Commissioner Spotlight: Manuel M. Dayrit

Why did you want to join a commission focused on faith, trust, and health, and what are you hoping it will achieve?

The invitation to join the Commission came at an auspicious moment. I had recently returned from Southern Philippines [Mindanao], where I met with Imams to discuss teenage pregnancy prevention in a culture where girls are married off as soon as their monthly periods begin. I also met Catholic educators who were teaching Muslim children about health at school. I saw that our local efforts could be shared and amplified by joining a global Commission that seeks to bring faith and health communities together to improve health care for marginalized populations.

I also saw this as an opportunity to more deeply reflect on my experiences as a public health practitioner in a career that now spans 49 years. Promoting health has both physical and spiritual dimensions, and I aspire to see how a Commission focused on faith, trust, and health might explore the interplay of these values across different cultures, societies, and generations.

Your early work as a physician took you to rural communities in Southern Mindanao. What did those experiences teach you about the role of trust in public health?

My work in the rural areas of Southern Mindanao from 1977 to 1984 took place under Martial Law, imposed by the late President Ferdinand Marcos. In these communities, villagers rarely saw a doctor and only did so when a serious illness required hospitalization. Government health centers existed but were understaffed and often lacked supplies, while private clinics were unaffordable for most families.

The work that my two companions – a community organizer and my wife, who was also a doctor – and I did flourished by building personal relationships rooted in trust. Villagers typically associated doctors with clinics and hospitals. But a doctor working in a village? How strange was that?

Over time, we built a community of kindred spirits. We learned traditional practices that had been handed down through generations – practices often different from the modern medical training we had received. We also learned Cebuano, the local language. More importantly, we learned to speak the language of the heart by listening to their needs and aspirations.

This work was not isolated; it was shaped by broader movements of the time. Within the Catholic Church, reforms from the Second Vatican Council encouraged greater participation by laypeople. Since priests were often unable to regularly visit remote villages, local lay leaders stepped in to lead Sunday gatherings. At the same time, many community organizers working with farmers were influenced by ideologies focused on social justice and equity, including Marxist thought. And in the global health field, the Alma-Ata Declaration of 1978 inspired efforts to build more equitable systems through primary health care.

Decades later, I remain in touch with one of those health workers. Her daughter became a nurse, practiced in the Philippines, and now works as a caregiver in the Falkland Islands. This enduring connection is a constant personal reminder that relationships built on trust can have a lasting impact.

Having served as Secretary of Health in the Philippines and later at the World Health Organization, what lessons have you learned about building and sustaining institutional trust within national and global health systems?

Every institution has a defined mission, but there are often different paths toward achieving it. It is the role of leaders to set clear direction and inspire the staff to pursue shared goals.

Even when the goals are clearly stated, commitment to them may not be universal. In large organizations like the Department of Health, some may doubt or even oppose the goals.

The leader’s challenge is to communicate effectively and unify the workforce around a common purpose.

To do this, the leader has to be competent, fair, and trustworthy and be seen as such. Gaining and sustaining trust is vital, especially in a large bureaucracy that serves the public daily.

There is also an external dimension to institutional trust, which involves earning the confidence of those the institution serves. For a Secretary of Health, this includes local officials, private sector organizations, and the broader public.

In the case of the World Health Organization (WHO), the key constituents are the Member States, represented by their Health Ministers. Before negotiations on [the] WHO Code for the International Recruitment of Health Personnel could begin, a climate of trust had to be built. In this particular case, Member States agreed to set aside demands for compensation for the loss of migrating health workers, recognizing both the right to migrate and the difficulty of establishing fair terms for compensation.  

In what ways has your Catholic faith influenced how you approach public health?

My Catholic faith has deeply influenced my thinking and approach to public health. I was in high school at the time of the Second Vatican Council. Years later, as a young physician, I found it inspiring to see the Catholic Church in Mindanao, Southern Philippines, journeying to put the Council’s teachings into practice in parishes and communities.

Two books have had a lasting impact on my worldview in public health. The first is Pierre Teilhard de Chardin’s The Phenomenon of Man. He suggests that evolution is not only biological but also spiritual. Over time, human consciousness grows and leads us toward union with the divine, what he calls the Omega Point, or Christ’s second coming. I believe that we are called to prepare the world for the Omega Point by “building the Kingdom” here on earth during our lifetime.

The second is E.F. Schumacher’s Small is Beautiful: Economics as if People Mattered. Schumacher promotes an approach to health focused on simplicity, unity between spiritual and material well-being, and technology that is affordable, ecologically sound, and compatible with local cultures. He also points out the ecological limits of economic growth and argues that economic development should veer away from the obsession with GDP growth. Schumacher drew on Buddhist economics, which values simplicity, non-violence, and inner well-being, an approach that I have adopted in my personal life.

I often remind myself that promoting universal health care in the Philippines requires attention not only to the political and technical issues, but also to the spiritual journey of individuals and communities toward greater compassion, a sense of fairness, and a desire for peace.

In pursuing the mission, I feel a deep connection to the prayer attributed to the late Archbishop Oscar Romero of El Salvador:

We plant the seeds that one day will grow. We water the seeds already planted, knowing that they hold future promise. We lay foundations that will need further development. We provide yeast that produces effects far beyond our capabilities.

We cannot do everything and there is a sense of liberation in realizing that. This enables us to do something and to do it well. It may be incomplete, but it is a beginning, a step along the way, an opportunity for the Lord’s grace to enter and do the rest. We may never see the
end results, but that is the difference between the master builder and the worker.

We are workers, not master builders; ministers, not messiahs.

We are prophets of a future not our own.

Amen.