants are requested to book flights that will arrive Saturday, after 12 noon local time. The first official activity of the program is an Orientation Meeting followed by a Welcome Dinner that takes place on the Sunday after arrival.
No visa is required for U.S. citizens for stays 30 days or less. For stays of 30 days or more you must apply for a 59 day visa at the Philippine Embassy or Consulate prior to arrival. If you are participating in a 4-week program, but plan to stay in the Philippines for longer than 30 days please notify firstname.lastname@example.org at least 1 1/2 months in advance of your start date, so you have sufficient time to receive your visa and we can send you a Letter of Support (required document for visa application). We do not automatically send a letter of support to those participating for 4-weeks.
- Guidance from CFHI staff in San Francisco before departure
- Program-specific materials with information on making travel arrangements, visa requirements, recommended immunizations, etc.
- Airport pick-up upon arrival and transportation to lodging site in Manila with local CFHI representative
- Welcome dinner at a restaurant, with a traditional dance and music show
- Welcome orientation with other participants covering safety, transportation, and other logistics
- Public and private transportation to official site visits in Metro Manila
- Round trip from Manila to remote island sites through land and sea transportation
- Within islands, arrange for the most appropriate mode of transportation
- CFHI Local Team: providing instruction, logistical support, and 24/7 emergency response
- Regular processing sessions and discussions on local healthcare system and social determinants of health
- Placement and coordination of clinical/public health activities
- Local pre-paid cell phone
- International emergency medical and evacuation insurance
- Accommodations in Metro Manila and remote island sites with two meals a day
- Access to CFHI alumni-only LinkedIn group featuring news and career opportunities related to Global Health
- CFHI alumni newsletter highlighting events, resources, and ways to stay involved
Uniquely CFHI, 50% or more of student program fees go directly to the communities they will be visiting, benefiting the local economy at large and specifically underserved health systems.
Dr. Joel Buenaventura MD, MPH – CFHI Philippines Medical Director:
Dr. Buenaventura is a young and passionate doctor who is involved in global health diplomacy and in issues addressing health disparities and inequities. In 2004, Dr. Buenaventura graduated with honors at the University of Santo Tomas Faculty of Medicine and Surgery. The following year, he completed his postgraduate internship at the University of the Philippines General Hospital. In 2011, he earned a Masters in Public Health at Boston University, with a dual concentration in International Health and Heath Policy and Management and bestowed the John Snow, Inc. Award in International Health, after doing prestigious internships at the World Health Organization Headquarters in Geneva, Switzerland and the Médecins Sans Frontières (or Doctors Without Borders) US Office in New York. He has served as a Doctor-to-the Barrio, with seven years of grassroots experience as a rural health physician and later as a Municipal Health Officer in a poor, sixth class, remote island, serving as the only doctor in a town of approximately 10,000 people. Dr. Buenaventura currently serves as the Chief Health Program Officer for the Department of Health-Philippines with a focus on alignment of international health cooperation to local health system needs. Altogether, his valuable education and experience with global health and medicine made him a recipient of various grants and scholarships recognizing his leadership skills and academic excellence.
Dr. Paolo Victor Medina, MD – CFHI Associate Medical Director:
Dr. Medina is a Community Medicine and Primary Health Care practitioner with more than five years’ experience in local health systems development as the Municipal Health Officer of the island municipality of Quezon, Quezon from 2009 to 2014. Since 2015 he has taught at his alma mater, the University of the Philippines (UP) College of Medicine, as an Assistant Professor for Community Medicine and is presently pursuing his Master in Health Professions Education degree from the National Teachers Training Center for the Health Professions in UP Manila. In his first year of teaching, he was awarded the UP Medical Alumni Society Outstanding Teacher Award for Clinical Clerks for AY 2015-2016.
Dr. Jeremiah Carlo V. Alejo, M.C.D., M.D. – CFHI Local Preceptor, Alabat Island:
Dr. Alejo is the current Municipal Health Officer of Quezon in Alabat Island in the Province of Quezon. He finished his medical education in 2017 at the University of the Philippines College of Medicine. Prior to taking up medicine, he finished his Master's Degree in Community Development while working as a community health nursing faculty, also at the University of the Philippines. Aside from trying to escape the traffic in Manila, he decided to pursue a career in a rural/remote area as it provides the challenges of both health care and community development where practitioners of both fields can be of more help.
Dr. Jobin Maestro, MD, PHSAE – CFHI Local Preceptor, Tablas Island:
Dr. Maestro is an excellent example of a public health physician serving his own hometown in the Municipality of Alcantara in Tablas Island, Romblon. To date, he has served as the Municipal Health Officer (MHO) of Alcantara for 10 years. He finished his medical school at the Far Eastern University Dr. Nicanor Reyes Medical Foundation in 2004. In 2011, became Public Health Specialist in Applied Epidemiology through the Department of Health’s local Field Epidemiology Program. As an MHO with a strong background in field epidemiology, he is highly capable in developing, implementing and monitoring public health programs in his locality. He is currently taking up his Master in Public Management, major in Health System Development at the Development Academy of the Philippines to further enhance his skills in public health policy and management.
Dr. Mangunay is the Municipal Health Officer of Torrijos in the island province of Marinduque. He was a former Doctor-to-the-Barrio (DTTB) under the Department of Health (DOH) for three years deployed in the same town, and has since fell in love with the kind and serene community of Torrijos. He took up a Master’s degree in Public Management at the Development Academy of the Philippines (DAP) majoring in Health Systems and Development. Kris was a DOH Medical Scholar and a UP Medical Alumni Society in the Americas (UPMASA) scholar during medical school, and a Biology scholar of the Department of Science and Technology (DOST) during college at the University of the Philippines Manila.
Dr. Buluag is the current Municipal Health Officer of Carabao Island, San Jose, Romblon. Prior to his appointment, he has worked under the Department of Health’s “Doctors to the Barrios” Program for six years. He finished his medical education in 2013 at the University of the Philippines College of Medicine. He also earned his Master’s Degree in Public Management, major in Health Systems and Development in 2015 from the Development Academy of the Philippines.
Dr. Marcelo is currently the Medical Officer of the Municipality of Carles in the Province of Iloilo and concurrently designated as the Municipal Nutrition Action Officer of the town. He previously served as a Rural Health Physician in Carles for three years under the Doctors-to-the-Barrios (DTTB) Program of the Department of Health (DOH). He obtained his Doctor of Medicine degree from the University of the Philippines Manila College of Medicine under the Regionalization Program. He graduated and received the Hugh Greenwood Community Service Award and the Oreta-Dizon-Santos-Ocampo Research Award in May 2013. Immediately after passing the Physician Licensure Exam in August 2013, he joined the DTTB Program and previously served as the Municipal Health Officer of the island municipality of Almagro, Samar from January 2014 to October 2015. He obtained his Master in Public Management, Major in Health System and Development in October 2015 at the Development Academy of the Philippines.
What Alumni Say
"The Remote Island Program has a strong emphasis on emerging you in the local culture as well as providing you with medical observatory experience… One year later, I can already say that many of these valuable experiences keep coming back to me when I ask myself why I want to study medicine, and I think by now I can say that my time in the Philippines will keep impacting me in my studies and future practice. I am very grateful to have had this experience and would definitely recommend it!"
-- Esther van Trierum, June 2018
"I chose CFHI because of their partnership with the local people year round, rather than other non-profits who come in temporarily and then leave. CFHI works with local preceptors to integrate participants into the local existing healthcare system, providing what I think is a more authentic and accurate view of the local country’s health care. I want to learn how the locals provide sustainable healthcare, not go there to provide only a temporary solution. The Philippines program is highly structured, while still flexible to meet the various education levels of the participants. The local program Medical Director, Dr. Joel Buenaventura, has a strong vision of what participants will gain from their experience: Understanding the structure of the Philippine Health System (PhilHealth), how health care is delivered in local units, called barangays, and what goals and strategies the barangays use to keep their local population the healthiest based on their specific needs. Dr. Joel and Dr. Medina, the associate director, is great to work with. They make sure that we safe and also know all the local secrets: great food and activity recommendation... CFHI Philippines does a great job of escorting you to all of the different sites so that you are not lost or left figuring things out on your own... I had a great time here connecting with the locals and learning from them how health care resources can be best utilized. We were able to see health care in many different settings: big tertiary care centers in Manila, smaller local hospitals on smaller island as well as immunization and prenatal clinics in geographically isolated areas. I am so grateful that CFHI created this partnership with the locals so I could truly see the Philippine health care system up close and personal. Thank you Child Family Health International for a life and career changing experience!"
-- Nicole Powell, April 2017
“What struck me about these experiences, even on the first day, was the sense of community. It was not just the stroke patient who came to the Rural Health Unit (RHU) but the patient, his family, wife, daughter, and neighbor. This observation was repeated many times over the next few weeks.”
-- Alaina Brinley, February 2016
“CFHI Philippines provides a unique insight on the workings of the Philippine health care system through cultural immersion and participation at community level clinics, one can expect to leave this program with not only a better understanding of how to provide health care but with a community oriented mindset as well”
-- Quezon participants, July 2016
“I’m so lucky to have chosen such a wonderful country to spend two much too short months. The people I met, the lessons I learned, and the culture I became a part of pushed me out of my comfort zone, teaching me how to think more critically and more globally and allowing me to further develop as an individual. I’m lucky because, after choosing to travel to the other side of the world to the Philippines on a whim, I now see it as a home away from home, as a place that I want to hopefully return to for my gap year while applying to medical school. So maybe, hopefully, my experiences in the Philippines are not completely over.”
-- Taylor Panzer, July-August 2016
“The ethics of the CFHI program I am with are sound, and I’m very thankful for that. Their students are not walking into the clinics with the intentions of pushing their limited knowledge of western medicinal practices down local’s throats. I don’t care if I’m doing busy work, washing dishes or shadowing a surgeon in an operating room. You can learn in any situation – it just depends on your attitude! And I’m happy to say I’ve been learning a lot. I would say it’s been healthy for me to experience this feeling of uselessness or helplessness. I’ve always had strong inclinations to programs and projects of service wherever I am, because I want to help. I always want to help. Being in a developing world, and seeing dichotomies of wealth and poverty on levels that I’ve never seen before has changed the way I think about being helpful, and about where help and service is really needed.”
-- Alexis Baun, July-September 2016
“I saw a developing country in the middle of developing an effective healthcare system. It is all about the spectrum of healthcare and the spectrum of perception. There is a visible connection between all aspects of the healthcare system from public health at the international level (WHO) to the rural barangay health stations at the community level. I saw how each sector interacts and the roles each play.... it is truly fascinating.” Read more on Jennifer’s blog
-- Jennifer Harter, June 2015
The Sustainable Development Goals are a global roadmap set forth by the United Nations General Assembly to end poverty, protect the planet, and ensure the well-being of all individuals by the year 2030. This program highlights the following SDGs: