Agutaya archipelago doctor who cared for 13,000 people on her own

When 99-year-old Eleuthera Abus lifts her right arm, she winces as the broken bones move. It’s been six months since her fall.

“All I can do is manage her pain,” says Alena Yap, the 28-year-old doctor who is examining her on her porch. “She really needs to have the bone pinned. But the family is refusing to take her to hospital.”

Eleuthera’s daughters are not heartless. They are poor.

The nearest surgical facility is hundreds of miles away across the sea from the tiny island of Diit where they live. It’s one of a cluster of islands that make up the Agutaya archipelago, stranded in the middle of the Philippines’ Sulu Sea.

For the 13,000 or so people who live here, Dr Alena, as they call her, is the only doctor. Petite, with glasses and long hair tied back in a ponytail, she always wears a broad smile that masks quiet determination.

There is only one island in the archipelago she does not visit – Amanpulo, named after the luxury resort on it, which has reportedly hosted Tom Cruise and Beyoncé. On a clear day, it’s visible from the beaches of Diit, just 20km (12 miles) away.

Dr Alena arrived just before the coronavirus – and learned to live with the death threats that came when she insisted people isolate. But the pandemic that swallowed the world was far from her only challenge in this oft-forgotten corner of the Philippines. She battled new diseases and old, and came up against her country’s biggest challenges. She says she came to Agutaya to make “real changes” – but she left deeply disillusioned.

These remote, volcanic islands are not where you expect to find a graduate of the country’s top medical school, who had spent all her life in Manila, the teeming Philippine capital. Unlike so many of her peers who have left to seek careers in Australia, America and Britain, Dr Alena volunteered to join a government programme that sent her here, to one of the poorest municipalities in the country.

The main island of Agutaya is a two-and-half day journey from Manila. It includes one flight, followed by a sleepless 15-hour night crossing on an open-deck ferry from the port city of Iloilo to a bigger island called Cuyo. Then the only way in and out of Agutaya is a drenching, two-hour roller coaster ride in an outrigger canoe.

As the skilled boatman guides the outrigger across the reef and into the shallows, Agutaya looks like a piece of paradise. Below the palm-fringed shoreline, a broad swathe of white sand stretches in each direction. Colourful outrigger canoes bob around on water so clear they could be floating in mid-air.

But geography is both a blessing and a curse. Scattered over hundreds of square kilometres of sea, the dozen or so islands that make up the archipelago are cut off for days, even weeks, when the monsoon comes, winds in…