The Philippines is a beautiful Southeast Asian country in the Western Pacific. With more than 7,000 islands it is one of the largest island groups in the world. The country is home to picture-perfect landscapes: emerald rice fields, smouldering volcanoes and stunning beaches. SOLACE is a research project bringing together UK-based and Philippines-based researchers from a wide range of disciplinary backgrounds.
The Philippines is a Lower Middle Income Country (LMIC) with a population of 100 million. The country’s geography with many isolated rural areas, the poverty levels (25% live below the poverty line) and the weak infrastructure make equitable access to health care for the population a big challenge. Clinicians in the Philippines usually do not want to work as primary care doctors in rural areas. Only 10% of the country’s clinicians work in these areas where more than half of the population lives. The shortage of primary care doctors in such regions is one of the most urgent challenges for public health in the Philippines. This is also the case in other LMICs as well as countries in the global north. Likewise in the UK there are many rural areas faced with a shortage of health professionals. Another change in the health landscape is that people around the world are living longer and the disease burden is being increasingly dominated by disability instead of people dying early. The main causes of death and disability have changed from communicable diseases in children to non-communicable diseases in adults (for instance, mental health, musculoskeletal diseases, strokes, diabetes). To address these problems in a cost and clinically effective way, strong evidence-based systems of primary care are essential to identify healthcare needs and to develop and implement strategies for addressing those needs.
The SOLACE partnership will work around (1) equal distribution of health workers and (2) efficient primary care for people with non-communicable diseases. SOLACE brings together researchers from different disciplines (medicine, arts and humanities) who are keen to work with colleagues who they would not normally work with. The partnership activities will allow these researchers from Keele University (UK) and Ateneo de Manila University (Philippines) to learn new research methods and to use original ways to bring the results to several stake holders: academics, governmental and community organisations and, most importantly, the people living in rural and remote areas.
We have established two SOLACE health hubs in Catarman and Laoang in Northern Samar, a rural province in the Philippines. About 60 participants (locals, doctors, community workers and local politicians) will come together for a Cultural Animation workshop in these hubs. Over a period of 10 months all participants will create artistic, personal health diaries. Two SOLACE ethnographers will meet the participants on a regular basis in their home and work environments. The health diaries (in many formats: texts, songs, drawings, films, pictures), the discussion group and fieldwork data will be analysed by the SOLACE team. The Keele team will visit Northern Samar for a fieldwork trip and the Ateneo team will travel to Keele for a research and capacity building week. Also two cultural exchange visits with Keele and Ateneo student pairs from medicine, arts and humanities will take place.
Our ambition is to lay the foundations for a ‘SOLACE tradition’ (#WeAreSolace) in global public health which can be expanded to other LMICs. Interdisciplinary research carried out in this tradition will be characterised by sustained and genuine engagement with local communities, dissolving knowledge hierarchies, and co-producing innovative public health initiatives and clinical interventions.
Images taken by SOLACE team members during field trips in Northern Samar, the Philippines.