Wednesday, January 05, 2011

The state of our public hospitals

This was my column on the date indicated above. This post is antedated.

The country’s attention in the last few days has been riveted on the casualties from the New Year revelry. Cameras focused on the grimacing faces of the victims while medical professionals ran around trying to do what they could given the dire situation; and I refer not only to the seemingly endless stream of victims that needed to be attended to. Also present were a number of aggravations such as lack of resources, inadequate facilities, parents or family members that get in the way, etc.

Of course the whole drill is something we do regularly - on an annual basis, in fact. This will probably not sit well with some people, but it must be said: We’ll soon forget about the people—children included- who lost limbs because they were careless or because someone was stupid or irresponsible enough to allow them to play with firecrackers on New Year’s Eve. Even our sense of indignation has an expiration date, it seems. Until next year, of course, when we will have to go through the whole routine again.

As a form of closure to this year’s episode, perhaps the government can put in place proactive measures such as regulating the manufacture of dangerous firecrackers—months before the onset of the holiday season. There’s really no point in wailing our guts out and delivering all kinds of homilies about the stupidity of blindly following traditions once the firecrackers are already out in the streets or have already been bought; more so, when they have already claimed casualties.

I must empathically stress that government must run after those who fired guns into the air on New Year’s Eve which resulted in the death of some people. I am aghast that there are people who actually continue to do so. Government must hunt these people down and make them pay for their extreme stupidity and irresponsibility.

***

Because media attention was focused on them, our public hospitals and our medical practitioners were seen in various stages of readiness and preparation to handle emergencies. Hospitals were spic and span. Medical supplies were readily available. Facilities were adequate. There were enough doctors and nurses in attendance. Patients got attended to immediately.

Anyone out there who thinks this picture is realistic and reflects the actual conditions in our public hospitals has obviously never been to a government hospital during normal times.

I don’t want to knock the great work our government hospitals and medical practitioners did while attending to the casualties of the New Year revelry but certain observations need to be made regardless of how painful they are. The problem is not really our doctors and nurses per se because most of them are competent and caring enough. However, when faced with the most difficult circumstance such as when facilities, equipment and resources are painfully inadequate, even the most professional doctor is bound to become unqualified, surly and difficult to deal with.

The truth is that there is a huge—a gigantic, monstrous—gap between conditions in private hospitals and those in government hospitals today. I know what some of you are thinking— this is rightly so. Not really. In many countries, government hospitals usually have better facilities and have more advanced technology than private hospitals. The differences between private and government hospitals in other countries are more in terms of the type of amenities offered and in the level of attention given by the medical professionals.

Besides, even if private hospitals are expected to offer better facilities and care, the difference should not be so ridiculously humongous! The differences used to be fodder for stand-up comedy acts. I remember stand up comedians making fun of the differences—e.g., when someone goes to the Makati Medical Center, a condition can be diagnosed as bipolar disorder but when one goes to a public hospital, one is a lunatic. Nobody is making those jokes anymore today because there is no more room for exaggeration—the conditions in many of our public hospitals are truly awful beyond description.

At hospitals such as the Eastern Visayas Regional Medical Center in Tacloban City, as many as three patients share a bed, and that is if they are lucky. Some actually simply commandeer monobloc chairs or occupy benches in the hallways because there are no beds available and they are too sick or don’t have the resources to move elsewhere. The bathrooms stink to high heavens because there is no running water and the stench wafts through the whole hospital. For many months, the whole hospital could only do limited surgical procedures because the contraption used to sterilize surgical equipment broke down—a cousin who needed to have a myoma removed had to wait for three months before she finally went under the knife. And forget about free medicines!

Fortunately, hospitals like the EVRMC have relatively good doctors; perhaps there really is value in the training one gets from having to attend to hundreds of cases every day. But if conditions at regional hospitals are already worse, imagine how much worst they are in district hospitals! Conditions at the Abuyog General Hospital in my hometown are beyond deplorable —doctors there cannot even do basic medical procedures such as stitching a severed finger because they don’t have the equipment.

Clearly the situation is dire and urgent. The truth is that we need to build more government hospitals because existing ones are not enough to cater to the needs of the citizenry.

It must be pointed out that not only is the population increasing, social conditions have also changed making the need for hospitals even more important. The types of seasonal diseases that plague this country, for example, are those that now require confinement in a hospital such as dengue, leptospirosis, etc. Confinement to a hospital has also become some kind of a social trend; it seems most people have become paranoid to the point that someone suffering from simple diarrhea is immediately rushed to a hospital for confinement. Of course, the advent of the medical insurance system has contributed to this trend.

But since we cannot even provide adequate resources to the existing ones, any talk of building other hospitals is pointless.

It’s been said more than often enough that health is a basic right. One wishes that we not only respect that right; that we actually uphold and protect it. Improving the deplorable state of our public hospitals would be a step in the right direction.

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