Is our health care system heartless?
By Dr. Daisy Joy A. Espejo-Torina
(First of two parts)
Tatang Noli was 70 years old. He consulted the clinic because he was coughing. It turned out he had pneumonia and needed to be admitted in the hospital. He begged off saying he could not afford it. So I gave him antibiotics to be taken orally. The following day, he was knocking at our home. He said he could not afford the medicine I prescribed and he had to go to the city hall to ask for help. He was given 500 pesos. He came to ask me if I could prescribe a cheaper medicine. After Tatang Noli left, I cried. I felt hopeless and helpless.
Tatang Noli was one of the reasons why I left private practice. I would volunteer for the UN, I resolved, I would look after people needing health care and they won’t have to pay me for it. God would have other plans but almost just as fulfilling. My pursuit for charity would lead me to East Timor where services and medicines were all free (Yes! Even 4 weeks of Vancomycin can be completed and the patient’s parents won’t have to spend a single cent for it!). It was not uncommon that patients would defer hospital consult for financial reasons (i.e. they can’t afford transport although a microlet would probably take them to their destination for only 10 cents! A taxi would cost a little more but the rate was flat at a dollar to any destination.) It was for this reason that an ambulance roamed around and took whoever needed health care to the hospital. There were satellite clinics all over the town as well and any patient that needed further management would be taken to the hospital by the clinic staff. There were district hospitals in strategic locations, each with its own ambulance, radio and telephone so that they have access to the national hospital should their residents need it.
The hospital was not perfect. It won’t pass for a tertiary hospital in the Philippines but being the only referral center in East Timor, it was what they considered to be a tertiary hospital. Instead of an ICU, the pediatric ward had a “critical area” where patients needing close attention were admitted. Although the resources were meager, the hospital did not turn away any patient, no matter that the ER was full or that the ward was full, no matter that the nurses complained of being overworked and understaffed, somehow we always made it through.
When I had a baby, I had to plant my feet where I could grow roots. There’s no other home for us but the Philippines. So I went back to private practice. I wanted to go into government service primarily for additional steady income and secondarily to allay my guilt a bit (I thought that it would be my “charity” work, once a week won’t be so bad). But once in, I was surprised and upset to discover that the government hospital I was working for wasn’t so charitable after all. At the height of admissions in August when all the wards were full and the ER was overflowing with patients awaiting admission, I found it heartless the way we should only admit the dead and the dying.
(To be continued)