Bu-lat-lat (boo-lat-lat) verb: to search, probe, investigate, inquire; to unearth facts Vol. IV, No. 32 September 12-18, 2004 Quezon City, Philippines |
Philippine
Public Health ‘in Emergency Room’ – Health Activist The
Philippine public health sector is now “in the emergency room,”
according to a health activist. Among the proofs she offers is the fact
that treatable diseases are among the country’s top killers, and public
hospitals now charge for most of the services they render. BY
ALEXANDER MARTIN REMOLLINO With
the continuously decreasing health budget, can it be said that the
Philippine public health sector is now in the emergency room? Ross Mayor,
an activist who works with the non-government organization Council for
Health and Development (CHD), thinks so. Mayor
was also among 400 health workers who participated in a protest motorcade
by the Kilosbayan para sa Kalusugan (KbK or People’s Health Action) last
Sept. 7 to call for an increase in the national health budget. The Quezon
City-based CHD is part of the KbK. The
protesting health workers, after braving the heat of the afternoon sun,
proceeded to the House of Representatives, attended the session, and
waited patiently for hours to hear Bayan Muna (People First) Rep. Satur
Ocampo deliver a privilege speech on the “deplorable condition” of the
country’s public health sector. “In
the face of widespread poverty,” said the KbK in a statement distributed
during the protest action, “the allocation of a measly P10.4 billion
($1.86 billion) or 1.75 percent of the 2004 budget and the proposed P10.3
billion ($1.84 billion) for 2005 amount to a grave neglect of the
people’s health on the part of the Macapagal-Arroyo administration.” Mayor
deplores the fact that debt servicing and militarization rank higher in
the government’s list of budgetary priorities than health. She said that
most of the country’s debts did not benefit the people. Asked
for her opinion on the argument of pro-government commentators that the
“terrorist” threat the country faces requires a large military budget,
Mayor said: “One
example is tuberculosis. It is the primary public health threat: you
don’t see it but it’s there. It kills 75 Filipinos daily. Just think
how many Filipinos it kills in a year! The ‘terrorist’ threats they
talk about, how many have these killed? Where is the body count for the
victims of ‘terrorism’ that they are talking about?” Some
opinion writers have commented that tuberculosis has killed more Filipinos
than the small bandit group Abu Sayyaf, which is included in the U.S. list
of “foreign terrorist organizations.” Mayor agrees. “If I remember
right we have the seventh highest number of tuberculosis deaths in the
world, and second highest in the Western Pacific region,” she added. The
treatable killers Particularly
reflective of the Philippine public health sector’s situation, Mayor
said in an interview with Bulatlat, is the fact that among the
leading causes of death in the Philippines are diseases that could in fact
be treated, provided there are sufficient funds. Number
one among them is tuberculosis, she revealed. Once tuberculosis is
detected, it could be cured within six months of continuous medication.
But as it is, it rarely gets detected, and if detected there are usually
no available medicines in health centers: these have to be bought. “So
what happens is that usually, patients take medicines for a few months,
and then they don’t complete treatment,” she adds. “Their sickness
now develops a multiple drug-resistant strain – which is more difficult
to treat, and at the same time is more contagious.” Other
treatable diseases that usually end up killing their victims are cholera,
diarrhea, and measles, Mayor further disclosed. In other countries
diarrhea and measles are no big deals, but these diseases can kill people
in Third World countries like the Philippines. Mayor
also recounted the CHD’s experience medical mission to Oriental Mindoro,
a province south of Manila, in 2001. A measles epidemic had struck the
Mangyans, a tribe native to the island. They
were living in a remote area, and had to walk about one and a half to two
hours to get to the nearest health center, Mayor recalled. And they had to
traverse hills and rivers. So the children had fevers, and they had to be
brought through the rivers. “By the time the people got to the health
centers, many of the children had died,” she said. Mission
members talked with the local officials of Calapan, the capital city of
Oriental Mindoro, and asked them to send health teams because the people
were unable to go down. However, they were told that there were neither
personnel nor medicines available, and that they could only afford to send
dump trucks to fetch the patients. “The
provincial health officer was unable to do anything. The result, among
others, was that in one tribe, out of 25 kids, only one survived,” Mayor
said. Fees The
KbK, in its statement, also noted that patients in public hospitals now
also have to pay fees they didn’t have to pay before. If before 90
percent of hospital beds were reserved for indigent patients, at present
‘charity beds’ make up less than 50 percent, the statement said.
“Patients even have to pay for the cotton, gauze, plaster, alcohol,
needles and syringes, and even the life-saving medicines,” it said. Mayor
said that this was because public hospitals, from lack of funds, are
forced to resort to revenue-raising measures to finance their operations. The
statement also noted that in a survey conducted by KbK among 553 patients
of 13 public hospitals from Aug. 31 to Sept. 2, the respondents had to pay
professional fees ranging from P1,000 ($17.86) to P10,000 ($178.57). According
to Mayor, doctors working in public hospitals are usually paid a monthly
wage of P15,000 ($267.87), while the salaries of nurses range from P5,000
($89.29) to P6,000 ($107.14). “Even
the doctors are hard up, though their wages are relatively higher,”
Mayor points out. “If you have a family, you can’t live on P15,000 a
month these days.” Based
on computations by Bulatlat’s Danilo Araña Arao, the daily cost
of living for a family of six, or the average Filipino family, is P594
($10.61). This translates to P17,820 (the equivalent of $318.21) a month.
Arao based his computations on data from the National Wages and
Productivity Commission. “In
some cases,” Mayor reveals, “their patients are so poor that they have
to help shoulder their expenses. So if you are already underpaid and you
still have to shell out money to help your patients, just imagine what you
have to put up with.” HSRA The
government, apparently feeling the pressure of mass protests since the
mid-1990s against the low spending for public health, institutionalized a
Health Sector Reform Agenda (HSRA) in 2000. The HSRA, states a document
found on http://www.logos-net.net/ilo/150_base/en/init/phi_7.htm,
“aims to improve health financing, health regulation, hospital systems,
local health systems, and public health programs.” Was
the HSRA able to fulfill its avowed purpose? Mayor
doesn’t think so. “When
you do the rounds of government hospitals, you’d see the very long lines
of patients, whose needs are mostly not addressed. The hospitals lack
facilities, and now they have to charge fees for their services whereas
before at least there were a few services they could render for free. Now
you can almost no longer get free medical services. “The HSRA merely perfumed the government’s plan to commercialize health services.” Bulatlat We want to know what you think of this article.
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