Guardians of Health: Mark Joseph Alforque, the outpatient nurse who believes cultural competence matters as much as clinical skill

During the peak surges of COVID-19, beds, oxygen, staff and even time were in short supply. Mark Joseph V. Alforque, a nurse from Tuyan in the City of Naga, Cebu, learned there that leadership is not about a title but about staying steady when everyone is looking to you. Ten years into his nursing career, he now works in the busy Out-patient Department of a semi-government healthcare facility in Abu Dhabi, and he brings the same calm, and the same malasakit, to every patient he meets.

Leading through the surges

As a COVID-19 nurse, Mark faced crisis management, resource allocation and team coordination at their most intense. “Leadership was not defined by titles,” he says, “but by the ability to remain steady, make sound clinical decisions, and guide others through uncertainty.” He learned to prioritise quickly but in a structured way, assessing patients continuously and directing care to where it was needed most.

Clear communication became his strongest tool: concise updates for doctors and fellow nurses, concerns escalated early, and everyone on the team aware of the immediate priorities. He learned when to step forward and when to step back for colleagues with more urgent tasks or specialist expertise. At times, simply being a calm presence eased the anxiety of patients and colleagues alike.

Malasakit beyond the job description

In the outpatient department, Mark cares for patients of many nationalities, cultures and walks of life, often at high volume and under time pressure. Amid the demands, he reminds himself that every patient may be anxious, in pain or uncertain. He explains procedures clearly, answers questions honestly and offers reassurance whenever he can.

“One thing I am proud of is that I never limit my care to what is written in my job description,” he says. Helping a patient move safely, comforting someone while they wait, or noticing a small detail that improves their experience: to him, these are the true meaning of malasakit. Above all, he strives to care for every patient as he would a member of his own family.

Learning from his first Ramadan

Mark’s biggest culture shock was his first Ramadan in the UAE. It reminded him of Holy Week back home, especially Good Friday: quieter roads, softer voices and a sense of calm and reflection everywhere. As a newcomer, he had to be mindful even of a sip of water during fasting hours, making sure he was in a private area, especially during long shifts.

Rather than seeing it as a restriction, he chose to learn. He asked colleagues questions, observed local customs and came to appreciate the self-discipline, patience, compassion and generosity the holy month represents. “Living and working in another country means embracing its culture, not expecting it to adapt to mine,” he says.

The early riser from Cebu

One of the simplest lessons from his Philippine upbringing has shaped his whole career: wake up early. As a child, household chores came first, which taught him discipline, time management and responsibility. Today he arrives at work 30 minutes to an hour before his shift, to assess the clinic, prepare his area and anticipate what patients and the team will need. “Instead of beginning my shift feeling rushed, I start with a clear mind and a plan.”

On his days off, the early start gives him time to run, exercise outdoors and spend time in nature. “Nursing is a demanding profession, and I have learned that taking care of myself enables me to take better care of others.”