How do you usually help other people? Is it through engaging in charity work or are you already able to do that through your everyday profession? For Beverly Ho, it’s a mix of both. Ho is currently the director for the Health Promotion Bureau and the Disease Prevention and Control Bureau in the Department of Health, and although she took the conventional path of medicine, she managed to go beyond borders by proving that being a doctor doesn’t always mean you will be a clinician.
Ho grew up with humble beginnings. Her father was an insurance agent and her mother was an obstetrician and gynecologist. She describes her family as frugal. They would always eat at home instead of dine at restaurants. Their baon came in the form of food rather than money, and they never held parties to celebrate their birthdays. Despite being thrifty, Ho’s family was quite generous when it came to charity.
“My parents would say that it’s better to share what we have for others. So your birthday would mean bringing some things to the orphanage or buying wheelchairs to donate to certain organizations. And that was really [my] first few lessons [on] charity [amd] generosity, [and] I learned from them that it’s not just about us, but really about the people around us,” Ho shares.
Since her mother was a doctor, there was an underlying expectation that her children might follow in her footsteps. For Ho, pursuing medicine wasn’t a difficult decision, as she would often spend time in her mother’s clinic to observe what she does.
“Seeing how my mom has helped so many people, I think that was important, not just with relatives coming to our house on weekends when her clinic is closed, but also in school, I will have classmates’ parents come up to me and say: ‘pasyente kami ng mommy mo or yung classmate mo mommy mo yung nagpa-anak’. You [would] come on the first day of school and then [the teachers] would say: ‘Oh, anak ka ba ni Doc. Luisa?’ So there’s just so much family pride in the fact that mom was able to help so many people through her profession. And so seeing that, it was clear to me that I wanted to also be able to do that for other people,” Ho says.
Despite knowing what career path she wanted early on, Ho faced a dilemma in terms of which college to go to. During her time, La Salle, Ateneo, and UST were the common destinations for Chinoys, but since Ho managed to ace the UPCAT, she couldn’t pass up the opportunity to go to UP.
“At that time, obviously, one of the concerns was, are you gonna be too Chinese when you go into that environment? But [according to] my mom, if you’re going to go to medecine, it would be a really good opportunity to go to UP for your Pre-Med. So maybe it wasn’t an issue altogether, but that was the moment when I was asked: ‘does it really matter that I look like this? Is it really a risk to look like this and go to UP?’”
Ho eventually decided to study BS Chemistry at UP and later shifted to BS Biology. She didn’t experience as much culture shock as she expected, since she found her place in UP’s Chinese Student Association (CSA). “A huge part of my non academic time actually was spent with CSA, and that was an opportunity to really grow and know more about embracing your being Chinoy, because we were kind of making fun of ourselves with: ‘Oh, you also experienced this in high school? You also experienced this in family gatherings, etc.? As simple as celebrating Chinese New Year on campus, and kind of being celebrated for this ethnicity [of] being Chinoy, you had this group who had this commonality. So overall, it made the supposed transition very smooth.”
“Actually, I think when I started going out for–not just studies, but also conferences, it became very clear that while here in the Philippines, people can often judge you for your looks. They immediately assume [you are] Chinese, but even if I look Chinese, at the end of the day, I represent the Philippines.You’re not really counted as a Chinoy in the class, but as a Filipino,” Ho says.
Although she was intent to pursue a career in medicine, Ho wasn’t so keen on the idea of being in a clinic all day. Her parents never dictated what path she had to pursue, but she felt the external pressure from her relatives and family friends, who expected her to continue her mother’s work. But studying at UP helped Ho realize that there were other ways she could help society through her profession.
“The biggest realization came from working with colleagues or other students who had the passion for public health, and of course, our teachers were either former activists [or] former public servants. And that’s really where I realized that maybe the definition of a physician [does not] just mean you are seeing patients or not. Their [definition of] physician doesn’t mean a clinician.”
“So in this global health course [in UP], the aspect of becoming a different kind of doctor came about. They brought in graduates who went into WHO or went to DOH, and I think more [it’s more] than just seeing, oh, these are the possible career paths in one of those reflection sessions. I remember when we talked about why [we] help people, it circles back to my experience as a young person. When they ask: ‘how do you define helping out or a charity, immediately my own example is bringing stuff to the orphanages and going for a medical mission. And it’s not that my teachers or the facilitators in that course said that that wasn’t the correct thing, but they challenged that definition and said: ‘Is it really what charity only means, is it really what generosity and great things do? Is it an option or is it a responsibility? Is it more [than just the] interest for you and your family? Or is it because it’s a social responsibility?’”
After she graduated, Ho did not immediately go into the residency program and instead asked her parents to give her a year to do what she wanted. She taught at the Ateneo School of Medicine and did projects for the National Telehealth Center of UP. She also worked with an NGO called Kalusugan ng Mga Ina, which taught midwives about essential newborn care protocols. During this time, it became evident to Ho that she would rather explore public health management than dive into clinical work.
The problem with the healthcare system
“What UP showed us was that people aren’t sick because they need to consult. People are sick and continue to be sick because some part of the system is broken. So in UP, for example, I would remember as an intern, we’d start seeing patients maybe nine or ten in the morning. But the patients have actually lined up at four, ilang oras na silang nakapila. They’d come in with really large tumors [that are] sometimes bigger than their own appendages, and that happens because they didn’t have primary care. They didn’t have someone to look at them and take care of them very early on when they were still in the rural areas. It becomes so severe that even if they reach PGH (Philippine General Hospital), what can we still do? Maybe ten, 20% of the time we can do something, but if it’s that severe, we can’t do anything anymore,” Ho points out.
“And yet we actually don’t have the solution because the solution is bigger than a single hospital. It’s bigger than just the combined intellect of 600 faculty members and how many thousands of students. So it’s this: really knowing that the solution is beyond clinical care. The solution is outside the walls of the best tertiary government hospitals in the country.”
Ho had a short stint with PhilHealth in 2012, and after that, it became clear to her that she wanted a career in government service. “No one really grows up dreaming of being a public servant. Sa totoo lang, you’re never actually told by your parents to work in government, but during that time, I saw how a mix of good mind and good skills could actually bring about [change] in government service.”
Ho became the chief of policy research for the Department of Health in 2016. She later became the head of Health Promotion at the start of the pandemic, and in 2021, she took on the additional role as the director of the Disease Prevention and Control Bureau.
“Part of my work now in the health promotion bureau is to increase health literacy, but at the same time, enable conditions there for people to choose to be healthy. There’s the entire framing of: pag alam na ng tao kung ano kailangang gawin, gagawin nila yon. That was the older paradigm of health promotion. If I teach all of you about the bad effects of smoking, I expect that all of you will not smoke. But we know that doesn’t really happen, right? Even among doctors, we studied how bad smoking is, but some doctors still smoke. And that’s because if your environment enables it, if it’s still cheap to buy cigarettes, if there are no restrictions in public places to smoke, you are enabled. So this is the paradigm that we wanted to change. Meaning if you want people to practice, becoming healthy, make it so easy for them. So now, for example, we’ve worked with our legislators to increase tobacco taxes.”
“In terms of Filipinos’ health-seeking behavior, we do know that a huge part of it is also as a result of the enabling environment. If primary care services are given for free or actually paid for already, it won’t really be a question of whether they can afford seeing a primary care physician or not, and hence their health-seeking behavior would be better.”
Universal Healthcare Law
Ho says she was fortunate enough to be at the right place at the right time to see the conception of the Universal Healthcare Law, which had been in the works for many years but only gained political traction recently.
“The UHC law outlines the shift in how we’re running the health care system. And the two main shifts that I can talk about is the shift in the way we see preventive care or health promotion being done. As I’ve mentioned a while ago, we look at or we prioritize curative services provided by physicians or by specialists. Under this law, it talks about how to set up our primary care system like the one you’re seeing in many parts of Europe, Australia, and the UK. It’s really not their hospitals that they’re proud of, but really that level of primary care, when if you miss your vaccination, your primary care provider calls you because they know you, and they know your kids. So it’s that level of the system that we want to build up–shifting from a largely curative hospital centric care into a strong primary care system.”
“The other aspect is recognizing that if you want people to be healthy, no matter how many clinics or hospitals you build, it doesn’t add up because studies repeatedly show that 80% of health care is not [done] in clinics or hospitals. 80% of our health is related to our education, through our [surroundings], kung delikado ba don sa lugar? It’s related to your ability to buy food. It’s related to your healthy behavior. It’s related to the air you breathe. And this means that for this 80%, the interventions are not in our clinics or in our hospitals. The interventions are working with other sectors, housing, environment, etc.”
“Many would say that the pandemic stops UHC implementation, though I’d say with all honesty [that] maybe the pandemic actually accelerated how we implement UHC, and that’s primarily because in the past, no one minds what the health care sector is doing. But now everyone is invested because we cannot jump start the economy again if we don’t make sure that the health care sector will not collapse.”
Ho cites some examples of the beginnings of the UHC law being in the works, which includes the practice of telemedicine, LGU vaccination programs, and the public’s adherence to health and safety protocols.
Message to the youth
“To the many young people out there, first of all, public [health does not] just need doctors, as you can see the entire spectrum includes people who are good at marketing and people who are good in supply chain. It doesn’t necessarily mean that kailangan ng health related background for you to have a huge impact in public health. So just keep your mind open. You will be able to help out in health.”
“Second [is] I want to remind young people that we need to start realizing that the world is getting smaller and smaller, and when the health of [a certain] population is not good, it does not translate well for the rest of the society. So our job as citizens of this world, not just of the Philippines, is to make sure that the gaps or the inequity gets smaller and smaller. To be able to do that, you are all encouraged to go into the public sector, not just public health or contribute to the public sector, perhaps through NGOs, etc. And you can actually do this by starting out in school pa lang with a lot of exposure activities.”
“Charity can be defined in many ways. I do think that when we have more, that’s also the time that we should be giving more, and giving more can be in material things, but it can also be interpreted as giving our time and giving our talent to shape bigger things. So I just want [everyone] to recognize that giving shouldn’t just be limited to boxes or gifts now [because] our efforts shape how the future will look like.”
Tune in this Sunday, June 26, 8PM to catch Beverly Ho’s full story on 1CH1NOY: Chinese by Blood, Filipino by Heart, only on CNN Philippines (Free TV Channel 9, Sky Cable Channel 14, Cignal Channel 10).