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Hospital of Our Hope, System of Our Despair

by Gene Nisperos, MD

The Philippine General Hospital is the face of our perpetually neglected public healthcare system. As the biggest tertiary training hospital in the country, it provides specialized and very specialized services and training. It is also the end referral hospital of other public hospitals. Pero ito din ang Ospital ng Bayan na sadyang pinabayaan.

The ever-increasing number of patients in PGH reflects the country’s worsening social conditions. The poor’s limited access to basic services, aggravated by their absent economic power and the prohibitive costs of healthcare, all lead them to this single health institution.

Thus, we need to take a close, hard look at the state of PGH and its patients.

A casual stroll from the PGH Out-Patient Department (OPD) to the wards can break your heart.

Patients. Families. All are trying their best to get a measure of the health services they need, never mind deserve. Some are eating their baon along the sidewalk. Others are desperately trying to make their patients more comfortable under the sweltering heat and crowd. Many have been waiting in line since 3-4am just to get in.

A walk through the Emergency Room (ER) can break your spirit.

Everywhere, quietly, patients find small consolation in cold metal beds, in stretchers, in wheelchairs, or even in monobloc chairs. They fill up any unpeopled space that they can find and comfort is a luxury that they will readily forego if only to get seen and treated.

And all of them want to be seen, need to be seen. Many have travelled long distances hoping to be treated for their various infirmities. But the hospital is always shorthanded. The 4000-strong health personnel are almost always never enough for the deluge of patients that come daily.

The ER, currently under renovation, only has a 25-bed capacity. But its daily census is easily north of 150. In the last three years, PGH’s patient census has steadily increased from 586,000 to 647,000 per year.

There are patients who should be in the intensive care unit (ICU) but are still in the wards. There are patients who should be in the wards but are still in the ER. There are patients in “ectopic beds”, or beds in departments other than that where the patient should be confined in.

There is just not enough beds or space. There is just not enough health personnel.

Yes, even the best that PGH can provide remains too little. And everyone can do with much more.

Yet in spite of these, for 2020, Congress deemed it fit to cut the PGH budget rather than increase it. Apparently, for our honourable legislators, the less than P3 billion per year allocation is enough and there are more pressing matters to fund, like the P100 million pork barrel they will each get.

To provide its patients with the barest minimum, PGH needs about P5 billion per year. So why give the hospital much less than what it needs to operate?

Limited funds nga daw kasi.

Currently, around two-thirds of PGH’s budget goes to pay for its personnel, whose numbers cannot match those of the patients, even with medical and health sciences students taking up the cudgels.

Because of insufficient budget, the hospital cannot hire the additional health human resources it needs. It cannot even regularize the contractual employees it has. Worse, it is looking to further subcontract the work being done by institutional/utility workers, the “manongs” who brings patients around the hospital for their labs, x-rays, and what not.

About 25% of PGH’s budget goes to its operations, which directly benefit its patients. Even then, supplies and meds are often lacking so patients need to buy these outside.

Some laboratory exams are unavailable so these have to be done outside as well. Basic equipment, like respirators, have also been subcontracted to private firms and their use have to be paid for by patients.

All of these amount to out-of-pocket expenses that are catastrophic for an already impoverished patient.

To be fair, the PGH Administration exerts effort to augment the hospital’s funds. Donations from private individuals and/or corporations help stretch the meager resources. But at the end of the day, patients and health personnel alike, including students, shell out money to cover for what the hospital lacks.

Either that or they become mute witnesses to the consequences of unmet health needs: morbidity if not death.

PGH supporters calling for a higher budget for the country’s most important teaching hospital.

When government refuses to give enough funds, everyone suffers. Because in PGH, the need will always be much greater than what can be given. Sadly, this is being done to almost all public hospitals: they get less than half of the budget they need but are expected to operate fully, with VERY LITTLE support.

When health officials grow tired of asking enough to provide for what patients deserve, what is given is not even enough to provide for what patients need. When health officials console themselves by asking just enough to provide for what patients need, what is given is barely enough, so that patients expect even less.

This is government policy and it must be changed. THIS is the rotten system that refuses to see healthcare as a public good.

It is therefore right and fair to demand for a bigger budget for health and for PGH.

Every year, PGH should get P10 billion to give its patients the care THEY DESERVE. The hospital should not have to rely on the kind heart of philanthropists or on corporate social responsibility just to keep itself financially afloat. The hospital should NOT EXACT any more from the pockets of its patients and its staff.

The amount also enables PGH to hire and regularize enough hospital personnel to meet the ever-increasing demands of healthcare. The money affords the hospital enough to provide essential supplies and medicine, and ensures that the laboratory and diagnostic equipment are working.

If PGH is given the budget that it deserves, then it can fulfill its most important role: enable the poor and destitute to exercise, and maybe even experience, their right to health. #

Judy Taguiwalo’s speech after CA rejection

Former DSWD Judy Taguiwalo’s speech before supporters who stayed all day Wednesday outside the Senate to express support and call for her confirmation.

The Commission on Appointment, however, rejected Taguiwalo.

(FB live video by Charlotte Robles Job Despuez / Featured image by Kilab Multimedia)

‘Judy’s ideology is to serve the people’–Recto

Senator Ralph Recto delivered this speech in anticipation of the confirmation of Prof. Judy Taguiwalo as Department of Social Welfare and Development secretary at the Commission on Appointments hearing Wednesday.

Recto said he was for Taguiwalo’s confirmation, but was defeated in a secret balloting by majority of his fellow CA members.

Read Recto’s full speech he read after the CA has announced it has endorsed the rejection on the Senate floor.

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Mr Chairman, my dear colleagues:

I have been told that the nominee is a fan of my grandfather, and of my wife. That she can recite passages from Don Claro’s writings. And hugot lines from the movies of Vi.

So on that score alone, she gets my vote.

But if my grandfather were alive today, he, Vi and the nominee, would make a mutual admiration club.

Don Claro would only have the deepest esteem for someone who did not only agree with his causes, but spent a lifetime fighting for it.

And Vi would find in her, as she does, a real life character who looms larger than Sister Stella L, and who has more guts and grit than all the strong women she had played on the silver screen.

Mr Chairman:

The first pages of the nominee’s CV describe an intellectual at home in the academia.

Retired professor of UP. Head of its Center for Women Studies. Director of Research and Extension for Development Office. Faculty Regent.

In a school where merit is rewarded, she would not have been able to assume these posts without the academic degrees that validate a first-rate mind:

She has a PhD from UP, a Masters from a Canadian university, and a Social Work degree from the same state university where she graduated cum laude in 1970.

She could have been magna cum laude, Mr Chairman, if she did not let her real-life education outside of UP interfere with her studies.

Indeed, her CV catalogues, in fine print, the research papers, articles, books she had written.

But what is not there are her other engagements in her storied life which I believe makes her qualifications more sterling – and prove without doubt her fitness to perform the duties of the office she holds.

She is also an alumnae of 3 Martial Law prisons, went underground, and joined the resistance – only because legal pathways for change were blocked, and peaceful avenues to protest were closed.

To those who would see this as impediment to a Cabinet post, here’s my rebuttal: Political imprisonment is no bar to public office and neither is the taking up of arms when conditions warrant.

On the contrary – these are experiences we should look for in scouting for talent because they are the toughest “stress tests” one can endure.

I don’t have to remind you that in our pantheon of heroes, those who were jailed for their beliefs occupy an honored place. Warriors, especially women, are revered, from Gabriela Silang to Tandang Sora.

I think, Mr President, that it is her work during the “unsalaried phase” of her checkered career which is her biggest qualification in holding the DSWD portfolio.

It immersed her into the grinding poverty that continues to slave our people. It allowed her to closely see how the denial of basic social services drives people, first, to despair, and then, defiance.

If the ideal DSWD secretary is one who possesses competence, compassion and commitment, then it can be said that UP gave her the first, her activism gave her the second, and her underground years gave her the third.

We can never ask for a package as complete as her. She had been serving DWSD’s clientele long before Digong thought of running for mayor.

So if we would like to know her views about poverty, we can leaf through the forest of newsprint that contains her writings.

But if we would like to know if she really cares about the poor, then her stints in factories, in farms and in forests are enough to dispel any doubt.

Mr Chairman:

The nominee should not be dismissed as one of the token Leftists in the Cabinet. She was not put there as a memento to prove Digong’s Big Tent approach in forming a government.

Rather, I believe that she holds the post by virtue of her ability, and not by her affiliation.

She is not there to represent one color in Digong’s rainbow Cabinet. She is there to serve all the colors in the tapestry of our democracy.

She represents all of us, all our dreams, all our aspirations for our nation, our people, and our children. She personifies that elusive political ideal that persons of different persuasions can come together for the common good.

If she is an ideologue, then the ideology she subscribes to is the same one we believe in, and that ideology is to serve the people.

Mr Chairman:

I am seconding her confirmation because she brings a fresh perspective in the DSWD – and that is to treat not poverty’s symptoms but its roots, for the poor need more than relief, but a release from the social shackles that prevent them from bettering their lives.

It is, therefore, my pleasure to endorse the confirmation of the appointment of Doctor, Professor Judy M. Taguiwalo, or Ka Judy, as Secretary of Social Welfare and Development.

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(Featured image by Kilab Multimedia)